Project 1: The Environmental Riskscape, Disasters and Obstetric Outcomes

项目 1：环境风险状况、灾害和产科结果

• 批准号: 10062087
• 负责人: Hamisu Salihu
• 金额: $ 32.8万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-16 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10062087
• 关键词: Address; African American; Anthracenes; Area; Aromatic Polycyclic Hydrocarbons; Benzo(a)pyrene; Biological; Birth; Case-Control Studies; Chemical Exposure; Chemicals; Child; Color; Communities; Complex; Computerized Medical Record; Data; Development; Disasters; Environment; Environmental Health; Epidemiology; Event; Exposure to; Family; Floods; Fluorine; Foundations; Future; Genetic; Goals; Hazardous Waste Sites; Health; Healthcare; Hurricane; Individual; Industry; Inequality; Infant; Infant Health; Maternal Exposure; Maternal Health; Maternal and Child Health; Medicine; Metal exposure; Metals; Morbidity - disease rate; Mothers; Natural Disasters; Neighborhoods; Not Hispanic or Latino; Outcome; Outcomes Research; Perinatal; Personal Satisfaction; Physical environment; Placenta; Play; Population; Population Heterogeneity; Poverty; Predisposition; Pregnancy; Pregnant Women; Premature Birth; Preventive Intervention; Questionnaires; Research; Research Project Grants; Rest; Risk; Role; Sampling; Social Environment; Source; Statistical Methods; Term Birth; Texas; Woman; Work; base; biobank; black/white disparity; built environment; chemical association; college; data warehouse; design; disorder risk; economic cost; experience; health disparity; improved; low socioeconomic status; mortality; obstetric outcomes; pollutant; racial disparity; response; societal costs; stressor; successful intervention; superfund site; Address; African American; Anthracenes; Area; Aromatic Polycyclic Hydrocarbons; Benzo(a)pyrene; Biological; Birth; Case-Control Studies; Chemical Exposure; Chemicals; Child; Color; Communities; Complex; Computerized Medical Record; Data; Development; Disasters; Environment; Environmental Health; Epidemiology; Event; Exposure to; Family; Floods; Fluorine; Foundations; Future; Genetic; Goals; Hazardous Waste Sites; Health; Healthcare; Hurricane; Individual; Industry; Inequality; Infant; Infant Health; Maternal Exposure; Maternal Health; Maternal and Child Health; Medicine; Metal exposure; Metals; Morbidity - disease rate; Mothers; Natural Disasters; Neighborhoods; Not Hispanic or Latino; Outcome; Outcomes Research; Perinatal; Personal Satisfaction; Physical environment; Placenta; Play; Population; Population Heterogeneity; Poverty; Predisposition; Pregnancy; Pregnant Women; Premature Birth; Preventive Intervention; Questionnaires; Research; Research Project Grants; Rest; Risk; Role; Sampling; Social Environment; Source; Statistical Methods; Term Birth; Texas; Woman; Work; base; biobank; black/white disparity; built environment; chemical association; college; data warehouse; design; disorder risk; economic cost; experience; health disparity; improved; low socioeconomic status; mortality; obstetric outcomes; pollutant; racial disparity; response; societal costs; stressor; successful intervention; superfund site

