RACIAL AND NEIGHBORHOOD DISPARITIES IN INFANT HEALTH

婴儿健康方面的种族和社区差异

• 批准号: 6526330
• 负责人: IRMA T. ELO
• 金额: $ 45.08万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-01 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6526330
• 关键词: African American; Asian Americans; Hispanic Americans; Medicare /Medicaid; behavioral /social science research tag; caucasian American; clinical research; female; health behavior; health care cost /financing; health care service availability; health insurance; housing; human data; human pregnant subject; human subject; infant human (0-1 year); longitudinal human study; low socioeconomic status; managed care; medical records; pediatrics; prenatal care; public health; racial /ethnic difference; social class; social support network; socioeconomics; urban poverty area; vital statistics

In this project, we construct a unique data set for Philadelphia, which merges information from vital statistics records with Medicaid claims records and individual-level data from publicly funded health centers. We then merge the individual-level data with a rich set of contextual information from multiple sources to create various measures of neighborhood quality, including housing and environmental quality, economic distress, social disorganization, health and service availability. We examine the influence of individual and contextual factors on racial and neighborhood variations on birth outcomes using rigorous statistical techniques suited for analyses of multilevel data. We will examine social class differences within race as well as the racial disparity itself. A second set of analyses addresses the effectiveness of publicly funded health services on prenatal care use, infant health, and costs for low-income women. We will compare the content of prenatal care and birth outcomes of women who received Medicaid services in a managed care setting versus women who received services from fee-for-service provides who accepted Medicaid patients in 1989-1992. Another set of analyses will focus specifically on women using city-funded health centers for prenatal care in 1993-1996. To complement the above analyses we will undertake an in-depth longitudinal study of low-income women. We propose to follow approximately 1,900 women from their first prenatal care visit through their baby s first birthday. This study will enable us to examine the effects of factors present in our conceptual framework that are not available from vital statistics data, including the mother s social support networks, living arrangements, housing stability, psychosocial factors, the wantedness of her pregnancy and risk-taking behaviors. The sample will consist of white, African American, Hispanic and Asian women. The sample composition will permit us to address explicitly the role of race in infant health, and to examine whether factors contributing to infant health are similar for low income women in all racial/ethnic groups.

在这个项目中，我们为费城构建了一个独特的数据集，该数据集将重要的统计记录中的信息与医疗补助索赔记录和来自公共资助的保健中心的个人级别数据合并。 然后，我们将个人级别的数据与来自多个来源的丰富上下文信息相结合，以创建各种社区质量的衡量标准，包括住房和环境质量，经济困扰，社会混乱，健康和服务可用性。我们使用适合分析多级数据的严格统计技术来研究个人和情境因素对种族和邻里变化对出生结果的影响。 我们将研究种族中的社会阶层差异以及种族差异本身。 第二组分析介绍了公共资助的卫生服务对低收入妇女的产前护理，婴儿健康和费用的有效性。我们将比较在托管护理环境中接受医疗补助服务的妇女的产前护理和出生结果的内容与从服务费为服务的妇女提供的妇女提供了1989 - 1992年接受医疗补助患者的人。 另一套分析将专门针对1993 - 1996年使用城市资助的健康中心进行产前护理的妇女。为了补充上述分析，我们将对低收入妇女进行深入的纵向研究。 我们建议从婴儿的第一个生日第一次拜访产前护理访问中关注大约1,900名妇女。 这项研究将使我们能够研究概念框架中存在的因素的影响，这些因素从重要的统计数据中无法获得，包括母亲的社会支持网络，生活安排，住房稳定，社会心理因素，她的怀孕和冒险行为的需求。 样本将包括白人，非裔美国人，西班牙裔和亚洲妇女。 样本组成将使我们能够明确解决种族在婴儿健康中的作用，并检查所有种族/族裔群体中低收入妇女的因素是否相似。