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Keith MH, Martin MA. Social Determinant Pathways to Hypertensive Disorders of Pregnancy Among Nulliparous U.S. Women. Womens Health Issues 2024; 34:36-44. [PMID: 37718230 PMCID: PMC10840909 DOI: 10.1016/j.whi.2023.08.001] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Hypertensive disorders of pregnancy are a leading cause of maternal morbidity and mortality in the United States and impact Black mothers at disproportionately higher rates. Hypertensive disparities among racialized groups are rooted in systemic inequalities, and we hypothesize that clinical markers of allostatic load capture embodied disparities in stressors that can link upstream social determinants of health with downstream hypertensive outcomes. METHODS We analyzed observational cohort data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (n = 6,501) and developed a structural equation model linking latent social determinants of health, longitudinal markers of allostatic load across gestation, and hypertensive pregnancy outcomes in a multigroup framework. RESULTS Non-Hispanic Black mothers-to-be (n = 1,155) showed higher rates of hypertensive disorders of pregnancy (32%) than non-Hispanic white women (n = 5,346, 23%). Among both groups, the social environment showed stronger direct effects on allostatic markers than via behaviorally mediated dietary, exercise, or smoking pathways. Demographic aspects of the social environment (e.g., household income, partnered status) were the most salient predictor of hypertensive risk and showed stronger effects among Black women. CONCLUSIONS Embodied stress rooted in the social environment is a major path driving maternal hypertensive disparities in the United States, with effects that vary across racialized groups. These pathway findings underscore the greater impact of systemic stressors relative to individual health behaviors. More comprehensive and detailed analyses of sociostructural domains are needed to identify promising avenues for policy and intervention to improve maternal health.
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Affiliation(s)
- Monica H Keith
- Department of Anthropology, University of Washington, Seattle, Washington.
| | - Melanie A Martin
- Department of Anthropology, University of Washington, Seattle, Washington; Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington
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Starkweather KE, Keith MH, Zohora FT, Alam N. Economic impacts and nutritional outcomes of the 2017 floods in Bangladeshi Shodagor fishing families. Am J Hum Biol 2023; 35:e23826. [PMID: 36331095 DOI: 10.1002/ajhb.23826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES As climate change continues to increase the frequency and severity of flooding in Bangladesh and globally, it becomes increasingly critical to understand the pathways through which flooding influences health outcomes, particularly in lower-income and subsistence-based communities. We aim to assess economic pathways that link flooding to nutritional outcomes among Shodagor fishing families in Bangladesh. METHODS We examine longitudinal economic data on kilograms of fish caught, the income earned from those fish, and household food expenditures (as a proxy for dietary intake) from before, during, and after severe flooding in August-September of 2017 to enumerate the impacts of flooding on Shodagor economics and nutrition. We also analyze seasonally collected anthropometric data to model the effects of flooding and household food expenditures on child growth rates and changes to adult body size. RESULTS While Shodagor fishing income declined during the 2017 flooding, food expenditures simultaneously spiked with market inflation, and rice became the predominant expenditure only during and immediately following the flood. Our nutritional models show that children and adults lost more body mass in households that spent more money on rice during the flood. Shodagor children lost an average of 0.36 BMI-for-age z-scores and adults lost an average of 0.32 BMI units during the flooded 2017 rainy season, and these metrics continued to decline across subsequent seasons and did not recover by the end of the study period in 2019. CONCLUSIONS These results show major flood-induced economic impacts that contributed to loss of child and adult body mass among Shodagor fishing families in Bangladesh. More frequent and severe flooding will exacerbate these nutritional insults, and more work is needed to effectively stabilize household nutrition throughout natural disasters and economic hardship.
