Mickelson Kristin D, Witsoe Megan, Krzyzanowski Brittany, Doehrman Pooja, Dinh Samantha, Zhou Guangying, Nguyen Jacqueline
School of Social & Behavioral Sciences, Arizona State University, 4701 W. Thunderbird Road, Glendale, AZ 85306, USA.
School of Medicine, Creighton University, 3100 N Central Ave, Phoenix, AZ 85012, USA.
Int J Environ Res Public Health. 2025 Jan 15;22(1):112. doi: 10.3390/ijerph22010112.
Health inequities begin before birth and are influenced by pregnancy conditions, race/ethnicity, social class, and environment. Research indicates that, in the United States, Black women are significantly more likely to have low-birth-weight babies compared to White women. Interestingly, Hispanic women in the United States do not experience this birth weight inequity. The reasons for this disparity remain unclear. Both Hispanic and Black women face discrimination, and this is often cited as a primary reason for the higher prevalence of low-birth-weight babies among Black women. One type of discrimination that is less examined is neighborhood deprivation.
This study systematically examined the impact of various sociodemographic and pregnancy predictors among 9607 women in Phoenix, Arizona. Using multilevel modeling, we analyzed whether neighborhood deprivation (using the Area Deprivation Index) influenced the association between demographic and pregnancy risk and protective factors on birth weight outcomes.
Consistent with prior research, we found that Black and Asian women had lower-birth-weight babies than White women, while Hispanic women did not show a significant difference from non-Hispanic women. Additionally, multilevel modeling suggested that increased neighborhood deprivation tends to exacerbate the impact of some risk factors (e.g., race) and reduce the impact of specific protective factors (e.g., gestational age) on birth weight.
These findings suggest that both place and individual factors synergistically influence birth weight outcomes. Moreover, the results underscore the importance of targeting interventions to enhance resources among those who live in the most deprived neighborhoods.
健康不平等在出生前就已存在,并受到孕期状况、种族/族裔、社会阶层和环境的影响。研究表明,在美国,与白人女性相比,黑人女性生出低体重婴儿的可能性要高得多。有趣的是,美国的西班牙裔女性并未经历这种出生体重不平等现象。这种差异的原因尚不清楚。西班牙裔和黑人女性都面临歧视,这通常被认为是黑人女性中低体重婴儿患病率较高的主要原因。一种较少受到审视的歧视类型是社区贫困。
本研究系统地考察了亚利桑那州凤凰城9607名女性中各种社会人口统计学和孕期预测因素的影响。我们使用多层次模型分析了社区贫困(使用地区贫困指数)是否会影响人口统计学和孕期风险及保护因素与出生体重结果之间的关联。
与先前研究一致,我们发现黑人女性和亚洲女性生出的婴儿体重低于白人女性,而西班牙裔女性与非西班牙裔女性相比没有显著差异。此外,多层次模型表明,社区贫困加剧往往会加剧某些风险因素(如种族)的影响,并降低特定保护因素(如孕周)对出生体重的影响。
这些发现表明,地区因素和个体因素会协同影响出生体重结果。此外,研究结果强调了针对最贫困社区居民加强资源投入的干预措施的重要性。