Pregnancy-Related Mortality Disparities During the COVID-19 Pandemic.

To compare pregnancy-related mortality ratios (PRMRs) associated with COVID-19 by race/ethnicity, by region of residence, and in states with and without Medicaid expansion. We used 2020-2021 data from the US Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research in our analysis. We stratified PRMRs by race/ethnicity, census regions, and Medicaid expansion and nonexpansion states.

Road to Equity in Maternal and Child Health: Honoring the Past and Blazing New Paths.

Purpose: This paper is a historical account of an initiative, as recalled by the authors who were directly involved, that brought to the forefront the long-standing and unjust reproductive health inequities in the United States. It is composed of three distinct but interrelated parts that together map the past, present, and future of addressing racial inequities in Maternal and Child Health.

Description: This paper is composed of three distinct but interrelated parts that together map the past, present, and future of addressing racial inequities in Maternal and Child Health.

REPRINT OF: Racism, Sexism, and Social Class: Implications for Studies of Health, Disease, and Well-being.

Editor's Note: This article is a reprint of a previously published article. For citation purposes, please use the original publication details: Krieger N, Rowley DL, Herman AA, Avery B, Phillips MT. Racism, sexism, and social class: implications for studies of health, disease, and well-being.

The Other Side of Through: Young Breast Cancer Survivors' Spectrum of Sexual and Reproductive Health Needs.

The long-term reproductive health impact of cancer treatments is a concern for premenopausal women with a history of breast cancer. This study examined the unmet sexual and reproductive health needs of breast cancer survivors, as well as concordances and discordances in needs by childbearing status and race. We interviewed 17 women diagnosed with breast cancer between the ages of 18 and 45 years and living in North Carolina.

Preterm Birth and Receipt of Postpartum Contraception Among Women with Medicaid in North Carolina.

Objectives: To compare receipt of contraception and method effectiveness in the early postpartum period among women with and without a recent preterm birth (PTB).

Methods: We used data from North Carolina birth certificates linked to Medicaid claims. We assessed contraceptive claims with dates of service within 90 days of delivery among a retrospective cohort of women who had a live birth covered by Medicaid between September 2011 and 2012 (n = 58,201).

DNA methylation of imprinted genes at birth is associated with child weight status at birth, 1 year, and 3 years.

Background: This study assessed the associations between nine differentially methylated regions (DMRs) of imprinted genes in DNA derived from umbilical cord blood leukocytes in males and females and (1) birth weight for gestational age score, (2) weight-for-length (WFL) score at 1 year, and (3) body mass index (BMI) score at 3 years.

Methods: We conducted multiple linear regression in  = 567 infants at birth,  = 288 children at 1 year, and  = 294 children at 3 years from the Newborn Epigenetics Study (NEST). We stratified by sex and adjusted for race/ethnicity, maternal education, maternal pre-pregnancy BMI, prenatal smoking, maternal age, gestational age, and paternal race.

Low maternal adherence to a Mediterranean diet is associated with increase in methylation at the differentially methylated region in female infants.

Diet is dictated by the surrounding environment, as food access and availability may change depending on where one lives. Maternal diet during pregnancy is an important part of the environment, and may affect the epigenome. Studies looking at overall diet pattern in relation to DNA methylation have been lacking.

Achieving Breastfeeding Equity: A Study of a National Breastfeeding Initiative.

Background: Equity in breastfeeding could reduce excess morbidity and mortality among children and mothers of color. Few programs that support breastfeeding have been evaluated for their capacity to create equity. The aim of this study was to assess the extent to which a diverse set of national breastfeeding programs actively promoted equity.

Dimensionality and R4P: A Health Equity Framework for Research Planning and Evaluation in African American Populations.

Introduction Existing health disparities frameworks do not adequately incorporate unique interacting contributing factors leading to health inequities among African Americans, resulting in public health stakeholders' inability to translate these frameworks into practice. Methods We developed dimensionality and R4P to integrate multiple theoretical perspectives into a framework of action to eliminate health inequities experienced by African Americans. Results The dimensional framework incorporates Critical Race Theory and intersectionality, and includes dimensions of time-past, present and future.

Cumulative Lactation and Onset of Hypertension in African-American Women.

Hypertension affects nearly 1 of 3 women and contributes to cardiovascular disease, the leading cause of death in the United States. Breastfeeding leads to metabolic changes that could reduce risks of hypertension. Hypertension disproportionately affects black women, but rates of breastfeeding among black women lag behind those in the general population.

