Abstract:
The COVID-19 pandemic exposed and exacerbated persistent health inequities in perinatal populations, resulting in disparities of maternal and fetal complications. In this narrative review, we present an adapted conceptual framework of perinatal social determinants of health in the setting of the COVID-19 pandemic and use this framework to contextualize the literature regarding disparities in COVID-19 vaccination and infection. We synthesize how elements of the structural context, individual socioeconomic position, and concrete intermediary determinants influence each other and perinatal COVID-19 vaccination and infection, arguing that systemic inequities at each level contribute to observed disparities in perinatal health outcomes. From there, we identify gaps in the literature, propose mechanisms for observed disparities, and conclude with a discussion of strategies to mitigate them.
摘要:
COVID-19大流行暴露并加剧了围产期人群持续的健康不平等,导致母婴并发症的差异。在这篇叙述性评论中,我们提出了COVID-19大流行背景下围产期健康社会决定因素的适应概念框架,并利用该框架将有关COVID-19疫苗接种和感染差异的文献背景化.我们综合了结构环境的要素,个人社会经济地位,具体的中介决定因素相互影响,围产期COVID-19疫苗接种和感染,认为每个级别的系统不平等导致围产期健康结局的差异。从那里,我们发现文献中的空白,提出观察到的差异的机制,最后讨论了缓解这些问题的策略。