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Chai L. Unpacking the Association Between Length of Residence and Health Among Immigrants in Canada: A Moderated Mediation Approach. J Immigr Minor Health 2023; 25:38-49. [PMID: 35778538 DOI: 10.1007/s10903-022-01377-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2022] [Indexed: 01/07/2023]
Abstract
The present study examines (1) whether perceived life stress mediates the associations between length of residence in Canada and self-rated mental health and general health and (2) how these processes differ across levels of perceived local community belonging. Data are from the 2017-2018 Canadian Community Health Survey (N = 14,570)-a nationally representative survey collected by Statistics Canada. Simple mediation and moderated mediation models are employed. The simple mediated associations are evaluated first and found to be statistically significant for both self-rated mental health (b = 0.046, 95% PBCI = 0.035, 0.058) and general health (b = 0.045, 95% PBCI = 0.034, 0.056). Moderated mediation analysis then reveals that while perceived local community belonging does not moderate the effects of length of residence on perceived life stress, it does moderate the effects of perceived life stress on self-rated mental health (b = - 0.042, 95% PBCI = - 0.057, - 0.028) and general health (b = - 0.026, 95% PBCI = - 0.042, - 0.011), suggesting that the adverse associations between perceived life stress and self-rated mental health and general health are weaker among immigrants with greater perceived local community belonging. Consistent with the predictions, the indirect effects are significant at all levels of local community belonging. Findings from this study highlight the need to focus more research and policy interventions on community-based coping resources.
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Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, 725 Spadina Ave, Toronto, ON, M5S 2J4, Canada.
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Prybylowski A, Howland J, Rankin KM, Collins JW Jr. The First-Year Mortality Rates of Singleton Infants Born at Term of US-Born and Foreign-Born Women: The Effect of Paternal Acknowledgment. J Pediatr 2022:S0022-3476(22)00996-9. [PMID: 36372097 DOI: 10.1016/j.jpeds.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/02/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the whether a greater percentage of deaths of infants born at term among US-born (vs foreign-born) women is attributable to paternal nonacknowledgement. STUDY DESIGN Using a cross-sectional population-based design, stratified and multivariable binomial regression analyses were performed on a subset of the 2017 National Center for Health Statistics linked live birth-infant death cohort dataset of singleton infants born at term (37-42 weeks) of US-born (N = 2 127 243) and foreign-born (N = 334 664) women. RESULTS Infants of US-born women had a prevalence of paternal nonacknowledgement of 11.3% vs 7.5% for foreign-born women, P < .001. The infant mortality rate of term births to US-born women with paternal nonacknowledgment equaled 5.0/1000 vs 2.0/1000 for those with paternal acknowledgment; relative risk (RR) = 2.47 (2.31, 2.86). The infant mortality rate of term births to foreign-born women with paternal nonacknowledgment equaled 2.5/1000 vs 1.6/1000 for those with paternal acknowledgment, RR = 1.61 (1.24, 2.10). The adjusted (controlling for selected covariates) RR of first-year mortality of term births among US-born and foreign-born women with nonacknowledged (vs acknowledged) fathers equaled 1.43 (1.33, 1.54) and 1.38 (1.04, 1.84), respectively. The population-attributable risk percent of deaths in infants born at term for paternal nonacknowledgement among US-born and foreign-born women equaled 4.9% (246 deaths) and 2.8% (15 deaths), respectively. CONCLUSIONS Paternal nonacknowledgement is associated with a 40% greater infant mortality rate among term births to US-born and foreign-born women; however, a greater proportion of first-year deaths among term births to US-born (vs foreign-born) women is attributable to paternal nonacknowledgment. These findings highlight the importance of a father's involvement in the outcomes of infants born at term.
