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Pradip K Muhuri, PhD, ORM, National Center for Health Statistics, 3311 Toledo Road, Hyattsville, MD 20782, 301-458-4391, pmuhuri@cdc.gov
The study was designed to test the hypothesis that the black-white disparity in the incidence of preterm birth (<37 weeks’ gestation) was likely to be greater in “rich” counties than in “poor” counties because of “differential access to resources”. Data were obtained from the county-level Area Resource File and the 1995-99 Linked Birth/Infant Death Files. The analysis included 3,411,605 black and white infants nested within 771 counties that were randomly chosen from 3,084 counties for which both county- and infant-level data were available. Hierarchical linear models were estimated to examine the net effects of infant-level maternal characteristics (race, age, marital status and education), county-level contextual factors (e.g., median family income) and the cross-level interactions on preterm birth (PTB) among singleton infants born to non-Hispanic black and white mothers in the United States. Results show that only five percent of the total variance was explainable by county. Inclusion of the county- and individual-level characteristics resulted in the reduction of much of the total variance (0.05 to .013). The higher the county-level median family income, the lower the odds of PTB. Blacks had much higher odds of PTB when compared with whites. However, the significant positive interaction between the infant-level race and county-level median income suggests that the relative black disadvantage in PTB was disproportionately greater in counties with higher median income than in those with lower median income. Results support the hypothesis that the relative black disadvantage in preterm birth appears to be greater in “rich” counties than in “poor” counties.
Learning Objectives: At the conclusion of the session, the participant will be able to
Keywords: Research,
Related Web page: Not Apllicable
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.