Neighborhood crime, deprivation, and preterm birth.
OBJECTIVE
Significant racial disparity in preterm birth (PTB; birth at <37 weeks' gestation) exists, poorly explained by Individual-level factors. This research explores whether neighborhood crime contributes to the racial disparity in PTB.


METHODS
Geocoded Wake County, NC, birth records and crime-report data for 1999 to 2001 were merged with US Census data (2000). Race-stratified logistic and multilevel logistic models produced odds ratios (ORs) and 95% confidence intervals (CIs) for block-group violent, theft, property, and vice crime rates and singleton PTB.


RESULTS
A total of 13,960 women resided in a 114-block-group crime area. Non-Hispanic black women were more likely than non-Hispanic white women to deliver preterm (12.8% versus 6.7%), live in economically deprived block groups (42.2% versus 19.3% in the highest deprivation quartile), and experience more crime (32.0% versus 3.8% in the highest violent-crime-rate quartile). Quartiles of violent, theft, property, and vice crimes were associated with PTB in unadjusted models. Living in very high violent-crime-rate block-group quartiles was suggestive of increased odds of PTB for white and black non-Hispanic women (OR = 1.5; 95% CI, 0.9-2.6; and OR = 1.4; 95% CI, 1.0-2.1, respectively) in adjusted models. Other crime effects were attenuated after adjustment.


CONCLUSIONS
Differential neighborhood exposures may contribute to racial disparity in PTB.
Messer
Lynne C
LC
Departments of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC, USA. lmesser@email.unc.edu
Kaufman
Jay S
JS
Dole
Nancy
N
Savitz
David A
DA
Laraia
Barbara A
BA
D000293:Adolescent; D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D003415:Crime / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology* / Q000208:ethnology*; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data*