Neighborhood conditions and birth outcomes

Stephanie Marie Eick · Lara J. Cushing · Dana E. Goin · Amy M. Padula · Aileen Andrade · Erin DeMicco +2 more

12 citations0/0 files storedEnvironmental Epidemiology

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Health disparities and outcomes Maternal and Neonatal Healthcare Environmental Justice and Health Disparities

Abstract

Living in a disadvantaged neighborhood has been associated with adverse birth outcomes. Most prior studies have conceptualized neighborhoods using census boundaries and few have examined the role of neighborhood perceptions, which may better capture the neighborhood environment. In the present study, we examined associations between extrinsic and perceived neighborhood quality measures and adverse birth outcomes. Methods: Participants resided in the San Francisco Bay Area of California and were enrolled in Chemicals in Our Bodies, a prospective birth cohort (N = 817). The Index of Concentration at the Extremes (ICE) for income, Area Deprivation Index (ADI), and the Urban Displacement Project's measure of gentrification were included as census block group-level extrinsic neighborhood quality measures. Poor perceived neighborhood quality was assessed using an interview questionnaire. Linear regression models were utilized to examine associations between extrinsic and perceived neighborhood quality measures, and gestational age and birthweight for gestational age z-scores. Covariates in adjusted models were chosen via a directed acyclic graph (DAG) and included maternal age, education, and marital status. Results: In adjusted models, having poor perceived neighborhood quality was associated with higher birthweight z-scores, relative to those who did not perceive their neighborhood as poor quality (β = 0.21, 95% confidence intervals = 0.01, 0.42). Relative to the least disadvantaged tertile, the upper tertile of the ADI was associated with a modest reduction in gestational age (β = -0.35, 95% confidence intervals = -0.67, -0.02). Conclusions: In the Chemicals in Our Bodies study population, extrinsic and perceived neighborhood quality measures were inconsistently associated with adverse birth outcomes.

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References

1997Neighborhoods and Violent Crime: A Multilevel Study of Collective Efficacy 2018Making Neighborhood-Disadvantage Metrics Accessible — The Neighborhood Atlas 2006Financial Strain over the Life Course and Health among Older Adults 2015Public Health Monitoring of Privilege and Deprivation With the Index of Concentration at the Extremes 2021NVSR 70-2: Births: Final Data for 2019 2021Births: Final Data for 2019.2005Social and Physical Environments and Disparities in Risk for Cardiovascular Disease: The Healthy Environments Partnership Conceptual Model 2010Neighborhoods, daily activities, and measuring health risks experienced in urban environments

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