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- Title
Neighborhood Privilege, Preterm Delivery, and Related Racial/Ethnic Disparities: An Intergenerational Application of the Index of Concentration at the Extremes.
- Authors
Shrimali, Bina Patel; Pearl, Michelle; Karasek, Deborah; Reid, Carolina; Abrams, Barbara; Mujahid, Mahasin
- Abstract
We assessed whether early childhood and adulthood experiences of neighborhood privilege, measured by the Index of Concentration at the Extremes (ICE), were associated with preterm delivery and related racial/ethnic disparities using intergenerationally linked birth records of 379,794 California-born primiparous mothers (born 1982–1997) and their infants (born 1997–2011). ICE measures during early childhood and adulthood approximated racial/ethnic and economic dimensions of neighborhood privilege and disadvantage separately (ICE-income, ICE-race/ethnicity) and in combination (ICE–income + race/ethnicity). Results of our generalized estimating equation models with robust standard errors showed associations for ICE-income and ICE–income + race/ethnicity. For example, ICE–income + race/ethnicity was associated with preterm delivery in both early childhood (relative risk (RR) = 1.12, 95% confidence interval (CI): 1.08, 1.17) and adulthood (RR = 1.07, 95% CI: 1.03, 1.11). Non-Hispanic black and Hispanic women had higher risk of preterm delivery than white women (RR = 1.32, 95% CI: 1.28, 1.37; and RR = 1.11, 95% CI: 1.08, 1.14, respectively, adjusting for individual-level confounders). Adjustment for ICE–income + race/ethnicity at both time periods yielded the greatest declines in disparities (for non-Hispanic black women, RR = 1.23, 95% CI: 1.18, 1.28; for Hispanic women, RR = 1.05, 95% CI: 1.02, 1.09). Findings support independent effects of early childhood and adulthood neighborhood privilege on preterm delivery and related disparities.
- Subjects
BIRTH certificates; BLACK people; CONFIDENCE intervals; ETHNIC groups; HISPANIC Americans; INCOME; PREMATURE infants; MOTHERS; RACE; WHITE people; RESIDENTIAL patterns; HEALTH equity; DESCRIPTIVE statistics
- Publication
American Journal of Epidemiology, 2020, Vol 189, Issue 5, p412
- ISSN
0002-9262
- Publication type
Article
- DOI
10.1093/aje/kwz279