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Tuesday, 14 July 2009
Learning Objective 1: describe health disparities related to preterm birth in African-American women living in the United States.
Learning Objective 2: identify factors that influence women’s stress responses and preterm birth.
Purpose: In 2006 in the United States, more than half a million infants were born prematurely (<37 weeks), the leading cause of neonatal mortality and long-term health problems. Compared with white women, African-American (AA) women have almost twice the rate of preterm birth, are more likely to experience racial discrimination and live in impoverished neighborhoods. The purpose of this study was to (1) examine the relationships among adverse neighborhood conditions (poverty, disorder, crime), racial discrimination, personal resources (optimism, self-esteem, social support), and stress responses (distress, anxiety, depression); and (2) explore whether differences exist in these variables between women with preterm birth and women with full term birth.
Methods: In a descriptive cross-sectional design, guided by Lazarus and Folkman transactional model of stress and coping, we compared neighborhood conditions, racial discrimination, personal resources and stress responses between women with preterm birth and women with full term birth.
Results: Participants (n1=39 full term birth, n2=33 preterm birth) had a mean age of 23 years and a mean gestation of 36.5 weeks at birth. These women tended to be single (82%), employed (53%), and have some college education (39%). Women who reported higher levels of neighborhood crime and disorder also reported higher levels of racial discrimination, distress, anxiety, depression and lower levels of optimism, self-esteem, and social support. Women who reported higher levels of racial discrimination also reported higher levels of distress, anxiety, depression and lower levels of optimism, self-esteem, and social support. Compared with women with full term birth, women with preterm birth had lower levels of self-esteem and higher levels of distress and anxiety.
Conclusion: Health care providers need to (1) assess how neighborhood conditions and experiences of racial discrimination influence women’s personal resources and stress responses; and (2) implement strategies to enhance women's self-esteem and reduce the distress and anxiety they are experiencing.
Methods: In a descriptive cross-sectional design, guided by Lazarus and Folkman transactional model of stress and coping, we compared neighborhood conditions, racial discrimination, personal resources and stress responses between women with preterm birth and women with full term birth.
Results: Participants (n1=39 full term birth, n2=33 preterm birth) had a mean age of 23 years and a mean gestation of 36.5 weeks at birth. These women tended to be single (82%), employed (53%), and have some college education (39%). Women who reported higher levels of neighborhood crime and disorder also reported higher levels of racial discrimination, distress, anxiety, depression and lower levels of optimism, self-esteem, and social support. Women who reported higher levels of racial discrimination also reported higher levels of distress, anxiety, depression and lower levels of optimism, self-esteem, and social support. Compared with women with full term birth, women with preterm birth had lower levels of self-esteem and higher levels of distress and anxiety.
Conclusion: Health care providers need to (1) assess how neighborhood conditions and experiences of racial discrimination influence women’s personal resources and stress responses; and (2) implement strategies to enhance women's self-esteem and reduce the distress and anxiety they are experiencing.