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dc.contributor.authorAuger, N
dc.contributor.authorGiraud, J
dc.contributor.authorDaniel, M
dc.date.available2014-05-21T20:39:21Z
dc.date.available2009-07-14
dc.date.available2009-07-14
dc.date.available2009-07-14
dc.date.issued2009-07-14
dc.identifierpii: 1471-2458-9-237
dc.identifier.citationAuger, N., Giraud, J. & Daniel, M. (2009). The joint influence of area income, income inequality, and immigrant density on adverse birth outcomes: a population-based study. BMC PUBLIC HEALTH, 9 (1), https://doi.org/10.1186/1471-2458-9-237.
dc.identifier.issn1471-2458
dc.identifier.urihttp://hdl.handle.net/11343/27661
dc.descriptionC1 - Journal Articles Refereed
dc.description.abstractBACKGROUND: The association between area characteristics and birth outcomes is modified by race. Whether such associations vary according to social class indicators beyond race has not been assessed. METHODS: This study evaluated effect modification by maternal birthplace and education of the relationship between neighbourhood characteristics and birth outcomes of newborns from 1999-2003 in the province of Québec, Canada (N = 353,120 births). Areas (N = 143) were defined as administrative local health service delivery districts. Multi-level logistic regression was used to model the association between three area characteristics (median household income, immigrant density and income inequality) and the two outcomes preterm birth (PTB) and small-for-gestational age (SGA) birth. Effect modification by social class indicators was evaluated in analyses stratified according to maternal birthplace and education. RESULTS: Relative to the lowest tertile, high median household income was associated with SGA birth among Canadian-born mothers (odds ratio (OR) 1.13, 95% confidence interval (CI) 1.06, 1.20) and mothers with high school education or less (OR 1.13, 95% CI 1.02, 1.24). Associations between median household income and PTB were weaker. Relative to the highest tertile, low immigrant density was associated with a lower odds of PTB among foreign-born mothers (OR 0.79, 95% CI 0.63, 1.00) but a higher odds of PTB among Canadian-born mothers (OR 1.14, 95% CI 1.07, 1.21). Associations with income inequality were weak or absent. CONCLUSION: The association between area factors and birth outcomes is modified by maternal birthplace and education. Studies have found that race interacts in a similar manner. Public health policies focussed on perinatal health must consider the interaction between individual and area characteristics.
dc.formatapplication/pdf
dc.languageEnglish
dc.publisherBIOMED CENTRAL LTD
dc.subjectEpidemiology; Community Child Health; Health Policy Evaluation; Child Health
dc.titleThe joint influence of area income, income inequality, and immigrant density on adverse birth outcomes: a population-based study
dc.typeJournal Article
dc.identifier.doi10.1186/1471-2458-9-237
melbourne.peerreviewPeer Reviewed
melbourne.affiliationThe University of Melbourne
melbourne.affiliation.departmentMedicine - St Vincent'S Hospital
melbourne.source.titleBMC PUBLIC HEALTH
melbourne.source.volume9
melbourne.source.issue1
dc.rights.licenseCC BY
melbourne.publicationid142931
melbourne.elementsid321662
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714302
melbourne.contributor.authorDaniel, Mark
dc.identifier.eissn1471-2458
melbourne.fieldofresearch420299 Epidemiology not elsewhere classified
melbourne.fieldofresearch420601 Community child health
melbourne.seocode200205 Health policy evaluation
melbourne.seocode200506 Neonatal and child health
melbourne.accessrightsAccess this item via the Open Access location


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