Henderson Kionna L, Shortridge Ashton M, Sadler Richard C, Canfield Caitlin, Mendelsohn Alan L, Khan Mahbuba, Key Kent D
Baylor Scott & White Health and Wellness Center, Baylor Scott & White Health, Dallas, TX, USA.
Department of Geography, Environment, and Spatial Sciences, Michigan State University, East Lansing, MI, USA.
J Racial Ethn Health Disparities. 2025 May 20. doi: 10.1007/s40615-025-02453-2.
Eleven years have passed since the 2014 Flint water crisis (FWC), yet many voices still go unheard. There is limited evidence of the impact of the FWC on maternal health. This paper used a cross-sectional study design to survey 152 women enrolled in the Supporting Parents and Raising Resilient Kids (SPARRK) study in Flint, Michigan to examine racial differences in women's perceptions of their overall health pre- and post-FWC, perceived maternal health services, and explore the interaction of race and living in Flint on maternal morbidity.
Perceived maternal health was defined using the Centers for Disease Control and Prevention's 21 Severe Maternal Morbidity (SMM) diagnosis codes. SMM were obtained via questionnaire. Logistic regression analyses were performed to identify factors associated with SMM within two domains: (1) overall health pre- and post-FWC and (2) perceived maternal health care received during birth.
There were 17 cases of SMM in which Black women accounted for 62.5% of these cases. Perceived quality of care was overall positive; yet, perceived overall health decreased post-FWC for all women. The odds of SMM were 6 times higher for those who had a college degree or higher.
In the predominately Black city of Flint, race was not a significant factor in the perception of health and quality of care. Surprisingly, educational attainment was significantly associated with a 6-time increase in odds of experiencing an SMM. More research is needed to examine the association of patient-provider perception of quality care and education on maternal health outcomes.
自2014年弗林特水危机(FWC)以来,已经过去了11年,但许多声音仍未被听到。关于FWC对孕产妇健康影响的证据有限。本文采用横断面研究设计,对密歇根州弗林特市参与“支持父母培养有韧性的孩子”(SPARRK)研究的152名女性进行了调查,以研究女性在FWC前后对自身整体健康的认知、感知到的孕产妇保健服务方面的种族差异,并探讨种族与居住在弗林特对孕产妇发病率的相互作用。
使用美国疾病控制与预防中心的21种严重孕产妇发病(SMM)诊断代码来定义感知到的孕产妇健康。通过问卷调查获取SMM数据。进行逻辑回归分析,以确定在两个领域中与SMM相关的因素:(1)FWC前后的整体健康状况;(2)分娩期间接受的孕产妇保健服务。
有17例SMM病例,其中黑人女性占这些病例的62.5%。对护理质量的总体感知是积极的;然而,所有女性在FWC后对整体健康的感知都有所下降。拥有大学学位或更高学历的人发生SMM的几率高出6倍。
在以黑人为主的弗林特市,种族不是影响健康认知和护理质量的重要因素。令人惊讶的是,教育程度与发生SMM的几率增加6倍显著相关。需要更多研究来探讨患者与提供者对护理质量的认知以及教育与孕产妇健康结果之间的关联。