group synthesis
State the background of the problem. Tell the reader why we should care about this issue. You may briefly cite the articles' reviews of literature for this part of the paper. (In a true review of literature you would need to actually go to the original sources, but let's try to keep things in perspective.
To begin with, the article “Despite an Overall Decline in U.S. Infant Mortality Rates, the Black/White Disparity Persists: Recent Trends and Future Projections”, focuses on the the Black/White disparity in regards to infant mortality rate in thE united states. It is explained that the infant mortality rate in the United States still is at large, where the gap is now problematic. The has been a significant improvement n infant mortality as a whole but when comparing racial groups the Black pregnant women still have a persistent disparity in comparison to the White pregnant women. For example in 1995 there were 6.3 infant deaths per 1,0000 live births while there were Black women experienced 14.7 infant deaths which is about a 23-fold difference (Loggins & Andrade, 2013, p.118). In 2009, the latest year most recently studied, the rate dropped to 5.5 for White and 12.4 for Blacks however the gap still remained the same. It is discussed in this article that socioecinomical factors do play a role in the infant mortality rate. Therefore, this study examines marital status, education level, and prenatal care in risk factors that may influence IMR. The background of the article, “Black/White disparities in pregnant women in the United States: An examination of risk factors associated with Black/White racial identity”, is the outstanding difference between the adverse pregnancy outcomes such as low birth weights in Black pregnant women compared to White pregnant women. Though there has been laws to help bridge the gap between the disparities such as legislative act H.R.45171, this law only improves the overall health of children by tasing awareness of infant mortality. However, the article points out a need to pin point the issue in the disparity of care in the black women. Furthermore, the article will explore the factors associated with low birth weights in Black and White pregnant women. In turn this article will gather information on how institutionalized racism contributes to adverse pregnancy outcomes as well as take a look at health behaviors and factors to see if they’re different between the people groups.
Summarize the research articles you have critiqued including their findings. You should have six to eight articles now, so it would be helpful to include a table, chart, or visual representation of the articles. Synthesize the articles, i.e. weave them together, discuss how they fit, how they contradict, how they paint a picture of reality. Include their limitations.
The study ”Despite an Overall Decline in U.S. Infant Mortality Rates, the Black/White Disparity Persists: Recent Trends and Future Projections”, used data from the CDC with information from years 1995 through 2009 in the United States excluding U.S. territories. According to the findings, the sample population were mothers that were 17% Black and 83% White. Between the years 1995 to 2009 the IMR went down to 11.9% in White women and 15.3% in Black women however though this decline is great Black women had IMR 2.2 times greater. As a result the declines differed compared to marital status, education level and prenatal care. Overall, woes that were married versus unmarried experienced a greater decline in IMR, but still Black women only have a decline of 15.2% compared to 19.6% in White women. Maternal education varied in comparison to decline, it seems that the higher the education level for a black women is the more of the decline in IMR. “For those with the highest levels of education, the IMR declined more sharply among Blacks (28.1 %) than among Whites (21.1 %)”(Loggins & Andrade, 2013, p.120). Equally important, prenatal care is vital for the decline of IMR. Results show that as the trimesters increase from 1st, 2nd, and 3rd the IMR decrease. Nonetheless, though IMR decreases with prenatal care Black women have a smaller decrease that White women. Furthermore, the findings of “Black/White disparities in pregnant women in the United States: An examination of risk factors associated with Black/White racial identity” found that both black women and white women had similar trends in areas such as marital status (mostly unmarried), about the same varying education level, were employed, between the ages of 18-25, most of them did not smoke or use drugs however most did drink alcohol. Nonetheless, both had insurance, most did not attend church, had a father in the household, and most were not depressed. In contrast, even though risks and behaviors seem about the same, black women were more likely to have medicaid/medicare rather than private insurance compared to white pregnant women. Black women were less likely to be employed, and more likely to have less income levels. With these findings it should that though both people groups have similar results in factors, black women have more of a challenge in their households. Higher stress is a burden to black women than white women due to the economic and institualized stand point. Institutionalized racism is defined as the differences to the access to certain resources by their race and differences in politics, laws and practices that reinforce racial inequality”(p.655. Because they have less income, government insurance, less income jobs these additional stressors combined with overwhelming effect of institutionalized racism has cause black pregnant women to have lower birth outcomes. In addition, the article shows that it has nothing to do with the women health behaviors because white women are more likely to be involved in health eroding behaviors than black women. In fact black women are less likely to smoke. Even with this trend white women will still have an outstanding higher birth weight than black women.