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Affiliation(s)
- Kathrine E Starkweather
- Department of Anthropology, University of Illinois Chicago, Chicago, Illinois.,Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Monica H Keith
- Department of Anthropology, Vanderbilt University, Nashville, Tennessee, USA
| | - Fatema Tuz Zohora
- Health Systems and Population Studies Division, ICDDR, B, Dhaka, Bangladesh
| | - Nurul Alam
- Health Systems and Population Studies Division, ICDDR, B, Dhaka, Bangladesh
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Keith MH, Flinn MV, Durbin HJ, Rowan TN, Blomquist GE, Taylor KH, Taylor JF, Decker JE. Genetic ancestry, admixture, and population structure in rural Dominica. PLoS One 2021; 16:e0258735. [PMID: 34731205 PMCID: PMC8565749 DOI: 10.1371/journal.pone.0258735] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 10/04/2021] [Indexed: 12/23/2022] Open
Abstract
The Caribbean is a genetically diverse region with heterogeneous admixture compositions influenced by local island ecologies, migrations, colonial conflicts, and demographic histories. The Commonwealth of Dominica is a mountainous island in the Lesser Antilles historically known to harbor communities with unique patterns of migration, mixture, and isolation. This community-based population genetic study adds biological evidence to inform post-colonial narrative histories in a Dominican horticultural village. High density single nucleotide polymorphism data paired with a previously compiled genealogy provide the first genome-wide insights on genetic ancestry and population structure in Dominica. We assessed family-based clustering, inferred global ancestry, and dated recent admixture by implementing the fastSTRUCTURE clustering algorithm, modeling graph-based migration with TreeMix, assessing patterns of linkage disequilibrium decay with ALDER, and visualizing data from Dominica with Human Genome Diversity Panel references. These analyses distinguish family-based genetic structure from variation in African, European, and indigenous Amerindian admixture proportions, and analyses of linkage disequilibrium decay estimate admixture dates 5–6 generations (~160 years) ago. African ancestry accounts for the largest mixture components, followed by European and then indigenous components; however, our global ancestry inferences are consistent with previous mitochondrial, Y chromosome, and ancestry marker data from Dominica that show uniquely higher proportions of indigenous ancestry and lower proportions of African ancestry relative to known admixture in other French- and English-speaking Caribbean islands. Our genetic results support local narratives about the community’s history and founding, which indicate that newly emancipated people settled in the steep, dense vegetation along Dominica’s eastern coast in the mid-19th century. Strong genetic signals of post-colonial admixture and family-based structure highlight the localized impacts of colonial forces and island ecologies in this region, and more data from other groups are needed to more broadly inform on Dominica’s complex history and present diversity.
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Affiliation(s)
- Monica H. Keith
- Department of Anthropology, University of Missouri, Columbia, Missouri, United States of America
- * E-mail: (MHK); (JED)
| | - Mark V. Flinn
- Department of Anthropology, University of Missouri, Columbia, Missouri, United States of America
| | - Harly J. Durbin
- Division of Animal Sciences, University of Missouri, Columbia, Missouri, United States of America
| | - Troy N. Rowan
- Division of Animal Sciences, University of Missouri, Columbia, Missouri, United States of America
- Genomics Center for the Advancement of Agriculture, University of Tennessee Institute for Agriculture, Knoxville, Tennessee, United States of America
| | - Gregory E. Blomquist
- Department of Anthropology, University of Missouri, Columbia, Missouri, United States of America
| | - Kristen H. Taylor
- Department of Anatomy and Pathological Sciences, University of Missouri, Columbia, Missouri, United States of America
| | - Jeremy F. Taylor
- Division of Animal Sciences, University of Missouri, Columbia, Missouri, United States of America
| | - Jared E. Decker
- Division of Animal Sciences, University of Missouri, Columbia, Missouri, United States of America
- * E-mail: (MHK); (JED)
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Starkweather KE, Keith MH, Prall SP, Alam N, Zohora F, Emery Thompson M. Are fathers a good substitute for mothers? Paternal care and growth rates in Shodagor children. Dev Psychobiol 2021; 63:e22148. [PMID: 34087947 DOI: 10.1002/dev.22148] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/21/2022]
Abstract
Biparental care is a hallmark of human social organization, though paternal investment varies between and within societies. The facultative nature of paternal care in humans suggests males should invest when their care improves child survival and/or quality, though testing this prediction can be challenging because of the difficulties of empirically isolating paternal effects from those of other caregivers. Additionally, the broader context in which care is provided, vis-à-vis care from mothers and others, may lead to different child outcomes. Here, we examine the effects of paternal care on child growth among Shodagor fisher-traders, where fathers provide high levels of both additive and substitutive care, relative to mothers. We modeled seasonal z-scores and velocities for height, weight, and body mass index (BMI) outcomes using linear mixed models. Our evidence indicates that, as predicted, the context of paternal care is an important predictor of child outcomes. Results show that environmental seasonality and alloparental help contribute to a nuanced understanding of the impact of Shodagor paternal care on child physiology.
