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.

项目总结