Neighborhood-Level Effects on Preterm and Very Preterm Birth among a Multi-Year Birth Cohort in Wake County, NC

Lynne Messer, University of North Carolina at Chapel Hill
Jay S. Kaufman, University of North Carolina at Chapel Hill
Barbara A. Laraia, University of North Carolina at Chapel Hill

The independent effects of the neighborhood environment on health outcomes are of increasing interest in the public health literature. Residence in areas characterized by high concentrations of poverty and economic underdevelopment has been correlated with adverse health effects, including low birthweight. This study builds upon prior work by exploring the neighborhood effects on preterm and very preterm birth in NC. We merged three years of geocoded birth record data (30,481 births) with census tract variables (tract level poverty, residential stability, proportion of renters and proportion of Black-NonHispanic residents) for Wake County NC. Race-stratified multilevel analyses estimated modest effects of neighborhood level variables. After controlling for individual level covariates, poverty was associated with increased risk among White-NonHispanic women delivering very preterm while residential stability was associated with increased risk of very preterm birth among Black-NonHispanic women. This study represents substantial progress in understanding how neighborhoods influence birth outcomes.