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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.

项目概要不孕不育是一个重要的公共卫生问题，影响着高达 15% 的育龄夫妇。美国。黑人女性的不孕率大约是白人女性的两倍，但寻求医疗护理的可能性较小，生育治疗结果也较差。尽管存在这种差距，关于不孕不育的流行病学研究主要是在经济条件优越的白人夫妇中进行的在生育诊所寻求治疗。在受孕前或早期招募女性的生育力研究怀孕在招募黑人女性方面同样取得了有限的成功。因此，几乎没有黑人妇女不孕原因的研究。种族居住隔离和种族化模式邻里投资和撤资导致了空间分布的不公平负担有色人种社区的环境暴露。在本提案中，我们研究了几项暴露与黑人女性高度相关，重点关注环境和社区层面的暴露。我们将使用数据来自黑人妇女健康研究 (BWHS)，这是现有最大的关注黑人妇女健康的研究黑人女性。 BWHS 于 1995 年从美国招募了 59,000 名黑人女性并跟踪她们每两年一次，已有超过 25 年的历史。结果信息是在 2011 年回顾性收集的，当时妇女报告每次计划怀孕并最终活产的怀孕时间 (TTP) 信息，他们是否曾经尝试怀孕超过 12 个月但没有成功，如果是，查明原因是什么。我们将使用这些数据来检查 TTP、不孕症和特定原因不孕症的关联，其中 1) 历史红线，20世纪30年代政府发起的一项政策，其中社区按照投资风险主要基于黑人居民的存在，2）居住种族和经济隔离和邻里社会经济地位，以及 3) 住宅环境暴露（包括空气污染、绿地和环境噪音）。最后，我们将探讨红线等级是如何关联的邻里劣势和环境污染的模式以及社会和环境的混合如何环境暴露与生育能力有关。风险暴露将源自 BWHS 之间的联系参与者地址（1995-2011 年每两年收集一次）和地理空间数据集。拟议的研究是可能对生殖流行病学、环境健康、和健康差异。以黑人妇女为中心的不孕不育研究促进了健康公平，对抗种族主义刻板印象传播这样一种观念，即不孕不育对黑人妇女来说不是问题，并允许确定干预机会，以减少和消除不孕不育的差异。这将是第一个这项研究的重点是黑人女性不孕的原因，并且对于了解环境决定人类的繁衍。