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Affiliation(s)
- K E Starkweather
- Department of Anthropology, University of Illinois Chicago, Chicago, Illinois.,Department of Anthropology, University of New Mexico, Albuquerque, New Mexico.,Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - M H Keith
- Department of Anthropology, University of Washington, Seattle, Washington
| | - S P Prall
- Department of Anthropology, University of Missouri, Columbia, Missouri
| | - N Alam
- Health Systems and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - F Zohora
- Health Systems and Population Studies Division, ICDDR,B, Dhaka, Bangladesh
| | - M Emery Thompson
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico
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Keith MH, Blomquist GE, Flinn MV. Anthropometric heritability and child growth in a Caribbean village: A quantitative genetic analysis of longitudinal height, weight, and body mass index in Bwa Mawego, Dominica. Am J Phys Anthropol 2019; 170:393-403. [PMID: 31460671 DOI: 10.1002/ajpa.23924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Body size and composition vary widely among individuals and populations, and long-term research in diverse contexts informs our understanding of genetic, cultural, and environmental impacts on this variation. We analyze longitudinal measures of height, weight, and body mass index (BMI) from a Caribbean village, estimating the extent to which these anthropometrics are shaped by genetic variance in a small-scale population of mixed ancestry. MATERIALS AND METHODS Longitudinal data from a traditionally horticultural village in Dominica document height and weight in a non-Western population that is transitioning to increasingly Westernized lifestyles, and an 11-generation pedigree enables us to estimate the proportions of phenotypic variation in height, weight, and BMI attributed to genetic variation. We assess within-individual variation across growth curves as well as heritabilities of these traits for 260 individuals using Bayesian variance component estimation. RESULTS Age, sex, and secular trends account for the majority of anthropometric variation in these longitudinal data. Independent of age, sex, and secular trends, our analyses show high repeatabilities for the remaining variation in height, weight, and BMI growth curves (>0.75), and moderate heritabilities (h2 height = 0.68, h2 weight = 0.64, h2 BMI = 0.49) reveal clear genetic signals that account for large proportions of the variation in body size observed between families. Secular trends show increases of 6.5% in height and 16.0% in weight from 1997 to 2017. DISCUSSION This horticultural Caribbean population has transitioned to include more Westernized foods and technologies over the decades captured in this analysis. BMI varies widely between individuals and is significantly shaped by genetic variation, warranting future exploration with other physiological correlates and associated genetic variants.
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Affiliation(s)
- Monica H Keith
- Department of Anthropology, University of Missouri, Columbia, Missouri
| | | | - Mark V Flinn
- Department of Anthropology, University of Missouri, Columbia, Missouri
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Starkweather KE, Keith MH. Estimating impacts of the nuclear family and heritability of nutritional outcomes in a boat-dwelling community. Am J Hum Biol 2018; 30:e23105. [DOI: 10.1002/ajhb.23105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 11/21/2017] [Accepted: 01/13/2018] [Indexed: 01/06/2023] Open
Affiliation(s)
| | - Monica H. Keith
- Max Planck Institute for Evolutionary Anthropology; Leipzig 04103 Germany
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