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Diamond-Smith N, Baer RJ, Jelliffe-Pawlowski L. Impact of being underweight before pregnancy on preterm birth by race/ethnicity and insurance status in California: an analysis of birth records. J Matern Fetal Neonatal Med 2024; 37:2321486. [PMID: 38433400 DOI: 10.1080/14767058.2024.2321486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND The US still has a high burden of preterm birth (PTB), with important disparities by race/ethnicity and poverty status. There is a large body of literature looking at the impact of pre-pregnancy obesity on PTB, but fewer studies have explored the association between underweight status on PTB, especially with a lens toward health disparities. Furthermore, little is known about how weight, specifically pre-pregnancy underweight status, and socio-economic-demographic factors such as race/ethnicity and insurance status, interact with each other to contribute to risks of PTB. OBJECTIVES The objective of this study was to measure the association between pre-pregnancy underweight and PTB and small for gestational age (SGA) among a large sample of births in the US. Our secondary objective was to see if underweight status and two markers of health disparities - race/ethnicity and insurance status (public vs. other) - on PTB. STUDY DESIGN We used data from all births in California from 2011 to 2017, which resulted in 3,070,241 singleton births with linked hospital discharge records. We ran regression models to estimate the relative risk of PTB by underweight status, by race/ethnicity, and by poverty (Medi-cal status). We then looked at the interaction between underweight status and race/ethnicity and underweight and poverty on PTB. RESULTS Black and Asian women were more likely to be underweight (aRR = 1.0, 95% CI: 1.01, 1.1 and aRR = 1.4, 95% CI: 1.4, 1.5, respectively), and Latina women were less likely to be underweight (aRR = 0.7, 95% CI: 0.7, 0.7). Being underweight was associated with increased odds of PTB (aRR = 1.3, 95% CI 1.3-1.3) and, after controlling for underweight, all nonwhite race/ethnic groups had increased odds of PTB compared to white women. In interaction models, the combined effect of being both underweight and Black, Indigenous and People of Color (BIPOC) statistically significantly reduced the relative risk of PTB (aRR = 0.9, 95% CI: 0.8, 0.9) and SGA (aRR = 1.0, 95% CI: 0.9, 1.0). The combined effect of being both underweight and on public insurance increased the relative risk of PTB (aRR = 1.1, 95% CI: 1.1, 1.2) but there was no additional effect of being both underweight and on public insurance on SGA (aRR = 1.0, 95% CI: 1.0, 1.0). CONCLUSIONS We confirm and build upon previous findings that being underweight preconception is associated with increased risk of PTB and SGA - a fact often overlooked in the focus on overweight and adverse birth outcomes. Additionally, our findings suggest that the effect of being underweight on PTB and SGA differs by race/ethnicity and by insurance status, emphasizing that other factors related to inequities in access to health care and poverty are contributing to disparities in PTB.
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Affiliation(s)
- Nadia Diamond-Smith
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
| | - Rebecca J Baer
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
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Matoba N, Kim C, Branche T, Collins JW. Social Determinants of Premature Birth. Clin Perinatol 2024; 51:331-343. [PMID: 38705644 DOI: 10.1016/j.clp.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Social determinants of health have received increasing attention in public health, leading to increased understanding of how social factors-individual and contextual-shape the health of the mother and infant. However, racial differences in birth outcomes persist, with incomplete explanation for the widening disparity. Here, we highlight the social determinants of preterm birth, with special attention to the social experiences among African American women, which are likely attributed to structural racism and discrimination throughout life.
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Affiliation(s)
- Nana Matoba
- Division of Neonatology, Rady Children's Hospital San Diego, Department of Pediatrics, University of California San Diego, 3020 Children's Way, MC 5008, San Diego, CA 92123, USA.
| | - Christina Kim
- Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Northwestern University, 225 East Chicago Avenue, Box #45, Chicago, IL 60611, USA
| | - Tonia Branche
- Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Northwestern University, 225 East Chicago Avenue, Box #45, Chicago, IL 60611, USA
| | - James W Collins
- Division of Neonatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Northwestern University, 225 East Chicago Avenue, Box #45, Chicago, IL 60611, USA
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3
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Gao X, Thomas TA, Morello-Frosch R, Allen AM, Snowden JM, Carmichael SL, Mujahid MS. Neighborhood gentrification, displacement, and severe maternal morbidity in California. Soc Sci Med 2023; 334:116196. [PMID: 37678111 PMCID: PMC10959124 DOI: 10.1016/j.socscimed.2023.116196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/29/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
Gentrification, a racialized and profit-driven process in which historically disinvested neighborhoods experience an influx of development that contributes to the improvement of physical amenities, increasing housing costs, and the dispossession and displacement of existing communities, may influence the risk of severe maternal morbidity (SMM). Leveraging a racially diverse population-based sample of all live hospital births in California between 2006 and 2017, we examined associations between neighborhood-level gentrification and SMM. SMM was defined as having one of 21 procedures and diagnoses, as described in the SMM index developed by Centers for Disease Control and Prevention. We compared three gentrification measures to determine which operationalization best captures aspects of gentrification most salient to SMM: Freeman, Landis 3-D, and Urban Displacement Project Gentrification and Displacement Typology. Descriptive analysis assessed bivariate associations between gentrification and birthing people's characteristics. Overall and race and ethnicity-stratified mixed-effects logistic models assessed associations between gentrification and SMM, adjusting for individual sociodemographic and pregnancy factors while accounting for clustering by census tract. The study sample included 5,256,905 births, with 72,718 cases of SMM (1.4%). The percentage of individuals living in a gentrifying neighborhood ranged from 5.7% to 11.7% across exposure assessment methods. Net of individual and pregnancy-related factors, neighborhood-level gentrification, as measured by the Freeman method, was protective against SMM (OR = 0.89, 95% CI: 0.86-0.93); in comparison, gentrification, as measured by the Gentrification and Displacement Typology, was associated with greater risk of SMM (OR = 1.18, 95% CI: 1.14-1.23). These associations were significant among non-Hispanic White, non-Hispanic Black, and Hispanic individuals. Findings demonstrate that gentrification plays a role in shaping the risk of SMM among birthing people in California. Differences in how gentrification is conceptualized and measured, such as an emphasis on housing affordability compared to a broader characterization of gentrification's multiple aspects, may explain the heterogeneity in the directions of observed associations.
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Affiliation(s)
- Xing Gao
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Timothy A Thomas
- Urban Displacement Project, Institute of Governmental Studies, University of California Berkeley, Berkeley, CA, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management, University of California Berkeley, Berkeley, CA, USA; Division of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Division of Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Amani M Allen
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA; Division of Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Jonathan M Snowden
- School of Public Health, Oregon Health & Science University-Portland State University, OR, USA
| | - Suzan L Carmichael
- Department of Pediatrics, Division of Neonatal & Developmental Medicine, Stanford University, Stanford, CA, USA; Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Stanford University, Stanford, CA, USA
| | - Mahasin S Mujahid
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA.
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Vazquez CE, Hess KE, McBride MJ, Cubbin C, Bearman SK, Calzada EJ. Impact of COVID social distancing measures on eating and exercise behaviors among a sample of Hispanic parents of young children in the United States. J Public Health Res 2022; 11:22799036221132389. [PMID: 36337260 PMCID: PMC9634197 DOI: 10.1177/22799036221132389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background: In the United States, healthy behaviors, such as eating fruits/vegetables and
exercise, are well below recommended levels, particularly for Hispanics. The
COVID pandemic may have exacerbated existing health behavior disparities.
The current study examines the impact of COVID social distancing measures on
Hispanic parents’ eating and exercise behaviors, and how the impact may
differ by socioeconomic status (SES) and distress levels. Design and methods: This cross-sectional logistic regression study utilized data from a sample of
Hispanic parents in Texas (n = 237). COVID-related
questions were collected in Summer 2020. Dependent variables included
self-reported changes in exercise and eating behaviors due to the pandemic
(i.e. got better or got worse). Primary independent variables included
family-SES, neighborhood-SES, and distress due to COVID. Results: More than half (60%) of parents reported that their eating and exercise
behaviors worsened. Results showed a significant relationship between
distress due to COVID and both dependent variables; changes in eating
(OR = 1.38, 95% CI [1.20, 1.58]) and changes in exercise (OR = 1.28, 95% CI
[1.11, 1.48]). There were no observed differences by SES. Conclusions: Results suggest distress due to COVID was associated with worsening of eating
and exercise behaviors, regardless of SES. The direction of the relationship
between distress and healthy eating and exercise behaviors requires further
attention.