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Ifatunji MA, Faustin Y, Lee W, Wallace D. Black Nativity and Health Disparities: A Research Paradigm for Understanding the Social Determinants of Health. Int J Environ Res Public Health 2022; 19:ijerph19159166. [PMID: 35954520 PMCID: PMC9367942 DOI: 10.3390/ijerph19159166] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/07/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022]
Abstract
After more than a century of research and debate, the scientific community has yet to reach agreement on the principal causes of racialized disparities in population health. This debate currently centers on the degree to which "race residuals" are a result of unobserved differences in the social context or unobserved differences in population characteristics. The comparative study of native and foreign-born Black populations represents a quasi-experimental design where race is "held constant". Such studies present a unique opportunity to improve our understanding of the social determinants of population health disparities. Since native and foreign-born Black populations occupy different sociocultural locations, and since populations with greater African ancestry have greater genetic diversity, comparative studies of these populations will advance our understanding of the complex relationship between sociocultural context, population characteristics and health outcomes. Therefore, we offer a conceptual framing for the comparative study of native and foreign-born Blacks along with a review of 208 studies that compare the mental and physical health of these populations. Although there is some complexity, especially with respect to mental health, the overall pattern is that foreign-born Blacks have better health outcomes than native-born Blacks. After reviewing these studies, we conclude with suggestions for future studies in this promising area of social and medical research.
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Affiliation(s)
- Mosi Adesina Ifatunji
- Departments of African American Studies and Sociology, College of Letters and Science, University of Wisconsin at Madison, Madison, WI 53706, USA
- Correspondence:
| | - Yanica Faustin
- Department of Public Health Studies, College of Arts and Sciences, Elon University, Elon, NC 27244, USA;
| | - Wendy Lee
- Department of Sociology, College of Letters and Science, University of Wisconsin at Madison, Madison, WI 54706, USA;
| | - Deshira Wallace
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
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Kwapong YA, Boakye E, Obisesan OH, Shah LM, Ogunwole SM, Hays AG, Blumenthal RS, Creanga AA, Blaha MJ, Cainzos-Achirica M, Nasir K, Douglas PS, Wang X, Sharma G. Nativity-Related Disparities in Preterm Birth and Cardiovascular Risk in a Multiracial U.S. Cohort. Am J Prev Med 2022; 62:885-894. [PMID: 35597568 DOI: 10.1016/j.amepre.2021.12.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Having a preterm birth is associated with future cardiovascular risk. Non-Hispanic Black women have higher rates of preterm birth than non-Hispanic White and Hispanic women, but nativity-related disparities in preterm birth are not well understood. METHODS Data from 6,096 women in the Boston Birth Cohort: non-Hispanic Black (2,699), non-Hispanic White (997), or Hispanic (2,400), were analyzed in June 2021. Differences in cardiovascular risk factors were assessed. The association of preterm birth with nativity and duration of U.S. residence were investigated using multivariable logistic regression. RESULTS U.S.-born women in all 3 racial-ethnic groups had a higher prevalence of obesity, smoking, and severe stress than foreign-born women. Foreign-born non-Hispanic Black and Hispanic women had lower odds of preterm birth than U.S.-born counterparts (non-Hispanic Black: AOR=0.79, 95% CI=0.65, 0.97; Hispanic: AOR=0.72, 95% CI=0.56, 0.93). In all the 3 groups, foreign-born women with shorter (<10 years) duration of U.S. residence had lower odds of preterm birth than the U.S.-born women (non-Hispanic Black: AOR=0.57, 95% CI=0.43, 0.75; Hispanic: AOR=0.72, 95% CI=0.55, 0.94; non-Hispanic White: AOR=0.46, 95% CI=0.25, 0.85), whereas the odds of preterm birth in foreign-born women with ≥10 years of residence were not significantly different. CONCLUSIONS Foreign-born women had better cardiovascular risk profiles in all groups and lower odds of preterm birth in non-Hispanic Black and Hispanic groups. In all the 3 groups, a shorter duration of U.S. residence was associated with lower odds of preterm birth. Further studies are needed to understand the biological and social determinants underlying these nativity-related disparities and the impact of acculturation.
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Affiliation(s)
- Yaa A Kwapong
- The Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Ellen Boakye
- The Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Olufunmilayo H Obisesan
- The Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Lochan M Shah
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - S Michelle Ogunwole
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Allison G Hays
- The Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Roger S Blumenthal
- The Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Andreea A Creanga
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Michael J Blaha
- The Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Miguel Cainzos-Achirica
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas; Center for Outcomes Research, Houston Methodist Hospital, Houston, Texas
| | - Khurram Nasir
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas; Center for Outcomes Research, Houston Methodist Hospital, Houston, Texas
| | - Pamela S Douglas
- Duke Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Garima Sharma
- The Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland.
