IntroductionGestational diabetes mellitus (GDM) is the most common complication of pregnancy and is associated with an increased risk for type 2 diabetes. Racial/ethnic minority populations are at a higher risk than non-Hispanic white populations of developing type 2 diabetes after GDM. The aim of this study was to describe racial/ethnic differences in hyperglycemia and receipt of screening services in a nationally representative sample of women with a history of GDM.MethodsOur sample included 765 women from the US National Health and Nutrition Examination Survey (2007–2016) with a history of GDM. We used logistic, multinomial, linear, and proportional hazards regression to evaluate racial/ethnic differences in development of diabetes after GDM, hyperglycemia (measured by HbA1c), and receipt of diabetes screening services.ResultsNon-Hispanic black women had 63% higher risk and Hispanic women and “other” racial/ethnic women had more than double the risk for diabetes compared with non-Hispanic white women. Among women with a GDM history who did not receive a diagnosis of diabetes by the time of the study examination, both non-Hispanic black women and Hispanic women were more likely than non-Hispanic white women to be in the prediabetes or diabetes range (measured HbA1c ≥5.7%). However, non-Hispanic black women had 2.07 (95% confidence interval, 1.29–3.81) times the odds of being screened for diabetes compared with non-Hispanic white women (P = .02).ConclusionDelays in identification of hyperglycemia and diagnosis of diabetes in racial/ethnic minority women may reflect differential delivery of guideline-based care or poor follow-up of abnormal screening test results.

While evidence for neighborhood effects on adverse birth outcomes is growing, no studies have examined whether living in a neighborhood impacted by mass incarceration is associated with preterm birth risk. We used modified Poisson regression to test whether residence in a neighborhood impacted by mass incarceration predicted future risk of preterm birth, among African American women. We linked data from the Justice Atlas of Sentencing and Corrections to survey and medical record data from the Life-course Influences on Fetal Environments study (n = 681). We also tested for effect modification by age and marital status. The association between prison admission expenditures and future risk of PTB varied by maternal age at birth, with younger women (< 35) having a modest increase in risk (relative risk (RR) 1.07; 95% confidence interval (CI) 0.99, 1.15), and older (35+ year old) women having lower risk (RR 0.86; 95% CI 0.69, 1.07). The association between the number of prison admissions due to new court cases and future risk of PTB varied by marital status, with evidence that married women may be protected (RR 0.75; 95% CI 0.61, 0.92), while little evidence of association was observed among unmarried women (RR 1.02; 95% CI 0.80, 1.30). The association between residence in an area impacted by mass incarceration and future risk of PTB among African American women may vary by age and marital status. Future research to identify the mechanisms of these associations is warranted.

Introduction: Housing stability is an impor­tant determinant of health, but no studies to our knowledge have examined the spill-over effects of neighborhood eviction rates on individual risk of preterm birth (PTB) among African American women.Objective: We assessed whether living in a neighborhood with high eviction rates was associated with risk of PTB among African American women, and whether marital/co­habiting status modified the association.Methods: We spatially linked interview, medical record, and current address data from the Life-course Influences on Fetal Environments Study (2009-2011, N=1386) of postpartum African American women from Metropolitan Detroit, Michigan, to publicly available data on block-group level rates of eviction filings and judgements. PTB was defined as birth before 37 completed weeks of gestation and occurred in 16.3% of the sample (n=226). Eviction rate vari­ables were rescaled by their interquartile ranges (75th vs 25th percentiles). Women self-reported whether they were married to, or cohabiting with, the father of their baby during the in-person interview. We used Modified Poisson regression with robust er­ror variance to estimate relative risks of PTB associated with each eviction variable sepa­rately and included an interaction term with marital/cohabiting status (P<.10 considered significant) in adjusted models.Results: In the overall sample, neighbor­hood eviction filings and judgements did not predict PTB, but the associations were modified by marital/cohabiting status (P for interaction = .02, and .06, respectively). Among women who were married/cohabit­ing, those who lived in neighborhoods with high eviction filings (adjusted relative risk: 1.25, 95% CI: 1.06, 1.47) and eviction judgements (adjusted relative risk: 1.18, 95% CI: 1.05, 1.33) had higher risk of PTB than women who did not. Little evidence of an association was observed for women who were not married/cohabiting.Conclusions: Future studies should examine the mechanisms of the reported associations to identify novel intervention targets (eg, addressing landlord discrimina­tion) and policy solutions (eg, ensuring a living wage and providing affordable hous­ing assistance to everyone who qualifies) to reduce the burden of PTB among African Americans. Ethn Dis. 2021;31(2):197-204; doi:10.18865/ed.31.2.197