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Affiliation(s)
- Christian E Vazquez
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Katherine E Hess
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, TX, USA
| | - Megan J McBride
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, TX, USA
| | - Catherine Cubbin
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Sarah Kate Bearman
- Department of Educational Psychology, College of Education, The University of Texas at Austin, Austin, TX, USA
| | - Esther J Calzada
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
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Examining School and Neighborhood Effects of Socioeconomic Status on Childhood Obesity in the U.S. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105831. [PMID: 35627368 PMCID: PMC9141304 DOI: 10.3390/ijerph19105831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 01/19/2023]
Abstract
Obesity amongst Kindergartners in Texas is above the national average, particularly among Hispanic students. Research on the impact of school and neighborhood-level SES on obesity in childhood using multilevel models is lacking. Survey data were collected from Hispanic caregivers of pre-kindergarten students in Fall 2019 (n = 237). Students were clustered in thirty-two neighborhoods and twelve schools. The dependent variable was the child’s body mass index z-score (BMIz). Covariates included the child’s sex, primary caregiver’s marital status, education level, relationship to the child, and family income. Level-two variables included neighborhood poverty and school SES. CTableross-classified multilevel linear regression models were conducted to examine the unique associations of neighborhood poverty and school SES with individual student BMIz, and how they interact. Twenty-four percent of students were classified as overweight, and five percent were classified as obese. The models resulted in a significant association between school SES and BMIz (B = −0.13; SE = 0.06; p < 0.05) and between neighborhood poverty and BMIz (B = −1.41; SE = 0.49; p < 0.01). Individual students’ BMIz decreased as school SES increased and decreased as neighborhood poverty increased. Neighborhood poverty and school SES appear to play a role in the development of obesity in childhood, although in differing directions.
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CURTIS DAVIDS, FULLER‐ROWELL THOMASE, CARLSON DANIELL, WEN MING, KRAMER MICHAELR. Does a Rising Median Income Lift All Birth Weights? County Median Income Changes and Low Birth Weight Rates Among Births to Black and White Mothers. Milbank Q 2022; 100:38-77. [PMID: 34609027 PMCID: PMC8932634 DOI: 10.1111/1468-0009.12532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Policy Points Policies that increase county income levels, particularly for middle-income households, may reduce low birth weight rates and shrink disparities between Black and White infants. Given the role of aggregate maternal characteristics in predicting low birth weight rates, policies that increase human capital investments (e.g., funding for higher education, job training) could lead to higher income levels while improving population birth outcomes. The association between county income levels and racial disparities in low birth weight is independent of disparities in maternal risks, and thus a broad set of policies aimed at increasing income levels (e.g., income supplements, labor protections) may be warranted. CONTEXT Low birth weight (LBW; <2,500 grams) and infant mortality rates vary among place and racial group in the United States, with economic resources being a likely fundamental contributor to these disparities. The goals of this study were to examine time-varying county median income as a predictor of LBW rates and Black-White LBW disparities and to test county prevalence and racial disparities in maternal sociodemographic and health risk factors as mediators. METHODS Using national birth records for 1992-2014 from the National Center for Health Statistics, a total of approximately 27.4 million singleton births to non-Hispanic Black and White mothers were included. Data were aggregated in three-year county-period observations for 868 US counties meeting eligibility requirements (n = 3,723 observations). Sociodemographic factors included rates of low maternal education, nonmarital childbearing, teenage pregnancy, and advanced-age pregnancy; and health factors included rates of smoking during pregnancy and inadequate prenatal care. Among other covariates, linear models included county and period fixed effects and unemployment, poverty, and income inequality. FINDINGS An increase of $10,000 in county median income was associated with 0.34 fewer LBW cases per 100 live births and smaller Black-White LBW disparities of 0.58 per 100 births. Time-varying county rates of maternal sociodemographic and health risks mediated the association between median income and LBW, accounting for 65% and 25% of this estimate, respectively, but racial disparities in risk factors did not mediate the income association with Black-White LBW disparities. Similarly, county median income was associated with very low birth weight rates and related Black-White disparities. CONCLUSIONS Efforts to increase income levels-for example, through investing in human capital, enacting labor union protections, or attracting well-paying employment-have broad potential to influence population reproductive health. Higher income levels may reduce LBW rates and lead to more equitable outcomes between Black and White mothers.
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Affiliation(s)
| | | | | | - MING WEN
- University of UtahSalt Lake City
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7
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Blebu BE. Neighborhood Context and the Nativity Advantage in Preterm Birth among Black Women in California, USA. J Urban Health 2021; 98:801-811. [PMID: 34665425 PMCID: PMC8688666 DOI: 10.1007/s11524-021-00572-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
Non-Hispanic Black women remain at increased risk for adverse birth outcomes, yet Black immigrant women are at lower risk than their US-born counterparts. This study examines whether neighborhood context contributes to the nativity advantage in preterm birth (PTB, < 37 weeks) among Black women in California. A sample of live singleton births to non-Hispanic US-born (n = 83,169), African-born (n = 7151), and Caribbean-born (n = 943) Black women was drawn from 2007 to 2010 California birth records and geocoded to urban census tracts. We used 2010 American Community Survey data to measure tract-level Black immigrant density, Black racial concentration, and a neighborhood deprivation index. Risk ratios (RR) and 95% confidence intervals (95%CI) were estimated using log-binomial regression to assess whether neighborhood context partially explained nativity differences in PTB risk. Compared to US-born Black women, African-born Black women had lower PTB risk (RR = 0.65, 95%CI: 0.60-0.71). The difference in PTB risk between US- and Caribbean-born women did not reach statistical significance (RR = 0.87, 95%CI: 0.71-1.05). The nativity advantage in PTB risk was robust to neighborhood social conditions and maternal factors for African-born women (RR = 0.59, 95%CI: 0.51-0.67). This study is one of few that considers area-level explanations of the nativity advantage among Black immigrants and makes a significant contribution by showing that the neighborhood context does not explain the nativity advantage in PTB among Black women in California. This could be due to many factors that should be examined in future research.
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Affiliation(s)
- Bridgette E Blebu
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, USA.
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Edmonds A, Breskin A, Cole SR, Westreich D, Ramirez C, Cocohoba J, Wingood G, Cohen MH, Golub ET, Kassaye SG, Metsch LR, Sharma A, Konkle-Parker D, Wilson TE, Adimora AA. Poverty, Deprivation, and Mortality Risk Among Women With HIV in the United States. Epidemiology 2021; 32:877-885. [PMID: 34347686 PMCID: PMC8478815 DOI: 10.1097/ede.0000000000001409] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prior studies suggest neighborhood poverty and deprivation are associated with adverse health outcomes including death, but evidence is limited among persons with HIV, particularly women. We estimated changes in mortality risk from improvement in three measures of area-level socioeconomic context among participants of the Women's Interagency HIV Study. METHODS Starting in October 2013, we linked geocoded residential census block groups to the 2015 Area Deprivation Index (ADI) and two 2012-2016 American Community Survey poverty variables, categorized into national tertiles. We used parametric g-computation to estimate, through March 2018, impacts on mortality of improving each income or poverty measure by one and two tertiles maximum versus no improvement. RESULTS Of 1596 women with HIV (median age 49), 91 (5.7%) were lost to follow-up and 83 (5.2%) died. Most women (62%) lived in a block group in the tertile with the highest proportions of individuals with income:poverty <1; 13% lived in areas in the tertile with the lowest proportions. Mortality risk differences comparing a one-tertile improvement (for those in the two highest poverty tertiles) in income:poverty <1 versus no improvement increased over time; the risk difference was -2.2% (95% confidence interval [CI] = -3.7, -0.64) at 4 years. Estimates from family income below poverty level (-1.0%; 95% CI = -2.7, 0.62) and ADI (-1.5%; 95% CI = -2.8, -0.21) exposures were similar. CONCLUSIONS Consistent results from three distinct measures of area-level socioeconomic environment support the hypothesis that interventions to ameliorate neighborhood poverty or deprivation reduce mortality risk for US women with HIV. See video abstract at, http://links.lww.com/EDE/B863.
