使用空间贝叶斯模型来估计结构性种族歧视与严重孕产妇发病率差异之间的关联
Jasmin A Darville1, Katherine Campbell2, Kaitlyn K Stanhope2
1Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Social science & medicine (1982)
|March 13, 2025
概括
格鲁吉亚的结构性种族主义加剧了黑人分娩人群的严重孕产妇发病率 (SMM) 差异. 资源剥夺和种族两极分化较高的县,SMM种族差异较大.
科学领域:
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
- 社会医学科学 社会医学科学
背景情况:
- 美国面临着孕产妇健康危机,特别是在格鲁吉亚,黑人分娩个体经历严重孕产妇发病率不成比例.
- 在格鲁吉亚,黑人占所有出生人数的35%,SMM率明显超过全国平均水平.
研究的目的:
- 调查结构性种族歧视 (SRD) 和严重孕产妇发病率 (SMM) 之间的关系,在格鲁吉亚的黑人与白人分娩人群中.
- 分析由四个领域定义的县级SRD如何影响中小企业的种族差异.
主要方法:
- 利用格鲁吉亚链接活产/胎儿死亡证明和从2013年到2021年的医院出院数据.
- 在四个领域定义了县级的结构性种族歧视 (SRD).
- 使用贝叶斯条件自回归的Poisson模型估计的特定县的SMM率.
- 在SRD层中比较黑人和白人分娩个体之间的SMM率差异.
主要成果:
- 这项研究包括709,335次分娩. 黑人 (3.2%) 与白人 (1.7%) 的SMM患病率更高,平均每1000次分娩有13.1次的差异.
- 与富裕县相比,在资源剥夺较高的县中观察到SMM中存在更大的黑人和白人种族差异.
- 与同质人口相比,在有着两极分化的黑人和低收入人口的县,在SMM中发现了更大的种族差异.
结论:
- 结构性种族主义与格鲁吉亚的严重孕产妇发病率 (SMM) 结果密切相关.
- 在SMM中仍然存在显著的种族差异,特别受到县级社会经济因素和种族构成的影响.
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