scholarly journals Racial and ethnic disparities in maternal mental health during COVID-19

2021 ◽  
Author(s):  
Ananya Suresh Iyengar ◽  
Tsachi Ein-Dor ◽  
Emily Xujia Zhang ◽  
Sabrina Josephine Chan ◽  
Anjali Joann Kaimal ◽  
...  
Keyword(s):  
Mental Health ◽  
Traumatic Stress ◽  
Maternal Mental Health ◽  
Minority Group ◽  
Ethnic Disparities ◽  
Racial And Ethnic Disparities ◽  
Black African ◽  
Clinically Significant ◽  
Skin To Skin ◽  
Hispanic White

Knowledge of childbirth outcomes of Black and Latinx individuals during the coronavirus pandemic is limited. Black/African American and Latinx/Hispanic individuals were matched to non-Hispanic white individuals on socio-demographics. Minority individuals were nearly three times more likely to have clinically significant traumatic stress in response to childbirth and two times more likely to report postpartum depression. Unplanned Cesarean rates were higher and incidences of skin-to-skin and breastfeeding were lower in the minority group. Racial and ethnic maternal disparities exist during COVID-19.

scholarly journals Racial/ethnic disparities in sleep in mothers and infants during the Covid-19 pandemic

2021 ◽  
Author(s):  
Maristella Lucchini ◽  
Margaret Kyle ◽  
Nicolò Pini ◽  
Ayesha Sania ◽  
Vanessa Babineau ◽  
...  
Keyword(s):  
Mental Health ◽  
Maternal Mental Health ◽  
Post Partum ◽  
Ethnic Disparities ◽  
Infant Sleep ◽  
Maternal Sleep ◽  
Hispanic Mothers ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

ABSTRACTStudy ObjectivesTo quantify the association between race/ethnicity and maternal and infant self-reported sleep health at 4 months, exploring the role of maternal depression, stress and symptoms of trauma related to the COVID-19 pandemic as potential mediators.MethodsParticipants were recruited as part of the COVID-19 Mother Baby Outcomes (COMBO) cohort at Columbia University (N=71 non-Hispanic White, N=14 African American (AA), N=113 Hispanic, N=40 other/declined). Data on infant sleep were collected at 4 months postpartum. A subset of 149 women also completed questionnaires assessing maternal mental health and sleep. Multivariable regressions were used to separately estimate associations of race/ethnicity and mental health with multiple sleep domains for infants and mothers adjusting for individual-level covariates.ResultsCompared to non-Hispanic White, Hispanic infants slept less at night (β=- 101.7±17.6, p<0.0001) and AA and Hispanic infants went to bed later (respectively β =1.9±0.6, p<0.0001, β=1.7±0.3, p<0.0001). Hispanic mothers were less likely to perceive infant sleep as a problem (β=1.0±0.3, p=0.006). Compared to non-Hispanic White mothers, Hispanic mothers reported worse maternal sleep latency (β=1.2±0.4, p=0.002), and efficiency (β=0.8±0.4, p=0.03), but better subjective sleep quality (β=-0.7±0.4, p=0.05), and less daytime dysfunction (β=-0.8±0.4, p=0.04). Maternal mental health scores were statistically significant predictors of multiple domains of maternal sleep but did not mediate the association between race/ethnicity and sleep.ConclusionsRacial/ethnic disparities in maternal and infant sleep are observable at 4 months post-partum. Maternal stress, depression and symptoms of trauma related to the COVID-19 pandemic did not mediate these associations.

Abstract MP046: Gestational Hypertension in Minorities: Can Racial and Ethnic Disparities Be Attributed to Socio-Economic Status?

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Alexander V Sergeev ◽  
Christina M Nyirati
Keyword(s):  
White Women ◽  
Gestational Hypertension ◽  
Economic Status ◽  
Ethnic Disparities ◽  
Asian Women ◽  
Low Ses ◽  
Racial And Ethnic Disparities ◽  
Socio Economic Status ◽  
Race Ethnicity ◽  
Hispanic White

