量化结构性种族主义的多维工具:在伊利诺伊州芝加哥对不良妊娠结果的应用
Alexa A Freedman1, Lauren S Keenan-Devlin2, Britney P Smart3
1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, United States.
Social science & medicine (1982)
|March 27, 2025
概括
邻里地区的结构性种族主义,特别是在执法和教育方面,与黑人患者早产风险的增加有关. 解决这些系统性因素对于减少怀孕结果的种族健康不平等至关重要.
科学领域:
- 公共卫生 公共卫生
- 社会流行病学 社会流行病学
- 健康 公平 研究 健康 公平 研究
背景情况:
- 结构性种族主义对健康不平等作出了重大贡献,特别是在不良妊娠结果方面.
- 了解结构性种族主义的多面性质对于制定有针对性的干预措施至关重要.
- 早产的种族差异凸显了迫切需要检查健康的社会决定因素.
研究的目的:
- 开发和验证基于邻居的结构性种族主义措施.
- 调查结构性种族主义领域与孕妇中早产风险之间的关联.
- 按种族和种族分层分析以确定特定的人口风险.
主要方法:
- 利用了来自芝加哥地区六家医院的89,410名孕妇的电子健康记录.
- 将患者地址链接到人口普查区,以量化对六个领域22个结构性种族主义指标的暴露.
- 根据邻居的社会经济地位调整的回归模型,以评估结构性种族主义和早产之间的关联,按种族/种族分层.
主要成果:
- 居住在不良执法实践的社区的黑人患者患早产的可能性更高 (RR: 1.07;95% CI: 1.02,1.12).
- 在学校特色差的社区的黑人患者也有早产风险增加 (RR: 1.08;95% CI: 1.03,1.14).
- 该研究成功量化了结构性种族主义的多个领域及其对早产的影响.
结论:
- 社区层面的结构性种族主义,特别是在执法和教育方面,与黑人患者中早产风险增加有显著的关联.
- 开发的方法提供了一个有价值的工具,用于量化结构性种族主义对健康结果的影响.
- 调查结果强调,需要采取政策和实践干预措施解决结构性种族主义,以减少在母亲和婴儿健康方面的种族不平等.
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