Aims: This study assessed the relationship between spatial social polarization measured by the index of the concentration of the extremes (ICE) and preterm birth (PTB) and infant mortality (IM) in New York City. A secondary aim was to examine the ICE measure in comparison to neighborhood poverty. Methods: The sample included singleton births to adult women in New York City, 2010–2014 (n=532,806). Three ICE measures were employed at the census tract level: ICE − Income (persons in households in the bottom vs top 20th percentile of US annual household income), ICE −Race/Ethnicity (black non-Hispanic vs white non-Hispanic populations), and ICE – Income + Race/Ethnicity combined. Preterm birth was defined as birth before 37 weeks’ gestation. Infant mortality was defined as a death before one year of age. A two-level generalized linear model with random intercept was utilized adjusting for individual-level covariates. Results: Preterm birth prevalence was 7.1% and infant mortality rate was 3.4 per 1000 live births. Women who lived in areas with the least privilege were more likely to have a preterm birth or infant mortality as compared to women living in areas with the most privilege. After adjusting for covariates, this association remained for preterm birth (ICE – Income: Adjusted Odds Ratio (AOR) 1.16 (1.10–1.21); ICE – Race/Ethnicity: AOR 1.41 (1.34–1.49); ICE – Income + Race/Ethnicity: AOR 1.36 (1.29–1.43)) and IM (ICE – Race/Ethnicity (AOR 1.80 (1.43–2.28) and ICE – Income + Race/Ethnicity (AOR 1.54 (1.23–1.94)). High neighborhood poverty was associated with PTB only (AOR 1.09 (1.04–1.14). Conclusions: These results provide preliminary evidence for the use of the ICE measure in examining structural barriers to healthy birth outcomes.
PikettyT.Capital in the 21st century. Cambridge, MA: Harvard University Press, 2014.
2.
StiglitzJ.The great divide: unequal societies and what we can do about them. New York: W.W. Norton; 2015.
3.
WalksA.From financialization to sociospatial polarization of the city? Evidence from Canada. Econ Geog2014;90:33–66.
4.
BradbyHFrenzMSnowS.Migration and danger: ethnicity and health. Ethnicity & Health. 2016;21:333–9.
5.
OmiMWinantH.Racial formation in the United States: Routledge; 2014.
6.
KriegerN.Discrimination and health inequities. Int J Health Services. 2014;44(4):643–710.
7.
HortaBLVictoraCGMenezesAMet al. Low birthweight, preterm births and intrauterine growth retardation in relation to maternal smoking. Paediatr Perinat Epidemiol. 1997;11:140–51.
8.
Kyrklund-BlombergNBCnattingiusS.Preterm birth and maternal smoking: risks related to gestational age and onset of delivery. Am J Obstetrics Gynecol1998;179:1051–5.
9.
CopperRLGoldenbergRLDasAet al. The preterm prediction study: Maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks’ gestation. Am J Obstetrics Gynecol1996;175:1286–92.
10.
DoleNSavitzDAHertz-PicciottoIet al. Maternal stress and preterm birth. Am J Epidemiol2003;157:14–24.
11.
XiongXDemianczukNNSaundersLDet al. Impact of preeclampsia and gestational hypertension on birth weight by gestational age. Am J Epidemiol2002;155:203–9.
12.
GoldenbergRLCulhaneJFIamsJDet al. Epidemiology and causes of preterm birth. Lancet2008;371:75–84.
13.
MenonR.Spontaneous preterm birth, a clinical dilemma: etiologic, pathophysiologic and genetic heterogeneities and racial disparity. Acta Obstet Gynecol Scand2008;87:590–600.
14.
AhernJPickettKESelvinSet al. Preterm birth among African American and white women: a multilevel analysis of socioeconomic characteristics and cigarette smoking. J Epidemiol Community Health. 2003;57:606–11.
15.
O’CampoPBurkeJGCulhaneJet al. Neighborhood deprivation and preterm birth among non-Hispanic Black and White women in eight geographic areas in the United States. Am J Epidemiol2008;167:155–63.
16.
HuynhMParkerJDHarperSet al. Contextual effect of income inequality on birth outcomes. Int J Epidemiol2005;34:888–95.
17.
FarleyTAMasonKRiceJet al. The relationship between the neighbourhood environment and adverse birth outcomes. Paediatr Perinat Epidemiol. 2006;20:188–200.
18.
MesserLCKaufmanJSDoleNSavitzDALaraiaBA.Neighborhood crime, deprivation, and preterm birth. Ann Epidemiol2006;16:455–62.
19.
KaufmanJSDoleNSavitzDAet al. Modeling community-level effects on preterm birth. Ann Epidemiol2003;13:377–84.
20.
WoodwardR.Approaches towards the study of social polarization in the UK. Prog Human Geo1995;19:75–89.
21.
MasseyDS.The age of extremes: Concentrated affluence and poverty in the twenty-first century. Demography. 1996;33:395–412.
22.
MasseyDS.Reflections on the dimensions of segregation. Social Forces. 2012;91:39–43.
23.
MasseyDSBrodmannS.Spheres of influence: The social ecology of racial and class inequality: Russell Sage Foundation; 2014.
24.
KriegerNWatermanPDGryparisAet al. Black carbon exposure more strongly associated with census tract poverty compared to household income among US black, white, and Latino working class adults in Boston, MA (2003–2010). Environ Pollution2014;190:36–42.
