Understanding how the concentration of neighborhood advantage and disadvantage affects spina bifida risk among births to non-Hispanic white and Hispanic women, Texas, 1999-2014.

Abstract:

BACKGROUND:This is the first study to utilize the index of concentration at the extremes (ICE) to examine risk factors for spina bifida in Texas. The ICE is a useful measure for providing the degree to which residents in a certain area are concentrated into groups at the extremes of disadvantage and privilege. We introduce two novel ICE measures (language and nativity), and three existing ICE measures (race/ethnicity, income, and education), which we applied specifically to Texas residents. METHODS:We used multivariable mixed-model Poisson regression analyses to estimate spina bifida birth prevalence and prevalence ratios among singleton live births in Texas, 1999-2014, for each of our ICE measures. Maternal census tract at delivery was included in the models as a random effect. Analyses were stratified by maternal race/ethnicity (Hispanics and non-Hispanic whites). Live births served as denominators for each category. RESULTS:Among non-Hispanic white women, those in the most disadvantaged versus the advantaged census tract quintile had adjusted relative risk between 1.6 and 8.5 for having a baby affected by spina bifida. However, Hispanic women in the most disadvantaged versus advantaged census tract quintile for four ICE measures had a 33% to 87% lower risk of having an affected pregnancy. CONCLUSIONS:Findings suggest spina bifida risk is associated with neighborhood disadvantage or advantage, and that relationship seems to vary by race-ethnicity. The varied associations between ICE measures and spina bifida by race/ethnicity highlights the importance of using targeted interventions in the prevention of spina bifida.

journal_name

Birth Defects Res

journal_title

Birth defects research

authors

Shumate C,Hoyt A,Liu C,Kleinert A,Canfield M

doi

10.1002/bdr2.1374

subject

Has Abstract

pub_date

2019-08-15 00:00:00

pages

982-990

issue

14

issn

2472-1727

journal_volume

111

pub_type

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