Research pub­lished in the Amer­ican Journal of Epi­demi­ology dis­cusses star­tling findings

New research sug­gests that one reason behind racial dis­par­i­ties in preterm birth may have a lot to do with where the mother lives. Written by North­eastern Uni­ver­sity pro­fessor Theresa Osypuk, the study found that regional hyper­seg­re­ga­tion (res­i­den­tial racial seg­re­ga­tion across four or more dimen­sions*) may con­tribute to the higher rate of preterm births among Black women com­pared to White women. Prior research has shown that infants born to Black women in the U.S. are 50% more likely to be preterm than infants born to White women, although the causes remain poorly understood.

The paper, titled “Are Racial Dis­par­i­ties in Preterm Birth Larger in Hyper­seg­re­gated Areas?,” also found that older Black women living in areas of the country with very high levels of neigh­bor­hood seg­re­ga­tion expe­ri­ence even higher risk of preterm birth than Black mothers in less seg­re­gated areas. The study appeared in the latest issue of the Amer­ican Journal of Epi­demi­ology. The abstract is avail­able at http://​aje​.oxford​jour​nals​.org/​c​g​i​/​c​o​n​t​e​n​t​/​a​b​s​t​r​a​c​t​/​1​6​7​/​1​1​/​1​295.

Dr. Osypuk ana­lyzed data related to births in 237 met­ro­pol­itan areas, including Boston – almost two mil­lion infants – to esti­mate the odds of preterm birth by hyper­seg­re­ga­tion, race and age. Lead author Dr. Osypuk and her cor­re­sponding author, Dolores Acevedo-​​Garcia, Asso­ciate Pro­fessor of Society, Human Devel­op­ment, and Health at Har­vard School of Public Health, also found that regional hyper­seg­re­ga­tion may con­tribute to the larger racial dis­parity in preterm births between Black and White infants.

The com­plexity of res­i­den­tial seg­re­ga­tion and its impact on preterm births and related health out­comes has been over­looked by health lit­er­a­ture,” said Dr. Osypuk, Assis­tant Pro­fessor in Northeastern’s Bouvé Col­lege of Health Sci­ences. “We believe that the asso­ci­a­tion between res­i­den­tial seg­re­ga­tion and higher risk of preterm birth is related to the neigh­bor­hood envi­ron­ments in which Black women live, including neigh­bor­hoods char­ac­ter­ized by high levels of poverty, vio­lent crime, and worse housing stock.”

The authors found that the asso­ci­a­tion between higher rates of preterm births and hyper­seg­re­gated areas was more pro­nounced at higher maternal ages. The racial dis­parity was also larger at higher ages. For example, an infant born to a Black woman over 40 years of age had a 2-​​times higher risk of preterm birth than a White infant of the same age in non-​​segregated regions, but this dis­parity in risk was 3 times higher in hyper­seg­re­gated areas.

This finding sug­gests that age-​​related preterm birth pat­terns may be related to stres­sors asso­ci­ated with res­i­den­tial seg­re­ga­tion and neigh­bor­hood inequal­i­ties facing Black women, which accu­mu­late with age. And these are stres­sors that White women just may not expe­ri­ence,” said Dr. Osypuk.

Because of high levels of racial seg­re­ga­tion, most Black and White women in the US live in entirely sep­a­rate neigh­bor­hoods, and these neigh­bor­hoods differ markedly in their quality. In fact, some of our prior work finds that the racial dis­parity in neigh­bor­hood quality is largest in highly seg­re­gated areas,” added Dr. Osypuk.

*Hyper­seg­re­ga­tion refers to a region that expe­ri­ences high res­i­den­tial seg­re­ga­tion along at least four of these five dimen­sions simul­ta­ne­ously: expo­sure (the prob­a­bility that Blacks have con­tact with Black neigh­bors); uneven­ness (the degree to which each neigh­bor­hood incor­po­rates the same pro­por­tions of Blacks and Whites as the met­ro­pol­itan area overall); clus­tering the ten­dency of Black neigh­bor­hoods to cluster together); cen­tral­iza­tion (the degree to which Black neigh­bor­hoods are at the center of the met­ro­pol­itan area); and con­cen­tra­tion (pop­u­la­tion density).

For more infor­ma­tion and for a copy of the paper dis­cussing the research, please con­tact Renata Nyul at 617–373-7424 or at r.​nyul@​neu.​edu.

About the Bouvé Col­lege of Health Sciences

The mis­sion of the Bouvé Col­lege of Health Sci­ences is to be a center of excel­lence in health pro­fes­sional edu­ca­tion, research, and ser­vice, with an inter­dis­ci­pli­nary emphasis that reflects today’s team approach to health care. The Col­lege is com­mitted to the gen­er­a­tion and advance­ment of knowl­edge to improve the health and health care ser­vices of indi­vid­uals and com­mu­ni­ties through basic and applied research. The three schools – health pro­fes­sions, nursing, and phar­macy – encourage inno­va­tion in the edu­ca­tion of both entry level and advanced prac­tice health pro­fes­sionals, and rec­og­nize the autonomy of each pro­fes­sion. Through part­ner­ships with health care delivery sys­tems and the com­mu­nity, Bouvé stu­dents and fac­ulty have access to prac­tice sites that pre­pare our grad­u­ates to meet the health care needs of our urban neigh­bors and society.

About North­eastern

Founded in 1898, North­eastern Uni­ver­sity is a pri­vate research uni­ver­sity located in the heart of Boston. North­eastern is a leader in inter­dis­ci­pli­nary research, urban engage­ment, and the inte­gra­tion of class­room learning with real-​​world expe­ri­ence. The university’s dis­tinc­tive coop­er­a­tive edu­ca­tion pro­gram, where stu­dents alter­nate semes­ters of full-​​time study with semes­ters of paid work in fields rel­e­vant to their pro­fes­sional inter­ests and major, is one of the largest and most inno­v­a­tive in the world.The Uni­ver­sity offers a com­pre­hen­sive range of under­grad­uate and grad­uate pro­grams leading to degrees through the doc­torate in six under­grad­uate col­leges, eight grad­uate schools, and two part-​​time divi­sions. For more infor­ma­tion, please visit www​.north​eastern​.edu.