Prospective Survey of Discrimination in Pregnant Persons and Correlation with Unplanned Healthcare Utilization. J Racial Ethn Health Disparities 2024 Dec;11(6):3358-3366
Date
09/18/2023Pubmed ID
37721668DOI
10.1007/s40615-023-01789-xScopus ID
2-s2.0-85171481438 (requires institutional sign-in at Scopus site) 1 CitationAbstract
OBJECTIVE: To determine the association between lifetime exposure to discrimination and unplanned healthcare utilization in pregnant persons.
METHODS: This was a prospective cohort study of pregnant persons receiving care from 2021 to 2022. Primary data was collected from participants on sociodemographic factors and on Perceived Ethnic Discrimination Questionnaire (PED-Q), a validated 17-item scale measuring perceived lifetime interpersonal racial and ethnic discrimination in four domains: work/school, social exclusion, stigmatization, and threat. The primary outcome was unplanned healthcare utilization, defined as unplanned labor and delivery admissions, triage, Emergency Department, or urgent care visits. Bivariate and multivariate analyses were done to examine the association between lifetime exposure to discrimination and unplanned healthcare utilization.
RESULTS: A total of 289 completed the PED-Q and were included in the analysis. Of these, 123 (42.6%) had unplanned healthcare utilization. Mean (SD) of lifetime racial and ethnic discrimination was significantly higher in people with unplanned healthcare utilization compared to those with planned healthcare utilization [1.67 (0.63) vs 1.48 (0.45), p = 0.003]. Univariate analysis showed that lifetime racial and ethnic discrimination was significantly associated with unplanned healthcare utilization (OR 1.96, 95% CI 0.23-3.11). Significant associations were found between unplanned healthcare utilization and maternal age (p = 0.04), insurance type (p = 0.01), married status (p < 0.001), education (p = 0.013), household income (p = 0.001), and chronic hypertension (p = 0.004). After controlling for potential confounding factors, self-reported lifetime racial and ethnic discrimination remained significantly associated with higher odds of unplanned healthcare utilization (aOR 1.78, CI 95% 1.01-3.11).
CONCLUSION: We found that a higher level of self-reported lifetime racial and ethnic discrimination was associated with increased unplanned healthcare utilization during pregnancy.
Author List
Greenberg R, Anguzu R, Jaeke E, Palatnik AAuthors
Ronald Anguzu MD, PhD Assistant Professor in the Institute for Health and Humanity department at Medical College of WisconsinAnna Palatnik MD Associate Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultFemale
Humans
Patient Acceptance of Health Care
Pregnancy
Prospective Studies
Racism
Surveys and Questionnaires
Young Adult
