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1.
The objectives of this study were to determine if racial and ethnic differences in personal capital during pregnancy exist and to estimate the extent to which any identified racial and ethnic differences in personal capital are related to differences in maternal sociodemographic and acculturation characteristics. Data are from the 2007 Los Angeles Mommy and Baby study (n = 3,716). Personal capital comprised internal resources (self-esteem and mastery) and social resources (partner, social network, and neighborhood support) during pregnancy. The relationships between race/ethnicity and personal capital were assessed using multivariable generalized linear models, examining the impact of sociodemographic and acculturation factors on these relationships. Significant racial and ethnic disparities in personal capital during pregnancy exist. However, socioeconomic status (i.e., income and education) and marital status completely explained Black-White disparities and Hispanic-White disparities in personal capital, whereas acculturation factors, especially nativity and language spoken at home, partially mediated the disparities in personal capital between Asian/Pacific Islander women and White women. Findings suggest that the risks associated with low socioeconomic status, single motherhood, and low acculturation, rather than race or ethnicity, contribute to low personal capital for many pregnant women. As personal capital during pregnancy may influence subsequent maternal and child health outcomes, the development of interventions should consider addressing sociodemographic and acculturation factors in order to reduce racial and ethnic disparities in personal capital and ultimately in poor maternal and child health outcomes.  相似文献   

2.
Discrepancies exist in existing research regarding the association between social capital and self-rated health, most of which has been undertaken in the developed world. The aim of this study is first to assess the levels of the various variables describing individual social capital in Jews and Arab residing in Israel, and second to assess the association between individual social capital and self-rated health in these two population groups. The data were obtained from an Israeli health interview survey (knowledge, attitudes and practices (KAP)) conducted during 2004-2005, which is based on 3,365 interviews with adult Jews and 985 adult Arabs. Social capital measures included social trust, neighborhood safety, perceived helpfulness, trust in local and national authorities and social support. Data were also obtained on self-rated health and socioeconomic and demographic variables. Multivariate logistic regression revealed that Jews reported higher levels of social trust, perceived helpfulness, trust in authorities, and social support compared to Arabs, after adjusting for demographic and socioeconomic variables. Social contacts, however, were reported more frequently in the Arab population. Neighborhood safety was similar in the two population groups. Among Jews, those reporting higher levels of individual social capital reported better self-rated health after adjusting for demographic and socioeconomic variables. Among Arabs, only those reporting higher levels of social support reported better self-rated health. In Israel, individual levels of social capital seem to be lower in the Arab minority than in the Jewish majority. Individual social capital was associated with better self-rated health mainly in the Jewish population and less so in the Arab population. Social capital factors may be associated with health to a higher extent in affluent populations with relatively high social capital and less so in low social capital and more traditional communities. More research is needed to verify these differences.  相似文献   

3.
This study examines the association between neighborhood socioeconomic status (SES) and preterm birth among U.S. Black women. A composite variable for neighborhood SES, derived from 7 U.S. Census Bureau indicators, was assessed in relation to self-reported preterm birth (505 spontaneous and 452 medically indicated) among 6,390 women in the Black Women’s Health Study who delivered singleton births during 1995–2003. The odds ratio (OR) for preterm birth, comparing the lowest (most deprived) to the highest (least deprived) quartiles of neighborhood SES, was 0.98 (95 % CI, 0.80, 1.20) after adjustment for individual-level characteristics. Low neighborhood SES was not associated with spontaneous or medically indicated preterm birth overall or within strata of maternal age, education, or geographic region. The only significant finding was higher odds of medically indicated preterm birth associated with low neighborhood SES among unmarried women. Low neighborhood SES was not materially associated with preterm birth in this study of U.S. Black women.  相似文献   

