Migration, Dynamic Social Environments, and Birth Outcomes

移民、动态社会环境和出生结果

• 批准号: 10471423
• 负责人: Goleen Samari
• 金额: $ 13.08万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10471423
• 关键词: 37 weeks gestation; Address; Adolescence; Adult; Affect; Area; Attention; Attitude; Behavior Therapy; Big Data; Birth; Buffers; COVID-19; Cessation of life; Child; Child Health; Childhood; Consensus; Country; Data; Data Science; Demography; Destinations; Development; Educational Intervention; Environment; Ethnic Origin; Family; Generations; Growth; Health; Health system; Heterogeneity; Home; Immigrant; Immigration; Individual; Infant; Infant Mortality; Internet; Knowledge; Length of Stay; Life; Life Cycle Stages; Link; Low Birth Weight Infant; Maternal Health; Maternal and Child Health; Maternal-fetal medicine; Measures; Mentored Research Scientist Development Award; Mentors; Methodology; Methods; Migration Policy; Not Hispanic or Latino; Olives - dietary; Outcome; Pathway interactions; Perinatal Epidemiology; Personal Satisfaction; Plant Roots; Policies; Politics; Population; Pregnancy; Premature Birth; Prenatal care; Process; Qualitative Methods; Race; Reproductive Health; Research; Research Personnel; Risk; Risk Factors; Role; Shapes; Small for Gestational Age Infant; Social Environment; Social Policies; Societies; Socioeconomic Status; Stress; Surveys; System; Techniques; Testing; Training; United States; United States National Center for Health Statistics; Variant; Woman; adverse birth outcomes; base; career; child bearing; cost; experience; fetal; health disparity; improved; infancy; innovation; insight; migration; perinatal health; policy implication; reproductive; response; skills; social; social disadvantage; social factors; social integration; social stigma; stressor

PROJECT SUMMARY Adverse birth outcomes, such as preterm birth, low birth weight, and small for gestational age, have serious health consequences not just during infancy but across the life course. Past research shows an immigrant advantage in birth outcomes compared to women born in the United States; however, recent studies increasingly show that immigrant women have worse birth outcomes than non-Hispanic white women. Much research at the intersection of migration and reproductive, maternal, and child health has focused on individual exposures and risk factors. Yet there is growing evidence that structural factors such as migration policies are associated with health disparities, and there is limited understanding of the process by which social and policy environments impact individual-level maternal–fetal medicine outcomes. This K01 Mentored Research Scientist Development Award focuses on conceptualizing this structural context and its potential impact on women’s pregnancy and birth outcomes through pathways of structural stigma, social disadvantage, and spatial isolation. Three proposed areas of training will allow the candidate to develop an independent research career focused on migration and structural determinants of perinatal health: 1) perinatal epidemiology and demography, 2) spatial and data science techniques, and 3) qualitative methods. The specific aims will be achieved using National Center for Health Statistics period-linked infant birth–death data, the National Survey of Family Growth, and qualitative data on immigrant experiences of social and policy environments collected during the project period. These data will be used to carry out the following aims: 1) to examine multilevel effects of social and policy environments on foreign and US-born women’s pregnancy and birth outcomes, 2) to investigate area-level measures of social and policy environments and foreign and US-born women’s pregnancy and birth outcomes, and 3) to explore immigrant women’s experiences of stress due to social and policy environments at destination and their implications for birth outcomes. Expected outcomes are rigorous knowledge of the impact of structural contexts on pregnancy and birth outcomes as well as health system precursors of birth outcomes for immigrants in the US. Findings from this research can both identify immigrant responses to social and policy environments and suggest educational and behavioral interventions that could improve immigrant responses to structural environment stressors, access to prenatal care, and birth outcomes. Training and insights from this project will lead to development of a large-scale R01 study extending this line of research and will further help develop policies that promote maternal, perinatal, and child health.

项目摘要 不良的出生结果，例如早产，低出生体重，胎龄小，有严重的 健康后果不仅在婴儿期，而且在整个生活过程中。过去的研究表明移民 与在美国出生的妇女相比，出生结果的优势；但是，最近的研究 越来越多的人表明，移民妇女的出生结果比非西班牙裔白人妇女差。很多 在迁移和生殖，孕产妇和儿童健康的交集的研究都集中在个人上 暴露和危险因素。然而，越来越多的证据表明，诸如移民政策之类的结构性因素是 与健康差异相关，对社会和政策的过程有限 环境会影响个人水平的母亲 - 美好医学结果。这项K01指导了研究 科学家发展奖的重点是概念化这种结构背景及其对其潜在影响 通过结构性污名，社会灾难和 空间隔离。提出的三个培训领域将使候选人能够开发独立的研究 职业专注于围产期健康的移民和结构决定者：1）围产期流行病学和 删除术，2）空间和数据科学技术，以及3）定性方法。具体目标将是 使用国家卫生统计中心时期与婴儿出生 - 死亡数据实现的国家调查 收集的社会和政策环境的移民经历的家庭成长以及定性数据 在项目期间。这些数据将用于执行以下目的：1）检查多级 社会和政策环境对外国和美国出生的妇女怀孕和出生结果的影响，2） 调查社会和政策环境以及外国和美国妇女的地区级别的衡量标准 怀孕和出生结果，以及3）探索由于社会和 目的地的政策环境及其对出生结果的影响。预期的结果是严格的 了解结构环境对怀孕和出生结果以及卫生系统的影响 美国移民的出生结果前体。这项研究的发现都可以识别移民 对社会和政策环境的回应，并提出可能的教育和行为干预措施 改善对结构环境压力，获得产前护理和出生结果的反应。 该项目的培训和见解将导致开发大规模R01研究，以扩展这一行 研究并将进一步帮助制定促进母校，围产期和儿童健康的政策。