Residential Environment and Preterm Delivery among African American Women

7.项目摘要/摘要 在早产(PTD)方面存在巨大的、持续的种族差异，非裔美国人(AA) 具有比非西班牙裔白人更高的比率。由于传统的风险因素没有完全考虑到 对于这种差异，必须找到其他解释。居住环境可能是一种 不良生育结局的重要风险因素，因为 哪些戒酒协会和白人女性居住，以及由此导致的社会接触方面的种族差异 健康的决定因素。居住环境的某些方面已经与不利的 出生结局，包括PTD，然而现有的研究只定义了邻里 使用美国人口普查的汇总数据进行暴露，美国人口普查无法确定以下方面 居住环境可能是有害的。最近的证据表明，主观的 居民对社区的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，当前 这项研究试图检查客观和感知到的身体和社会之间的联系 再生障碍性贫血患者居住环境与PTD的生命过程对胎儿的影响 环境(LIFE)研究，具体目标如下：(1)检查测量 主观邻域结构，包括主观的方法论属性 评估，(2)确定感知的社会和身体之间的联系 环境和PTD患病率，以及(3)检查客观身体状况之间的联系 环境和PTD使用多层建模。这项研究将扩展目前的 对邻里效应对PTD影响的几个关键方面的认识：(1)通过比较客观 以及居住环境的主观衡量，(2)通过判断是否客观 邻里措施会影响人们对邻里的认知，以及(3)通过在 队列完全由AA女性组成，这是一个已知的患有PTD的不成比例的群体。 如果物质和社会居住环境的各个方面与创伤后应激障碍相关 AAS，这种知识可以为未来的干预研究以及重点关注的政策努力提供信息 消除街区的不良特征。拟议的研究金将提供 申请人必须接受严格的培训，才能成为一名独立调查员 致力于确定PTD中长期存在的种族差异的原因，特别是 把重点放在社区上。

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.