Preterm Delivery Among African-American Women: A Research Strategy

Rowley, D.; Hogue, Carol J.; Blackmore, Cheryl A.; Ferré, Cynthia; Hatfield-Timajchy, Kendra; Branch, P. Kay; Atrash, Hani K.

doi:10.1016/s0749-3797(18)30659-7

Cited by 75 publications

(32 citation statements)

References 60 publications

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“…7 The persistence of the Black-White gap, even after taking into account socioeconomic position and other known risk factors, has led to formulation of a new hypothesis: that racial discrimination, as a psychosocial stressor, may increase the risk of preterm and LBW deliveries. 6,[8][9][10] Supporting inquiry on the impact of racial discrimination on birth outcomes are the results of 2 recent studies. One of these studies showed that self-reported experiences of racial discrimination were associated with extremely LBW deliveries in a sample of lowincome Black women, 11 and the other produced evidence of an increased risk of prelarge sample of young Black and White women and men.…”

Section: Self-reported Experiences Of Racial Discrimination and Blackmentioning

confidence: 99%

Self-Reported Experiences of Racial Discrimination and Black–White Differences in Preterm and Low-Birthweight Deliveries: The CARDIA Study

et al. 2004

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Mustillo et al. | Peer Reviewed | Research and Practice | 2125 RESEARCH AND PRACTICE  Objectives. We examined the effects of self-reported experiences of racial discrimination on Black-White differences in preterm (less than 37 weeks gestation) and low-birthweight (less than 2500 g) deliveries.Methods. Using logistic regression models, we analyzed data on 352 births among women enrolled in the Coronary Artery Risk Development in Young Adults Study.Results. Among Black women, 50% of those with preterm deliveries and 61% of those with low-birthweight infants reported having experienced racial discrimination in at least 3 situations; among White women, the corresponding percentages were 5% and 0%. The unadjusted odds ratio for preterm delivery among Black versus White women was 2.54 (95% confidence interval [CI] = 1.33, 4.85), but this value decreased to 1.88 (95% CI = 0.85, 4.12) after adjustment for experiences of racial discrimination and to 1.11 (95% CI = 0.51, 2.41) after additional adjustment for alcohol and tobacco use, depression, education, and income. The corresponding odds ratios for low birthweight were 4.24 (95% CI=1.31, 13.67), 2.11 (95% CI = 0.75, 5.93), and 2.43 (95% CI = 0.79, 7.42).Conclusions. Self-reported experiences of racial discrimination were associated with preterm and low-birthweight deliveries, and such experiences may contribute to Black-White disparities in perinatal outcomes. (Am J Public Health.

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Section: Self-reported Experiences Of Racial Discrimination and Blackmentioning

confidence: 99%

Self-Reported Experiences of Racial Discrimination and Black–White Differences in Preterm and Low-Birthweight Deliveries: The CARDIA Study

et al. 2004

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“…In the absence of conceptual frameworks, selection of contextual variables for study has been somewhat ad hoc and constrained within the range of those commonly used or readily available through routinely collected data (Mitchell et al 2000). To some extent contextual effects research on health remains mired in a “poverty paradigm” (Rowley et al 1993), focusing mostly on the association between census‐based indicators of community socioeconomic position and individual health outcomes, with a heavy emphasis on the deleterious effects of concentrated poverty and other forms of disadvantage. The main thrust of such studies has been to show that poorer places are associated with worse health outcomes, above and beyond the characteristics of the individuals who live there (Robert 1999).…”

