Neighborhood poverty and preterm birth revisited: Comparing cross-sectional measures to longitudinal poverty trajectories
Methods. We categorized California neighborhoods (i.e., census tracts) as having low (<5% poor), moderate (5-20% poor), or high (>20% poor) cross-sectional poverty based on data from the American Community Survey 2005-2009 (ACS). We then estimated longitudinal poverty trajectories from 1970-2009 using data from the ACS and the Neighborhood Change Database using three methods: a priori categorization, latent class growth modeling, and non-parametric clustering. We used logistic regression to estimate associations between neighborhood poverty measures and PTB for 24,394 women in the Maternal and Infant Health Assessment who gave birth between 2003-2009.
Results. High (compared to low) neighborhood poverty based on cross-sectional data was not associated with PTB after adjustment for individual-level demographic and socioeconomic factors (OR=1.03, 95% CI=0.88,1.21) . However, trajectories characterized by long-term high (compared to long-term low) neighborhood poverty were associated with 30-40 percent increases in odds of PTB in fully adjusted models (e.g., OR=1.39, 95% CI=1.17, 1.64), regardless of method used to estimate trajectories.
Conclusions. The longitudinal poverty experience of neighborhoods may be more strongly associated with factors influencing birth outcomes compared to cross-sectional measures of poverty.
Social and behavioral sciences
Compare methods for assessing longitudinal trajectories of neighborhood poverty. Examine associations between neighborhood poverty (measured using both cross-sectional and longitudinal data) and preterm birth. Discuss the potential implications of using longitudinal data to measure trajectories of neighborhood poverty with respect to birth outcomes.
Keyword(s): Birth Outcomes
Qualified on the content I am responsible for because: I have a PhD in epidemiology and have been studying neighborhood characteristics and health for five years as a doctoral student and post-doc.
Any relevant financial relationships? No
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