Journal of Obstetric, Gynecologic & Neonatal Nursing
Article OnlineRelationships among Neighborhood Environment, Racial Discrimination, Psychological Distress, and Preterm Birth in African American Women
Section snippets
Neighborhood Environment
We examined three aspects of the neighborhood environment: physical disorder, social disorder, and violent crime. Disorder is “visible cues indicating a lack of order and social control” in the community (Ross & Mirowsky, 2001, p. 413). Cues are physical and social (Skogan, 1990). Physical disorder includes physical conditions of the neighborhood, such as vacant housing, vacant lots, and vandalism. Social disorder refers to activities involving people, such as drug dealing, prostitution, and
Design
In this pilot study, we used a cross‐sectional comparative design.
Sample
A sample of 72 self‐identified African American women was enrolled in the study. They were recruited into two groups: 33 women with preterm birth (<37 weeks gestation) and 39 women with full‐term birth (≥37 weeks gestation). Selection criteria included (a) at least 18 years of age, (b) singleton pregnancy, (c) at least 24 weeks gestation at the time of birth, (d) at least 24 hours after birth, and (e) medically stable. Also, the
Sample Characteristics
The women's mean age was 23 years and the mean gestational age was 36.7 weeks. Women with preterm birth had infants with a mean gestational age of 33.5 weeks, and women with full‐term birth had infants with a mean gestational age of 39.4 weeks. The majority of women were single (82%), employed (53%), had household annual incomes of <$10,000 (42%), and had either some college (39%) or graduated high school (38%) (Table 1).
Relationships among Variables
Objective neighborhood social disorder was positively related to
Discussion
Our results show that objective physical disorder was the only neighborhood environment variable that predicted preterm birth. Our findings regarding objective physical disorders were similar to the findings from Reagan and Salsberry (2005) that for African American women only, housing vacancy rates increased the risk of preterm birth at fewer than 33 weeks gestation. Furthermore, objective social disorder increased the level of psychological distress and indirectly affected the risk for
Conclusion
The results of this study suggest that psychological distress mediated the effects of objective social disorder and perceived crime on preterm birth. Health care providers need to assess women's perception of their neighborhoods and their influence on women's psychological distress. Nurses need to advocate for public policies that improve women's living conditions. By incorporating assessment of neighborhood environment during prenatal care and developing relevant interventions, nurses may
REFERENCES (45)
- et al.
Neighborhood context and reproductive health
American Journal of Obstetrics & Gynecology
(2005) - et al.
Racial disparities in preterm birth
Seminars in Perinatology
(2011) - et al.
Neighborhood deprivation and adverse birth outcomes among diverse ethnic groups
Annals of Epidemiology
(2010) - et al.
Modeling community‐level effects on preterm birth
Annals of Epidemiology
(2003) Racial and gender discrimination: Risk factors for high blood pressure?
Social Science and Medicine
(1990)- et al.
Racism, sexism, and social class: Implications for studies of health, disease, and well‐being
American Journal of Preventive Medicine
(1993) - et al.
Experiences of discrimination: Validity and reliability of a self‐report measure for population health research on racism and health
Social Science and Medicine
(2005) - et al.
Impact of maternal psychological distress on fetal weight, prematurity, and intrauterine growth retardation
Journal of Affective Disorders
(2008) - et al.
Neighborhood economic disadvantage, violent crime, group density, and pregnancy outcomes in a diverse, urban population
Social Science & Medicine
(2007) - et al.
Neighborhood crime, deprivation, and preterm birth
Annals of Epidemiology
(2006)
Neighborhood socioeconomic status, maternal race, and preterm delivery: A case‐control study
Annals of Epidemiology
The effects of racial density and income incongruity on pregnancy outcomes
Social Science and Medicine
Race and ethnic differences in determinants of preterm birth in the USA: Broadening the social context
Social Science and Medicine
Psychosocial stress and neuroendocrine mechanisms in preterm delivery
American Journal of Obstetrics & Gynecology
Social inequalities, stressors, and self reported health status among African American and white women in the Detroit metropolitan area
Social Science and Medicine
Preterm birth among African American and White women: A multilevel analysis of socioeconomic characteristics and cigarette smoking
Journal of Epidemiology and Community Health
Maternal stress and preterm birth
American Journal of Epidemiology
Psychosocial factors and preterm birth among African American and white women in central North Carolina
American Journal of Public Health
The psychological general well‐being index
Inner‐city parents under economic pressure – Perspectives on the strategies of parenting
Journal of Marriage and the Family
Using the expectation maximization algorithm to estimate coefficient alpha for scales with item‐level missing data
Psychological Methods
The relationship between the neighbourhood environment and adverse birth outcomes
Paediatric and Perinatal Epidemiology
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