Place Matters: Racial Residential Segregation and Low Birth Weight Among African American, Hispanic, and Asian/Pacific Islander Mothers

We sought to understand the association between low birthweight (LBW) and neighborhood-level segregation for mothers of varying race/ethnic groups in a multi-ethnic metropolitan area. 2000-2004 California vital statistics data for LA County were matched to 2000 Census Tract data for mother's address. We used two-level hierarchical logistic models to estimate the relationship between segregation and LBW, independent of other individual/neighborhood factors. We also estimated multinomial models of relative risk between sub-categories of LBW: small for gestational age (SGA) and appropriate for gestational age (AGA). Isolation from whites predicts increased odds of LBW for both black (OR = 1.128, 95% CI = 1.020,1.247) and Hispanic mothers (OR = 1.123, 95%CI = 1.069,1.181). Among blacks, this was driven by increased odds of SGA (OR = 1.165, 95% CI = 1.031,1.316) . For API mothers, isolation from Hispanics predicts decreased odds of LBW (OR = 0.848, 95% CI = 0.728,0.987), driven by decreased relative odds of AGA (OR = 0.737, 95% CI = 0.567,0.960). Isolation from whites predicts an increase in odds of LBW for blacks and Hispanics. Among black women, increased odds of SGA may imply increased vulnerability to vascular dysfunction. Decreased odds of LBW among isolated API women may suggest a benefit of racial isolation for API mothers. Practically, these results may help to guide appropriate resource allocation and intervention choices for disparities reduction. We should strive to reverse or reduce the impact of segregation, keeping in mind that risk/benefit trade-offs of reducing racial isolation may vary between groups.