Parental Race Research Articles

The maternal and infant health consequences of restricted access to abortion in the United States

Since the recent US Supreme Court decision in Dobbs v. Jackson Women's Health Organization, people across the country have experienced large sudden changes in their access to abortion care. In this paper, I look to the history of abortion access in the United States to inform predictions for this new future. I study the effects of targeted regulations on abortion providers (TRAP laws) on a variety of maternal and infant health outcomes, using variation in the timing of policy adoption across states and a direct measure of the distance to an abortion provider. I implement difference-in-differences techniques across outcomes from restricted-use microdata on the universe of US births. I find that TRAP laws lead to 11–16 % increased rates of hypertensive disorders of pregnancy. Additionally, I find evidence that TRAP laws widen existing disparities in adverse infant health outcomes across parental race. These results demonstrate the potentially wide-ranging health effects of restricting access to abortion.

Secular variation and risk factors of preterm birth in Hainan, the Free Trade Port in China from 2010 to 2021

ObjectivesPreterm delivery rates have increased obviously worldwide over the past decade, yet reliable epidemiological studies on the incidence of preterm birth and temporal trends are not available in Hainan, The Free Trade Port in China. We aimed to describe the rate of preterm birth and trends between 2010 and 2021 and to primarily explore risk factors associated with preterm birth in Hainan, China.MethodsThis was an observational study was based on data from the Hainan Provincial Birth Certificate System (HPBCS) for live births between 1 January 2010 and 31 December 2021. We included pregnancies resulting in at least one live birth, with newborns born at a gestational age of 28 weeks or greater, or with a birth weight of 1000 g or more. The outcome were preterm birth rates and their trends over time. Potential risk factors were collected, including infant gender, maternal age, paternal age, maternal ethnicity, paternal ethnicity, home address, and single or multiple pregnancies. The logistic regression model was used to assess the relationship between preterm birth and potential risk factors.ResultsA total of 1,537,239 live births and 86,328 preterm births were investigated, giving a total preterm birth rate of 5.62%. The overall preterm birth rate increased from 4.47% in 2010 to 7.12% in 2021 (compound annual growth rate [CAGR] 4.32). The CAGR of late preterm birth is consistent with the overall preterm birth rate (4.32%). The fastest growth is observed in the rate of very preterm births (5.53%), while the rate of moderate preterm births exhibits the slowest growth (3.87%). Infant gender, multiple pregnancy, home address, parental age, and ethnicity had significant effects on preterm birth.ConclusionThe preterm birth rate was increasing year by year from 2010 to 2021 in Hainan, The Free Trade Port in China. Incidence of preterm births in Hainan Province in relation to multiple pregnancies, infant sex, parental age, parental race and residential address.

Exploring Vaccine Hesitancy Among Parents in a Rural Pediatric Clinic System: A Statistical Study.

Vaccine hesitancy has been a growing concern in the United States, particularly in rural areas where access to healthcare services may be limited. A rural pediatric clinic system in central Louisiana serves a population with historically low childhood immunization rates. This study explored the prevalence and determinants of vaccine hesitancy among parents of pediatric patients at the organization's clinics. A qualitative survey was conducted among parents who declined vaccines for their children at the organization's clinics. The survey collected information on parents' attitudes, beliefs, decision-making processes regarding childhood vaccinations, and demographic information about the parents, including income and education levels. Thematic analysis was used to identify key themes and patterns in the survey responses. Thirty out of 47 parents (response rate: 64%) completed the survey. Most respondents (n=24, 80%) expressed concerns about vaccine safety and potential side effects. Many parents (n=16, 60%) cited information from social media and alternative health sources as influencing their decision to decline vaccines. Religious and philosophical beliefs were also common reasons for vaccine refusal (n=13, 43%). Another significant theme was the lack of trust in healthcare providers and the pharmaceutical industry (n=17, 53%). No significant differences in responses were observed based on the parent's race or the child's sex. Ninety percent of participants (n=27) reported a household income of under $50,000, and 87% of participants (n=26) had a high school education or less. Vaccine hesitancy among parents in this rural pediatric population appears to be driven by concerns about vaccine safety, exposure to misinformation, religious and philosophical beliefs, and distrust in the healthcare system. Addressing these factors through targeted education, provider communication, and community engagement may be essential for improving childhood immunization rates in this vulnerable population. The findings highlight the need for culturally sensitive, evidence-based interventions to combat vaccine hesitancy in rural communities.

