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133rd Annual Meeting & Exposition
December 10-14, 2005
Lynne C. Messer, PhD1, Lisa C. Vinikoor, MSPH1, Jay S. Kaufman, PhD2, and Barbara A. Laraia, PhD, MPH, RD3. (1) Department of Epidemiology, The University of North Carolina at Chapel Hill, CB # 7435, School of Public Health, Chapel Hill, NC 27599, (919)843-9472, email@example.com, (2) Department of Epidemiology, University of North Carolina at Chapel Hill, 2104C McGavran-Greenberg Hall, Pittsboro Road, CB#7435, Chapel Hill, NC 27599-7435, (3) Department of Nutrition, The University of North Carolina at Chapel Hill, Carolina Population Center, CB #8120, Chapel Hill, NC 27599-8120
Background. Neighborhood-level deprivation has long been associated with adverse outcomes, including preterm birth (PTB), as observed in the authors' previous work using a composite deprivation index. Area disadvantage is multifaceted comprising income, employment, education and other sociodemographic domains, but is often estimated using single census variables. Objective: Assess the independent contribution of neighborhood deprivation domains in multilevel models for dichotomized (birth < 37 weeks gestational age) PTB. Methods. Geocoded 1999-2001 vital records (n=28,226 births) and 2000 US Census data (n=105 census tracts) for Wake County NC were analyzed using race-stratified multilevel random effects logistic regression models. Using census data representing a priori defined domains, principal components analysis (PCA) produced indices estimating poverty (n=6 variables), education (n=3), housing (n=6), employment (n=3), occupation (n=4) and residential stability (n=3); index alphas ranged 0.74-0.96. Single domain quartiles were modeled. Findings. In maternal age and education adjusted models, tract poverty, education and occupation domains were associated with PTB odds for non-Hispanic (NH) white women; Odds Ratios (OR) (95% Confidence Intervals [CI]) = 1.3 (1.0, 1.6), 1.4 (1.1, 1.7) and 0.7 (0.6, 0.8), respectively. Among NH black women, tract poverty [OR=1.6 (1.2, 2.3)] and residential stability [OR=1.3 (1.0, 1.6)] were associated with PTB odds. For black and white NH women, tract housing and employment domains were unassociated with PTB. Conclusion: Different deprivation domains appear associated with PTB odds for NH white and black women, a finding with important policy implications for PTB reduction efforts in this country. Results for other MODE-PTD sites will be discussed.
Keywords: Birth Outcomes,
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.
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA