You are here:
Black-white preterm birth disparity: a marker of inequality
Citation:
MESSER, L. C., J. S. Kaufman, B. A. Laraia, AND P. MENDOLA. Black-white preterm birth disparity: a marker of inequality. ANNALS OF EPIDEMIOLOGY. Elsevier Science Ltd, New York, NY, 18(11):851-858, (2008).
Impact/Purpose:
research results
Description:
Purpose. The racial disparity in preterrn birth (PTB) is a persistent feature of perinatal epidemiology, inconsistently modeled in the literature. Rather than include race as an explanatory variable, or employ race-stratified models, we sought to directly model the PTB disparity by creating a neighborhood-level PTB disparity variable. Methods. Using geocoded birth records (1999-2001) and year 2000 census data, we created a tract-level PTB disparity variable for each woman in our study area, comprised of 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 unambiguously associated with increased odds of PTB among white and black women. In individual-adjusted models. odds of delivering preterm increased by 40, 50 and 80 percent for the second, third and fourth quartiles of exposure to PTB disparity (OR =1.4, 95% CI: 1.0. 2.0; OR =1.5. 95% CI: 1.1, 2.2; and OR =1.8, 95% CI: 1.2,2.7, respectively). Conclusions. Directly modeling PTB disparity addresses an important methodological issue in reproductive epidemiology. Knowing where PTB disparity is greatest has implications for PTB prevention policy efforts to buffer adverse conditions.
