Migration, Dynamic Social Environments, and Birth Outcomes

移民、动态社会环境和出生结果

• 批准号: 10471423
• 负责人: Goleen Samari
• 金额: $ 13.08万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10471423
• 关键词: 37 weeks gestation; Address; Adolescence; Adult; Affect; Area; Attention; Attitude; Behavior Therapy; Big Data; Birth; Buffers; COVID-19; Cessation of life; Child; Child Health; Childhood; Consensus; Country; Data; Data Science; Demography; Destinations; Development; Educational Intervention; Environment; Ethnic Origin; Family; Generations; Growth; Health; Health system; Heterogeneity; Home; Immigrant; Immigration; Individual; Infant; Infant Mortality; Internet; Knowledge; Length of Stay; Life; Life Cycle Stages; Link; Low Birth Weight Infant; Maternal Health; Maternal and Child Health; Maternal-fetal medicine; Measures; Mentored Research Scientist Development Award; Mentors; Methodology; Methods; Migration Policy; Not Hispanic or Latino; Olives - dietary; Outcome; Pathway interactions; Perinatal Epidemiology; Personal Satisfaction; Plant Roots; Policies; Politics; Population; Pregnancy; Premature Birth; Prenatal care; Process; Qualitative Methods; Race; Reproductive Health; Research; Research Personnel; Risk; Risk Factors; Role; Shapes; Small for Gestational Age Infant; Social Environment; Social Policies; Societies; Socioeconomic Status; Stress; Surveys; System; Techniques; Testing; Training; United States; United States National Center for Health Statistics; Variant; Woman; adverse birth outcomes; base; career; child bearing; cost; experience; fetal; health disparity; improved; infancy; innovation; insight; migration; perinatal health; policy implication; reproductive; response; skills; social; social disadvantage; social factors; social integration; social stigma; stressor

PROJECT SUMMARY Adverse birth outcomes, such as preterm birth, low birth weight, and small for gestational age, have serious health consequences not just during infancy but across the life course. Past research shows an immigrant advantage in birth outcomes compared to women born in the United States; however, recent studies increasingly show that immigrant women have worse birth outcomes than non-Hispanic white women. Much research at the intersection of migration and reproductive, maternal, and child health has focused on individual exposures and risk factors. Yet there is growing evidence that structural factors such as migration policies are associated with health disparities, and there is limited understanding of the process by which social and policy environments impact individual-level maternal–fetal medicine outcomes. This K01 Mentored Research Scientist Development Award focuses on conceptualizing this structural context and its potential impact on women’s pregnancy and birth outcomes through pathways of structural stigma, social disadvantage, and spatial isolation. Three proposed areas of training will allow the candidate to develop an independent research career focused on migration and structural determinants of perinatal health: 1) perinatal epidemiology and demography, 2) spatial and data science techniques, and 3) qualitative methods. The specific aims will be achieved using National Center for Health Statistics period-linked infant birth–death data, the National Survey of Family Growth, and qualitative data on immigrant experiences of social and policy environments collected during the project period. These data will be used to carry out the following aims: 1) to examine multilevel effects of social and policy environments on foreign and US-born women’s pregnancy and birth outcomes, 2) to investigate area-level measures of social and policy environments and foreign and US-born women’s pregnancy and birth outcomes, and 3) to explore immigrant women’s experiences of stress due to social and policy environments at destination and their implications for birth outcomes. Expected outcomes are rigorous knowledge of the impact of structural contexts on pregnancy and birth outcomes as well as health system precursors of birth outcomes for immigrants in the US. Findings from this research can both identify immigrant responses to social and policy environments and suggest educational and behavioral interventions that could improve immigrant responses to structural environment stressors, access to prenatal care, and birth outcomes. Training and insights from this project will lead to development of a large-scale R01 study extending this line of research and will further help develop policies that promote maternal, perinatal, and child health.

项目摘要 不良出生结局，例如早产、低出生体重和小于胎龄，会造成严重的后果。 不仅在婴儿期，而且在整个生命过程中都会对健康产生影响。过去的研究表明， 与在美国出生的妇女相比，在出生结果方面具有优势;然而，最近的研究表明， 越来越多地表明，移民妇女的生育结果比非西班牙裔白色妇女更差。多 移徙与生殖、孕产妇和儿童健康交叉领域的研究侧重于个人 暴露和风险因素。然而，越来越多的证据表明，移民政策等结构性因素是 与健康差距有关，对社会和政策影响健康的过程了解有限。 环境影响个体水平的母胎医学结果。此K 01指导研究 科学家发展奖的重点是概念化这一结构背景及其潜在的影响， 妇女的怀孕和分娩结果通过结构性耻辱，社会劣势， 空间隔离。三个拟议的培训领域将允许候选人发展独立的研究 职业生涯侧重于移民和围产期健康的结构性决定因素：1）围产期流行病学和 人口统计学，2）空间和数据科学技术，以及3）定性方法。具体目标将是 使用国家卫生统计中心的婴儿出生-死亡数据，全国调查 家庭增长的数据，以及收集的关于移民在社会和政策环境中的经历的定性数据 在项目期间。这些数据将用于实现以下目标：1）检查多层次 社会和政策环境对外国和美国出生的妇女怀孕和分娩结果的影响，2） 调查社会和政策环境以及外国和美国出生的妇女 怀孕和分娩结果，3）探讨移民妇女的压力，由于社会和 目的地的政策环境及其对生育结果的影响。预期成果严谨 了解结构背景对怀孕和分娩结果以及卫生系统的影响 美国移民出生结果的前兆。这项研究的结果既可以识别移民 对社会和政策环境的反应，并建议教育和行为干预， 改善移民对结构性环境压力因素的反应，获得产前护理和生育结果。 该项目的培训和见解将导致大规模R 01研究的开发， 研究，并将进一步帮助制定促进孕产妇、围产期和儿童健康的政策。