Institutional racism, neighborhood factors, stress, and preterm birth
Institutional racism, neighborhood factors, stress, and preterm birth
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DOI：
10.1080/13557858.2013.846300
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发表时间：
2014-01-01
影响因子：
3.1
通讯作者：
Culhane, Jennifer F.
中科院分区：
文献类型：
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作者：
Mendez, Dara D.;Hogan, Vijaya K.;Culhane, Jennifer F.
Objective.早产风险的种族/民族差异可以用各种因素来解释，以前的研究局限于审查制度性种族主义的作用。这项研究的重点是以下问题：什么是早产和制度性种族主义之间的关联，衡量住宅种族隔离（种族的地理隔离）和红线（黑人和白人在抵押贷款拒绝的差异）;和什么是早产和报告的压力，歧视和邻里质量之间的关联。我们使用的数据来自于1999年至2004年在美国宾夕法尼亚州费城进行的一项压力和妊娠研究中的孕妇（n = 3462）的临床样本。我们从2000年美国人口普查和住房抵押贷款披露法案（HMDA）的数据从1999年至2004年的数据相关联，并制定了住宅红线和隔离措施。在整个人口中，年龄较大，未婚，吸烟，以前生育次数较多，日常歧视经历较高，拥有自己的房屋，居住在非红线地区以及隔离指数衡量的隔离程度较高的地区的妇女早产风险增加。在黑人妇女中，居住在红线区（黑人比白人更有可能被拒绝抵押贷款）与早产风险降低中度相关（aRR = 0.8，95%CI：0.6，0.99）。住宅红线作为一种形式的制度性种族主义和邻里特征可能是重要的了解种族/民族差异怀孕和早产。
Objective. Racial/ethnic disparities in the risk of preterm birth may be explained by various factors, and previous studies are limited in examining the role of institutional racism. This study focused on the following questions: what is the association between preterm birth and institutional racism as measured by residential racial segregation (geographic separation by race) and redlining (black-white disparity in mortgage loan denial); and what is the association between preterm birth and reported stress, discrimination, and neighborhood quality.Design. We used data from a clinic-based sample of pregnant women (n = 3462) participating in a stress and pregnancy study conducted from 1999 to 2004 in Philadelphia, PA (USA). We linked data from the 2000 US Census and Home Mortgage Disclosure Act (HMDA) data from 1999 to 2004 and developed measures of residential redlining and segregation.Results. Among the entire population, there was an increased risk for preterm birth among women who were older, unmarried, tobacco users, higher number of previous births, high levels of experiences of everyday discrimination, owned their homes, lived in nonredlined areas, and areas with high levels of segregation measured by the isolation index. Among black women, living in a redlined area (where blacks were more likely to be denied mortgage loans compared to whites) was moderately associated with a decreased risk of preterm birth (aRR = 0.8, 95% CI: 0.6, 0.99).Conclusion. Residential redlining as a form institutional racism and neighborhood characteristic may be important for understanding racial/ethnic disparities in pregnancy and preterm birth.