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Affiliation(s)
- Andrew Edmonds
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alexander Breskin
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- NoviSci Inc., Durham, NC
| | - Stephen R. Cole
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Daniel Westreich
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Catalina Ramirez
- Division of Infectious Diseases, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer Cocohoba
- Department of Clinical Pharmacy, The University of California San Francisco, San Francisco, CA
| | - Gina Wingood
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Mardge H. Cohen
- Department of Medicine, Stroger Hospital, Cook County Bureau of Health Services, Chicago, IL
| | - Elizabeth T. Golub
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Seble G. Kassaye
- Department of Medicine, Georgetown University Medical Center, Washington, DC
| | - Lisa R. Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | | | - Tracey E. Wilson
- Department of Community Health Sciences, School of Public Health, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY
| | - Adaora A. Adimora
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
- Division of Infectious Diseases, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC
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9
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Burgos Ochoa L, Bertens LCM, Garcia-Gomez P, Van Ourti T, Steegers EAP, Been JV. Association of neighbourhood socioeconomic trajectories with preterm birth and small-for-gestational-age in the Netherlands: a nationwide population-based study. THE LANCET REGIONAL HEALTH. EUROPE 2021; 10:100205. [PMID: 34806067 PMCID: PMC8589710 DOI: 10.1016/j.lanepe.2021.100205] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adverse birth outcomes have serious health consequences, not only during infancy but throughout the entire life course. Most evidence linking neighbourhood socioeconomic status (SES) to birth outcomes is based on cross-sectional SES measures, which do not reflect neighbourhoods' dynamic nature. We investigated the association between neighbourhood SES trajectories and adverse birth outcomes, i.e. preterm birth and being small-for-gestational-age (SGA), for births occurring in the Netherlands between 2003 and 2017. METHODS We linked individual-level data from the Dutch perinatal registry to the Netherlands Institute for Social Research neighbourhood SES scores. Based on changes in their SES across four-year periods, neighbourhoods were categorised into seven trajectories. To investigate the association between neighbourhood SES trajectories and birth outcomes we used adjusted multilevel logistic regression models. FINDINGS Data on 2 334 036 singleton births were available for analysis. Women living in stable low-SES neighbourhoods had higher odds of preterm birth (OR[95%CI]= 1·12[1·07-1·17]) and SGA (OR[95%CI]= 1·19[1·15-1·23]), compared to those in high SES areas. Higher odds of preterm birth (OR[95%CI]= 1·12[1·05-1·20]) and SGA (OR[95%CI]=1·12[1·06-1·18]) were also observed for those living in areas declining to low SES. Women living in a neighbourhood where SES improved from low to medium showed higher odds of preterm birth (OR[95%CI]= 1·09[1·02-1·18]), but not of SGA (OR[95%CI]= 1·04[0.98-1·10]). The odds of preterm or SGA birth in other areas were comparable to those seen in high SES areas. INTERPRETATION In the Netherlands, disadvantaged neighbourhood SES trajectories were associated with higher odds of adverse birth outcomes. Longitudinal neighbourhood SES measures should also be taken into account when selecting a target population for public health interventions. FUNDING Erasmus Initiative Smarter Choices for Better Health.
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Affiliation(s)
- Lizbeth Burgos Ochoa
- Department of Obstetrics and Gynaecology, Erasmus MC – Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Loes CM Bertens
- Department of Obstetrics and Gynaecology, Erasmus MC – Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Pilar Garcia-Gomez
- Erasmus School of Economics, Tinbergen Institute and Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Tom Van Ourti
- Erasmus School of Economics, Tinbergen Institute and Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Eric AP Steegers
- Department of Obstetrics and Gynaecology, Erasmus MC – Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Jasper V Been
- Department of Obstetrics and Gynaecology, Erasmus MC – Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Division of Neonatology, Department of Paediatrics, Erasmus MC – Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, Netherlands
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
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Kim Y, Cubbin C. Neighborhood Poverty Histories and Physical Activity Among Children: Findings From the Geographic Research on Wellbeing (GROW) Study. Am J Health Promot 2020; 34:876-885. [PMID: 32390465 PMCID: PMC7839318 DOI: 10.1177/0890117120923948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Examine the association between neighborhood poverty histories and physical activity, and the moderation effect of family poverty and the mediation effect of built environments in such association. DESIGN A cross-sectional study of the Geographic Research on Wellbeing (2012-2013), a follow-up survey of statewide-representative Maternal and Infant Health Assessment (2003-2007). SETTING California. PARTICIPANTS A total of 2493 women with children. MEASURES Outcome measures are (1) daily leisure physical activity and (2) days of physical activity among children. An independent variable is poverty histories of census tract where the child resided. Mediators were mother-perceived social cohesion, mother-perceived neighborhood safety, distance to the closest park, and park acreage within 0.5 miles from the home. A moderator is family poverty. ANALYSIS Weighted regression analysis. RESULTS Family poverty was a significant moderator (P < .05); poor children in neighborhoods with long-term moderate poverty, long-term high poverty, or increasing poverty (vs long-term low poverty) had greater odds of daily physical activity (odds ratio [OR] = 1.46, 1.50, 1.66, respectively). Nonpoor children in neighborhoods with long-term moderate poverty or increasing poverty (vs long-term low poverty) were associated with decreased odds of daily physical activity (OR = 0.61 and 0.44, respectively). Mediation associations were insignificant (P > .05). CONCLUSION The combined effect of family financial strains and neighborhood economic resources might prevent poor children in neighborhoods with long-term low poverty and decreasing poverty from utilizing health-promoting resources in neighborhoods.
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Affiliation(s)
- Yeonwoo Kim
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Catherine Cubbin
- Steve Hicks School of Social Work, The University of Texas at Austin, TX, USA
- Population Research Center, The University of Texas at Austin, TX, USA
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Luo R, Mukherjee N, Chen S, Jiang Y, Arshad SH, Holloway JW, Hedman A, Gruzieva O, Andolf E, Pershagen G, Almqvist C, Karmaus WJ. Paternal DNA Methylation May Be Associated With Gestational Age at Birth. Epigenet Insights 2020; 13:2516865720930701. [PMID: 32964196 PMCID: PMC7488897 DOI: 10.1177/2516865720930701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/09/2020] [Indexed: 11/15/2022] Open
Abstract
Background: How epigenetic modifications of DNA are associated with gestational age at birth is not fully understood. We investigated potential effects of differential paternal DNA methylation (DNAm) on offspring gestational age at birth by conducting an epigenome-wide search for cytosine-phosphate-guanine (CpG) sites. Methods: Study participants in this study consist of male cohort members or partners of the F1-generation of the Isle of Wight Birth Cohort (IoWBC). DNAm levels in peripheral blood from F1-fathers (n = 92) collected around pregnancy of their spouses were analyzed using the Illumina 450K array. A 5-step statistical analysis was performed. First, a training-testing screening approach was applied to select CpG sites that are potentially associated with gestational age at birth. Second, functional enrichment analysis was employed to identify biological processes. Third, by centralizing on biologically informative genes, Cox proportional hazards models were used to assess the hazard ratios of individual paternal CpGs on gestational age adjusting for confounders. Fourth, to assess the validity of our results, we compared our CpG-gestational age correlations within a Born into Life Study in Sweden (n = 15). Finally, we investigated the correlation between the detected CpGs and differential gene expression in F2 cord blood in the IoWBC. Results: Analysis of DNAm of fathers collected around their partner’s pregnancy identified 216 CpG sites significantly associated with gestational age at birth. Functional enrichment pathways analyses of the annotated genes revealed 2 biological pathways significantly related to cell-cell membrane adhesion molecules. Differential methylation of 9 cell membrane adhesion pathway-related CpGs were significantly associated with gestational age at birth after adjustment for confounders. The replication sample showed correlation coefficients of 2 pathway-related CpGs with gestational age at birth within 95% confidence intervals of correlation coefficients in IoWBC. Finally, CpG sites of protocadherin (PCDH) gene clusters were associated with gene expression of PCDH in F2 cord blood. Conclusions: Our findings suggest that differential paternal DNAm may affect gestational age at birth through cell-cell membrane adhesion molecules. The results are novel but require future replication in a larger cohort.
