12 Mar In class, we learned how to write the introduction and conclusion of the Literature Review section, which includes: Introduction?(6 sentences on p. 10a) Review of Literature?(u
In class, we learned how to write the introduction and conclusion of the Literature Review section, which includes:
- Introduction (6 sentences on p. 10a)
- Review of Literature (using notes on p. 13a – ONE objective summary is graded already — apply feedback)
- Analysis of Literature (compare and contrast activity on p. 16a)
For this submission: You will submit your full draft of the Literature Review in a WORD document.
- YOU MUST CHECK YOUR SIMILARITY prior to submission here.
Grading:
- Title Page = 10 pts
- Literature Review: Intro, Review of Literature, and Analysis of Literature WITH in-text citations and correct level headings:
- Introduction = 15 pts
- Review of Literature = 40 pts
- Analysis of Literature = 20 pts
- References page with ALL three research articles listed = 15 pts
Your hard work has paid off (!!!), and you will use the following workshop activities completed in class to help you write your complete draft of your discussion section:
- p. 17b – Think of this like your formal introduction into the Discussion section.
- p. 17c – Summary of the foundation to your recommendation. (evidence-based)
- p. 18a - Your actual recommendation. You will took at specific parts of the Foundation to the Recommendation and choose, at most, 3 specific parts to recommend. Define your chosen parts, and explain how it can serve a particular population/location ailed with the problem. Cite every step of the way.
YOU MUST USE THE "CHECK YOUR SIMILARITY HERE" FOLDER TO ENSURE NO PLAGAIRISM BEFORE SUBMITTING HERE FOR GRADING!
Grading: MUST USE ALL ASPECTS OF APA-7
Create an APA-7-Compliant Title Page = 10 pts
- p. 2 of the document must have a Level 1 Header – "Discussion" = 5 pts
- Use p. 17b notes to write paragraph 1 = 15 pts
- Use p. 17c notes to write paragraph 2 = 25 pts
- Use p. 18a notes to write paragraph 3 = 25 pts
APA-7-Compliant References Page = 20 pts
2
Compare & Contrast assignment – Pollution issues in India
Student’s name
Professor’s name
Course title
Institution
Date
Compare & contrast assignment – Pollution issues in India
1. What articles have similarities in each section below?
a. Methodology
All the articles used statistical techniques to analyze the collected data. Gupta and Dhir (2021) utilized Mann-Kendall test to evaluate the tendencies in air pollutant concentrations over time. To contemplate on potential relations between microplastic quantities and several prompting aspects, Lechthaler et al. (2021) utilized Pearson’s t-tests whereas Sasmita et al.(2022) utilized pair-wise post-hoc Tukey's assessment to approximate the P-value in cluster evaluation. S et al. (2022) utilized concentration indices and Lorenz curves to examine the disparity in air pollution attributed to disease burden across individual states.
b. Findings
Gupta and Dhir (2021) in their study to investigate dimensional and chronological differences of air contaminants they found that the quantities of air contaminants were generally higher in the winter period than in the summer period. Similarly, Sasmita et al. (2022) found that the health effect of PM10 on individuals is 3 to 5 times more in winter times when compared to the summer season.
c. Recommendations
The authors recommend the need to implement and enforce policies to reduce air pollution. Lechthaler et al. (2021) recommends the need for further research on the sources and fate of microplastics in Indian rivers and their potential effects population health and the surrounding. Sasmita et al. (2022) signifys the pollution harshness and the necessity for consideration by legislators to fight city air contamination to protect public well-being. On the other hand, S et al. (2022) recommends the need for coordinated efforts by governments, industries, and civil society to reduce air contamination and its related health and economic impacts in India.
