Document Detail


Black-white preterm birth disparity: a marker of inequality.
MedLine Citation:
PMID:  18940633     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The racial disparity in preterm birth (PTB) is a persistent feature of perinatal epidemiology. Its consistency is not only an outcome of reproductive interest but may function as a persistent inequality to which women are exposed over time. Herein we sought to analyze exposure to area-level PTB disparity and its association with individual-level PTB risk.
METHODS: Using geocoded birth records (1999-2001) and year 2000 census data for Wake County, North Carolina, we created a tract-level PTB disparity variable for each woman in our study area, comprising all births in her tract excluding her birth. Multilevel random intercept models for exposure to neighborhood PTB disparity and odds of PTB were fit.
RESULTS: Exposure to area-level PTB disparity was associated with increased odds of PTB for all women. After adjustment for maternal and neighborhood covariates, odds of delivering preterm increased by 25%, 26%, and 36% for the second, third, and fourth quartiles of exposure to PTB disparity (odds ratio [OR]=1.25, 95% confidence interval [CI]: 1.00-1.57; OR=1.26, 95% CI: 1.01-1.58; and OR=1.36, 95% CI: 1.06-1.75, respectively).
CONCLUSIONS: Exposure to persistent inequality, in the form of PTB disparity, appears associated with individual-level PTB risk. Knowing where PTB disparity is greatest has implications for PTB prevention policy efforts to buffer adverse conditions.
Authors:
Lynne C Messer; Jay S Kaufman; Pauline Mendola; Barbara A Laraia
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of epidemiology     Volume:  18     ISSN:  1873-2585     ISO Abbreviation:  Ann Epidemiol     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-22     Completed Date:  2008-11-26     Revised Date:  2011-05-02    
Medline Journal Info:
Nlm Unique ID:  9100013     Medline TA:  Ann Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  851-8     Citation Subset:  IM    
Affiliation:
Health Inequalities Program, Center for Health Policy, Duke Global Health Institute, Duke University, Durham, NC 27708, USA. lynne.messer@duke.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
African Americans*
European Continental Ancestry Group*
Female
Health Status Disparities*
Humans
Infant, Newborn
Middle Aged
North Carolina / epidemiology
Odds Ratio
Pregnancy
Premature Birth / ethnology*,  etiology
Residence Characteristics
Socioeconomic Factors
Grant Support
ID/Acronym/Agency:
K01 HD047122-01A1/HD/NICHD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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