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Affiliation(s)
- Rui Luo
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Nandini Mukherjee
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Su Chen
- Department of Mathematical Sciences, University of Memphis, Memphis, TN, USA
| | - Yu Jiang
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
| | - S Hasan Arshad
- The David Hide Asthma and Allergy Research Centre, Newport, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anna Hedman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Olena Gruzieva
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Ellika Andolf
- Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - Goran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Unit of Pediatric Allergy and Pulmonology at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Wilfried Jj Karmaus
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
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12
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Exposure to Community Homicide During Pregnancy and Adverse Birth Outcomes: A Within-Community Matched Design. Epidemiology 2020; 30:713-722. [PMID: 31180933 DOI: 10.1097/ede.0000000000001044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Community violence is an understudied aspect of social context that may affect risk of preterm birth and small-for-gestational age (SGA). METHODS We matched California mothers with live singleton births who were exposed to a homicide in their Census tract of residence in 2007-2011 to unexposed mothers within the same tract. We estimated risk differences with a weighted linear probability model, with weights corresponding to the matched data structure. We estimated the average treatment effect on the treated of homicide exposure on the risk of preterm birth and SGA during the preconception period and first and second trimester. RESULTS We found a small increase in risk of SGA associated with homicide exposure in the first trimester (0.14% [95% confidence interval (CI) = -0.01%, 0.30%]), but not for exposure during the preconception period (-0.01% [95% CI = -0.17%, 0.15%]) or the second trimester (-0.06% [95% CI = -0.23%, 0.11%]). Risk of preterm birth was not affected by homicide exposure. When women were exposed to homicides during all three exposure windows, there was a larger increase in risk of SGA (1.09% [95% CI = 0.15%, 2.03%]) but not preterm birth (0.14% [95% CI = -0.74%, 1.01%]). Exposure to three or more homicides was also associated with greater risk of SGA (0.78% [95% CI = 0.15%, 1.40%]). Negative controls indicated that residual confounding by temporal patterning was unlikely. CONCLUSIONS Homicide exposure during early pregnancy is associated with a small increased risk of SGA.
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13
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Abstract
Studies of the effect of neighborhood poverty on health are dominated by research designs that measure neighborhood poverty at a single point in time, ignoring the potential influence of exposure to neighborhood poverty over the life course. Applying latent class analysis to restricted residential history data from the National Longitudinal Survey of Youth, 1979 Cohort, we identify four trajectories of life-course exposure to high-poverty neighborhoods between adolescence and midlife and then examine how these groups differ in their physical health conditions (SF-12 score) and self-rated health at around age 40. Linear and logistic regression analyses show that life-course exposure to high-poverty neighborhoods is a stronger predictor of midlife physical health than are point-in-time measures of neighborhood poverty observed during either adolescence or midlife. Our findings suggest that a life-course approach can enhance our understanding of how neighborhood poverty affects physical health.
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Affiliation(s)
- Tse-Chuan Yang
- University at Albany, State University of New York, Albany, NY, USA.
| | - Scott J South
- University at Albany, State University of New York, Albany, NY, USA
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14
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Living in High-SES Neighborhoods Is Protective against Obesity among Higher-Income Children but Not Low-Income Children: Results from the Healthy Communities Study. J Urban Health 2020; 97:175-190. [PMID: 32107723 PMCID: PMC7101452 DOI: 10.1007/s11524-020-00427-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Numerous studies have focused on the role of neighborhood socioeconomic status in childhood obesity and physical activity, but few studies have examined the effect of neighborhood socioeconomic changes over time and the interaction between family and neighborhood SES on childhood obesity and physical activity. This study measured neighborhood socioeconomic histories between 2000 and 2010 and examined the associations between neighborhood socioeconomic histories and childhood obesity, as well as physical activity. The moderating role of family poverty status was also examined. Using the Healthy Communities Study (2013-2015), we measured obesity indicators (objectively measured body mass index z-score and waist circumference) and a physical activity indicator (self-reported moderate-to-vigorous physical activity) for a cohort of 4114 children. Multilevel linear regression models were used to examine the associations between neighborhood socioeconomic histories between 2000 and 2009-2013 and body-mass index z-score, waist circumference, and moderate-to-vigorous physical activity. Results showed that higher-income children in consistently high socioeconomic neighborhoods had lower measured BMIz and WC and engaged in more moderate-to-vigorous physical activity than higher-income children in consistently low socioeconomic neighborhoods. Additionally, low-income children in consistently moderate socioeconomic neighborhoods reported a lower level of moderate-to-vigorous physical activity than low-income children in consistently low socioeconomic neighborhoods. The findings indicate that considering both family and neighborhood socioeconomic status may help elucidate the underlying differences in childhood obesity and physical activity levels by socioeconomic status.
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15
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Kim Y, Vohra-Gupta S, Margerison CE, Cubbin C. Neighborhood Racial/Ethnic Composition Trajectories and Black-White Differences in Preterm Birth among Women in Texas. J Urban Health 2020; 97:37-51. [PMID: 31898203 PMCID: PMC7010896 DOI: 10.1007/s11524-019-00411-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The black-white disparity in preterm birth has been well documented in the USA. The racial/ethnic composition of a neighborhood, as a marker of segregation, has been considered as an underlying cause of the racial difference in preterm birth. However, past literature using cross-sectional measures of neighborhood racial/ethnic composition has shown mixed results. Neighborhoods with static racial/ethnic compositions over time may have different social, political, economic, and service environments compared to neighborhoods undergoing changing racial/ethnic compositions, which may affect maternal health. We extend the past work by examining the contribution of neighborhood racial/ethnic composition trajectories over 20 years to the black-white difference in preterm birth. We used natality files (N = 477,652) from birth certificates for all live singleton births to non-Hispanic black and non-Hispanic white women in Texas from 2009 to 2011 linked to the Neighborhood Change Database. We measured neighborhood racial/ethnic trajectories over 20 years. Hierarchical generalized linear models examined relationships between neighborhood racial/ethnic trajectories and preterm birth, overall and by mother's race. Findings showed that overall, living in neighborhoods with a steady high proportion non-Hispanic black was associated with higher odds of preterm birth, compared with neighborhoods with a steady low proportion non-Hispanic black. Furthermore, while black women's odds of preterm birth was relatively unaffected by neighborhood proportions of the Latinx or non-Hispanic white population, white women had the highest odds of preterm birth in neighborhoods characterized by a steady high proportion Latinx or a steady low proportion non-Hispanic white. Black-white differences were the highest in neighborhoods characterized by a steady high proportion white. Findings suggest that white women are most protected from preterm birth when living in neighborhoods with a steady high concentration of whites or in neighborhoods with a steady low concentration of Latinxs, whereas black women experience high rates of preterm birth regardless of proportion white or Latinx.
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Affiliation(s)
- Yeonwoo Kim
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA.,Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Shetal Vohra-Gupta
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Claire E Margerison
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Catherine Cubbin
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA. .,Population Research Center, The University of Texas at Austin, Austin, TX, USA.
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16
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Cubbin C, Kim Y, Vohra-Gupta S, Margerison C. Longitudinal measures of neighborhood poverty and income inequality are associated with adverse birth outcomes in Texas. Soc Sci Med 2019; 245:112665. [PMID: 31778899 DOI: 10.1016/j.socscimed.2019.112665] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 10/30/2019] [Accepted: 11/03/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Inequity in adverse birth outcomes between black and white women in the U.S. is persistent, despite decades of research and prevention efforts. Neighborhood environments are plausibly related to pre-pregnancy health and other risk factors for adverse birth outcomes and may help explain black/white inequities. Despite the fact that neighborhoods change over time, most prior work has relied upon cross-sectional measures of neighborhood economic contexts. METHODS We used birth certificates for non-Hispanic black and white women in Texas (2009-2011, N = 470,896) to examine whether longitudinal measures of neighborhood economic context (poverty and income inequality, based on census tract data from 1990 to 2010) were associated with preterm birth, low birthweight and small-for-gestational-age (SGA) with hierarchical generalized linear models. We also tested whether (1) the longitudinal measures explained black/white inequities or (2) moderated the effect of race on the birth outcomes. Finally, we compared the models with longitudinal measures to models with cross-sectional measures of neighborhood economic context. RESULTS Longitudinal measures of neighborhood economic context were associated with all three birth outcomes, but did not explain racial inequities. Except for income inequality and SGA, there was no evidence of moderation by race. Substituting cross-sectional measures of economic context for longitudinal ones resulted in similar findings. CONCLUSION Policies that either address structural neighborhood-level economic disadvantage or mitigate the effects of such disadvantage are warranted to improve the health of mothers and prevent adverse birth outcomes.
