Targeted Investment and Meaningful Engagement to Improve MCH Outcomes and Rectify Historical Structural Racism: The TIME Study

有针对性的投资和有意义的参与可改善妇幼保健成果并纠正历史结构性种族主义：《时代》杂志研究

• 批准号: 10474914
• 负责人: Deena Chisolm
• 金额: $ 62.58万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-15 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10474914
• 关键词: African American population; Birth; Black Populations; Black race; Caring; Cessation of life; Child; Child Welfare; Cities; Communities; Community Developments; Complex; Developed Countries; Discrimination; Economic Development; Economic Factors; Education; Environmental Risk Factor; Equipment and supply inventories; Family; Fibrinogen; Generations; Geography; Goals; Health; Health Food; Housing; Infant Health; Infant Mortality; Interview; Investments; Life Cycle Stages; Link; Live Birth; Longevity; Low Birth Weight Infant; Maternal Health; Maternal and Child Health; Measures; Medical; Minority; Modeling; Neighborhoods; Not Hispanic or Latino; Ohio; Outcome; Pediatric Hospitals; Personal Satisfaction; Persons; Phase; Plant Roots; Policies; Population; Poverty; Pregnancy; Probability; Race; Recording of previous events; Reproductive Health; Research; Research Personnel; Resources; Risk Factors; Science; Side; Societies; Stress; Structural Racism; Structure; Sum; System; Tilia; Time; Time Study; Woman; Work; base; black women; community partnership; design; experience; federal poverty level; food insecurity; formative assessment; health care availability; health care delivery; health disparity; health inequalities; housing instability; implementation evaluation; implementation outcomes; improved; innovation; lens; multidisciplinary; premature; prenatal; primary outcome; racial disparity; racism; segregation; social; social factors; social health determinants; theories

Project Summary In Columbus Ohio’s Linden neighborhood, a historically segregated and disinvested community that has been devastated by decades of discriminatory race-based policies, infant mortality rates (IMR) are over 20 deaths per 1,000 live births (2%) with racial disparity ratios nearing three. Researchers have linked infant mortality and poor birth outcomes to maternal education, maternal experiences of stress and discrimination, pove rty, lack of access to healthy foods, lack of stable housing, and lack of access to prenatal/medical care. These risk factors are concentrated in majority minority neighborhoodsdue to historical and contemporary policies and practices rooted in structural racism (e.g., redlining, restrictive covenants, unfavorable zoning) that segregated both people and resources within communities. Linden is apredominately Black (63%) neighborhood with apopulation of 180,000 residents, of which approximately 45% live below the federal poverty level. Building on Nationwide Children’s Hospital’s (NCH) history of housing and community development through its Health Neighborhoods/Healthy Families community partnership on the city’s south side, NCH targeted re-investments in Linden are intended to improve housing quality and affordability, educational outcomes, access to healthcare, economic development, and social connections of residents. Informed by Life Course Theory (LCT), the objective of this proposal is to describe discriminatory policies influencing IMR and other maternal and child health experiences and outcomes across generations of Black women and importantly, demonstrate how community re-investment can be designed to target and rectify historic and contemporary structural racism and discrimination. Specifically, we aim to: (1) examine the experiences of multiple generations of Black women on the intersection of structural racism and reproductive health through the lens of historical and contemporary policies that effect communities; (2) conduct real-time formative evaluation of a targeted community investment initiative explicitly informed by the community’s history of structural racism; and (3) measure relative changes in short term infant and maternal health disparities in the target community and a statistically matched comparison geography.

项目摘要 在俄亥俄州哥伦布的林登（Linden）附近 由于数十年的基于种族的政策而破坏，婴儿死亡率（IMR）的死亡人数超过20人 1,000只活产（2％），比塔差异比例接近三个。研究人员已经将婴儿死亡率和贫困 孕产妇教育的出生成果，压力和歧视的产妇经历，卑鄙的人，缺乏访问权限 对于健康食品，缺乏稳定的住房以及无法获得产前/医疗服务。这些风险因素是 集中于多数少数民族社区，以扎根于历史和当代政策和实践 在结构性种族主义（例如，红线，限制性盟约，不利的分区）中，将两个人隔离 社区内的资源。林登（Linden 居民，其中约45％的人居住在联邦贫困水平以下。建立在全国儿童的基础上 医院（NCH）通过其健康社区/健康的住房和社区发展历史 在城市南侧的家庭社区伙伴关系，林登的针对性重新投资旨在 提高住房质量和负担能力，教育成果，获得医疗保健，经济发展， 和居民的社会联系。通过生命课程理论（LCT）的知识，该提议的目的是 描述歧视性政策影响IMR以及其他物质和儿童健康经历，以及 几代黑人妇女的成果，重要的是，表明社区重新投资如何 旨在针对和纠正历史和当代的结构种族主义和歧视。具体来说， 我们的目的是：（1）研究几代黑人妇女在结构上的交汇处的经历 种族主义和生殖健康通过历史和当代政策的镜头 社区； （2）明确对有针对性的社区投资计划进行实时形成性评估 社区的结构种族主义历史所告知； （3）测量短期婴儿的相对变化 目标社区中的孕产妇健康差异以及统计匹配的比较地理。