25.
KriegerNWatermanPDGryparisAet al. Black carbon exposure, socioeconomic and racial/ethnic spatial polarization, and the Index of Concentration at the Extremes (ICE). Health Place2015;34:215–28.
26.
FeldmanJMWatermanPDCoullBAet al. Spatial social polarisation: using the Index of Concentration at the Extremes jointly for income and race/ethnicity to analyse risk of hypertension. J Epidemiol Community Health2015;69:1199–207.
27.
KriegerNWatermanPDSpasojevicJet al. Public health monitoring of privilege and deprivation with the index of concentration at the extremes. Am J Public Health2016:e1–e8.
28.
DoDPDubowitzTBirdCEet al. Neighborhood context and ethnicity differences in body mass index: a multilevel analysis using the NHANES III survey (1988–1994). Econ Human Bio2007;5:179–203.
29.
CarpianoRMLloydJEHertzmanC.Concentrated affluence, concentrated disadvantage, and children’s readiness for school: A population-based, multi-level investigation. Soc Sci Med2009;69:420–32.
30.
FinchBKDoDPHeronMet al. Neighborhood effects on health: concentrated advantage and disadvantage. Health Place2010;16:1058–60.
31.
KriegerNFeldmanJMWatermanPDet al. Local residential segregation matters: stronger association of census tract compared to conventional city-level measures with fatal and non-fatal assaults (total and firearm related), using the Index of Concentration at the Extremes (ICE) for Racial, Economic, and Racialized Economic Segregation, Massachusetts (US), 1995–2010. J Urban Health, 2017. Epub ahead of print 27 January 2017. DOI: 10.1007/s11524-016-0116-z.
32.
FloresRJLoboAP.The reassertaion of a black/non-black color line: the rise in integrated neighborhoods without blacks in New York City, 1970–2010. J Urban Affairs2013;35:255–82.
33.
LiuJ.Income inequality in New York City. New York City: New York City Comptroller’s Office, May2012.
WilliamsDRCollinsC.Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Rep2001;116:404–416.
36.
WenMBrowningCRCagneyKA.Poverty, affluence, and income inequality: neighborhood economic structure and its implications for health. Soc Sci Med2003;57:843–860.
MasseyDS.The prodigal paradigm returns: Ecology comes back to sociology. In: BoothACrouterA (eds) Does it take a village? Community Effects on children, adolescents, and families. Mahwah, NJ: Lawrence Erlbaum, 2001, pp.41–48.
40.
Li WHMLeeELasner-FraterLet al. Summary of vital statistics 2014, The City of New York: New York: New York City Department of Health and Mental Hygiene, 2016.
41.
PearlMBravemanPAbramsB.The relationship of neighborhood socioeconomic characteristics to birthweight among 5 ethnic groups in California. Am J Public Health2001;91:1808–14.
42.
Diez RouxAV. Investigating neighborhood and area effects on health. Am J Public Health2001;91:1783–9.
43.
CascianoRMasseyDS.Neighborhoods, employment, and welfare use: Assessing the influence of neighborhood socioeconomic composition. Soc Sci Res2008;37:544–58.
44.
CubbinCHaddenWCWinklebyMA.Neighborhood context and cardiovascular disease risk factors: the contribution of material deprivation. Ethnicity Disease2000;11:687–700.
45.
CubbinCSundquistKAhlénHet al. Neighborhood deprivation and cardiovascular disease risk factors: protective and harmful effects. Scand J Public Health2006;34:228–37.
46.
CubbinCWinklebyMA.Protective and harmful effects of neighborhood-level deprivation on individual-level health knowledge, behavior changes, and risk of coronary heart disease. Am J Epidemiol2005;162:559–68.
47.
WinklebyMSundquistKCubbinC.Inequities in CHD incidence and case fatality by neighborhood deprivation. Am J Preventive Med2007;32:97–106.
48.
BrennerNKeilR.The global cities reader: Psychology Press; 2006.
49.
ShawGMMalcoeLH.Residential mobility during pregnancy for mothers of infants with or without congenital cardiac anomalies: a reprint. Arch Environ Health1992;47:236–8.
50.
FellDBDoddsLKingWD.Residential mobility during pregnancy. Paediatr Perinat Epidemiol. Nov2004;18:408–14.
51.
CanfieldMARamadhaniTALangloisPHet al. Residential mobility patterns and exposure misclassification in epidemiologic studies of birth defects. J Expo Sci Environ Epidemiol2006;16:538–543.
52.
ChenLBellEMCatonARet al. Residential mobility during pregnancy and the potential for ambient air pollution exposure misclassification. Environ Res2010;110:162–8.
53.
SouthSJCrowderKChavezE.Migration and spatial assimilation among U.S. Latinos: classical versus segmented trajectories. Demography2005;42:497–521.
54.
SouthSJCrowderKD.Residential mobility between cities and suburbs: race, suburbanization, and back-to-the-city moves. Demography1997;34:525–38.
55.
PallottoEKCollinsJWDavidRJ.Enigma of maternal race and infant birth weight: A population-based study of US-born Black and Caribbean-born black women. Am J Epidemiol2000;151:1080–5.
56.
DavidRJCollinsJWJr. Differing birth weight among infants of US-born blacks, African-born blacks, and US-born whites. New Engl J Med1997;337:1209–14.
