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Structural Racism and Black Maternal-Infant Birth Outcomes
Structural Racism and Black Maternal-Infant Birth Outcomes
Structural Racism and Black Maternal-Infant Birth Outcomes

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자료유형  
 학위논문 서양
최종처리일시  
20260209102833
ISBN  
9798270249908
DDC  
614
저자명  
Kristensen-Cabrera, Alexandria.
서명/저자  
Structural Racism and Black Maternal-Infant Birth Outcomes
발행사항  
[Sl] : University of Minnesota, 2023
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2023
형태사항  
98 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-06, Section: A.
주기사항  
Advisor: Kozhimannil, Katy Backes;Hardeman, Rachel.
학위논문주기  
Thesis (Ph.D.)--University of Minnesota, 2023.
초록/해제  
요약The United States is currently in a perinatal health crisis. Among high-income countries, the United States has one of the highest rates of maternal morbidity-a range of conditions that can cause short- and long-term consequences for birthing people and include some "near misses" of maternal deaths. There are 100 cases of maternal morbidity for each case of maternal mortality. And racial disparities persist. Black people are twice as likely to experience maternal morbidity or infant mortality than their white counterparts. There is increasing awareness regarding the role of structural racism in driving these disparities, but there is no consensus on how this occurs. This project describes how Black birthing people experience structural racism, in their own words, and measures how structural factors and structural racism may contribute to adverse Black maternal and infant birth outcomes.This dissertation first describes how Black birthing people in the Midwest experience structural racism, especially as it relates to their reproductive health and birthing experiences. Then it examines the relationship between the Maternal Vulnerability Index (MVI; a county-level aggregate measure of determinants of maternal health) and adverse birth outcomes for Black pregnant people and their infants. Finally, this dissertation describes Black-white disparities in adverse birth outcomes at the intersection of one hospital structural factor (hospital birth volume) and race. The first study summarizes how 20 Black women in the Midwest experience structural racism, primarily related to their reproductive healthcare and neighborhood experiences, and outlines their recommendations to address the impacts of racism in their lives. Identified themes included structural racism in law enforcement, healthcare, housing, education, and immigration. Participant recommendations to address racism in healthcare included recruiting, retaining, and better-paying Black providers, reviewing, addressing, and eliminating racist practices, and centering Black women in care. In the second study we found that among term, singleton births without pre-existing conditions (lower-risk births) in urban areas of South Carolina, the odds of Severe Maternal Morbidity (SMM) were higher among Black people with a high (top quintile) MVI compared to those with a low (bottom quartile) MVI. The same relationship was not observed for white individuals nor an infant outcome (Unexpected Newborn Complications). In the third study, we examined the association between hospital volume and maternal-infant birth outcomes among Black and white low-risk pregnant people. Among lower-risk births, we found that Black and white infants have higher odds of UNC at low-volume hospitals than high-volume hospitals. In this same population, white pregnant people had greater odds of SMM when delivering in low-volume hospitals compared to high-volume hospitals, but the same was not true for Black pregnant people.
일반주제명  
Public health
일반주제명  
Pediatrics
일반주제명  
Black studies
키워드  
Child health
키워드  
Maternal health
키워드  
Structural racism
키워드  
Black pregnant people
키워드  
Racial disparities
기타저자  
University of Minnesota Health Services Research Policy and Administration
기본자료저록  
Dissertations Abstracts International. 87-06A.
전자적 위치 및 접속  
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MARC

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■1001  ▼aKristensen-Cabrera,  Alexandria.
■24510▼aStructural  Racism  and  Black  Maternal-Infant  Birth  Outcomes
■260    ▼a[Sl]▼bUniversity  of  Minnesota▼c2023
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2023
■300    ▼a98  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-06,  Section:  A.
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■5021  ▼aThesis  (Ph.D.)--University  of  Minnesota,  2023.