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Duh-Leong C, Tomopoulos S, Nastro A, Sharif I, Gomez LI, Di Caprio C, Nagpal N, Fierman AH. Duration of US Residence And Resource Needs In Immigrant Families With Young Children. J Child Fam Stud 2022; 31:211-219. [PMID: 36714395 PMCID: PMC9881011 DOI: 10.1007/s10826-021-02182-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 06/18/2023]
Abstract
To mitigate the negative impact of resource needs on child health, practices serving low-income immigrant families have implemented screening programs to connect families to community resources. Little is known about how duration of US residence relates to patterns of resource needs and indicators of acculturation such as community resource knowledge/experience or self-efficacy. We conducted a cross-sectional analysis of a convenience sample of immigrant families with young children at an urban primary care clinic. These families were seen 5/2018-1/2020 for well child care, screening positive for ≥1 social need using a tool derived from Health Leads. Analysis of 114 families found that newly arrived families with a shorter duration of US residence (≤5 years) were more likely to report immediate material hardships like food insecurity and need for essential child supplies. Newly arrived families were also less likely to have access to technology resources such as a computer or smartphone. Long-term families with a longer duration of US residence (≥15 years) were more likely to report chronic needs like poor housing conditions, but also reported increased community resource knowledge/experience and increased self-efficacy. Primary care pediatric practices should assess immigration contextual factors to identify subgroups such as newly arrived families with young children to target resources (e.g., increase screening frequency) or enhance services (e.g., patient navigators) to relieve resource needs.
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Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics; Department of Pediatrics, NYU Grossman School of Medicine, 462 First Avenue, New York, NY 10016, USA
| | - Suzy Tomopoulos
- Division of General Pediatrics; Department of Pediatrics, NYU Grossman School of Medicine, 462 First Avenue, New York, NY 10016, USA
| | - Andrew Nastro
- Division of Child & Adolescent Health, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA
| | - Iman Sharif
- Division of General Pediatrics; Department of Pediatrics, NYU Grossman School of Medicine, 462 First Avenue, New York, NY 10016, USA
| | - Laura Ibanez Gomez
- Family Health Centers at NYU Langone, 6025 6th Ave, Brooklyn, NY 11220, USA
| | - Cecilia Di Caprio
- University of Minnesota Medical School, 420 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Nikita Nagpal
- Division of General Pediatrics; Department of Pediatrics, NYU Grossman School of Medicine, 462 First Avenue, New York, NY 10016, USA
| | - Arthur H. Fierman
- Division of General Pediatrics; Department of Pediatrics, NYU Grossman School of Medicine, 462 First Avenue, New York, NY 10016, USA
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McKenzie-Sampson S, Baer RJ, Blebu BE, Karasek D, Oltman SP, Pantell MS, Rand L, Rogers EE, Torres JM, Jelliffe-Pawlowski LL, Scott KA, Chambers BD. Maternal nativity and risk of adverse perinatal outcomes among Black women residing in California, 2011-2017. J Perinatol 2021; 41:2736-2741. [PMID: 34282261 PMCID: PMC8939260 DOI: 10.1038/s41372-021-01149-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 06/23/2021] [Accepted: 07/06/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Examine the risk of adverse perinatal outcomes among the United States (US)-born and foreign-born Black women in California. STUDY DESIGN The study comprised all singleton live births to Black women in California between 2011 and 2017. We defined maternal nativity as US-born or foreign-born. Using Poisson regression, we computed risk ratios (RR) and 95% confidence intervals (CI) for three adverse perinatal outcomes: preterm birth, small for gestational age deliveries, and infant mortality. RESULTS Rates of adverse perinatal outcomes were significantly higher among US-born Black women. In adjusted models, US-born Black women experienced an increased risk of preterm birth (RR 1.51, 95% CI 1.39, 1.65) and small for gestational age deliveries (RR 1.52, 95% CI 1.41, 1.64), compared to foreign-born Black women. CONCLUSIONS Future studies should consider experiences of racism across the life course when exploring heterogeneity in the risk of adverse perinatal outcomes by nativity among Black women in the US.
