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African-American Women's Early-Life Exposure to Neighborhood Mortgage Discrimination and Preterm Birth Rates: A
Christina Kim1, S J Cavé Doi2, Liz Lamere2
1Ann & Robert H. Lurie Children's Hospital, McGaw Medical Center of Northwestern University, Chicago, IL, USA. chrkim@luriechildrens.org.
Maternal and Child Health Journal
|September 19, 2025
Summary
Early-life residence in urban neighborhoods with mortgage discrimination increases preterm birth (PTB) risk for African-American women. This association persists, particularly for early PTB, even when controlling for adult risk factors.
Area of Science:
- Environmental Health
- Reproductive Health
- Sociology
Background:
- Mortgage discrimination in urban neighborhoods has historically disadvantaged minority communities.
- Early-life environmental exposures can have long-lasting health consequences.
- Preterm birth (PTB) remains a significant public health concern, especially among African-American women.
Purpose of the Study:
- To investigate the association between early-life residence in urban neighborhoods with mortgage discrimination and the risk of preterm birth (PTB) in African-American women.
- To compare PTB rates in African-American women who grew up in neighborhoods with versus without mortgage discrimination.
Main Methods:
- Utilized a Chicago transgenerational dataset of African-American women and their infants.
- Employed stratified and multivariable binomial regression analyses.
- Integrated Home Mortgage Disclosure Act and Index of Concentration at the Extremes (ICE) data to characterize neighborhoods.
Main Results:
- African-American women with early-life residence in mortgage-discriminated neighborhoods had a higher PTB rate (15.8%) compared to those in non-discriminated neighborhoods (13.1%).
- The adjusted risk ratio for early PTB (<34 weeks) was significantly higher (1.60) for women residing in mortgage-discriminated neighborhoods during childhood.
- Even with adulthood residence in non-discriminated neighborhoods, early-life exposure to mortgage-discriminated areas was linked to increased early PTB risk.
Conclusions:
- Early-life exposure to urban neighborhoods characterized by mortgage discrimination and predominantly non-Hispanic White populations is associated with an elevated risk of PTB in African-American women.
- The increased risk is particularly pronounced for early preterm birth, suggesting a critical developmental window.
- These findings highlight the enduring impact of historical residential segregation and discrimination on adverse birth outcomes, independent of adult socioeconomic status.
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