Document Detail

Race and ethnic differences in determinants of preterm birth in the USA: broadening the social context.
MedLine Citation:
PMID:  15748670     Owner:  NLM     Status:  MEDLINE    
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.
Patricia B Reagan; Pamela J Salsberry
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2004-12-07
Journal Detail:
Title:  Social science & medicine (1982)     Volume:  60     ISSN:  0277-9536     ISO Abbreviation:  Soc Sci Med     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-03-07     Completed Date:  2005-07-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8303205     Medline TA:  Soc Sci Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  2217-28     Citation Subset:  IM    
Department of Economics, Center for Human Resource Research, Ohio State University, 1945 N. High St., Columbus, OH 43221, USA.
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MeSH Terms
African Americans / statistics & numerical data*
European Continental Ancestry Group / statistics & numerical data*
Hispanic Americans / statistics & numerical data*
Infant, Low Birth Weight*
Infant, Newborn
Premature Birth / epidemiology,  ethnology*
Residence Characteristics*
Risk Factors
Social Environment*
Socioeconomic Factors
United States / epidemiology
Grant Support
744892//PHS HHS; R01 NR008512-01/NR/NINR NIH HHS

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

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