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Affiliation(s)
- Catherine Cubbin
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA.
| | - Yeonwoo Kim
- School of Kinesiology, University of Michigan, 1402 Washington Heights, Ann Arbor, MI, 48109-2013, USA
| | - Shetal Vohra-Gupta
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX, 78712, USA
| | - Claire Margerison
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Wilson Road, Room B601, East Lansing, MI, 48824, USA
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17
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Cantu P, Kim Y, Sheehan C, Powers D, Margerison CE, Cubbin C. Downward Neighborhood Poverty Mobility during Childhood Is Associated with Child Asthma: Evidence from the Geographic Research on Wellbeing (GROW) Survey. J Urban Health 2019; 96:558-569. [PMID: 31049846 PMCID: PMC6890910 DOI: 10.1007/s11524-019-00356-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Causal evidence regarding neighborhood effects on health remains tenuous. Given that children have little agency in deciding where they live and spend proportionally more of their lives in neighborhoods than adults, their exposure to neighborhood conditions could make their health particularly sensitive to neighborhood effects. In this paper, we examine the relationship between exposure to poor neighborhoods from birth to ages 4-10 and childhood asthma. We used data from the 2003-2007 California Maternal Infant and Health Assessment (MIHA) and the 2012-2013 Geographic Research on Wellbeing (GROW) survey (N = 2619 mother/child dyads) to fit relative risks of asthma for children who experience different types of neighborhood poverty mobility using Poisson regression controlling for individual-level demographic and socioeconomic characteristics, and neighborhood satisfaction. Our results demonstrate that [1] living in a poor neighborhood at baseline and follow-up and [2] moving into a poor neighborhood were each associated with higher risk of asthma, compared with children not living in a poor neighborhood at either time. Exposure to impoverished neighborhoods and downward neighborhood poverty mobility matters for children's health, particularly for asthma. Public health practitioners and policymakers need to address downward neighborhood economic mobility, in addition to downward family economic mobility, in order to improve children's health.
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Affiliation(s)
- P Cantu
- Population Research Center, The University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX, 78712, USA.,Department of Sociology, The University of Texas at Austin, Austin, TX, USA
| | - Y Kim
- School of Kinesiology and Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - C Sheehan
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - D Powers
- Population Research Center, The University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX, 78712, USA.,Department of Sociology, The University of Texas at Austin, Austin, TX, USA
| | - C E Margerison
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Catherine Cubbin
- Population Research Center, The University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX, 78712, USA. .,Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX, 78712, USA.
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18
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Bruckner TA, Kane JB, Gailey S. Strong upward neighborhood mobility and preterm birth: a matched-sibling design approach. Ann Epidemiol 2019; 36:48-54.e1. [PMID: 31324410 DOI: 10.1016/j.annepidem.2019.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/10/2019] [Accepted: 05/31/2019] [Indexed: 01/05/2023]
Abstract
PURPOSE Much cross-sectional work reports an association between neighborhood disadvantage and adverse birth outcomes. Limitations of this work include that mothers with pre-existing unmeasured morbidity may "select" into, or out of, certain neighborhoods. This selection issue remains a key rival explanation for work concerned with place-based disparities in birth outcomes. We move beyond a cross-sectional approach and exploit a sibling-linked data set in California to test whether upwardly mobile mothers, who move from a very high to a very low disadvantaged neighborhood, exhibit a lower than expected risk of preterm birth (PTB) (i.e., delivery <37 weeks). METHODS We used a matched-sibling design for 461,061 sibling pairs (i.e., 922,122 births total) to mothers in urban areas in who gave birth in California from 2005 to 2010. We linked mother's address at two time points (i.e., two sibling birth dates) to a census-derived composite indicator of neighborhood disadvantage. Conditional logistic regression methods controlled for mother's risk of PTB in the sibling delivered before the move when estimating the relation between strong upward mobility and preterm of the subsequent birth after the move. RESULTS As hypothesized, strong upward mobility (relative to no mobility) varies inversely with the odds of PTB of the second sibling (odds ratio [OR] for PTB = 0.83, 95% confidence interval: 0.74, 0.93). CONCLUSIONS Mothers moving from very high to very low disadvantaged neighborhoods show a reduced odds of PTB. Our findings, if replicated, raise the possibility that improvements in neighborhood quality may improve perinatal health in a relatively short time span.
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Affiliation(s)
- Tim A Bruckner
- Program in Public Health, College of Health Sciences, University of California, Irvine.
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19
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Kim Y, Lee S, Jung H, Jaime J, Cubbin C. Is neighborhood poverty harmful to every child? Neighborhood poverty, family poverty, and behavioral problems among young children. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:594-610. [PMID: 30417383 PMCID: PMC6652175 DOI: 10.1002/jcop.22140] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 10/13/2018] [Accepted: 10/14/2018] [Indexed: 05/30/2023]
Abstract
This longitudinal study investigates the association between neighborhood poverty and behavioral problems among young children. This study also examines whether social environments mediate the relationship between neighborhood poverty and behavioral problems. We used data from the third and fourth waves of the Fragile Families and Child Wellbeing study to assess behavioral problems separately for children who experienced no family poverty, moved out of family poverty, moved into family poverty, and experienced long-term family poverty. Regression models assessed the effect of neighborhood poverty on behavioral problem outcomes among children aged 5 years, after controlling for sociodemographic characteristics and earlier behavioral problems. Results showed an association between neighborhood poverty and lower social cohesion and safety, which lead to greater externalizing problems among children with long-term family poverty living in high-poverty neighborhoods compared with those in low-poverty neighborhoods. Policies and community resources need to be allocated to improve neighborhood social environments, particularly for poor children in high-poverty neighborhoods.
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20
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Xiao Q, Berrigan D, Powell-Wiley TM, Matthews CE. Ten-Year Change in Neighborhood Socioeconomic Deprivation and Rates of Total, Cardiovascular Disease, and Cancer Mortality in Older US Adults. Am J Epidemiol 2018; 187:2642-2650. [PMID: 30137194 DOI: 10.1093/aje/kwy181] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 08/14/2018] [Indexed: 12/24/2022] Open
Abstract
Low neighborhood socioeconomic status has been linked to adverse health outcomes. However, it is unclear whether changing the neighborhood may influence health. We examined 10-year change in neighborhood socioeconomic deprivation in relation to mortality rate among 288,555 participants aged 51-70 years who enrolled in the National Institutes of Health-AARP Diet and Health Study in 1995-1996 (baseline) and did not move during the study. Changes in neighborhood socioeconomic deprivation between 1990 and 2000 were measured by US Census data at the census tract level. All-cause, cardiovascular disease, and cancer deaths were ascertained through annual linkage to the Social Security Administration Death Master File between 2000 and 2011. Overall, our results suggested that improvement in neighborhood socioeconomic status was associated with a lower mortality rate, while deterioration was associated with a higher mortality rate. More specially, a 30-percentile-point reduction in neighborhood deprivation among more deprived neighborhoods was associated with 11% and 19% reductions in the total mortality rate among men and women, respectively. On the other hand, a 30-point increase in neighborhood deprivation in less deprived neighborhoods was associated with an 11% increase in the mortality rate among men. Our findings support a longitudinal association between changing neighborhood conditions and mortality.
