Barboza-Salerno Gia Elise, Duhaney Sharefa, Liebhard Brittany, Schockley-McCarthy Karla
College of Public Health, The Ohio State University, Columbus, Ohio, United States of America.
College of Social Work, The Ohio State University, Columbus, Ohio, United States of America.
PLoS One. 2025 Aug 25;20(8):e0330449. doi: 10.1371/journal.pone.0330449. eCollection 2025.
How do patterns of socioeconomic inequality shape the risk of child fatality in urban areas? Research has shown that both intentional and unintentional child deaths are concentrated in areas of social disadvantage. Yet in densely populated cities, child fatality risk may not follow smooth spatial patterns and instead exhibit abrupt shifts across neighborhood boundaries. This study applies a dissimilarity-based Bayesian spatial conditional autoregressive (CAR) model to detect localized discontinuities in child mortality risk associated with structural inequality. Using a continuous dissimilarity function based on differences in Economic Hardship and Inequality (EHI) scores between adjacent census tracts, the model allows spatial smoothing to attenuate across sharp transitions. The model identified 413 spatial boundaries-termed social frontiers-where sharp structural discontinuities in EHI were associated with a 22% increase in the relative risk of child mortality, even after adjusting for racial segregation, concentrated disadvantage, residential mobility, and immigrant concentration. The significance of identifying neighborhoods characterized as social frontiers, where children may benefit from additional preventive interventions, is discussed in this context.
社会经济不平等模式如何影响城市地区儿童死亡风险？研究表明，儿童的意外死亡和非意外死亡都集中在社会弱势地区。然而，在人口密集的城市中，儿童死亡风险可能不会呈现出平滑的空间模式，而是在邻里边界处出现突然变化。本研究应用基于差异的贝叶斯空间条件自回归（CAR）模型，以检测与结构不平等相关的儿童死亡风险中的局部不连续性。该模型使用基于相邻普查区经济困难和不平等（EHI）得分差异的连续差异函数，允许空间平滑在急剧转变处减弱。该模型识别出413个空间边界，即所谓的社会边界，即使在调整了种族隔离、集中劣势、居民流动性和移民集中度之后，EHI中明显的结构不连续性与儿童死亡相对风险增加22%相关。在此背景下，讨论了识别被视为社会边界的社区的重要性，在这些社区中儿童可能受益于额外的预防干预措施。
