197693 Mutilevel analysis of the role of residential segregation on perinatal outcomes in the South: The effects of space and place

Monday, November 9, 2009: 9:15 AM

Tabia K. Henry Akintobi, PhD, MPH , Community Health and Preventive Medicine, Morehouse School of Medicine Prevention Research Center, Atlanta, GA
Melinda Forthofer, PhD , The Institute for Families in Society, University of South Carolina, Columbia, SC
Carol A. Bryant, PhD , Florida Prevention Research Center, University of South Florida, Tampa, FL
Background: The health statuses of mothers and infants are critical indicators of the nation's health. Adverse perinatal outcomes of low birth weight, preterm birth and small for gestational age represent leading causes of neonatal death and compromised quality of life. Regional findings indicate that these outcomes are often higher in the South.

Purpose: This presentation will highlight results of investigation of relationships between residential segregation and adverse perinatal outcomes in Florida, Georgia and Louisiana utilizing an Ecosocial conceptual framework.

Methods: An observational, cross-sectional study design was employed. Live birth certificates of non-Hispanic White and Black primaparous women between 15 and 49 years of age experiencing singleton live births delivered at > 45 weeks gestation provided information on individual covariates and perinatal outcomes. Structural indicators of residential segregation and contextual covariates were obtained from the U.S. Census Bureau. Three-level, hierarchical generalized linear models were used to test research hypotheses.

Results: The sample consisted of 255,548 women. While residential segregation did not have a direct relationship adverse perinatal outcomes under study, models testing the moderating effects of ethnicity indicated that increased Isolation, a residential segregation index, decreased the risk of low birth weight deliveries among Black women (OR 0.36, 95% CI: 0.15, 0.87, p=0.02).

Discussion: The effects of residential segregation may be birth outcome- and ethnicity-specific. Specification of a broader constellation of biological, social and spatial factors and assessment of residential preferences and experiences are critical to better understand of the associations between residential segregation and adverse birth outcomes.

Learning Objectives:
1. Describe the application of hierarchical linear modeling to analysis of residential segregation and adverse perinatal outcomes 2. Describe the roles of individual, contextual and structural factors on adverse perinatal outcomes examined 3. List recommendations for future research on the measurement of residential segregation and its association with adverse perinatal outcomes

Keywords: Maternal and Child Health, MCH Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed my doctoral disseration on this topic and successfully defended towards completion of my Doctorate of Philosophy in Public Health from the University of South Florida College of Public Health Department of Community and Family Health.
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.