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Affiliation(s)
- Qian Xiao
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Iowa City, Iowa
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - David Berrigan
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Tiffany M Powell-Wiley
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland
- Intramural Research Program of the National Institute of Minority Health and Health Disparities, Bethesda, Maryland
| | - Charles E Matthews
- Metabolic Epidemiological Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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21
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Huang H, Woodruff TJ, Baer RJ, Bangia K, August LM, Jellife-Palowski LL, Padula AM, Sirota M. Investigation of association between environmental and socioeconomic factors and preterm birth in California. ENVIRONMENT INTERNATIONAL 2018; 121:1066-1078. [PMID: 30075861 PMCID: PMC6638551 DOI: 10.1016/j.envint.2018.07.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/27/2018] [Accepted: 07/17/2018] [Indexed: 05/29/2023]
Abstract
BACKGROUND Preterm birth (PTB),2 defined as birth at gestational age <37 weeks, is a major public health concern. Infants born prematurely, comprising of about 10% of the US newborns, have elevated risks of neonatal mortality and a wide array of health problems. Although numerous clinical, genetic, environmental and socioeconomic factors have been implicated in PTB, very few studies investigate the impacts of multiple pollutants and social factors on PTB using large scale datasets. OBJECTIVES To evaluate association between environmental and socioeconomic factors and PTB in California. METHODS We linked the birth cohort file maintained by the California Office of Statewide Health Planning and Development from 2009 to 2012 years across 1.8 million births and the CalEnviroScreen 3.0 dataset from California Communities Environmental Health Screening Tool at the census tract level for 56 California counties. CalEnviroScreen contains 7 exposure and 5 environmental effects variables that constitute the Pollution Burden variable, and 5 socioeconomic variables. We evaluated relationships between environmental exposures and the risk of PTB using hierarchical clustering analyses and GIS-based visualization. We also used logistic regression to evaluate the relationship between specific pollutant and exposure indicators and PTB, accounted for socio-demographic determinants such as maternal race/ethnicity, maternal age, maternal education and payment of delivery costs. RESULTS There exists geographic variability in PTB for groups of counties with similar environmental and social exposure profiles. We found an association between Pollution Burden, particulate matter ≤2.5 μm (PM2.5), and Drinking Water Scores and PTB (adjusted odds ratios were 1.03 (95% Confidence Interval (CI): 1.01, 1.04), 1.03 (95% CI: 1.02,1.04), and 1.04 (95% CI: 1.03,1.05), respectively). Additional findings suggest that certain drinking water contaminants such as arsenic and nitrate are associated with PTB in California. CONCLUSIONS CalEnviroScreen data combined with birth records offer great opportunity for revealing novel exposures and evaluating cumulative exposures related to PTB by providing useful environmental and social information. Certain drinking water contaminants such as arsenic and nitrate are potentially associated with PTB in California and should be investigated further. Small association signals may involve sizeable population impacts.
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Affiliation(s)
- Hongtai Huang
- Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA; Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Rebecca J Baer
- Department of Pediatrics, University of California, San Diego, CA, USA; California Preterm Birth Initiative, University of California, San Francisco, CA, USA
| | - Komal Bangia
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Sacramento, CA, USA
| | - Laura M August
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Sacramento, CA, USA
| | - Laura L Jellife-Palowski
- California Preterm Birth Initiative, University of California, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Amy M Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Marina Sirota
- Bakar Computational Health Sciences Institute, University of California, San Francisco, CA, USA; Department of Pediatrics, University of California, San Francisco, CA, USA.
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22
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Zhang D, Matthews CE, Powell-Wiley TM, Xiao Q. Ten-year change in neighborhood socioeconomic status and colorectal cancer. Cancer 2018; 125:610-617. [PMID: 30423200 DOI: 10.1002/cncr.31832] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/02/2018] [Accepted: 10/05/2018] [Indexed: 11/05/2022]
Abstract
BACKGROUND A growing body of research has demonstrated that individuals who live in neighborhoods with more severe socioeconomic deprivation may have higher risks for colorectal cancer (CRC). However, previous studies have examined neighborhood socioeconomic status (SES) at only 1 point in time, and it is unclear whether changes in neighborhood SES also can influence the risks of CRC. METHODS Cox regression analysis was used to examine different trajectories of change in neighborhood SES over 10 years in relation to the incidence of CRC among 266,804 participants (ages 51-70 years) in the National Institutes of Health-AARP Diet and Health Study. Eligible participants reported living in the same neighborhood at baseline (1995-1996) and from 2004 to 2006 according to a follow-up questionnaire. Changes in neighborhood SES were measured between 1990 and 2000 by SES indices derived from Census data. Neighborhoods were grouped into 4 categories based on median SES indices in 1990 and 2000 (low-low, low-high, high-low, and high-high). RESULTS Compared with residents whose neighborhoods were in the higher SES group at both time points (reference category), those whose neighborhoods were consistently in the low SES group had a 7% higher risk of developing CRC (hazard ratio, 1.07; 95% confidence interval, 1.00-1.14). Moreover, the risk of CRC was 15% higher (hazard ratio, 1.15; 95% confidence interval, 1.02-1.28) for those living in neighborhoods with decreasing SES (high-low) over time. CONCLUSIONS The current findings suggest that exposure to consistently low SES neighborhoods and/or a decrease in neighborhood SES over a period of time may be associated with higher risks of CRC.
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Affiliation(s)
- Dong Zhang
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
| | - Charles E Matthews
- Department of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Tiffany M Powell-Wiley
- National Heart, Lung, and Blood Institute, Bethesda, Maryland.,National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - Qian Xiao
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
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23
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Sheehan C, Powers D, Margerison-Zilko C, McDevitt T, Cubbin C. Historical neighborhood poverty trajectories and child sleep. Sleep Health 2018; 4:127-134. [PMID: 29555124 PMCID: PMC5863576 DOI: 10.1016/j.sleh.2017.12.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/07/2017] [Accepted: 12/12/2017] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To determine whether historical neighborhood poverty measures are associated with mothers' reports of their children's sleep duration and to compare results from historical neighborhood poverty measures to contemporaneous measures of neighborhood poverty. DESIGN The Geographic Research on Wellbeing (GROW) study is a follow-up survey of mothers who gave birth between 2003 and 2007. GROW mothers assessed their own and their children's health and health behaviors 5-10 years later (2012-2013). SETTING Urban Californian counties. PARTICIPANTS GROW respondents. MEASUREMENTS We categorized children's sleep as adequate or inadequate using clinical age-specific guidelines and based on mothers' reports of their child's sleep duration. We conducted a latent class analysis to identify historical poverty classes for all California census tracts using data from 1970 to 2005-2009, and we categorized current neighborhood poverty based on data from 2005 to 2009 only. We then assigned children to different neighborhood exposure classes based on their neighborhood of residence at birth and follow-up. RESULTS Logistic models indicated that net of controls for demographics, child behavior and health characteristics, mother characteristics, and household socioeconomic status, children who grew up in historically low (OR: 0.64, 95% confidence interval=0.45-0.92) or historically moderate poverty classes (OR: 0.68, 95% confidence interval=0.48-0.98) had lower odds of inadequate sleep duration compared with children who grew up in historically high poverty. We show that the historical specification of neighborhood poverty remained significant despite controls, whereas contemporaneous measures of neighborhood poverty did not. CONCLUSIONS Our findings indicate strong associations between historical neighborhood poverty and child sleep duration.
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Affiliation(s)
- Connor Sheehan
- Leonard Davis School of Gerontology, University of Southern California.
| | - Daniel Powers
- Department of Sociology and Population Research Center, University of Texas at Austin
| | | | - Teresa McDevitt
- School of Psychological Sciences, University of Northern Colorado
| | - Catherine Cubbin
- School of Social Work and Population Research Center, University of Texas at Austin
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Kramer MR, Schneider EB, Kane JB, Margerison-Zilko C, Jones-Smith J, King K, Davis-Kean P, Grzywacz JG. Getting Under the Skin: Children's Health Disparities as Embodiment of Social Class. POPULATION RESEARCH AND POLICY REVIEW 2017; 36:671-697. [PMID: 29398742 PMCID: PMC5791911 DOI: 10.1007/s11113-017-9431-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 03/02/2017] [Indexed: 10/19/2022]
Abstract
Social class gradients in children's health and development are ubiquitous across time and geography. The authors develop a conceptual framework relating three actions of class-material allocation, salient group identity, and inter-group conflict-to the reproduction of class-based disparities in child health. A core proposition is that the actions of class stratification create variation in children's mesosystems and microsystems in distinct locations in the ecology of everyday life. Variation in mesosystems (e.g., health care, neighborhoods) and microsystems (e.g., family structure, housing) become manifest in a wide variety of specific experiences and environments that produce the behavioral and biological antecedents to health and disease among children. The framework is explored via a review of theoretical and empirical contributions from multiple disciplines and high-priority areas for future research are highlighted.
