J Urban Health. 2014 Feb;91(1):211-20. doi: 10.1007/s11524-013-9823-x.
Adverse birth outcomes have been linked to neighborhood level socioeconomic status. However, little work has examined the influence of social and economic change over time (i.e., gentrification) on health. This study aims to assess the association between gentrification and preterm birth (PTB) while examining the modifying effect of maternal race/ethnicity and educational attainment. New York City births, 2008–2010, (n=126,165) were linked to a measure of gentrification at the community district level (n=59). The gentrification measure was calculated using percent change in education level, poverty level, and median household income (MHI) between the 2005–2009 American Community Survey and the 1990 Census. PTB was defined as clinical gestational age less than 37 weeks. Generalized estimating equations were utilized to examine the association. Gentrification (i.e., increase in residents with a college education, increase in MHI, and decrease in residents living below the poverty line) was not associated with PTB. However, among Non-Hispanic Blacks, very high gentrification was adversely associated with PTB (AOR, 1.16; 95 % CI, 1.01–1.33) as compared to those who lived in a very low gentrified neighborhood. Among non- Hispanic Whites, living in a very high gentrified neighborhood was protective as compared to living in a very low gentrified neighborhood (AOR, 0.78; 95 % CI, 0.64– 0.94). Although there is a need to develop a more nuanced measure of gentrification, these results indicate that changes in the economic character of a neighborhood may have a significant influence on birth outcomes.
不良出生结局与社区层面的社会经济地位有关。然而，很少有研究探讨社会和经济随时间的变化（即，高档化）对健康的影响。本研究旨在评估高档化与早产（PTB）之间的关联，同时检验母性种族/民族和教育程度的调节作用。2008-2010 年纽约市出生的婴儿（n=126165）与社区区一级的高档化程度（n=59）相关联。使用教育水平、贫困水平和家庭中位数收入（MHI）在 2005-2009 年美国社区调查和 1990 年人口普查之间的百分比变化来计算高档化指标。PTB 的定义是临床妊娠期小于 37 周。使用广义估计方程来检验关联。高档化（即，具有大学学历的居民增加，MHI 增加，生活在贫困线以下的居民减少）与 PTB 无关。然而，与生活在非常低档化社区的非西班牙裔黑人相比，非常高档化与 PTB 呈负相关（OR，1.16；95%CI，1.01-1.33）。对于非西班牙裔白人，与生活在非常低档化社区相比，生活在非常高档化社区具有保护作用（OR，0.78；95%CI，0.64-0.94）。尽管需要开发更细致的高档化衡量标准，但这些结果表明，社区经济特征的变化可能对出生结局产生重大影响。
