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Housing conditions and the quality of children at birth
E L Struening1, R Wallace, R Moore
1Epidemiology of Mental Disorders Research Department, New York State Psychiatric Institute, New York.
Insights
New York City saw decreasing low birth weight rates overall, but increasing disparities between neighborhoods. Some areas achieved very low rates, while others experienced exceptionally high rates, indicating growing health status polarization.
Area of Science:
- Public Health
- Epidemiology
- Urban Health Disparities
Background:
- Low birth weight (LBW) is a critical indicator of newborn health and a predictor of long-term health outcomes.
- Understanding geographic variations in LBW rates is essential for targeted public health interventions.
- Previous studies have highlighted socioeconomic factors influencing LBW, but temporal trends in urban settings require further investigation.
Purpose of the Study:
- To analyze temporal trends and geographic disparities in low birth weight (LBW) rates across New York City's health areas.
- To examine the changing distribution of LBW rates over three decades (1970s-1980s).
- To identify potential correlations between LBW rate polarization and urban environmental factors.
Main Methods:
- Computed LBW rates (birth weight < 2,501 grams) for 338 NYC health areas across three time periods: 1969-1971, 1979-1981, and 1985-1987.
- Developed frequency distributions of LBW percentages for each period.
- Analyzed changes in rate distributions, focusing on shifts in the tails (very low and very high rates) and overall variability.
Main Results:
- Overall LBW rates decreased between the 1970s and 1980s.
- Significant polarization of LBW rates occurred, with some areas achieving very low rates and others experiencing sharp increases.
- The range of minimum to maximum LBW rates widened considerably from 1970 to 1986, indicating increased variability and disparity.
- Areas with high LBW rates in 1980 showed significant housing destruction and community devastation between 1970 and 1980.
Conclusions:
- LBW rate trends in NYC demonstrate increasing geographic disparities, moving beyond simple decreases to a polarized distribution.
- The widening range of LBW rates suggests that while some areas improved, others faced worsening conditions contributing to adverse birth outcomes.
- Environmental factors, such as urban devastation, may be linked to the rise in high LBW rates in specific communities.
Abstract:
Low birth weight (less than 2,501 grams at birth) rates were computed for the 338 health areas of New York City for three time periods: 1969-1971, 1979-1981, and 1985-19. Frequency distributions of the 338 health areas were developed according to the percent of babies with birth weights less than 2,501 grams for each of the periods indicated above. Comparison of the 1970 and 1980 distributions indicates a decrease in low birth weight rates, but an increase in both tails of the 1980 distribution, resulting in greater variability in 1980 rates. This polarization reveals that some areas of New York City had achieved very low rates while other areas had increased to exceptionally high rates. The distribution for 1986 (1985-1987) indicates a continuation of rate shifts, particularly in the low rate tail where, in comparison with 1980, 19 additional health area populations had rates of low birth weight less than 0.05. With 1970 as a reference point, 71 additional health area populations had achieved rates less than 0.05 by 1986. In contrast, the high tail for 1986 does not shift and is very similar to that of 1980. As previously noted, the shift in rate values in the high tail from 1970 to 1980 is not in the expected direction and contributes to the polarization of health status in New York City populations by contributions of newborns. Low birth weight values for 1986 stabilize this shift in the "wrong" direction. The range of minimum and maximum values, which increased from 0.144 to 0.190 to 0.226 for 1970, 1980, and 1986 respectively, document the change in degree of polarization. Health areas in the high low birth weight tail experienced the greatest amount of housing destruction and community devastation between 1970 and 1980.