Investigating structural maternal health inequities among Black reproductive aged women in Georgia: a mixed methods and multi-level approach
调查格鲁吉亚黑人育龄妇女的结构性孕产妇健康不平等:混合方法和多层次方法
基本信息
- 批准号:10474830
- 负责人:
- 金额:$ 45.24万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-19 至 2027-05-31
- 项目状态:未结题
- 来源:
- 关键词:AddressAffectAttitudeBayesian ModelingBehaviorBeliefBirthBlack raceCaringChronicChronic stressColorCommunitiesComplexConsciousCountyCriminal JusticeCrowsDataData AnalysesDehumanizationDiscipline of obstetricsDiscriminationEconomicsEmploymentFocus GroupsFutureGoalsHealthHealth InsuranceHealth Services AccessibilityHealth StatusHealth behaviorHealth systemHealthcareHealthcare SystemsHospitalsHousingHypertensionIncomeIndividualInstitutional RacismInterventionLawsLife Cycle StagesLinkLiteratureMaternal HealthMaternal MortalityMeasuresMedicalMental DepressionMethodsModelingOnline SystemsOutcomePatientsPerceptionPerinatal mortality demographicsPersonsPhysiciansPhysiologicalPlant RootsPoliciesPoliticsPopulationPostpartum PeriodPregnancyPregnancy ComplicationsPremature BirthProcessProviderQualitative MethodsReactionRecordsResearchRespondentRiskSlaveSocial BehaviorStressStructural RacismStructureSurveysSymptomsSystemTimeUrsidae FamilyWarWomanadverse maternal outcomesagedbaseblack womenblack/white disparitycopingcritical perioddisparities in morbidityexperiencehealinghealth beliefhealth care availabilityhealth care qualityhealth disparityhealth inequalitiesinfant outcomeinsightintergenerationalintersectionalitymaternal morbiditymaternal outcomemortalitynovelorganizational climatepoor sleeppopulation healthpregnancy related deathpregnantpsychological stressorracial discriminationracial disparityracismreproductiveresiliencesevere maternal morbiditysocialsocioeconomicstheories
项目摘要
Project Summary/Abstract
Racial injustice and oppression are prevalent and devastating causes of health disparities. Black women are 2-
3 times more likely than White women to experience severe maternal morbidity (SMM) and to die from
pregnancy-related causes. The maternal health crisis is particularly profound in Georgia, where Black women
account for 35% of all births and the pregnancy-related mortality ratio is 1.5 times higher than national
estimates. Research that examines disparities in maternal health often focus on individual-level behaviors
when the root of the issues are better conceptualized as being within structures and systems that perpetuate
injustice intergenerationally and over the life course. This study will address three major gaps in the literature
to date. First, traditional measures of structural racial discrimination (SRD) often fail to capture the full range of
historical oppression, and research is needed to explore an array of measures to better understand and
address the contemporary effects of historically unjust practices, policies, and structures. Second, it is unclear
what multi-level strategies could mitigate the impact of SRD on SMM and promote resilience for Black women.
Third, with research seeking to address multi-level inequities, it is important to integrate qualitative methods
that center the experiences of Black women within SRD in order to approach solutions. The objective of this
proposal is to ascertain new information from diverse perspectives using a robust mixed-methods
approach to understand how SRD affects Black maternal health outcomes at the population, health
system, and individual level. At the population level, we will conduct a secondary data analysis to estimate
county-level associations between measures of SRD and Black-White SMM disparities (Aim 1). Recognizing
that provider practices are influenced by individual biases and institutional structures, we will use a causal
attribution framework to characterize physician perceptions regarding the underlying causes of Black-White
maternal health disparities and the racial climate of the organizations in which they practice. (Aim 2). Lastly, we
will assess Black women’s lived experiences of obstetric and institutional racism and how these experiences
influence access to care and health status before, during, and after pregnancy, using a framework of radical
healing for communities of color to identify risk and resilience coping processes. (Aim 3). This multi-level and
mixed-methods study will allow us to contextualize Black maternal outcomes and capture structural
intersectionality constructs that have yet to be studied. Our findings will provide critical insight on potentially
modifiable factors for addressing the current maternal health crisis in a southern state where the legacy of
slavery and oppression lingers.
项目总结/摘要
种族不公正和压迫是造成健康差距的普遍和破坏性原因。黑人女性2-
重度孕产妇发病率(SMM)和死亡率是白色女性的3倍
与怀孕有关的原因。孕产妇健康危机在格鲁吉亚尤为严重,那里的黑人妇女
占所有出生人数的35%,与怀孕有关的死亡率比全国高1.5倍。
估算研究孕产妇健康差异的研究往往侧重于个人行为
当问题的根源被更好地概念化为永久存在的结构和系统时
代际和生命历程中的不公正。本研究将解决文献中的三个主要空白
迄今第一,传统的结构性种族歧视衡量标准往往不能全面反映
历史压迫,需要研究探索一系列措施,以更好地了解和
解决历史上不公正的做法,政策和结构的当代影响。二是不明确
什么样的多层次战略可以减轻SRD对SMM的影响,并促进黑人妇女的复原力。
第三,随着研究寻求解决多层次的不平等,重要的是要整合定性方法
以SRD内黑人妇女的经历为中心,以寻求解决方案。的目的
建议是使用一种稳健的混合方法从不同的角度确定新的信息
了解SRD如何影响黑人孕产妇健康结果的方法
制度和个人层面。在人口层面,我们将进行二次数据分析,
SRD和黑白SMM差异(目标1)的措施之间的县级协会。认识
提供者的做法受到个人偏见和制度结构的影响,我们将使用因果关系,
归因框架,以表征医生对黑白病根本原因的看法
产妇保健方面的差异以及她们所在组织的种族气氛。(Aim 2)的情况。最后我们
将评估黑人妇女的产科和制度性种族主义的生活经验,以及这些经验如何
影响获得保健和健康状况之前,期间和之后,使用激进的框架,
治愈有色人种社区,以确定风险和弹性应对过程。(Aim(3)第三章。这种多层次和
混合方法的研究将使我们能够将黑人孕产妇的结局和结构
交叉性结构尚待研究。我们的研究结果将提供关键的洞察力,
解决南部一个州目前产妇保健危机的可改变因素,
奴隶制和压迫仍然存在。
项目成果
期刊论文数量(0)
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Sheree L Boulet其他文献
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{{ truncateString('Sheree L Boulet', 18)}}的其他基金
Investigating structural maternal health inequities among Black reproductive aged women in Georgia: a mixed methods and multi-level approach
调查格鲁吉亚黑人育龄妇女的结构性孕产妇健康不平等:混合方法和多层次方法
- 批准号:
10707074 - 财政年份:2022
- 资助金额:
$ 45.24万 - 项目类别:
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