R01HD109000

Targeted Investment and Meaningful Engagement to Improve MCH Outcomes and Rectify Historical Structural Racism: The Time Study - Project Summary

In Columbus, Ohio's Linden neighborhood, a historically segregated and disinvested community that has been devastated by decades of discriminatory race-based policies, infant mortality rates (IMR) are over 20 deaths per 1,000 live births (2%), with racial disparity ratios nearing three. Researchers have linked infant mortality and poor birth outcomes to maternal education, maternal experiences of stress and discrimination, poverty, lack of access to healthy foods, lack of stable housing, and lack of access to prenatal/medical care. These risk factors are concentrated in majority-minority neighborhoods due to historical and contemporary policies and practices rooted in structural racism (e.g., redlining, restrictive covenants, unfavorable zoning) that segregated both people and resources within communities.

Linden is a predominantly Black (63%) neighborhood with a population of 180,000 residents, of which approximately 45% live below the federal poverty level. Building on Nationwide Children's Hospital's (NCH) history of housing and community development through its Health Neighborhoods/Healthy Families Community Partnership on the city's south side, NCH targeted reinvestments in Linden are intended to improve housing quality and affordability, educational outcomes, access to healthcare, economic development, and social connections of residents.

Informed by Life Course Theory (LCT), the objective of this proposal is to describe discriminatory policies influencing IMR and other maternal and child health experiences and outcomes across generations of Black women and, importantly, demonstrate how community reinvestment can be designed to target and rectify historic and contemporary structural racism and discrimination. Specifically, we aim to:

(1) Examine the experiences of multiple generations of Black women on the intersection of structural racism and reproductive health through the lens of historical and contemporary policies that affect communities;
(2) Conduct real-time formative evaluation of a targeted community investment initiative explicitly informed by the community's history of structural racism; and
(3) Measure relative changes in short-term infant and maternal health disparities in the target community and a statistically matched comparison geography.

Research Institute At Nationwide Children's Hospital

NOT APPLICABLE

93.361 - Nursing Research

National Institute of Child Health and Human Development (NICHD) [HHS - NIH]

Columbus, Ohio 432052664 United States

Single Zip Code

Understanding and Addressing the Impact of Structural Racism and Discrimination on Minority Health and Health Disparities (R01 Clinical Trial Optional) (RFA-MD-21-004)

Amendment Since initial award the total obligations have increased 493% from $525,812 to $3,118,023.