The Joint Influence of Area Income, Income Inequality, and Immigrant Density on Adverse Birth Outcomes: a Population-Based Study

The Joint Influence of Area Income, Income Inequality, and Immigrant Density on Adverse Birth Outcomes: a Population-Based Study

The Joint Influence of Area Income, Income Inequality, and Immigrant Density on Adverse Birth Outcomes: a Population-Based Study

The Joint Influence of Area Income, Income Inequality, and Immigrant Density on Adverse Birth Outcomes: a Population-Based Studys

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BMC Public Health, vol. 9, no 237.

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1. Objectifs


Intentions :
« The objective of this study was to examine the association between birth outcomes and area income, income inequality and segregation across different social markers in Quebec, Canada. [...] We evaluated whether the relationship between area characteristics and these birth outcomes was modified by two social markers, maternal birthplace and education. » (p. 2)

2. Méthode


Échantillon/Matériau :
« Data were obtained from the 1) Quebec birth file and 2) 2001 Canada census. [...] The final dataset was hierarchically structured with 353,120 births nested in 143 CLSCs. » (p. 2)

Type de traitement des données :
Analyse statistique

3. Résumé


« This study evaluated effect modification by maternal birthplace and education of the relationship between neighbourhood characteristics and birth outcomes of newborns from 1999-2003 in the province of Quebec, Canada (N = 353,120 births). Areas (N = 143) were defined as administrative local health service delivery districts. The results showed that « [...] relative to the lowest tertile, high median household income was associated with SGA birth among Canadian-born mothers (odds ratio (OR) 1.13, 95% confidence interval (CI) 1.06, 1.20) and mothers with high school education or less (OR 1.13, 95% CI 1.02, 1.24). Associations between median household income and PTB [ preterm birth ] were weaker. Relative to the highest tertile, low immigrant density was associated with a lower odds of PTB among foreign-born mothers (OR 0.79, 95% CI 0.63, 1.00) but a higher odds of PTB among Canadian-born mothers (OR 1.14, 95% CI 1.07, 1.21). Associations with income inequality were weak or absent.» In conclusion, researchers demonstrate that « [...] the association between area factors and birth outcomes is modified by maternal birthplace and education. Studies have found that race interacts in a similar manner. Public health policies focussed on perinatal health must consider the interaction between individual and area characteristics. » (p. 1)