Does the Association Between Concussion Measures and Social Context Factors Differ in Black and White Parents?

Middle school (MS) parents may benefit from education supporting timely concussion identification and care-seeking in their young children (aged approximately 10 to 15 years). However, such education may not consider individual needs and different social context factors, including lower socioeconomic status, disadvantaged social determinants of health, and different racial and ethnic backgrounds. To examine the relationship between social context factors and concussion knowledge, attitudes, and communication in MS parents and to explore the possible role of race and ethnicity (Black or White) as an effect measure modifier. Cross-sectional study. Online survey. A nationally representative sample of MS parents who completed an online survey (n = 1248). Parent outcomes were a history of concussion education, concussion symptom knowledge and attitudes, and communication with children about concussion. Main exposures were parental race and ethnicity (Black or White) and social context factors. Uni- and multivariable statistical analyses were performed to achieve the study aims. Black parents were more likely than White parents to have received concussion education (69.5% versus 60.5%, P = .009), although median concussion knowledge scores were higher for White parents than for Black parents (40 versus 37, P < .001). Few associations were found for social context factors with concussion knowledge, attitudes, and communication in Black and White parents separately. Among MS parents, race and ethnicity may not influence the association between social context factors and concussion-related knowledge, attitudes, or communication. However, differences were present by race and ethnicity regarding previous concussion education and other parental outcomes, concussion symptom knowledge in particular.

Factors Influencing Parental Willingness to Consent to a Survey Study for Patients in the Pediatric Emergency Department.

To identify factors that impact parental willingness to consent to research studies conducted for their children during visits to pediatric emergency departments (EDs). Parents and guardians of children receiving care in our pediatric ED were approached and asked if they would be willing to let their child participate in a research study requiring the child to complete an electronic questionnaire. No such questionnaire existed, however, because the primary purpose was to ascertain the parent's willingness to let their child participate. All parents were debriefed and informed of the true purpose of the study and asked to complete a survey themselves to help understand factors that influenced their initial decision of whether to consent. Bivariate tests and logistic regression were used to evaluate unadjusted and adjusted associations between parent and patient characteristics and parental consent decision. We approached 431 eligible parents about the hypothetical research study involving their children, and 386 (89.6%) consented for their children to participate. After the debriefing, 392 (91.0%) parents consented to complete the parental survey. We observed statistically significant associations between shorter length of ED stay to approach for consent for the study ( P = 0.048) as well as longer travel time ( P = 0.03) and willingness to consent in bivariate analysis, though this did not hold in regression analysis. Regression analysis revealed parents of children who have previously participated in research had 79 times lower odds of consenting to participate in our study adjusted for parent race, ethnicity, actual and perceived length of stay, travel time to the ED, and altruism. A high proportion of parents consented to their child participating in research in our ED with previous child participation in research being associated with lower odds of parental consent even when adjusted for other factors. Our findings may inform future research practices and studies investigating parental perceptions and motivations surrounding research studies.

Neurodevelopmental Outcomes of Extremely Preterm Infants Fed Donor Milk or Preterm Infant Formula