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Affiliation(s)
- Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322
| | - Eric B Schneider
- Department of Economic History, London School of Economics and Political Science
| | | | - Claire Margerison-Zilko
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University
| | - Jessica Jones-Smith
- Department of International Health, Johns Hopkins Bloomberg School of Public Health
| | - Katherine King
- Department of Community and Family Medicine, Duke University
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25
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Kim Y, Cubbin C. The role of neighborhood economic context on physical activity among children: Evidence from the Geographic Research on Wellbeing (GROW) study. Prev Med 2017; 101:149-155. [PMID: 28601623 PMCID: PMC10627422 DOI: 10.1016/j.ypmed.2017.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 05/10/2017] [Accepted: 06/05/2017] [Indexed: 11/22/2022]
Abstract
Less than half of young children in the U.S. meet physical activity recommendations. While neighborhood economic context has been shown to be associated with physical activity, it is unknown whether this association varies according to family economic context. This study thus investigates whether neighborhood economic context, measured by poverty concentration and income inequality, are associated with physical activity among poor and non-poor children using data from the Geographic Research on Wellbeing study, California, 2012-2013 (N=2670). Poor children who resided in (a) poor and equal neighborhoods or (b) non-poor and equal neighborhoods were more likely to engage in sufficient physical activity than were children residing in non-poor and unequal neighborhoods. Poor children in (a) non-poor and equal neighborhoods, (b) poor and equal neighborhoods, or (c) poor and unequal neighborhoods were less likely to report insufficient physical activity than those in non-poor and unequal neighborhoods. Neighborhood economic context was not associated with physical activity among non-poor children. Findings suggest that neighborhood economic context presents a social barrier to physical activity among poor children. Increasing physical activity among poor children in non-poor and unequal neighborhoods should be a high policy priority. Perceived social cohesion, perceived neighborhood safety, and park and walkability indicators did not mediate the associations between neighborhood economic context and physical activity. Further research needs to explore the mechanisms by which neighborhood economic context affects physical activity among children.
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Affiliation(s)
- Yeonwoo Kim
- School of Social Work, The University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX 78712, USA.
| | - Catherine Cubbin
- School of Social Work, The University of Texas at Austin, 1925 San Jacinto Boulevard, Austin, TX 78712, USA; Population Research Center, The University of Texas at Austin, 305 E. 23rd Street Stop G1800, Austin, TX 78712, USA.
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26
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Sheehan CM, Cantu PA, Powers DA, Margerison-Zilko CE, Cubbin C. Long-term neighborhood poverty trajectories and obesity in a sample of california mothers. Health Place 2017; 46:49-57. [PMID: 28499148 DOI: 10.1016/j.healthplace.2017.04.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 03/14/2017] [Accepted: 04/08/2017] [Indexed: 01/10/2023]
Abstract
Neighborhoods (and people) are not static, and are instead shaped by dynamic long-term processes of change (and mobility). Using the Geographic Research on Wellbeing survey, a population-based sample of 2339 Californian mothers, we characterize then investigate how long-term latent neighborhood poverty trajectories predict the likelihood of obesity, taking into account short-term individual residential mobility. We find that, net of individual and neighborhood-level controls, living in or moving to tracts that experienced long-term low poverty was associated with lower odds of being obese relative to living in tracts characterized by long-term high poverty.
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Affiliation(s)
- Connor M Sheehan
- Department of Sociology and Population Research Center, University of Texas at Austin, USA.
| | - Phillip A Cantu
- Department of Sociology and Population Research Center, University of Texas at Austin, USA
| | - Daniel A Powers
- Department of Sociology and Population Research Center, University of Texas at Austin, USA
| | | | - Catherine Cubbin
- School of Social Work and Population Research Center, University of Texas at Austin, USA
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27
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Misra DP, Slaughter-Acey J, Giurgescu C, Sealy-Jefferson S, Nowak A. Why Do Black Women Experience Higher Rates of Preterm Birth? CURR EPIDEMIOL REP 2017. [DOI: 10.1007/s40471-017-0102-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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28
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Theoretical Insights into Preconception Social Conditions and Perinatal Health: The Role of Place and Social Relationships. POPULATION RESEARCH AND POLICY REVIEW 2017; 36:639-669. [PMID: 29398741 DOI: 10.1007/s11113-017-9430-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Recent efforts to explain the stark social and racial disparities in adverse birth outcomes that have persisted for decades in the U.S. have looked beyond prenatal factors, to explore preconception social conditions that may influence perinatal health via dysregulation of physiologic processes. The extant evidence supporting this link however remains limited, both due to a lack of data and theory. To address the latter, this manuscript generates a structured set of theoretical insights that further develop the link between two preconception social conditions - place and social relationships - and perinatal health. The insights propose the following. PLACE necessarily encompasses all social contexts to which females are exposed from infancy through young adulthood; encompasses a variety of related exposures that, when possible, should be jointly considered; and may compound the effect of poverty-in childhood, adolescence, or young adulthood-on perinatal health. Social relationships: span relationships from early life through adulthood, and extend to intergenerational associations; often involve (or induce) major changes in the lives of individuals and should be examined with an emphasis on the developmental stage in which the change occurred; and necessarily encompass a lack of social integration, or, social isolation. We also identify potential biological and social-structural mechanisms linking these preconception social conditions to perinatal health, and conclude by identifying promising directions for future research.
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29
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Walsemann KM, Child S, Heck K, Margerison-Zilko C, Braveman P, Marchi K, Cubbin C. Are the poverty histories of neighbourhoods associated with psychosocial well-being among a representative sample of California mothers? An observational study. J Epidemiol Community Health 2017; 71:558-564. [PMID: 28130392 DOI: 10.1136/jech-2016-207866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 12/08/2016] [Accepted: 01/04/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND We examine the association between the poverty histories of neighbourhoods and three indicators of psychosocial well-being-depressive symptoms, sense of control and number of stressors-in an observational study of mothers of young children in California. We also consider if length of residence in a neighbourhood moderates the association between neighbourhood poverty history and psychosocial well-being. METHODS Data come from the Geographic Research on Well-being (GROW) Study, a subsample of mothers who completed the population-based California Maternal and Infant Health Assessment in 2003-2007 and were reinterviewed in 2012-2013. Poverty histories of neighbourhoods were constructed using the Neighbourhood Change Database (1970-2000) and American Community Survey (2005-2009). The analytic sample included 2726 women from GROW residing in 1906 census tracts. RESULTS Adjusting for individual socioeconomic and demographic characteristics, women living in neighbourhoods where poverty decreased over the 40-year period had lower odds of depressive symptoms and a greater sense of control than women living in long-term, low-poverty neighbourhoods. Women living in long-term high-poverty neighbourhoods or in neighbourhoods where poverty increased over the 40-year period reported lower sense of control than women living in long-term, low-poverty neighbourhoods and these effects were modified by length of time living in the neighbourhood. No significant effects of neighbourhood poverty histories were found for number of stressors. CONCLUSIONS Policies aimed at reducing neighbourhood poverty may improve mothers' psychosocial well-being.
