Political representation and perinatal outcomes to Black, White, and Hispanic people in Georgia: a cross-sectional study.
Hypertensive disorders of pregnancy
Local government
Low birthweight
Maternal and infant health
Preterm birth
Structural racism
Journal
Annals of epidemiology
ISSN: 1873-2585
Titre abrégé: Ann Epidemiol
Pays: United States
ID NLM: 9100013
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
08
06
2023
revised:
24
07
2023
accepted:
05
09
2023
medline:
27
11
2023
pubmed:
10
9
2023
entrez:
9
9
2023
Statut:
ppublish
Résumé
Our goal was to estimate differences in perinatal outcomes by racial differences in political representation, a measure of structural racism. We gathered data on the racial composition of county-level elected officials for all counties in Georgia (n = 159) in 2022. We subtracted the percent of non-White elected officials from the percent of non-White residents to calculate the "representation difference," with greater positive values indicating a larger disparity. We linked this to data from 2020-2021 birth certificates (n = 238,795) on outcomes (preterm birth, <37 weeks, low birthweight birth <2500 g, birthweight, hypertensive disorders of pregnancy, cesarean delivery). We fit log binomial and linear models with generalized estimating equations, stratified by individual race/ethnicity and including individual and county covariates. Median representation difference was 17.5% points (interquartile range: 17.2). A 25-percentile point increase in representation difference was associated with a greater risk of hypertensive disorders of pregnancy [White: adjusted risk ratio (RR): 1.12, 95% confidence interval (CI): (1.05, 1.2), Black: 1.06, 95% CI: (0.95, 1.17), other: 1.14, 95% CI: (1.0, 1.3), Hispanic: 1.19, 95% CI: (1.07, 1.32)] and lower mean birthweight for Black birthing people [adjusted beta -15.3, 95% CI: (-25.5, -7.4)]. Parity in political representation may be associated with healthier environments.
Identifiants
pubmed: 37689094
pii: S1047-2797(23)00167-9
doi: 10.1016/j.annepidem.2023.09.001
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Kaitlyn Stanhope reports financial support was provided by National Institutes of Health. Sheree Boulet reports financial support was provided by National Institutes of Health. Sierra Carter reports financial support was provided by National Institutes of Health.