Residential Segregation, Neighborhood Social Environment, and Preterm Birth among

描述(由申请人提供)：由于早产是造成婴儿死亡率种族和民族差异的主要因素，疾病控制和预防中心已将早产确定为公共卫生研究的重要主题。虽然早产和早产差距的原因还不是很清楚，但越来越多的文献暗示，邻里的社会和物质环境是导致不良出生结果的决定因素。居住隔离将种族和族裔群体组织到不同的社区，因此，它可能会影响风险因素和资源在人口群体中的分布，从而导致早产差异。因此，在健康的地方建立一个健康人的国家可能取决于解决居住隔离问题，将其作为少数族裔社区健康的社会决定因素。之前的研究已经记录了居住隔离对美国黑人人口的不利社会、经济和健康影响。然而，一些理论文献和一些流行病学研究表明，种族隔离导致的邻里层面的种族/民族同质性可能对某些健康结果有利。事实上，种族隔离可能对健康既有积极的影响，也有消极的影响，不同种族和背景的平衡可能不同；例如，拉美裔人的积极生育结果往往被归因于有益的健康行为和社会支持，这可能会在拉美裔社区得到推广。因此，将居住隔离作为早产的一个社会决定因素加以适当处理，需要了解隔离与健康之间潜在的复杂关系。然而，由于大多数关于种族隔离和健康的研究只包括在美国出生的非西班牙裔黑人和白人人口，这种复杂性在很大程度上仍未被探索。此外，以前的研究使用了隔离的空间测量方法，忽略了社区之间潜在的重要空间关系。这项拟议的研究将使用与2000年人口普查数据相联系的隔离和纽约市出生记录(1995-2003年)的空间测量方法，以(1)评估隔离的影响，包括在美国和外国出生的白人、黑人、西班牙裔和亚洲人在内的14个群体中的早产风险；(2)检查居住在非黑人社区的黑人妇女的早产风险是否受到特定种族群体的影响；以及(3)在外国出生的黑人妇女中，探索早产风险受妇女所在社区中与其原籍(“文化”)群体相同的人的密度的影响程度。

DESCRIPTION (provided by applicant): Because it is a leading contributor to racial and ethnic disparities in infant mortality, the Centers for Disease Control and Prevention has identified preterm birth as a vital subject for public health research. While the causes of preterm birth and preterm birth disparities are not well understood, a growing body of literature implicates neighborhood social and material environments as determinants of poor birth outcomes. Residential segregation organizes racial and ethnic groups into different neighborhoods, and as such it may contribute to preterm birth disparities by influencing the distribution of risk factors and resources across population groups. Thus, building a nation of Healthy People in Healthy Places may depend on addressing residential segregation as a social determinant of health in minority communities. Previous research has documented detrimental social, economic, and health effects of residential segregation on the US black population. Some theoretical literature and a few epidemiologic studies have suggested that neighborhood-level racial/ethnic homogeneity resulting from segregation may be beneficial for certain health outcomes, however. Segregation may, in fact, have both positive and negative effects on health, the balance of which may differ across ethnic groups and contexts; for example, positive birth outcomes among Hispanics are often attributed to beneficial health behaviors and social support that may be promoted in Hispanic neighborhoods. Thus, appropriately addressing residential segregation as a social determinant of preterm birth requires an understanding of the potentially complex relationship between segregation and health. Because most studies of segregation and health have included only US-born non-Hispanic black and white populations, however, this complexity remains largely unexplored. Moreover, previous studies have used aspatial measures of segregation that ignore potentially important spatial relationships between neighborhoods. The proposed study will use a spatial measure of segregation and New York City birth records (1995-2003) linked to 2000 Census data in order to (1) assess the effects of segregation, defined as own-ethnic-group density in the residential area, on preterm birth risk in 14 groups including US- and foreign-born whites, blacks, Hispanics, and Asians; (2) examine whether preterm birth risk among black women residing in non-black neighborhoods is affected by the specific ethnic groups that are present; and (3) among foreign-born black women, explore the extent to which preterm birth risk is influenced by the density of individuals in a woman's neighborhood who share her region-of-origin ("cultural") group.