Gendered Racism Profiles, Resilience, and High-Risk Pregnancies Among Black Women

黑人女性的性别种族主义概况、复原力和高风险怀孕

• 批准号: 10748022
• 负责人: Shewit Jaynes
• 金额: $ 5.02万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10748022
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Age; Automobile Driving; Binding; Birth; Body mass index; Cardiovascular Diseases; Chronic; Data; Diabetes Mellitus; Discrimination; Disparity; Education; Educational Status; Environment; Exposure to; Family; Fostering; Future; Gender; Gestational Diabetes; Goals; Growth; Health; High Prevalence; High-Risk Pregnancy; Hybrids; Hypertension; Income; Individual; Inequality; Inequity; Intervention; Joints; Latina; Link; Literature; Logistic Regressions; Longitudinal Studies; Maternal Health; Maternal Mortality; Mediator; Mental Health; Methodology; Mission; National Institute of Nursing Research; National Longitudinal Survey of Adolescent to Adult Health; Nature; Nurses; Outcome; Play; Pregnancy; Pregnancy Histories; Pregnancy Outcome; Race; Recording of previous events; Recovery; Reporting; Research; Resistance; Risk; Risk Factors; Role; Scientist; Sexism; Societies; Source; Spirituality; Stress; Structural Racism; Subgroup; United States; Woman; adverse pregnancy outcome; allostatic load; black men; black subgroup; black women; cardiometabolism; case control; cellular resilience; classism; combat; disease disparity; experience; family support; health disparity; health equity; health inequalities; improved; innovation; insight; intersectionality; maternal morbidity; perceived discrimination; physical conditioning; population health; pregnancy disorder; prevent; psychologic; racial discrimination; racism; resilience; social health determinants; stressor

ABSTRACT. Black women in the United States are three to four times more likely to die from pregnancy- related causes than White women, a disparity that has persisted for the past five decades. Gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP) disproportionately develop in the pregnancies of Black women and negatively impact cardiometabolic health in the years following pregnancy. Gendered racism, a hybrid phenomenon of racism and sexism that interlocks to create a unique form of oppression, is a chronic stressor experienced by Black women and contributes to ongoing health disparities. However, the empirical evidence on the health implications of gendered racism is still nascent. Psychological resilience has been found to protect against adverse pregnancy outcomes, yet Black women benefit less from such resilience assets. A more culturally relevant understanding of resilience incorporating the individual-level (psychological resilience and spirituality) and family-level (family support) will be explored in this study. The overall purpose of this study is to examine the relationships between gendered racism experiences, resilience, and high-risk pregnancies among Black women. Data from the National Longitudinal Study of Adolescent to Adult Health will be used to assess experiences of gendered racism, high-risk pregnancy, and resilience among Black women with at least one pregnancy (N = 2,153). The aims are to: Aim 1. Identify latent subgroups of women with different gendered racism experiences determined by four indicators (structural sexism, interpersonal sexism, structural racism, and interpersonal racism). Aim 2. Determine the relationship of history of a high-risk pregnancy (GDM/HDP, cases vs controls) with gendered racism experiences characterizing the identified latent subgroups, covarying for chronic hypertension, diabetes (type 1 or 2), body mass index, level of education, and income. Aim 3. Describe the association of history of a high-risk pregnancy and gendered racism experiences with sources of resilience (individual and family) during adulthood, covarying for chronic hypertension, diabetes (type 1 or 2), body mass index, level of education, and income. Latent profile analysis will be used to identify subgroups for Black women with different gendered racism experiences. Bivariate and covariate-adjusted multinominal logistic regression approach will be used to determine the association between high-risk pregnancy and gendered racism subgroup experiences. Covariate-adjusted multiple regression will be conducted to examine the relationship of high-risk pregnancy and gendered racism subgroup experiences with resilience. This study uses an innovative methodological approach that integrates both interpersonal and structural gendered racism to quantity the multifaceted nature of oppression experienced by Black women along with a culturally relevant conceptualization of resilience. The findings will enhance the understanding of the health consequences of gendered racism and inform future research on multi-level interventions to combat systemic inequalities and foster resilience.

抽象的。美国黑人女性死于怀孕的可能性是黑人女性的三到四倍 相关原因的相关性高于白人女性，这种差距在过去五年中一直持续存在。妊娠期 糖尿病（GDM）和妊娠期高血压疾病（HDP）在妊娠期发病率不成比例 黑人女性的健康状况，并对怀孕后几年的心脏代谢健康产生负面影响。性别化 种族主义是种族主义和性别歧视的混合现象，它们相互交织，形成了一种独特的压迫形式， 黑人女性经历的慢性压力源，并导致持续的健康差异。然而， 关于性别种族主义对健康影响的经验证据仍处于起步阶段。心理承受能力有 研究发现可以防止不良妊娠结局，但黑人女性从这种恢复力中受益较少 资产。对复原力的理解更具文化相关性，纳入个人层面（心理层面） 本研究将探讨复原力和灵性）和家庭层面（家庭支持）。总体目的 这项研究的目的是探讨性别种族主义经历、复原力和高风险之间的关系 黑人妇女怀孕。来自全国青少年至成人健康纵向研究的数据将 用于评估黑人女性遭受性别种族主义、高风险怀孕和复原力的经历 至少怀孕过一次 (N = 2,153)。目标是： 目标 1. 识别患有以下疾病的潜在女性亚群： 由四个指标（结构性性别歧视、人际性别歧视、 结构性种族主义和人际种族主义）。目标 2. 确定高风险病史的关系 怀孕（GDM/HDP，病例与对照）与性别种族主义经历的特征 潜在亚组，慢性高血压、糖尿病（1 型或 2 型）、体重指数、糖尿病水平的共变 教育程度、收入。目标 3. 描述高危妊娠史与性别之间的关联 成年期间遭受种族主义经历与复原力来源（个人和家庭），长期共变 高血压、糖尿病（1 型或 2 型）、体重指数、教育水平和收入。潜在概况分析 将用于确定具有不同性别种族主义经历的黑人女性亚群体。双变量和 将使用协变量调整的多项逻辑回归方法来确定关联性 高风险怀孕和性别种族主义亚群体经历之间的关系。协变量调整倍数 将进行回归分析以检验高危妊娠与性别种族主义亚组之间的关系 具有韧性的经验。这项研究采用了一种创新的方法论，将两者结合起来 人际和结构性性别种族主义来量化所经历的压迫的多方面性质 黑人女性以及与文化相关的复原力概念。研究结果将增强 了解性别种族主义对健康的影响，并为未来的多层次研究提供信息 采取干预措施消除系统性不平等并增强复原力。