You are here:
RACIAL RESIDENTIAL SEGREGATION AND ADVERSE BIRTH OUTCOMES
Citation:
MESSER, L. C., J. S. KAUFMAN, AND B. A. LARAIA. RACIAL RESIDENTIAL SEGREGATION AND ADVERSE BIRTH OUTCOMES. Presented at Southern Sociological Society, New Orleans, LA, March 22 - 24, 2006.
Description:
INTRODUCTION. The disparity between black and white women's adverse birth outcomes has been subject to much investigation, yet the factors underlying its persistence remain elusive, which has encouraged research on neighborhood-level influences, including racial residential segregation. This work considers two main questions: 1) are black and white women living in Wake County, NC differentially exposed to each other? 2) is differential racial exposure associated with preterm birth outcomes? METHODS. The authors examine racial segregation Wake County NC census tracts (1999-2001) using logistic models. Geocoded vital records and US Census data (2000) were analyzed. PTB was defined as birth at < 37weeks (& < 3888g) gestational age. Residential segregation was defined as racial exposure, or the average probability of contact between racial groups residing in the same census tract. Race-stratified random effects logistic models with fixed slope predictor values and randomly distributed tract-specific intercepts were fit; models were adjusted for maternal age, education and tract-level deprivation. RESULTS. On average, white women are more isolated from black women (mean probability = 0.15) than black women are from white women (0.37). Exposure varies by maternal education, with > high school educated whites have less exposure to blacks (0.14) but more educated blacks having more exposure to whites (0.43). In adjusted models, increasing exposure to black women was associated with increased odds of PTB (Odds Ratios [OR] = 1.77; 95% Confidence Intervals [95% CI]: 1.2, 2.8), but this relationship was attenuated following adjustment for maternal and area-level covariates. In unadjusted models, increasing exposure to white women was associated with decreased odds of preterm birth for black women (OR= 0.54, 95% CI: 0.5, 0.9). This association remained significant for the highest tertiles of exposure, following adjustment (OR=0.57; 95% CI: 0.47, 0.97). IMPLICATIONS. Differential exposure to resources and disamenities are two mechanisms by which racial residential segregation may influence birth outcomes. Understanding how neighborhoods may affect the racial disparity in preterm birth has important implications for public policy and preterm prevention efforts.