Spatial social polarization and birth outcomes: preterm birth and infant mortality - New York City, 2010-14
Spatial social polarization and birth outcomes: preterm birth and infant mortality - New York City, 2010-14
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DOI：
10.1177/1403494817701566
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发表时间：
2018-02-01
影响因子：
3.4
通讯作者：
Krieger, N.
中科院分区：
文献类型：
--
作者：
Huynh, M.;Spasojevic, J.;Krieger, N.
目的：本研究以纽约市为研究对象，采用极端集中指数（ICE）对社会空间极化与早产（PTB）和婴儿死亡率（IM）之间的关系进行了评估。第二个目的是检查ICE措施相比，邻里贫困。方法：样本包括2010-2014年纽约市成年女性的单胎分娩（n= 532，806）。在人口普查区层面采用了三种ICE指标：ICE -收入（美国家庭年收入最低与最高20百分位数的家庭），ICE -种族/民族（非西班牙裔黑人与非西班牙裔白色人口），以及ICE -收入+种族/民族组合。早产定义为妊娠37周之前出生。婴儿死亡率的定义是一岁以前的死亡。采用具有随机截距的两水平广义线性模型调整个体水平协变量。结果：早产率为7.1%，婴儿死亡率为3.4/1000活产。与生活在最优越地区的妇女相比，生活在最不优越地区的妇女更有可能早产或婴儿死亡。在调整了协变量后，早产仍然存在这种关联（ICE -收入：调整后的比值比（AOR）1.16（1.10-1.21）; ICE -人种/种族：AOR 1.41（1.34-1.49）; ICE -收入+种族/民族：AOR 1.36（1.29-1.43））和IM（ICE -种族/族裔（AOR 1.80（1.43-2.28）和ICE -收入+种族/族裔（AOR 1.54（1.23-1.94）。高邻里贫困仅与PTB相关（AOR 1.09（1.04-1.14）。结论：这些结果提供了初步的证据，使用ICE措施在检查结构性障碍，健康的出生结果。
Aims: This study assessed the relationship between spatial social polarization measured by the index of the concentration of the extremes (ICE) and preterm birth (PTB) and infant mortality (IM) in New York City. A secondary aim was to examine the ICE measure in comparison to neighborhood poverty. Methods: The sample included singleton births to adult women in New York City, 2010-2014 (n=532,806). Three ICE measures were employed at the census tract level: ICE - Income (persons in households in the bottom vs top 20th percentile of US annual household income), ICE - Race/Ethnicity (black non-Hispanic vs white non-Hispanic populations), and ICE - Income + Race/Ethnicity combined. Preterm birth was defined as birth before 37 weeks' gestation. Infant mortality was defined as a death before one year of age. A two-level generalized linear model with random intercept was utilized adjusting for individual-level covariates. Results: Preterm birth prevalence was 7.1% and infant mortality rate was 3.4 per 1000 live births. Women who lived in areas with the least privilege were more likely to have a preterm birth or infant mortality as compared to women living in areas with the most privilege. After adjusting for covariates, this association remained for preterm birth (ICE - Income: Adjusted Odds Ratio (AOR) 1.16 (1.10-1.21); ICE - Race/Ethnicity: AOR 1.41 (1.34-1.49); ICE - Income + Race/Ethnicity: AOR 1.36 (1.29-1.43)) and IM (ICE - Race/Ethnicity (AOR 1.80 (1.43-2.28) and ICE - Income + Race/Ethnicity (AOR 1.54 (1.23-1.94)). High neighborhood poverty was associated with PTB only (AOR 1.09 (1.04-1.14). Conclusions: These results provide preliminary evidence for the use of the ICE measure in examining structural barriers to healthy birth outcomes.