245395 Neighborhood-Level Immigrant Concentration and Infant Mortality in Los Angeles County

Sunday, October 30, 2011

Lisa Ross DeCamp, MD, MSPH , Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, MI
Hwajung Choi, PhD , Robert Wood Johnson Foundation Clinical Scholars Program, University of Michigan, Ann Arbor, MI
Elena Fuentes-Afflick, MD, MPH , Department of Pediatrics, University of California-San Francisco, San Francisco, CA
Narayan Sastry, PhD , Population Studies Center, University of Michigan, Ann Arbor, MI
Background: Infant mortality rates are generally lower for Latinos than would be expected on the basis of socioeconomic characteristics. Individual-level factors have not explained this ‘paradox'; thus, neighborhood context may be important. Immigrant enclaves are hypothesized to be protective for infant mortality among Latinos, but this hypothesis has not been tested.

Methods: Infant and maternal characteristics were obtained from geocoded Los Angeles County 2002-2006 vital statistics records. Data on neighborhood characteristics were obtained from the 2000 Census. The primary neighborhood variable of interest, immigrant concentration, was constructed via factor analysis and included percentages of foreign-born residents, non-citizens, immigrants, Spanish-speaking adults, and Latinos (Cronbach's alpha: 0.88). Neighborhoods were defined as census tracts. Logistic models of infant mortality, stratified by race/ethnicity, were estimated using random effects models to account for spatial clustering.

Results: Infant mortality rates were similar among white and Latino infants. Latino infants whose mothers lived in neighborhoods with the lowest immigrant concentration had reduced odds of mortality. The odds ratio for mortality for Latino infants in the lowest quartile of immigrant concentration vs. those in the third quartile was 0.65 (95% CI: 0.48-0.86). Neighborhood median income was not significantly associated with infant mortality among Latinos. However, lower neighborhood income had a stronger negative effect on mortality in areas of high immigrant concentration.

Conclusions: In Los Angeles County, immigrant enclaves were not associated with a lower risk of infant mortality for Latinos. This may be due, in part, to lower neighborhood incomes in areas of high immigrant concentration. This interaction warrants further exploration.

Learning Areas:
Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Objectives: (1) identify measure of neighborhood immigrant concentration; (2) describe race/ethnic variation in neighborhood exposures; (3) discuss the effects of neighborhood characteristics on infant mortality by race/ethnicity.

Keywords: Infant Mortality, Hispanic

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a research fellow working on this project with primary mentorship from my co-author Narayan Sastry.
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.