Table 3.
Crude and adjusted odds ratios of severe adverse maternal outcomes associated with state-level indicators of structural racism (United States, 2017–2018)
| Black-to-white inequity ratio | Crude OR (95% CI) (a) | Adjusted OR (95% CI) (b) | Adjusted regression coefficient (95% CI) for the interaction between the inequity ratio and maternal race and ethnicity |
|---|---|---|---|
|
| |||
| Lower education level(less than high school diploma) | |||
| Non-Hispanic white | 0.99 (0.95, 1.03) | 1.01 (0.94, 1.09) | – |
| Non-Hispanic Black | 0.98 (0.89, 1.08) | 0.99 (0.87, 1.14) | Not applicable |
| Unemployment rate | |||
| Non-Hispanic white | 1.19 (1.11, 1.27) | 1.16 (1.01, 1.33) | – |
| Non-Hispanic Black | 1.38 (1.25, 1.53) | 1.35 (1.04, 1.73) | 0.095 (0.005, 0.184) |
| Prison incarceration rate | |||
| Non-Hispanic white | 1.04 (1.02, 1.05) | 1.04 (1.02, 1.06) | – |
| Non-Hispanic Black | 1.05 (1.03, 1.08) | 1.06 (1.03, 1.10) | 0.030 (0.020, 0.040) |
Odds ratios are per 1-unit increase in the indicator. Indicators are non-Hispanic Black to non-Hispanic white inequity ratios in the three domains described above
CI confidence interval, OR odds ratio
Estimated using univariate mixed-effect logistic regression with the hospital county nested within the hospital state as the random effect
Adjusted for maternal age, health insurance, body mass index, residence (rural, suburban, urban), preexisting diabetes, preexisting hypertension, gestational hypertension, previous cesarean section, month prenatal care began, number of prenatal visits, mother transferred in, gestational age at delivery, multiple gestation, non-cephalic presentation, attendant at birth, delivery mode, birth weight, hospital location (rural, suburban, urban), and state Medicaid income eligibility threshold