5027.0: Wednesday, October 24, 2001 - 9:00 AM

Abstract #29484

Neighborhood level measures of socioeconomic context in maternal and infant health

Catherine Cubbin, PhD1, Paula A. Braveman, MD, MPH1, Kristen S. Marchi, MPH1, Brooke Maury, BA1, Susan Egerter, PhD1, and Gilberto Chavez, MD, MPH2. (1) Family and Community Medicine, University of California, San Francisco, 500 Parnassus Avenue, MU-3 East, Box 0900, San Francisco, CA 94143-0900, 415-476-6620, ccubbin@itsa.ucsf.edu, (2) California Department of Health Services, Maternal and Child Health Branch, 714 P Street, Room 476, Sacramento, CA 95814

Background: Neighborhood socioeconomic context (NSC) has been shown to be independently associated with various health measures, after controlling for individual- level socioeconomic status (SES). However, theoretical and empiric considerations raise doubts about the manner in which NSC is commonly measured. This study aims to provide a conceptual and empiric basis for selecting and interpreting measures of NSC in studies of low birthweight, delayed prenatal care, unintended birth, and breastfeeding (initiation & continuation).

Methods: Data are from 2 large statewide-representative surveys (1994-5; 1999-2000) of California=s ethnically diverse maternity population and census estimates (1990) and projections (1995). We will examine correlations among multiple NSC measures (education, income, occupation, poverty, unemployment, deprivation index, principal components index, economic segregation, cluster analysis) at census tract- and zip code- levels. We will graph the distribution of each NSC measure by individual SES and race/ethnicity. We will construct logistic regression models for the age-adjusted association between each NSC measure and outcome (overall and by SES and race/ethnicity).

Hypotheses: Correlations between NSC measures will be strong and low-SES women and women of color will live in more disadvantaged neighborhoods than high-SES and white women. In the models, the associations between NSC and outcomes will vary by NSC measure and by outcome; and these associations will vary across individual SES and race/ethnicity.

Implications: These results will guide researchers on measuring NSC in studies of these outcomes but should also apply to other areas of health research.

Learning Objectives: 1. Describe socioeconomic disparities in maternal and infant health at the neighborhood level. 2. Develop recommendations for measuring the neighborhood socioeconomic context.

Keywords: Community, Social Class Measurement

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA