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Objectives. To compare pregnancy-related mortality ratios (PRMRs) associated with COVID-19 by race/ethnicity, by region of residence, and in states with and without Medicaid expansion. Methods. We used 2020–2021 data from the US Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research in our analysis. We stratified PRMRs by race/ethnicity, census regions, and Medicaid expansion and nonexpansion states. Results. The 2020–2021 PRMR was 40.3 per 100 000 live births. American Indian/ Alaska Native pregnant people had the greatest PRMR, followed by non-Hispanic Blacks and non-Hispanic Native Hawaiians/other Pacific Islanders. PRMRs associated with COVID-19 in the southern region were at least 2 times higher than in other regions and were highest for all pregnant people in the various racial/ethnic groups. PRMRs associated with COVID-19 were lower in Medicaid expansion states than in nonexpansion states. Conclusions. The US COVID-19 epidemic exacerbated racial and ethnic disparities in pregnancy-related mortality. Public Health Implications. The alarming increase in disparities among racial and ethnic pregnant people during the COVID-19 pandemic underscores the need to address social determinants of health at the structural level. (Am J Public Health. 2024;114(S9): S723–S730. https://doi.org/10.2105/AJPH.2024.307814) [ABSTRACT FROM AUTHOR]

Introduction Existing health disparities frameworks do not adequately incorporate unique interacting contributing factors leading to health inequities among African Americans, resulting in public health stakeholders' inability to translate these frameworks into practice. Methods We developed dimensionality and R4P to integrate multiple theoretical perspectives into a framework of action to eliminate health inequities experienced by African Americans. Results The dimensional framework incorporates Critical Race Theory and intersectionality, and includes dimensions of time-past, present and future. Dimensionality captures the complex linear and non-linear array of influences that cause health inequities, but these pathways do not lend themselves to approaches to developing empirically derived programs, policies and interventions to promote health equity. R4P provides a framework for addressing the scope of actions needed. The five components of R4P are (1) Remove, (2) Repair, (3) Remediate, (4) Restructure and (5) Provide. Conclusion R4P is designed to translate complex causality into a public health equity planning, assessment, evaluation and research tool., Author(s): Vijaya Hogan [sup.1] [sup.2] , Diane L. Rowley [sup.1] , Stephanie Baker White [sup.3] , Yanica Faustin [sup.1] Author Affiliations: (1) Department of Maternal and Child Health, Gillings School [...]

Objective To determine which combination of risk factors from Community Care of North Carolina's (CCNC) Pregnancy Medical Home (PMH) risk screening form was most predictive of preterm birth (PTB) by parity and race/ethnicity. Methods This retrospective cohort included pregnant Medicaid patients screened by the PMH program before 24 weeks gestation who delivered a live birth in North Carolina between September 2011-September 2012 (N = 15,428). Data came from CCNC's Case Management Information System, Medicaid claims, and birth certificates. Logistic regression with backward stepwise elimination was used to arrive at the final models. To internally validate the predictive model, we used bootstrapping techniques. Results The prevalence of PTB was 11 %. Multifetal gestation, a previous PTB, cervical insufficiency, diabetes, renal disease, and hypertension were the strongest risk factors with odds ratios ranging from 2.34 to 10.78. Non-Hispanic black race, underweight, smoking during pregnancy, asthma, other chronic conditions, nulliparity, and a history of a low birth weight infant or fetal death/second trimester loss were additional predictors in the final predictive model. About half of the risk factors prioritized by the PMH program remained in our final model (ROC = 0.66). The odds of PTB associated with food insecurity and obesity differed by parity. The influence of unsafe or unstable housing and short interpregnancy interval on PTB differed by race/ethnicity. Conclusions Evaluation of the PMH risk screen provides insight to ensure women at highest risk are prioritized for care management. Using multiple data sources, salient risk factors for PTB were identified, allowing for better-targeted approaches for PTB prevention. Electronic supplementary material The online version of this article (doi:10.1007/s10995-015-1763-5) contains supplementary material, which is available to authorized users., Author(s): Christine M. Tucker[sup.1] [sup.2] , Kate Berrien[sup.3] , M. Kathryn Menard[sup.4] , Amy H. Herring[sup.2] [sup.5] , Julie Daniels[sup.6] , Diane L. Rowley[sup.7] , Carolyn Tucker Halpern[sup.1] [sup.2] Author [...]

Treatment of newborns with an intramuscular injection of vitamin K is controversial. Newborns with vitamin K deficiency have a risk of developing classic hemorrhagic disease of the newborn (HDN). HDN is unexpected bleeding caused by low levels of vitamin K-dependent blood clotting factors. Preventive treatment with vitamin K can prevent classic HDN or late HDN in older infants. A research study found that newborns treated with intramuscular vitamin K may have an increased risk of developing leukemia and other types of childhood cancer. Children treated with oral vitamin K may have a lower risk of developing childhood cancer. Other researchers have found that an association may not exist between intramuscular vitamin K and childhood cancer. The American Academy of Pediatrics recommends that all newborns receive a single injection of vitamin K. It also recommends that the safety of vitamin K be examined further.

The article examines why culturally competent care and education are essential to the medical profession in the U.S. With this, the authors offer some hypotheses of the root causes of health care disparities, concluding with total joint replacement as an accepted example of education in culturally competent care. Moreover, there is considerable evidence that there are disparities in the health care status of racial and ethnic minorities in the country and in the medical care provided.

Discusses the severity of conditions originating in the perinatal period by estimating the proportion of deaths that occur among infants in the United States from 1986-1987 using weighted estimates to calculate morbidity and case fatality rates (CFR) for perinatal conditions. Newborn morbidity and infant mortality due to causes originating in the perinatal period; CFR associated with conditions originating in the perinatal period by race.

Abstract. From July through September 1984, acute convulsions caused by endrin poisoning occurred in the subdistrict of Talagang, Attock District, Punjab province, Pakistan. Eighteen of the 21 affected villages were surveyed; 70% of the cases for which ages were known (106 of 152) were in children I to 9 years of age; 9.8% of all affected persons (19 of 194) died. The outbreak occurred in villages on the main roads of the subdistrict and peaked in early September. Endrin was detected in the blood of 12 of 18 patients with a history of convulsions but was not found in the blood of four hospitalized control patients. One composite sugar sample taken from the homes of three persons had an endrin level of 0.04 ppm. Because of the high toxicity, repeated association with large-scale outbreaks of neurologic illness, and the difficulties of monitoring distribution, endrin should not be used for agricultural purposes. [ABSTRACT FROM AUTHOR]