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Affiliation(s)
- Safyer McKenzie-Sampson
- Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine, San Francisco, CA, USA. .,UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine, San Francisco, CA, USA.
| | - Rebecca J. Baer
- UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine,Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco School of Medicine,Department of Pediatrics, University of California San Diego School of Medicine
| | - Bridgette E. Blebu
- UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine,Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco School of Medicine
| | - Deborah Karasek
- UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine,Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco School of Medicine
| | - Scott P. Oltman
- Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine,UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine
| | - Matthew S. Pantell
- Department of Pediatrics, University of California San Francisco School of Medicine
| | - Larry Rand
- UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine,Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco School of Medicine
| | - Elizabeth E. Rogers
- UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine,Department of Pediatrics, University of California San Francisco School of Medicine
| | - Jacqueline M. Torres
- Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine,UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine
| | - Laura L. Jelliffe-Pawlowski
- Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine,UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine
| | - Karen A. Scott
- UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine,Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco School of Medicine,Department of Humanities and Social Sciences, University of California San Francisco School of Medicine
| | - Brittany D. Chambers
- Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine,UCSF California Preterm Birth Initiative, University of California San Francisco School of Medicine
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Minhas AS, Boakye E, Obisesan OH, Kwapong YA, Zakaria S, Creanga AA, Vaught AJ, Mehta LS, Davis MB, Bello NA, Cainzos-Achirica M, Nasir K, Blaha MJ, Blumenthal RS, Douglas PS, Wang X, Sharma G. The Association of Preterm Birth With Maternal Nativity and Length of Residence Among Non-Hispanic Black Women. CJC Open 2021; 4:289-298. [PMID: 35386126 PMCID: PMC8978076 DOI: 10.1016/j.cjco.2021.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background Preterm birth (PTB) is associated with future cardiovascular disease (CVD) risk and disproportionally affects non-Hispanic Black (NHB) women. Limited data exist on the influence of length of US residence on nativity-related disparities in PTB. We examined PTB by maternal nativity (US born vs foreign born) and length of US residence among NHB women. Methods We analyzed data from 2699 NHB women (1607 US born; 1092 foreign born) in the Boston Birth Cohort, originally designed as a case-control study. Using multivariable logistic regression, we investigated the association of PTB with maternal nativity and length of US residence. Results In the total sample, 29.1% of women delivered preterm (31.4% and 25.6% among US born and foreign born, respectively). Compared with foreign born, US-born women were younger (25.8 vs 29.5 years), had higher prevalence of obesity (27.6% vs 19.6%), smoking (20.5% vs 4.9%), alcohol use (13.2% vs 7.4%), and moderate to severe stress (73.5% vs 59.4%) (all P < 0.001). Compared with US-born women, foreign-born women had lower odds of PTB after adjusting for sociodemographic characteristics, alcohol use, stress, parity, smoking, body mass index, chronic hypertension, and diabetes (adjusted odds ratio [aOR], 0.79; 95% confidence interval [CI], 0.65-0.97). Foreign-born NHB women with < 10 years of US residence had 43% lower odds of PTB compared with US-born (aOR, 0.57; 95% CI, 0.43-0.75), whereas those with ≥ 10 years of US residence did not differ significantly from US-born women in their odds of PTB (aOR, 0.76; 95% CI, 0.54-1.07). Conclusions The prevalence of CVD risk factors and proportion of women delivering preterm were lower in foreign-born than US-born NHB women. The "foreign-born advantage" was not observed with ≥ 10 years of US residence. Our study highlights the need to intensify public health efforts in exploring and addressing nativity-related disparities in PTB.
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Affiliation(s)
- Anum S. Minhas
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA,Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ellen Boakye
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Olufunmilayo H. Obisesan
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Yaa A. Kwapong
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Sammy Zakaria
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andreea A. Creanga
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA,Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Arthur J. Vaught
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Laxmi S. Mehta
- Division of Cardiology, the Ohio State University School of Medicine, Columbus, Ohio, USA
| | - Melinda B. Davis
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Natalie A. Bello
- Division of Cardiology, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - Miguel Cainzos-Achirica
- Houston Methodist Hospital and DeBakey Heart & Vascular Center, Center for Outcomes Research, Houston, Texas, USA
| | - Khurram Nasir
- Houston Methodist Hospital and DeBakey Heart & Vascular Center, Center for Outcomes Research, Houston, Texas, USA
| | - Michael J. Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Roger S. Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Pamela S. Douglas
- Division of Cardiology, Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Garima Sharma
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland, USA,Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,Corresponding author: Dr Garima Sharma, Johns Hopkins University School of Medicine–Ciccarone Center of Prevention of Cardiovascular Disease, 565 C Carnegie Building, 600 N Wolfe Street, Baltimore, Maryland 21287, USA.
