- St. David's CHPR
The long-term goal of this project is to investigate the relationship between neighborhood socioeconomic histories and black/white disparities in birth outcomes with the aim of informing policies and interventions.
Persistent black/white disparities in health begin at birth. Research indicates that black women in the United States persistently experience substantially higher rates of adverse birth outcomes compared with white women. These early life black/white disparities may have particularly devastating repercussions for the well-being of the black population over the lifecourse since adverse birth outcomes are associated with infant mortality, morbidity, and social outcomes.
Known individual-level risk factors do not consistently explain racial/ethnic disparities in adverse birth outcomes. Thus, researchers have increasingly begun to examine whether broader social factors, including neighborhood context, may influence these outcomes. Given the very high level of residential segregation between blacks and whites in the United States, a large portion of the black/white disparity in health may be due to greater cumulative exposure to neighborhood disadvantage for blacks.
Existing studies, with few exceptions, operationalize neighborhood environments as static (i.e., point-in-time) measures, despite the fact that neighborhood environments evolve over decades as a result of economic, social, and political forces; neighborhood histories may have differential impacts on health compared with conventional, static measures.
The purpose of this project is to determine whether neighborhood socioeconomic histories (measured using 40 years of data) contribute more to birth outcomes—and the black/white disparities in these outcomes—than traditional point-in-time measures of neighborhood socioeconomic status (SES).
This project will utilize a range of census tract-level socioeconomic variables from 1970-2010 to create neighborhood socioeconomic histories (e.g., long-term disadvantage, deterioration, economic growth), which we will compare to neighborhood socioeconomic variables from 2010 (as a point-in-time, i.e., conventional, measure). Black/white disparities in birth outcomes will also be examined, comparing analyses with neighborhood socioeconomic history measures to those with point-in-time measures. In addition, the research team will conduct a historical policy analysis through a critical race lens for the same time frame to examine impacts of health outcomes, more specifically black/white birth outcomes.
The project has the ability to shift the way that future research on neighborhood context and health is conducted and interpreted. The study provides an innovative method to examine the impact of neighborhood factors on adverse birth outcomes, and has the potential to inform interventions that will decrease black/white health inequities in adverse birth outcomes by understanding and identifying neighborhoods that are particularly detrimental or beneficial for birth outcomes.