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Journal article
Racism and Perinatal Health Inequities Research: Where we have been and where we should go
American journal of obstetrics and gynecology, v 227(4), pp 560-570
18 May 2022
PMID: 35597277
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
For over a century, substantial racial and ethnic inequities in perinatal health outcomes have persisted despite technical clinical advances and changes in public health practice that lowered the overall incidence of morbidity. Race is a social construct and not an inherent biological or genetic reality; therefore, racial differences in health outcomes represent the consequences of structural racism, or the inequitable distribution of opportunities for health along racialized lines. Clinicians and scientists in obstetrics and gynecology have a responsibility to work to eliminate health inequities for Black, Brown, and Indigenous birthing people, and fulfilling this responsibility requires actionable evidence from high quality research. In order to generate this actionable evidence, the research community must realign paradigms, praxis, and infrastructure with an eye toward reproductive justice and anti-racism. This special report offers a set of key recommendations as a roadmap to transform perinatal health research to achieve health equity. The recommendations are based on expert opinion and evidence presented at the Society for Maternal Fetal Medicine’s 41st Annual Pregnancy Meeting State of the Science Research Symposium in 2021. Recommendations fall into three broad categories – changing research paradigms, reforming research praxis, and transforming research infrastructure – and are grounded in an historical foundation of the advances and shortcomings of clinical, public health, and sociological scholarship in health equity. Changing the research paradigm requires leveraging a multi-disciplinary perspective on structural racism; promoting mechanistic research that identifies the biologic pathways perturbed by structural racism; and utilizing conceptual models that account for racism as a factor in adverse perinatal outcomes. Changing praxis approaches to promote and engage multidisciplinary teams and develop standardized guidelines for data collection will ensure that paradigm shifts center the historically marginalized voices of Black, Brown and Indigenous birthing people. Finally, infrastructure changes that embed community-centered approaches are required to make shifts in paradigm and praxis possible. Institutional policies that break down silos and support true community partnership, as well as alignment of institutional, funding, and academic publishing objectives with strategic priorities for perinatal health equity, are paramount. Achieving health equity requires shifting the structures that support the ecosystem of racism that Black, Brown, and Indigenous birthing people must navigate before, during, and after childbearing. These structures extend beyond the healthcare system in which clinicians operate day-to-day, but they cannot be excluded from research endeavors in order to create the actionable evidence needed to achieve perinatal health equity.
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Details
- Title
- Racism and Perinatal Health Inequities Research: Where we have been and where we should go
- Creators
- Irene E. Headen - Drexel UniversityMichal A. Elovitz - Center for Research in Reproduction and Women’s health, Department of Obstetrics and Gynecology and Microbiology, University of Pennsylvania, Philadelphia, PennsylvaniaAshley N. Battarbee - University of Alabama at BirminghamJamie O. Lo - Oregon Health & Science UniversityMichelle P. Debbink - University of Utah
- Publication Details
- American journal of obstetrics and gynecology, v 227(4), pp 560-570
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Community Health and Prevention
- Web of Science ID
- WOS:000891582600003
- Scopus ID
- 2-s2.0-85133392423
- Other Identifier
- 991019174125704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Obstetrics & Gynecology