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Racial and ethnic disparities in adverse birth outcomes: Differences by racial residential segregation.
- Source :
-
SSM - population health [SSM Popul Health] 2019 May 28; Vol. 8, pp. 100417. Date of Electronic Publication: 2019 May 28 (Print Publication: 2019). - Publication Year :
- 2019
-
Abstract
- Racial and ethnic disparities in adverse birth outcomes have persistently been wide and may be explained by individual and area-level factors. Our primary objective was to determine if county-level black-white segregation modified the association between maternal race/ethnicity and adverse birth outcomes using birth records from the National Center for Health Statistics (2012). Based on maternal residence at birth, county-level black-white racial residential segregation was calculated along five dimensions of segregation: evenness, exposure, concentration, centralization, and clustering. We conducted a two-stage analysis: (1) county-specific logistic regression to determine whether maternal race and ethnicity were associated with preterm birth and term low birth weight; and (2) Bayesian meta-analyses to determine if segregation moderated these associations. We found greater black-white and Hispanic-white disparities in preterm birth in racially isolated counties (exposure) relative to non-isolated counties. We found reduced Hispanic-white disparities in term low birth weight in racially concentrated and centralized counties relative to non-segregated counties. Area-level poverty explained most of the moderating effect of segregation on disparities in adverse birth outcomes, suggesting that area-level poverty is a mediator of these associations. Segregation appears to modify racial/ethnic disparities in adverse birth outcomes. Therefore, policy interventions that reduce black-white racial isolation, or buffer the poor social and economic correlates of segregation, may help to reduce disparities in preterm birth and term low birth weight.
Details
- Language :
- English
- ISSN :
- 2352-8273
- Volume :
- 8
- Database :
- MEDLINE
- Journal :
- SSM - population health
- Publication Type :
- Academic Journal
- Accession number :
- 31193960
- Full Text :
- https://doi.org/10.1016/j.ssmph.2019.100417