■520    ▼aThe  United  States  is  currently  in  a  perinatal  health  crisis.  Among  high-income  countries,  the  United  States  has  one  of  the  highest  rates  of  maternal  morbidity-a  range  of  conditions  that  can  cause  short-  and  long-term  consequences  for  birthing  people  and  include  some  "near  misses"  of  maternal  deaths.  There  are  100  cases  of  maternal  morbidity  for  each  case  of  maternal  mortality.  And  racial  disparities  persist.  Black  people  are  twice  as  likely  to  experience  maternal  morbidity  or  infant  mortality  than  their  white  counterparts.  There  is  increasing  awareness  regarding  the  role  of  structural  racism  in  driving  these  disparities,  but  there  is  no  consensus  on  how  this  occurs.  This  project  describes  how  Black  birthing  people  experience  structural  racism,  in  their  own  words,  and  measures  how  structural  factors  and  structural  racism  may  contribute  to  adverse  Black  maternal  and  infant  birth  outcomes.This  dissertation  first  describes  how  Black  birthing  people  in  the  Midwest  experience  structural  racism,  especially  as  it  relates  to  their  reproductive  health  and  birthing  experiences.  Then  it  examines  the  relationship  between  the  Maternal  Vulnerability  Index  (MVI;  a  county-level  aggregate  measure  of  determinants  of  maternal  health)  and  adverse  birth  outcomes  for  Black  pregnant  people  and  their  infants.  Finally,  this  dissertation  describes  Black-white  disparities  in  adverse  birth  outcomes  at  the  intersection  of  one  hospital  structural  factor  (hospital  birth  volume)  and  race. The  first  study  summarizes  how  20  Black  women  in  the  Midwest  experience  structural  racism,  primarily  related  to  their  reproductive  healthcare  and  neighborhood  experiences,  and  outlines  their  recommendations  to  address  the  impacts  of  racism  in  their  lives.  Identified  themes  included  structural  racism  in  law  enforcement,  healthcare,  housing,  education,  and  immigration.  Participant  recommendations  to  address  racism  in  healthcare  included  recruiting,  retaining,  and  better-paying  Black  providers,  reviewing,  addressing,  and  eliminating  racist  practices,  and  centering  Black  women  in  care.  In  the  second  study  we  found  that  among  term,  singleton  births  without  pre-existing  conditions  (lower-risk  births)  in  urban  areas  of  South  Carolina,  the  odds  of  Severe  Maternal  Morbidity  (SMM)  were  higher  among  Black  people  with  a  high  (top  quintile)  MVI  compared  to  those  with  a  low  (bottom  quartile)  MVI.  The  same  relationship  was  not  observed  for  white  individuals  nor  an  infant  outcome  (Unexpected  Newborn  Complications).  In  the  third  study,  we  examined  the  association  between  hospital  volume  and  maternal-infant  birth  outcomes  among  Black  and  white  low-risk  pregnant  people.  Among  lower-risk  births,  we  found  that  Black  and  white  infants  have  higher  odds  of  UNC  at  low-volume  hospitals  than  high-volume  hospitals.  In  this  same  population,  white  pregnant  people  had  greater  odds  of  SMM  when  delivering  in  low-volume  hospitals  compared  to  high-volume  hospitals,  but  the  same  was  not  true  for  Black  pregnant  people.
■590    ▼aSchool  code:  0130.
■650  4▼aPublic  health
■650  4▼aPediatrics
■650  4▼aBlack  studies
■653    ▼aChild  health
■653    ▼aMaternal  health
■653    ▼aStructural  racism
■653    ▼aBlack  pregnant  people
■653    ▼aRacial  disparities
■690    ▼a0573
■690    ▼a0767
■690    ▼a0325
■71020▼aUniversity  of  Minnesota▼bHealth  Services  Research,  Policy  and  Administration.
■7730  ▼tDissertations  Abstracts  International▼g87-06A.
■790    ▼a0130
■791    ▼aPh.D.
■792    ▼a2023
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17365831▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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