Background: Gestational hypertension (GHTN) remains a compelling clinical and public health problem. It can increase risks of intrauterine growth restriction, low-birth weight, and stillbirth. Little is known about whether racial and ethnic minorities and lower socio-economic status (SES) population groups are more vulnerable to GHTN. Hypothesis: We hypothesized that racial and ethnic disparities in GHTN exist beyond the scope of SES-related health disparities. Methods: A case-control study of GHTN was conducted using the data of 114,298 births in the year 2010 in Ohio. The comprehensive births data were obtained from Ohio Department of Health. Cases were identified as those with GHTN. Controls were identified as those without GHTN. Mothers utilizing Medicaid or the Federal Special Supplemental Nutrition Program for Women, Infants and Children were considered of low SES. Odds ratios of GHTN in relation to mother’s race, ethnicity, and SES were obtained using multivariable logistic regression (SAS software), adjusting for known confounders - gestational age, mother’s age, pre-pregnancy and pregnancy smoking status, pre-pregnancy or gestational diabetes, and plurality. Results: GHTN was statistically significantly associated with maternal race and ethnicity, even after adjustment for SES. Compared to non-Hispanic whites, non-Hispanic blacks were more likely to develop GHTN (adjusted OR = 1.867, 95% CI 1.663–2.096, p<0.001), while Asian women were less likely to develop GHTN (adjusted OR = 0.538, 95% CI 0.426–0.679, p<0.001). Hispanic white women were less likely to develop GHTN than non-Hispanic white women, although the difference between them did not reach a conventional p<0.05 level of statistical significance (adjusted OR = 0.651, 95% CI 0.395–1.076, p=0.09). Adjusted for maternal race, ethnicity, age, and known clinical confounders, women of lower SES were more likely to develop GHTN (adjusted OR = 1.475, 95% CI 1.32–1.647, p<0.001). Conclusions: Non-Hispanic black women are at the highest risk of developing GHTN, while Asian women are at the lowest. The Hispanic paradox phenomenon extends to the issue of GHTN. Racial and ethnic disparities cannot be attributed to low SES only; other mechanisms need to be investigated further.

Racial and Ethnic Disparities in Cesarean Morbidity

2021 ◽  
Author(s):  
Adina R. Kern-Goldberger ◽  
Whitney Booker ◽  
Alexander Friedman ◽  
Cynthia Gyamfi-Bannerman
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Race And Ethnicity ◽  
Primary Outcome ◽  
Ethnic Disparities ◽  
Neonatal Morbidity ◽  
Secondary Outcome ◽  
Racial And Ethnic Disparities ◽  
Hispanic White ◽  
Maternal Race

Background Maternal race and ethnicity have been identified as significant independent predictors of obstetric morbidity and mortality in the United States. An appreciation of the clinical contexts in which maternal racial and ethnic disparities are most pronounced can better target efforts to alleviate these disparities and improve outcomes. It remains unknown whether cesarean delivery precipitates these divergent outcomes. Objective This study assessed the association between maternal race and ethnicity and cesarean complications. Study Design We conducted a retrospective cohort study from a multicenter observational cohort of women undergoing cesarean delivery. Nulliparous women with non-anomalous singleton gestations who underwent primary cesarean section were included. Race/ethnicity was categorized as non-Hispanic White, non-Hispanic Black, Hispanic, Asian, Native American, or unknown. The primary outcome was a composite of maternal cesarean complications including hysterectomy, uterine atony, blood transfusion, surgical injury, arterial ligation, infection, wound complication, and ileus. A composite of neonatal morbidity was evaluated as a secondary outcome. We created a multivariable logistic regression model adjusting for selected demographic and obstetric variables that may influence the likelihood of the primary outcome. Results A total of 14,570 women in the parent trial met inclusion criteria with an 18.8% incidence of the primary outcome (2,742 women). After adjusting for potential confounding variables, maternal surgical morbidity was found to be significantly higher for non-Hispanic Black (adjusted odds ratios [aORs] 1.96, 95% confidence intervals [CIs] 1.63–2.35) and Hispanic (aOR 1.66, 95% CI 1.37–2.01) women as compared with non-Hispanic white women. Neonatal morbidity was similarly found to be significantly associated with the Black race and Hispanic ethnicity. Conclusion In this cohort, the odds of cesarean-related maternal and neonatal morbidity were significantly higher for non-Hispanic Black and Hispanic women. These findings suggest race as a distinct risk factor for cesarean complications, and efforts to alleviate disparities should highlight cesarean section as an opportunity for improvement in outcomes. Key Points

Have Racial and Ethnic Disparities in Juvenile Justice Declined Over Time? An Empirical Assessment of the DMC Mandate

2020 ◽  
pp. 154120402096216
Author(s):  
Steven N. Zane
Keyword(s):  
Juvenile Justice ◽  
Ethnic Disparities ◽  
Criminal Court ◽  
Racial And Ethnic Disparities ◽  
Implementation Failure ◽  
Theory Failure ◽  
Hispanic White ◽  
Final Disposition ◽  
Over Time ◽  
Research And Policy

The present study examines whether racial and ethnic disparities in juvenile justice declined significantly in a state that has made substantial reform efforts in compliance with the Disproportionate Minority Contact (DMC) mandate. Using a sample of all referrals in Connecticut with final disposition in 2000 (N = 18,458) or 2010 (N = 12,265), the study employed multilevel modeling with cross-level interactions to assess whether disparities changed over time for five outcomes: detention, petition, adjudication, commitment, and waiver to criminal court. Findings indicated that Black-White disparities in detention decreased over time, while Black-White disparities increased for petition, adjudication, and waiver. Findings also indicated that Hispanic-White disparities increased for adjudication (while not changing for other outcomes). The limited success of the DMC mandate may be explained by implementation failure or theory failure. Adjudicating between these alternative explanations is needed to guide future reform efforts. Several implications for research and policy are discussed, including whether reform efforts should focus on overall harm reduction rather than proportional representation.

