Racial and ethnic variation in low birthweight in the United States: individual and contextual determinants.

Using the Linked Birth and Death data set for 1990, the County-City Plus for 1993, and Summary Tape Files (STF) for 1990, a multilevel model is utilized to examine the influence of county and individual-level characteristics on low birthweight risk for white, black, Mexican, Cuban and Puerto Rican infants in the United States. Logistic regression results show that the racial and ethnic differences in low birthweight are not only the result of the individual-level characteristics of the mother, but also are a function of the characteristics of the county where the mother resides. Support for the contention that contextual factors work directly and indirectly to affect low birthweight risk was found. Separate racial/ethnic models indicate that the specific contextual variables that account for low birthweight risk vary across racial/ethnic groups.

[1]  S. Ventura,et al.  Childbearing characteristics of U.S.- and foreign-born Hispanic mothers. , 1985, Public health reports.

[2]  R. T. Coward,et al.  A multivariate assessment of the effects of residence on infant mortality. , 1991, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[3]  N. Binkin,et al.  Pregnancy outcomes among Spanish-surname women in California. , 1986, American journal of public health.

[4]  A. Geronimus On Teenage Childbearing and Neonatal Mortality in the United States , 1987 .

[5]  L. Ta Linking residential segregation to the infant-mortality race disparity in U.S. cities. , 1989 .

[6]  N. Binkin,et al.  Racial differences in neonatal mortality. What causes of death explain the gap? , 1988, American journal of diseases of children.

[7]  R. Hummer Racial differentials in infant mortality in the U.S.: an examination of social and health determinants. , 1993 .

[8]  N. Binkin,et al.  Racial differences in neonatal mortality. , 1988 .

[9]  C. Hogue,et al.  Impact of very low birthweight on the black-white infant mortality gap. , 1992, American journal of preventive medicine.

[10]  T. Laveist,et al.  Race/ethnicity, the social environment, and health. , 1996, Social science & medicine.

[11]  B. Larroque Chapter 2 Alcohol and the Fetus , 1992 .

[12]  G. Alexander,et al.  The role of prenatal care in preventing low birth weight. , 1995, The Future of children.

[13]  C. Brooks Social, economic, and biologic correlates of infant mortality in city neighborhoods. , 1980, Journal of health and social behavior.

[14]  R. Rochat,et al.  Lung cancer mortality and smoking habits: Mexican-American women. , 1982, American journal of public health.

[15]  G. Richardson,et al.  Prenatal alcohol exposure: a continuum of effects. , 1991, Seminars in perinatology.

[16]  B. Cohen,et al.  Patterns of cigarette smoking among Hispanics in the United States: results from HHANES 1982-84. , 1990, American journal of public health.

[17]  E. Ginzberg Access to health care for Hispanics. , 1991, JAMA.

[18]  Kelvyn Jones,et al.  Individuals and their ecologies: analysing the geography of chronic illness within a multilevel modelling framework , 1995 .

[19]  H. Atrash,et al.  Infant mortality among Hispanics. A portrait of heterogeneity. , 1991, JAMA.

[20]  T. Laveist Simulating the Effects of Poverty on the Race Disparity in Postneonatal Mortality , 1990, Journal of public health policy.

[21]  D. Massey,et al.  Segregation, the concentration of poverty, and the life chances of individuals , 1991 .

[22]  N. Moss,et al.  Explaining racial and ethnic differences in birth outcomes: the effect of household structure and resources. , 1992 .

[23]  Ita G. G. Kreft,et al.  Multilevel Analysis Methods , 1994 .

[24]  J. Samet Health benefits of smoking cessation. , 1991, Clinics in chest medicine.

[25]  C. B. Hale Infant Mortality: An American Tragedy. , 1990 .

[26]  E. Lieberman,et al.  The role of lifestyle in preventing low birth weight. , 1995, The Future of children.

[27]  L. Burmeister,et al.  The relationship of unwed status to infant mortality. , 1990, Obstetrics and gynecology.

[28]  T. Laveist The Political Empowerment and Health Status of African-Americans: Mapping a New Territory , 1992, American Journal of Sociology.

[29]  D. Commerce Statistical abstract of the United States , 1978 .

[30]  K. Markides,et al.  The health of Hispanics in the southwestern United States: an epidemiologic paradox. , 1986, Public health reports.

[31]  S. Kessel,et al.  Racial Differences in Low Birth Weight , 1987 .

[32]  Infant mortality by socioeconomic status and race in Richmond, Virginia 1979-1981: a research note. , 1990, Sociological spectrum : the official journal of the Mid-South Sociological Association.

[33]  P. Smith Sociologic Aspects of Adolescent Fertility and Childbearing among Hispanics , 1986, Journal of Developmental and Behavioral Pediatrics.

[34]  M S Kramer,et al.  Determinants of low birth weight: methodological assessment and meta-analysis. , 1987, Bulletin of the World Health Organization.

[35]  J. Gould,et al.  Generational differences in perinatal health among the Mexican American population: findings from HHANES 1982-84. , 1990, American journal of public health.

[36]  D. A. Swanson,et al.  Economic status differences in infant mortality by cause of death. , 1988, Public health reports.

[37]  R. Little Moderate alcohol use during pregnancy and decreased infant birth weight. , 1977 .

[38]  R. Behrman,et al.  Low birth weight: analysis and recommendations. , 1995, The Future of children.

[39]  H. Blalock,et al.  Contextual-Effects Models: Theoretical and Methodological Issues , 1984 .

[40]  R. Martorell,et al.  Selected measures of health status for Mexican-American, mainland Puerto Rican, and Cuban-American children. , 1991, JAMA.

[41]  J. Billy,et al.  Social Context and Adolescent Behavior: The Impact of Community on the Transition to Sexual Activity , 1993 .

[42]  T. Bennett,et al.  Marital status and infant health outcomes. , 1992, Social science & medicine.

[43]  G. Moon,et al.  Context, composition and heterogeneity: using multilevel models in health research. , 1998, Social science & medicine.

[44]  W T Boyce,et al.  Permanence and change: psychosocial factors in the outcome of adolescent pregnancy. , 1985, Social science & medicine.

[45]  R. Waldmann,et al.  Income Distribution and Infant Mortality , 1992 .

[46]  D. Hughes,et al.  The role of social change in preventing low birth weight. , 1995, The Future of children.