Cowan K N, Haight S C, Edwards J K, Luben T J, Martin C L
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; US Environmental Protection Agency, Office of Research and Development, Durham, NC, United States; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Ann Epidemiol. 2025 Jul;107:54-60. doi: 10.1016/j.annepidem.2025.05.014. Epub 2025 May 28.
Epidemiologists often investigate the impacts of neighborhood disadvantage (ND) on health using indices created from publicly available data. However, it is not clear how choice of ND index impacts results. We (1) determined commonly used ND indices in recent epidemiological research and (2) investigated how choice of index impacts the magnitude of the racial disparity in preterm birth (PTB) by level of ND. We reviewed abstracts in epidemiology journals and conferences from 2020 to 2023 to determine commonly used ND indices and assigned them to birth records for singleton live births with no birth defects to non-Hispanic (NH) Black and NH White birthing parents in North Carolina, 2016-2018. Prevalence differences in PTB per 100 births were estimated using linear binomial regression comparing births from NH Black and NH White birthing parents, stratified by ND index quartile. The most used indices in perinatal-specific research were the Neighborhood Deprivation Index, racial and economic Index of Concentration at the Extremes, Social Vulnerability Index, and Area Deprivation Index. We observed no significant differences in the magnitude of the Black-White disparity in PTB by ND index. While there were no notable differences in estimates, interpretation of results should consider the intent of an index and its components.
流行病学家经常使用从公开数据创建的指数来调查邻里劣势（ND）对健康的影响。然而，尚不清楚ND指数的选择如何影响结果。我们（1）确定了近期流行病学研究中常用的ND指数，（2）研究了指数选择如何按ND水平影响早产（PTB）中种族差异的程度。我们回顾了2020年至2023年流行病学杂志和会议上的摘要，以确定常用的ND指数，并将其分配给2016 - 2018年北卡罗来纳州非西班牙裔（NH）黑人与NH白人分娩父母的无出生缺陷单胎活产出生记录。使用线性二项回归估计每100例出生中PTB的患病率差异，比较NH黑人和NH白人分娩父母的出生情况，并按ND指数四分位数分层。围产期特定研究中使用最多的指数是邻里剥夺指数、极端种族和经济集中度指数、社会脆弱性指数以及地区剥夺指数。我们观察到，按ND指数划分，PTB中黑白差异的程度没有显著差异。虽然估计值没有明显差异，但结果的解释应考虑指数及其组成部分的意图。