Purpose of Review The Environmental Justice Movement centers on addressing inequitable distribution of environmental harms in marginalized communities. It has been commonly understood as the disproportionate concentration of environmental pollutants or hazards. As such, much of the work on environmental harms and maternal pregnancy complications have focused on environmental toxins. This scoping review surveyed the literature exploring the built and social environment factors and maternal pregnancy complications among racially marginalized women and highlights how an environmental justice framework can inform policy interventions for maternal health inequities caused by structural racism in built and social environments. Recent Findings The literature examining the association between neighborhood level built and social environment factors and maternal pregnancy complications in the last five years is sparse. When excluding environmental toxins, we identified 16 studies that fit our criteria of neighborhood-level environmental exposure, with the majority focused on built environment factors, specifically proximity to greenspace and food environment. Summary We identified a few important gaps and opportunities for future research in this area. First is a need to explore additional built environment elements. Secondly, extensive research is needed on the social environment. Third is a critical understanding to incorporate structural racism and cultural perspectives to better understand these relationships in minoritized populations and highlight the intersection between environmental hazards concentration and their structural causes. Finally, an environmental justice framework is critically needed in the interpretation and translation of this literature to inform policy solutions that can counteract the harms in racially marginalized communities and improve health.

 Community Profile Eight represents 3 percent of the US population and is the most rural cohort, consisting of an older White population with the most limited access to healthy food. The counties are mostly in the north part of the West, Midwest, and Northeast regions. These community profiles' health outputs link the health differences across the US to the prevailing behavioral, demographic, economic, and social profiles of the population. Our novel approach sorts the information of 26 behavioral, demographic, economic, and social factors across 3,192 US counties into eight community profiles. Ultimately, it leverages and makes sense of county-level information to create a dataset that can inform local and national policies. This data-driven method informs policy issues using community profiles as reference groups and highlights similarities across the US counties, even when they are non-neighbors. It identifies : (i) what factors matter depending on the community profile and the health issues, (ii) whether the policy that focuses on influencing the relevant factors should be at the local, regional, or national level, and (iii) refined policy benchmarks to monitor the impact of the policy. When it comes to public health policy, our findings advocate for coordinated efforts between national and local authorities with community partners such as health-care professionals, business and community leaders, schools, and childcare facilities.. Department brown bag meetings for useful discussions.

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Background: Women with GDM have seven times higher risk of T2D compared to women with normoglycaemic pregnancies, with black women having the highest risk. Immigrants are a growing share of the U.S. population, with approximately 9% of the black population and 34% of Hispanic population being foreign-born. Due to differences in acculturation and assimilation, foreign-born U.S. women experience different pregnancy-related outcomes and subsequent chronic disease development, depending on their race/ethnicity. Objective: To examine the association between nativity and T2D diagnosis following a prior GDM pregnancy and whether this association differs by racial/ethnic group. Methods: We conducted a cross-sectional analysis of data from the 2007-2014 National Health and Nutrition Examination Survey, a nationally representative survey of non-institutionalized Americans. The analytic population included women with at least one prior GDM pregnancy. Logistic regression (OR, 95% CI) was used to examine the association. Results: Our final sample included 433 women. The population was predominantly non-Hispanic white (62%), followed by Hispanic (18%) and black (12%). T2D was found in 29% of the population. After controlling for confounders, foreign-born black women had 0.14 (0.02-0.82) times the odds of developing T2D post GDM compared to black U.S. born women. Nativity was not significantly associated with cumulative incidence of T2D among Hispanics (1.45, 0.48-4.41) or non-Hispanic whites (1.53, 0.04,-6.07). Conclusion: We found differential effects of nativity across racial/ethnic groups consistent with prior literature. Among black women, being foreign-born significantly decreases the odds of developing T2D following a GDM pregnancy but not among other groups. This observed effect may be due to U.S. born black women experiencing higher levels of racialized and gendered stress, both associated with higher levels of inflammation that can lead to higher risk of T2D. Disclosure B. Butler: None. P. Salsberry: None. J.K. Bower: None.

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