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Objective <p>To determine the extent to which African-American women’s early-life residence in urban neighborhoods with mortgage discrimination (compared to neighborhoods without mortgage discrimination) is associated with preterm birth (&lt; 37 weeks, PTB).</p> Methods <p>Stratified and multivariable binominal regression analyses were performed on a Chicago transgenerational dataset of African-American women (born 1989–1991) and their infants (born 2005–2017) with appended Home Mortgage Disclosure Act and Index of Concentration at the Extremes (ICE) data.</p> Results <p>In mortgage discriminated neighborhoods, the proportion of non-Hispanic White residents exceeded that of neighborhoods without mortgage discrimination: 84% vs. 31%, <i>p</i> &lt; 0.01. Additionally, mean ICE<sub>race/ethnicity</sub> for mortgage discriminated neighborhoods equaled 0.78 (0.64–0.91) confirming the greater concentrations of non-Hispanic White populations. African-American women (<i>n</i> = 735) with early-life residence in mortgage discriminated neighborhoods had a PTB rate of 15.8% compared to 13.1% for those (<i>n</i> = 23,369) with early-life residence in non-mortgage discriminated neighborhoods; RR = 1.20 (1.01, 1.43). The adjusted (controlling for trimester of prenatal care usage and cigarette smoking) RR of early (&lt; 34 weeks), late (34–36 weeks), and total PTB for African-American women with early-life residence in mortgage (compared to non-mortgage discriminated) neighborhoods equaled 1.60 (1.20, 2.14), 1.18 (0.92,1.53), and 1.31 (1.09,1.57), respectively. The subgroup of African-American women (<i>n</i> = 536) with early-life residence in mortgage discriminated neighborhoods and adulthood residence in non-mortgage discriminated neighborhoods had an early PTB rate of 8.0% versus 5.1% for those (<i>n</i> = 20,298) with a lifelong residence in non-mortgage discriminated neighborhoods; RR = 1.58 (1.18, 2.12).</p> Conclusions <p>Urban African-American women’s early-life residence in predominately non-Hispanic White, mortgage discriminated neighborhoods is associated with an increased risk of PTB, particularly its’ early component, independent of adulthood risk status.</p>

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African-American Women’s Early-Life Exposure to Neighborhood Mortgage Discrimination and Preterm Birth Rates: A Population-Based Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月19日

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  • Christina Kim,
  • S. J. Cavé Doi,
  • Liz Lamere,
  • Kristin Rankin,
  • Nana Matoba,
  • Nikhil Prachand,
  • James W. Collins

摘要

Objective

To determine the extent to which African-American women’s early-life residence in urban neighborhoods with mortgage discrimination (compared to neighborhoods without mortgage discrimination) is associated with preterm birth (< 37 weeks, PTB).

Methods

Stratified and multivariable binominal regression analyses were performed on a Chicago transgenerational dataset of African-American women (born 1989–1991) and their infants (born 2005–2017) with appended Home Mortgage Disclosure Act and Index of Concentration at the Extremes (ICE) data.

Results

In mortgage discriminated neighborhoods, the proportion of non-Hispanic White residents exceeded that of neighborhoods without mortgage discrimination: 84% vs. 31%, p < 0.01. Additionally, mean ICErace/ethnicity for mortgage discriminated neighborhoods equaled 0.78 (0.64–0.91) confirming the greater concentrations of non-Hispanic White populations. African-American women (n = 735) with early-life residence in mortgage discriminated neighborhoods had a PTB rate of 15.8% compared to 13.1% for those (n = 23,369) with early-life residence in non-mortgage discriminated neighborhoods; RR = 1.20 (1.01, 1.43). The adjusted (controlling for trimester of prenatal care usage and cigarette smoking) RR of early (< 34 weeks), late (34–36 weeks), and total PTB for African-American women with early-life residence in mortgage (compared to non-mortgage discriminated) neighborhoods equaled 1.60 (1.20, 2.14), 1.18 (0.92,1.53), and 1.31 (1.09,1.57), respectively. The subgroup of African-American women (n = 536) with early-life residence in mortgage discriminated neighborhoods and adulthood residence in non-mortgage discriminated neighborhoods had an early PTB rate of 8.0% versus 5.1% for those (n = 20,298) with a lifelong residence in non-mortgage discriminated neighborhoods; RR = 1.58 (1.18, 2.12).

Conclusions

Urban African-American women’s early-life residence in predominately non-Hispanic White, mortgage discriminated neighborhoods is associated with an increased risk of PTB, particularly its’ early component, independent of adulthood risk status.