Racial-Ethnic and Nativity Inequalities in Gestational Diabetes Mellitus: The Role of Psychosocial Stressors

Files

Dissertation Paper final submission.pdf

Citation

kristin.erbetta, “Racial-Ethnic and Nativity Inequalities in Gestational Diabetes Mellitus: The Role of Psychosocial Stressors,” Scholar@Simmons, accessed September 25, 2020, https://beatleyweb.simmons.edu/scholar/items/show/485.

Title

Racial-Ethnic and Nativity Inequalities in Gestational Diabetes Mellitus: The Role of Psychosocial Stressors

Creator

Erbetta, Kristin

Date

2020

Description

Abstract: Gestational Diabetes Mellitus (GDM) is an important public health issue due to its numerous adverse maternal/child health complications and comorbidities. Racial-ethnic minority and immigrant women in the United States (US) have higher rates of GDM compared to US-born White women. Identified factors associated with these differences do not fully explain them. Research has recognized psychosocial stressors as potentially modifiable risk factors for GDM. This dissertation includes three separate publishable papers that employed the 2009-2014 New York City Pregnancy Risk Assessment Monitoring System (PRAMS) data linked with birth certificate variables. These studies conducted bivariate and multivariate analyses to examine GDM across race-ethnicity and nativity, the associations of three separate psychosocial stressors (stressful events, intimate partner violence [IPV], and racial discrimination), respective of each paper with GDM, and whether these stressors partially explain racial-ethnic and nativity disparities in GDM. Study 1 findings indicate that racial-ethnic minority and immigrant women have a higher risk of both stressful events and GDM, relative to US-born White women. While financial and summed stressors predict higher risk of GDM, they do not explain the elevated risk of GDM among racial-ethnic minority and immigrant women. Study 2 results demonstrate that although the relative risk of IPV before or during pregnancy was higher for racial-ethnic minority and immigrant women compared to US-born White women, the risk was no longer significantly higher after full adjustment for maternal sociodemographic, medical and behavioral covariates. IPV was not associated with risk of GDM and did not account for the racial-ethnic and nativity disparities in GDM. Study 3 identified significant interactions between race and nativity status associated with discrimination, and associations between racial discrimination and GDM, but racial discrimination did not account for the racial-ethnic and nativity disparities in GDM. Limitations and implications for policy and practice were discussed in each study.

Subject

Reproductive health inequalities; Psychosocial stress

Publisher

Simmons University (Boston, Mass.)

Rights

Material from the Simmons University Archives collections are made available for study purposes only. For more information, or to request rights to reproduce or reuse any material, contact the the Simmons University Archives at archives@simmons.edu.

Format

1 PDF (160 Pages)

Language

English

Type

Doctoral Dissertations

PhD Collections

Social Work, PhD

Collection