Associations between Neighborhood Support Characteristics and Prenatal Care Utilization: Findings from the Los Angeles Mommy and Baby (LAMB) Survey

OBJECTIVE: To determine associations between neighborhood support and prenatal care utilization and to discern if this relationship differs based on maternal nativity. METHODS: We used data from the 2007 LAMB survey, a population-based, mail sample survey with telephone follow-up for non-respondents based on a multistage clustered design. Analyses were based on weighted responses of 6264 women with live births. Neighborhood support was assessed by asking women how often their neighbors “do favors for each other”, “have get-togethers where neighbors were invited”, if their neighbors were “willing to help each other”, and “can be trusted”. The Kotelchuck Adequacy of Prenatal Care Utilization Index was used to classify prenatal care utilization as either adequate (including Adequate Plus and Adequate groups) or inadequate (including Intermediate and Inadequate groups). Relationships between neighborhood support and prenatal care utilization were analyzed using Pearson's chi square tests. RESULTS: Eighty-five percent of the respondents had adequate prenatal care utilization. Women who reported higher neighborhood support were more likely to access adequate prenatal care (favors for neighbors: OR 1.28, p<0.01; neighbors helpful: OR 1.30, p<0.01; trust between neighbors: OR 1.21, p<0.03). When stratified by maternal nativity, the positive association between neighborhood support characteristics and prenatal care utilization remained significant for U.S.-born women (p<0.04) but not for foreign-born women. CONCLUSIONS: U.S.-born but not foreign-born women who reported higher neighborhood support were more likely to utilize prenatal care adequately. Further research is warranted to elucidate the relationship between maternal nativity, neighborhood support, and prenatal care utilization.