Abstract
BACKGROUND: Health inequities begin before birth and are influenced by pregnancy conditions, race/ethnicity, social class, and environment. Research indicates that, in the United States, Black women are significantly more likely to have low-birth-weight babies compared to White women. Interestingly, Hispanic women in the United States do not experience this birth weight inequity. The reasons for this disparity remain unclear. Both Hispanic and Black women face discrimination, and this is often cited as a primary reason for the higher prevalence of low-birth-weight babies among Black women. One type of discrimination that is less examined is neighborhood deprivation. METHOD: This study systematically examined the impact of various sociodemographic and pregnancy predictors among 9607 women in Phoenix, Arizona. Using multilevel modeling, we analyzed whether neighborhood deprivation (using the Area Deprivation Index) influenced the association between demographic and pregnancy risk and protective factors on birth weight outcomes. RESULTS: Consistent with prior research, we found that Black and Asian women had lower-birth-weight babies than White women, while Hispanic women did not show a significant difference from non-Hispanic women. Additionally, multilevel modeling suggested that increased neighborhood deprivation tends to exacerbate the impact of some risk factors (e.g., race) and reduce the impact of specific protective factors (e.g., gestational age) on birth weight. CONCLUSION: These findings suggest that both place and individual factors synergistically influence birth weight outcomes. Moreover, the results underscore the importance of targeting interventions to enhance resources among those who live in the most deprived neighborhoods.