2. What articles have differences in each section below?
a. Methodology
Contrary to Gupta and Dhir (2021) and S et al. (2022) who used secondary sources of data, Lechthaler et al. (2021) and Sasmita et al.(2022) used primary sources of data. Again, Gupta and Dhir (2021) utilized a quantitative research methodology whereas Lechthaler et al. (2021) used laboratory analysis technique whereby the samples were assessed by microscope and partly with Fourier-transform infrared spectroscopy. Contrary to that, Sasmita et al.(2022) used a combination of experimental and modeling approaches to achieve its objectives. On the other hand, S et al. (2022) used the Global Burden of Disease methodology to approximation the disease problem relatable to air pollution in each state, which uses epidemiological studies and other data sources to estimate the number of deaths and years of life lost.
b. Findings
Gupta and Dhir (2021) found that the highest concentrations of PM10, PM2.5, and NO2 were in industrial areas, whereas the huge quantities of SO2 and CO were found in cities. They also found that the highest quantities of PM10 and PM2.5 were in the winter season whereas the huge quantities of SO2, NO2, and CO were found in summer season. On the other hand, Lechthaler et al. (2021) found that there was more microplastics in places with high anthropogenic influences in contrast to places with a minimal anthropogenic effect. On the contrary, S et al. (2022) found that air pollution was responsible for a significant disease burden in India and was associated with economic losses.
c. Recommendations
Gupta and Dhir (2021) recommend that choice makers and city organizers should explore the main foundations of particulate matter for more effective monitoring. Lechthaler et al. (2021) recommends further environmental sampling to enhance the efficiency of the data by getting more comprehensive data concerning the storing and conveyance of fluvial microplastics within diverse climate circumstances. Sasmita et al.(2022) called for consideration to emphasize on regulating and preventing air contamination in handling health-connected problem due to PM10. On the other end, S et al. (2022) recommends increasing public awareness about the health impacts of air pollution and the importance of reducing air pollution for economic growth and sustainable development.
References.
Gupta, A., & Dhir, A. (2021). Spatial and temporal variations of air pollutants in urban agglomeration areas in Gujarat, India during 2004–2018. MAPAN, 37(1), 215-226. https://doi.org/10.1007/s12647-021-00495-5
Lechthaler, S., Waldschläger, K., Sandhani, C. G., Sannasiraj, S. A., Sundar, V., Schwarzbauer, J., & Schüttrumpf, H. (2021). Baseline study on microplastics in Indian rivers under different anthropogenic influences. Water, 13(12), 1648. https://doi.org/10.3390/w13121648
S, S. K., Bagepally, B. S., & Rakesh, B. (2022). Air pollution attributed disease burden and economic growth in India: Estimating trends and inequality between states. The Lancet Regional Health – Southeast Asia, 7, 100069. https://doi.org/10.1016/j.lansea.2022.100069
Sasmita, S., Kumar, D. B., & Priyadharshini, B. (2022). Assessment of sources and health impacts of PM10 in an urban environment over eastern coastal plain of India. Environmental Challenges, 7, 100457. https://doi.org/10.1016/j.envc.2022.100457
,
2
Objective summary: Pollution issues in India
Name of Student
Name of Instructor
Course title
Institution
Date
Objective summary: Pollution issues in India
Gupta and Dhir (2021) conducted a study to investigate the dimensional and chronological differences of air contaminants within agglomeration zones in Gujarat. The study was conducted to address the issue of air pollution, which has become a growing concern in the country due to its negative effects on public health and the environment. The research was conducted in the urban agglomeration areas of four major cities in Gujarat: Ahmedabad, Vadodara, Surat, and Rajkot. The study period spanned 14 years from 2004 to 2018. Gupta and Dhir (2021) utilized a quantitative research methodology. Furthermore, the researchers used geographic information systems (GIS) to create maps showing the spatial variations of air pollutant concentrations in the urban agglomeration areas of the four cities. (Gupta & Dhir, 2021)
The study utilized data from air quality monitoring stations within agglomeration zones of the four cities, which measured the quantity of air contaminants like particulate matter (PM10 and PM2.5), nitrogen oxides (NO2), and sulfur dioxide (SO2). The data was analyzed using statistical tools such as the Mann-Kendall test to evaluate the tendencies in air pollutant concentrations over time. These statistical tools allowed the researchers to identify and quantify any significant temporal changes in the air pollutant concentrations over the study period. The study found that the concentrations of air pollutants varied spatially, with higher concentrations observed in areas with heavy traffic and industrial activities (Gupta & Dhir, 2021). Again, the researchers found that that PM2.5 and PM10 led to more contamination when equated with SO2 and NO2. Additionally, the study found that the quantities of air contaminants were generally higher in the winter period than in the summer period. (Gupta & Dhir, 2021)
Reference.
