Neighborhood Social Environment and Health Communication at Prepregnancy and Maternal Stages among Caucasian and Asian Women: Findings from the Los Angeles Mommy and Baby Survey
Introduction. We study whether the relationship between neighborhood social environment and maternal communication with healthcare providers differs between Asians and Caucasians. Method and Materials. Using the 2007 Los Angeles Mommy and Baby (LAMB) survey, we measure new mother’s neighborhood social environment by four key variables: (1) instrumental/emotional support during pregnancy, (2) neighborhood social cohesion, (3) neighborhood social exchange, and (4) neighborhood services. Logistic regressions were applied for data analysis. Neighborhood social exchange predicts less chance of lacking communication about sensitive issues in preconception visits among Caucasians (logged odds: ？0.045; ) and Asians (L.O.: ？0.081; ) and predicts less chance of lacking communication during preconception visits among Asians (L.O.: ？0.092; ). Neighborhood social cohesion predicts more chance for lacking communication about preparation for pregnancy only among Asians (L.O.: 0.065; ). Neighborhood services predict less chance of lacking communication about stigmatized issues in the prenatal visit among Asians (L.O.: ？0.036; ). Discussion. Caucasians and Asians with more neighborhood social exchange are more likely to discuss sensitive issues during preconception visits. Neighborhood service significantly predicts maternal discussion of stigmatized issues with health care providers, but only among Asians. 1. Introduction In developed nations, racial/ethnic disparities persist in receipt of a wide range of health services such as specialty care, pain assessment and treatment, and mental health services [1]. Asian women above 35 years are at higher risk of giving birth to a child with Down syndrome in comparison with Caucasian women in the same age group [2]. This risk could be effectively reduced by seeing an obstetrician prior to the pregnancy and obtaining recommended nutritional supplements such as folic acid, as well as by taking a prenatal screening to monitor the fetal growth. However, a study from the United Kingdom shows that South Asian women with positive attitudes toward taking prenatal screening for Down syndrome are less likely to take the test than Caucasian women with positive attitudes toward the test [3]. The racial difference in receiving maternal health services is an important topic in racial/ethnic health disparities, since maternal health affects both women and their children’s health. It is also a health service the majority of women will receive at least once in their lives. Thus, the disparity of receiving maternal health services between Asian
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