在非西班牙裔黑人和白人妇女中,美国与怀孕相关的死亡率的增加和不公平,2000-2019年
Arline T Geronimus1,2, John Bound2,3, Landon D Hughes4,5
1Department of Health Behavior and Health Equity, University of Michigan, 1415 Washington Heights, Ann Arbor, Michigan 48109-2029, United States.
American journal of epidemiology
|January 6, 2026
概括
美国的孕产妇死亡率正在上升,黑人和白人之间的差异很大. 分析表明,教育水平对这些趋势产生影响,受教育程度较低的白人妇女在与怀孕有关的死亡率中经历了最大的增加.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 社会医学科学 社会医学科学
背景情况:
- 美国的孕产妇死亡率显示出惊人的增长和持续的黑人/白人不平等.
- 气候变化框架表明,随着时间的推移,社会和生物压力因素会导致健康差异.
研究的目的:
- 分析2000-2019年美国与怀孕相关的死亡率 (PRMR) 趋势.
- 调查改变孕产妇年龄分布对PRMR趋势和不平等的贡献.
- 检查种族,母亲年龄和教育水平如何相互作用以影响PRMR.
主要方法:
- 利用了来自美国怀孕死亡率监测系统 (2000-2019) 的数据.
- 按母亲的年龄,种族,教育水平和死亡原因进行分层分析.
- 使用模拟来评估母亲年龄分布转移的影响.
主要成果:
- 美国PRMR的不平等仍然存在,但在人口统计学中,增长并不均.
- 高中学历或以下的白人女性平均每年PRMR增加3.61%.
- 更受过高等教育的黑人女性的PRMR数量呈下降趋势 (每年超过1%),但仍超过白人女性的比例. 转向更年长的孕产妇年龄对白人PRMR增加的影响很小,但总体上会增加黑人PRMR.
结论:
- 教育成就是改变PRMR趋势和黑人/白人不平等的关键因素.
- 增加的孕产妇年龄分布对整体PRMR趋势和不平等的影响有限.
- 解决教育差异对于缓解孕产妇死亡率和种族不平等至关重要.
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