scholarly journals Incidence of Mild Cognitive Impairment, Conversion to Probable Dementia, and Mortality

2021 ◽  
Vol 36 ◽  
pp. 153331752110122
Author(s):  
Yun Zhang ◽  
Ginny Natale ◽  
Sean Clouston
Keyword(s):  
Cognitive Impairment ◽  
Ethnic Disparities ◽  
Community Dwelling ◽  
High Rate ◽  
Survival Models ◽  
Racial And Ethnic Disparities ◽  
Older Americans ◽  
Cognitively Normal ◽  
Beneficial Impact ◽  
Hispanic White

Background: Few studies have jointly estimated incidence of MCI, conversion to probable dementia, and mortality in a nationally representatie sample. Methods: We used data from six waves of the National Health and Aging Trends Study (2011-2016). Multivariable-adjusted multi-state survival models (MSMs) were used to model incidence upon accounting for misclassification. Results: A total of 6,078 eligible NHATS participants were included (average age: 77.49 ± 7.79 years; 58.42% females; 68.99% non-Hispanic white). The incidence of MCI was estimated to be 41.0 [35.5, 47.3]/1,000 person-years (PY). Participants converted to probable dementia at a high rate of 241.3 [189.6, 307.0]/1,000 PY, though a small number also reverted from MCI to cognitively normal. Education was associated with lower incidence of MCI and conversion to probable dementia, but increased mortality in those with MCI. There were also substantial racial and ethnic disparities in the incidence of MCI and dementia. Conclusions: Our results underscore the relatively common incidence of and conversions between MCI and dementia in community-dwelling older Americans and uncover the beneficial impact of education to withstand cognitive impairment before death.

scholarly journals Racial and Ethnic Disparities in Heart and Cerebrovascular Disease Deaths During the COVID-19 Pandemic in the United States

Circulation ◽  
2021 ◽  
Author(s):  
Rishi Wadhera ◽  
Jose F. Figueroa ◽  
Fatima Rodriguez ◽  
Michael Liu ◽  
Wei Tian ◽  
...  
Keyword(s):  
United States ◽  
Heart Disease ◽  
Cerebrovascular Disease ◽  
Ethnic Minorities ◽  
Minority Group ◽  
Ethnic Disparities ◽  
The United States ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

Background: Cardiovascular deaths increased during the early phase of the COVID-19 pandemic in the United States. However, it is unclear whether racial/ethnic minorities have experienced a disproportionate rise in heart disease and cerebrovascular disease deaths. Methods: We used the National Center for Health Statistics to identify heart disease and cerebrovascular disease deaths for non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic individuals from March-August 2020 (pandemic period), as well as for the corresponding months in 2019 (historical control). We determined the age- and sex-standardized deaths per million by race/ethnicity for each year. We then fit a modified Poisson model with robust standard errors to compare change in deaths by race/ethnicity for each condition in 2020 vs. 2019. Results: There were a total of 339,076 heart disease and 76,767 cerebrovascular disease deaths from March through August 2020, compared to 321,218 and 72,190 deaths during the same months in 2019. Heart disease deaths increased during the pandemic in 2020, compared with the corresponding period in 2019, for non-Hispanic White (age-sex standardized deaths per million, 1234.2 vs. 1208.7; risk ratio for death [RR] 1.02, 95% CI 1.02-1.03), non-Hispanic Black (1783.7 vs. 1503.8; RR 1.19, 1.17-1.20), non-Hispanic Asian (685.7 vs. 577.4; RR 1.19, 1.15-1.22), and Hispanic (968.5 vs. 820.4, RR 1.18, 1.16-1.20) populations. Cerebrovascular disease deaths also increased for non-Hispanic White (268.7 vs. 258.2; RR 1.04, 95% CI 1.03-1.05), non-Hispanic Black (430.7 vs. 379.7; RR 1.13, 95% CI 1.10-1.17), non-Hispanic Asian (236.5 vs. 207.4; RR 1.15, 1.09-1.21), and Hispanic (264.4 vs. 235.9; RR 1.12, 1.08-1.16) populations. For both heart disease and cerebrovascular disease deaths, each racial and ethnic minority group experienced a larger relative increase in deaths than the non-Hispanic White population (interaction term, p<0.001). Conclusions: During the COVID-19 pandemic in the US, Black, Hispanic, and Asian populations experienced a disproportionate rise in deaths due to heart disease and cerebrovascular disease, suggesting that racial/ethnic minorities have been most impacted by the indirect effects of the pandemic. Public health and policy strategies are needed to mitigate the short- and long-term adverse effects of the pandemic on the cardiovascular health of minority populations.

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