About this poster

---

Panel information
Panel 1. Context: Cross-Cultural, Neighborhood, and Social

Abstract

---

Introduction

U.S. perinatal outcomes such as infant mortality and preterm birth are significantly higher than comparative wealthy nations with significant racial disparities evident (Tanne, 2020). Poor perinatal outcomes contribute to lower life expectancies, with those who do survive experiencing numerous long-term health challenges. Previous research explaining racial differences in perinatal outcomes has focused on individual contributing factors such as maternal health, socio-economic status, and race (Hill et al., 2022). While individual risk factors remain important to consider, a growing body of evidence points to communities as critical contributors to health outcomes. Although community factors are recognized as robust predictors of health throughout the lifespan, little work has examined their role in perinatal outcomes. Given that health inequities emerge early in life, communities represent a potentially important but underexplored feature of what shapes perinatal outcomes. Further, widespread residential segregation in the United States means communities and their resources are often also segregated along racial/ethnic lines. Structural barriers and unequal access to socioeconomic or health resources, thus, likely play a role in perpetuating this racial health gap (Assari, 2018). The purpose of this study, then, is to explore the association of community-level resources and racial density with multiple perinatal outcomes within Virginia.

Methods

Advances in geospatial techniques enable us to combine multiple place-based datasets in order to examine the intersection of community resources, racial density, and perinatal outcomes at the county level. Utilizing this approach, we combined the 2017 publicly available perinatal health data from the Virginia Department of Health (VDH) with the Child Opportunity Index (COI) 2.0 (diversitydatakids.org), a census tract measure of community resources, conditions, and opportunities (e.g., access and quality of early childhood education, green space) that are important for children’s healthy development. COI also contains census race/ethnicity data of children 0-4 years old that, when aggregated to the county level, provides a measure of the racial density of young children. COI data were aggregated to the 133 counties/localities as defined in the VDH data, and then the two datasets were merged. Descriptives are reported in Table 1.

Results

A series of multivariate regression models were run to examine the contribution of community-level resources and racial density of young children to multiple perinatal outcomes, including teen pregnancies, infant mortality rate, percent of preterm birth rate, and percent of low-birth weight. As shown in Table 2, each model was significant, meaning that the community-level resources and racial density of young children consistently predicted perinatal outcomes at the county level across the state of Virginia. Further, each independent variable proved consistently significant: communities with greater access to resources and communities with a lower density of minority children duly exhibiting better perinatal outcomes.

Conclusion

Findings suggest that communities play a significant role in perinatal outcomes and may potentially explain some of the racial disparities observed. Thus, health outcomes previously associated with individual characteristics are also connected to the environment within which they occur. Individual health outcomes cannot be viewed in isolation; these health outcomes must be viewed from the larger, communal level to adequately address the social determinants contributing to them. Understanding how community experiences intersect with individual characteristics to contribute to health inequity, then, requires a more complex and nuanced examination of the multiple systems and contextual factors at play. These insights point to policy levers as potential interventions to enhance health at the community level and address the persistent racial health gap in perinatal outcomes.

Author information

Author	Role
Jennifer LoCasale-Crouch, Virginia Commonwealth University	Presenting author
Bergen Nelson, Virginia Commonwealth University, United States	Non-presenting author
Genevieve Deeken, University Paris Cité, United States	Non-presenting author
Michelle Taylor, California State University – Long Beach, United States	Non-presenting author
Bisola Duyile, Montclair State University, United States	Non-presenting author

⇦ Back to session