Inequalities in cesarean births between American Indian &amp; Alaska Native people and White people

Gartner, Danielle R.; Debbink, Michelle P.; Brooks, Jada L.; Margerison, Claire E.

doi:10.1111/1475-6773.14122

Cited by 3 publications

(1 citation statement)

References 88 publications

(133 reference statements)

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“…Although several studies have examined racial and ethnic disparities in CD/PCD use among US women [11][12][13][14][15][16][17][18][19][20], AA women were often not included in their analyses [15,18,20], or if included, they were examined as a single racial and ethnic group [11][12][13]16,17,19]. Viewing AA women from a homogeneous lens does not take into account the differences between and among Asian women and thus may be a contributing factor toward the inconsistent findings reported in previous studies as regards to PCD/CD use [11][12][13]16,17,19].…”

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confidence: 99%

Health Disparities in the Use of Primary Cesarean Delivery among Asian American Women

Zhang,

Heelan-Fancher,

Leveille

et al. 2023

IJERPH

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This study examined the health disparities in primary cesarean delivery (PCD) use among Asian American (AA) women and within AA subgroups. We examined 22 years of birth registry data from one diverse northeastern state in the United States, including singleton vertex live births between 24 and 44 weeks of gestation without congenital abnormalities. Multivariate logistic regression was used to test the association between PCD and race and ethnicity groups adjusting for maternal demographic and health behaviors, infant gender and birth weight, gestational age, initiation of prenatal care, and other risk factors. Among the eligible sample, 8.3% were AA. AAs had the highest rate of PCD (18%) among all racial and ethnic groups. However, extensive heterogeneity was found among the AA subgroups. After controlling for confounding variables, compared to non-Hispanic White women, Filipino, Asian Indian, and Other Asian subgroups had a higher risk for PCD (Adj OR = 1.40, 1.37, and 1.21, p < 0.001), while Japanese, Chinese, and Korean had a lower risk (Adj OR = 0.57, 0.83, and 0.90, p < 0.001), and Vietnamese had no significant difference in PCD use. Although AA as a single racial and ethnic group had higher prevalence of PCD, more studies are warrantied to address the disproportional distribution of health disparities in PCD use within AA subgroups.

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Section: Introductionmentioning

confidence: 99%

Health Disparities in the Use of Primary Cesarean Delivery among Asian American Women

Zhang,

Heelan-Fancher,

Leveille

et al. 2023

IJERPH

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Inequalities in cesarean births between American Indian & Alaska Native people and White people

Gartner

Debbink

Brooks

et al. 2023

Health Services Research

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Objective: To explore population-level American Indian & Alaska Native-White inequalities in cesarean birth incidence after accounting for differences in cesarean indication, age, and other individual-level risk factors. Data Sources and Study Setting: We used birth certificate data inclusive of all live births within the United States between January 1 and December 31, 2017. Study Design: We calculated propensity score weights that simultaneously incorporate age, cesarean indication, and clinical and obstetric risk factors to estimate the American Indian and Alaska Native-White inequality. Data Collection/Extraction Methods: Births to individuals identified as American Indian, Alaska Native, or White, and residing in one of the 50 US states or the District of Columbia were included. Births were excluded if missing maternal race/ethnicity or any other covariate.Principal Findings: After weighing the American Indian and Alaska Native obstetric population to be comparable to the distribution of cesarean indication, age, and clinical and obstetric risk factors of the White population, the cesarean incidence among American Indian and Alaska Natives increased to 33.4% (95% CI: 32.0-34.8), 3.2 percentage points (95% CI: 1.8-4.7) higher than the observed White incidence. After adjustment, cesarean birth incidence remained higher and increased in magnitude among American Indian and Alaska Natives in Robson groups 1 (low risk, primary), 6 (nulliparous, breech presentation), and 9 (transverse/oblique lie). Conclusions:The unadjusted lower cesarean birth incidence observed among American Indian and Alaska Native individuals compared to White individuals may be related to their younger mean age at birth. After adjusting for this demographic difference, we demonstrate that American Indian and Alaska Native individuals undergo cesarean birth more frequently than White individuals with similar risk profiles, particularly within the low-risk Robson group 1 and those with non-cephalic presentations (Robson groups 6 and 9). Racism and bias in clinical decision making, structural racism, colonialism, or other unidentified factors may contribute to this inequality.

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Interdisciplinary approaches to the opioid crisis: optimizing pain management through nurse-pharmacist collaboration

Almotairi,

Alharbi,

Alanazi

et al. 2024

Int. J. of Health Sci.

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Background: With disastrous effects on both individuals and communities, the opioid crisis continues to be a major public health concern. Widespread opiate abuse and overdose deaths have been exacerbated by fragmented care, inappropriate prescribing practices, and a lack of patient education. A multidisciplinary strategy that makes use of the distinct expertise of healthcare providers is necessary for effective pain management, especially in complex circumstances. A promising approach to overcoming these obstacles is nurse-pharmacist collaboration, which aims to minimize opioid-related risks while improving pain management. Aim: this essay is to examine the multidisciplinary contributions that pharmacists and nurses may make to the fight against the opioid crisis. It specifically looks into how collaborative models support responsible opioid use, increase patient safety, and improve pain management outcomes. Methods: Evidence from clinical guidelines, policy evaluations, and peer-reviewed studies was synthesized in a comprehensive assessment of the literature. The review concentrated on nurse-pharmacist collaboration treatments, their application in various healthcare environments, and their effects on patient outcomes and opioid prescriptions. Results: Through individualized treatment plans, greater patient education, and strict oversight of opioid usage, interdisciplinary collaboration improves pain management.

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Inequalities in cesarean births between American Indian & Alaska Native people and White people

Cited by 3 publications

References 88 publications

Health Disparities in the Use of Primary Cesarean Delivery among Asian American Women

Health Disparities in the Use of Primary Cesarean Delivery among Asian American Women

Inequalities in cesarean births between American Indian & Alaska Native people and White people

Interdisciplinary approaches to the opioid crisis: optimizing pain management through nurse-pharmacist collaboration

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