The Effects of Institutional Racism and Residential Segregation on Preterm Birth

制度种族主义和居住隔离对早产的影响

• 批准号: 7600310
• 负责人: Dara Daneen Mendez
• 金额: $ 0.99万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2009-08-19
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7600310
• 关键词: Bacterial Vaginosis; Behavior; Birth; Birth Records; Censuses; Communities; Cross-Sectional Studies; Data; Databases; Development; Disclosure; Discrimination; Evaluation; Excess Mortality; Future; Gender; Health; Health Policy; Home environment; Housing; Individual; Infant; Infant Mortality; Institution; Intervention; Life; Link; Logistic Regressions; Low Birth Weight Infant; Measures; Mediating; Methods; Minority; Morbidity - disease rate; N-hydroxysuccinimidyl digoxigenin-3-O-methylcarbonyl-epsilon-aminocaproate; Neonatal; Outcome; Patient Self-Report; Personal Satisfaction; Philadelphia; Policies; Population; Pregnancy; Pregnant Women; Premature Birth; Property; Public Health; Race; Recommendation; Recording of previous events; Regression Analysis; Reporting; Research; Research Design; Research Personnel; Research Project Grants; Research Proposals; Risk Factors; Sex Bias; Social Environment; Stress; Testing; United States; Urban Population; Woman; Women' s Group; base; contextual factors; design; experience; health disparity; improved; indexing; inner city; maternal stress; perinatal health; racial and ethnic disparities; racial discrimination; racism; segregation; social; stressor; urban area

DESCRIPTION (provided by applicant): The long-term objectives of this research proposal are to understand the social and contextual factors that influence perinatal health and preterm birth, beyond individual risk factors and behaviors. Previous studies have investigated racial discrimination on the individual level yet few studies explore institutional measures of racism as potential social, contextual factors in association with the racial and ethnic disparities in preterm birth. This research project will apply multilevel methods to investigate both individual-level measures of discrimination and institutional racism measured in the form of "redlining" (housing discrimination based on race) and residential segregation in association with maternal stress and preterm birth among pregnant women. The specific aims are to: (1) Explore the development of measures of institutional racism in the form of "redlining" and residential segregation by using The Home Mortgage Disclosure Act (HMDA) database and the US census among an urban population of pregnant women to test its association with maternal stress and preterm birth; (2) Understand the relationships between self-reported measures of individual personally-mediated discrimination and institutional measures of racism; and (3) Measure the associations between self-report of personally-mediated discrimination, institutional racism, stress and preterm birth among a group of women in an urban area. The primary hypothesis for the proposed study is that individual and institutional forms of racism are independently and jointly associated with stress and birth preterm birth. To test this hypothesis, a "redlining" measure will be explored from the HMDA database and an index for residential segregation will be explored and created from the US Census. Secondary multilevel logistic regression analyses will be conducted, linking individual-level data about perceived discrimination, maternal stress and other sociodemographic factors from the Stress, Pregnancy and Evaluation Community Project (SPEAC) with community-level data about "redlining" and residential segregation. SPEAC is a cross-sectional study of pregnant women linked to birth records based in Philadelphia, PA originally designed to understand the relationships between stress and bacterial vaginosis. Exploring institutional and structural community factors that influence perinatal health are of great public health importance. The findings from the proposed study will potentially provide recommendations for public health policy and interventions aiming to eliminate racial/ethnic disparities in preterm birth, which will also influence disparities in infant mortality in the US.

描述（由申请人提供）：本研究提案的长期目标是了解影响围产期健康和早产的社会和环境因素，超越个人风险因素和行为。以前的研究调查了种族歧视的个人层面上，但很少有研究探讨种族主义的制度措施，作为潜在的社会，与早产的种族和民族差异的背景因素。该研究项目将采用多层次方法，调查个人一级的歧视措施和制度性种族主义，其形式是“红线”（基于种族的住房歧视）和与产妇压力和孕妇早产有关的居住隔离。具体目标是：（1）利用《住房抵押贷款披露法》数据库和美国城市孕妇人口普查，探讨制定以“红线”和居住隔离为形式的制度性种族主义措施，以检验其与产妇压力和早产的关系;（2）了解自我报告的个人调解歧视措施与种族主义体制措施之间的关系;（3）测量某城市妇女群体中自我报告的个人介导的歧视、制度性种族主义、压力与早产之间的关联。这项拟议研究的主要假设是，个人和机构形式的种族主义是独立和共同与压力和出生有关 早产为了检验这一假设，将从HMDA数据库中探索一个“红线”措施，并从美国人口普查中探索和创建一个居住隔离指数。将进行二级多层次逻辑回归分析，将来自压力、怀孕和评估社区项目（SPEAC）的关于感知歧视、产妇压力和其他社会人口因素的个人层面数据与关于“红线”和居住隔离的社区层面数据联系起来。SPEAC是一项针对与出生记录相关的孕妇的横断面研究，最初旨在了解压力和细菌性阴道病之间的关系。探索影响围产期健康的制度和结构性社区因素具有重要的公共卫生意义。拟议研究的结果可能会为公共卫生政策和干预措施提供建议，旨在消除早产中的种族/民族差异，这也将影响美国婴儿死亡率的差异。