Neighborhood Deprivation and Adverse Birth Outcomes among Diverse Ethnic Groups

Abstract

Purpose-Living in a socioeconomically deprived neighborhood has been associated with an increased risk of adverse birth outcomes. However, variation in the effect of neighborhood deprivation among diverse ethnic groups has not been studied.Methods-Using linked hospital discharge and birth data for 517,994 singleton live births in New York City from 1998-2002, we examined the association between neighborhood deprivation, preterm birth (PTB), and term low birthweight (TLBW)(≥37 weeks and <2500g). Adjusted odds ratios (aOR) for PTB (<32 and 33-36 weeks) and TLBW were estimated using logistic regression.Results-The aOR for PTB <32 weeks for the highest quartile of deprivation compared to the lowest was 1.24 (95% Confidence Interval (CI)=1.13, 1.36), for PTB 33-36 weeks was 1.06 (95%CI=1.01, 1.11), and for TLBW was 1.19 (95%CI=1.11, 1.27). Measures of association varied by ethnicity; AORs of the greatest magnitude for PTB were found among Hispanic Caribbean women (PTB<32weeks: aOR=1.63, 95%CI=1.27, 2.10; PTB 33-36 weeks: aOR=1.32, 95%CI=1.02, 1.70), and for TLBW among African women (aOR=1.47, 95%CI=1.02, 2.13).Conclusions-The mechanisms linking neighborhood deprivation to adverse birth outcomes may differ depending on individual ethnicity and/or cultural context and should be investigated in future research.

Neighborhood Socioeconomic Status in Relation to Preterm Birth in a U.S. Cohort of Black Women

“…Our results overall do not support the positive findings from some previous studies that assessed preterm birth in relation to neighborhood deprivation as a summary variable among AfricanAmerican women in different geographic regions. [16][17][18][19] O'Campo et al 16 presented a summary odds ratio of 1.15 (95 % CI, 1.08, 1.23) for Non-Hispanic Black women comparing the highest versus lowest quintile of neighborhood deprivation using data from four states. The authors also examined effect estimates for Non-Hispanic Black women across eight study areas and reported that six of the eight area-specific odds ratios, ranging from 0.88 to 1.40, were not statistically significant.…”

“…Messer et al 18 reported a statistically significant odds ratio for Black women (OR=1.6; 95 % CI, 1.1, 2.3) comparing the highest versus lowest quartile of neighborhood deprivation, using data from Wake County, North Carolina after adjusting for individual-level factors and measures of crime. Lastly, Janevic et al 19 presented an adjusted odds ratio for Non-Hispanic Black women of 1.12 (95 % CI, 1.02, 1.22) for preterm births at 33-36 weeks gestation in relation to living in the most deprived neighborhoods of New York City. No association was observed among Non-Hispanic Black women for preterm births at G32 weeks gestation.…”

“…7,8 Several studies have examined the association of neighborhood socioeconomic characteristics with preterm birth. [9][10][11][12][13][14][15][16][17][18][19] All except one 14 found statistically significant associations with at least one neighborhood-level indicator after adjustment for individual-level factors. Although many studies have assessed neighborhood characteristics as single variables, [9][10][11][12][13][14][15] the complexities of neighborhood SES may be better captured by a summary variable comprised of multiple area-level factors.…”

“…20 In four large studies based on vital statistic birth records, a summary variable of neighborhood deprivation was significantly associated with increased risk of preterm birth among women of various races/ethnicities. [16][17][18][19] Although all previous studies except for a Canadian report 15 included Black women, it is unclear whether the association between neighborhood deprivation and preterm birth is present for particular subgroups of Black women, such as well-educated women. It is possible that higher levels of personal educational attainment buffer adverse effects of neighborhood deprivation on birth outcomes in Black women.…”

Neighborhood Deprivation and the Effectiveness of Mobile Health Coaching to Improve Periconceptional Nutrition and Lifestyle in Women: Survey in a Large Urban Municipality in the Netherlands (Preprint)

“…The use of area-based indices as a proxy for socio-economic health is well supported in the literature, thus the used neighborhood deprivation index can be considered a valid indicator. [33,34] The NSS is a measure based on factors that are specific for (the residents in) that particular neighborhood. Indeed, we found that the NSS is a representative measure for deprivation characteristics on the individual level; in less deprived neighborhoods, participating women had a lower BMI and were more likely to be of non-Western geographic origin.…”