The differential effect of traditional risk factors on infant birthweight among blacks and whites in Chicago.

Collins, Jr . James W.; David, Richard J.

doi:10.2105/ajph.80.6.679

Cited by 131 publications

(50 citation statements)

References 21 publications

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“…However, these rates are similar to previously reported rates for low-income African-Americans and Hispanics in the United States [17][18][19].…”

Section: Discussionsupporting

confidence: 89%

The pediatric pulmonary and cardiovascular complications of vertically transmitted human immunodeficiency virus (P2C2 HIV) infection study: Design and methods

Kattan¹,

Peavy²,

Kalica³

et al. 1996

Journal of Clinical Epidemiology

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The P 2 C 2 HIV Study is a prospective natural history study initiated by the National Heart, Lung, and Blood Institute in order to describe the types and incidence of cardiovascular and pulmonary disorders that occur in children with vertically transmitted HIV infection (i.e., transmitted from mother to child in utero or perinatally). This article describes the study design and methods. Patients were recruited from five clinical centers in the United States. The cohort is composed of 205 infants and children enrolled after 28 days of age (Group I) and 612 fetuses and infants of HIV-infected mothers, enrolled prenatally (73%) or postnatally at age <28 days (Group II). The maternal-to-infant transmission rate in Group II was 17%. The HIV-negative infants in Group II (Group IIb) serves as a control group for the HIV-infected children (Group IIa). The cohort is followed at specified intervals for clinical examination, cardiac, pulmonary, immunologic, and infectious studies and for intercurrent illnesses. In Group IIa, the cumulative loss-to-follow-up rate at 3 years was 10.5%, and the 3-year cumulative mortality rate was 24.9%. The findings will be relevant to clinical and epidemiologic aspects of HIV infection in children.

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“…However, these rates are similar to previously reported rates for low-income African-Americans and Hispanics in the United States [17][18][19].…”

Section: Discussionsupporting

confidence: 89%

The pediatric pulmonary and cardiovascular complications of vertically transmitted human immunodeficiency virus (P2C2 HIV) infection study: Design and methods

Kattan¹,

Peavy²,

Kalica³

et al. 1996

Journal of Clinical Epidemiology

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“…Their health may also begin to deteriorate in early adulthood as a physical consequence of the cumulative effects of racism, not race per se.2122 This hypothesis is partly supported by the lack of a Black-White disparity in the prevalence of low-birthweight among adolescent womenwho reside in impoverished neighborhoods. 4 It is important to note that although low birthweight is the primary contributor to the high Black neonatal mortality rate, the bulk of the race effect is due to verylow-birthweight (<1500 g) infants. In our study sample, only eight biracial infants born to Black women weighed less than 1500 g at birth.…”

Section: Methodsmentioning

confidence: 99%

“…[3][4][5][6][7] This fact has led certain researchers to pursue a genetic hypothesis. 8,9 Others believe that race lacks biologic significance and that the association between race and low birthweight is affected by unmeasured societal factors.…”

Section: Introductionmentioning

confidence: 99%

Race and birthweight in biracial infants.

Collins

David

1993

Am J Public Health

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OBJECTIVES. The purpose of the study was to determine the role of infant race as a determinant of the Black-White disparity in low birthweight (< 2500 g). METHODS. Univariate analysis and multivariate logistic regression were performed on Illinois vital records from 1982 and 1983 and on 1980 United States census income data. RESULTS. Fourteen percent of the infants born to Black mothers and White fathers were of low birthweight, compared with 9% of infants born to White mothers and Black fathers and 6% of a random sample of White infants. Both groups of biracial infants were more likely to have been born to unmarried mothers and to reside in very low-income (< $10,000 per year) census tracts than were White infants. When all confounding variables were entered into a logistic model, the adjusted odds ratio of low birthweight for biracial infants born to Black mothers and White fathers equaled 1.4. When biracial infants born to White mothers and Black fathers were compared with White infants, the adjusted odds ratio of low birthweight equaled 1.0. CONCLUSIONS. Paternal and consequent infant race does not affect the birthweight distribution of those born to White mothers and Black fathers. Unidentified factors closely related to maternal race underlie the Black-White disparity in infant birthweight.

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“…Much research has focused on individuallevel risk factors for low birthweight; individual-level models, however, have been able to explain only a small proportion of the overall variability seen for birthweight.2 Moreover, it is increasingly being recognized that environmental factors contribute to the risk of low birthweight. [3][4][5][6][7] Previous studies of low birthweight have been limited to individual factors in their conceptualization of social risk.89 Social risk, however, should also include environmental stressors, which shape individual vulnerability and resistance to risk factors for health. Analyses that include both individuallevel and macrolevel data-referred to as contextual or multilevel models-have several advantages.21 First, multilevel analytic methods are more consistent with social theories than are traditional methods of analysis (e.g., ordinary regression) in that they explicitly accommodate the multiple levels of data.22 Second, multilevel methods can contribute new knowledge to our current understanding of public health issues by allowing for the inclusion of macrolevel factors in our current explanatory models, thereby bridging the micro-macro gap by increasing our understanding of how contextual factors translate into differences in individual-level risk.…”

Section: Introductionmentioning

confidence: 99%

Neighborhood risk factors for low birthweight in Baltimore: a multilevel analysis.

O’Campo¹,

Xue²,

Wang³

et al. 1997

Am J Public Health

386

270

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OBJECTIVES: Past research on low birthweight has focused on individual-level risk factors. We sought to assess the contribution of macrolevel social factors by using census tract-level data on social stratification, community empowerment, and environmental stressors. METHODS: Census tract-level information on social risk was linked to birth certificate records from Baltimore, Md, for the period 1985 through 1989. Individual level factors included maternal education, maternal age, medical assistance health insurance (Medicaid), and trimester of prenatal care initiation. Methods of multilevel modeling using two-stage regression analyses were employed. RESULTS: Macrolevel factors had both direct associations and interactions with low birthweight. All individual risk factors showed interaction with macrolevel variables; that is, individual-level risk factors for low birthweight behaved differently depending upon the characteristics of the neighborhood of residence. For example, women living in high-risk neighborhoods benefited less from prenatal care than did women living in lower-risk neighborhoods. CONCLUSIONS: Multilevel modeling is an important tool that allows simultaneous study of macro- and individual-level risk factors. Multilevel analyses should play a larger role in the formulation of public health policies.

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The differential effect of traditional risk factors on infant birthweight among blacks and whites in Chicago.

Abstract: We analyzed 103,072 White and Black births in

Cited by 131 publications

References 21 publications

The pediatric pulmonary and cardiovascular complications of vertically transmitted human immunodeficiency virus (P2C2 HIV) infection study: Design and methods

The pediatric pulmonary and cardiovascular complications of vertically transmitted human immunodeficiency virus (P2C2 HIV) infection study: Design and methods

Race and birthweight in biracial infants.

Neighborhood risk factors for low birthweight in Baltimore: a multilevel analysis.

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