There Goes the Neighborhood: The Relationship Between the Built Environment and Birth Weight in Central Durham, NC

Abstract

This project seeks to understand the relationship between neighborhood quality and birth weight in Central Durham, NC. Previous studies have shown that neighborhood context influences birth outcomes, even after adjusting for individual maternal characteristics and behaviors. Yet the traditional measures of neighborhood quality rely primarily on US Census socioeconomic demographic data that only reflect the aggregation of characteristics of individual residents to determine neighborhood conditions. These measures fail to account for the physical disorder (i.e. broken windows, peeling paint) present in the neighborhood’s built environment. My study employs the recently developed Neighborhood Health Indices (NHI), which measure neighborhood quality along eight separate domains: nuisances, housing damage, property characteristics, security measures, crime level, amenities, tenure status and vacancy at three different spatial resolutions. Using 2005-2007 birth data (N=2679) from the North Carolina Detailed Birth Record, I performed a multivariable regression analysis to explore the effects of neighborhood quality on birth weight after controlling for individual maternal risk factors. As predicted, the increased presence of nuisances, housing damage, property damage, renter-occupied status, and vacant houses were correlated with a decrease in birth weight. Proximity to amenities, increased security measures, and higher crime levels did not correlate significantly with birth weight. Across all indices, the magnitude and significance of the change in birth weight increased when widening the neighborhood context from individual block to primary adjacency to secondary adjacency level. This indicates that while living in a disadvantaged neighborhood can already be detrimental to birth weight, living adjacent to other poor quality neighborhoods further exacerbates these outcomes.