The Relation of Neighborhood Racial and Income Polarity to Preterm Birth Rates in Chicago
Objectives To investigate the extent to which spatial social polarization is associated with preterm birth among urban African-American and non-Latinx white women, and whether prenatal care modifies this relationship. Methods We performed multilevel logistic regression analyses on a 2013–2017 dataset of Chicago vital records (N = 29,179) with appended Index of Concentration at the Extremes (ICE) values for race and income. Results Women who resided in the bottom ICE quintile neighborhoods had a preterm birth rate of 11.5%, compared to 7.3% for those who live in the top ICE quintile areas; adjusted odds ratio (aOR) equaled 1.72 (95% confidence interval [CI] = 1.39, 2.12). This disparity widened for early (< 34 weeks) preterm birth rates, aOR = 2.60 (1.77, 3.81). These associations persisted among women with adequate prenatal care utilization. Conclusions for Practice Spatial polarization of race and income in urban African-American and non-Latinx white women’s residential environment is strongly associated with preterm birth rates, even among those who receive adequate prenatal care. These findings highlight the benefit of using ICE to contextualize the impact of urban neighborhood-level characteristics on preterm birth rates..
Significance To better understand the social determinants of preterm birth, research efforts have shifted from women’s individual-level characteristics toward their exposure to contextual markers. The Index of Concentration at the Extremes (ICE) is a novel measure of spatial social polarization that quantifies the extremes of both privilege and deprivation. Our population-based study adds to the limited published literature on the relation of ICE to preterm birth rates among African-American and non-Latinx white women. We found that the high degree of both racial and income polarization within communities was associated with preterm birth rates even among those who received adequate prenatal care.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Maternal and child health journal - 27(2023), 3 vom: 09. Feb., Seite 556-565 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Weiss, Aaron J. [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
African-American |
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| Anmerkungen: |
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s10995-023-03608-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Objectives To investigate the extent to which spatial social polarization is associated with preterm birth among urban African-American and non-Latinx white women, and whether prenatal care modifies this relationship. Methods We performed multilevel logistic regression analyses on a 2013–2017 dataset of Chicago vital records (N = 29,179) with appended Index of Concentration at the Extremes (ICE) values for race and income. Results Women who resided in the bottom ICE quintile neighborhoods had a preterm birth rate of 11.5%, compared to 7.3% for those who live in the top ICE quintile areas; adjusted odds ratio (aOR) equaled 1.72 (95% confidence interval [CI] = 1.39, 2.12). This disparity widened for early (< 34 weeks) preterm birth rates, aOR = 2.60 (1.77, 3.81). These associations persisted among women with adequate prenatal care utilization. Conclusions for Practice Spatial polarization of race and income in urban African-American and non-Latinx white women’s residential environment is strongly associated with preterm birth rates, even among those who receive adequate prenatal care. These findings highlight the benefit of using ICE to contextualize the impact of urban neighborhood-level characteristics on preterm birth rates. | ||
| 520 | |a Significance To better understand the social determinants of preterm birth, research efforts have shifted from women’s individual-level characteristics toward their exposure to contextual markers. The Index of Concentration at the Extremes (ICE) is a novel measure of spatial social polarization that quantifies the extremes of both privilege and deprivation. Our population-based study adds to the limited published literature on the relation of ICE to preterm birth rates among African-American and non-Latinx white women. We found that the high degree of both racial and income polarization within communities was associated with preterm birth rates even among those who received adequate prenatal care | ||
| 650 | 4 | |a Social polarization | |
| 650 | 4 | |a African-American | |
| 650 | 4 | |a Urban health | |
| 650 | 4 | |a Preterm birth | |
| 650 | 4 | |a Prenatal care | |
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| 700 | 1 | |a Matoba, Nana |4 aut | |
| 700 | 1 | |a Prachand, Nik |4 aut | |
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