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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
4109.0: Tuesday, December 13, 2005 - 12:30 PM

Abstract #117469

Does neighborhood poverty concentration contribute to racial/ethnic disparities in maternal and infant health? Evidence using a stratified approach

Catherine Cubbin, PhD1, Paula Braveman, MD, MPH2, Kristen S. Marchi, MPH1, and Susan A. Egerter, PhD3. (1) Department of 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) Family and Community Medicine, University of California, San Francisco, 500 Parnassus Avenue, MU-3 East, Box 0900, San Francisco, CA 94143, (3) Center on Social Disparities in Health, University of California, San Francisco, 500 Parnassus Avenue, MU-3 East, Box 0900, San Francisco, CA 94143-0900

Background: Previous research suggests that racial/ethnic disparities in maternal and infant health can be partly explained by residential segregation; that is, compared with white populations, populations of color are far more likely to live in socioeconomically disadvantaged neighborhood environments, which in turn can influence health. To test this hypothesis, we examined racial/ethnic disparities in four important maternal and infant health indicators (unintended pregnancy, delayed/no prenatal care, low birth weight, and breastfeeding), both among childbearing women overall and within strata based on neighborhood (census tract) poverty concentration. Methods: Data are from the Maternal and Infant Health Assessment, a large annual statewide-representative survey of California's ethnically diverse maternity population, for 1999-2003 (N~17,500), linked with birth certificates and census tract-level data from the 2000 census. For each dependent variable, we examined racial/ethic disparities by calculating odds ratios for each racial/ethnic group (using white women as the reference) adjusted for maternal age, parity, marital status, household poverty status, education, and paternal education. We examined the role of neighborhood-level socioeconomic context by comparing results for the overall sample with those for women in strata defined by neighborhood poverty concentration (<5%, 5-10%, 10-20%, >20%). Hypothesis: We expect that statistically significant racial/ethnic disparities in these four health indicators among women overall will be substantially reduced or eliminated after stratification by neighborhood poverty concentration. Implications: This study should provide convincing and policy-relevant evidence about how neighborhood socioeconomic context may influence racial ethnic disparities in maternal and infant health among postpartum women in California.

Learning Objectives:

Keywords: Health Disparities, Poverty

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

[ Recorded presentation ] Recorded presentation

Public Health Policies and Practices and Current Health Status of People of Color

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA