title: Ethnic enclaves and gestational diabetes among immigrant women in New York City.
abstract: Previous research has shown that immigrants living in their own ethnic enclave are at decreased risk of poor health outcomes, but this question has not been studied in relation to gestational diabetes, an important early marker of lifecourse cardiovascular health. We ascertained gestational diabetes, census tract of residence, and individual-level covariates for Sub-Saharan African, Chinese, South Central Asian, Non-Hispanic Caribbean, Dominican, Puerto Rican, Mexican, and Central and South American migrant women using linked birth-hospital discharge data for 89,703 singleton live births in New York City for the years 2001-2002. Using 2000 census data, for each immigrant group we defined a given census tract as part of an ethnic enclave based on the population distribution for the corresponding ethnic group. We estimated odds ratios for associations between living in an ethnic enclave and risk of gestational diabetes adjusted for neighborhood deprivation, percent commercial space, education, age, parity, and insurance status, using multilevel logistic regression. Overall, we found no effect of ethnic enclave residence on gestational diabetes in most immigrant groups. Among South Central Asian and Mexican women, living in a residential ethnic enclave was associated with an increased odds of gestational diabetes. Several explanations are proposed for these findings. Mechanisms explaining an increased risk of gestational diabetes in South Central Asian and Mexican ethnic enclaves should be examined.
authors.affiliation: Department of Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA. Electronic address: tjanevic@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Janevic
authors.affiliation: Department of Health Sciences, Graduate Program in Public Health, Lehman College, CUNY, 250 Bedford Park Boulevard West Bronx, NY 10468, USA. Electronic address: Luisa.borrell@lehman.cuny.edu.
authors.forename: L N
authors.initials: LN
authors.lastname: Borrell
authors.affiliation: Departments of Epidemiology and Obstetrics and Gynecology, Brown University Box G-S121-2, Providence, RI 02912, USA. Electronic address: david_savitz@brown.edu.
authors.forename: D A
authors.initials: DA
authors.lastname: Savitz
authors.affiliation: Department of Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA. Electronic address: Sandra.Echeverria@Rutgers.edu.
authors.forename: S E
authors.initials: SE
authors.lastname: Echeverria
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, USA. Electronic address: agr@columbia.edu.
authors.forename: A
authors.initials: A
authors.lastname: Rundle
mesh_terms: D000328:Adult; D017677:Age Distribution; D016000:Cluster Analysis; D016640:Diabetes, Gestational / Q000208:ethnology*; D054242:Emigrants and Immigrants; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D009519:New York City / Q000453:epidemiology; D011247:Pregnancy; D012111:Residence Characteristics; D018570:Risk Assessment; D055815:Young Adult
keywords: Gestational diabetes; Immigrant; Neighborhood; Pregnancy