Municipal social expenditures and maternal health disparities: a study of linked birth and hospitalisation records.

Background: Local government expenditures provide services and benefits that can affect health but the extent to which they are associated with narrowing or widening of racial/ethnic and socioeconomic disparities in health is unknown. We examined race/ethnicity-stratified and education-stratified associations between municipal social expenditures-those on housing, transportation, education, and other society-wide needs-and serious life-threatening maternal health conditions in a large US state.

Methods: In this cross-sectional study, we used individual birth records for 1 003 974 births in the state of New Jersey from 1 January 2008 to 31 December 2018 linked to individual maternal hospital discharge records and municipality-level characteristics for 564 municipalities.

Cost of Public Health Insurance for US-Born and Immigrant Adults.

Importance: The immigrant population in the US has low health insurance coverage. Surveys find that approximately one-half of the US population is opposed to public health insurance of immigrants, and there is a widely held belief that immigrants are a state fiscal liability.

Objective: To estimate the cost of providing public health insurance to immigrants in the US.

Racialized police use of force and birth outcomes.

Objective: To estimate associations between police use of force (PUOF) in local jurisdictions and birth outcomes of Black women compared to White women.

Methods: Using birth records linked to municipal police department data on PUOF incidents, we estimated associations between overall and racialized PUOF and birth outcomes of 75,461 Black women and 278,372 White women across 430 municipalities in New Jersey (2012-2016).

Results: Overall PUOF was not associated with birth outcomes of Black or White women.

Association Between Housing Affordability and Severe Maternal Morbidity.

Importance: The number of people living in unaffordable housing (relative to income) is projected to continue increasing as housing cost inflation outpaces incomes in the US. Although reproductive-aged women have disproportionately high housing costs, particularly around the time of childbirth, data on associations between housing costs and maternal health and the role of publicly supported affordable housing programs in mitigating those associations are lacking.

Objective: To estimate associations between area-level rental housing costs and severe maternal morbidity (SMM) and assess the potential mitigating role of publicly supported affordable housing.

Effect of Schooling on Anemia and Nutritional Status Among Women: A Natural Experiment in Ethiopia.

This study estimates the effect of length of schooling on anemia and nutritional status and evaluates the cost-effectiveness of primary schooling as an anemia intervention for women of childbearing age in Ethiopia. In 1994-1995, Ethiopia abolished primary school tuition fees and embarked on a large-scale educational investment program, which increased primary school enrollment and retention. An instrumented regression-discontinuity design was used to examine the effect on anemia risk and body mass index (BMI) of an increase in length of schooling resulting from the reforms, as a natural experiment.

Municipality-Level Variation in Severe Maternal Morbidity and Association With Municipal Expenditures in New Jersey.

Importance: Severe maternal morbidity (SMM) is a major risk factor for maternal mortality, yet little is known about geographic variation in SMM or factors associated with geographical variation at the local level. Municipal governments incur substantial expenditures providing services that are an essential part of residents' lives, but associations between municipal expenditures and SMM have not been previously examined.

Objective: To investigate variation in rates of SMM across municipalities in New Jersey, the contributions of individual-level characteristics and municipal expenditures to that variation, and associations between municipal expenditures and SMM.

Medicaid Expansions and Participation in Supplemental Security Income by Noncitizens.

To estimate the effect of Medicaid expansion on noncitizens' and citizens' participation in the Supplemental Security Income (SSI) program. The Affordable Care Act (ACA) expanded Medicaid eligibility to cover low-income nonelderly adults without children, thus delinking their Medicaid participation from participation in the SSI program. Using data from the Social Security Administration for 2009 through 2018 (n = 1020 state-year observations) and the Current Population Survey for 2009 through 2019 (n = 78 776 respondents), we employed a difference-in-differences approach comparing SSI participation rates in US states that adopted Medicaid expansion with participation rates in nonexpansion states before and after ACA implementation.

Disability among children of immigrants from India and China: Is there excess disability among girls?

We investigate whether there is excess morbidity among daughters of Indian or Chinese immigrants in the US by studying the prevalence of disability among children. We use data from the 2012-14 American Community Surveys on approximately 20,000 US-born children of Indian and Chinese immigrants. Children of US natives are used as a comparison group to account for innate differences in disability between the sexes.

Sex Composition of Children and Spousal Sexual Violence in Sub-Saharan Africa.

Objective In societies with a cultural preference for sons over daughters, women who do not bear sons may be at increased risk for spousal violence. This study examined whether women with daughters only are at an elevated risk for spousal sexual violence compared to women with sons only in Sub-Saharan Africa. The study tested the hypothesis that the association between sex composition of children and spousal sexual violence would be observed only in large families.

Missing Time with Parents: Son Preference among Asians in the United States.

We study prevalence of son preference in families of East and South Asian origin living in the U.S. by investigating parental time investments in children using American Time Use Surveys.

'Drug adherence levels are falling down again': health worker perceptions of women's service utilization before and after integration of HIV/AIDS services into general care in India.

Integrated models of HIV/AIDS service delivery are believed to have advantages over stand-alone models of care from health planners' and providers' perspectives. Integration models differ, yet there is little information about the influence of differing models on workers' beliefs about models' efficacy. Here, we examine the effect of integration of HIV care into the general health system in India.

Women's Land Tenure Security and Household Human Capital: Evidence from Ethiopia's Land Certification.

This paper examines the impact of Ethiopia's gendered land certification programs on household consumption of healthcare, food, education, and clothing. Ethiopia embarked on a land tenure reform program in 1998, after years of communism during which all land was nationalized. The reform began in Tigray region where land certificates were issued to household heads, who were primarily male.

Importance of Women's Relative Socioeconomic Status within Sexual Relationships in Communication about Safer Sex and HIV/STI Prevention.

The socioeconomic status (SES) of women is increasingly considered an important factor for HIV/STI risk. The HIV/STI literature has largely focused on women's absolute levels of SES, and therefore, the importance of their SES relative to their male sexual partners remains understudied. This paper examines the association between women's relative SES and frequency of safer sex communication among heterosexual couples.

Symptom trajectories and psychosis onset in a clinical high-risk cohort: the relevance of subthreshold thought disorder.

Background: Prior studies have implicated baseline positive and negative symptoms as predictors of psychosis onset among individuals at clinical high risk (CHR), but none have evaluated latent trajectories of symptoms over time. This study evaluated the dynamic evolution of symptoms leading to psychosis onset in a CHR cohort.

Method: 100 CHR participants were assessed quarterly for up to 2.

Women's land ownership and risk of HIV infection in Kenya.

Theory predicts that land ownership empowers women to avoid HIV acquisition by reducing their reliance on risky survival sex and enhancing their ability to negotiate safer sex. However, this prediction has not been tested empirically. Using a sample of 5511 women working in the agricultural sector from the 1998, 2003 and 2008-09 Kenya Demographic and Health Surveys, we examined the relationship between women's land ownership and participation in transactional sex, multiple sexual partnerships and unprotected sex, and HIV infection status.

State of the science of adherence in pre-exposure prophylaxis and microbicide trials.

For pre-exposure prophylaxis (PrEP) and microbicides to effectively prevent HIV, optimal treatment adherence is required. Adherence to these strategies, however, has not been sufficiently studied. This investigation systematically reviews oral PrEP and microbicide trials across 4 domains of adherence: (1) definition and measures used, (2) risks for nonadherence, (3) promotion strategies, and (4) effects on outcomes.