Does Universal Coverage Mitigate Racial Disparities in Potentially Avoidable Maternal Complications?

Abstract Objective Potentially avoidable maternity complications (PAMCs) have been validated as an indicator of access to quality prenatal care. African-American mothers have exhibited a higher incidence of PAMCs, which has been attributed to unequal health coverage. The objective of this study was to assess if racial disparities in the incidence of PAMCs exist in a universally insured population. Study Design PAMCs in each racial group were compared relative to White mothers using multivariate logistic regression. Stratified subanalyses assessed for adjusted differences in the odds of PAMCs for each racial group within direct versus purchased care. Results A total of 675,553 deliveries were included. Among them, 428,320 (63%) mothers were White, 112,170 (17%) African-American, 37,151 (6%) Asian/Pacific Islanders, and 97,912 (15%) others. African-American women (adjusted odds ratio [aOR]: 1.05, 95% CI: 1.02–1.08) were more likely to have PAMCs compared with White women, and Asian women (aOR: 0.92, 95% CI: 0.89–0.95) were significantly less likely to have PAMCs compared with White women. On stratified analysis according to the system of care, equal odds of PAMCs among African-American women compared with White women were realized within direct care (aOR: 1.03, 95% CI: 1.00–1.07), whereas slightly higher odds among African-American persisted in purchased (aOR: 1.05, 95% CI: 1.01–1.10). Conclusion Higher occurrence of PAMCs among minority women sponsored by a universal health coverage was mitigated compared with White women. Protocol-based care as in the direct care system may help overcome health disparities.

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Race-Specific Association of Caesarean-Section Delivery with Body Size at Age 2 Years

Ethnicity & Disease ◽

10.18865/ed.26.1.61 ◽

2016 ◽

Vol 26 (1) ◽

pp. 61 ◽

Cited By ~ 1

Author(s):

Andrea E Cassidy-Bushrow ◽

Ganesa Wegienka ◽

Suzanne Havstad ◽

Albert M. Levin ◽

Susan V. Lynch ◽

...

Keyword(s):

African American ◽

Caesarean Section ◽

African American Women ◽

Birth Cohort ◽

Racial Differences ◽

White Women ◽

Specific Effect ◽

Delivery Mode ◽

Font Size ◽

African American Mothers

Objectives: African American children are at higher risk of obesity than White children and African American women are more likely to undergo caesarean-section (CS) delivery than White women. CS is associated with childhood obesity, however, little is known whether this relationship varies by race.We examined if the association of CS with obesity at age 2 years varied by race. Design: Longitudinal birth cohort.Setting: Birth cohort conducted in a health care system in metropolitan Detroit, Michigan with follow-up at age 2 years.Participants: 639 birth cohort participants; 367 children (57.4%) were born to African American mothers and 230 (36.0%) children were born via CS.Main Outcome Measure: Obesity defined as body mass index ≥95th percentile at age 2 years.Results: Slightly more children of African American (n=37; 10.1%) than non-African American mothers (n=18; 6.6%) were obese (P=.12). There was evidence of effect modification between race and delivery mode with obesity at age 2 years (interaction P=.020). In children of African-American mothers, CS compared to vaginal birth was associated with a significantly higher odds of obesity (aOR=2.35 (95% CI: 1.16, 4.77), P=.017). In contrast, delivery mode was not associated with obesity at age 2 years in children of non-African-American mothers (aOR=.47 (95% CI: .13, 1.71), P=.25). Conclusions: There is evidence for a race-specific effect of CS on obesity at age 2 years; potential underlying mechanisms may be racial differences in the developing gut microbiome or in epigenetic programming. Future research is needed to determine if this racial difference persists into later childhood. Ethn Dis. 2016;26(1):61-68; doi:10.18865/ed.26.1.61

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African American Women and Domestic Violence: Addressing their Voice of Silence

10.35455/brk12345678 ◽

2019 ◽

Author(s):

Bernice Kennedy ◽

Chalice Rhodes (Former Jenkins)

Keyword(s):

United States ◽

Domestic Violence ◽

African American ◽

Black Women ◽

African American Women ◽

White Women ◽

The United States ◽

Slave Owner ◽

American Women ◽

Strong Black Women

Abstract Historically, during slavery, the international slave trade promoted normalization of violence against African American women. During slavery, African American women endured inhuman conditions because of the majority race views of them as being over-sexualized, physically strong, and immoral. This perception of the African American women as being highly sexual and more sexual than white women results in slave owner justifying their sexual violation and degrading of the African American women. The stereotypical representations of African American women as strong, controlling, dangerous, fearless, and invulnerable may interfere with the African American women receiving the needed services for domestic violence in the community. The Strong Black Women Archetype has been dated back to slavery describing their coping mechanism in dealing with oppression by developing a strong, less traditionally female role. The authors developed a model: The Multidimensional Perspectives of Factors Contributing to Domestic Violence of African American Women in the United States. This model depicts historically, the factors contributing to domestic violence of African American women in the United States. Also, this model addressed the African American women subscribing to the Strong Black Women Archetype to cope with domestic violence. Despite the increase in domestic violence in African American women, they focused more on the issue of racism instead of sexism in America. African American women have experienced the two obstacles of racism and sexism in America. However, African American women and men believe racism is more critical than sexism. Therefore, domestic violence in the African American population may remain silent because of cultural loyalty. However, the voice of silence of African American females is gradually changing with the upcoming generations.

