Testing the Association Between Traditional and Novel Indicators of County-Level Structural Racism and Birth Outcomes among Black and White Women
Testing the Association Between Traditional and Novel Indicators of County-Level Structural Racism and Birth Outcomes among Black and White Women
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DOI：
10.1007/s40615-017-0444-z
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发表时间：
2018-10-01
影响因子：
3.9
通讯作者：
Brown-Jeffy, Shelly
中科院分区：
文献类型：
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作者：
Chambers, Brittany D.;Erausquin, Jennifer Toller;Brown-Jeffy, Shelly
尽管美国早产儿和低出生体重婴儿的数量有所减少，但黑人和白人妇女之间的种族差异仍在继续。作为回应，本分析的目的是研究黑人和白人妇女之间的传统和新型县级结构性种族主义指标与生育结果之间的联系。我们将2009-2013年加州出生统计总档案中的个人数据与美国的县级数据合并。人口普查美国社区调查。我们使用分层线性模型来检验加州33个县531,170名初产妇女的黑白差异。传统指标（如差异指数）和新指标（如当选公职中的黑人与白人比例）与黑人和白人妇女较早的胎龄和较低的出生体重有关。与白人女性相比，传统指标与黑人女性更早的孕龄有更强的关联。这是第一个实证研究，通过传统和新指标来衡量，结构性种族主义与黑人和白人妇女所生婴儿的健康和福祉状况不佳有关。然而，研究结果表明，结构性种族主义的传统指标，而不是新的指标，更能解释出生结果中的种族差异。研究结果还表明，需要开发更多的创新方法：(1)衡量县一级的结构性种族主义；(2)改革公共政策以增加整合和获取资源的机会。
Despite decreases in infants born premature and at low birth weight in the United States (U.S.), racial disparities between Black and White women continue. In response, the purpose of this analysis was to examine associations between both traditional and novel indicators of county-level structural racism and birth outcomes among Black and White women. We merged individual-level data from the California Birth Statistical Master Files 2009-2013 with county-level data from the United States (U.S.) Census American Community Survey. We used hierarchical linear modeling to examine Black-White differences among 531,170 primiparous women across 33 California counties. Traditional (e.g., dissimilarity index) and novel indicators (e.g., Black to White ratio in elected office) were associated with earlier gestational age and lower birth weight among Black and White women. A traditional indicator was more strongly associated with earlier gestational age for Black women than for White women. This was the first study to empirically demonstrate that structural racism, measured by both traditional and novel indicators, is associated with poor health and wellbeing of infants born to Black and White women. However, findings indicate traditional indicators of structural racism, rather than novel indicators, better explain racial disparities in birth outcomes. Results also suggest the need to develop more innovative approaches to: (1) measure structural racism at the county-level and (2) reform public policies to increase integration and access to resources.