Section: Background On Contextual Characteristics and Healthmentioning

confidence: 99%

Measuring Contextual Characteristics for Community Health

Hillemeier

Lynch²,

Harper³

et al. 2003

Health Services Research

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Objective. To conceptualize and measure community contextual influences on population health and health disparities. Data Sources. We use traditional and nontraditional secondary sources of data comprising a comprehensive array of community characteristics. Study Design. Using a consultative process, we identify 12 overarching dimensions of contextual characteristics that may affect community health, as well as specific subcomponents relating to each dimension. Data Collection. An extensive geocoded library of data indicators relating to each dimension and subcomponent for metropolitan areas in the United States is assembled. Principal Findings. We describe the development of community contextual health profiles, present the rationale supporting each of the profile dimensions, and provide examples of relevant data sources. Conclusions. Our conceptual framework for community contextual characteristics, including a specified set of dimensions and components, can provide practical ways to monitor health-related aspects of the economic, social, and physical environments in which people live. We suggest several guiding principles useful for understanding how aspects of contextual characteristics can affect health and health disparities.Key Words. Health disparity, residence characteristics, contextual data, population health, socioeconomic factors Much has been accomplished to improve health and reduce disparities through understanding and intervening on individual-level risk factors for major causes of morbidity and mortality (U.S. Preventive Services Task Force 1996; Ketola, Sipila, and Makela 2000). However, far less attention has been paid to understanding the effect of community contextual characteristics on health outcomes and disparities. Although research interest in the role of socioenvironmental factors in the etiology of disease has surged over the past decade (for reviews see Pickett and Pearl 2001;Macintyre, Ellaway, and Cummins 2002;Yen and Syme 1999), a recurrent theme in this literature is the need for greater attention to the conceptualization and empirical assessment of 1645 ways in which contextual characteristics of places impact health (Pickett and Pearl 2001;Macintyre, Ellaway, and Cummins 2002;Lynch 1997, 2001;Yen and Syme 1999;Diez-Roux 1998). In addition, there has been great academic and policy interest in implementing interventions aimed at improving socioenvironmental factors that could produce wide-ranging health benefits (for example see articles in the April 2003 supplement to the American Journal of Preventive Medicine on this topic). Many in public health believe these represent a promising approach to reducing the marked health disparities that remain a high-priority public health concern (U.S. Department of Health and Human Services 2000). Furthermore, this approach provides critical data to ensure that decisions regarding the provision of health care services do not occur in a vacuum, but instead are integrated into the larger picture of health-promoting and health-endangering char...

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“…Despite the generally high rates of asthma among low-income minority children, most disadvantaged African American and Hispanic children do not develop asthma, suggesting marked variability in either exposures or vulnerabilities, or both, of individuals within these populations. The poverty paradigm is simply not an adequate explanation for high rates of childhood asthma and many other child health problems in this country (15). The search for other sources of variability in health and well-being among low-income urban populations must include the contribution of more proximal risk factors, both social and physical, including conditions that are potentially modifiable.…”

Section: Childhood Asthmamentioning

confidence: 99%

Deteriorated housing contributes to high cockroach allergen levels in inner-city households.

Rauh

Chew

Garfinkel

2002

Environ Health Perspect

156

122

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The high prevalence of childhood asthma in low-income, inner-city populations is not fully understood but has been at least partly attributed to the disproportionate exposures associated with socioeconomic disadvantage. The contribution of indoor allergens to asthma is well documented, but links between socioeconomic disadvantage and indoor allergen levels are not clear. We investigated levels of cockroach allergens (Bla g 2) in a sample of 132 Dominican or African American low-income households with young children in northern Manhattan in New York City (40% were receiving public assistance) to determine whether the distribution of allergens is a function of housing deterioration. Deterioration was measured by the presence and number of physical housing problems (holes in the ceilings and walls, water damage, etc.). More than 50% of the sample had two or more types of housing dilapidation, and 67% of the sample reported cockroach sightings in their homes. Samples of dust were collected from kitchen and bedroom surfaces. We hypothesized that the greater the dilapidation, the higher the allergen levels, independent of income, sociocultural factors, and pest-control methods. In addition, we hypothesized that the homes of families characterized by frequent moves (23.5%) would have higher allergen levels than more stable families. Results showed significant positive associations between housing deterioration and allergen levels in kitchens, after adjusting for income and ethnicity, with independent effects of residential stability (p< 0.05). Bedroom allergen levels were associated with housing instability (p < 0.01) and ethnicity (p< 0.01). Findings demonstrated that indoor household allergen levels are related to degree of household disrepair, after adjusting for individual family attributes, suggesting that social-structural aspects of housing may be appropriate targets for public health interventions designed to reduce allergen exposure.

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Preterm Delivery Among African-American Women: A Research Strategy

Cited by 75 publications

References 60 publications

Self-Reported Experiences of Racial Discrimination and Black–White Differences in Preterm and Low-Birthweight Deliveries: The CARDIA Study

Self-Reported Experiences of Racial Discrimination and Black–White Differences in Preterm and Low-Birthweight Deliveries: The CARDIA Study

Measuring Contextual Characteristics for Community Health

Deteriorated housing contributes to high cockroach allergen levels in inner-city households.

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