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Meaning of Pregnancy Terms Among African-American Women

The Qualitative Report ◽

10.46743/2160-3715/2017.2543 ◽

2017 ◽

Author(s):

Stephanie Solomon ◽

Sandra Suther ◽

Ivette Lopez ◽

Alicestine Ashford ◽

Linda Amankwaa ◽

...

Keyword(s):

African American ◽

African American Women ◽

White Women ◽

Childbearing Age ◽

American Women ◽

Planning Policy ◽

Pregnancy Intendedness ◽

Women's Lives ◽

Recurrent Patterns ◽

Descriptive Method

The concept of pregnancy intendedness is complex and may not bear the same meaning to all women. Moreover, researcher definition and women’s meaning were thought to be different. Some researchers have indicated that it is unclear how well women understand and relate to questions used by the National Survey of Family Growth (NSFG) and how the classifications relate to women’s lives. The purpose of this study was to explore the meaning of terms such as planned and/or intended pregnancy among African-American women of childbearing age using a qualitative exploratory descriptive method. Although African-American women want children, they are three times as likely to experience an unintended pregnancy as white women. Data extracted from transcripts were coded and analyzed for recurrent patterns and themes. For this study, the Theory of Planned Behavior (Ajzen & Fishbein, 1980) was employed to frame interview questions and to interpret data. Findings suggest participants and partners often did not have the same perceptions or meanings of pregnancy planning or intentions. These findings have implications for research and family planning policy.

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Racial Disparities Affecting the Reproductive Health of African-American Women

Medical Clinics of North America ◽

10.1016/j.mcna.2005.04.001 ◽

2005 ◽

Vol 89 (5) ◽

pp. 935-943 ◽

Cited By ~ 13

Author(s):

Groesbeck P. Parham ◽

Michael L. Hicks

Keyword(s):

African American ◽

Reproductive Health ◽

Racial Disparities ◽

African American Women ◽

American Women

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African American Women, Racism and Triple Oppression

Interdisciplinary Journal of Management and Social Sciences ◽

10.3126/ijmss.v1i1.34615 ◽

2020 ◽

Vol 1 (1) ◽

pp. 113-117

Author(s):

Rajendra Prasad Chapagain

Keyword(s):

African American ◽

African American Women ◽

Racial Discrimination ◽

Black Men ◽

Black Males ◽

White Women ◽

Black American ◽

American Women ◽

Black American Women ◽

Sexual Repression

African American women have been made multiple victims: racial discrimination by the white community and sexual repression by black males of their own community. They have been subjected to both kind of discrimination - racism and sexism. It is common experience of black American women. Black American women do have their own peculiar world and experiences unlike any white or black men and white women. They have to fight not only against white patriarchy and white women's racism but also against sexism of black men within their own race. To be black and female is to suffer from the triple oppression- sexism, racism and classicism.

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Determinants of Mammographic Breast Density by Race Among a Large Screening Population

JNCI Cancer Spectrum ◽

10.1093/jncics/pkaa010 ◽

2020 ◽

Author(s):

Justin Xavier Moore ◽

Yunan Han ◽

Catherine Appleton ◽

Graham Colditz ◽

Adetunji T Toriola

Keyword(s):

African American ◽

African American Women ◽

Breast Density ◽

White Women ◽

Menopausal Status ◽

Dense Breast ◽

Mammographic Breast Density ◽

Age At First Birth ◽

American Women ◽

Hispanic White

Abstract BACKGROUND Due to mixed reports from smaller studies, we examined associations of race with mammographic breast density and evaluated racial differences in the determinants of breast density. METHODS Participants included 37,839 women (23,166 non-Hispanic White, and 14,673 African American women) receiving screening mammograms at the Joanne Knight Breast Health Center at Washington University School of Medicine, St. Louis, Missouri from June 2010 to December 2015. Mammographic breast density was assessed using Breast Imaging Reporting and Data System (5th edition). To determine the association of race and participant characteristics with mammographic breast density, we used multivariable polytomous logistic regression models (reference group: almost entirely fatty). RESULTS African American women had increased odds of extremely dense (adjusted odds ratio (AOR) = 1.31, 95% CI = 1.13–1.52) and reduced odds of heterogeneously dense breasts (AOR= 0.91, 95% CI = 0.84 – 0.99) compared to non-Hispanic White women. Altogether, race, parity and age at first birth, age, current body mass index (BMI), BMI at age 18, menarche, family history of breast cancer, oral contraceptive use, alcohol, and menopausal status explained 33% of the variation in mammographic breast density. Among African American and non-Hispanic White women these factors explained nearly 28.6% and 33.6% of the variation in mammographic density, respectively. Current BMI provided the greatest explanation of breast density (26.2% overall, 22.2% in African American, and 26.2% in non-Hispanic White women). CONCLUSIONS The determinants of mammographic breast density were generally similar between African-American women and non-Hispanic white women. After adjustments for confounders, African Americans had higher likelihood of extremely dense breast but lower likelihood of heterogeneously dense breast. The greatest explanation of breast density was provided by BMI, regardless of race.

