The Black-White racial disparities in maternal and infant health outcomes are among the largest disparities seen in traditional perinatal health measures. 1,2 Black pregnant and postpartum people * have a pregnancy-related mortality ratio that is three to four times that of their White counterparts, and disparities in severe maternal morbidity are similar. 3-5 Additionally, the infant mortality rate among Black neonates is more than twice that of White neonates (10.8 vs. 4.6 per 1,000 live births), 6,7 and the proportion of births that are preterm is more than 50% higher among Blacks than among Whites (14% vs. 9%). 8 The reasons for these disparities are multifactorial, but have been linked to Black individuals having higher prevalence of preexisting chronic disease 5,9 and less access to primary and prenatal care, 10 as well as to social and structural determinants of health (e.g., poor housing, food insecurity, high-crime neighborhoods) 11-13 and to racial discrimination that results in poor patient-provider communication, disrespectful care, delayed medical intervention and lower quality of care. 14-18 As the United States battles the COVID-19 pandemic, racial disparities in COVID-related deaths have risen alarmingly, 19 and mounting data suggest that similar increases are occurring for disparities in birth outcomes. Providing pregnant individuals with support to mitigate the social and structural factors that are key drivers of COVID-19-related health inequities may help ameliorate these disparities. For pregnant and birthing people, community-based doulas are a potential source of such support. Community-based doulas are a type of health worker who focuses on the care of pregnant people and their infants, and use of their services is associated with improved birth outcomes among low-income and marginalized racial and ethnic populations. 20-23 Despite evidence suggesting they can improve maternal and infant health, community-based doulas have been deemed nonessential workers during the pandemic, and pregnant patients have often had limited access to their services in hospital labor and delivery settings. This lack of access could have serious implications for maternal and infant health outcomes and threatens to worsen the already extensive racial disparities. * We use "people" as a gender-inclusive term to refer to individuals with the capacity for pregnancy and childbirth, and use "woman, " "women, " "mother" and "maternal" when reporting the results of studies that used these terms.
The Soldier Health Promotion to Examine and Reduce Health Disparities (SHPERHD) Project was designed to be a partnership between the Institute for Partnerships to Eliminate Health Disparities at the University of South Carolina and the Fort Jackson United States Army Base located in Columbia, South Carolina. SHPERHD Project researchers are studying problems related to obesity and weight management, musculoskeletal injuries and infection, and mental health issues during recruitment, basic training, and post-deployment. In order to successfully develop targeted interventions to prevent and lower the incidence of injury, promote healthy nutrition, and decrease mental health issues, at the same time also reducing disparity gaps, the SHPERHD Project comprises a professional, technical, and administrative staff with specific competence in the operation of a Coordinating Center to handle the wide variety of areas related to military studies. This article discusses the procedures and processes that were implemented in the development of the SHPERHD Project Coordinating Center.
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