title: Community Level Correlates of Low Birthweight Among African American, Hispanic and White Women in California.
abstract: OBJECTIVE
  Racial and ethnic groups in the US exhibit major differences in low birthweight (LBW) rates. While previous studies have shown that community level social indicators associated with LBW vary by race and ethnicity, it is not known whether these differences exist among racial or ethnic groups who live in the same neighborhood or community. To address this question, we examined the association of community level features with LBW among African American, White and Hispanic women who live in similar geographic areas.
  
  
  METHODS
  The analysis is based on geocoded birth certificates for all singleton live births in the year 2000 to women residing in 805 California ZIP codes. Community level social and demographic data were obtained from U.S. Census data files for the year 2000 and surrogate indices of population level alcohol and drug abuse and dependence were derived from hospital discharge data (HDD). Tobit and bootstrap analyses were used to test associations with birth outcomes, maternal characteristics, and community level social and demographic features within and across the three groups of women living in similar geographic areas.
  
  
  RESULTS
  The results demonstrate major racial and ethnic differences in community level correlates of LBW. Rates of LBW among African Americans were lower if they lived in areas that were more densely populated, had greater income disparities, were more racially segregated, and had low rates of alcohol abuse or dependence. These associations were different or absent for Hispanic and White women.
  
  
  CONCLUSIONS
  The results suggest that despite living in the same areas, major differences in neighborhood features and social processes are linked to birth outcomes of African American women compared to Hispanic and White women. Further research, especially using multilevel approaches, is needed to precisely identify these differences to help reduce racial and ethnic disparities in LBW.
authors.affiliation: School of Public Health, University of California, 50 University Hall, Berkeley, CA, 94720, USA. tiara@berkeley.edu.
authors.forename: Denise
authors.identifier: http://orcid.org/0000-0002-4938-7096
authors.initials: D
authors.lastname: Herd
authors.affiliation: Prevention Research Center, 180 Grand Avenue, Oakland, CA, 94612, USA. paul@prev.org.
authors.forename: Paul
authors.initials: P
authors.lastname: Gruenewald
authors.affiliation: Prevention Research Center, 180 Grand Avenue, Oakland, CA, 94612, USA. lilli@prev.org.
authors.forename: Lillian
authors.initials: L
authors.lastname: Remer
authors.affiliation: School of Public Health, University of California, 50 University Hall, Berkeley, CA, 94720, USA. sylviag@berkeley.edu.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Guendelman
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D002140:California; D005190:Family / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007230:Infant, Low Birth Weight; D011247:Pregnancy; D044469:Racial Groups / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: African Americans; Alcohol; Community level indicators; Drugs; Hispanics; Low birthweight; Neighborhoods; Socioeconomic status