Abstract
An ecological study was conducted of fetal death and birth outcomes in Georgia counties from 1994 to 2006 to examine the effects of area-level social and economic factors upon the occurrence of stillbirths. Fetal death and live birth certificate data were merged with census and racial residential segregation data from census data sources and the Population Studies Center of the University of Michigan. Stillbirths were defined as fetal death with gestation of >20 weeks. Analysis was limited to 1,419,767 birth outcomes (12,114 stillbirths and 1,407,653 live births) among non-Hispanic black (N=4748 stillbirths) and white (N=7366 stillbirths) mothers. Multivariate logistic regression, using a generalized estimating equation (GEE) to account for the clustering of individuals within counties, was used to estimate the odds of having a stillbirth among the black and white mothers of Georgia counties, controlling for their individual-level attributes. There was an interaction between individual race and residential segregation. Among white mothers, increased county segregation was associated with decreased stillbirth risk (highest vs. lowest quintile of segregation, aOR=0.82, 95% CI: 0.71, 0.94), while for black mothers, stillbirth risk increased in more segregated counties (highest vs. lowest quintile of segregation, aOR=1.15, 95% CI: 0.99, 1.33). The black-white racial disparity in stillbirth risk rose from an aOR of 1.67 (95% CI: 1.52, 1.83) for low-segregation counties to an aOR of 2.35 (95% CI: 2.16, 2.55) for high-segregation counties. These results speak: of the enduring nature of race in shaping African Americans’ life chances, specifically for this study with regard to the viability of black infants.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call