title: Does Neighborhood Risk Explain Racial Disparities in Low Birth Weight among Infants Born to Adolescent Mothers?
abstract: OBJECTIVE
  To test associations and interactions between racial identification, neighborhood risk, and low birth weight disparities between infants born to African-American and white adolescent mothers.
  
  
  METHODS
  Retrospective cross-sectional study. Birth cases were geocoded and linked to census tract information from the 2010 US Census and the 2007-2011 American Community Survey. A "neighborhood risk" index was created using principal component analysis, and mothers were grouped into 3 neighborhood risk levels (low, medium, high). Multilevel models with cross-level interactions were used to identify variation in racial differences in low birth weight outcomes across neighborhood risk levels when controlling for maternal demographic characteristics and pregnancy behaviors (smoking, prenatal care use).
  
  
  METHODS
  North Carolina, United States.
  
  
  METHODS
  Singleton infants (n = 7923 cases) born to non-Hispanic African American and white adolescent mothers from the North Carolina State Center of Health Statistics for 2011.
  
  
  METHODS
  Low birth weight.
  
  
  RESULTS
  African American mothers were significantly more likely to have infants of low birth weight than white mothers in this sample (odds ratio = 1.89; 95% confidence interval, 1.53-2.34). Mothers that resided in areas of high neighborhood risk were significantly more likely to have infants of low birth weight than mothers residing in areas of low neighborhood risk (odds ratio = 1.55; 95% confidence interval, 1.25-1.93). Even when controlling for confounding factors, racial disparities in low birth weight odds did not significantly vary according to neighborhood risk level.
  
  
  CONCLUSIONS
  Racial disparities can remain in low birth weight odds among infants born to adolescent mothers when controlling for maternal characteristics, pregnancy behaviors, and neighborhood risk.
authors: Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina; Center for Women's Health and Health Disparities Research, University of Wisconsin-Madison, Madison, Wisconsin. Electronic address: scoley2@wisc.edu.
authors: Sheryl L
authors: SL
authors: Coley
authors: Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina.
authors: Tracy R
authors: TR
authors: Nichols
authors: Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina.
authors: Kelly L
authors: KL
authors: Rulison
authors: Public Health Program, Taylor University, Upland, Indiana.
authors: Robert E
authors: RE
authors: Aronson
authors: Department of Sociology, University of North Carolina at Greensboro, Greensboro, North Carolina.
authors: Shelly L
authors: SL
authors: Brown-Jeffy
authors: Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina.
authors: Sharon D
authors: SD
authors: Morrison
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology* / Q000706:statistics & numerical data; D011295:Prenatal Care; D012111:Residence Characteristics; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data*
keywords: Adolescent pregnancy; African-American; Health disparities; Low birth weight; Neighborhood; Racial disparities; Socioeconomic status