Gupta, A., & Dhir, A. (2021). Spatial and temporal variations of air pollutants in urban agglomeration areas in Gujarat, India during 2004–2018. MAPAN, 37(1), 215-226. https://doi.org/10.1007/s12647-021-00495-5
,
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 1
Racial Disparities in Healthcare Among Pregnant Women in the United States
Tamifer Lewis
Department of Public Health, Monroe College, King Graduate School
KG604-144: Graduate Research and Critical Analysis
Dr. Manya Bouteneff
December 4, 2022
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I attest that I incorporated ALL feedback from all previous assignments to make this paper
SHINE
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 2
Racial Disparities in Healthcare Among Pregnant Women in the United States
Introduction
African American, American Indian, and Alaska Native women are up to three times
more likely to die from adverse pregnancy related outcomes, a disparity that increases with age
(Centers for Disease Control and Prevention [CDC], 2019). Researchers found a program which
provided support to African American women through group trainings, entailing of stress
reduction techniques, life skills development, and the building of social support. This enabled
mitigation efforts to be focused and geared around the factors that influence and contributed to
adverse pregnancy outcomes among the minority women within the community, thus reducing
and preventing negative pregnancy outcomes in women of color. In the United States, maternal
mortality and adverse health outcomes persist within the minority community, yet as racial
disparities in healthcare among pregnant women is a current preventable public health concern, it
is vital to understand the determinants of health that influences negative pregnancy related
outcomes in minority women, similar to one of California’s intervention programs, the Black
Infant Health Program (Nichols & Cohen, 2019).
Literature Review
Introduction to Literature Review
Research suggests that racial disparities in healthcare among pregnant women persists in
the United States (Zhang et al., 2013). Due to this continuous occurrence, it is vital to examine
the factors that contribute to the adverse outcomes in maternal health. The literature review
contained only research articles about factors that impacted and influenced disparities in
pregnancy outcomes. Factors that were reviewed were socioeconomic status, public health
insurance, race/ethnicity, and poverty status. The literature review was conducted using EBSCO
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 3
Host and ProQuest databases from the Monroe College Library. The search terms used to
compile pertinent articles were racial disparities maternal health, adverse pregnancy outcomes,
and maternal health outcomes.
Review of Literature
Adverse Pregnancy Outcome Factors
Darling et al. (2021) conducted a study between 2001 and 2018 to examine the efficiency
of qualified interventions in preterm birth, small for gestational age, low birth weight, neonatal
death, cesarean deliveries, maternal care satisfaction, and coast effectiveness programs. A
systematic review was used to collect data from the United States, France, Spain, and the
Netherlands. The studies consisted of mostly non- Caucasian women from low-income
population ranging from 12 to 46 years of age and being between 20 to 32 weeks' gestation.
Interventional programs were implemented into three categories: group prenatal care, augmented
prenatal care, or a combination of both group and augmented prenatal care (Darling et al., 2021).
The researchers found that certain interventions, such as prenatal care and augmented care, or a
combination of both, may decrease adverse outcomes in small-for-gestational-age and preterm
birth, and could aid in increasing maternal care satisfaction. Interventions that worked on
enhancing coordination of care were found to result in providing more effective cost savings.
The researchers also found disparities in the quality of access to care in the vulnerable
population. There was insufficient evidence of suitable quality to confirm that the interventions
were successful at enhancing clinical outcomes in prenatal care for at risk populations (Darling et
al., 2021).
Similar observations were made in a study conducted by Nichols and Cohen (2020),
between 2006 and 2018 to examine the methods used to improve the results of maternal
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 4
mortality in California. The study was conducted using a scoping review to evaluate research on
women and maternal health in the United States. The researchers used information from the US
Maternal Fetal Medicine Network to measure the percentage of studies where pregnant women,
women, and children were the main focus. The researchers also reviewed documentation on
healthcare policies and practices from California’s public health department, healthcare
foundation, and Maternal Quality Care Collaborative. Nichols and Cohen (2020) found that
although the health of fetus and children could be adversely affected by the health of the mother,
the majority of maternal programs in the United States places emphasis on the child. The
researchers also found four areas of concern in women health experiences, both in pre and
postnatal care. The problem areas entailed inadequate investment in women's health, inefficient
quality of care and avoidable caesarean delivers, expanding disparities in minority women and
women living in rural areas, and contradictory collection and distribution of data (Nichols &
Cohen, 2020).
