RACIAL AND NEIGHBORHOOD DISPARITIES IN INFANT HEALTH

婴儿健康方面的种族和社区差异

• 批准号: 6526330
• 负责人: IRMA T. ELO
• 金额: $ 45.08万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-01 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6526330
• 关键词: African American; Asian Americans; Hispanic Americans; Medicare /Medicaid; behavioral /social science research tag; caucasian American; clinical research; female; health behavior; health care cost /financing; health care service availability; health insurance; housing; human data; human pregnant subject; human subject; infant human (0-1 year); longitudinal human study; low socioeconomic status; managed care; medical records; pediatrics; prenatal care; public health; racial /ethnic difference; social class; social support network; socioeconomics; urban poverty area; vital statistics

In this project, we construct a unique data set for Philadelphia, which merges information from vital statistics records with Medicaid claims records and individual-level data from publicly funded health centers. We then merge the individual-level data with a rich set of contextual information from multiple sources to create various measures of neighborhood quality, including housing and environmental quality, economic distress, social disorganization, health and service availability. We examine the influence of individual and contextual factors on racial and neighborhood variations on birth outcomes using rigorous statistical techniques suited for analyses of multilevel data. We will examine social class differences within race as well as the racial disparity itself. A second set of analyses addresses the effectiveness of publicly funded health services on prenatal care use, infant health, and costs for low-income women. We will compare the content of prenatal care and birth outcomes of women who received Medicaid services in a managed care setting versus women who received services from fee-for-service provides who accepted Medicaid patients in 1989-1992. Another set of analyses will focus specifically on women using city-funded health centers for prenatal care in 1993-1996. To complement the above analyses we will undertake an in-depth longitudinal study of low-income women. We propose to follow approximately 1,900 women from their first prenatal care visit through their baby s first birthday. This study will enable us to examine the effects of factors present in our conceptual framework that are not available from vital statistics data, including the mother s social support networks, living arrangements, housing stability, psychosocial factors, the wantedness of her pregnancy and risk-taking behaviors. The sample will consist of white, African American, Hispanic and Asian women. The sample composition will permit us to address explicitly the role of race in infant health, and to examine whether factors contributing to infant health are similar for low income women in all racial/ethnic groups.

在这个项目中，我们为费城构建了一个独特的数据集，该数据集将生命统计记录中的信息与医疗补助索赔记录和公共资助的医疗中心的个人数据合并在一起。 然后，我们将个人层面的数据与来自多个来源的丰富的上下文信息相结合，以创建各种社区质量指标，包括住房和环境质量、经济困境、社会混乱、健康和服务可用性。我们研究的影响，个人和背景因素的种族和邻里的变化，出生结果采用严格的统计技术，适合多层次数据的分析。 我们将研究种族内部的社会阶级差异以及种族差异本身。 第二组分析涉及公共资助的保健服务对产前护理使用，婴儿健康和低收入妇女的费用的有效性。我们将比较的内容，产前护理和分娩结果的妇女谁收到医疗补助服务的管理式护理环境与妇女谁收到的服务，从收费服务提供谁接受医疗补助病人在1989-1992年。 另一组分析将特别侧重于1993-1996年利用城市资助的保健中心进行产前护理的妇女。为了补充上述分析，我们将对低收入妇女进行深入的纵向研究。 我们建议跟踪大约1,900名妇女，从她们第一次产前检查到她们婴儿的第一个生日。 这项研究将使我们能够检查我们的概念框架中存在的因素的影响，而这些因素是无法从生命统计数据中获得的，包括母亲的社会支持网络，生活安排，住房稳定性，心理社会因素，她怀孕的意愿和冒险行为。 样本将包括白色、非裔美国人、西班牙裔和亚洲女性。 样本的组成将使我们能够明确地解决种族在婴儿健康中的作用，并检查是否有助于婴儿健康的因素是相似的低收入妇女在所有种族/民族群体。