Applying mixtures methodology to analyze how exposure to structural racism and economic disadvantage affect perinatal health outcomes: an ECHO study.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Goin Dana E, Ghidey Ronel, Schuh Holly, Dean Lorraine T, Barrett Emily, Bastain Theresa M, Buckley Jessie P, Bush Nicole R, Camerota Marie, Carroll Kecia N, Cragoe Nicholas, Cushing Lara J, Dabelea Dana, Dunlop Anne L, Eick Stephanie M, Elliott Amy J, Felson Tali, Geiger Sarah Dee, Gilliland Frank D, James-Todd Tamarra, Kahn Linda G, Kasman Matt, Kuiper Jordan R, Leventhal Bennett, Lucchini Maristella, Nelson Morgan, Norman Gwendolyn, Nutor Chaela, O'Shea T Michael, Padula Amy M, Schantz Susan L, Mehta-Lee Shilpi S, Steiger Benjamin, Woodruff Tracey J, Wright Rosalind J, Morello-Frosch Rachel A, ECHO Cohort Consortium+
Аннотация
Our objective was to examine the role of structural racism and economic disadvantage in perinatal health inequities using the Environmental influences on Child Health Outcomes Cohort. Participants' addresses were linked to area-level measures of life expectancy, education, unemployment, health insurance, jail rate, segregation, and housing cost burden. We created absolute measures to represent economic disadvantage and relative measures comparing values for Black or Latinx people to White people in the same area to represent structural racism. We used quantile G-computation to estimate the effects of a one-quartile increase in all exposures simultaneously on fetal growth and gestational age measures. A one-quartile increase in economic disadvantage was associated with a reduction in birthweight [(-25.65 grams, 95% CI (-45.83, -5.48)], but not gestational age [-0.02 weeks, 95% CI (-0.13, 0.09)]. With a one-quartile increase in Latinx-White structural racism, we observed reductions in birthweight [-80.83, 95% CI (-143.42, -18.23)] among Latinx participants. A one-quartile increase in Black-White structural racism was weakly associated with lower birthweight among Black participants [-15.70, 95% CI (-82.89, 51.48)] but was associated with higher birthweight among White participants [57.47, 95% CI (13.26, 101.67)]. Our findings suggest co-occurring forms of structural inequity likely influence racialized disparities in fetal growth outcomes.