Global Health Institute, Duke University, Durham, NC 27708, USA.
Children's Environmental Health Initiative, University of Notre Dame, South Bend, IN 46556, USA.
Int J Environ Res Public Health. 2021 Sep 6;18(17):9384. doi: 10.3390/ijerph18179384.
We develop a local, spatial measure of educational isolation (EI) and characterize the relationship between EI and our previously developed measure of racial isolation (RI). EI measures the extent to which non-college educated individuals are exposed primarily to other non-college educated individuals. To characterize how the RI-EI relationship varies across space, we propose a novel measure of local correlation. Using birth records from the State of Michigan (2005-2012), we estimate associations between RI, EI, and birth outcomes. EI was lower in urban communities and higher in rural communities, while RI was highest in urban areas and parts of the southeastern United States (US). We observed greater heterogeneity in EI in low RI tracts, especially in non-urban tracts; residents of high RI tracts are likely to be both educationally and racially isolated. Associations were also observed between RI, EI, and gestational length (weeks) and preterm birth (PTB). For example, moving from the lowest to the highest quintile of RI was associated with a 1.11 (1.07, 1.15) and 1.16 (1.10, 1.22) increase in odds of PTB among NHB and NHW women, respectively. Moving from the lowest to the highest quintile of EI was associated with a 1.07 (1.02, 1.12) and 1.03 (1.00, 1.05) increase in odds of PTB among NHB and NHW women, respectively. This work provides three tools (RI, EI, and the local correlation measure) to researchers and policymakers interested in how residential isolation shapes disparate outcomes.
我们开发了一种本地、空间教育隔离（EI）度量标准，并描述了 EI 与我们之前开发的种族隔离（RI）度量标准之间的关系。EI 衡量的是未受过大学教育的人主要接触其他未受过大学教育的人的程度。为了描述 RI-EI 关系在空间上的变化，我们提出了一种新的局部相关度量标准。我们使用密歇根州（2005-2012 年）的出生记录来估计 RI、EI 和出生结果之间的关联。EI 在城市社区中较低，在农村社区中较高，而 RI 在城市地区和美国东南部的部分地区最高。我们观察到低 RI 区的 EI 异质性更大，特别是在非城市区；RI 高的地区的居民很可能同时受到教育和种族隔离。RI、EI 与妊娠期（周）和早产（PTB）之间也存在关联。例如，从 RI 的最低五分位到最高五分位，NHB 和 NHW 女性的 PTB 比值比分别增加了 1.11（1.07，1.15）和 1.16（1.10，1.22）。从 EI 的最低五分位到最高五分位，NHB 和 NHW 女性的 PTB 比值比分别增加了 1.07（1.02，1.12）和 1.03（1.00，1.05）。这项工作为研究人员和政策制定者提供了三种工具（RI、EI 和局部相关度量标准），以研究居住隔离如何影响不同的结果。
