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RACIAL AND NEIGHBORHOOD DISPARITIES IN INFANT HEALTH

婴儿健康方面的种族和社区差异

基本信息

批准号：
6654783
负责人：
IRMA T. ELO
金额：
$ 0.37万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
1999
资助国家：
美国
起止时间：
1999-09-01 至 2004-08-31
项目状态：
已结题

项目摘要

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，它将生命统计记录中的信息与医疗补助索赔记录以及来自公共资助的医疗中心的个人数据合并起来。然后，我们将个人层面的数据与来自多个来源的丰富的背景信息合并，以创建各种社区质量衡量标准，包括住房和环境质量、经济困境、社会解体、健康和服务可用性。我们使用适合多级数据分析的严格统计技术来研究个人和背景因素对种族和邻里差异对出生结果的影响。我们将研究种族内部的社会阶层差异以及种族差异本身。第二组分析涉及公共资助的卫生服务对产前护理使用、婴儿健康和低收入妇女费用的有效性。我们将比较 1989 年至 1992 年间在管理式医疗环境中接受医疗补助服务的妇女与接受医疗补助患者的按服务收费提供者的服务的妇女的产前护理内容和出生结果。另一套分析将专门针对 1993 年至 1996 年期间使用城市资助的卫生中心进行产前护理的妇女。为了补充上述分析，我们将对低收入女性进行深入的纵向研究。我们建议跟踪大约 1,900 名女性从第一次产前护理到婴儿一岁生日的整个过程。这项研究将使我们能够检验概念框架中存在的因素的影响，这些因素无法从生命统计数据中获得，包括母亲的社会支持网络、生活安排、住房稳定性、社会心理因素、怀孕的意愿和冒险行为。样本将包括白人、非裔美国人、西班牙裔和亚洲女性。样本构成将使我们能够明确讨论种族在婴儿健康中的作用，并检查所有种族/族裔群体中的低收入妇女对婴儿健康的影响因素是否相似。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Continuous source of care among young underserved children: associated characteristics and use of recommended parenting practices.

服务不足的幼儿的持续护理来源：相关特征和推荐养育做法的使用。

DOI：
10.1016/j.ambp.2007.08.005
发表时间：
2008
期刊：
Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association
影响因子：
0
作者：
Chung,EstherK;Mathew,Leny;McCollum,KellyF;Elo,IrmaT;Culhane,JenniferF
通讯作者：
Culhane,JenniferF

Neighbourhood deprivation and small-for-gestational-age term births in the United States.

DOI：
10.1111/j.1365-3016.2008.00991.x
发表时间：
2009-01
期刊：
Paediatric and perinatal epidemiology
影响因子：
2.8
作者：
Elo IT;Culhane JF;Kohler IV;O'Campo P;Burke JG;Messer LC;Kaufman JS;Laraia BA;Eyster J;Holzman C
通讯作者：
Holzman C

Does prenatal care at community-based health centers result in infant primary care at these sites?

社区卫生中心的产前护理是否会导致这些地点的婴儿初级护理？

DOI：
10.1016/j.ambp.2005.08.002
发表时间：
2006
期刊：
Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.
影响因子：
0
作者：
Chung,EstherK;McCollum,KellyF;Elo,IrmaT;Culhane,JenniferF
通讯作者：
Culhane,JenniferF

Subjective social status and maternal health in a low income urban population.