Prevalence of preterm, low birthweight, and small for gestational age delivery after breast cancer diagnosis: a population-based study.

Background: Black-white disparities in breast cancer incidence rates and birth outcomes raise concerns about potential disparities in the reproductive health of premenopausal breast cancer survivors. We examined the prevalence of preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) by breast cancer history and effect modification by race.

Methods: We analyzed linked North Carolina birth records and Central Cancer Registry files from 1990 to 2009 (n = 2,325,229).

Predicting Preterm Birth Among Women Screened by North Carolina's Pregnancy Medical Home Program.

Objective: To determine which combination of risk factors from Community Care of North Carolina's (CCNC) Pregnancy Medical Home (PMH) risk screening form was most predictive of preterm birth (PTB) by parity and race/ethnicity.

Methods: This retrospective cohort included pregnant Medicaid patients screened by the PMH program before 24 weeks gestation who delivered a live birth in North Carolina between September 2011-September 2012 (N = 15,428). Data came from CCNC's Case Management Information System, Medicaid claims, and birth certificates.

Contextualized stress, global stress, and depression in well-educated, pregnant, African-American women.

Purpose: Well-educated, pregnant, African-American women are disproportionately at risk for adverse birth outcomes and depression linked to stress has been established as a significant contributor to poor birth outcomes. Since racial and gendered stress have been identified as threats to birth outcomes, a cross-sectional study was conducted that utilized the Jackson, Hogue, Phillips Contextualized Stress Measure (JHP), a measurement of racial and gendered stress, and the Perceived Stress Scale (PSS), an assessment of global stress, to detect their associations and predictions for depression as measured by the Beck Depression Inventory II (BDI-II).

Method: We recruited 101 pregnant, well-educated, African-American women from ob-gyn offices who were administered the JHP, the PSS, and the BDI-II.

Barriers to women's participation in inter-conceptional care: a cross-sectional analysis.

Background: We describe participation rates in a special interconceptional care program that addressed all commonly known barriers to care, and identify predictors of the observed levels of participation in this preventive care service.

Methods: A secondary analysis of data from women in the intervention arm of an interconceptional care clinical trial in Philadelphia (n = 442). Gelberg-Andersen Behavioral Model for Vulnerable Populations to Health Services (herein called Andersen model) was used as a theoretical base.

Disparities in infant mortality and effective, equitable care: are infants suffering from benign neglect?

Quality care for infant mortality disparity elimination requires services that improve health status at both the individual and the population level. We examine disparity reduction due to effective care and ask the following question: Has clinical care ameliorated factors that make some populations more likely to have higher rates of infant mortality compared with other populations? Disparities in postneonatal mortality due to birth defects have emerged for non-Hispanic black and Hispanic infants. Surfactant and antenatal steroid therapy have been accompanied by growing disparities in respiratory distress syndrome mortality for black infants.

Where is the F in MCH? Father involvement in African American families.

Objectives: To: 1) review the historical contexts and current profiles of father involvement in African American families; 2) identify barriers to, and supports of, involvement; 3) evaluate the effectiveness of father involvement programs; and 4) recommend directions for future research, programs, and public policies.

Methods: Review of observational and interventional studies on father involvement.

Results: Several historical developments (slavery, declining employment for Black men and increasing workforce participation for Black women, and welfare policies that favored single mothers) led to father absence from African American families.

The Healthy African American Families (HAAF) project: from community-based participatory research to community-partnered participatory research.

During the past two decades, there has been an increased use of community-based participatory research in public health activities, especially as part of efforts to understand health disparities affecting communities of color. This article describes the history and lessons learned of a long-standing community participatory project, Healthy African American Families (HAAF), in Los Angeles, California. HAAF evolved from a partnership formed by a community advisory board, university, and federal health agency to an independent, incorporated community organization that facilitates and brokers research and health promotion activities within its community.

United States black:white infant mortality disparities are not inevitable: identification of community resilience independent of socioeconomic status.

Introduction: U.S. disparities in Black:White infant mortality are persistent.

Utilization of joint arthroplasty: racial and ethnic disparities in the Veterans Affairs Health Care System.

Studies within the Veterans Administration health care system have been very useful in identifying the existence of racial and ethnic disparities with regard to patient utilization of hip and knee joint arthroplasty. Existing studies have focused on three factors: estimates of joint arthroplasty utilization,postoperative outcomes, and patient-related variables (eg, expectations of and familiarity with the procedure, religious beliefs). Although Veterans Administration-based studies have produced helpful data, these data are limited because the populations studied are not representative of the larger US population.