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Genetic and Environmental Risks for High Blood Pressure Among African American Mothers and Daughters

Biological Research For Nursing ◽

10.1177/1099800409334817 ◽

2009 ◽

Vol 11 (1) ◽

pp. 53-65 ◽

Cited By ~ 23

Author(s):

Jacquelyn Y. Taylor ◽

Rosanna Maddox ◽

Chun Yi Wu

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

African American ◽

African American Women ◽

Sodium Intake ◽

Buccal Swab ◽

African American Mothers ◽

Cross Sectional ◽

Mothers And Daughters ◽

American Women

Objective: To determine the relationship between genetic and environmental lifestyle factors (physical activity and sodium) on blood pressure (BP) among African-American women. Method: In this cross-sectional study involving 108 African-American mothers and daughters from a Midwestern area, investigators obtained BP measurements, information on minutes of physical activity, amount of sodium intake, and buccal swab saliva samples. Results: Of the 4 single nucleotide polymorphisms (SNPs) on the sodium bicarbonate cotransporter gene (SLC4A5), rs8179526 had a statistically significant interaction with cytosine/thymine (C/T) genotype by sodium status on systolic BP (SBP; p = .0077). For gene × physical activity interaction, 2 significant interactions (cytosine/adenine [C/A] genotype by physical activity and adenine/adenine [A/A] genotype by physical activity, p = .0107 and p = .0171, respectively) on SBP and 1 on diastolic BP (DBP; A/A genotype by physical activity, p = .0233) were found on rs1017783. Two significant guanine/adenine [G/A] genotype by physical activity interactions were found on rs6731545 for SBP and DBP (p = .0160 and p = .0492, respectively). Discussion: A gene × environmental interaction with rs8179526 has a protective effect on SBP in African-American women with high sodium intake. Participants with C/T genotype of rs8179526 who consumed greater than 2,300 mg of sodium had lower SBP than those who consumed less than recommended. Women with thymine/thymine (T/T) genotype of rs8179526 who consumed greater than 2,300 mg had lower SBP than those who consumed less. Awareness of both the protective and deleterious properties of rs8179526 in African-American women may one day assist in determining appropriate treatment plans.

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Body mass index at age 18 years and recent body mass index in relation to risk of breast cancer overall and ER/PR/HER2-defined subtypes in white women and African-American women: a pooled analysis

Breast Cancer Research ◽

10.1186/s13058-017-0931-5 ◽

2018 ◽

Vol 20 (1) ◽

Cited By ~ 11

Author(s):

Huiyan Ma ◽

Giske Ursin ◽

Xinxin Xu ◽

Eunjung Lee ◽

Kayo Togawa ◽

...

Keyword(s):

Breast Cancer ◽

Body Mass Index ◽

African American ◽

African American Women ◽

Body Mass ◽

White Women ◽

Pooled Analysis ◽

American Women

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Abstract B089: [Advocate Abstract] Racial disparities in African American women

10.1158/1538-7755.disp18-b089 ◽

2020 ◽

Author(s):

Sheila McGlown

Keyword(s):

African American ◽

Racial Disparities ◽

African American Women ◽

American Women

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The Timothy 0. Webster Papers and the Pearce Civil War Collection: Using Civil War Military Collections for Women's History

Collections ◽

10.1177/155019061801400311 ◽

2018 ◽

Vol 14 (3) ◽

pp. 365-381

Author(s):

Julie L. Holcomb

Keyword(s):

African American ◽

Civil War ◽

Working Class ◽

African American Women ◽

White Women ◽

Final Part ◽

American Women ◽

Women's Experience ◽

History Of ◽

Civil War Era

Working-class and rural white women and free and enslaved African American women left few material traces, making it difficult for scholars to document their experience of the Civil War. This three-part article uses the story of the Timothy O. Webster Papers, which is part of the Pearce Civil War Collection at Navarro College in Corsi-cana, Texas, to examine the possibilities and limitations of recovering women's experience of the war from military collections. The first part examines the practice of collecting Civil War documents, the history of the Pearce Civil War Collection, and the collection and preservation of the Webster letters. In the second part, I begin to reconstruct Harriet's story using letters from the Webster Papers. The final part returns to the archive to consider how archivists might aid scholars in recovering the story of Civil War-era women from military collections.

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