Doctoral Disseratation Research: Living the "Latina Paradox": An Ethnography of Pregnant Latinas in Cleveland, Ohio

尽管拉丁美洲妇女（拉丁裔）属于低收入群体，受教育程度和获得医疗保健的机会都很低，但她们的婴儿健康结果（如婴儿死亡率和出生体重）与白人相似，后者通常受教育程度更高，收入更高，获得医疗保健的机会也更多。流行病学家将拉丁裔婴儿意想不到的积极健康结果称为“拉丁悖论”。研究表明，与第二代美国出生的拉丁裔相比，移民拉丁裔和第一代美国出生的拉丁裔更有可能有积极的生育结果。此外，随着在美国出生的每一代人和文化适应率的提高，拉丁裔婴儿的健康状况也在下降，不再能反映白人的健康状况。凯斯西储大学医学人类学博士生的这篇论文研究将试图了解是什么保护了俄亥俄州克利夫兰的墨西哥妇女免受婴儿健康状况不佳的影响，以及是什么侵蚀了每一代人，使她们面临更大的不健康风险。利用从案例研究、人种学访谈和结构化问卷中收集的数据，该项目将确定墨西哥妇女的种族/少数民族身份、移民身份和世代是否以及在多大程度上可能影响她们使用非正式产前护理(例如，使用非生物医学提供者、未认证/非专业助产士、家人/朋友、以及草药医生)和/或医学上多元化的妊娠管理做法（例如非正式+生物医学），这些做法实际上可能保护墨西哥移民和第一代美国出生的妇女免受婴儿健康状况不佳的影响。这个拟议的项目不仅将有助于关于生殖、拉丁裔和移民的人类学学术研究，而且还将建立在先前在公共卫生和流行病学方面进行的工作的基础上。这项拟议研究的更广泛影响是，它将提供一个非常需要的、更清晰的理解，即社会文化因素如何促成“拉丁裔悖论”；卫生保健提供者、政策制定者和公众将会非常感兴趣的新知识。此外，这项研究将进一步教育和培养博士生。

Even though Latin American women (Latinas) represent a low-income group, maintain low education rates and low access to healthcare, their infant health outcomes (e.g. infant mortality and birth weight) resemble those of whites who generally have more education, higher income, and improved access to care. Epidemiologists refer to Latinas' unexpected positive infant health outcomes as the "Latina paradox." Studies suggest that immigrant Latinas and first generation US-born Latinas are more likely to have positive birth outcomes when compared to second generation US-born Latinas. In addition, with each US-born generation and increasing rates of acculturation, Latinas' infant health outcomes decline and no longer mirror those of whites. This dissertation research by a medical anthropology doctoral student from Case Western Reserve University will seek to understand what it is that protects Mexican women in Cleveland, Ohio from poor infant health outcomes, and what it is that erodes with each generation that places them at greater risk of having unhealthy outcomes. Using data gathered from case studies, ethnographic interviews, and structured questionnaires, this project will determine whether and to what extent Mexican women's ethnic/minority identity, immigrant status, and generation may impact their use of informal prenatal care (e.g. use of non-biomedical providers, uncertified/lay midwives, family/friends, and herbalists) and/or medically pluralistic pregnancy management practices (e.g. informal + biomedical) which may in fact protect Mexican immigrant and first generation US-born women from poor infant health outcomes. This proposed project will not only contribute to the anthropological scholarship on reproduction, Latinos, and migration, but it will also build upon previous work conducted in public health and epidemiologyA broader impact of this proposed research is that it will provide a much needed and clearer understanding of how sociocultural factors contribute to the "Latina paradox"; new knowledge that will be of great interest to health care providers, policy makers, and the general public. Additionally, this research will further the education and training of a doctoral student.