Building Community for Healthy Moms and Healthy Babies: The Protective Effect of Urban Black Communities

Authors: Elisabeth Root*, The Ohio State University, Kaiting Lang, The Ohio State University, Pamela Salsberry, The Ohio State University, Chris Browning, The Ohio State University
Topics: Geography and Urban Health, Medical and Health Geography, Spatial Analysis & Modeling
Keywords: healthy communities, health geography, preterm birth, spatial modeling, GIS
Session Type: Paper
Day: 4/3/2019
Start / End Time: 2:35 PM / 4:15 PM
Room: Tyler, Marriott, Mezzanine Level
Presentation File: No File Uploaded


Ohio has one of the highest reported infant mortality (IM) rates in the United States at 7.2, consistently ranking 45 the country. Further, racial disparities of birth outcomes within the state are alarming: the black IM rate of 15.1 is nearly triple the white IM rate of 5.5. The State of Ohio formed the Ohio Equity Institute (OEI) in 2013 to target nine counties for infant mortality prevention efforts. Many of the efforts by OEI organizations target community building and collective support of pregnant women and new mothers in low-income urban communities. We use spatial hierarchical conditional autoregressive models to explore the impact of these programs on infant mortality and preterm birth in the major urban centers across Ohio. First we examine the impact of living in a racially segregated urban community on the black-white disparity in birth outcomes. Next, we model the impact of specific urban socioeconomic and environmental factors on this disparity and explore cross-level interactions. Findings indicate 22% increase in the odds of a preterm birth for mother’s living in a high concentration black neighborhood, but this effect is attenuated when additional neighborhood characteristics are considered. Cross-level interactions show a protective effect for black mothers living in a high concentration black neighborhood (10% decrease in odds), and this effect grows stronger the longer an OEI program has been in the area. Results suggest that the community-building focus of the OEI initiative in Ohio may be having a positive impact on birth outcomes in low-income communities.

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