Structural Racism and Adverse Birth Outcomes in the US South: A Multigenerational Perspective

项目摘要摘要 人们认为，长期的物质匮乏和日常歧视的“磨损”是关键的社会因素 为黑人妇女糟糕的生育结局做出贡献。这些进程植根于结构性种族主义， 这是一个更大的政策、实践、意识形态和制度体系，通过以下方式强化种族不平等 创造对资源和机会的差异化访问。然而，到目前为止，大多数关于结构的研究 种族主义和不良生育结果只考虑了产妇暴露于结构性疾病的一个或两个方面 在单一的时间点上，种族主义，从而低估了其对黑人妇女生育结果的贡献。这个 该项目的目标是研究多代人暴露于结构性种族主义对生育的影响。 在美国南部黑人女性中的结果。我们将测量多个维度的风险敞口 南卡罗来纳州黑人祖母和同一家庭中的母亲的结构性种族主义，并确定他们的 与儿童不良出生结局(低出生体重、早产、小于胎龄)的关系。我们 将生成一个独特的、综合的1989-2020年间出生的数据集，这些数据集与母系相关联 并与衡量结构性种族主义不同层面的多个行政数据来源合并。这个 拟议的项目将：(1)量化黑人妇女受到结构性种族主义四个方面的影响；(2)审查 结构性种族主义的四个维度与不良生育结果之间的联系 跨几代黑人母亲；以及(3)评估结构性种族主义对黑人/白人的贡献 不良生育结局的差异。拟议中的研究将使这一领域超越个人层面。 干预措施侧重于可改变的风险因素，这些因素还不足以改善黑人妇女的生育 结果。由于黑人女性在获得商品、服务和机会方面面临结构性障碍， 重点必须向上游转移。通过系统地检查结构性种族主义的多个维度 世世代代，我们将对影响黑人妇女出生的不成比例的因素有重要的洞察 随着时间的推移而产生的结果。从这项研究中获得的知识将指导政策制定者关于 (例如，刑事司法、教育)，在这些部门采取干预措施，改善黑人母亲的生育结果。

Project Summary Abstract Chronic material deprivation and the ‘wear and tear’ of everyday discrimination are key social factors thought to contribute to Black women’s poor birth outcomes. These processes are embedded within structural racism, which is the larger system of policies, practices, ideologies, and institutions that reinforces racial inequality by creating differential access to resources and opportunities. To date, however, most research on structural racism and poor birth outcomes considers maternal exposure to only one or two dimensions of structural racism, at a single point in time, thereby underestimating its contribution to Black women’s birth outcomes. The goal of this project is to examine the effects of multigenerational exposure to structural racism on birth outcomes among Black women in the US South. We will measure exposure to multiple dimensions of structural racism for South Carolina Black grandmothers and mothers in the same family, and determine their relationship to children’s adverse birth outcomes (low birth weight, preterm birth, small for gestational age). We will generate a unique, integrative dataset of births between 1989-2020 that are linked along the maternal line and merged with multiple administrative data sources measuring different dimensions of structural racism. The proposed project will: (1) quantify Black women’s exposure to four dimensions of structural racism; (2) examine the association between the four dimensions of structural racism and adverse birth outcomes both within and across generations of Black mothers; and (3) assess the contribution of structural racism to the Black/White disparity in adverse birth outcomes. The proposed study will move the field beyond individual-level interventions focused on modifiable risk factors, which have not been sufficient to improve Black women’s birth outcomes. Because Black women face structural barriers to accessing goods, services, and opportunities, the focus must shift upstream. By systematically examining multiple dimensions of structural racism across generations, we will gain important insight into the factors that disproportionately affect Black women’s birth outcomes over time. Knowledge gained from this study will guide policy-makers’ decisions regarding possible sectors (e.g., criminal justice, education) in which to intervene to improve birth outcomes for Black mothers.