Approaches to Improving Pregnancy Outcomes
In contrast to the preceding studies, Zhang et al. (2013) conducted a study between 2005
and 2007 to calculate the excessive rate of unfavorable outcomes in pregnancy within racial and
ethnic groups. The study also aimed to measure the possibility of Medicaid savings that are
linked to paid maternal care claims resulting from the inequalities that contribute to unfavorable
maternal outcomes. A cross-sectional study using Medicaid Analytic eXtract (MAX) data was
used to gather pregnancy outcome information from inpatient hospitals from 14 states (Florida,
Alabama, Arkansas, North Carolina, Georgia, Louisiana, Kentucky, Mississippi, Maryland,
Missouri, Tennessee, South Carolina, Virginia, and Texas). The study consisted of a little over 2
million patients who were insured with Medicaid and had a delivery code of maternal delivery
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 5
stay. Zhang et al. (2013) found that, with the exception of gestational diabetes, African American
women showed the worst outcomes out of all unfavorable pregnancy outcomes. These disparities
are postulated as being multi-factorial, having causes stemming from complicated experiences
with racism, poverty, and complex healthcare interactions. It was also found that women covered
under Medicaid health insurance were more likely to have consistency in care from prenatal care
through delivery compared to their counterparts. However, due to participation in Medicaid
programs being influenced by reimbursement rates, some providers may choose to stop
accepting Medicaid patients because of reimbursement delays and low payment rates, which
could contribute to negative birth outcomes (Zhang et al., 2013).
Analysis of Literature
In the United States, the persistence of maternal mortality continues to be a problem area
in public health. The contributing factors that impact pregnancy outcomes persist in burdening
the U.S., leading to poor healthcare quality, and increasing health disparities. The studies used in
this literature review each used a different form of research methodology to collect data,
including systematic and scoping reviews and cross-sectional studies. Similarly, Darling et al.
(2021), Nichols and Cohen (2020), and Zhang et al. (2013) have emphasized the correlation
between race/ethnicity and financial status playing a part in influencing quality of care, access of
care, and pregnancy outcomes in pregnant minority women. To mitigate the disparities in
maternal health Darling et al. (2021) and Zhang et al. (2013) suggested that interventions should
be inspected and geared towards determining and eradicating the racial and ethnic disparities that
affect pregnancy-related outcomes. Whereas Nichols and Cohen (2020) suggested focusing on
exploring the distinctive experiences of particular at-risk subgroups of women, such as women in
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 6
prison, who are of childbearing age, and the pregnant women who are less likely to pursue
prenatal care, such as undocumented women.
Discussion
Introduction to Discussion
There is current evidence that racial disparities in healthcare among pregnant women
continues to be a problem in the United States. In an article published by The New York Times
(Rabin, 2019), there has been a persistence and growth in racial disparity throughout the years
despite calls to take action to improve medical care access for women of color. Similarly, in a
study conducted by Nichols and Cohen (2019) mounting disparities continue amid women health
outcomes in the United States, primarily among race and ethnicity and within residents living in
urban and rural areas (Nichols & Cohen, 2019). These disparities directly affect African
American, Alaska Native and Native American Women (Rabin, 2019). When compared to other
high-income countries, the United States has substandard records in maternal health outcomes,
and while the rate of maternal mortality dropped across the world, America's maternal health
outcomes have worsened (Rabin, 2019).
Evidence-Based Recommendation
To reduce the disparities among minority women policy changes have been made.
