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APHA Scientific Session and Event Listing

Recorded presentation

Michelyn W. Bhandari, DrPH, MPH¹, F. Douglas Scutchfield, MD², Claudia Hopenhayn, MPH, PhD², and Evelyn A. Knight, PhD³. (1) Department of Health Promotion and Administration, Eastern Kentucky University, 420 Begley, 521 Lancaster Avenue, Richmond, KY 40475, 859-622-1145, michelyn.bhandari@eku.edu, (2) College of Public Health, University of Kentucky, 121 Washington Ave., Lexington, KY 40536, (3) Appalachian Center, University of Kentucky, 624 Maxwelton Court, Lexington, KY 40536

Background: As in the United States, rates of preterm birth in Kentucky have continued to increase over the past 10 years. However, Kentucky's percentage change in preterm births from 1992 to 2002 is notably higher than the U.S. Much of the research to date has focused on improving the understanding of the causes of preterm labor and learning how to prevent it. However, mounting evidence suggests community contextual factors, in addition to individual level factors, are related to preterm birth. Purpose: This study aimed to demonstrate that multiple factors including community context influence the incidence of preterm birth. Methods: Data from the 2000 Kentucky birth certificate records (n=54,600) were used to identify the preterm birth outcome as well as all individual-level measures for this study. Community contextual factors were taken from the 2000 U.S. Census and the 2001 Area Resource File. Multilevel logistic regression models were used to analyze the log-odds of preterm birth. Results: The odds for preterm birth were higher if the mother resided in a county with a larger percentage of adults with less than a high school education, a county with a higher median household income, and a county with a greater level of income inequality. The predictors of the odds of preterm birth were very different for whites and nonwhites. Community context did not appear to be a major influence in the risk for preterm birth among nonwhites. Conclusions: Community context, particularly income inequality, was a significant predictor of preterm birth in Kentucky.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Identify the communtiy contextual factors that are important predictors of preterm birth in Kentucky.
• Discuss the role of income inequality in preterm birth.

Keywords: Maternal and Child Health,

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation