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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Perinatal health among 1 million Chinese-Americans
1Columbia University and NBER, United States.
Insights
Despite son preference in Chinese culture, newborn Chinese-American girls receive intensive hospital care due to poorer birth health. This intensive care, however, does not offset higher mortality rates for these infants.
Area of Science:
- Sociology
- Public Health
- Neonatal Medicine
Background:
- Literature indicates a son preference in China and among Chinese immigrants.
- Existing research on "missing girls" focuses on sex-selective practices.
- This study examines the healthcare outcomes of newborn Chinese-American girls.
Purpose of the Study:
- To investigate the intensity of neonatal medical treatment for Chinese-American girls.
- To explore the underlying reasons for observed differences in medical care.
- To assess the impact of birth health on neonatal care and survival rates.
Main Methods:
- Comparative analysis of hospital treatment intensity for Chinese-American girls versus non-Chinese newborns.
- Documentation of birth health indicators, including low birth weight, congenital anomalies, maternal hypertension, and APGAR scores.
- Examination of mortality rates in the neonatal and post-neonatal periods.
Main Results:
- Chinese-American newborn girls receive more intensive hospital care (longer stays, more procedures, higher charges) than predicted by non-Chinese gender differences.
- Chinese-American girls exhibit higher rates of adverse birth health outcomes compared to the non-Chinese gender gap.
- Despite intensive care, Chinese-American girls experience higher mortality rates, suggesting compromised birth health outweighs treatment benefits.
Conclusions:
- Son preference may negatively impact the birth health of female infants in Chinese communities.
- Intensive neonatal care for Chinese-American girls may be a response to their poorer health at birth.
- Compromised newborn health in Chinese-American girls leads to poorer survival outcomes, challenging typical beliefs about the timing of sex selection's impact.
Abstract:
The literature on "missing girls" suggests a net preference for sons both in China and among Chinese immigrants to the West. Perhaps surprisingly, we find that newborn Chinese-American girls are treated more intensively in US hospitals: they are kept longer following delivery, have more medical procedures performed, and have more hospital charges than predicted (by the non-Chinese gender difference). What might explain more aggressive medical treatment? We posit that hospitals are responding to worse health at birth of Chinese-American girls. We document higher rates of low birth weight, congenital anomalies, maternal hypertension, and lower APGAR scores among Chinese American girls - outcomes recorded prior to intensive neonatal medical care and relative to the non-Chinese gender gap. To the best of our knowledge, we are the first to find that son preference may also compromise "survivor" health at birth. On net, compromised newborn health seems to outweigh the benefit of more aggressive neonatal hospital care for girls. Relative to non-Chinese gender differences, death on the first day of life and in the post-neonatal period is more common among Chinese-American girls, i.e. later than sex selection is typically believed to occur.
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