Maternal milk feeding of extremely preterm infants during the birth hospitalization has been associated with better neurodevelopmental outcomes compared with preterm formula. For infants receiving no or minimal maternal milk, it is unknown whether donor human milk conveys similar neurodevelopmental advantages vs preterm formula. To determine if nutrient-fortified, pasteurized donor human milk improves neurodevelopmental outcomes at 22 to 26 months' corrected age compared with preterm infant formula among extremely preterm infants who received minimal maternal milk. Double-blind, randomized clinical trial conducted at 15 US academic medical centers within the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants younger than 29 weeks 0 days' gestation or with a birth weight of less than 1000 g were enrolled between September 2012 and March 2019. Preterm formula or donor human milk feeding from randomization to 120 days of age, death, or hospital discharge. The primary outcome was the Bayley Scales of Infant and Toddler Development (BSID) cognitive score measured at 22 to 26 months' corrected age; a score of 54 (score range, 54-155; a score of ≥85 indicates no neurodevelopmental delay) was assigned to infants who died between randomization and 22 to 26 months' corrected age. The 24 secondary outcomes included BSID language and motor scores, in-hospital growth, necrotizing enterocolitis, and death. Of 1965 eligible infants, 483 were randomized (239 in the donor milk group and 244 in the preterm formula group); the median gestational age was 26 weeks (IQR, 25-27 weeks), the median birth weight was 840 g (IQR, 676-986 g), and 52% were female. The birthing parent's race was self-reported as Black for 52% (247/478), White for 43% (206/478), and other for 5% (25/478). There were 54 infants who died prior to follow-up; 88% (376/429) of survivors were assessed at 22 to 26 months' corrected age. The adjusted mean BSID cognitive score was 80.7 (SD, 17.4) for the donor milk group vs 81.1 (SD, 16.7) for the preterm formula group (adjusted mean difference, -0.77 [95% CI, -3.93 to 2.39], which was not significant); the adjusted mean BSID language and motor scores also did not differ. Mortality (death prior to follow-up) was 13% (29/231) in the donor milk group vs 11% (25/233) in the preterm formula group (adjusted risk difference, -1% [95% CI, -4% to 2%]). Necrotizing enterocolitis occurred in 4.2% of infants (10/239) in the donor milk group vs 9.0% of infants (22/244) in the preterm formula group (adjusted risk difference, -5% [95% CI, -9% to -2%]). Weight gain was slower in the donor milk group (22.3 g/kg/d [95% CI, 21.3 to 23.3 g/kg/d]) compared with the preterm formula group (24.6 g/kg/d [95% CI, 23.6 to 25.6 g/kg/d]). Among extremely preterm neonates fed minimal maternal milk, neurodevelopmental outcomes at 22 to 26 months' corrected age did not differ between infants fed donor milk or preterm formula. ClinicalTrials.gov Identifier: NCT01534481.

Latent profile analysis of risk and protective factors among foster parents: A cross-sectional study

Foster parents serve a critical role in child welfare systems. However, foster parents express dissatisfaction in their roles as caregivers, thus impacting placement stability. Placement disruption has many negative impacts on foster youth including delayed permanency, increased behavioral symptoms, and negative educational outcomes. Utilizing a cross-sectional design, this survey study collected data from 362 foster parents in six states. Results from a latent profile analysis indicated a three-profile solution was found, representing three subpopulations of foster parents, subsequently named Resourceful, Strained, and Disadvantaged Foster Parents. Differences between groups on indicators were noted in scores on burnout, secondary-traumatic stress, social support, thoughts on training usefulness, and foster parent satisfaction. Added covariates showed significant differences among group make-up on foster youth behavioral issues, and foster parent race. Foster parent profiles were explored in relation to intention to turnover and disrupt current foster youth placement. There were significant differences across all profiles on turnover and placement disruption intent. These findings give insight into the training and support needs of foster parents.

Exploring the association between parental ethnic-racial socialization and parental closeness on Black-White biracial adolescents' choice of racial identification toward blackness.

To explore the influences of Black-White biracial adolescents' choice to racially identify with Blackness, parental ethnic-racial socialization (ERS) messages, parental race, and perceived parental closeness were examined. Specifically, this study investigated how messages that promote monoracial Black pride and messages that prepare youth for monoracial Black bias may be related to adolescents' identification with Blackness, and whether parental race or parental closeness moderated these relationships. Three hundred thirty Black-White biracial adolescents (Mage = 14.82) were recruited across the United States via social media. Participants completed the Racial Socialization Questionnaire for Biracial Adolescents and a demographic questionnaire to indicate how close they felt to each parent. The analytic sample (n = 280) included respondents who racially identified as exclusively Black, blended Black, or exclusively biracial. Multinomial logistic regression analyses revealed significant differences in the association between ERS messages and adolescent racial identification based on the race of the parent socializer. Further moderation analyses indicated that parental closeness, particularly regarding fathers, amplifies these findings. Maternal and paternal ERS messages are differentially associated with biracial adolescents' choice of racial identification toward Blackness. interestingly, ERS messages from White parents seem to significantly influence racial identification compared to Black parents. Parental closeness further elucidates these findings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Black-White Differences in Offspring Educational Attainment and Older Parents' Dementia.

