The Effects of Neighborhood Social Stressors on Birth Weight

Abstract

Background/Aim: Racial and economic isolation are two social stressors that are novel in studying neighborhood effects on public health. Since these variables depend on the race and economic status of each individual subject, they represent a finer and perhaps more accurate measure of social and economic status. We investigate the effect of these social stressors on birth weights of Massachusetts newborns between 2001 and 2012. Methods: Racial and economic isolation were both scored from -1 to +1, where -1 represents the least isolated and +1 the most. We assign these social stressor indices to each birth (n = 664,828) based on maternal race and address at the block group level. Regression was used to determine the effect of each stressor on birth weight, adjusted for covariates marital status, maternal education, government-supported prenatal care, maternal/paternal age and race, maternal cigarette smoking before/during pregnancy, parity, Kotelchuck Index for prenatal care, gestational/other diabetes and hypertension, mode of delivery, infant sex, and clinical gestational age. We adjusted for particulate air pollution (PM2.5) additionally. Results: An interquartile range (IQR) increase in racial isolation (0.57 units) was associated with a -10.04 (95% CI: -13.25, -6.83) gram change in birth weight. After adjusting for PM2.5, this change was attenuated to -8.36 (-11.87, -4.84) g. In the full model with racial isolation, economic isolation, PM2.5, and covariates found an association of -8.61 (-12.11, -5.10) g change per IQR increase in racial isolation. Conclusions: Increased maternal racial isolation was found to be associated with lower birth weights in Massachusetts. Even with adjustment for economic isolation, PM2.5 exposure, and many individual health and socioeconomic covariates, racial isolation had a statistically significant detriment on birth weight.