Judith R. Katzburg, PhD, MPH, RN and Ronald M. Andersen, PhD. Department of Health Services, School of Public Health, UCLA, PO Box 951772, Los Angeles, CA 90095-1772, 310-825-2594, jkatzbur@ucla.edu

Research Objective: Significant low birth weight disparities exist in Los Angeles County. Public health planners consider geographic as well as racial and ethnic disparities in considering interventions to improve birth outcomes. This study intends to examine both individual and environmental (neighborhood) determinants of low birth weight to aid planners, with particular attention given to racial and ethnic effects at both the individual and census tract level. The appropriateness of targeting geographic regions will be considered. Study design: This retrospective study uses logistic regression and multilevel modeling to analyze the determinants of low birth weight. The population studied includes over 150,000 infants born to mothers who are residents of Los Angeles County employing a linked data set (year 2000 birth certificate and census data). Principal Findings: In multivariate analyses, Latina women do not appear to be at increased risk for low birth weight births in comparison to White women. However, both Asian and African American women have increased odds for having a low birth weight infant in comparison to Latinas. The neighborhood effects were particularly informative. Race/ethnicity had no significant effect at the neighbor level. However, the socio-economic status of the neighborhood did make a difference. In neighborhoods with higher levels of education, the odds of having a low birth weight infant were significantly reduced. Conclusions and Policy Implications: Disparities at the individual level do exist with African American and Asian women at greatest risk for low birth weight infants. Socio-economic disparities at the neighborhood level appear to play a role in outcomes as well. In less educated neighborhoods, program interventions targeting specific racial and ethnic groups at risk as well as other individuals at high risk for low birth weight, as identified in the analyses, may be appropriate. A cautionary note: given that Latina births account for both the highest number of births in the County as well as the highest number of the low birth weight births, it would be misguided to ignore the issue of low birth weight among this population, which is deemed to be at lower risk.

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