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Updated: Feb 2, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

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カリフォルニア州における農村性、人種的周縁化、および重度の母体罹患率のリスク（1997年～2019年）

Elleni M Hailu¹, Rachel L Berkowitz², Peiyi Kan¹

¹Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, 1701 Page Mill Road, Palo Alto, CA 94304, USA.

Preventive medicine

|January 31, 2026

要旨

Objective:

The compounded impact of racialization and rurality on risk of severe maternal morbidity (SMM) remains underexplored. We aimed to examine how residence in rural neighborhoods may shape differential SMM risk by racial marginalization.

Methods:

Data were from all live births in California born at 20-45 weeks' gestation between 1997 and 2019 (N = 10,681,950). Census-tract (neighborhood) rurality was defined using Rural-Urban Commuting Area codes. We used race/ethnicity stratified generalized estimating equation models accounting for neighborhood clustering, sociodemographic factors, clinical characteristics, and neighborhood poverty to estimate risk ratios (RR) of SMM comparing those residing in rural versus urban neighborhoods. Population attributable fractions (PAF%) were also calculated to estimate the contribution of rural residence to SMM risk.

Results:

Residing in rural compared to urban neighborhoods was associated with increased risk of SMM for each racial/ethnic group in fully adjusted models. Associations were strongest among Pacific Islander individuals (RR = 1.63; 95% Confidence Interval (CI): 1.19,2.24) and weakest among White individuals (RR = 1.04; 95% CI: 1.00,1.09). The highest PAFs were observed for American Indian/Alaska Native (PAF% = 6.30; 95% CI: 2.01,10.63) and Pacific Islander (PAF% = 1.84; 95% CI: 0.43,3.32) individuals.

Conclusions:

Findings highlight the need for targeted interventions that alleviate rural-urban disparities in maternal health within the context of racial marginalization.

キーワード:

母体健康人種人種的周縁化農村部と都市部の不平等農村性

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