The Index of Concentration at the Extremes (ICE) and Pregnancy-Associated Mortality in Louisiana, 2016-2017.
The Index of Concentration at the Extremes (ICE) and Pregnancy-Associated Mortality in Louisiana, 2016-2017.
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DOI：
10.1007/s10995-021-03189-1
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发表时间：
2022-04
影响因子：
2.3
通讯作者：
Wallace M
中科院分区：
文献类型：
--
作者：
Dyer L;Chambers BD;Crear-Perry J;Theall KP;Wallace M
社会和背景因素的基础上不断不成比例的和负担的风险，在美国黑人妇女经历的不良健康结果是在文献中探索不足。本研究的目的是使用一个基于种族和收入的地区级人口分布的指数来预测路易斯安那州妇女在怀孕期间和产后一年内的死亡风险。使用路易斯安那州卫生部2016-2017年提供的生命记录数据（n= 125，537），使用广义估计方程拟合了修改的泊松模型，以检查与人口普查区级极端浓度指数（ICE）值相关的妊娠相关死亡风险-按三分位数分组-同时调整个体和区级混杂因素。分析结果显示，与其他因素无关，相对于集中特权地区（高比例的白色和高收入居民），集中贫困地区（高比例的黑人和低收入居民）的妊娠相关死亡风险估计增加1.73倍（95% CI：=1.02 - 2.93）。除了继续考虑根深蒂固的种族主义和经济不平等造成的与妊娠有关的死亡外，我们还必须考虑它们对获得资源、孕产妇健康和健康不平等的协同效应。
Social and contextual factors underlying the continually disproportionate and burdensome risk of adverse health outcomes experienced by Black women in the US are underexplored in the literature. The aim of this study was to use an index based on area-level population distributions of race and income to predict risk of death during pregnancy and up to one year postpartum among women in Louisiana. Using vital records data provided by the Louisiana Department of Health 2016–2017 (n=125,537), a modified Poisson model was fit with generalized estimating equations to examine the risk of pregnancy-associated death associated with census tract-level values of the Index of Concentration at the Extremes (ICE) – grouped by tertile – while adjusting for both individual and tract-level confounders. Analyses resulted in an estimated 1.73 (95% CI:=1.02 – 2.93) times increased risk for pregnancy-associated death for those in areas which were characterized by concentrated deprivation (high proportions of Black and low-income residents) relative to those in areas of concentrated privilege (high proportions of white and high-income residents), independent of other factors. In addition to continuing to consider the deeply entrenched racism and economic inequality that shape the experience of pregnancy-associated death, we must also consider their synergistic effect on access to resources, maternal population health, and health inequities.
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影响因子：
10.4
作者：
Gee, Gilbert C;Payne-Sturges, Devon C
通讯作者：
Payne-Sturges, Devon C
影响因子：
10.4
作者：
Hystad P;Davies HW;Frank L;Van Loon J;Gehring U;Tamburic L;Brauer M
通讯作者：
Brauer M
影响因子：
4.5
作者：
Carey, Gemma;Crammond, Brad
通讯作者：
Crammond, Brad
影响因子：
2.3
作者：
DiGiuseppe, David L;Aron, David C;Rosenthal, Gary E
通讯作者：
Rosenthal, Gary E
影响因子：
4.1
作者：
Mendez, Dara D.;Hogan, Vijaya K.;Culhane, Jennifer F.
通讯作者：
Culhane, Jennifer F.