OHSU-PSU School of Public Health, Portland, OR, USA.
OHSU-PSU School of Public Health, Portland, OR, USA.
Health Place. 2024 Nov;90:103378. doi: 10.1016/j.healthplace.2024.103378. Epub 2024 Nov 6.
Neighborhood socioeconomic marginalization and racial residential segregation are associated with differential health outcomes in adulthood and pregnancy, but the intergenerational effects of these exposures on early childhood growth are underexplored. Our objective was to investigate racial and ethnic differences in the association between neighborhood deprivation and early childhood growth trajectories, with modification by neighborhood racial concentration.
Using longitudinal clinical data among 58,860 children receiving care in community-based clinics in the ADVANCE Clinical Data Research Network, we identified four early childhood (0-24 months) body mass index (BMI) trajectories using group-based trajectory modeling: Low, Catch-Up, Moderate, and High. In race- and ethnicity-stratified multinomial logistic regression analyses, trajectory group membership was modeled as a function of neighborhood deprivation, neighborhood racial concentration, neighborhood deprivation*racial concentration interactions, and confounders.
Greater neighborhood deprivation was marginally associated with greater odds of Catch-Up trajectory for most racial and ethnic groups, with a null association observed among Assimilated Hispanic children. Conversely, neighborhood deprivation was not associated with Low trajectory for non-Hispanic Black or White children; however, in Less Assimilated Hispanic children, higher neighborhood deprivation was marginally associated with higher odds of Low trajectory, most strongly in neighborhoods with higher vs. lower Hispanic concentration. Associations between neighborhood deprivation and High trajectories varied substantially by race and ethnicity, ranging from inverse among Less Assimilated Hispanic children to a positive association among non-Hispanic White children that was attenuated in neighborhoods with higher White concentration.
Greater neighborhood deprivation was generally associated with greater or similar odds of each alternative growth trajectory, most consistently for non-Hispanic White and Black children. Associations were largely similar across levels of neighborhood racial concentration. Further research is needed to understand contextual or behavioral factors that contribute to the observed racial and ethnic differences in the association between neighborhood deprivation and early childhood growth.
社区社会经济边缘化和种族居住隔离与成年期和孕期的不同健康结果相关，但这些暴露对儿童早期生长的代际影响仍未得到充分探索。我们的目的是研究邻里剥夺与儿童早期生长轨迹之间的关联在种族和民族方面的差异，并探讨邻里种族集中程度的修饰作用。
我们利用 ADVANCE 临床数据研究网络中社区诊所的纵向临床数据，使用基于群组的轨迹建模，识别了四个儿童早期（0-24 个月）体重指数（BMI）轨迹：低、追赶、中等和高。在按种族和族裔分层的多项逻辑回归分析中，轨迹组别的成员资格是根据邻里剥夺、邻里种族集中程度、邻里剥夺与种族集中程度的交互作用以及混杂因素来建模的。
对于大多数种族和族裔群体，更大的邻里剥夺与追赶轨迹的几率更高相关，而同化西班牙裔儿童则观察到了零关联。相反，对于非西班牙裔黑人或白人儿童，邻里剥夺与低轨迹无关；然而，在同化程度较低的西班牙裔儿童中，较高的邻里剥夺与低轨迹的几率较高相关，在西班牙裔集中程度较高的邻里中相关性最强。邻里剥夺与高轨迹之间的关联因种族和族裔而异，范围从同化程度较低的西班牙裔儿童的负相关到非西班牙裔白人儿童的正相关，在西班牙裔集中程度较高的邻里中，这种关联减弱。
一般来说，更大的邻里剥夺与每个替代生长轨迹的几率更大或相似，对于非西班牙裔白人和黑人儿童最为一致。关联在邻里种族集中程度的各个水平上基本相似。需要进一步研究，以了解导致观察到的邻里剥夺与儿童早期生长之间关联的种族和民族差异的背景或行为因素。