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Contag S, Nardos R, Buhimschi IA, Almanza J. Population based cohort study of fetal deaths, and neonatal and perinatal mortality at term within a Somali diaspora. BMC Pregnancy Childbirth 2021; 21:740. [PMID: 34719388 PMCID: PMC8559350 DOI: 10.1186/s12884-021-04163-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background Somali women deliver at greater gestational age with limited information on the associated perinatal mortality. Our objective is to compare perinatal mortality among Somali women with the population rates. Methods This is a retrospective cohort study from all births that occurred in Minnesota between 2011 and 2017. Information was obtained from certificates of birth, and neonatal and fetal death. Data was abstracted from 470,550 non-anomalous births ≥37 and ≤ 42 weeks of gestation. The study population included U.S. born White, U.S. born Black, women born in Somalia or self-identified as Somali, and women who identified as Hispanic regardless of place of birth (377,426). We excluded births < 37 weeks and > 42 weeks, > 1 fetus, age < 18 or > 45 years, or women of other ethnicities. The exposure was documented ethnicity or place of birth, and the outcomes were live birth, fetal death, neonatal death prior to 28 days, and perinatal mortality rates. These were calculated using binomial proportions with 95% confidence intervals and compared using odds ratios adjusted (aOR) for diabetes, hypertension and maternal body mass index. Results The aOR [95%CI] for stillbirth rate in the Somali cohort was greater than for U.S. born White (2.05 [1.49–2.83]) and Hispanic women (1.90 [1.30–2.79]), but similar to U.S. born Black women (0.88 [0.57–1.34]). Neonatal death rates were greater than for U.S. born White (1.84 [1.36–2.48], U.S. born Black women (1.47 [1.04–2.06]) and Hispanic women (1.47 [1.05–2.06]). This did not change after analysis was restricted to those with spontaneous onset of labor. When analyzed by week, at 42 weeks Somali aOR for neonatal death was the same as for U.S. born White women, but compared against U.S. born Black and Hispanic women, was significantly lower. Conclusions The later mean gestational age at delivery among women of Somali ethnicity is associated with greater overall risk for stillbirth and neonatal death rates at term, except compared against U.S. born Black women with whom stillbirth rates were not different. At 42 weeks, Somali neonatal mortality decreased and was comparable to that of the U.S. born White population and was lower than that of the other minorities. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04163-z.
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Affiliation(s)
- Stephen Contag
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota School of Medicine, Medical School MMC 395, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Rahel Nardos
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology and Women's Health, University of Minnesota School of Medicine, Global Women's Health, Center for Global Health and Social Responsibility, Medical School MMC 395, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Irina A Buhimschi
- Department of Obstetrics & Gynecology, University of Illinois at Chicago College of Medicine, Chicago, IL, 60612, USA
| | - Jennifer Almanza
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota School of Medicine, Medical School MMC 395, 420 Delaware St SE, Minneapolis, MN, 55455, USA
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9
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Boakye E, Sharma G, Ogunwole SM, Zakaria S, Vaught AJ, Kwapong YA, Hong X, Ji Y, Mehta L, Creanga AA, Blaha MJ, Blumenthal RS, Nasir K, Wang X. Relationship of Preeclampsia With Maternal Place of Birth and Duration of Residence Among Non-Hispanic Black Women in the United States. Circ Cardiovasc Qual Outcomes 2021; 14:e007546. [PMID: 33563008 PMCID: PMC7887058 DOI: 10.1161/circoutcomes.120.007546] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Preeclampsia is one of the leading causes of maternal mortality in the United States. It disproportionately affects non-Hispanic Black (NHB) women, but little is known about how preeclampsia and other cardiovascular disease risk factors vary among different subpopulations of NHB women in the United States. We investigated the prevalence of preeclampsia by nativity (US born versus foreign born) and duration of US residence among NHB women. METHODS We analyzed cross-sectional data from the Boston Birth Cohort (1998-2016), with a focus on NHB women. We performed multivariable logistic regression to investigate associations between preeclampsia, nativity, and duration of US residence after controlling for potential confounders. RESULTS Of 2697 NHB women, 40.5% were foreign born. Relative to them, US-born NHB women were younger, in higher percentage current smokers, had higher prevalence of obesity (body mass index ≥30 kg/m2) and maternal stress, but lower educational level. The age-adjusted prevalence of preeclampsia was 12.4% and 9.1% among US-born and foreign-born women, respectively. When further categorized by duration of US residence, the prevalence of all studied cardiovascular disease risk factors except for diabetes was lower among foreign-born NHB women with <10 versus ≥10 years of US residence. Additionally, the odds of preeclampsia in foreign-born NHB women with duration of US residence <10 years was 37% lower than in US-born NHB women. In contrast, the odds of preeclampsia in foreign-born NHB women with duration of US residence ≥10 years was not significantly different from that of US-born NHB women after adjusting for potential confounders. CONCLUSIONS The prevalence of preeclampsia and other cardiovascular disease risk factors is lower in foreign-born than in US-born NHB women. The healthy immigrant effect, which typically results in health advantages for foreign-born women, appears to wane with longer duration of US residence (≥10 years). Further research is needed to better understand these associations.
