title: The Relation of Neighborhood Income to the Age-Related Patterns of Preterm Birth Among White and African-American Women: The Effect of Cigarette Smoking.
abstract: Objectives We investigated the contributions of cigarette smoking to the age-related patterns of preterm (<37 weeks) birth (PTB) rates among African-American and White women within the context of lifelong neighborhood income. Methods Stratified and multilevel logistic regression analyses were performed on an Illinois transgenerational dataset of non-Hispanic White and African-American infants (1989-1991) and their mothers (1956-1976) with appended US census income information.
  
  
  
  Among non-smoking African-American women (n = 20,107) with a lifelong residence in lower income neighborhoods, PTB rates decreased from 18.5 % for teens to 15.0 % for 30-35 year-olds, p < 0.0001. The opposite pattern occurred among African-American women smokers (n = 5936) with a lifelong residence in lower income neighborhoods, p < 0.01. Among upwardly mobile African-American women smokers (n = 756), PTB rates increased from 11.1 % for teens to 24.9 % for 30-35 year-olds, p < 0.05. Cigarette smoking was not associated with an age-related increase in PTB rates among African-American women with a lifelong residence in upper income neighborhoods. No subgroup of White women, even cigarette smokers with a lifelong residence in lower income neighborhoods, exhibited weathering with regard to PTB. Conclusions A weathering pattern of rising PTB rates with advancing age occurs only among African-American women cigarette smokers with an early-life or lifelong residence in lower income neighborhoods, underscoring the public health policy importance of targeted smoking cessation programs in eliminating the racial disparity in the age-related patterns of PTB rates.
authors.affiliation: Division of Neonatology-#45, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, 60611, USA.
authors.forename: Shayna
authors.initials: S
authors.lastname: Hibbs
authors.affiliation: Department of Epidemiology, University of Illinois School of Public Health, 1200 W. Harrison St., Chicago, IL, 60607, USA.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Rankin
authors.affiliation: Division of Neonatology, Stroger Hospital of Cook County, 1969 W. Ogden Ave., Chicago, IL, 60612, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: David
authors.affiliation: Division of Neonatology-#45, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, 60611, USA. jcollins@northwestern.edu.
authors.forename: James W
authors.initials: JW
authors.lastname: Collins
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D005865:Gestational Age; D054624:Health Status Disparities; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D007182:Income; D007230:Infant, Low Birth Weight; D008423:Maternal Age; D009035:Mothers; D011159:Population Surveillance; D047928:Premature Birth / Q000208:ethnology*; D012111:Residence Characteristics; D012907:Smoking / Q000009:adverse effects* / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data
keywords: Cigarette smoking; Maternal age; Neighborhood income; Preterm birth; Racial disparity; Weathering