Abstract
Objectives: This study sought to determine whether neighborhood impoverishment explains the racial disparity in urban postneonatal mortality rates. Methods: Stratified and multivariate logistic regression analyses were performed on the vital records of all African-Americans and whites born in Chicago by means of a linked 1992–1995 computerized birth–death file with appended 1990 U.S. census income and 1995 Chicago Department of Public Health data. Four community-level variables (low median family income, high rates of unemployment, homicide, and lead poisoning) were analyzed. Communities with one or more ecologic risk factors were classified as impoverished. Results: The postneonatal mortality rate of African-Americans (N = 104,656) was 7.5/1000 compared to 2.7/1000 for whites (N = 52,954); relative risk (95% confidence interval) equaled 2.8 (2.3–3.3). Seventy-nine percent of African-American infants compared to 9% of white infants resided in impoverished neighborhoods; p < 0.01. In impoverished neighborhoods, the adjusted odds ratio (controlling for infant and maternal individual-level risk factors) of postneonatal mortality for African-American infants equaled 1.5 (0.5–4.2). In nonimpoverished neighborhoods, the adjusted odds ratio of postneonatal mortality for African-American infants equaled 1.8 (1.1–2.9). Conclusions: We conclude that urban African-American infants who reside in nonimpoverished neighborhoods are at high risk for postneonatal mortality.
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Papacek, E.M., Collins, J.W., Schulte, N.F. et al. Differing Postneonatal Mortality Rates of African-American and White Infants in Chicago: An Ecologic Study. Matern Child Health J 6, 99–105 (2002). https://doi.org/10.1023/A:1015464207740
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DOI: https://doi.org/10.1023/A:1015464207740