Federal law enacted the Preventing Maternal Death Act providing states with grants to explore,
examine and investigate pregnancy related deaths for up to one year after the birth of a child
(Rabin, 2019). Also, The American College of Obstetrics and Gynecologists created new
guidelines in treating cardiovascular disease in pregnant women (Rabin, 2019). In 2014 Alliance
for Innovation on Maternal Health (AIM) was developed by the American College of Obstetrics
and Gynecology to collaborate with partners of the states and hospitals to gather information on
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 7
safety measures being taken to improve maternal health outcomes, allowing partners to assess
and track program progress (Nichols & Cohen, 2019). In the study conducted by Nichols and
Cohen (2019), two out of the various programs that California implemented were the Black
Infant Health Program (BIH) and increasing the states income eligibility for pregnant women to
200% of the federal poverty level. With the implementation of these programs, mortality rates
decreased from 22.1% to 8.3% in the best practices toolkit, a program developed for hemorrhage
and high blood pressure during pregnancy. Altogether, California's maternal mortality rate
decreased by above 50% between 2006 and 2018 (Nichols & Cohen, 2019). To prevent negative
pregnancy outcomes in women of color, California used federal funds to develop programs that
focused on African American mothers and the health determinants that are influenced by social
and structural factors. The Black Infant Health Program provided support to African American
women through group trainings, entailing of stress reduction, life skills development, and
building social support (Nichols & Cohen, 2019). Nearly half of the babies born in the United
States are insured under Medicaid which covers the child through the first year of life. However,
in most states, Medicaid provides coverage for the mother until 60 days postpartum, after which
the mother must meet the federal poverty level to be eligible for coverage (Nichols & Cohen,
2019). This exposes the mother to various risks that can adversely affect her health. Expanding
Medicaid access would mitigate the maternal healthcare barriers that affect low socioeconomic
minority women.
Racial disparities in maternal healthcare are a persistent problem in the United States.
African American mothers experience higher adverse pregnancy outcomes and are less likely to
obtain sufficient prenatal care when compared to Caucasian women (Zhang et al., 2013).
Similarly, racial disparities among women of color are made worse by partialities in the
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 8
healthcare that they receive (Nichols & Cohen, 2019). To mitigate racial disparities in maternal
health among minority women it is important to understand the determinants that contribute to
their health outcomes. With increased federal funding, programs can be geared towards
providing quality care to women of color. This can be established by utilizing specific methods
of care that are relatable to those being serviced in the community, providing them with medical
professionals that are culturally competent and adequately trained in servicing underserved
communities, fostering a trusting provider-patient relationship. Nichols and Cohen (2019)
suggest that funding should be used to address the social factors that influence maternal health to
reduce the psychosocial risks in women who may be more vulnerable to adverse pregnancy
outcomes. The pregnancy-related risks of a mother do not end after her child's birth. The
expansion of Medicaid access and coverage would provide a mother with the means of receiving
adequate care during all stages of pregnancy and during the postpartum period, in which she can
still be adversely affected from her pregnancy. It is vital for the federal government to enact
policies requiring states to provide medical coverage to women for one year after the birth of
their child. Providing coverage to various specialties would ensure the mother has efficient
access to care should adverse symptoms develop. Nichols and Cohen (2019) postulated that state
programs should expand Medicaid coverage for women focusing on their healthcare needs
before, during and after pregnancy, paying close attention to women’s health and chronic disease
management, especially to those who have or had high risk pregnancies. Implementing these
programs would develop a foundation in the quality of racial maternal care across all states and
provide cohesion and uniformity in the delivery of care.
Conclusion
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 9
As seen in one of California’s intervention programs, the Black Infant Health Program
(Nichols & Cohen, 2019), a program which provided support to African American women
through group trainings, which entailed stress reduction techniques, life skills development, and
the building of social support enabled mitigation efforts to be focused and geared around the
influencing factors that contributed to adverse pregnancy outcomes among the minority women
within the community, thus reducing and preventing negative pregnancy outcomes in women of
color. African American, American Indian, and Alaska Native women are up to three times more
likely to die from adverse pregnancy related outcomes, a disparity that increases with age (CDC,
2019). In the United States, maternal mortality and adverse health outcomes persist within the
minority community and as a result racial disparities in healthcare among pregnant women is a
current preventable public health concern, therefore it is vital to understand the determinants of
health that influences negative pregnancy related outcomes in minority women.
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