New York State Psychiatric Institute, New York, NY 10032, USA.
J Urban Health. 2011 Jun;88(3):454-68. doi: 10.1007/s11524-011-9581-6.
Struening et al.1 demonstrated a widening disparity of low birthweight (LOB) rates among New York City health areas from 1980-1986, clearly a dynamic process. In contrast, the New York City Department of Health reported static citywide LOB rate in 1988-2008.2 Struening et al.1 is extended here at the health district level with mapping and regression analyses. Additionally, birthweight data are reported for babies born in 1998-2001 to a group of African-American and Dominican women in Upper Manhattan. The data reported in this paper indicate that both fetal programming of the mother herself (life course model) and stress during or shortly before pregnancy may play a role in LOB. Current stress may arise from past events. Intergenerational effects, thus, could arise from stresses on the grandmother and their residual impacts on the mother as well as new stresses on the mother as an adult. The average weight of babies born to the Upper Manhattan mothers who were born in 1970-1974 was 3,466 g, with 1.6% below 2,500 g; that of babies of mothers born in 1975-1979, 3,320 g, with 6% below 2,500 g. The latter group was born during the 1975-1979 housing destruction. Intergenerational impacts of that event may be reflected in this elevated rate of LOB. Health district maps of LOB incidence ranges show improvement from 1990-2000 and then deterioration in 2005 and 2008. Bivariate regressions of socioeconomic (SE) factors and LOB incidence showed many strong associations in 1990; but by 2000, the number and strength of these associations declined. In 1990, 2000, and 2008, black segregation was the SE factor most strongly associated with LOB. Black segregation and murder rate explained about 85% of the pattern of 1990 LOB. Regressing the 1970-1980 percent population change against the SE factors showed effects even in 2000. The 1990 murder rate and 1989 percentage of public assistance explained over half the 2008 LOB incidence pattern. The housing destruction of the 1970s continued to influence LOB incidence indirectly in 2008. The ability of community and individual to cope with current stressors may hinge on resilience status, which is shaped by past events and circumstances. The present interacts with the past in many ways. Serial displacement exemplifies this interaction of immense importance to public health.
斯特伦宁等人 1 证明了纽约市各卫生区 1980-1986 年期间低出生体重 (LOB) 率的差距不断扩大，这显然是一个动态过程。相比之下，纽约市卫生局报告称，1988-2008 年全市 LOB 率保持不变。2 斯特伦宁等人的研究在此扩展到卫生区层面，采用绘图和回归分析。此外，还报告了 1998-2001 年出生于上曼哈顿的一群非裔美国人和多米尼加妇女的婴儿的出生体重数据。本文报告的数据表明，母亲自身的胎儿编程（生命历程模型）和怀孕期间或怀孕前不久的压力都可能在 LOB 中发挥作用。当前的压力可能源于过去的事件。因此，代际效应可能源于祖母的压力及其对母亲的残余影响，以及母亲作为成年人的新压力。1970-1974 年出生的上曼哈顿母亲所生婴儿的平均体重为 3466 克，其中 1.6%低于 2500 克；1975-1979 年出生的婴儿体重为 3320 克，其中 6%低于 2500 克。后者出生于 1975-1979 年的住房破坏期间。该事件的代际影响可能反映在这一升高的 LOB 率中。LOB 发生率范围的卫生区地图显示，1990-2000 年有所改善，然后在 2005 年和 2008 年恶化。1990 年和 2000 年，社会经济 (SE) 因素与 LOB 发生率的双变量回归显示出许多强烈的关联；但到 2000 年，这些关联的数量和强度都有所下降。1990 年、2000 年和 2008 年，黑人隔离是与 LOB 关系最密切的 SE 因素。黑人隔离和谋杀率解释了 1990 年 LOB 模式的 85%左右。1970-1980 年人口变化与 SE 因素的回归显示，即使在 2000 年也存在影响。1990 年的谋杀率和 1989 年的公共援助百分比解释了 2008 年 LOB 发生率模式的一半以上。20 世纪 70 年代的住房破坏持续到 2008 年间接地影响着 LOB 的发病率。社区和个人应对当前压力源的能力可能取决于弹性状况，而弹性状况则由过去的事件和环境决定。现在以多种方式与过去相互作用。连续流离失所就是这种对公共卫生至关重要的相互作用的一个例子。