Emerging research documents the health benefits of having highly educated adult offspring. Yet less is known about whether those advantages vary across racial groups. This study examines how offspring education is tied to parents' dementia risk for Black and White parents in the United States. Using data from the Health and Retirement Study, findings suggest that children's education does not account for the Black-White gap in dementia risk. However, results confirm that parental race moderates the relationship between children's education and dementia risk and that the association between children's education and parents' dementia risk is strongest among less-educated parents. Among less-educated parents, higher levels of children's attainment prevent the risk of dementia onset for Black parents, but low levels of offspring schooling increase dementia risk among White parents. The study highlights how offspring education shapes the cognitive health of social groups differently and points to new avenues for future research.

What advice do parents give their children about plea bargains? Understanding the role of parent race, attorney race, and attorney recommendations

This study examined parent acquiescence to attorney recommendations in plea bargain decisions, and the effect of racial similarity between an attorney and their juvenile client’s parent. Scholarship indicates that youth are vulnerable to the influence of authority figures in plea-bargaining, leading to a reliance on parental and attorney input for plea decisions. Parents read a vignette with attorney’s race manipulated, imagining they are participating in the plea-bargaining process and the attorney is giving them recommendations regarding how to plea. Results show White parents were more likely to take a plea and had more trust in the attorneys. Black attorneys were found to be most trustworthy, especially for White parents. Parent race impacted plea advice acquiescence more than attorney/parent racial similarity.

Incidence of Newborn Drug Testing and Variations by Birthing Parent Race and Ethnicity Before and After Recreational Cannabis Legalization

Thirty-seven US states and the District of Columbia mandate reporting newborns with suspected prenatal substance exposure to the state, and punitive policies that link prenatal substance exposure to newborn drug testing (NDT) may lead to disproportionate reporting of Black parents to Child Protective Services. The impact of recreational cannabis legalization on racial disproportionality in NDT is unknown. To examine variations in the incidence and results of NDT by birthing parent race and ethnicity, variables associated with variation, and changes after statewide legalization of recreational cannabis. This retrospective cohort study was conducted from 2014 to 2020 with 26 366 live births to 21 648 birthing people who received prenatal care at an academic medical center in the Midwestern United States. Data were analyzed from June 2021 to August 2022. Variables included birthing parent age, race, ethnicity, marital status, zip code, insurance type, prenatal and newborn diagnoses codes, and prenatal urine drug test orders and results. The primary outcome was an NDT order. Secondary outcomes were substances detected. Among 26 366 newborns of 21 648 birthing people (mean [SD] age at delivery, 30.5 [5.2] years), most birthing parents were White (15 338 [71.6%]), were non-Hispanic (20 125 [93.1%]), and had private insurance coverage (16 159 [74.8%]). The incidence of NDT ordering was 4.7% overall (1237 newborns). Clinicians ordered more NDTs for Black compared with White newborns (207 of 2870 [7.3%] vs 335 of 17 564 [1.9%]; P < .001) when the birthing parent had no prenatal urine drug test, a presumably low-risk group. Overall, 471 of 1090 NDTs (43.3%) were positive for only tetrahydrocannabinol (THC). NDTs were more likely to be positive for opioids in White compared with Black newborns (153 of 693 [22.2%] vs 29 of 308 [9.4%]; P < .001) and more likely to be positive for THC in Black compared with White newborns (207 of 308 [67.2%] vs 359 of 693 [51.8%]; P < .001). Differences remained consistent after state recreational cannabis legalization in 2018. Newborn drug tests were more likely to be positive for THC after legalization vs before legalization (248 of 360 [68.9%] vs 366 of 728 [50.3%]; P < .001) with no significant interaction with race and ethnicity groups. In this study, clinicians ordered NDTs more frequently for Black newborns when no drug testing was done during pregnancy. These findings call for further exploration of how structural and institutional racism contribute to disproportionate testing and subsequent Child Protective Services investigation, surveillance, and criminalization of Black parents.

