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Objective Study Setting and Design Data Sources and Analytic Sample Principal Findings Conclusions To examine racial inequities in low‐risk and high‐risk (or “medically appropriate”) cesarean delivery rates in New Jersey during the era surrounding the United States cesarean surge and peak.This retrospective repeated cross‐sectional study examined the universe of childbirth hospitalizations in New Jersey from January 1, 2000 through September 30, 2015. We estimate the likelihood of cesarean delivery by maternal race and ethnicity, with mixed‐level logistic regression models, stratified by cesarean risk level designated by the Society of Maternal Fetal Medicine (SMFM).We used all‐payer hospital discharge data from the Healthcare Cost and Utilization Project's State Inpatient Discharge Database and linked this data to the American Hospital Association Annual Survey. ZIP‐code Tabulation Area (ZCTA)‐level racialized economic segregation index data were from the 2007–2011 American Community Survey. We identified 1,604,976 statewide childbirth hospitalizations using International Classification of Diseases‐9‐CM (ICD‐9) diagnosis and procedure codes and Diagnosis‐Related Group codes, and created an indicator of cesarean delivery using ICD‐9 codes.Among low‐risk deliveries, Black patients, particularly those in the age group of 35–39 years, had higher predicted probabilities of giving birth via cesarean than White people in the same age categories (Black‐adjusted predicted probability = 24.0%; vs. White‐adjusted predicted probability = 17.3%). Among high‐risk deliveries, Black patients aged 35 to 39 years had a lower predicted probability (by 2.7 percentage points) of giving birth via cesarean compared with their White counterparts.This study uncovered a lack of medically appropriate cesarean delivery for Black patients, with low‐risk Black patients at higher odds of cesarean delivery and high‐risk Black patients at lower odds of cesarean than their White counterparts. The significant Black‐White inequities highlight the need to address misalignment of evidence‐based cesarean delivery practice in the efforts to improve maternal health equity. Quality metrics that track whether cesareans are provided when medically needed may contribute to clinical and policy efforts to prevent disproportionate maternal morbidity and mortality among Black patients. [ABSTRACT FROM AUTHOR]

While the majority of U.S. Christians opposed the Affordable Care Act (ACA) in 2010, opinion was deeply divided by race/ethnicity and denominational group. Using national data from the Cooperative Congressional Election Study, we analyzed variation in ACA support across Christian denominational groups and offered explanations for these differences. We found overwhelming support among African Americans, less unified but majority support from Hispanics, and majority opposition from non-Hispanic White Christians. Among White Catholics and Protestants, ACA support varied considerably, and views toward abortion policy statistically explained much of the difference in likelihood to support the ACA across denominational categories (comparing White mainline versus Evangelical Protestants, and white moderate versus devout Catholics). Differences in anti-Black racial resentment were substantial between White Evangelical and mainline Protestants, and helped explain some of the gaps in ACA support between these groups. We conclude that differences in ACA views by denomination can be explained by firmly held group beliefs that may be difficult to sway, even if the program is a technical success. [ABSTRACT FROM AUTHOR]

Both African American and LGBT voters can prove pivotal in electoral outcomes, but we know little about civic participation among Black LGBT people. Although decades of research on political participation has made it almost an article of faith that members of dominant groups (such as White people and individuals of higher socioeconomic status) vote at higher rates than their less privileged counterparts, recent work has suggested that there are circumstances under which members of marginalized groups might participate at higher rates. Some of this research suggests that political participation might also increase when groups perceive elections as particularly threatening. We argue that when such threats are faced by marginalized groups, the concern to protect hard-earned rights can activate a sense of what we call "political hypervigilance," and that such effects may be particularly pronounced among members of intersectionally-marginalized groups such as LGBT African Americans. To test this theory, we use original data from the 2016 National Survey on HIV in the Black Community, a nationally-representative survey of Black Americans, to explore the relationship among same-sex sexual behavior, attitudes toward LGBT people, and respondent voting intentions in the 2016 presidential election. We find that respondents who reported having engaged in same-sex sexual behavior were strongly and significantly more likely to say they "definitely will vote" compared to respondents who reported no same-sex sexual behavior. More favorable views of LGBT individuals and issues (marriage equality) were also associated with greater intention to vote. We argue that these high rates provide preliminary evidence that political hypervigilance can, in fact, lead to increased political engagement among members of marginalized groups. [ABSTRACT FROM AUTHOR]