Changes in the spatial pattern of low birth weight in a southern California county: the role of individual and neighborhood level factors
AbstractIndividual-level maternal risk factors have been able to explain only a small proportion of low birth weight (LBW) births in the US to date and neighborhood-level factors have not been recognized as important predictors of reproductive outcomes. At the US/Mexico border, tremendous demographic changes have taken place between 1980 and 1990. Whether high population growth, economic pressures, and community instability have affected reproductive health in this region is not known. We used spatial epidemiologic methods to investigate the importance of changes in neighborhood and individual-level risk factors in predicting changes in two measures of adverse reproductive health: term and preterm LBW. Using approximately 16,000 births in 1980 and 24,000 births in 1990, we produced a continuous surface of LBW change (Z scores for difference in proportions) for southern San Diego County, CA, and identified statistically significant "hot spots" of elevated risk. Using a geographic information system, data from the 1980 and 1990 US Census were smoothed to link neighborhood-level variables with individual-level data from the 1980 and 1990 California birth certificates. Multivariate regression models were developed to identify individual- and neighborhood-level variables of 1980-1990 changes which were predictive of Z scores of LBW change. Results of conditional autoregressive models were used to assess effects of spatial autocorrelation. The continuous surface of LBW identified areas with statistically significant increases (17 areas for term LBW and 14 areas for preterm LBW). While individual- and neighborhood-level variables explained about an equal amount of variance in term LBW, only neighborhood-level variables were significant predictors of preterm LBW. While changes in maternal race/ethnicity composition and a measure of stability were related to term LBW, measures of affluence were related to preterm LBW. This study highlights the importance of socioeconomic and demographic changes in a woman's neighborhood on reproductive health.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Elsevier in its journal Social Science & Medicine.
Volume (Year): 56 (2003)
Issue (Month): 10 (May)
Contact details of provider:
Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description
You can help add them by filling out this form.
reading list or among the top items on IDEAS.Access and download statisticsgeneral information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei).
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.