142nd APHA Annual Meeting and Exposition

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308191
Maternal health providers' perceptions of the social determinants of preterm birth among African American women in Newark, New Jersey

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Teresa Janevic, MPH, PhD , Epidemiology, Rutgers School of Public Health, Piscataway, NJ
Laurie Navin, BBA , March Of Dimes, Sayreville, NJ
Anna Bess Brown, MPH , Chapter Program Support Dept., March of Dimes, White Plains, NY
Kitaw Demissie, MD, PhD , Epidemiology, Rutgers School of Public Health, Piscataway, NJ
Ndidi Amutah, PhD, MPH, CHES , Department of Health and Nutrition Sciences, Montclair State University, Upper Montclair, NJ
Background: Epidemiologic evidence is increasing on the importance of the social determinants of preterm birth (PTB) among women of color, but it is unknown how this evidence is perceived by providers.  We examined providers’ perceptions of racism, poverty, and living in a poor neighborhood as contributors to PTB among African Americans.

Methods:  We used data from a 2012-2013 survey of n=171 maternal healthcare providers administered as part of the Healthy Babies are Worth the Wait® program at five healthcare facilities in Newark.  Providers rated the importance of determinants of PTB among African Americans on a Likert scale, from which we selected questions on social determinants, dichotomizing responses into important (quite a bit/very) vs. not important (not at all/a little/somewhat).  We estimated adjusted risk ratios using log-binomial regression to compare perceptions by occupation, ethnicity, age, and facility.

Results:  43% of providers felt racism is an important contributor to PTB, whereas 69% and 67% felt poverty and living in a poor neighborhood are important, respectively.  Administrative/technical staff were more likely than nurses/doctors to view racism as important (Adjusted risk ratio (aRR) = 1.4, 95%CI=1.0, 2.2), as were Asians/Others, Hispanics, and African Americans relative to Whites (aRR=2.0, 95%CI=1.0, 4.0; aRR=2.0, 95%CI=1.0, 4.1; aRR=1.5, 95%CI=0.8,2.5), and providers aged >50 relative to aged <40 (aRR=1.6, 95%CI=1.0, 2.4).  No other differences were found, and trends were similar in a subgroup analysis of nurses/doctors only.

Conclusions: Racism was less frequently recognized as an important contributor to PTB among African Americans than poverty and living in a poor neighborhood, with perceptions varying by provider characteristics.  These findings can inform the integration of provider perceptions into the translation of epidemiologic research on the social determinants of PTB.

Learning Areas:

Social and behavioral sciences

Learning Objectives:
Describe maternal health care providersí perceptions of the importance of racism, poverty, and living in a poor neighborhood as determinants of preterm birth among African Americans. Identify characteristics of providers associated with their perceptions of the social determinants of preterm birth. Evaluate the potential implications of providersí views on the social determinants of preterm birth on translation of epidemiologic research into policy.

Keyword(s): Health Disparities/Inequities, Perinatal Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a PhD in epidemiology, and have researched the social determinants of maternal and child health for over 10 years. I also teach perinatal epidemiology at Rutgers School of Public Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.