Discuss the implications for practice from this research. Do the results of these studies support changing our practice at this time or do the limitations of the studies prevent their use?
Limitations varied among studies however some included not considering other types of relationships the participants might of had other than marriage. Though marriage signified two parents in the household that wasn’t always the case. It lacked researching other relationships such as common law or cohabitation. In addition, the data stops at the year 2009. More recent date is needed to fully examine the IMR declines between the two racial groups. It is hard to establish is there is an improvement since 2009. Moreover, the other study also was restricted from data and was only confined to the National Survey on Drug Use and Health. The data also didn’t help explore the outcomes of the pregnancy nor did it measure multiracial and ethnics such as Adrian born vs United States born. Overall the implications for practice from this research included policy implantation. Law makers need to continual monitor the IMR’s and reduce key factors that cause the differences. In a healthcare setting, prioritizing access to quality care is important and necessary. Nurse and other medical professionals should be encourage to serve in underprivileged areas. These findings of this study definitely propel the advancement of healthcare awareness of a pressing issue. The overwhelming disparity in the poor outcomes of black babies and mothers has always been alluring however with no cause or reason why this is occurring. With this article it spreads light to the issue to be more than risk factors black women may be doing or involved in to cause this phenomenon. This study stops the notion that it has to be issues with the pregnant women and their behaviors and shows that institutionalized factors embedded in the laws, perceptions of care, insurance, and employment (discrimination) is the main cause of this gap. Knowing this key factor changes can be made with handling pregnant patients and to take special care of pregnant black women in particular. Being more aware as a health care provider of unconscious discrimination and be more attentive to black women’s needs all together will definitely help this disparity.
Discuss the questions that remain unanswered. Identify areas for further study. Identify pitfalls to avoid or things that should be considered when conducting research on this topic.
The articles still need to expound upon the differences in environments the two racial groups may be living in. Despite the education level, marital status, and prenatal care the research fails to explore their level of availability to resources imperative for pregnant women. It is important in conducting other research studies to explore the structural levels of discrimination, how it effects the people groups such as Black women and White women. In addition, how discrimination affects them on an individual level. If istutionalized racism is the key factor as to why black pregnant women have such a low birth outcomes then we need to see how the healthcare providers perpetuate this problem in their quality of care.
Loggins, S., & Andrade, F. C. (2013). Despite an Overall Decline in U.S. Infant Mortality Rates,
the Black/White Disparity Persists: Recent Trends and Future Projections. Journal of Community Health, 39(1), 118-123. doi:10.1007/s10900-013-9747-0
Clay, S. L., Griffin, M., & Averhart, W. (2018). Black/White disparities in pregnant women in the
United States: An examination of risk factors associated with Black/White racial identity. Health & Social Care in the Community,26(5), 654-663. doi:10.1111/hsc.12565
This may already be in the paper but I included it anyway just in case this is everything from Crystal. remember in the original work that I sent you Crystal already had an article present. the work above is both articles combined. Remove her original work from the original document and add in this summary. there are limitations and everything in here edited as you please. But please add this stuff to the final document.
"There were several limitations in this study. We were restricted to data that already existed in the 2012 National Survey on Drug Use and Health (NSDUH) but there were several variables that we would have liked to explore such as the outcome of the pregnancy (e.g. normal birth weight, low birth weight or very low birth weight), other measures of institutionalised racism (e.g. occupation and fam- ily economic history), and direct measures of racism (e.g. perceived experience of racial behaviours/acts). Similarly, the restrictive data- base did not allow for inter-group analyses or multiracial analyses. Research has shown great health differences within different racial and ethnic groups such as Black women (e.g. African- born vs. US- born mothers) (David & Collins, 1997). Future research should con- tinually explore racial differences (intra- and inter-group analyses) in risk factors of LBW, but should also compare the results to actual outcomes (if a LBW variable is available in the data). Furthermore, researchers should continually look for measures of institutionalized racism and discrimination in existing data and incorporate measures into new data collection strategies"(Clay, Griffin, & Averhart, 2018, p.662)
citation:
Clay, S. L., Griffin, M., & Averhart, W. (2018). Black/White disparities in pregnant women in the United States: An examination of risk factors associated with Black/White racial identity. Health & Social Care in the Community,26(5), 654-663. doi:10.1111/hsc.12565