Understanding the Relationship Between Gender Representation in County Government and Perinatal Outcomes to Black, White, and Hispanic Birthing People in Georgia

Objective: To characterize the association between percent of county-level elected officials who were female-presenting and perinatal outcomes in Georgia and variation by individual race, 2020–2021. Materials and Methods: We gathered data on the gender composition of county-level elected officials f...

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Main Authors: Kaitlyn K. Stanhope, Pragati Kapila, Afsha Hossain, Maha Abu-Salah, Vanshika Singisetti, Amal Umerani, Sierra Carter, Sheree Boulet
Format: Article
Language:English
Published: Mary Ann Liebert 2024-04-01
Series:Women's Health Reports
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Online Access:https://www.liebertpub.com/doi/10.1089/whr.2023.0158
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author Kaitlyn K. Stanhope
Pragati Kapila
Afsha Hossain
Maha Abu-Salah
Vanshika Singisetti
Amal Umerani
Sierra Carter
Sheree Boulet
author_facet Kaitlyn K. Stanhope
Pragati Kapila
Afsha Hossain
Maha Abu-Salah
Vanshika Singisetti
Amal Umerani
Sierra Carter
Sheree Boulet
author_sort Kaitlyn K. Stanhope
collection DOAJ
description Objective: To characterize the association between percent of county-level elected officials who were female-presenting and perinatal outcomes in Georgia and variation by individual race, 2020–2021. Materials and Methods: We gathered data on the gender composition of county-level elected officials for all Georgia counties (n = 159) in 2022 and calculated the percent of female elected officials (percent female, 0–100). We linked this to data from 2020 to 2021 birth certificates (n = 238,795) to identify preterm birth (PTB, <37 weeks), low birthweight (LBW, <2500 grams), hypertensive disorders of pregnancy, and cesarean delivery. We fit multilevel log binomial models with generalized estimating equations, with percent female as the primary independent variable. We adjusted for individual and county-level potential confounders and individual race/ethnicity as an effect modifier. Results: County median percent female elected officials was 22.2% (interquartile range: 15.5). Overall, 14.6% of births were PTB and 10.1% LBW. A 15 percentage point increase in percent female elected officials was associated with lower risk of hypertensive disorders of pregnancy for white (adjusted risk ratio [RR]: 0.94, 95% confidence interval [CI]: 0.88–0.99), and possibly Hispanic (adjusted RR: 0.95, 95% CI: 0.89–1.0) and non-Hispanic other (adjusted RR: 0.94 (0.87–1.01), but not black birthing people (adjusted RR: 1.0, 95% CI: 0.95–1.05). There was not a clear pattern for PTB, birthweight, or cesarean delivery. Conclusion: Greater female representation in county government was associated with improved maternal health for some racial/ethnic groups in Georgia.
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spelling doaj-art-95010ff7ced742669d1e4f54e9ac92e22025-08-20T01:50:56ZengMary Ann LiebertWomen's Health Reports2688-48442024-04-015120121010.1089/whr.2023.0158Understanding the Relationship Between Gender Representation in County Government and Perinatal Outcomes to Black, White, and Hispanic Birthing People in GeorgiaKaitlyn K. Stanhope0Pragati Kapila1Afsha Hossain2Maha Abu-Salah3Vanshika Singisetti4Amal Umerani5Sierra Carter6Sheree Boulet7Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA.Emory College of Arts and Sciences, Atlanta, Georgia, USA.Emory College of Arts and Sciences, Atlanta, Georgia, USA.Emory College of Arts and Sciences, Atlanta, Georgia, USA.Biology and Women's Studies, University of Georgia, Athens, Georgia, USA.Emory College of Arts and Sciences, Atlanta, Georgia, USA.Department of Psychology, Georgia State Uniersity, Atlanta, Georgia, USA.Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA.Objective: To characterize the association between percent of county-level elected officials who were female-presenting and perinatal outcomes in Georgia and variation by individual race, 2020–2021. Materials and Methods: We gathered data on the gender composition of county-level elected officials for all Georgia counties (n = 159) in 2022 and calculated the percent of female elected officials (percent female, 0–100). We linked this to data from 2020 to 2021 birth certificates (n = 238,795) to identify preterm birth (PTB, <37 weeks), low birthweight (LBW, <2500 grams), hypertensive disorders of pregnancy, and cesarean delivery. We fit multilevel log binomial models with generalized estimating equations, with percent female as the primary independent variable. We adjusted for individual and county-level potential confounders and individual race/ethnicity as an effect modifier. Results: County median percent female elected officials was 22.2% (interquartile range: 15.5). Overall, 14.6% of births were PTB and 10.1% LBW. A 15 percentage point increase in percent female elected officials was associated with lower risk of hypertensive disorders of pregnancy for white (adjusted risk ratio [RR]: 0.94, 95% confidence interval [CI]: 0.88–0.99), and possibly Hispanic (adjusted RR: 0.95, 95% CI: 0.89–1.0) and non-Hispanic other (adjusted RR: 0.94 (0.87–1.01), but not black birthing people (adjusted RR: 1.0, 95% CI: 0.95–1.05). There was not a clear pattern for PTB, birthweight, or cesarean delivery. Conclusion: Greater female representation in county government was associated with improved maternal health for some racial/ethnic groups in Georgia.https://www.liebertpub.com/doi/10.1089/whr.2023.0158local governmentmaternal and infant healthpreterm birthhypertensive disorders of pregnancybirthweight
spellingShingle Kaitlyn K. Stanhope
Pragati Kapila
Afsha Hossain
Maha Abu-Salah
Vanshika Singisetti
Amal Umerani
Sierra Carter
Sheree Boulet
Understanding the Relationship Between Gender Representation in County Government and Perinatal Outcomes to Black, White, and Hispanic Birthing People in Georgia
Women's Health Reports
local government
maternal and infant health
preterm birth
hypertensive disorders of pregnancy
birthweight
title Understanding the Relationship Between Gender Representation in County Government and Perinatal Outcomes to Black, White, and Hispanic Birthing People in Georgia
title_full Understanding the Relationship Between Gender Representation in County Government and Perinatal Outcomes to Black, White, and Hispanic Birthing People in Georgia
title_fullStr Understanding the Relationship Between Gender Representation in County Government and Perinatal Outcomes to Black, White, and Hispanic Birthing People in Georgia
title_full_unstemmed Understanding the Relationship Between Gender Representation in County Government and Perinatal Outcomes to Black, White, and Hispanic Birthing People in Georgia
title_short Understanding the Relationship Between Gender Representation in County Government and Perinatal Outcomes to Black, White, and Hispanic Birthing People in Georgia
title_sort understanding the relationship between gender representation in county government and perinatal outcomes to black white and hispanic birthing people in georgia
topic local government
maternal and infant health
preterm birth
hypertensive disorders of pregnancy
birthweight
url https://www.liebertpub.com/doi/10.1089/whr.2023.0158
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