The Effects of Intersecting Identity and Social Determinants of Health on Afro-Latina Maternal Morbidity and Infant Birth Outcomes in Florida

交叉身份和健康的社会决定因素对佛罗里达州非裔拉丁裔孕产妇发病率和婴儿出生结果的影响

• 批准号: 10749549
• 负责人: Alexa mercedes Parra
• 金额: $ 4.54万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10749549
• 关键词: Address; Adult; Age; Award; Birth; Birth Weight; Black Populations; Black race; Body mass index; Categories; Characteristics; Child; Data; Development; Diabetes Mellitus; Disadvantaged; Discrimination; Disparity; Ethnic Origin; Ethnic Population; Fellowship; Florida; Foundations; Gestational Diabetes; Goals; Growth; Health; Heterogeneity; Hispanic; Hispanic Populations; Hypertension; Individual; Inequity; Infant; Infant Health; Intervention; Latina; Latina Population; Latino; Latino Population; Learning; Literature; Low Birth Weight Infant; Maternal Health; Maternal and Child Health; Measures; Mentorship; Methodology; Minority; Mothers; Neighborhoods; Nurses; Outcome; Perinatal; Persons; Pre-Eclampsia; Pregnancy; Premature Birth; Prenatal care; Race; Racial Segregation; Registered nurse; Research; Research Methodology; Research Personnel; Scientist; Small for Gestational Age Infant; Subgroup; Training; Translating; United States; Vital Statistics; Vulnerable Populations; Woman; Work; adverse birth outcomes; black women; career; career development; child bearing; data management; delivery complications; deprivation; ethnic identity; experience; fighting; health disparity; health equity; health inequalities; improved; innovation; intersectionality; low socioeconomic status; maternal morbidity; maternal risk; neighborhood disadvantage; perinatal outcomes; prepregnancy; racial disparity; racial population; racism; reproductive; research and development; residential segregation; skills; skills training; skin color; social health determinants; stressor; theories; women of color

ABSTRACT Afro-Latinos make up 12% of the Latino population, rapidly increasing in the US, with approximately 6 million Afro-Latinos adults in 2020. Notably, over two-thirds are of reproductive age, emphasizing the importance of including this group when examining health outcomes related to maternal and child health. Most of the existing literature on maternal and infant health disparities in the US has identified ethnicity and race as mutually exclusive categories, e.g., non-Latino Black vs Latino.Afro-Latinas may be disadvantaged in health outcomes due to the intersectionality of multiple minority identities. Little is known about the perinatal outcomes for women who are both Black and Latina. It is well established in the literature that women of color, particularly non-Latina Black women, experience detrimental social determinants of health, such as structural barriers, racism, discrimination, and residential racial segregation. However, the burden of these barriers is not well understood among Afro-Latinas who may be experiencing distinctive stressors of societal disadvantages based on race and skin color. Guided by Intersectionality Theory, this proposal aims to determine if Afro-Latinas mothers and their infants are at increased risk of maternal morbidities and adverse birth outcomes compared to childbearing women of other racial/ethnic identities through two specific aims: 1) Determine differences in maternal morbidity (pregnancy-related hypertension, pregnancy-related diabetes) and infant birth outcomes (birth weight, preterm birth) among Afro-Latinas in Florida compared to White Latina, non-Latina Black, and non- Latina White mothers and their infants. (2) Examine the effects of residential racial segregation, neighborhood deprivation, and prenatal care utilization with maternal morbidity and infant birth outcomes among Afro-Latinas in Florida compared to women of other racial/ethnic identities. This research will use data from the Florida Vital Statistics (2004-2022) with Afro-Latina mothers and their infants (n=176,040) compared to childbearing women of other racial/ethnic identities (n=3,805,588). The accompanying career training plan will provide a foundation for me to (1) Expand my expertise in the social determinants of health and health equity for Afro- Latina mothers and their children (2) Develop methodological, analytic, and data management skills in multi-level data research methods (3) Expand career development and interdisciplinary team skills and accomplish professional development goals. My interdisciplinary mentorship team will guide me throughout this award. The career development and research plan will support my growth as an independent nurse scientist examining maternal- child health disparities. This proposal provides an innovative perspective directly aligned with the NINR’s aim to address social determinants of health barriers that place vulnerable populations, like Afro-Latinas, at avoidable health disadvantages.

摘要 非洲裔拉丁美洲人占拉丁美洲人口的12%，在美国迅速增加，约有600万 2020年的非洲裔拉丁美洲成年人值得注意的是，超过三分之二的人处于生育年龄，这突出表明， 在审查与孕产妇和儿童健康有关的健康成果时，将这一群体包括在内。大多数现有 关于美国母婴健康差异的文献已经确定种族和种族是相互的。 专有类别，例如，非拉丁裔黑人与拉丁裔。非裔拉丁裔可能在健康结果方面处于不利地位 由于多重少数民族身份的交叉性。对妇女的围产期结局知之甚少 黑人和拉丁裔在文学作品中，有色人种的女性，特别是非拉丁裔女性， 黑人妇女经历着有害的健康社会决定因素，如结构性障碍、种族主义、 种族歧视和居住地种族隔离。然而，这些障碍的负担并没有得到很好的理解 在非洲裔拉丁美洲人中，他们可能正在经历基于种族的社会不利因素的独特压力， 肤色在交叉性理论的指导下，该提案旨在确定非洲裔拉丁美洲母亲和 他们的婴儿在产妇发病率和不良出生结果的风险增加相比， 其他种族/民族身份的育龄妇女通过两个具体目标：1）确定 产妇发病率（妊娠高血压、妊娠糖尿病）和婴儿出生结果 （出生体重，早产）之间的非裔拉丁人在佛罗里达相比，白色拉丁美洲，非拉丁美洲黑人，和非 拉丁裔白色母亲和她们的婴儿。(2)研究住宅种族隔离的影响，邻里 贫困和产前护理利用与孕产妇发病率和婴儿出生结果 在佛罗里达与其他种族/民族身份的妇女相比。这项研究将使用来自佛罗里达Vital 2004-2022年拉丁美洲黑人母亲及其婴儿（n= 176 040）与育龄妇女的统计数据 其他种族/民族身份（n= 3，805，588）。随附的职业培训计划将提供基础 对我来说，（1）扩大我在非裔拉丁母亲健康和健康公平的社会决定因素方面的专业知识， （2）在多层次数据研究中培养方法论、分析和数据管理技能 方法（3）拓展职业发展和跨学科团队技能， 发展目标我的跨学科导师团队将在整个颁奖过程中指导我。职业 发展和研究计划将支持我成长为一个独立的护士科学家检查产妇- 儿童健康差距。该提案提供了一个创新的视角，直接符合NINR的目标， 解决健康障碍的社会决定因素，这些因素使拉丁美洲黑人等弱势群体处于可以避免的境地， 健康不利因素。