title: Using geographical information systems to explore disparities in preterm birth rates among foreign-born and U.S.-born Black mothers.
abstract: OBJECTIVE
  To examine spatial patterns of neighborhood contextual factors of stress with preterm birth (PTB) and nativity (foreign-born and U.S.-born) among Black mothers.
  
  
  METHODS
  Descriptive geographic-spatial research.
  
  
  METHODS
  Births to Philadelphia residents during 2003-2005 in the context of Philadelphia residential neighborhoods (N = 350) were studied.
  
  
  METHODS
  All data were aggregated to neighborhood levels (census tracts). Maps were created to assess geographic-spatial patterns. A geographic information system (GIS) database was created that imported geo-coded data on births, crime (assaults with guns and domestic abuse), poverty, race, and nativity (foreign-born vs. U.S.-born).
  
  
  RESULTS
  Clear visual patterns of "bad" neighborhoods emerged and were significantly associated with higher prevalence of PTB for foreign-born Black and U.S.-born Black mothers (p < .0001).
  
  
  CONCLUSIONS
  This study demonstrated how GIS visually clarified important spatial patterns of adverse living conditions and PTB prevalence. Nurses can use GIS to better understand living environments of mothers and their families and to target interventions in geographical areas with the greatest service needs. Further research on individual and contextual factors is warranted to address the observed health disparities among the heterogeneous groups of foreign-born Black mothers. Despite limitations of aggregate data, it is clear that where mothers live matters. This has important implications for nursing practice and policy.
authors.affiliation: College of Nursing and Health Professions, Drexel University, 245 N. 15th Street, Philadelphia, PA 19102, USA. jrb68@drexel.edu
authors.forename: Joan Rosen
authors.initials: JR
authors.lastname: Bloch
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D001723:Birth Rate / Q000208:ethnology*; D044383:Black People / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005260:Female; D040362:Geographic Information Systems / Q000706:statistics & numerical data*; D005865:Gestational Age; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015143:Philadelphia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology* / Q000208:ethnology; D012111:Residence Characteristics; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult