205516 Local racial residential segregation and low birthweight in Michigan cities

Monday, November 9, 2009: 10:30 AM

Michelle L. Precourt Debbink , School of Public Health, University of Michigan, Ann Arbor, MI
Michael David Bader , Department of Sociology, University of Michigan, Ann Arbor, MI
  
Background/Significance: Racial inequities in low birthweight remain a public health problem. Part of the disparity may be related to different social environments in which blacks and whites live as a consequence of racial segregation.

Objective/Purpose: We explored the relationship between segregation -- racial and economic -- and low birthweight, independent of other neighborhood risk factors, in Michigan's metropolitan areas. We hypothesize that increasing racial segregation has independent associations with low birthweight.

Methods: Michigan birth records for 2000 were geo-coded to Census tract for all metropolitan statistical areas (MSAs), resulting in 114,140 singleton births in 2,203 tracts. Low birthweight (LBW) and very low birthweight (VLBW) were conditioned on mother's age and race, then used to calculate rates by tract. Following Krivo et al., we calculated racial and economic segregation indices for each tract. We modeled counts of LBW and VLBW by segregation levels and neighborhood-level scales developed from factor analysis.

Results: Black segregated tracts have an elevated incidence rate ratio (IRR) of LBW (1.23, 95% CI 1.19-1.28) compared to white integrated areas after controlling for economic segregation. LBW is also elevated in black integrated and white segregated areas; however, residential stability mitigates the latter relationship. The IRR in black segregated tracts remains significantly elevated (1.13, 95% CI 1.08-1.18) when neighborhood-level scales are included. The results for VLBW are similar.

Discussion/Conclusions: Racial segregation has a significant relationship with LBW independent of other neighborhood characteristics, including economic segregation. Future studies should incorporate more nuanced measures of risk at both individual and neighborhood levels.

Learning Objectives:
By the end of this session, participants will be able to: 1) DESCRIBE local residential segregation and its relationship to racial disparities in low birthweight.

Keywords: Low Birthweight, Urban Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: my graduate work revolves around social-structural processes related to health and the ways in which policy may address these issues. My PhD coursework has included theoretical and statistical topics, and my MD coursework has included biological and clinical topics. I have undertaken my studies through a Medical Scientist Training Program Fellowship.
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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