Affordable Care Act standards for race and ethnicity mask disparities in maternal smoking during pregnancy.
Affordable Care Act standards for race and ethnicity mask disparities in maternal smoking during pregnancy.
复制标题
《平价医疗法案》的种族和民族标准掩盖了孕产妇在怀孕期间吸烟的差异。
DOI：
10.1016/j.ypmed.2014.05.002
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发表时间：
2014
影响因子：
5.1
通讯作者：
Cohen,BruceB
中科院分区：
文献类型：
--
作者：
Hawkins,SummerSherburne;Cohen,BruceB
目的本研究比较了新的《患者保护和平价医疗法案》(ACA) 数据收集标准和联邦管理和预算办公室 (OMB) 标准之间母亲在怀孕期间吸烟的情况。方法数据来自 1996 年至 2010 年 1,156,472 名婴儿的马萨诸塞州标准活产证明。一位家长报告母亲在怀孕期间是否吸烟（是/否）、她的种族（5 个选项）以及她的种族（39 个类别）。比较了 ACA 和 OMB 标准之间的产前吸烟率。然后在 ACA 标准的所有大类中检查出生证明中的详细种族：白人、黑人/非裔美国人、其他西班牙裔、其他亚裔/太平洋岛民和其他类别。结果对于西班牙裔/拉丁裔和亚裔母亲，ACA 标准比 OMB 标准更能体现种族/族裔群体之间和种族/族裔群体内吸烟的变异性。然而，对于白人和黑人/非裔美国母亲来说，广泛的 ACA 类别掩盖了产前吸烟的显着差异。虽然白人的总体患病率为 10.2%，但伊朗人的患病率为 0.8%，佛得角人的患病率为 21.0%。在黑人/非裔美国人 (7.6%) 中，这一比例从尼日利亚人的 0.5% 到非裔美国人的 12.9% 不等。 ACA 标准还将人口规模较大的族裔群体合并为其他西班牙裔和其他亚洲/太平洋岛民。结论在修订人口健康调查和其他报告工具时，州和联邦机构应考虑扩大所有种族/族裔类别，以获取每个人的详细种族信息。
ObjectiveThis study compared maternal smoking during pregnancy between the new Patient Protection and Affordable Care Act (ACA) data collection standards and Federal Office of Management and Budget (OMB) standards.MethodData were from the Massachusetts Standard Certificate of Live Births on 1,156,472 babies from 1996 to 2010. A parent reported whether the mother smoked during pregnancy (yes/no), her race (5 options) and, separately, her ethnicity (39 categories). Prenatal smoking rates were compared between the ACA and OMB standards. Detailed ethnicity from the birth certificate was then examined within all broad categories of the ACA standards: White, Black/African American, Other Hispanic, Other Asian/Pacific Islander, and Other categories.ResultsFor Hispanic/Latina and Asian mothers, the ACA standards captured the variability in smoking across and within racial/ethnic groups more than the OMB standards. However, for White and Black/African American mothers, the broad ACA categories masked striking differences in prenatal smoking. While the overall prevalence among Whites was 10.2%, this ranged from 0.8% for Iranians to 21.0% for Cape Verdeans. Among Black/African Americans (7.6%), this ranged from 0.5% for Nigerians to 12.9% for African Americans. The ACA standards also combined ethnic groups with sizeable populations into Other Hispanics and Other Asian/Pacific Islanders.ConclusionWhen population health surveys and other reporting tools are being revised, state and federal agencies should consider expanding all race/ethnicity categories to capture detailed ethnicity on everyone.