An assessment of environmental and neighborhood-level risk factors for subfertility among Black women in the U.S.

对美国黑人女性生育力低下的环境和社区风险因素的评估

基本信息

批准号：
10636026
负责人：
Amelia Kent Wesselink
金额：
$ 40.48万
依托单位：
BOSTON UNIVERSITY MEDICAL CAMPUS
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-10 至 2028-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10636026
关键词：
Address Affect Air Pollution Aircraft American Assisted Reproductive Technology Black race Body mass index Caring Censuses Classification Clinic Color Communities Conceptions Couples Data Data Set Disparity Disparity population Economics Education Employment Enrollment Environment Environmental Exposure Environmental Hazards Environmental Health Environmental Pollution Equity Exposure to Factor Analysis Female infertility Fertility Fertility Study Government Government Programs Green space Health Human Income Inequality Inequity Infertility Intention Intervention Investments Life Cycle Stages Link Live Birth Maps Measures Medical Methods Modeling Modernization National Institute of Environmental Health Sciences Neighborhoods Nitrogen Dioxide Noise Occupations Outcome Ozone Participant Particulate Matter Pathway interactions Pattern Planned Pregnancy Policies Pregnancy Pregnancy Histories Principal Component Analysis Prospective, cohort study Public Health Race Recording of previous events Reporting Reproduction Reproductive Health Research Risk Risk Assessment Risk Factors Scholarship Shapes Societies Socioeconomic Status Statistical Methods Stereotyping Time Toxic Environmental Substances Treatment outcome United States Woman Women&apos s Health Work aged black women cohort early pregnancy environmental health disparity epidemiology study experience hazard health disparity health equity high risk indexing infertility treatment meter neighborhood disadvantage novel racial disparity racism recruit reproductive reproductive epidemiology research clinical testing residential segregation segregation shift work social socioeconomic disadvantage structural determinants study population subfertility success theories time-to-pregnancy trying to conceive virtual

项目摘要

PROJECT SUMMARY Infertility is an important public health problem that affects up to 15% of reproductive-aged couples in the United States. Black women experience infertility at approximately two times the rate of white women, yet are less likely to seek medical care and have poorer fertility treatment outcomes. Despite this disparity, epidemiologic research on infertility has largely been conducted among economically privileged white couples seeking treatment at fertility clinics. Studies of fertility that enroll women during preconception or early pregnancy have likewise had limited success in recruiting Black women. Thus, there has been virtually no study of causes of infertility in Black women. Racial residential segregation and racialized patterns of neighborhood investment and disinvestment have resulted in inequitable burdens of spatially-distributed environmental exposures on communities of color. In the present proposal, we examine several exposures of high relevance to Black women, with a focus on environmental and neighborhood-level exposures. We will use data from the Black Women’s Health Study (BWHS), the largest study in existence focusing on the health of Black women. BWHS recruited 59,000 Black women from the United States in 1995 and have followed them biennially for over 25 years. Outcome information was collected retrospectively in 2011, when women reported information on time-to-pregnancy (TTP) for each of their planned pregnancies that ended in a live birth, whether they had ever tried to conceive for >12 months without success, and if so, what cause was identified. We will use these data to examine the association of TTP, infertility, and cause-specific infertility, with 1) historical redlining, a 1930s government sponsored policy in which neighborhoods were classified by investment risk based largely on the presence of Black residents, 2) residential racial and economic segregation and neighborhood socioeconomic status, and 3) residential environmental exposures (including air pollution, green space, and environmental noise). Finally, we will explore how redlining grades are associated with patterns of neighborhood disadvantage and environmental pollution and how mixtures of social and environmental exposures are related to fertility. Exposures will be derived from linkage between BWHS participant addresses (collected biennially from 1995-2011) with geospatial data sets. The proposed study is likely to have a large and sustained impact on the fields of reproductive epidemiology, environmental health, and health disparities. The centering of Black women in infertility research advances health equity, combats racist stereotypes that propagate the idea that infertility is a non-issue for Black women, and allows for the identification of opportunities for intervention to reduce and eliminate infertility disparities. This will be the first study to focus on causes of infertility in Black women, and is highly relevant for understanding how the environment shapes human reproduction.

项目摘要不育是一个重要的公共卫生问题，影响多达15％的生殖夫妇美国。黑人妇女的不孕症大约是白人妇女的两倍，但寻求医疗服务的可能性较小，生育治疗结果较差。尽管存在这种差异，关于不育的流行病学研究主要是在经济特权的白人夫妇中进行的在生育诊所寻求治疗。研究孕妇或早期妇女的生育能力的研究怀孕在招募黑人妇女方面的成功同样有限。那几乎没有研究黑人妇女不孕的原因。种族居住隔离和种族化模式邻里的投资和投资导致了空间分布的伯恩斯不平等环境暴露于有色社区。在本提案中，我们研究了与黑人妇女相关，重点是环境和邻里水平的暴露。我们将使用来自黑人妇女健康研究（BWHS）的数据，这是现有的最大研究，重点是黑人妇女。 BWHS于1995年从美国招募了59,000名黑人妇女，并跟随他们两年一度超过25年。结果信息是在2011年回顾性收集的，当时妇女报告有关其计划的怀孕的预期时间（TTP）的信息，以现场出生结束，他们是否曾经尝试过构想> 12个月而没有成功的话，如果是的，则发现了什么原因。我们将使用这些数据来检查TTP，不育和特定原因的不孕症的关联，与1）历史红线，1930年代政府赞助政策，在该政策中，社区被归类为投资风险主要基于黑人居民的存在，2）居民种族和经济学种族隔离和邻里社会经济地位，以及3）居民环境暴露（包括空气污染，绿色空间和环境噪声）。最后，我们将探讨如何相关的红利等级邻里灾难和环境污染的模式以及社会和社会混合环境暴露与生育有关。曝光将来自BWH之间的联系参与者的地址（从1995年至2011年每两年收集），其地理空间数据集。拟议的研究是可能对生殖流行病学，环境健康，环境健康，环境健康领域产生巨大的影响和健康差异。在不育研究中，黑人妇女的中心促进了健康平等，打击种族主义刻板印象传播了不育对黑人妇女来说是不问题的观念，并允许识别干预机会减少和消除不育差异的机会。这将是第一个研究专注于黑人妇女不育的原因，并且与了解如何了解环境塑造人类的繁殖。