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Title of Journal: Matern Child Health J

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Abbravation: Maternal and Child Health Journal

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Springer US

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DOI

10.1007/s11412-006-8874-3

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1573-6628

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Measuring Women’s Cumulative Neighborhood Deprivat

Authors: Michael R Kramer Anne L Dunlop Carol J R Hogue
Publish Date: 2013/02/22
Volume: 18, Issue: 2, Pages: 478-487
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Abstract

A life course conceptual framework for MCH research demands new tools for understanding population health and measuring exposures We propose a method for measuring populationbased socioenvironmental trajectories for women of reproductive age We merged maternal longitudinallylinked births to Georgiaresident women from 1994 to 2007 with census economic and social measures using residential geocodes to create womancentered socioenvironmental trajectories We calculated a woman’s neighborhood deprivation index NDI at the time of each of her births and from these we calculated a cumulative NDI We fit Loess curves to describe average life course NDI trajectories and binomial regression models to test specific life course theory hypotheses relating cumulative NDI to risk for preterm birth Of the 1815944 total live births we linked 1000437 live births to 413048 unique women with two or more births Record linkage had high specificity but relatively low sensitivity which appears nondifferential with respect to maternal characteristics Georgia women on average experienced upward mobility across the life course although differences by race early life neighborhood quality and age at first birth produced differences in cumulative NDI Adjusted binomial models found evidence for modification of the effect of history of prior preterm birth and advancing age on risk for preterm birth by cumulative NDI The creation of trajectories from geocoded maternal longitudinallylinked vital records is one method to carry out life course MCH research We discuss approaches for investigating the impact of truncation of the life course selection bias from migration and misclassification of cumulative exposureThis study was supported by grant R40MC17180 from the Maternal and Child Health Bureau Title V Social Security Act Health Resources and Services Administration Department of Health and Human Services The authors also wish to acknowledge the cooperation of the Office of Health Indicators for Planning of the Georgia Department of Public Health

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