孕产妇死亡率的交叉不平等:检查身体残疾的黑色分娩个体的复合风险
Ilhom Akobirshoev1, Sarah Jerome1, Jonathan M Snowden2
1Brandeis University, The Lurie Institute for Disability Policy, 415 South Street, Waltham, MA, 02453, USA.
Disability and health journal
|December 6, 2024
概括
身体残疾的黑人面临着明显更高的孕产妇死亡风险. 交叉性揭示了一个复合效应,这些身份的综合影响加剧了超越单个因素的死亡风险.
科学领域:
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
- 生殖健康 生殖健康
背景情况:
- 由于种族主义和能力主义造成的系统压迫,为身体残疾的黑人个人带来了双重风险.
- 孕产妇死亡率是一个关键问题,不成比例地影响到边缘化人口.
研究的目的:
- 调查美国黑人生育中身体残疾的孕产妇死亡风险.
- 评估交叉边缘化身份对孕产妇死亡率的复合效应.
主要方法:
- 历史上的队列研究使用2004-2021年医疗保健成本和利用项目全国住院患者样本.
- 包括8,263,997次分娩住院的情况.
- 修改Poisson回归和添加相互作用分析 (RERI,AP) 来评估风险和相互作用.
主要成果:
- 与白人相比,黑人分娩个体面临的孕产妇死亡风险是白人个体的2.5倍.
- 与没有身体残疾的人相比,身体残疾的人患孕产妇死亡率的风险几乎是11倍.
- 一个显著的超添加相互作用 (RERI=11.3;AP=0.47) 表明黑人种族和身体残疾的综合效应大于单个效应的总和.
结论:
- 对于身体残疾的黑人个人来说,孕产妇死亡率存在实质性的不平等.
- 综合效应的证据凸显了对母体健康的交叉方法的关键需求.
- 迫切需要改变政策和干预措施来解决这些差异.
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