4.
Socioeconomic disadvantage can be harmful for mother’s health and can influence child’s health long term. The aim of this study is to analyse social inequalities between pregnant women from four INMA (INfancia y Medio Ambiente) cohorts. The analysis included 2,607 pregnant women recruited between 2004 and 2008 from four INMA cohorts. Data on maternal characteristics were collected through two questionnaires completed in the first and third trimester of pregnancy. The relationship between socioeconomic status (SES) and maternal health, dietary intake, lifestyle habits and self-care related variables was modelled using logistic regression analysis. 33.5 % of women had a university level of education and 47 % had high occupational class. Women with higher SES reported healthier habits, fewer complications during pregnancy, better weight gain control and attended more prenatal appointments than women with lower SES. The risk of sedentary behaviour and passive smoking was higher among women with a lower level of education (OR = 1.7, 95 % CI 1.3–2.2 and OR = 1.6, 95 % CI 1.2–2.3, respectively) and with less skilled occupations (OR = 1.7, 95 % CI 1.4–2.0 and OR = 1.2, 95 % CI 1.0–1.5, respectively). Although both SES indicators—occupation and education—act as social determinants of diet, occupation was a more powerful determinant than education. For other lifestyle and self-caring variables, education was a more powerful predictor than occupation. Social inequalities were observed in health, habits and self-care during pregnancy. Proper care during pregnancy requires the control of common clinical variables and the knowledge of socioeconomic conditions of the pregnant women.  相似文献   

5.
We investigated the relationships between neighborhood socio-demographic characteristics (socioeconomic status [SES], percentage of Black residents, and percentage of Hispanic residents) and survey-based measures of the social environment (social cohesion, safety) and the physical environment (healthy food environment, walking environment) in six sites from 2000 through 2011. Neighborhood environments were patterned by area SES and racial/ethnic composition, such that higher SES and lower percentage minority neighborhoods had better physical and social environments. Increasing disparities over time were observed for some neighborhood environments. Further research should explore the role of neighborhood environments in maintaining or increasing social disparities in health.  相似文献   

6.

Purpose

This study explores the relationships between neighborhood structural differences such as socioeconomic status (SES), income inequality, and ethnic diversity on women’s mental health in Accra, Ghana.

Methods

The study used secondary data from the 2009 Women Health Survey Accra II, linked with the 2010 sub-metro level census figures on income inequality. The analytical sample consists of 2814 women nested within 195 enumeration areas (clusters) in the Accra Metropolitan Area (AMA). Multilevel binary logit and complimentary log–log models were used to analyze the data.

Results

Results suggest that social capital and neighborhood socioeconomic structural factors such SES, ethnic diversity, and housing ownership were associated with depressive symptoms, feeling downhearted, and self-reported health.

Conclusions

These findings suggest that policies and programs that improve the physical and economic conditions of deprived neighborhoods, as well as civic initiatives that improve social capital and cohesion, may be important for promoting collective actions and improving health outcomes in urban settings like Accra.
  相似文献   

7.
Disparities in health exist between the three main population groups in Israel, non-immigrant Jews, immigrants from the former Soviet Union (arriving in Israel since 1990) and Arabs. This study examines the relationship between health and socioeconomic status in this multicultural population and assesses to what extent subjective and objective socioeconomic measures may explain the disparities in health. A random cross sectional telephone survey of 1004 Israelis aged 35–65 was performed. The questionnaire measured physical and mental health-related quality of life using the Short Form 12. Information regarding subjective socioeconomic status (SSS) and objective socioeconomic status (SES) was collected.Arabs and immigrant women from the former Soviet Union had worse physical health compared to non-immigrant Jews. Immigrant and Arab men and women had worse mental health compared to non-immigrant Jews. Multivariable log-linear regression analysis adjusting for age, SSS or SES explained the disparities in physical health between Arab and non-immigrant Jewish men. However, SSS and SES did not explain the disparities in physical health between the three groups of women. The disparities in mental health between immigrants and non-immigrant Jews can be explained by SSS for both men and women, whereas the disparities between Arabs and Jews can be explained by objective SES only among women. Employed men reported better physical and mental health. Part of the disparities in mental health in Israel can be attributed to differences in SSS and SES in the different groups. However, there is a need to identify additional factors that may add to the disparities in both physical and mental health. The disparities due to socioeconomic status vary by health measure and population group.  相似文献   

