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Health & Place
Volume 12, Issue 4, December 2006, Pages 547-556
 
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doi:10.1016/j.healthplace.2005.08.008    How to Cite or Link Using DOI (Opens New Window)
Copyright © 2005 Elsevier Ltd All rights reserved.

Maternal and child health and neighborhood context: The selection and construction of area-level variables

Julie K. Rajaratnama, E-mail The Corresponding Author, Jessica G. Burkeb, Corresponding Author Contact Information, E-mail The Corresponding Author and Patricia O’Campoc, E-mail The Corresponding Author

aDepartment of Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, 4th Floor, Baltimore, MD 21205, USA

bDepartment of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, 218 Parran Hall, 130 DeSoto Street, Pittsburgh, PA, 15261, USA

cCentre for Research on Inner City Health, University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, Canada M5B 1W8


Received 22 February 2005. 
Available online 26 September 2005.

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Abstract

 Background: Increasingly, maternal and child health researchers are employing the statistical approach of multilevel modeling analysis to simultaneously examine the relationship between contextual and individual determinants and maternal and child health outcomes. This review addresses the following questions: (1) What categories of neighborhood characteristics have been addressed? (2) How were those neighborhood characteristics operationalized?

 Methods: A literature review identified 31 relevant articles published between January 1999 and March 2004. The articles were read with special attention toward the measurement of neighborhood characteristics.

 Results: Twelve categories of neighborhood characteristics represented in the articles include income/wealth, employment, family structure, population composition, housing, mobility, education, occupation, social resources, violence and crime, deviant behavior and physical conditions. A wide diversity of approaches was used to measure these characteristics. The most widely utilized source of data was that of administrative records from the census or local government authorities. Although most authors provided theoretical explanations of their choice to examine broad neighborhood constructs, few were explicit about why certain indicators were selected to measure these constructs.

 Conclusions: There are theoretical, methodological and practical barriers in the measurement of the neighborhood context which must be addressed for the field to move forward. These barriers are discussed and recommendations are made for addressing them in future research.

Keywords: Neighborhood; Measurement; Maternal and child health; Context; Multilevel

Article Outline

Background
Methods
Results
Discussion
The theoretical barriers
The methodological barrier
The practical barrier
Conclusions
References

Health & Place
Volume 12, Issue 4, December 2006, Pages 547-556
 
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