Neighborhood Child Opportunity and Preterm Birth Rates by Race and Ethnicity

Area of Science:

• Public Health
• Epidemiology
• Social Determinants of Health

Background:

• Preterm birth rates are significantly higher for non-Hispanic Black infants compared to non-Hispanic White infants in the US.
• Individual factors do not fully explain these preterm birth disparities.
• Neighborhood context, influenced by historical structural racism, may be a key factor in understanding these inequities.

Purpose of the Study:

• To assess the association between neighborhood opportunity levels, using the Child Opportunity Index (COI), and the incidence of preterm birth in Massachusetts.
• To investigate the role of neighborhood context in preterm birth disparities.

Main Methods:

• Cross-sectional, population-based study utilizing Massachusetts birth certificates (2011-2015).
• Linked birth data with US Census tract-level Child Opportunity Index (COI) data.
• Employed log binomial regression and generalized estimating equations to analyze associations.

Main Results:

• Infants born in very low opportunity neighborhoods showed a higher prevalence of preterm birth (adjusted PR, 1.16; 95% CI, 1.10-1.23).
• Over half of infants born to non-Hispanic Black and Hispanic birthing parents resided in very low opportunity neighborhoods.
• Crude models indicated a 44% higher prevalence of preterm birth in the lowest versus highest opportunity neighborhoods.

Conclusions:

• Exposure to very low opportunity neighborhoods is associated with an elevated risk of preterm birth.
• The disproportionate exposure of racial and ethnic minority groups to low opportunity neighborhoods suggests a modifiable factor contributing to preterm birth inequities.
• Interventions targeting neighborhood opportunity are warranted to address racial and ethnic disparities in preterm birth.