Measuring the Effect of Neighborhood Racial Segregation on Fetal Growth.
Rebecca D Kehm, Dawn P Misra, Jaime C Slaughter-Acey and 1 others
PMID 34378455WHAT IT FOUND
The overall difference in birthweight was not clear.
Black women in neighborhoods with at least 75% Black residents had babies 47.3 grams lighter on average, but the association was clearer in married and higher-income women.
Key findings
01In the whole cohort, women in neighborhoods with at least 75% Black residents had infants 47.3 grams lighter on average than women in neighborhoods below that threshold, and the reported 95% CI was −99.0 to 4.4 grams.
02The association was evident in married women (fully adjusted difference −131.6 grams, 95% CI −230.6 to −32.6) and in women with household income at least $55,000 per year (fully adjusted difference −122.4 grams, 95% CI −215.0 to −29.8); it was not evident in unmarried women in the bivariate stratified model, and it was not evident in women with household income below $55,000 per year.
03Adjustment for childhood parental education changed the estimated difference to −41.6 grams, and adjustment for childhood neighborhood % Black changed it to −41.9 grams.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All participants were Black/African American women from one suburban hospital in Detroit, so the results do not speak to other groups or areas. The study measured only neighborhood percentage Black residents, not spatial segregation or other racial and ethnic groups. Childhood factors and income were partly self-reported after the fact, and more than 10% of data on adulthood household income and childhood neighborhood environment were missing, so they were imputed. The sample was relatively small for testing effect modification, and many possible mediators, such as stress, mental health, diet, activity, and environmental exposures, were not measured.
Declared interests
The authors declared no potential conflicts of interest. The article is listed as supported by NIH extramural funding.
The easy way to misread this
Do not conclude that living in a predominantly Black neighborhood caused lower birthweight. This was an observational study, the overall difference was not clear, and the association was clearer in married and higher-income women.