The Index of Concentration at the Extremes (ICE) and Pregnancy-Associated Mortality in Louisiana, 2016-2017.
Index of Concentration at the Extremes (ICE)
Maternal health
Maternal mortality
Structural racism
Journal
Maternal and child health journal
ISSN: 1573-6628
Titre abrégé: Matern Child Health J
Pays: United States
ID NLM: 9715672
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
accepted:
09
06
2021
pubmed:
21
6
2021
medline:
20
4
2022
entrez:
20
6
2021
Statut:
ppublish
Résumé
Social and contextual factors underlying the continually disproportionate and burdensome risk of adverse health outcomes experienced by Black women in the US are underexplored in the literature. The aim of this study was to use an index based on area-level population distributions of race and income to predict risk of death during pregnancy and up to 1 year postpartum among women in Louisiana. Using vital records data provided by the Louisiana Department of Health 2016-2017 (n = 125,537), a modified Poisson model was fit with generalized estimating equations to examine the risk of pregnancy-associated death associated with census tract-level values of the Index of Concentration at the Extremes (ICE)-grouped by tertile-while adjusting for both individual and tract-level confounders. Analyses resulted in an estimated 1.73 (95% CI 1.02-2.93) times increased risk for pregnancy-associated death for those in areas which were characterized by concentrated deprivation (high proportions of Black and low-income residents) relative to those in areas of concentrated privilege (high proportions of white and high-income residents), independent of other factors. In addition to continuing to consider the deeply entrenched racism and economic inequality that shape the experience of pregnancy-associated death, we must also consider their synergistic effect on access to resources, maternal population health, and health inequities.
Identifiants
pubmed: 34148221
doi: 10.1007/s10995-021-03189-1
pii: 10.1007/s10995-021-03189-1
pmc: PMC8684557
mid: NIHMS1732828
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
814-822Subventions
Organisme : NICHD NIH HHS
ID : R01 HD092653
Pays : United States
Organisme : NICHD NIH HHS
ID : R01 HD096070
Pays : United States
Organisme : National Institute of Child Health and Human Development
ID : R01HD092653; R01HD096070
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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