Examining the individual and contextual factors influencing low birth weight (LBW) in Nebraska

The purpose of this study is to examine the association between individual and neighborhood effects on low birth weight in Nebraska. The study sample consist of all births in Nebraska to mothers residing in the state from 2005 -2009. Neighborhood level characteristics were obtained from the 2009 Area Resource Files and the American Community Survey (2005-2009). The neighborhood was defined at the level of the census tract. Multilevel logistic regression modeling was used.Principal Component Analysis (PCA) with varimax rotation was used to obtain two comprehensive neighborhood need indicators: socioeconomic disadvantage and socio-cultural barriers. The findings indicate that neighborhood level indicators of socioeconomic disadvantage and socio-cultural barriers are not significant predictors of LBW in Nebraska. This study finds that maternal race, education, parity, health status and health behavior are all significant independent predictors of LBW. Age, marital status, and number of prenatal care visits were not found to associated with LBW in this study.In addition, county-level supply of primary care physicians and certified midwives were not associated with LBW births in the state. There was no interaction between race, age and both neighborhood level factors.