Despite advances in health care, African-Americans (AA) continue to experience a disproportionate burden of poor obstetric outcomes. This is alarming as pregnancy is a window of future health and many obstetric outcomes, such as preterm birth, are associated with severe morbidity and mortality for both the mother and her infant and result in high societal and economic costs. Unfortunately, the origin of racial disparities in obstetric outcomes does not appear to be genetic nor fully explained by individual-level factors; thus, we must look toward the broader context in the physical, built, and social environments to mitigate racial disparities in maternal health. Because communities of color and low socioeconomic status experience a higher burden of chemical exposures, in part due to the proximity of their neighborhoods to key exposure sources (e.g., industry and hazardous waste sites), ‘environment’ has been hypothesized to be a driver of racial disparities in obstetric outcomes. Two classes of pollutants with historic contamination in Houston, TX are polycyclic aromatic hydrocarbons (PAHs) and metals, which have each been positively associated with preterm birth. Additionally, under an environmental riskscape framework, place-based stressors may also contribute to racial disparities in maternal health by directly influencing disease risk and by modifying women’s susceptibility to chemical exposures. Enhanced understanding of the role of the riskscape, and mixtures of chemical and non-chemical stressors, in racial disparities in obstetric outcomes would promote efforts to design successful interventions and improve the wellbeing of health disparity populations. Finally, Houston is a disaster-prone area, which may result in increased exposures to chemical, biological and non-chemical stressors that may be heightened among health disparity populations. Our goal is to mitigate maternal and infant health disparities in an overburdened population living in a disaster-prone region. To achieve this goal, the Objective of this Research Project, The Environmental Riskscape, Disasters and Obstetric Outcomes, is to utilize a large-scale perinatal biobank and data repository (PeriBank) at Baylor College of Medicine to characterize racial disparities in the riskscape of AA and non- Hispanic white (NHW) pregnant women in Houston, to assess associations between the mixture of chemical and non-chemical stressors in the riskscape on preterm birth, and explore the impact of a natural disaster of unprecedented magnitude (Hurricane Harvey) on racial disparities in chemical exposures. Through the application of a riskscape-based approach paired with statistical methods to address mixture effects, the results from this study will enhance our understanding of the roles of chemical and non-chemical stressors in racial disparities in preterm birth in a disaster-prone region. This work will lay the foundation for future studies to improve our understanding of drivers of black-white disparities in obstetric outcomes, research that is imperative for the development and successful implementation of preventive interventions to mitigate these disparities.

尽管医疗保健取得了进步，但非洲裔美国人（AA）仍在经历不成比例的伯恩。 产科结果不佳。这令人震惊，因为怀孕是未来健康和许多产科的窗口 诸如早产之类的结果与母亲和她的严重发病率和死亡率有关 婴儿并带来高昂的社会和经济成本。不幸的是，产科种族差异的起源 结果似乎不是遗传因素，也没有完全解释。因此，我们必须看 在物理，建筑和社会环境中，更广泛的背景可以减轻孕产妇健康中的赛车分布。 因为有色人种和低社会经济地位的社区经历了更高的化学暴露负担，所以 部分原因是他们社区靠近关键的接触来源（例如，行业和有害废物 站点），“环境”被认为是产科结果中种族分布的驱动力。两个类 德克萨斯州休斯顿的历史污染物的污染物是多环芳烃（PAHS）和金属， 每个人都与早产相关。另外，在环境风险景观下 框架，基于地点的压力源也可能通过直接导致孕产妇健康的种族分布 影响疾病风险并通过改变妇女对化学暴露的敏感性。增强 了解风险景观的作用以及化学和非化学压力的混合物在种族中 产科结果的差异将促进设计成功的干预措施并改善 健康差异人群的福祉。最后，休斯顿是一个容易发生灾难的地区，可能导致增加 在健康差异之间可能会增加化学，生物学和非化学胁迫的暴露 人群。我们的目标是减轻居住在负担的人口中的生物和婴儿健康分配 容易发生的地区。为了实现这一目标，该研究项目的目的是环境 风险景观，灾难和产科结果是利用大规模的围产期生物库和数据存储库 （Peribank）在贝勒医学院（Peribank），以AA和非 - 休斯顿的西班牙白人（NHW）孕妇，以评估化学与化学混合物之间的关联 风险景观对早产的非化学压力源，并探索自然灾害的影响 关于化学暴露中种族差异的空前幅度（Harvey飓风）。通过 基于风险景观的方法与统计方法搭配以解决混合效应，结果 从这项研究中将增强我们对化学和非化学应激源在种族中的作用的理解 在容易灾难的地区早产的差异。这项工作将为以后的研究奠定基础 提高我们对产科结果中黑白差异的驱动因素的理解，这是必须的研究 为了开发和成功实施预防干预措施以减轻这些分布。