Syndemic Perspectives to Guide Black Maternal Health Research and Prevention During the COVID-19 Pandemic
Syndemic Perspectives to Guide Black Maternal Health Research and Prevention During the COVID-19 Pandemic
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DOI：
10.1007/s10995-020-02983-7
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发表时间：
2020-07-21
影响因子：
2.3
通讯作者：
Brown, Kyrah K.
中科院分区：
文献类型：
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作者：
Lemke, Michael Kenneth;Brown, Kyrah K.
2019冠状病毒（COVID-19）大流行和相关政策导致美国发病率和死亡率分布不均。对于黑人妇女和生育人群，地方性脆弱性和差异可能加剧COVID-19的有害影响。随着时间的推移，历史上和正在进行的宏观政策和力量导致黑人妇女和分娩人群的孕产妇发病率和死亡率不成比例地高，当代宏观经济和医疗保健政策和因素继续产生特别的后果。这些因素会诱发有害的心理、健康和行为反应，从而导致孕产妇健康差异。COVID-19大流行可能会对黑人妇女和生育人群造成不成比例的影响，因为政策应对措施未能考虑到他们独特的社会经济和医疗保健背景。由此产生的后果可能形成一个“恶性循环”，上游影响加剧上游宏观政策和力量，可能进一步使这一人群中孕产妇发病率和死亡率的聚集性永久化。了解COVID-19对黑人妇女和生育者的影响需要理论框架，这些理论框架可以充分概念化其多层次，相互作用和动态性质。因此，我们提倡传播流行病学观点，以指导COVID-19大流行期间的孕产妇差异研究和预防。这些观点可以使人们全面而细致地了解黑人妇女和生育者所经历的地方性和COVID-19特有的脆弱性和差异的交叉点。然后，基于疫情的研究可以产生有效的多层次预防战略，同时解决地方性和COVID-19特有的因素和结果，这些因素和结果导致脆弱性和差异随着时间的推移而聚集。
The coronavirus 2019 (COVID-19) pandemic and related policies have led to an unequal distribution of morbidity and mortality in the U.S. For Black women and birthing people, endemic vulnerabilities and disparities may exacerbate deleterious COVID-19 impacts. Historical and ongoing macro-level policies and forces over time have induced disproportionately higher rates of maternal morbidity and mortality among Black women and birthing people, and contemporary macroeconomic and healthcare policies and factors continue to hold particular consequence. These factors induce detrimental psychological, health, and behavioral responses that contribute to maternal health disparities. The COVID-19 pandemic is likely to disproportionately impact Black women and birthing people, as policy responses have failed to account for the their unique socioeconomic and healthcare contexts. The resulting consequences may form a 'vicious cycle', with upstream impacts that exacerbate upstream macro-level policies and forces that can further perpetuate the clustering of maternal morbidity and mortality in this population. Understanding the impacts of COVID-19 among Black women and birthing people requires theoretical frameworks that can sufficiently conceptualize their multi-level, interacting, and dynamic nature. Thus, we advocate for the proliferation of syndemic perspectives to guide maternal disparities research and prevention during the COVID-19 pandemic. These perspectives can enable a holistic and nuanced understanding of the intersection of endemic and COVID-19-specific vulnerabilities and disparities experienced by Black women and birthing people. Syndemic-informed research can then lead to impactful multi-level prevention strategies that simultaneously tackle both endemic and COVID-19-specific factors and outcomes that lead to the clustering of vulnerabilities and disparities over time.