8.
We explored how neighborhood socioeconomic status (SES) is related to negative consequences of drinking to explain why racial/ethnic minority group members are more at risk than Whites for adverse alcohol outcomes. We tested direct and indirect effects of neighborhood SES on alcohol problems and examined differences by gender and race. We used data from the 2000 and 2005 National Alcohol Surveys (N?=?7912 drinkers aged 18 and older; 49 % female) linked with data from the 2000 Decennial Census in multivariate path models adjusting for individual demographics. In the full sample, neighborhood disadvantage had a significant direct path to increased negative consequences, with no indirect paths through depression, positive affect or pro-drinking attitudes. Neighborhood affluence had significant indirect paths to increased negative consequences through greater pro-drinking attitudes and increased heavy drinking. Subgroup analyses showed the indirect path from affluence to consequences held for White men, with no effects of neighborhood disadvantage. For racial/ethnic minority men, significant indirect paths emerged from both neighborhood disadvantage and affluence to increased consequences through greater pro-drinking attitudes and more heavy drinking. For minority women, there was an indirect effect of neighborhood affluence through reduced depression to fewer drinking consequences. There were limited neighborhood effects on alcohol outcomes for White women. Interventions targeting pro-drinking attitudes in both affluent and disadvantaged areas may help reduce alcohol-related problems among men. Initiatives to improve neighborhood conditions could enhance mental health of minority women and reduce alcohol-related health disparities.  相似文献   

9.

Background

Unintended pregnancy (UIP) is a persistent public health concern in the United States disproportionately experienced by racial/ethnic minorities and women of low socioeconomic status. UIP often occurs with experiences of reproductive coercion (RC) and intimate partner violence (IPV). The purpose of the study was to qualitatively describe and compare contexts for UIP risk between low-income Black and White women with histories of IPV/RC.

Study Design

Semistructured interviews were conducted with low-income Black and White women with histories of IPV or RC, ages 18 to 29 years, recruited from family planning clinics in Pittsburgh, Pennsylvania.

Results

Interviews with 10 non-Hispanic Black women and 34 non-Hispanic White women (N = 44) were included in the analysis. Differences between White and Black women emerged regarding IPV/RC experiences, gender roles in intimate relationships, and trauma histories, including childhood adversity. Fatal threats and IPV related to childbearing were most influential among White women. Among Black women, pregnancy was greatly influenced by RC related to impending incarceration, subfertility, and condom nonuse, and decisions about contraception were often dependent on the male. Sexual abuse, including childhood sexual assault, in the context of sexual/reproductive health was more prominent among White women. Childhood experiences of neglect impacted pregnancy intention and love-seeking behaviors among Black women.

Conclusions

Racial differences exist in experiences of IPV/RC with regard to UIP even among women with similar economic resources and health care access. These findings provide much-needed context to the persistent racial/ethnic disparities in UIP and illustrate influences beyond differential access to care and socioeconomic status.  相似文献   

10.
South Asians have a high burden of cardiovascular disease compared to other racial/ethnic groups in the United States. Little has been done to evaluate how neighborhood environments may influence cardiovascular risk factors including hypertension and type 2 diabetes in this immigrant population. We evaluated the association of perceived neighborhood social cohesion with hypertension and type 2 diabetes among 906 South Asian adults who participated in the Mediators of Atherosclerosis in South Asians Living in America Study. Multivariable logistic regression adjusted for demographic, socioeconomic, psychosocial, and physiologic covariates. Subgroup analyses examined whether associations differed by gender. South Asian women living in neighborhoods with high social cohesion had 46 % reduced odds of having hypertension than those living in neighborhoods with low social cohesion (OR 0.54, 95 % CI 0.30–0.99). Future research should determine if leveraging neighborhood social cohesion prevents hypertension in South Asian women.  相似文献   

11.
Ambiguous feelings regarding women engaging in formal volunteering and concerns about their exploitation might explain the dearth of studies regarding the volunteering benefits specifically experienced by low socioeconomic status women. The current study examined benefits of volunteering among women participating in Women for Women’s Health (WWH), a lay health volunteers (LHV) programme implemented in Jewish and Arab communities in Israel, and aiming at empowering such women to become active volunteers and promote health activities in their communities. Two years after the introduction of WWH in each community, all 45 Jewish and 25 Arab volunteers were contacted by phone and invited to participate in the focus group discussions. Five focus group discussions were conducted with 25/42 Jewish volunteers in 2003 and four with 20/25 Arab volunteers in 2005. The other volunteers could not attend the scheduled meetings or became inactive for personal reasons. Four benefit categories were identified in both ethnic groups: 1. Personal benefits of having increased knowledge, feeling self‐satisfaction, mastering new skills and performing healthy behaviours; 2. Group‐social benefits of social support and sense of cohesion; 3. Purposive benefits of achieving the WWH mission and goals; 4. Sociopolitical benefits of learning to accept the other and experiencing increased solidarity. However, the relatively less privileged Arab volunteers enumerated more benefits within the personal and purposive categories. They also identified the unique sociocultural category of improving women’s status in the community by creating a legitimate space for women by public sphere involvement, traditionally solely a male domain. We conclude that volunteering in community‐based health promotion programmes can be an empowering experience for lay women without being exploitative. Positive volunteering benefits will be even more discernable among underprivileged women who enjoy fewer opportunities in the personal and public domains. More studies need to explore volunteering benefits as reported by LHVs, making these benefits more visible and desirable.  相似文献   

