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

抽象的。美国黑人女性死于怀孕的可能性是男性的三到四倍-- 与白人妇女相比，这一差距持续了50年。妊娠期 糖尿病(GDM)和妊娠期高血压疾病(HDP)在怀孕期间不成比例地发展 这对黑人妇女的健康和怀孕后数年的心脏代谢健康有负面影响。按性别划分 种族主义是种族主义和性别歧视的混合现象，它交织在一起，创造了一种独特的压迫形式，是一种 这是黑人妇女所经历的长期压力，也是造成持续健康差距的原因之一。然而， 有关性别种族主义对健康影响的经验证据仍处于萌芽阶段。心理韧性有 已被发现可以预防不良妊娠结局，但黑人女性从这种弹性中受益较少 资产。对复原力的文化相关性更高的理解，包括个人层面(心理 复原力和灵性)和家庭层面(家庭支持)将在本研究中探讨。总的目的 这项研究的目的是检查性别种族主义经历、韧性和高危之间的关系 黑人女性的怀孕率。全国青少年到成人健康纵向研究的数据 用于评估黑人妇女中的性别种族主义、高危怀孕和复原力的经历 至少有一次妊娠(N=2,153)。目标是：目标1.确定潜在的妇女亚群体 由四个指标决定的不同性别种族主义经历(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)。目的2.确定高危人群病史的关系 妊娠(妊娠期糖尿病/妊娠高血压综合征，病例与对照)与性别种族主义经历相比较 潜在亚组，与慢性高血压、糖尿病(1型或2型)、体重指数、 教育和收入。目的3.描述高危妊娠史与性别的关系 成年期的种族主义经历与复原力来源(个人和家庭)有关，在慢性疾病中是不同的 高血压、糖尿病(1型或2型)、体重指数、教育水平和收入。潜伏期分析 将被用来确定具有不同性别种族主义经历的黑人妇女的亚群。双变量AND 将使用协变量调整的多项Logistic回归方法来确定相关性 在高危怀孕和性别种族主义亚群经历之间。协变量调整倍数 将进行回归分析，以检查高危妊娠与性别种族主义亚群的关系 适应能力的体验。这项研究使用了一种创新的方法，将两者结合在一起 人与人之间和结构性的性别种族主义，以量化#年所经历的压迫的多方面性质 黑人妇女以及与文化相关的复原力概念。这些发现将加强 了解性别种族主义的健康后果，并为今后的多层面研究提供信息 采取干预措施打击系统性不平等并培养复原力。

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.