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

摘要 非洲裔拉美人占拉美裔人口的12%，在美国迅速增长，约有600万人 2020年非洲裔拉美裔成年人。值得注意的是，超过三分之二的人处于生育年龄，强调 在审查与孕产妇和儿童健康有关的健康结果时，将这一群体包括在内。大多数现有的 关于美国母婴健康差距的文献认为，种族和种族是相互作用的 排他性类别，例如，非拉丁裔黑人VS拉丁裔。非裔拉丁裔在健康结果方面可能处于不利地位 由于多个少数民族身份的交叉性。对妇女的围产期结局知之甚少 他们都是黑人和拉丁裔。在文学作品中，有色人种女性，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、 歧视和居民区种族隔离。然而，这些壁垒的负担还没有得到很好的理解。 在非洲裔拉美人中，他们可能正在经历基于种族和性别的独特的社会劣势压力来源 肤色。在交叉性理论的指导下，这项提议旨在确定非洲裔拉丁裔母亲和 他们的婴儿患母体疾病和不良分娩结局的风险比 其他种族/民族身份的育儿妇女通过两个具体目标：1)确定 孕产妇发病率(妊娠高血压、妊娠糖尿病)和婴儿出生结局 (出生体重、早产)佛罗里达州非裔拉丁裔与白人、非拉丁裔黑人和非 拉丁裔白人母亲和她们的婴儿。(2)考察居住种族隔离、邻里隔离的影响 非洲裔拉丁美洲人的剥夺、产前保健利用与产妇发病率和婴儿出生结局的关系 在佛罗里达州与其他种族/民族身份的女性进行比较。这项研究将使用佛罗里达州至关重要的数据 非裔拉丁裔母亲及其婴儿(n=176,040)与育龄妇女的统计数据(2004-2022) 其他种族/族裔特性(n=3,805,588)。随附的职业培训计划将提供一个基础 对我来说，(1)扩展我在健康的社会决定因素和非洲裔拉丁裔母亲的健康公平方面的专业知识 和他们的孩子(2)在多层次的数据研究中发展方法、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，实现专业化 发展目标。我的跨学科导师团队将指导我完成整个奖项。职业生涯 开发和研究计划将支持我成长为一名独立的护士科学家，检查产妇- 儿童健康差距。该提案提供了一个与NINR的目标直接一致的创新视角 解决健康障碍的社会决定因素，这些障碍使非洲裔拉丁裔等弱势群体处于可以避免的境地 对健康不利。

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.