12.
Research addressing the impact of neighborhood factors on intimate partner violence (IPV) often lacks discussion of how and why such factors impact IPV. In order to address this gap, 16 prominent neighborhood individuals (PNI) from 4 low-income urban neighborhoods were asked to share through in-depth interviews their insights and perceptions of IPV as an issue in their neighborhoods, and the relationship between social and structural neighborhood-level factors and IPV. PNIs most often associated IPV with only physical violence. Several did not feel IPV was a significant issue in their neighborhood, confirming a lack of awareness and underreporting of IPV. However, other PNIs were able to speak of the relationship between IPV and neighborhood factors, including lack of opportunities for employment, vacant housing, trash management, lack of community awareness, and social capacity to act to address IPV. Results provide unique insights regarding the mechanisms linking neighborhood factors to IPV outcomes. These results contribute to a deeper understanding of contextual influences upon IPV, the development of tailored quantitative research and to the design of local multi-level public health IPV intervention and prevention efforts.  相似文献   

13.
Objective This study examined whether socioeconomic status moderated the association between intimate partner violence (IPV) and postpartum depression among a community-based sample of women. Defining the role of poverty in the risk of postpartum depression for IPV victims enables prioritization of health promotion efforts to maximize the effectiveness of existing maternal-infant resources. Methods This cross-sectional telephone-survey study interviewed 301 postpartum women 2 months after delivery, screening them for IPV and depression [using Edinburgh Postnatal Depression Scale (EPDS)]. Socioeconomic status was defined by insurance (Medicaid-paid-delivery or not). This analysis controlled for the following covariates, collected through interview and medical-record review: demographics, obstetric history, prenatal health and additional psychosocial risk factors. After adjusting for significant covariates, multiple linear regression was conducted to test whether socioeconomic status confounded or moderated IPV’s relationship with EPDS-score. Results Ten percent of participants screened positive for postpartum depression, 21.3 % screened positive for current or previous adult emotional or physical abuse by a partner, and 32.2 % met poverty criteria. IPV and poverty were positively associated with each other (χ2 (1) = 11.76, p < .001) and with EPDS score (IPV: beta 3.2 (CI 2.0, 4.5) p < .001, poverty: beta 1.3 (CI 0.2, 2.4) p = .017). In the multiple linear regression, IPV remained significantly associated, but poverty did not (IPV: adjusted beta 3.1 (CI 1.8, 4.3) p < .001, poverty: adjusted beta 0.8 (CI ?0.3, 1.9) p = .141), and no statistically significant interaction between IPV and poverty was found. Conclusions Study findings illustrated that IPV was strongly associated with postpartum depression, outweighing the influence of socioeconomic status upon depression for postpartum women.  相似文献   

14.
We examined the relationship between neighborhood characteristics, parenting behaviors, experiences of intimate partner abuse or violence (IPV) and children's behavioral problems in a socioeconomically diverse sample of 383 families residing in an urban environment. Data were collected in the Fall/Winter of 2002. The census block group of residence was used as our measure of neighborhood. Census block groups typically contain 1500 residents on average. IPV was measured using a modified version of the HITS (physically Hurt, Insult, Threaten, and Screamed at) scale, a short four item tool assessing emotional and physical violence to which we added an item capturing domination or emotional control. IPV in the last year was reported by 50% of the sample with rates varying by socioeconomic position; families with the lowest and highest income reported the most IPV. Patterns of association between parenting, neighborhood and the children's behavioral problems differed for families who reported IPV in the last year compared to families who reported no IPV. While positive neighborhood characteristics such as high levels of Community Involvement with Children – based upon four scales capturing neighborhood levels of social interaction and collective socialization of children – were protective for high levels of behavioral problems among families not reporting IPV, this protective effect was not seen among families who did report IPV. Hypothesized interactions between negative neighborhood characteristics and IPV—namely that behavioral problems would be worse among families experiencing IPV in highly economically deprived or areas with negative social climates—were not supported by our data. These interactions between neighborhood factors and IPV were not explained by parental factors.  相似文献   

15.
Neighborhood context and youth cardiovascular health behaviors   总被引:17,自引:0,他引:17       下载免费PDF全文
OBJECTIVES: This study sought to determine the relationships between race/ethnicity, socioeconomic status (SES), and cardiovascular health behaviors among youths and whether neighborhood characteristics are associated with such behaviors independently of individual characteristics. METHODS: Linear models determined the effects of individual and neighborhood characteristics (SES, social disorganization, racial/ethnic minority concentration, urbanization) on dietary habits, physical activity, and smoking among 8165 youths aged 12 to 21 years. RESULTS: Low SES was associated with poorer dietary habits, less physical activity, and higher odds of smoking. After adjustment for SES, Black race was associated with poorer dietary habits and lower odds of smoking. Hispanic ethnicity was associated with healthier dietary habits, lower levels of physical activity, and lower odds of smoking than non-Hispanic ethnicity. Low neighborhood SES and high neighborhood social disorganization were independently associated with poorer dietary habits, while high neighborhood Hispanic concentration and urbanicity were associated with healthier dietary habits. Neighborhood characteristics were not associated with physical activity or smoking. CONCLUSIONS: Changes in neighborhood social structures and policies that reduce social inequalities may enhance cardiovascular health behaviors.  相似文献   

16.
The prevalence rate of obesity in the United States has been persistently high in recent decades, and disparities in obesity risks are routinely observed. Both individual and contextual factors should be considered when addressing health disparities. This study examines how Latino-white spatial segregation is associated with the risk of obesity for Latinos and whites, whether neighborhood socioeconomic resources, the built environment, and subcultural orientation serve as the underlying mechanisms, and whether neighborhood context helps explain obesity disparities across ethnic and immigrant groups. The study was based on an extensive database containing self-reported BMI measures obtained from driver license records in Utah merged with census data and several GIS-based data. Multilevel analyses were performed to examine the research questions. For both men and women, Latino residential isolation is significantly and positively linked to the risk of obesity; after controlling for immigrant concentration, this effect gets amplified. Moreover, for men and women, the segregation effect is partly attributable to neighborhood SES and the built environment; and only for women is it partly attributable to obesity prevalence in the neighborhood. Place matters for individual risk of obesity for both men and women and there are multifarious pathways linking residence to obesity. Among the demographic, socioeconomic, physical, and cultural aspects of neighborhood context examined in this study, perhaps the most modifiable environment features that could prevent weight gain and its associated problems would be the built environmental factors such as greenness, park access, and mixed land use.  相似文献   

17.
Self-rated health (SRH) has been found to predict future health, yet its importance is unique in the information it captures, beyond more objective measures. This information can include psychosocial and cultural factors that can be important in understanding women’s health. Our goal was to test whether long-term Jewish residents (LTJR), immigrant, and Arab women differed in their SRH, whether these differences were maintained after controlling for indicators of health status, and, if so, whether the differences among the three groups reflected psychosocial or socioeconomic factors. A nationally representative sample of 814 women in Israel aged 45–64 years was interviewed (between June 2004 and March 2006) regarding socio-demographics, physical health, health behaviors, and psychosocial aspects. Both immigrant and Arab women reported poorer SRH, physical and mental health, and socioeconomic status. Differences between Arab women and LTJR were mostly explained by differences in health measures (e.g., medications and symptoms) and psychosocial measures (e.g., caregiving load and depressive symptoms) and were eliminated when socioeconomic measures were added to the multiple regression models. Differences in SRH between immigrants and LTJR remained after multiple adjustments, suggesting that they reflected unmeasured cultural factors. Even with universal healthcare coverage in a small country (i.e., with minimal financial and geographical barriers to healthcare) minority groups’ health suffers in relation to their socioeconomic and life circumstances.  相似文献   

