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Race and ethnic differences in determinants of preterm birth in the USA: broadening the social context

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  • Reagan, Patricia B.
  • Salsberry, Pamela J.

Abstract

Preterm births occur in 9.7% of all US singleton births. The rate for blacks is double that of whites and the rate is 25% higher for Hispanics than for whites. While a number of individual correlates with preterm birth have been identified, race and ethnic differences have not been fully explained. Influenced by a growing body of literature documenting a relationship among health, individual income, and neighborhood disadvantage, researchers interested in explaining racial differences in preterm birth are designing studies that extend beyond the individual. No studies of adverse birth outcomes have considered contextual effects beyond the neighborhood level. Only a handful of studies, comparing blacks and whites, have evaluated the influence of neighborhood disadvantage on preterm birth. This study examines how preterm birth among blacks, whites and Hispanics is influenced by social context, broadly defined to include measures of neighborhood disadvantage and cumulative exposure to state-level income inequality, controlling for individual risk factors. Neighborhood disadvantage is determined by Census tract data. Cumulative exposure to income inequality is measured by the fraction of the mother's life since age 14 spent residing in states with a state-level Gini coefficient above the median. The results for neighborhood disadvantage are highly sensitive across race/ethnicities to the measure used. We find evidence that neighborhood poverty rates and housing vacancy rates increased the rate of very preterm birth and decreased the rate of moderately preterm birth for blacks. The rate of very preterm increased with the fraction of female-headed households for Hispanics and decreased with the fraction of people employed in professional occupations for whites. We find direct effects of cumulative exposure to income inequality only for Hispanics. However, we do find indirect effects of context broadly defined on behaviors that increased the risk of preterm birth.

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  • Reagan, Patricia B. & Salsberry, Pamela J., 2005. "Race and ethnic differences in determinants of preterm birth in the USA: broadening the social context," Social Science & Medicine, Elsevier, vol. 60(10), pages 2217-2228, May.
    • Handle: RePEc:eee:socmed:v:60:y:2005:i:10:p:2217-2228
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    1. Subramanian, S. V. & Kawachi, Ichiro & Kennedy, Bruce P., 2001. "Does the state you live in make a difference? Multilevel analysis of self-rated health in the US," Social Science & Medicine, Elsevier, vol. 53(1), pages 9-19, July.
    2. Pearl, M. & Braveman, P. & Abrams, B., 2001. "The relationship of neighborhood socioeconomic characteristics to birthweight among 5 ethnic groups in California," American Journal of Public Health, American Public Health Association, vol. 91(11), pages 1808-1814.
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    2. M. Luke Smith & Rachel R. Hardeman, 2020. "Association of Summer Heat Waves and the Probability of Preterm Birth in Minnesota: An Exploration of the Intersection of Race and Education," IJERPH, MDPI, vol. 17(17), pages 1-12, September.
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    5. Daniel Kim & Adrianna Saada, 2013. "The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review," IJERPH, MDPI, vol. 10(6), pages 1-40, June.
    6. Veni Kandasamy & Ashley H Hirai & Jay S Kaufman & Arthur R James & Milton Kotelchuck, 2020. "Regional variation in Black infant mortality: The contribution of contextual factors," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-15, August.
    7. Kristin B. Ashford & Mary Kay Rayens, 2015. "Ethnicity, Smoking Status, and Preterm Birth as Predictors of Maternal Locus of Control," Clinical Nursing Research, , vol. 24(2), pages 172-187, April.
    8. Ncube, Collette N. & Enquobahrie, Daniel A. & Albert, Steven M. & Herrick, Amy L. & Burke, Jessica G., 2016. "Association of neighborhood context with offspring risk of preterm birth and low birthweight: A systematic review and meta-analysis of population-based studies," Social Science & Medicine, Elsevier, vol. 153(C), pages 156-164.
    9. Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
    10. Amanda T. Charette & Mary B. Collins & Jaime E. Mirowsky, 2021. "Assessing residential socioeconomic factors associated with pollutant releases using EPA’s Toxic Release Inventory," Journal of Environmental Studies and Sciences, Springer;Association of Environmental Studies and Sciences, vol. 11(2), pages 247-257, June.
    11. Inagami, Sanae & Cohen, Deborah A. & Finch, Brian K., 2007. "Non-residential neighborhood exposures suppress neighborhood effects on self-rated health," Social Science & Medicine, Elsevier, vol. 65(8), pages 1779-1791, October.
    12. Reagan, Patricia B. & Salsberry, Pamela J. & Olsen, Randall J., 2007. "Does the measure of economic disadvantage matter? Exploring the effect of individual and relative deprivation on intrauterine growth restriction," Social Science & Medicine, Elsevier, vol. 64(10), pages 2016-2029, May.
    13. Auger, Nathalie & Park, Alison L. & Gamache, Philippe & Pampalon, Robert & Daniel, Mark, 2012. "Weighing the contributions of material and social area deprivation to preterm birth," Social Science & Medicine, Elsevier, vol. 75(6), pages 1032-1037.
    14. Tiedje, LindaBeth & Holzman, Claudia B. & De Vos, Eric & Jia, Xu & Korzeniewski, Steve & Rahbar, Mohammad H. & Goble, Monica M. & Kallen, David, 2008. "Hostility and anomie: Links to preterm delivery subtypes and ambulatory blood pressure at mid-pregnancy," Social Science & Medicine, Elsevier, vol. 66(6), pages 1310-1321, March.
    15. Paul, Kathleen & Boutain, Doris & Manhart, Lisa & Hitti, Jane, 2008. "Racial disparity in bacterial vaginosis: the role of socioeconomic status, psychosocial stress, and neighborhood characteristics, and possible implications for preterm birth," Social Science & Medicine, Elsevier, vol. 67(5), pages 824-833, September.
    16. Schempf, Ashley & Strobino, Donna & O'Campo, Patricia, 2009. "Neighborhood effects on birthweight: An exploration of psychosocial and behavioral pathways in Baltimore, 1995-1996," Social Science & Medicine, Elsevier, vol. 68(1), pages 100-110, January.

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