181598 Effects of Neighborhood Deprivation on Racial/Ethnic Disparities in Prenatal Smoking

Monday, October 27, 2008: 10:50 AM

Emmanuel Ngui, DrPH, MSc , Department of Pediatrics, Medical College of Wisconsin, Center for the Advancement of Underserved Children, Milwaukee, WI
Background: Wisconsin ranks among the top states in many health indicators, but has among the worst racial disparities in birth outcomes in the nation, particularly in the City of Milwaukee.

Objective: To examine the relationship between neighborhood level deprivation and racial/ethnic disparities in smoking during pregnancy (SDP).

Methods: Analysis of geocoded vital records data (1999-2004) from the City of Milwaukee (n=66,045) merged to US 2000 census tracts (CTs) data. Race/ethnicity-stratified random effects multilevel logistic regression models were fit to examine the association of neighborhood level deprivation with maternal SDP, controlling for individual-level characteristics.

Results: Of the 9,616 women who SDP, 55% were black, 52% had Conclusions: Adverse neighborhood conditions are associated with racial disparities in SDP. A gradient was found among black women with the likelihood of SDP increasing with each quartile of worsening neighborhood deprivation. Among white women, only those in moderately deprived neighborhoods had greater likelihood of SDP.

Implications: Study findings suggest the need for policies/strategies to improve neighborhood conditions as a way of reducing SDP and better understanding of community factors (i.e., community stressors) that increase risk of SDP among black women.

Learning Objectives:
1) Examine the effects of neighborhood factors on prenatal smoking 2) Describe disparities in prenatal smoking and the potential role of contextual factors

Keywords: Pregnancy Outcomes, Smoking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized the study, conducted the analyses, and interpreted the results.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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