18.
The relationship between neighborhood/individual characteristics and pediatric intensive care unit (PICU) outcomes is largely unexplored. We hypothesized that individual-level racial/ethnic minority status and neighborhood-level low socioeconomic status and minority concentration would adversely affect children’s severity of illness on admission to the PICU. Retrospective analyses (1/1/2007–5/23/2011) of clinical, geographic, and demographic data were conducted at an academic, tertiary children’s hospital PICU. Clinical data included age, diagnosis, insurance, race/ethnicity, Pediatric Index of Mortality 2 score on presentation to the PICU (PIM2), and mortality. Residential addresses were geocoded and linked with 2010 US Census tract data using geographic information systems geocoding techniques. Repeated measures models to predict PIM2 and mortality were constructed using three successive models with theorized covariates including the patient’s race/ethnicity, the predominant neighborhood racial/ethnic group, interactions between patient race/ethnicity and neighborhood race/ethnicity, neighborhood socioeconomic status, and insurance type. Of the 5,390 children, 57.8 % were Latino and 70.1 % possessed government insurance. Latino children (β = 0.31; p < 0.01), especially Latino children living in a Latino ethnic enclave (β = 1.13; p < 0.05), had higher PIM2 scores compared with non-Latinos. Children with government insurance (β = 0.29; p < 0.01) had higher PIM2 scores compared to children with other payment types and median neighborhood income was inversely associated with PIM2 scores (β = ?0.04 per $10,000/year of income; p < 0.05). Lower median neighborhood income, Latino ethnicity, Latino children living in a predominantly Latino neighborhood, and children possessing government insurance were associated with a higher severity of illness on PICU admission. The reasons why these factors affect critical illness severity require further exploration.  相似文献   

19.
Objectives Food insecurity in the United States is a stubborn public health issue, affecting more than one in five households with children and disproportionately impacting racial and ethnic minority women and their children. Past research and policy has focused on household predictors of food insecurity, but neglected broader factors, such as perceived neighborhood social cohesion, that might protect those most vulnerable to food insecurity. Methods We use a racially and ethnically diverse data set from the Geographic Research on Wellbeing study (N = 2847) of women and their young children in California to investigate whether social cohesion influences food insecurity and whether it moderates the relationship between race/ethnicity and food insecurity. Results We find that lower levels of perceived residential neighborhood social cohesion associate with higher odds of food insecurity even after considering important household socioeconomic factors. In addition, our results suggest that social cohesion is most relevant for reducing the risk of food insecurity among racial and ethnic minority mothers. For example, the probability of food insecurity for immigrant Latina mothers is nearly 0.40 in neighborhoods where mothers perceive little to no cohesion and less than 0.10 in neighborhoods where mothers perceive high cohesion. Conclusions for Practice Higher levels of neighborhood perceived social cohesion are protective against food insecurity in households with children and especially so for racial and ethnic minority households who are at a heightened risk of food insecurity. Supporting programs that focus on building closer knit communities may be a key to reducing food insecurity overall and for reducing disparities in food insecurity by race and ethnicity.  相似文献   

20.
Many studies document racial variation, gender differences, and socioeconomic status (SES) patterning in cardiovascular disease (CVD) risk factors but few studies have investigated heterogeneity in SES differences by race/ethnicity or gender. Using data from the Multi-Ethnic Study of Atherosclerosis (N=6,814) and stratified regression models, we investigated race/ethnic differences in the SES patterning of diabetes, hypertension, smoking, and body mass index (BMI). Inverse socioeconomic gradients in hypertension, diabetes, smoking, and BMI were observed in White and Black women but associations were weaker or absent in Hispanic and Chinese women (except in the case of diabetes for Hispanic women). Even greater heterogeneity in social patterning of risk factors was observed in men. In White men all four risk factors were inversely associated with socioeconomic position, although often associations were only present or were stronger for education than for income. The inverse socioeconomic patterning was much less consistent in men of other races/ethnic groups, and higher SES was associated with higher BMI in non-White men. These findings have implications for understanding the causes of social patterning, for the analysis of SES adjusted race/ethnic differences, and for the targeting of interventions.  相似文献   

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