The psychological determinants of classroom preferences: Implicit and explicit racial attitudes and racial composition of classrooms

AbstractThe opportunity for parents to select their children's school is both increasingly common and linked to school segregation in the U.S. Here, we investigate how race and racial attitudes shape parents' classroom preferences, which have direct implications for school choices. We measured the implicit and explicit racial attitudes of both White and Black parents (Study 1: N = 201; mean age = 35.46; 173 women, 28 men; 37 Black, 147 White) of preschool‐aged children who themselves were about to choose educational settings for their children, as well as those parents' preferences for classrooms varying in racial composition. Both implicit and explicit racial attitudes separately predicted classroom preferences, suggesting that both overt and covert racial prejudice play roles in the related decision of school enrollment. Results were replicated in a follow‐up study using a sample of college students (Study 2: N = 357; mean age = 18.90; 183 women, 169 men, 2 transgender, 2 non‐binary, 1 unreported; 144 Black, 213 White). Racially biased parents tend to prefer classrooms with fewer Black students, an effect that occurs even for implicit measures of bias and varies to some extent based on parental race. These effects have direct implications for patterns of segregation in American schools. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Does Parent Education Moderate the Effect of Adoptive Parents’ Race on Math Ability?

Few studies have examined the effect of the adoptive parents’ race on the adopted adolescent’s achievement test scores. Because there are differences in education levels across races among parents, one wonders whether parents’ race predicts the adolescent’s ability after accounting for parent education. The current study investigates the effect of adoptive parents’ race on adolescents’ math ability, separately by race of the adopted adolescents, with and without controlling for parent education levels. The findings from multiple regressions indicate that adoptive parents’ race is strongly associated with math scores, but that parent education does not moderate the large coefficient of the parents’ race variable. Possible unmeasured factors are discussed as explanations of the observed parental race effect. Keywords: Cognitive ability, Race, Parenting, Adoption

The completion of indicated paternal prenatal genetic and carrier testing at a public hospital in Los Angeles, California

PurposePregnant individuals are routinely advised to undergo genetic carrier screening, followed by carrier screening in the reproductive partner if the patient’s screen is positive. The objective of our study was to identify completion rates of and barriers to partner carrier screening or genetic testing. MethodsWe conducted a retrospective cohort study examining the completion of indicated partner genetic screening or testing at the Los Angeles General Medical Center Genetics clinic from January 1, 2017, to October 31, 2022. We examined factors linked to completing partner genetic screening or testing, including sociodemographic factors for patients and their partners, testing indications, and pregnancy characteristics via bivariate analyses (eg, t test, χ2, and Fisher’s exact tests). ResultsIn this primarily low-income, publicly insured, Spanish-speaking population, we identified 98 pregnancies for which partner genetic screening or testing was indicated. Only 26.5% (n = 26) completed testing, which did not vary by indication, parental age, parental race, parity, or primary language. Completion of partner genetic screening or testing was significantly linked to earlier gestational age at referral for genetic counseling (19.1 versus 21.5 weeks, P = .006). In 4 cases, being unable to obtain partner test results led to invasive diagnostic testing of the pregnant patient. ConclusionLess than one-third of pregnancies received indicated partner genetic screening or testing. Early referral to genetic counseling may improve partner testing completion rates, which could avoid invasive and unnecessary diagnostic testing in the pregnant patient.

The impact of psychological flexibility on family dynamics amidst the COVID-19 pandemic: A longitudinal perspective

BackgroundHealth risks associated with contracting COVID-19, stay-at-home orders, and pandemic-related economic and social hardships created unique challenges for individuals throughout the pandemic, and in particular for families whose daily routines were disrupted at the start of the pandemic. This study applied a contextual behavioral science lens to Family Systems Theory to examine the impact of COVID-19 stressors on family and individual functioning. MethodsA sample of 742 coparents (86% married/engaged; 84% Caucasian; 71% female; M = 40.7 years old, SD = 8.1; Mincome = $82,435, SDincome = $27,604) of school-aged children (5–18 years old) completed a baseline survey from late March to late April 2020. Of the initial sample, 556 coparents completed weekly diaries for 8 weeks. ResultsMediation models were tested within a multilevel path modeling framework to evaluate both the stable, between-family differences (i.e., at level 2) and the within-family changes from week to week (i.e., at level 1). Across both levels of the model, parent psychological inflexibility was robustly linked to poorer functioning across all levels of the family system, showing direct links to a majority of the processes assessed. The results further supported a top-down spillover cascade in which parent inflexibility was proximally linked to greater COVID-19 related stress and parent depressive symptoms, which were proximally linked to poorer romantic functioning (greater negative conflict, lower satisfaction), which were proximally linked to poorer family functioning (greater coparent discord and family chaos), which were proximally linked to poorer parenting (greater angry/reactive parenting), which was proximally linked to greater child distress. Multi-group models suggested that the results were largely stable across (1) parent race (white vs non-white), (2) family size (1 child vs 2 or more), (3) child age (less than 10 years old vs 10 or older), (4) parent age (under 40 vs. 40 or older), (5) perceived COVID-19 risk, (6) parent gender (mothers vs fathers), (7) household income groups (less than $100k vs $100k or more), and (8) perceived economic stress/uncertainty (low vs high). However, a handful of moderated effects emerged from those multi-group models suggesting that fathers might be slightly more prone to negative spillover effects across the family systems and that wealthier families might have experienced the stress of new demands (e.g., homeschooling, remote working) as more disruptive. ConclusionsResults highlight the crucial role parental psychological flexibility and inflexibility play in families managing the stress of COVID-19, as well as key mechanisms for how those stressors may either reverberate or become dampened throughout the family system.

Physiological aspects of sex differences and Haldane’s rule in Rumex hastatulus

Haldane’s rule (HR, impairment of fertility and/or viability of interracial hybrids) seems to be one of few generalizations in evolutionary biology. The validity of HR has been confirmed in animals, and more recently in some dioecious plants (Silene and Rumex). Dioecious Rumex hastatulus has two races differing in the sex chromosome system: Texas (T) and North Carolina (NC), and T × NC males showed both reduced pollen fertility and rarity—two classical symptoms of Haldane’s rule (HR). The reduced fertility of these plants has a simple mechanistic explanation, but the reason for their rarity was not elucidated. Here, we measured selected physiological parameters related to the antioxidant defense system in parental races and reciprocal hybrids of R. hastatulus. We showed that the X-autosome configurations, as well as asymmetries associated with Y chromosomes and cytoplasm, could modulate this system in hybrids. The levels and quantitative patterns of the measured parameters distinguish the T × NC hybrid from the other analyzed forms. Our observations suggest that the rarity of T × NC males is caused postzygotically and most likely related to the higher level of oxidative stress induced by the chromosomal incompatibilities. It is the first report on the physiological aspects of HR in plants.

Safe Sleep Behaviors and Factors Associated With Infant Second Sleep Practices.

To examine the prevalence and safety of infant second-sleep practices. A cross-sectional online survey of parents with infants ≤12 months assessed parent-reported sleep practices: position, use of a separate sleep surface, and sleep location at 2 time points (sleep onset and after nighttime waking). A composite score examined if all 3 safe sleep practices were used at each time point. Safe sleep was defined as: supine position, sleeping in a separate space, and in a crib, bassinet, cradle, or playard. Wilcoxon sign rank test was used to examine changes between the time points. Poisson regression models compared parents who reported a second-sleep location with those who did not. Of participants (n = 1500), 74% were female, 65% were White, 12% were Black, and 17% were of Hispanic ethnicity. Thirty-nine percent (n = 581) reported a second-sleep practice. Of parents who reported a second-sleep practice, 28% (n = 137) metall 3 safe sleep criteria at sleep onset; 9% (n = 42) metall 3 safe sleep criteria at both time points. A higher proportion of changes in sleep practices were to less-safe practices (P <.001). Factors associated with a second-sleep practice were parental age <25 years, parental race and ethnicity, first-time parents, homes with smoke exposure, and infants born at <37 weeks. Less than 10% of infants metall 3 safe sleep criteria at sleep onset and after nighttime waking. Interventions focused on safe sleep should highlight the importance of safe sleep practices after nighttime waking.

Effects of Child and Parent Race on Reported Externalizing and Internalizing Symptoms: Findings from the PACCT Study

Effects of Child and Parent Race on Reported Externalizing and Internalizing Symptoms: Findings from the PACCT Study

Child’s Developmental Disabilities and Parental Health in Later Life: Do Parental Race and Gender Matter?

Parents, particularly mothers, who experienced early life adversities (ELAs) are more likely to have a child with developmental disabilities (DD). We have little knowledge about how parental health varies across race-gender groups among those with a DD child and the role of ELAs in the associations. Using Black and White adults (n = 8,778; 25% Blacks) from the Midlife in the United States (MIDUS) study, we examine racial disparities in the impact of having a child with DD (vs. having healthy children) on parental health outcomes. This study questions (1) the extent to which parents’ ELAs (e.g., poverty and abuse) are associated with having a child with DD and (2) how considering early-life factors reveals racial and gender disparities in the impact of having a child with DD. We found that as the number of ELAs increases, the probability of having a healthy child decreases for all race-gender groups, but most dramatically for Black women. Having a DD has adverse effects on chronic illnesses and functional limitations more for mothers than fathers. Black women are most adversely affected, with no effect on Black men. There is no gender difference in the impact of having a DD child on depressive symptoms, yet White parents are more vulnerable than Black parents. After controlling for ELAs, the adverse effects of having a DD child on both physical and mental health remain significant. Future research should identify life-course circumstances that reveal why the impact of having a DD child varies by race and gender.

Parental Expression of Emotions and Surgeon Responses During Consultations for Obstructive Sleep-Disordered Breathing in Children

Little is known about emotional communication between parents and surgeons. Understanding the patterns and correlates of emotional communication may foster collaboration during surgical consultations. To describe the emotional expressions by parents when bringing their child for evaluation of obstructive sleep-disordered breathing (SDB) as well as surgeon responses to these emotional expressions and to evaluate the association between parental demographic characteristics and surgeon response types. This cross-sectional study analyzed the audio-recorded consultations between otolaryngologists and parents of children who underwent their initial otolaryngological examination for obstructive SDB at 1 of 3 outpatient clinical sites in Maryland from April 1, 2016, to May 31, 2017. Data analysis was performed from November 1 to December 31, 2019. Emotional expressions by parents and surgeon responses were audio recorded, transcribed, and coded using the Verona Coding Definitions of Emotional Sequences. A total of 59 consultations, of which 40 (67.8%) contained at least 1 emotional expression, were included. Participants included 59 parents (53 women [89.8%]; mean [SD] age, 33.4 [6.4] years) and 7 surgeons (4 men [57.1%]; mean [SD] age, 42.8 [7.9] years). Parents made 123 distinct emotional expressions (mean [SD], 3.08 [2.29] expressions per visit), which were often expressed as subtle cues (n = 103 of 123 [83.7%]) vs explicit concerns (n = 20 [16.3%]). Most expressions (n = 98 [79.7%]) were related to medical issues experienced by the child (eg, symptoms and surgical risks). Most surgeon responses provided parents space for elaboration of emotional expressions (n = 86 [69.9%]) and were nonexplicit (n = 55 [44.7%]). Surgeons were less likely to explore the emotions of parents from racial and ethnic minority groups compared with White parents (OR, 0.47; 95% CI, 0.18-0.98). This cross-sectional study found that emotional communication occurs between surgeons and parents of pediatric patients with obstructive SDB. However, surgeon responses varied according to parental race and ethnicity, suggesting the existence of implicit biases in surgeon-patient communication and calling for further research to inform efforts to promote family-centered, culturally competent communication in surgery.