The Racial Disparities in Maternal Mortality and Impact of Structural Racism and Implicit Racial Bias on Pregnant Black Women: A Review of the Literature.

IF 3.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Keisha E Montalmant, Anna K Ettinger
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引用次数: 0

Abstract

Background: The maternal mortality rate (MMR) in the United States (USA) continues to increase despite medical advances and is exacerbated by stark racial disparities. Black women are disproportionately affected and are three times more likely to experience a pregnancy-related death (PRD) compared to Non-Hispanic White (NHW) women.

Methods: A literature review was conducted to examine the racial disparities in the United States' MMR, specifically among pregnant Black women. PubMed and key organizations (World Health Organization, Center for Disease Control and Prevention, American College of Obstetricians and Gynecologists, Alliance for Innovation on Maternal Health, Association of American Medical Colleges, U.S. Census Bureau, and U.S. Congress) were searched for publications after 2014.

Result: Forty-two articles were reviewed to identify the role of structural racism, implicit biases, lack of cultural competence, and disparity education on pregnant Black women. This review highlights that maternal health disparities for Black women are further impacted by both structural racism and racial implicit biases. Cultural competence and educational courses targeting racial disparities among maternal healthcare providers (MHCP) are essential for the reduction of PRDs and pregnancy-related complications (PRC) among this target population. Additionally, quality and proper continuity of care require an increased awareness surrounding the risk of cardiovascular diseases for pregnant Black women.

Conclusions: The surging MMR for Black women is a public health crisis that requires a multi-tiered approach. Interventions should be implemented at the provider and healthcare institution level to dismantle implicit biases and structural racism. Improving patient-provider relationships through increased cultural competency and disparity education will increase patient engagement with the maternal healthcare (MHC) system.

Abstract Image

黑人孕妇孕产妇死亡率的种族差异及结构性种族主义和隐性种族偏见的影响:文献综述。
背景:尽管医疗进步,美国的孕产妇死亡率(MMR)仍在继续上升,并因明显的种族差异而加剧。黑人妇女受到的影响不成比例,与非西班牙裔白人妇女相比,黑人妇女经历与妊娠有关的死亡(PRD)的可能性高出三倍。方法:通过文献回顾来研究美国MMR的种族差异,特别是怀孕的黑人妇女。检索了PubMed和重点组织(世界卫生组织、疾病控制与预防中心、美国妇产科医师学会、孕产妇健康创新联盟、美国医学院协会、美国人口普查局和美国国会)2014年以后的出版物。结果:我们回顾了42篇文章,以确定结构性种族主义、内隐偏见、文化能力缺乏和差异教育对怀孕的黑人妇女的作用。本综述强调,黑人妇女的孕产妇保健差距进一步受到结构性种族主义和种族内隐偏见的影响。针对孕产妇保健提供者(MHCP)之间种族差异的文化能力和教育课程对于减少这一目标人群中的PRDs和妊娠相关并发症(PRC)至关重要。此外,护理的质量和适当的连续性要求提高对怀孕黑人妇女心血管疾病风险的认识。结论:黑人妇女的MMR激增是一场公共卫生危机,需要采取多层次的方法。应在提供者和保健机构一级实施干预措施,以消除隐性偏见和结构性种族主义。通过提高文化能力和差异教育改善患者与提供者的关系将增加患者与产妇保健(MHC)系统的参与。
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来源期刊
Journal of Racial and Ethnic Health Disparities
Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.30
自引率
5.10%
发文量
263
期刊介绍: Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.
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