Neighborhood risk factors for low birthweight in Baltimore: A multilevel analysis

Patricia O'Campo, Xiaonan (Nan) Xue, Mei Cheng Wang, Margaret O. Brien Caughy

Research output: Contribution to journalArticle

350 Citations (Scopus)

Abstract

Objectives: Past research on low birthweight has focused on individual- level risk factors. We sought to assess the contribution of macrolevel social factors by using census tract-level data oil social stratification, community empowerment, and environmental stressors. Methods: Census tract-level information on social risk was linked to birth certificate records from Baltimore, Md, for the period 1985 through 1989. Individual-level factors included maternal education, maternal age, medical assistance health insurance (Medicaid), and trimester of prenatal care initiation. Methods of multilevel modeling using two-stage regression analyses were employed. Results: Macrolevel factors had both direct associations and interactions with low birthweight. All individual risk factors showed interaction with macrolevel variables; that is, individual-level risk factors for low birthweight behaved differently depending upon the characteristics of the neighborhood of residence. For example, women living in high-risk neighborhoods benefited less from prenatal care than did women living in lower-risk neighborhoods. Conclusions: Multilevel modeling is an important tool that allows simultaneous study of macro- and individual-level risk factors. Multilevel analyses should play a larger role in the formulation of public health policies.

Original languageEnglish (US)
Pages (from-to)1113-1118
Number of pages6
JournalAmerican Journal of Public Health
Volume87
Issue number7
StatePublished - Jul 1997
Externally publishedYes

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Multilevel Analysis
Baltimore
Birth Certificates
Prenatal Care
Censuses
Medical Assistance
Maternal Age
Medicaid
Health Insurance
Public Policy
Health Policy
Oils
Public Health
Regression Analysis
Mothers
Education
Research

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Neighborhood risk factors for low birthweight in Baltimore : A multilevel analysis. / O'Campo, Patricia; Xue, Xiaonan (Nan); Wang, Mei Cheng; Brien Caughy, Margaret O.

In: American Journal of Public Health, Vol. 87, No. 7, 07.1997, p. 1113-1118.

Research output: Contribution to journalArticle

O'Campo, P, Xue, XN, Wang, MC & Brien Caughy, MO 1997, 'Neighborhood risk factors for low birthweight in Baltimore: A multilevel analysis', American Journal of Public Health, vol. 87, no. 7, pp. 1113-1118.
O'Campo, Patricia ; Xue, Xiaonan (Nan) ; Wang, Mei Cheng ; Brien Caughy, Margaret O. / Neighborhood risk factors for low birthweight in Baltimore : A multilevel analysis. In: American Journal of Public Health. 1997 ; Vol. 87, No. 7. pp. 1113-1118.
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