202188 An exploratory analysis of the effect of neighborhood change on low birthweight in a Chicago population

Sunday, November 8, 2009

Gandarvaka L. Gray, MPH Student , University of Illinois at Chicago School of Public Health, Chicago, IL
Richard J. David, MD , Stroger Cook County Hospital, University of Illinois at Chicago, Chicago, IL
Joan Kennelly, PhD , Community Health Sciences, University of Illinois School of Public Health, Chicago, IL
Kristin M. Rankin, PhD, MSPH , School of Public Health, University of Illinois at Chicago, Chicago, IL
James W. Collins, MD, MPH , Northwestern University, Children's Memorial Hospital, Chicago, IL
Background. The life-course experience and neighborhood context are receiving increasing attention in studies seeking to explain racial disparities in birth outcomes. However, there has been little convergence of these bodies of research and even fewer studies have simultaneously explored the impact of a changing neighborhood. We examined the association between a woman's exposure to a changing neighborhood racial demographic and delivering a low birthweight (LBW) infant in a Chicago population.

Methods. Focusing our analysis on a subset of the Illinois Transgenerational Birth File (TGBF), women residing in the same Chicago neighborhood from the time they were born (1956-1976) to the time they gave birth to their infant (1989-1991), race-specific adjusted odds ratios were produced using multivariable logistic regression.

Results. In this population (n=10356), white women with a lifelong neighborhood exposure to a high proportion (>25%) of black residents were at the greatest risk of delivering a LBW infant (AOR [adjusted odds ratio]=1.9; 95% CI [confidence interval]: 0.83-4.23). For black women, living in a neighborhood with a declining black population was associated with a significantly increased risk of having a LBW infant (AOR=2.1; 95% CI: 1.02, 4.27).

Conclusions. Black women living in neighborhoods where the proportion of black residents decreased over their lifetimes were at an increased risk of delivering an infant at a LBW. Our findings suggest that neighborhood change processes resulting in the displacement of black residents may have reproductive health implications for black women who remain in their birth neighborhoods.

Learning Objectives:
1) Describe the advantages of employing a life-course perspective to studies of neighborhood context and racial and ethnic disparities in low birthweight and infant mortality. 2) Identify neighborhood contextual factors associated with racial change in Chicago between 1960-1990. 3) Identify neighborhood-level factors associated with low birthweight in this population.

Keywords: Low Birthweight, Birth Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently enrolled in an MPH Program in Maternal and Child Health-Epidemiology.
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.