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Buka, S.L., R.T. Brennan, J.W. Rich-Edwards, Stephen W. Raudenbush, and F. Earls. 2003. "Neighborhood Support and the Birth Weight of Urban Infants." American Journal of Epidemiology, 157(1): 1-8.
Differences in maternal characteristics only partially explain the lower birth weights of infants of African-American women. It is hypothesized that economic and social features of urban neighborhoods may further account for these differences. The authors conducted a household survey of 8,782 adults residing in 343 Chicago, Illinois, neighborhoods to assess mean levels of perceived social support and used US Census data to estimate neighborhood economic disadvantage. Data on birth weight and maternal risk factors were gathered from 95,711 birth certificates (1994-1996). Before statistical adjustment of the data, infants born to African-American mothers were found to be, on average, 297 g lighter than those born to White mothers. After adjustment for individual-level risk factors, this difference was reduced to 154 g. For African-American mothers only, mean birth weight decreased significantly as the neighborhood level of economic disadvantage increased. For White mothers only, a significant positive association was found between perceived levels of neighborhood social support and infant birth weight. Adding these neighborhood-level predictors to the model reduced the adjusted White versus African-American difference in birth weight to 124 g. Results support the hypothesis that neighborhood-level factors are significantly associated with infant birth weight.