239777 Neighborhood-level determinants of smoking during pregnancy in Los Angeles: Findings from the Los Angeles Mommy and Baby (LAMB) Survey

Monday, October 31, 2011: 10:30 AM

Hsin-Chieh Chang, MSPH , Department of Community Health Sciences, School of Public Health, University of California Los Angeles, Los Angeles, CA
Jessica Chow, MPH , Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA
Dena Herman, PhD, MPH, RD , Department of Community Health Sciences, UCLA School of Public Health, Los Angeles, CA
Luwam Semere, MD , Robert Wood Johnson Foundation Clinical Scholars Program, Department of Medicine and Obstetrics and Gynecology, University of California Los Angeles School of Medicine, Los Angeles, CA
Erin Saleeby, MD, MPH , Robert Wood Johnson Foundation Clinical Scholars Program, Department of Medicine and Obstetrics and Gynecology, University of California Los Angeles School of Medicine, Los Angeles, CA
Fathima Wakeel, PhD, MPH , UCLA Center for Healthier Children, Families and Communities, Los Angeles, CA
Shin Margaret Chao, PhD, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Chandra Higgins, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Marian Eldahaby , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Nirvi Shah, MPH , Maternal Child & Adolescent Health, Los Angeles County, Palos Verdes Pensinsula, CA
Michael C. Lu, MD, MPH , Department of Community Health Sciences and Department of Obstetrics and Gynecology, University of California Los Angeles School of Public Health and School of Medicine, Los Angeles, CA
Maternal smoking during pregnancy is detrimental to infant health and has long-term effects on child development. Based on social disorganization theory and social capital theory, safe and cohesive neighborhood environments is associated with health-enhancing behaviors among residents through social interactions and reciprocity, shared values and collective monitoring, and resources available within the neighborhoods. Objective: To examine the associations between neighborhood-level determinants and smoking during pregnancy in Los Angeles County. Methods: Data were from the 2007 LAMB survey, a population-based, mail sample survey with telephone follow-up for non-respondents based on multistage clustered design. Multivariate logistic regressions were used to analyze weighted responses of 5,546 women. Neighborhood-level determinants include: neighborhood quality (α=.91) which measures safety, cleanness, and institutional resources; cohesion and trust (α=.77) and social interaction and reciprocity (α=.88) represent neighborhood social capital. Results: Forty-four percents of the sample were foreign-born, 21% received less than high school education, 15% had depression before pregnancy, and 3.3 % smoked during the last pregnancy. After controlling for race/ethnicity, income, education, foreign-born status, and depression, neighborhood quality was negatively associated (P=.008) with smoking during pregnancy. An educational gradient was observed: compared to women completed college education and beyond, those who received less than high school education, completed high school, and some college were 6 (P<.001), 4 (P<.001) and 3 times (P=.002) more likely to smoke during pregnancy, respectively. Conclusions: Social policies and welfare programs, which aim to improve neighborhood qualities and tailor smoking cessation services to young women in underserved communities, may reduce smoking during pregnancy.

Learning Areas:
Assessment of individual and community needs for health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1.Describe key concepts of neighborhood-level determinants and their impacts on the health behaviors among residents. 2.Identify the socio-demographic characteristics of women who smoked during their last pregnancy in Los Angeles County from the sample. 3.Discuss missed opportunities in supporting pregnant women to quit smoking and propose community-based intervention programs in high-risk neighborhoods.

Keywords: Pregnancy, Immigrant Women

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working with the LAMB data set and analyzed the data for this abstract.
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.

See more of: Greg Alexander Outstanding Student Paper Session: Maternal and Child Health Research and Implications
See more of: Maternal and Child Health