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Affiliation(s)
- Katrina M Walsemann
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | - Stephanie Child
- Department of Sociology, University of California, Berkeley, California, USA
| | - Katherine Heck
- Department of Family & Community Medicine, University of California San Francisco, San Francisco, California, USA
| | - Claire Margerison-Zilko
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Paula Braveman
- Department of Family & Community Medicine, University of California San Francisco, San Francisco, California, USA
| | - Kristen Marchi
- Department of Family & Community Medicine, University of California San Francisco, San Francisco, California, USA
| | - Catherine Cubbin
- School of Social Work, University of Texas at Austin, Austin, Texas, USA
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30
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Baugh N, Harris DE, Aboueissa AM, Sarton C, Lichter E. The Impact of Maternal Obesity and Excessive Gestational Weight Gain on Maternal and Infant Outcomes in Maine: Analysis of Pregnancy Risk Assessment Monitoring System Results from 2000 to 2010. J Pregnancy 2016; 2016:5871313. [PMID: 27747104 PMCID: PMC5055984 DOI: 10.1155/2016/5871313] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 07/30/2016] [Accepted: 08/02/2016] [Indexed: 11/18/2022] Open
Abstract
The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000-2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG. Dependent variables included maternal hypertension, premature birth, birth weight, infant admission to the intensive care unit (ICU), and length of hospital stay of the infant. Excessive prepregnancy BMI and excessive GWG independently predicted maternal hypertension. A high prepregnancy BMI increased the risk of the infant being born prematurely, having a longer hospital stay, and having an excessive birth weight. Excessive GWG predicted a longer infant hospital stay and excessive birth weight. A low pregnancy BMI and a lower than recommended GWG were also associated with poor outcomes: prematurity, low birth weight, and an increased risk of the infant admitted to ICU. These findings support the importance of preconception care that promotes achievement of a healthy weight to enhance optimal reproductive outcomes.
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Affiliation(s)
- Nancy Baugh
- Department of Nursing, Franklin Pierce University, Portsmouth, NH 03801, USA
| | - David E. Harris
- School of Nursing, University of Southern Maine, Portland, ME 04104, USA
| | | | - Cheryl Sarton
- School of Nursing, University of Southern Maine, Portland, ME 04104, USA
| | - Erika Lichter
- Department of Applied Medical Sciences, University of Southern Maine, Portland, ME 04104, USA
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31
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Clarke C, Sedlacek RK, Watson SB. Impact of a Simulation Exercise on Pharmacy Student Attitude toward Poverty. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2016; 80:21. [PMID: 27073274 PMCID: PMC4827572 DOI: 10.5688/ajpe80221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 12/16/2015] [Indexed: 05/25/2023]
Abstract
Objective. To evaluate the impact of a simulation on pharmacy student attitudes toward poverty using the Attitude toward Poverty (ATP) Short Form scale. Methods. Second-year pharmacy students participated in the 3-hour Missouri Association for Community Action Poverty Simulation. Students completed a survey of the ATP Short Form scale prior to and following participation in the simulation. Results. Significant improvements in attitude were noted in 15 of 21 ATP Short Form items. Improvements in the stigma and structural domains were significant while improvement in the personal deficiency domain was not significant. Conclusions. This poverty simulation exercise positively altered pharmacy student attitudes toward poverty. When combined with didactic and experiential curriculum, this simulation may enhance student achievement of the 2013 Center for the Advancement of Pharmacy Education (CAPE) outcome subdomain of cultural sensitivity.
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Affiliation(s)
- Cheryl Clarke
- Drake University College of Pharmacy and Health Sciences, Des Moines, Iowa
| | | | - Susan B. Watson
- Drake University College of Business and Public Administration, Des Moines, Iowa
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32
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Rubin LP. Maternal and pediatric health and disease: integrating biopsychosocial models and epigenetics. Pediatr Res 2016; 79:127-35. [PMID: 26484619 DOI: 10.1038/pr.2015.203] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 08/13/2015] [Indexed: 11/09/2022]
Abstract
The concepts of allostasis (stability through adaptation) and accumulated life stress (McEwen's allostatic load) aim to understand childhood and adult outcomes. Chronic malnutrition, changes in social condition, and adverse early-life experiences may program phenotypes and contribute to long-lasting disease risk. However, integration of life course approaches, social and economic contexts, and comparison among different biopsychosocial models has not generally been explored. This review critically examines the literature and evaluates recent insights into how environmental stress can alter lifelong hypothalamic-pituitary-adrenal axis and immune system responsiveness and induce metabolic and neurodevelopmental maladaptation. Models of biopsychosocial stress overlap but may consider different conditions. Concepts include allostasis, which incorporates hormonal responses to predictable environmental changes, and Geronimus's "weathering," which aims to explain how socially structured, repeated stress can accumulate and increase disease vulnerability. Weathering emphasizes roles of internalized/interpersonal racism in outcomes disparities. For Mexican immigrants and Mexican Americans, the "acculturation" framework has proven especially useful to explore disparities, including preterm birth and neuropsychiatric risks in childhood. Complexities of stress assessments and recent research into epigenetic mechanisms mediating effects of physical, nutritional, psychological, and social stress are reviewed.
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Affiliation(s)
- Lewis P Rubin
- Department of Pediatrics, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, Texas
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33
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Castro Y, Heck K, Forster JL, Widome R, Cubbin C. Social and Environmental Factors Related to Smoking Cessation among Mothers: Findings from the Geographic Research on Wellbeing (GROW) Study. Am J Health Behav 2015; 39:809-22. [PMID: 26450549 DOI: 10.5993/ajhb.39.6.9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The current study examined associations between race/ethnicity and psychosocial/environmental factors with current smoking status, and whether psychosocial/environmental factors accounted for racial differences in smoking status in a population-based sample of mothers in California. METHODS Cross-sectional data from 542 women with a history of smoking were used. Analyses adjusted for age, partner status, and educational attainment. RESULTS In models adjusted for sociodemographics, black women had significantly lower odds, and Latina immigrants had significantly higher odds of being a former smoker compared to white women. Persons smoking in the home, having a majority of friends who smoke, having perceptions of their neighborhood as being somewhat or very unsafe, and experiencing food insecurity were associated with decreased odds of being a former smoker. When these variables were entered into a single model, only being a Latina immigrant and having a majority of friends who smoke were significantly associated with smoking status. CONCLUSIONS Black women demonstrated a notable disparity compared with white women in smoking status, accounted for by psychosocial/environmental factors. Immigrant Latinas demonstrated notable success in ever quitting smoking. Social networks may be important barriers to smoking cessation among women.
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Affiliation(s)
- Yessenia Castro
- University of Texas at Austin, School of Social Work, Austin, TX, USA
| | - Katherine Heck
- University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA, USA
| | - Jean L Forster
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Rachel Widome
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Catherine Cubbin
- University of Texas at Austin, School of Social Work, Austin, TX, USA.
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Cubbin C, Heck K, Powell T, Marchi K, Braveman P. Racial/Ethnic Disparities in Depressive Symptoms Among Pregnant Women Vary by Income and Neighborhood Poverty. AIMS Public Health 2015; 2:411-425. [PMID: 29546117 PMCID: PMC5690242 DOI: 10.3934/publichealth.2015.3.411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 07/27/2015] [Indexed: 11/21/2022] Open
Abstract
We examined racial/ethnic disparities in depressive symptoms during pregnancy among a population-based sample of childbearing women in California (N = 24,587). We hypothesized that these racial/ethnic disparities would be eliminated when comparing women with similar incomes and neighborhood poverty environments. Neighborhood poverty trajectory descriptions were linked with survey data measuring age, parity, race/ethnicity, marital status, education, income, and depressive symptoms. We constructed logistic regression models among the overall sample to examine both crude and adjusted racial/ethnic disparities in feeling depressed. Next, stratified adjusted logistic regression models were constructed to examine racial/ethnic disparities in feeling depressed among women of similar income levels living in similar neighborhood poverty environments. We found that racial/ethnic disparities in feeling depressed remained only among women who were not poor themselves and who lived in long-term moderate or low poverty neighborhoods.
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Affiliation(s)
- Catherine Cubbin
- School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, D3500, Austin, TX 78712 USA
| | - Katherine Heck
- Department of Family & Community Medicine, University of California, San Francisco, 3333 California Street, Suite 365, San Francisco, CA 94118 USA
| | - Tara Powell
- School of Social Work, University of Texas at Austin, 1925 San Jacinto Blvd, D3500, Austin, TX 78712 USA.,Current affiliation: School of Social Work, University of Illinois Champaign-Urbana, 1010 West Nevada Street, Urbana, IL 61801 USA
| | - Kristen Marchi
- Department of Family & Community Medicine, University of California, San Francisco, 3333 California Street, Suite 365, San Francisco, CA 94118 USA
| | - Paula Braveman
- Department of Family & Community Medicine, University of California, San Francisco, 3333 California Street, Suite 365, San Francisco, CA 94118 USA
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