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Factors Contributing to Perinatal Health for Black and Latinx Infants and Their Caregivers

Fri, March 22, 7:45 to 9:15am, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Accumulated lifetime experiences of racial discrimination independently predict preterm delivery but not low birthweight amongst African American women (Collins et al., 2004). In addition, living in a disadvantaged neighborhood negatively predicts preterm delivery but not low birthweight amongst non-Hispanic black mothers (Ncube, Enquobahrie, Albert, Herrick, & Burke, 2016). However, the specific causal mechanisms for these disparities are still unclear. To better understand potential factors affecting prematurity and low birthweight amongst Black and Latinx infants, we conducted a series of focus group discussions in selected communities in three target cities (Yonkers, Mount Vernon, and Spring Valley) with large Black and Latinx populations. Based on these findings, we built a mixed methods community health survey to better understand the multiple intersecting factors within home, work, neighborhood, and wider physical and social environments that might impact both general health outcomes and low birthweight, premature birth and early postnatal health within a bioecocultural framework (Ferguson & Evans, 2018). In individual in-person qualitative interviews with associated quantitative pencil-and-paper components, we asked women and men aged 18-45 years about (1) their beliefs, values and practices concerning and (2) key physical and psychosocial environmental factors contributing towards prenatal and postnatal health. Across both focus groups and individual interviews with 45 (43 female, 2 male; age range 20-45 years; 27 African American or Black, 2 Afro Caribbean, 2 Black Hispanic/Latina, 5 White Hispanic/Latina, 3 Other) participants, several key themes emerged. Many participants expressed a lack of satisfaction with healthcare options, affordability, and accessibility. They noted that, while resources for good prenatal care do exist, they are often difficult to access or expensive. And, those who received good prenatal care noted that this was rarely true for others in their neighborhood. Many noted that they had to travel to another neighborhood to receive good quality care. Finally, many participants noted a need for affordable and accessible programming for children. For example, Participant 2 noted, “The cost, the waiting time, the waiting is ridiculous…We don’t have other things that other neighboring cities or towns have." In terms of factors contributing towards good prenatal health, most participants mentioned the importance of a good diet and that it was important to take prenatal vitamins. Many noted that there was a need for healthier food options in their neighborhoods. Beyond this, many participants were uncertain of the causes and effects of prematurity and low birthweight. Factors mentioned included smoking, a lack of proper nutrition, and stress (Table 1). Participants tended to highlight factors within – or perceived to be within – the mother’s control. Most participants noted that their families, and particularly their own parents, were their major supports during and after pregnancy. In addition, many participants expressed appreciation for the relevance of the survey to their lives. Ongoing work will develop a causal model to better understand the perinatal needs of Black and Latinx parents. We also hope that both the focus groups and individual interviews serve as an empowering and supportive forum in which community members can share experiences and concerns.

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