RACE AND ETHNIC DIFFERENTIALS IN BIRTH OUTCOMES

鉴于已知的不平等现象以及少数民族的迅速增长 人口(其中大部分增长是由于移民)，研究人员 政策制定者对健康需求越来越感兴趣， 种族/族裔和土生土长群体的问题和进步。然而， 比较拉美裔和亚洲人出生结局的多变量模型 非西班牙裔黑人和非西班牙裔白人在美国很少见， 部分原因是直到最近，很少有数据集存在 足够大，可以分析多个种族/民族人口。 因此，这项提案的总体目标是首先审查 我们所知道的时间，种族/民族，出生和广泛的 人口统计、社会经济和生物医学因素对怀孕的影响 11个种族/民族的结果(出生结果和婴儿死亡率) 使用具有全国代表性的大型数据集的小组。具体目标 包括：(1)记录11个人之间目前的妊娠结局差异 使用最新的国家卫生中心的种族/民族人口 卫生统计(NCHS)将全年出生/婴儿死亡数据联系在一起 美国(2)探讨妊娠结局是否在多大程度上以及原因 不同种族/民族的移民与他们的美国移民不同- 与生俱来的对手。(3)模拟以下方面的直接和间接影响 人口统计、社会经济、产妇健康、行为和生物医学 危险因素对出生结局的影响，并决定是否方向和 风险因素的影响程度因特定种族/民族而异。 团体和降生地。(4)建立直接和间接影响的模型， 相同危险因素的婴儿死亡风险控制近似值 风险，包括出生结果。除了总体目标之外 分析本身是创新的，因为它建立在扩展的 概念方案和测量策略，允许(1)识别 常规方法检测不到的不良分娩结局 人口统计学方法和(2)对人口统计学方法的差异影响的估计 不同结果的风险因素以及这些影响的任何交互作用 与种族/民族有关。

In light of known inequities as well as the rapid growth of minority populations (with much of the increase due to immigration), researchers and policy markers are increasingly interested in the health needs, problems, and progress of race/ethnic and nativity groups. However, multivariate models of birth outcomes comparing Hispanics and Asians with non-Hispanic blacks, and non-Hispanic whites in the U.S. are rare, partially because until recently, few data sets have existed which are large enough to allow analysis of more than a few race/ethnic populations. Thus, the general objective of this proposal is to examine, for the first time to our knowledge, the effects of race/ethnicity, nativity, and a wide range of demographic, socioeconomic, and biomedical factors on pregnancy outcomes (both birth outcomes and infant mortality) among 11 race/ethnic groups using a large, national representative data set. Specific aims include: (1) Document current pregnancy outcome differentials among 11 race/ethnic populations using the most recent National Center for Health for Health Statistics (NCHS) linked birth/infant death data for the entire U.S. (2) Explore whether, to what extent, and why, pregnancy outcomes of immigrants of various race/ethnic groups differ from those of their U.S.- born counterparts. (3) Model the effects, both direct and indirect, of demographic, socioeconomic, maternal health, behavioral, and biomedical risk factors on birth outcomes and determine whether the direction and magnitude of the effects of risk factors vary across specific race/ethnic groups and by nativity. (4) Model the effects, both direct and indirect, of the same risk factors of infant mortality risk controlling proximate risks, including birth outcomes. In addition to the general objective itself, the analysis is innovative in that it builds on an expanded conceptual scheme and measurement strategy that allows (1) identification of adverse birth outcomes that would go undetected with conventional demographic methods and (2) estimation of differential effects of the same risk factors on different outcomes and any interaction of these effects with race/ethnicity.