Neighborhood Threat of Eviction over Time and Risk of Preterm Birth in Black American Women.

BACKGROUND

Black communities are disproportionately impacted by dual crises: residential evictions and adverse birth outcomes. A growing literature has documented the spill-over effects of neighborhood evictions on adverse birth outcomes, but none have examined associations between these exposures over time and risk of preterm birth (PTB) among Black women.

METHODS

We linked survey data from the Life-course Influences on Fetal Environments Study (n = 807) and publicly available block group-level eviction filing rate data. Addresses from the preconception (from 2007 to 2009) and during pregnancy neighborhoods (from 2009 to 2011) were linked to data from the Eviction Lab. Eviction filing rate trajectories included (1) steady low (referent), (2) steady high, (3) decreasing, and (4) increasing categories. PTB was defined as birth before 37 completed weeks of gestation and was abstracted from participant medical records. Modified Poisson regression with robust error variance estimated relative risk and 95% confidence intervals. Models were adjusted for predictors of residential selection (income, education, marital/cohabiting status, and age), as well as duration of residence in current neighborhood, current neighborhood sociodemographic disadvantage, and residential move from the before pregnancy to during pregnancy neighborhood.

RESULTS

Preterm birth was experienced in 16.2% of the sample (n = 131), and the mean age of participants was 27 years. In adjusted models, PTB risk was strongly associated with increasing eviction filing rates (compared to steady low) (relative risk: 1.68, 95% CI: 1.05, 2.68).

CONCLUSION

Our results provide new evidence about the spillover effects of increased neighborhood threat of eviction over time, on risk of PTB among Black women. Future interventions, including policy solutions aimed at addressing the eviction and PTB crises, are warranted.