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Weighing the contributions of material and social area deprivation to preterm birth

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  • Auger, Nathalie
  • Park, Alison L.
  • Gamache, Philippe
  • Pampalon, Robert
  • Daniel, Mark
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    Abstract

    Evidence suggests that individual socioeconomic status is a better predictor of preterm birth (PTB) than other individual social characteristics, but it is not clear if socioeconomic (material) area context is likewise more strongly related to PTB than social area characteristics. We compared material and social area deprivation to determine which was more strongly associated with PTB. Live singleton births from Québec, Canada were obtained for 1999–2006 (N = 581,898). PTB was defined as <37 completed gestational weeks. Two composite indices representing area-level material and social deprivation were used in Cox proportional hazards regression models to compute hazard ratios (HR) and 95% confidence intervals (CI) for PTB, accounting for individual-level characteristics including maternal education. Results indicated that PTB rates were higher for areas with high material (7.1%) and social (6.8%) deprivation than those with low material (5.5%) and social (5.9%) deprivation. Adjusted hazards of PTB were slightly greater for material deprivation than social deprivation. These findings indicate that material area deprivation is marginally more strongly associated with PTB than social deprivation, but it is not clear that interventions to prevent PTB should focus on material deprivation any more than on social area deprivation.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 75 (2012)
    Issue (Month): 6 ()
    Pages: 1032-1037

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    Handle: RePEc:eee:socmed:v:75:y:2012:i:6:p:1032-1037

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    Related research

    Keywords: Pregnancy; Pregnancy outcome; Premature birth; Residence characteristics; Socioeconomic factors; Canada;

    References

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    1. Angela Testi & Enrico Ivaldi, 2009. "Material versus social deprivation and health: a case study of an urban area," The European Journal of Health Economics, Springer, vol. 10(3), pages 323-328, July.
    2. Fagg, James & Curtis, Sarah & Stansfeld, Stephen A. & Cattell, Vicky & Tupuola, Ann-Marie & Arephin, Muna, 2008. "Area social fragmentation, social support for individuals and psychosocial health in young adults: Evidence from a national survey in England," Social Science & Medicine, Elsevier, vol. 66(2), pages 242-254, January.
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    4. Schempf, Ashley & Strobino, Donna & O'Campo, Patricia, 2009. "Neighborhood effects on birthweight: An exploration of psychosocial and behavioral pathways in Baltimore, 1995-1996," Social Science & Medicine, Elsevier, vol. 68(1), pages 100-110, January.
    5. Masi, Christopher M. & Hawkley, Louise C. & Harry Piotrowski, Z. & Pickett, Kate E., 2007. "Neighborhood economic disadvantage, violent crime, group density, and pregnancy outcomes in a diverse, urban population," Social Science & Medicine, Elsevier, vol. 65(12), pages 2440-2457, December.
    6. Reagan, Patricia B. & Salsberry, Pamela J., 2005. "Race and ethnic differences in determinants of preterm birth in the USA: broadening the social context," Social Science & Medicine, Elsevier, vol. 60(10), pages 2217-2228, May.
    7. Pampalon, Robert & Hamel, Denis & Gamache, Philippe, 2008. "Recent changes in the geography of social disparities in premature mortality in Québec," Social Science & Medicine, Elsevier, vol. 67(8), pages 1269-1281, October.
    8. Kramer, Michael R. & Cooper, Hannah L. & Drews-Botsch, Carolyn D. & Waller, Lance A. & Hogue, Carol R., 2010. "Metropolitan isolation segregation and Black-White disparities in very preterm birth: A test of mediating pathways and variance explained," Social Science & Medicine, Elsevier, vol. 71(12), pages 2108-2116, December.
    9. Messer, Lynne C. & Vinikoor, Lisa C. & Laraia, Barbara A. & Kaufman, Jay S. & Eyster, Janet & Holzman, Claudia & Culhane, Jennifer & Elo, Irma & Burke, Jessica G. & O'Campo, Patricia, 2008. "Socioeconomic domains and associations with preterm birth," Social Science & Medicine, Elsevier, vol. 67(8), pages 1247-1257, October.
    10. Curtis, Sarah & Setia, Maninder S. & Quesnel-Vallee, Amelie, 2009. "Socio-geographic mobility and health status: A longitudinal analysis using the National Population Health Survey of Canada," Social Science & Medicine, Elsevier, vol. 69(12), pages 1845-1853, December.
    11. Pickett, Kate E. & Shaw, Richard J. & Atkin, Karl & Kiernan, Kathleen E. & Wilkinson, Richard G., 2009. "Ethnic density effects on maternal and infant health in the Millennium Cohort Study," Social Science & Medicine, Elsevier, vol. 69(10), pages 1476-1483, November.
    12. Bernard, Paul & Charafeddine, Rana & Frohlich, Katherine L. & Daniel, Mark & Kestens, Yan & Potvin, Louise, 2007. "Health inequalities and place: A theoretical conception of neighbourhood," Social Science & Medicine, Elsevier, vol. 65(9), pages 1839-1852, November.
    13. Bell, Janice F. & Zimmerman, Frederick J. & Almgren, Gunnar R. & Mayer, Jonathan D. & Huebner, Colleen E., 2006. "Birth outcomes among urban African-American women: A multilevel analysis of the role of racial residential segregation," Social Science & Medicine, Elsevier, vol. 63(12), pages 3030-3045, December.
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