RACE AND ETHNIC DIFFERENTIALS IN BIRTH OUTCOMES

鉴于已知的不平等以及少数民族的迅速增长， 人口（大部分增长是由于移民），研究人员 政策制定者越来越关注健康需求， 种族/族裔和出生群体的问题和进展。然而，在这方面， 多变量模型的出生结果比较西班牙裔和亚洲人， 在美国，非西班牙裔黑人和非西班牙裔白人是罕见的， 部分原因是直到最近，很少有数据集存在， 大到足以允许分析多个种族/族裔群体。 因此，本提案的总体目标是审查，首先， 时间，以我们的知识，种族/民族的影响，出生，和广泛的 一系列人口统计学、社会经济学和生物医学因素对妊娠的影响 11个种族/民族的结局（出生结局和婴儿死亡率） 使用大型国家代表性数据集的团体。具体目标 包括：（1）记录11个 使用最新的国家卫生中心的种族/民族人群 全国卫生统计局（NCHS）的出生/婴儿死亡数据 美国(2)探讨是否，在何种程度上，以及为什么， 不同种族/民族的移民与他们的美国移民不同， 天生的对手(3)模拟直接和间接的影响， 人口、社会经济、孕产妇健康、行为和生物医学 风险因素，并确定是否方向和 风险因素的影响程度在特定人种/种族之间存在差异 组和出生。(4)模拟直接和间接的影响， 婴儿死亡风险的相同危险因素， 风险，包括生育结果。除了总体目标外， 分析本身是创新的，因为它建立在一个扩展的 概念方案和测量战略，允许（1）识别 传统的分娩方式无法检测到的 人口统计学方法和（2）估计相同的差异效应 不同结局的风险因素以及这些影响的任何相互作用 种族/民族。

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.