Gendered Racism Profiles, Resilience, and High-Risk Pregnancies Among Black Women

黑人女性的性别种族主义概况、复原力和高风险怀孕

• 批准号: 10748022
• 负责人: Shewit Jaynes
• 金额: $ 5.02万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10748022
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Age; Automobile Driving; Binding; Birth; Body mass index; Cardiovascular Diseases; Chronic; Data; Diabetes Mellitus; Discrimination; Disparity; Education; Educational Status; Environment; Exposure to; Family; Fostering; Future; Gender; Gestational Diabetes; Goals; Growth; Health; High Prevalence; High-Risk Pregnancy; Hybrids; Hypertension; Income; Individual; Inequality; Inequity; Intervention; Joints; Latina; Link; Literature; Logistic Regressions; Longitudinal Studies; Maternal Health; Maternal Mortality; Mediator; Mental Health; Methodology; Mission; National Institute of Nursing Research; National Longitudinal Survey of Adolescent to Adult Health; Nature; Nurses; Outcome; Play; Pregnancy; Pregnancy Histories; Pregnancy Outcome; Race; Recording of previous events; Recovery; Reporting; Research; Resistance; Risk; Risk Factors; Role; Scientist; Sexism; Societies; Source; Spirituality; Stress; Structural Racism; Subgroup; United States; Woman; adverse pregnancy outcome; allostatic load; black men; black subgroup; black women; cardiometabolism; case control; cellular resilience; classism; combat; disease disparity; experience; family support; health disparity; health equity; health inequalities; improved; innovation; insight; intersectionality; maternal morbidity; perceived discrimination; physical conditioning; population health; pregnancy disorder; prevent; psychologic; racial discrimination; racism; resilience; social health determinants; stressor

ABSTRACT. Black women in the United States are three to four times more likely to die from pregnancy- related causes than White women, a disparity that has persisted for the past five decades. Gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP) disproportionately develop in the pregnancies of Black women and negatively impact cardiometabolic health in the years following pregnancy. Gendered racism, a hybrid phenomenon of racism and sexism that interlocks to create a unique form of oppression, is a chronic stressor experienced by Black women and contributes to ongoing health disparities. However, the empirical evidence on the health implications of gendered racism is still nascent. Psychological resilience has been found to protect against adverse pregnancy outcomes, yet Black women benefit less from such resilience assets. A more culturally relevant understanding of resilience incorporating the individual-level (psychological resilience and spirituality) and family-level (family support) will be explored in this study. The overall purpose of this study is to examine the relationships between gendered racism experiences, resilience, and high-risk pregnancies among Black women. Data from the National Longitudinal Study of Adolescent to Adult Health will be used to assess experiences of gendered racism, high-risk pregnancy, and resilience among Black women with at least one pregnancy (N = 2,153). The aims are to: Aim 1. Identify latent subgroups of women with different gendered racism experiences determined by four indicators (structural sexism, interpersonal sexism, structural racism, and interpersonal racism). Aim 2. Determine the relationship of history of a high-risk pregnancy (GDM/HDP, cases vs controls) with gendered racism experiences characterizing the identified latent subgroups, covarying for chronic hypertension, diabetes (type 1 or 2), body mass index, level of education, and income. Aim 3. Describe the association of history of a high-risk pregnancy and gendered racism experiences with sources of resilience (individual and family) during adulthood, covarying for chronic hypertension, diabetes (type 1 or 2), body mass index, level of education, and income. Latent profile analysis will be used to identify subgroups for Black women with different gendered racism experiences. Bivariate and covariate-adjusted multinominal logistic regression approach will be used to determine the association between high-risk pregnancy and gendered racism subgroup experiences. Covariate-adjusted multiple regression will be conducted to examine the relationship of high-risk pregnancy and gendered racism subgroup experiences with resilience. This study uses an innovative methodological approach that integrates both interpersonal and structural gendered racism to quantity the multifaceted nature of oppression experienced by Black women along with a culturally relevant conceptualization of resilience. The findings will enhance the understanding of the health consequences of gendered racism and inform future research on multi-level interventions to combat systemic inequalities and foster resilience.

抽象的。美国的黑人妇女死于怀孕的可能性是三到四倍。 相关原因比白人妇女，在过去五十年中一直存在的差距一直存在。妊娠 糖尿病（GDM）和高血压疾病（HDP）在怀孕中不成比例 在怀孕后的几年中，黑人妇女和心脏代谢健康产生负面影响。性别 种族主义是一种种族主义和性别歧视的混合现象，可以互锁以创造一种独特的压迫形式，是一个 黑人妇女经历的长期压力源并导致持续的健康差异。但是， 关于性别种族主义的健康含义的经验证据仍然很新生。心理弹性具有 发现可以防止不良怀孕结果，但是黑人妇女从这种韧性中受益较少 资产。对恢复能力的更具文化相关的理解，结合了个体级别（心理 本研究将探讨韧性和灵性）和家庭水平（家庭支持）。总体目的 这项研究的是研究性别种族主义经历，韧性和高风险之间的关系 黑人妇女怀孕。来自国家青少年到成人健康的国家纵向研究的数据将 用于评估黑人妇女的性别种族主义，高风险怀孕和韧性的经历 至少有一次怀孕（n = 2,153）。目的是：目标1。确定妇女的潜在亚组 不同的性别种族主义经历由四个指标（结构性别歧视，人际性别歧视， 结构性种族主义和人际种族主义）。目标2。确定高风险历史的关系 怀孕（GDM/HDP，案件与控制）具有性别种族主义经验的特征 潜在亚组，慢性高血压，糖尿病（1型或2型），体重指数，水平 教育和收入。目标3。描述高风险怀孕和性别的历史关系 成年期间具有韧性（个人和家庭）的种族主义经历，共同慢性病 高血压，糖尿病（1型或2型），体重指数，教育水平和收入水平。潜在轮廓分析 将用于确定具有不同性别种族主义经历的黑人妇女的亚组。双变量和 协变量调整的多元逻辑回归方法将用于确定关联 在高风险的怀孕和性别种族主义亚组经验之间。协变量调整多倍 将进行回归以检查高风险怀孕和性别种族主义亚组的关系 具有弹性的经验。本研究使用一种创新的方法论方法，将两者融合 人际关系和结构性性别种族主义，数量是压迫的多方面性质 黑人妇女以及具有文化相关的弹性概念化。这些发现将增强 了解性别种族主义的健康后果，并为未来的多层次研究提供信息 打击全身不平等和促进弹性的干预措施。