Residential Environment and Preterm Delivery among African American Women

7.项目概要/摘要 在早产（PTD）方面存在着巨大的，持续的种族差异，非洲裔美国人（AAs） 比非西班牙裔白人的发病率更高。由于传统的风险因素不能充分考虑 对于这种差异，必须找出其他解释。居住环境可能是一个 不利的出生结果的重要风险因素，鉴于惊人的不同社区， AA和白色妇女居住的地方，以及由此产生的种族差异， 健康的决定因素。住宅环境的某些方面已经与不利的 出生结局，包括PTD，然而现有的研究仅定义了邻居 使用美国人口普查的汇总数据，无法确定 居住环境可能是有害的。最近的证据表明，主观 来自居民的社区评估可能能够提供独特的背景信息， 人口普查数据中没有的信息，包括社会环境。因此目前 一项研究旨在研究客观和感知的身体和社会之间的联系， 从生命历程对胎儿的影响看再障妇女的居住环境与PTD 环境（生命）研究，具体目标如下：（1）检查测量 主观邻域构造，包括主观邻域构造的方法学特性， 评估，（2）确定感知的社会和身体之间的关联 环境和PTD的患病率，以及（3）检查客观物理之间的联系， 环境和PTD使用多级建模。这项研究将扩大目前 从几个关键方面了解了邻域对PTD的影响：（1）通过比较客观 和主观措施的居住环境，（2）通过确定是否客观 邻里措施影响邻里的看法，和（3）进行研究， 一个完全由AA女性组成的队列，这是一个已知患有PTD不成比例的群体。 如果物理和社会居住环境的各个方面与PTD有关， 这些知识可以为未来的干预研究和政策努力提供信息， 消除邻里的不利特征。拟议的研究金将提供 申请人成为独立调查员所需的严格培训， 致力于她的职业生涯，以确定PTD持久的种族差异的原因，特别是 专注于社区。

7. Project Summary/Abstract Large, persistent racial disparities in preterm delivery (PTD) exist, with African Americans (AAs) having higher rates than Non-Hispanic whites. Since traditional risk factors do not fully account for this disparity, other explanations must be identified. Residential environment may be an important risk factor for adverse birth outcomes, given the strikingly different neighborhoods in which AA and white women reside, and the resulting racial disparity in exposures to social determinants of health. Some aspects of residential environment have been linked to adverse birth outcomes, including PTD, however the existing studies have only defined neighborhood exposures using aggregate data from the US Census, which is unable to identify aspects of residential environment may be detrimental. Recent evidence suggests that subjective assessments of neighborhoods from residents may be able to provide unique contextual information not available in Census data, including social environment. Therefore, the current study seeks to examine the links between objective and perceived physical and social residential environment and PTD among AA women from the Life-course Influences on Fetal Environments (LIFE) study, with the following specific aims: (1) to examine measurement of subjective neighborhood constructs, including methodological properties of subjective assessments, (2) to determine the associations between perceived social and physical environment and prevalence of PTD, and (3) to examine the links between objective physical environment and PTD using multilevel modeling. This research will extend the current knowledge of neighborhood effects on PTD in several critical ways: (1) by comparing objective and subjective measures of residential environment, (2) by determining whether objective neighborhood measures affect perceptions of neighborhood, and (3) by conducting research in a cohort comprised entirely of AA women, a group known to suffer disproportionately from PTD. If aspects of the physical and social residential environment are associated with PTD among AAs, this knowledge can inform future intervention studies as well as policy efforts focused on eliminating adverse features of neighborhoods. The proposed fellowship will provide the rigorous training necessary for the applicant to become an independent investigator who will devote her career to identifying causes of the enduring racial disparities in PTD, with a particular focus on neighborhoods.