Association of Residence in High-Police Contact Neighborhoods With Preterm Birth Among Black and White Individuals in Minneapolis.
Association of Residence in High-Police Contact Neighborhoods With Preterm Birth Among Black and White Individuals in Minneapolis.
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DOI：
10.1001/jamanetworkopen.2021.30290
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发表时间：
2021-12-01
影响因子：
13.8
通讯作者：
Mendez DD
中科院分区：
文献类型：
--
作者：
Hardeman RR;Chantarat T;Smith ML;Karbeah J;Van Riper DC;Mendez DD
生活在一个有大量警察存在的社区与早产风险增加有关吗？在这项对2016年生下一个活单胞胎的1059名明尼阿波利斯居民的横断面研究中，居住在警察存在程度高的社区的孕妇早产的几率明显高于居住在警察存在程度低的社区的种族对应人群的几率。（白色人增加90%，美国出生的黑人增加100%，美国以外出生的黑人增加10%）。社区中黑人居民的比例越高，警察事件报告的数量就越多。这些研究结果表明，更多的警察存在于黑人与白色社区可能有助于持续的黑人-白色早产差异在明尼阿波利斯。这项横断面研究探讨了社区警察接触与白色孕妇、美国出生的黑人孕妇和美国以外出生的黑人孕妇早产风险之间的关系。警方接触可能对孕妇产生负面的心理影响，心理压力与早产（即妊娠37周以下分娩）有关。现有的知识，种族差异的警务模式及其与健康的关系表明，重新设计公共安全政策可能有助于种族健康公平。研究社区警察接触与白色孕妇、美国出生的黑人孕妇和美国以外出生的黑人孕妇早产风险之间的关系。这项横断面研究使用了745名白色人、121名美国出生的黑人和193名美国以外出生的黑人的病历数据，这些人是明尼阿波利斯居民，并在2016年1月1日至12月31日期间在大型卫生系统生下了一个活的单胞胎。数据分析时间为二零一九年三月至二零二零年十月。警方的接触是在孕妇居住的人口普查区一级进行的。人均警察事件（即，警察事件数除以人口普查区人口估计数）被分为高，如果值在第四个四分位数和低的其余三个四分位数。早产状态是基于疾病和相关健康问题国际统计分类，第10次修订，临床修改（ICD-10-CM）代码。早产儿是指在其病历中记录了ICD-10-CM编码P07.2和P07.3的早产儿。在1059名孕妇中（745 [70.3%]白色，121 [11.4%]美国出生的黑人，193 [18.2%]美国以外出生的黑人）在样本中，336个白色个体（45.1%）和62名在美国以外出生的黑人32.1%的黑人在30至34岁之间生育，而美国出生的黑人生育年龄更小，49人（40.5%）年龄在25岁或以下。白色个体的早产发生率为6.7%（50例妊娠），美国出生的黑人个体为14.0%（17例妊娠），美国以外出生的黑人个体为5.7%（11例妊娠）。在与警察接触频繁的地区，白色人早产的几率高出90（比值比[OR]，1.9; 95% CI，1.9-2.0），美国出生的黑人个体高100%（OR，2.0; 95%CI，1.8-2.2），在美国以外出生的黑人高出10%（OR，1.1; 95%CI，1.0-1.2）。二次地理空间分析进一步显示，明尼阿波利斯人口普查区黑人居民的比例与2012年至2016年报告的警察事件数量相关（P = .001）。在这项研究中，警察接触与黑人和白色孕妇的早产有关。以黑人为主的社区比以白色为主的社区有更多的警察接触，这表明黑人孕妇比白色孕妇更容易接触警察。这些研究结果表明，种族化的警察模式来自美国的种族主义历史，可能会导致早产的种族差异。
Is living in a neighborhood with high police presence associated with increased risk of preterm birth? In this cross-sectional study of 1059 Minneapolis residents who gave birth to a live singleton in 2016, the odds of preterm birth for pregnant people living in a neighborhood with high police presence was significantly higher compared with the odds of their racial counterparts in a low-presence neighborhood (90% increase for White individuals, 100% increase for US-born Black individuals, and 10% for Black individuals born outside of the US). The higher the proportion of Black residents in the neighborhood, the greater the number of police incident reports. These findings suggest that greater police presence in Black vs White neighborhoods may contribute to the persistent Black-White preterm birth disparity in Minneapolis. This cross-sectional study examines the association between community-level police contact and the risk of preterm birth among White pregnant people, US-born Black pregnant people, and Black pregnant people who were born outside the US. Police contact may have negative psychological effects on pregnant people, and psychological stress has been linked to preterm birth (ie, birth at <37 weeks’ gestation). Existing knowledge of racial disparities in policing patterns and their associations with health suggest redesigning public safety policies could contribute to racial health equity. To examine the association between community-level police contact and the risk of preterm birth among White pregnant people, US-born Black pregnant people, and Black pregnant people who were born outside the US. This cross-sectional study used medical record data of 745 White individuals, 121 US-born Black individuals, and 193 Black individuals born outside the US who were Minneapolis residents and gave birth to a live singleton at a large health system between January 1 and December 31, 2016. Data were analyzed from March 2019 to October 2020. Police contact was measured at the level of the census tract where the pregnant people lived. Police incidents per capita (ie, the number of police incidents divided by the census tract population estimate) were dichotomized into high if the value was in the fourth quartile and low for the remaining three quartiles. Preterm birth status was based on the International Statistical Classification of Diseases and Related Health Problems, 10th revision, Clinical Modification (ICD-10-CM) code. Preterm infants were those with ICD-10-CM codes P07.2 and P07.3 documented in their charts. Of 1059 pregnant people (745 [70.3%] White, 121 [11.4%] US-born Black, 193 [18.2%] Black born outside the US) in the sample, 336 White individuals (45.1%) and 62 Black individuals who were born outside the US (32.1%) gave birth between the ages of 30 and 34 years, while US-born Black individuals gave birth at younger ages, with 49 (40.5%) aged 25 years or younger. The incidence of preterm birth was 6.7% for White individuals (50 pregnant people), 14.0% for US-born Black individuals (17 pregnant people), and 5.7% for Black individuals born outside the US (11 pregnant people). In areas with high police contact vs low police contact, the odds of preterm birth were 90% higher for White individuals (odds ratio [OR], 1.9; 95% CI, 1.9-2.0), 100% higher for US-born Black individuals (OR, 2.0; 95% CI, 1.8-2.2), and 10% higher for Black individuals born outside the US (OR, 1.1; 95% CI, 1.0-1.2). Secondary geospatial analysis further revealed that the proportion of Black residents in Minneapolis census tracts was correlated with the number of police incidents reported between 2012 and 2016 (P = .001). In this study, police contact was associated with preterm birth for both Black and White pregnant people. Predominantly Black neighborhoods had greater police contact than predominantly White neighborhoods, indicating that Black pregnant people were more likely to be exposed to police than White pregnant people. These findings suggest that racialized police patterns borne from a history of racism in the United States may contribute to racial disparity in preterm birth.
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