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Affiliation(s)
- Ellen Boakye
- Johns Hopkins Ciccarone Center for Prevention of
Cardiovascular Diseases, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| | - Garima Sharma
- Johns Hopkins Ciccarone Center for Prevention of
Cardiovascular Diseases, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| | - S. Michelle Ogunwole
- Division of General Internal Medicine, Johns Hopkins
University School of Medicine, Baltimore, MD, USA
| | - Sammy Zakaria
- Division of Cardiology, Department of Medicine, Johns
Hopkins University School of Medicine, Baltimore, MD, USA
| | - Arthur J. Vaught
- Department of Maternal Fetal Medicine, Division of
Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore,
MD, USA
| | - Yaa Adoma Kwapong
- Department of Population, Family and Reproductive Health,
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Xiumei Hong
- Department of Population, Family and Reproductive Health,
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yuelong Ji
- Department of Population, Family and Reproductive Health,
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Laxmi Mehta
- Division of Cardiology, Ohio State University School of
Medicine, Columbus, OH, USA
| | - Andreea A. Creanga
- Department of Population, Family and Reproductive Health,
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of International Health, Johns Hopkins Bloomberg
School of Public Health, Baltimore, MD, USA
- Department of Gynecology and Obstetrics, Johns Hopkins
University School of Medicine, Baltimore, MD, USA
| | - Michael J. Blaha
- Johns Hopkins Ciccarone Center for Prevention of
Cardiovascular Diseases, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| | - Roger S. Blumenthal
- Johns Hopkins Ciccarone Center for Prevention of
Cardiovascular Diseases, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| | - Khurram Nasir
- Houston Methodist Hospital and DeBakey Heart & Vascular
Center, Center for Outcomes Research, Houston, TX, USA
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health,
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Hong X, Bartell TR, Wang X. Gaining a deeper understanding of social determinants of preterm birth by integrating multi-omics data. Pediatr Res 2021; 89:336-43. [PMID: 33188285 DOI: 10.1038/s41390-020-01266-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/13/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022]
Abstract
In the US, high rates of preterm birth (PTB) and profound Black-White disparities in PTB have persisted for decades. This review focuses on the role of social determinants of health (SDH), with an emphasis on maternal stress, in PTB disparity and biological embedding. It covers: (1) PTB disparity in US Black women and possible contributors; (2) the role of SDH, highlighting maternal stress, in the persistent racial disparity of PTB; (3) epigenetics at the interface between genes and environment; (4) the role of the genome in modifying maternal stress-PTB associations; (5) recent advances in multi-omics studies of PTB; and (6) future perspectives on integrating multi-omics with SDH to elucidate the Black-White disparity in PTB. Available studies have indicated that neither environmental exposures nor genetics alone can adequately explain the Black-White PTB disparity. Preliminary yet promising findings of epigenetic and gene-environment interaction studies underscore the value of integrating SDH with multi-omics in prospective birth cohort studies, especially among high-risk Black women. In an era of rapid advancements in biomedical sciences and technologies and a growing number of prospective birth cohort studies, we have unprecedented opportunities to advance this field and finally address the long history of health disparities in PTB. IMPACT: This review provides an overview of social determinants of health (SDH) with a focus on maternal stress and its role on Black-White disparity in preterm birth (PTB). It summarizes the available literature on the interplay of maternal stress with key biological layers (e.g., individual genome and epigenome in response to environmental stressors) and significant knowledge gaps. It offers perspectives that such knowledge may provide deeper insight into how SDH affects PTB and why some women are more vulnerable than others and underscores the critical need for integrating SDH with multi-omics in prospective birth cohort studies, especially among high-risk Black women.
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