US-Born Black Women and Black Immigrant Women: an Exploration of Disparities in Health Care and Sociodemographic Factors Related to Low Birth Weight.

PURPOSE: This study explores whether nativity differences in health care and sociodemographic factors help to account for nativity differences in low birth weight (LBW) when comparing US-born Black women (USBW) to Black Immigrant women (BIW). METHODS: Bivariate analyses and multinomial nested logit (MNL) models were performed using the National Survey of Family Growth (NSFG) dataset. RESULTS: Statistically significant nativity differences between USBW and BIW were found across variables of LBW (p = .009), marital status (p < .001), education level (p < .001), receiving public assistance (p < .001), health care coverage (p < .001), age (p < .001), and poverty level income (p < .001). Results from the MNL models indicated that BIW were 91% less likely to have a LBW baby (p < .001). When accounting for other sociodemographic and health care related variables differing by nativity, although a statistically significant, narrowing gap between BIW and USBW was observed (OR = .12, p < .001), BIW were still less likely to have a LBW baby. CONCLUSIONS: Differences between USBW and BIW across sociodemographic variables and health care related factors related to adverse pregnancy outcomes were observed in this study. Controlling for the factors attenuated nativity differences but did not eliminate the differences on LBW. Future research should continue to explore this relationship.

An Exploration of Socio-demographic, Economic, and Environmental Factors in Black/White Disparities in Low Birth Weight Outcomes: A Cross-Sectional Study.

BACKGROUND: Numerous studies have been conducted to seek a better understanding of disparities in adverse pregnancy outcomes. The present study aimed to explore racial differences in influential socio-demographic, economic, and environmental factors in women who have had a low birth weight (LBW) infant (outcome variable). STUDY DESIGN: A cross-sectional study. METHODS: This study used data from the Fragile Families and Child Wellbeing Study (FFCWS). Univariate and multivariate analyses were performed. RESULTS: The obtained results pointed to statistical racial differences between Non-Hispanic (NH) Black and NH White women in the socio-demographic variable of marital status (P<0.001).  Regarding the assessed economic stability variables, employment status (P=0.032), poverty level (P<0.001), earnings (P=0.038), and federal government assistance paying for rent (P=0.007) were statistically significant across the two racial groups.  The environmental factors that were statistically significant across racial groups were living in public housing projects (P=0.018), car ownership (P<0.001), and neighborhood safety (P=0.010).  The results of the multivariate models revealed that NH Black race and government assistance to pay rent were associated with an increased likelihood of LBW, while being married, having health care coverage, and living in public housing were associated with a decreased likelihood. CONCLUSION: As evidenced by the obtained results, there were statistically significant racial differences in sociodemographic, economic, and environmental/physical characteristics associated with adverse pregnancy outcomes.

Racial Disparities and COVID-19: Exploring the Relationship Between Race/Ethnicity, Personal Factors, Health Access/Affordability, and Conditions Associated with an Increased Severity of COVID-19.

COVID-19 was recognized as a pandemic in the United States in March 2020. Since the emergence, research has explored conditions associated with the illness; however, racial disparities remain underexplored. The purpose of this paper is to explore disparities in conditions associated with an increased severity risk of COVID-19 including race, personal factors, healthcare accessibility, and affordability. Using data from the 2018 National Health Interview Survey (NHIS), univariate and multivariate analysis were performed. More Non-Hispanic (NH) Blacks (61.1%) and NH Whites (61.2%) had conditions associated with increased severity risk of COVID-19 compared to Hispanics (47.1%) (p < .001). Racial differences revealed a higher proportion of NH Blacks with increased severity risk of COVID-19 were female (p < .001), not married (p < .001), not employed for wages (p < .001), had accessibility issues with transportation (p < .001), and had affordability issues with paying for medicine (p < .001). A higher proportion of Hispanic persons had a health place change (p = .020), had accessibility issues (e.g. telephone (p < .001), longer wait times (p < .001), closed facility (p = .038)) and had affordability issue with worrying about pay (p < .001). Significant predictors that were positively associated with increased severity risk of COVID-19 for all racial/ethnic groups were being NH Black, older age, having appointment issues, and affordability issues with medicine. Differences in magnitude across racial group dynamics were observed. Racial disparities exist in conditions associated with increased severity risk of COVID-19. As future policies and interventions are developed, it is important to consider differentials across racial group dynamics.

Racial Disparities in Low Birthweight Risk: an Examination of Stress Predictors.

OBJECTIVE: This paper describes racial disparities in low birthweight (LBW) risk between Black women and White women and examines the relationship between race and stressors such as socioeconomic factors, access to health care, and social and health characteristics. METHODS: We analyzed data from the National Survey of Family Growth dataset collected in the USA between 2006 and 2010 (N = 1516). Multivariate logistic regression models were performed. RESULTS: Prevalence of LBW was 5.6 % for pregnancies among White women and 12.2 % among Black women. Black women who had a LBW baby had a lower socioeconomic status (e.g., received assistance to pay for delivery of the baby and public assistance in the prior year). Black women who had a LBW baby were more likely to have reported having good health compared with White women (67.8 vs. 45.1 %, p < .10). Pregnancies of Black women were 2.6 times more likely (odds ratio (OR) = 2.33; 95 % confidence interval (CI), 1.12-6.04) to result in a LBW baby than pregnancies among White women. Pregnancies of women in the income group of 300 % or higher than the poverty level were less likely to be associated with a LBW baby than those among women in the 150-299 % income group (p < .10). Obese women were less likely to have LBW children than those who were underweight or normal weight (p < .10). Among pregnancies of White mothers (n = 943), the only significant variable was self-reported health status. White women who reported having poorer health were 3.7 times more likely to have LBW than those who reported having better health (p < .10). Among Black mothers, the only predictor that was negatively associated with an increased likelihood of having a LBW baby was the SES stressor related to receiving public assistance. CONCLUSION: Racial differences between Black and White women were observed in LBW risk based on socioeconomic factors. We analyzed a large number of stressors, but racial differences remained even after taking these stressors into account. Future policies and research should continually address these differences to decrease LBW risk within and across racial groups.