背景:在美国,与白人相比,种族人口的不良分娩结局发生率更高我们估计了社区社会和物理环境对加利福尼亚州不良分娩结局差异的中介作用。
方法:我们使用出生父母的居住地址来估算2019年以来加利福尼亚州的活产记录,以估算人口普查区块组的面积剥夺指数和环境细颗粒物(PM2.5)的人口普查区水平测量值,饮用水污染,树冠覆盖,作为绿色空间的衡量标准,潜在的热脆弱性,和噪音。我们进行了调解分析,以评估邻里因素是否可以解释早产(PTB)和足月出生低出生体重(TLBW)的种族/种族差异,Latinx,和亚洲人在控制了个人水平的因素后出生的白人。
结果:黑色,Latinx,亚洲父母的PTB率为67%,36%,高出11%,TLBW比率为150%,38%,比白人高81%。邻里剥夺贡献了7%(95%CI:3%,11%)至黑白和9%(95%CI:6%,12%)到PTB中的Latinx-White差异,和8%(95%CI:3%,12%)的黑白和9%(95%CI:5%,TLBW中Latinx-White差异的15%)。饮用水污染占2%(95%CI:1%,4%)到PTB中的Latinx-White差异。缺乏绿色空间占7%(95%CI:2%,Latinx-WhitePTB差异的10%)和7%(95%CI:3%,12%)的亚洲白人PTB差距。PM2.5贡献了11%(95%CI:5%,18%),饮用水污染占3%(95%CI:1%,7%),潜在的热脆弱性贡献了2%(95%CI:1%,3%)到Latinx-WhiteTLBW差异。缺乏绿色空间贡献了3%(95%CI:1%,6%)到亚洲白人TLBW的差距。
结论:我们的研究表明,社会环境解释了部分黑人/拉丁裔白人差异,而物理环境解释了PTB和TLBW中的拉丁裔/亚裔白人差异。
BACKGROUND: Racially minoritized populations experience higher rates of adverse birth outcomes than White populations in the U.S. We estimated the mediating effect of neighborhood social and physical environments on disparities in adverse birth outcomes in California.
METHODS: We used birthing parent\'s residential address for California live birth records from 2019 to estimate census block group Area Deprivation Index and census tract level measures of ambient fine particulate matter (PM2.5), drinking water contamination, tree canopy coverage, as a measure of greenspace, potential heat vulnerability, and noise. We performed mediation analysis to assess whether neighborhood factors explain racial/ethnic disparities in preterm birth (PTB) and term-birth low birth weight (TLBW) comparing Black, Latinx, and Asian with White births after controlling for individual-level factors.
RESULTS: Black, Latinx, and Asian parents had PTB rates that were 67%, 36%, and 11% higher, and TLBW rates that were 150%, 38%, and 81% higher than Whites. Neighborhood deprivation contributed 7% (95% CI: 3%, 11%) to the Black-White and 9% (95% CI: 6%, 12%) to the Latinx-White disparity in PTB, and 8% (95% CI: 3%, 12%) of the Black-White and 9% (95% CI: 5%, 15%) of the Latinx-White disparity in TLBW. Drinking water contamination contributed 2% (95% CI: 1%, 4%) to the Latinx-White disparity in PTB. Lack of greenspace accounted for 7% (95% CI: 2%, 10%) of the Latinx-White PTB disparity and 7% (95% CI: 3%, 12%) of the Asian-White PTB disparity. PM2.5 contributed 11% (95% CI: 5%, 18%), drinking water contamination contributed 3% (95% CI: 1%, 7%), and potential heat vulnerability contributed 2% (95% CI: 1%, 3%) to the Latinx-White TLBW disparity. Lack of green space contributed 3% (95% CI: 1%, 6%) to the Asian-White TLBW disparity.
CONCLUSIONS: Our study suggests social environments explain portions of Black/Latinx-White disparities while physical environments explain Latinx/Asian-White disparities in PTB and TLBW.