School of Social Ecology, University of California Irvine, Irvine, CA, USA.
Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
Soc Sci Med. 2021 Jun;279:113962. doi: 10.1016/j.socscimed.2021.113962. Epub 2021 May 4.
Substantial research documents health consequences of neighborhood disadvantage. Patterns of residential mobility that differ by race/ethnicity and socioeconomic status (SES) may sort non-Hispanic (NH) Black and low-SES families into disadvantaged neighborhoods. In this study, we leverage a sibling-linked dataset to track residential mobility among birthing persons between pregnancies and investigate baseline characteristics associated with downward mobility, including race/ethnicity, SES, and pre-existing health conditions.
We used a probabilistic linkage strategy to identify births to the same person between 2007 and 2015 (n = 624,222) and categorized downward residential mobility by quartile-level increases in neighborhood disadvantage. We defined strong downward mobility as a move from a neighborhood with very low (quartile 1) to very high (quartile 4) disadvantage and estimated the logit (i.e., log-odds) of strong downward mobility as a function of racial/ethnic, sociodemographic, and health characteristics of the birthing person and their first birth. We further explored the role of neighborhood housing affordability by examining changes in affordability from first to second birth by race/ethnicity.
NH Black birthing persons show an over three-fold increased odds of strong downward mobility relative to NH white birthing persons (OR = 3.34, CI: 2.91, 3.84). To a lesser extent, Hispanic race/ethnicity, WIC receipt, low educational attainment, obesity, and infant preterm birth (PTB) also predict strong downward mobility. Examination of changes in neighborhood affordability indicate that over half of NH Black birthing persons move to a more affordable neighborhood, compared to less than a quarter of NH white birthing persons, before the birth of their second child. Results remain consistent across outcomes, measures of neighborhood SES, and modified log-Poisson models.
We find an elevated risk of strong downward mobility among NH Black and low-SES birthing persons. Future research may identify other factors (e.g., housing affordability) that generate downward residential mobility to identify interventions that promote neighborhood equity.
大量研究文献记录了邻里环境劣势对健康造成的影响。不同种族/族裔和社会经济地位（SES）的居住流动模式可能会将非西班牙裔（NH）黑人家庭和低收入家庭安置在不利的社区中。在这项研究中，我们利用兄弟姐妹关联数据集来跟踪生育者在两次怀孕之间的居住流动情况，并调查与向下流动相关的基线特征，包括种族/族裔、SES 和现有的健康状况。
我们使用概率链接策略来识别 2007 年至 2015 年间的同一位生育者的分娩，并按邻里劣势程度的四分位级增加来划分向下的居住流动。我们将强烈的向下流动定义为从一个非常低（四分位 1）到非常高（四分位 4）的劣势社区的转移，并估计生育者及其第一次分娩的种族/族裔、社会人口统计学和健康特征作为强烈向下流动的对数几率（即对数值）的函数。我们进一步通过检查按种族/族裔划分的首次和第二次分娩时的住房负担能力变化，探索了邻里住房负担能力的作用。
与 NH 白人生育者相比，NH 黑人生育者强烈向下流动的可能性高出三倍以上（OR=3.34，95%CI：2.91，3.84）。在较小程度上，西班牙裔种族/族裔、接受 WIC 援助、低教育程度、肥胖和婴儿早产（PTB）也预示着强烈的向下流动。对邻里住房负担能力变化的检查表明，与 NH 白人生育者相比，超过一半的 NH 黑人生育者在第二次生育前搬到了一个更负担得起的社区，而不到四分之一的 NH 白人生育者这样做。结果在各种结果、邻里 SES 测量和修正的泊松回归模型中保持一致。
我们发现 NH 黑人及低 SES 生育者强烈向下流动的风险增加。未来的研究可能会确定其他因素（例如住房负担能力）导致向下的居住流动，以确定促进邻里公平的干预措施。
