Funded Projects

Uncovering Maternal and Child Health Disparities among Middle Eastern and North African Women and Children in the United States

Grantee: University of Texas at Arlington
Principal Investigator: Tiffany Kindratt
Project Number: R42MC45812
Project Date: 7/1/2022

Age group(s)

• Women/Maternal

Targeted/Underserved Population

• Immigrant

Abstract

Little attention has been paid to maternal and child health (MCH) research in the Middle Eastern or North African (MENA) population because this group has been clustered under the non-Hispanic (NH) white category, and any differences in MCH among MENA individuals are invisible. Results from this proposal will serve many purposes. It will move forward MCHB's Strategic Research Issues of increasing evidence for MCH practice and support innovation and collaboration in research for an underserved, minority, immigrant population. Promoting health equity is one of the main pillars of the Department of Health and Human Services. According to the current funding opportunity, ". . . more research is needed to understand the status and root causes of health inequity among different MCH populations, especially those associated with race/ethnicity." This proposal directly meets that effort by focusing on MENA MCH, which has never been studied from a comprehensive national perspective. This proposal also will address existing and emerging research topics of national significance to the MENA community by using a novel data analytic approach.

Goals and Objectives:

The goal of this proposal is to use national data to analyze and compare performance measures among MENA women and children and ultimately improve the health and well-being of this population. Performance measures will be compared to NH white, NH black, Hispanic and Asian women and children. We will develop six papers to fulfill these goals. PROPOSED DATA SETS AND TARGET POPULATIONS: The data sets we will use are 2000-2018 National Health Interview Survey (NHIS) and 2015-2019 five-year American Community Survey (ACS) publicly available files. Our comprehensive analysis of MENA MCH outcomes will include three samples: 1) women (ages >=18 years); 2) currently pregnant women; and 3) children (ages 0-17 years) using the NHIS for Papers 1-6. The NHIS sample of women includes 485,530 women ages 18+ years, specifically 361,521 US-born NH white, 12,591 foreign-born NH white, 9,517 foreign-born NH black, 69,445 foreign-born Hispanic, 29,336 foreign-born Asian, and 3,120 foreign-born MENA women. The average age of women is 48.1 years old, 55% of which are of childbearing age (ages 18-49 years). Our NHIS pregnant woman sample includes 3,997 pregnant women with an average age of 29.2 years old. The NHIS child sample includes 218,824 children ages 0-17 years, specifically 196,937 US-born non-Hispanic white, 1,857 foreign-born non-Hispanic white, 1,951 foreign-born non-Hispanic black, 13,147 foreign-born Hispanic, 4,4229 foreign-born Asian, and 703 foreign-born MENA children. The average age of sample children is 9 years old. There is roughly an equal distribution of children by sex (51% male, 49% female). For Paper 2, we will also include ACS data from children (ages 0-17 years). The ACS child sample includes 25,861 MENA children, specifically 19,970 US-born MENA children and 5,891 foreign-born MENA children. The average age of both NHIS and ACS child samples are 9 years old and there are roughly equal distributions by sex (51% male, 49% female). PRODUCTS: The findings of the study will be disseminated at national conferences and submitted for publication with peer-reviewed journals. We anticipate publishing six manuscripts to align with the objectives described above. We will also share our results through a local press release, on social media, and communicate our findings with other key stakeholders.

Evaluation:

This is a cross-sectional, secondary data analysis using national surveys. While we are not conducting an evaluation, we will collapse 19 years of NHIS data and use 5-year ACS estimates to ensure sufficient sample sizes. We will use appropriate weights and statistical methods to produce reliable and valid estimates.

Publications

Listed is descending order by year published.

Kindratt, T. B., Brannon, G. E., Boateng, G. O., & Brown, K. K. (2023). The Influence of Racial/Ethnic and Gender Concordance on Care Among Non-Pregnant Women of Childbearing Age with Diabetes Mellitus: an Analysis of the Medical Expenditure Panel Survey, 2010–2019. Journal of Racial and Ethnic Health Disparities, 1-10.

Brannon, G. E., Kindratt, T. B., Boateng, G. O., Sankuratri, B. Y. V., & Brown, K. K. (2023). Racial and Ethnic Disparities in Patient Experience and Diabetes Self-Management Among Nonpregnant Women of Childbearing Age With Diabetes in the United States: A Scoping Review, 1990 to 2020. Women's Health Issues.

Kindratt, T. B., Boateng, G. O., Brannon, G. E., Sankuratri, B. Y. V., & Brown, K. K. (2023). Testing proximal, intermediate, and health outcomes of patient centered communication among non-pregnant women of childbearing age with diabetes mellitus: Findings from the Medical Expenditure Panel Survey 2012-2018. PEC innovation, 3, 100185.