Perspectives of Doulas of Color on their Role in Alleviating Racial Disparities in Birth Outcomes: A Qualitative Study

Abstract Background A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. Methods We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. Results There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. Conclusion Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

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Does increasing access to prenatal care reduce racial disparities in birth outcomes?

Journal of Pediatric Nursing ◽

10.1016/j.pedn.2021.01.012 ◽

2021 ◽

Vol 59 ◽

pp. 96-102

Author(s):

Holly Thurston ◽

Bronwyn E. Fields ◽

Jamie White

Keyword(s):

Prenatal Care ◽

Racial Disparities ◽

Birth Outcomes

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Pre-pregnancy cardiovascular risk factors and racial disparities in birth outcomes: the Bogalusa Heart Study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-018-1959-y ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Emily W. Harville ◽

Leann Myers ◽

Tian Shu ◽

Maeve E. Wallace ◽

Lydia A. Bazzano

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Racial Disparities ◽

Cardiovascular Risk Factors ◽

Birth Outcomes ◽

Bogalusa Heart Study ◽

Heart Study

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Racial Disparities in US Infant Birth Outcomes: A Protective Effect of Military Affiliation?

Race and Social Problems ◽

10.1007/s12552-013-9108-8 ◽

2013 ◽

Vol 6 (2) ◽

pp. 161-180 ◽

Cited By ~ 2

Author(s):

Jennifer Lundquist ◽

Irma Elo ◽

Wanda Barfield ◽

Zhun Xu

Keyword(s):

Protective Effect ◽

Racial Disparities ◽

Birth Outcomes ◽

Infant Birth Outcomes ◽

Infant Birth

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Population Changes, Racial/Ethnic Disparities, and Birth Outcomes in Louisiana After Hurricane Katrina

Disaster Medicine and Public Health Preparedness ◽

10.1001/dmp.2010.15 ◽

2010 ◽

Vol 4 (S1) ◽

pp. S39-S45 ◽

Cited By ~ 15

Author(s):

Emily W. Harville ◽

Tri Tran ◽

Xu Xiong ◽

Pierre Buekens

Keyword(s):

Preterm Birth ◽

Prenatal Care ◽

Cesarean Section ◽

Racial Disparities ◽

New Orleans ◽

Birth Outcomes ◽

The State ◽

Obstetric Outcomes ◽

Population Changes ◽

Inadequate Prenatal Care

ABSTRACTObjective: To examine how the demographic and other population changes affected birth and obstetric outcomes in Louisiana, and the effect of the hurricane on racial disparities in these outcomes.Methods: Vital statistics data were used to compare the incidence of low birth weight (LBW) (<2500 g), preterm birth (PTB) (37 weeks' gestation), cesarean section, and inadequate prenatal care (as measured by the Kotelchuck index), in the 2 years after Katrina compared to the 2 years before, for the state as a whole, region 1 (the area around New Orleans), and Orleans Parish (New Orleans). Logistic models were used to adjust for covariates.Results: After adjustment, rates of LBW rose for the state, but preterm birth did not. In region 1 and Orleans Parish, rates of LBW and PTB remained constant or fell. These patterns were all strongest in African American women. Rates of cesarean section and inadequate prenatal care rose. Racial disparities in birth outcomes remained constant or were reduced.Conclusions: Although risk of LBW/PTB remained higher in African Americans, the storm does not appear to have exacerbated health disparities, nor did population shifts explain the changes in birth and obstetric outcomes.(Disaster Med Public Health Preparedness. 2010;4:S39-S45)

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