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 on social stratification, community empowerment, and environmental stressors.
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.
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.
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.
Mots-clés Pascal : Poids naissance faible, Aspect social, Effet groupe voisin, Environnement, Stress, Epidémiologie, Facteur risque, Nouveau né, Homme, Etats Unis, Amérique du Nord, Amérique, Gestation pathologie, Prématurité, Nouveau né pathologie
Mots-clés Pascal anglais : Low birth weight, Social aspect, Neighbouring group effect, Environment, Stress, Epidemiology, Risk factor, Newborn, Human, United States, North America, America, Pregnancy disorders, Prematurity, Newborn diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0447552
Code Inist : 002B20F02. Création : 03/02/1998.