Center to Advance Reproductive Justice and Behavioral Health among Black Pregnant/Postpartum Women and Birthing People (CORAL).

摘要 怀孕和产后的黑人妇女生活在三个最严重的公共卫生问题的交叉点上。 世纪美国面临的威胁：（1）孕产妇发病率和死亡率流行病;（2）行为 健康危机;（3）交叉歧视。在一个产妇死亡率最高的国家 在高收入国家，黑人妇女在怀孕或产后死亡的可能性是她们的三倍。 白色对应物。产妇行为健康状况-如焦虑，围产期和产后 抑郁症和与出生有关的创伤后应激障碍是怀孕和分娩最常见的并发症， 影响五分之一的妇女，不成比例地影响黑人妇女。药物过量，物质使用障碍，以及 相关的伤害在黑人妇女中激增。据产妇死亡率审查委员会称， 行为健康状况是孕产妇死亡的主要原因之一， 可预防的孕产妇死亡原因。尽管它们的规模和影响力，美国还没有准备好动员起来， 解决这些危机，因为长期存在的交叉歧视， 产妇保健领域忽视了健康问题，行为健康领域忽视了 孕产妇健康。黑人妇女尤其遭受痛苦：从历史上和目前来看，解决 黑人孕产妇死亡率和行为健康系统地未能使社区与生活在一起的人接触， 体验.由埃默里大学莫尔豪斯医学院和一个强大的网络， 以社区为基础的组织，并遵循生殖正义，研究正义和 NIMHHD心理健康框架，促进生殖正义和行为健康中心， 黑人孕妇/产后妇女（CORAL）将提供有关多层次的可采取行动的证据。 与黑人妇女建立密切和平等的伙伴关系， 以及为他们服务的社区组织，其目标是结束母亲的行为， 格鲁吉亚及其他地区卫生危机。格鲁吉亚是这项工作的一个重要地点，因为它是世界上最高的 在美国，与怀孕有关的死亡率是黑人女性的2.3倍，是白色女性的2.3倍。 妇女国家MMRC发现，行为健康状况是一个主要的-和不断增长的-原因， 产妇死亡利用跨越两所主要大学的优秀基础设施和强大的网络， 社区组织，CORAL将动员学术和社区合作伙伴，以支持黑人孕产妇 通过发展和维持一个强大的跨学科社区驱动研究的行为健康 基础设施;与社区合作开展严格的、符合伦理道德的跨学科研究; 下一代研究人员的能力;与学术界、政府和 社区传播和翻译发现。

Abstract Pregnant and postpartum women who are Black live at the intersection of three of the gravest public health threats confronting the 21st century US: (1) the maternal morbidity and mortality epidemic; (2) the behavioral health crisis; and (3) intersectional discrimination. In a nation with the highest maternal mortality rate of all high-income countries, Black women are three times more likely to die while pregnant or postpartum than their White counterparts. Maternal behavioral health conditions – such as anxiety, perinatal and postpartum depression, and birth-related PTSD – are the most common complications of pregnancy and childbirth, affecting 1 in 5 women, and disproportionately afflict Black women. Overdoses, substance use disorders, and related harms are surging among Black women. According to maternal mortality review committees (MMRCs), behavioral health conditions are one of the leading causes of maternal deaths and are the leading preventable cause of maternal deaths. Despite their size and impact, the US is ill prepared to mobilize to address these crises because of longstanding legacies of intersectional discrimination whereby behavioral health problems are neglected within the field of maternal health and the field of behavioral health neglects maternal health. Black women in particular have suffered: historically and presently, approaches to address Black maternal mortality and behavioral health have systematically failed to engage communities with lived experience. Led by a partnership of Morehouse School of Medicine, Emory, and a robust network of community-based organizations, and guided by principles of Reproductive Justice, Research Justice, and the NIMHHD Mental Health framework, the Center to Advance Reproductive Justice and Behavioral Health among Black pregnant/postpartum women (CORAL) will generate actionable evidence about the multilayered determinants of maternal behavioral health conditions in close and equitable partnerships with Black women, and the community-based organizations that serve them, with the goal of ending the maternal behavioral health crisis in Georgia and beyond. Georgia is an essential site for this work as it has among the highest pregnancy-related mortality ratios in the US, and Black women experience a rate that is 2.3 times that of White women. The state MMRC has found that behavioral health conditions are a leading – and growing – cause of maternal death. Leveraging an outstanding infrastructure spanning 2 major universities and a strong network of community organizations, CORAL will mobilize academic and community partners to support Black maternal behavioral health by developing and sustaining a robust transdisciplinary community-drive research infrastructure; conducting rigorous, ethical transdisciplinary research in partnership with communities; building the capacity of the next generation of investigators; and collaborating with academic, governmental, and community to disseminate and translate discoveries.