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Pathways of neighbourhood-level socio-economic determinants of adverse birth outcomes

Meng, Gang, Thompson, Mary E, Hall, G Brent·2013·International Journal of Health Geographics
DOI 10.1186/1476-072x-12-32
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Abstract

Background: Although socio-economic factors have been identified as one of the most important groups of neighbourhood-level risks affecting birth outcomes, uncertainties still exist concerning the pathways through which they are transferred to individual risk factors. This poses a challenge for setting priorities and developing appropriate community-oriented public health interventions and planning guidelines to reduce the level of adverse birth outcomes. Method: This study examines potential direct and mediated pathways through which neighbourhood-level socio-economic determinants exert their impacts on adverse birth outcomes. Two hypothesized models, namely the materialist and psycho-social models, and their corresponding pathways are tested using a binary-outcome multilevel mediation analysis. Live birth data, including adverse birth outcomes and person-level exposure variables, were obtained from three public health units in the province of Ontario, Canada. Corresponding neighbourhood-level socio-economic, psycho-social and living condition variables were extracted or constructed from the 2001 Canadian Census and the first three cycles (2001, 2003, and 2005) of the Canadian Community Health Surveys. Results: Neighbourhood-level socio-economic-related risks are found to have direct effects on low birth weight and preterm birth. In addition, 20-30% of the total effects are contributed by indirect effects mediated through person-level risks. There is evidence of four person-level pathways, namely through individual socio-economic status, psycho-social stress, maternal health, and health behaviours, with all being simultaneously at work. Psycho-social pathways and buffering social capital-related variables are found to have more impact on low birth weight than on preterm birth. Conclusion: The evidence supports both the materialist and psycho-social conceptualizations and the pathways that describe them, although the magnitude of the former is greater than the latter.

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Metadata

Authors
Meng, G., Thompson, M. E., & Hall, G. B.
Venue
International Journal of Health Geographics
Publisher
Springer Science and Business Media LLC
Published
2013-06-20
Volume
12
Issue
1
ISSN
1476-072X
DOI
10.1186/1476-072x-12-32
Cited by
53
References
4
Language
en

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CoChat. (2026). Citation check: Pathways of neighbourhood-level socio-economic determinants of adverse birth outcomes. https://app.cochat.ai/papers/10.1186/1476-072x-12-32
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Meng, G., Thompson, M. E., & Hall, G. B. (2013). Pathways of neighbourhood-level socio-economic determinants of adverse birth outcomes. International Journal of Health Geographics. https://doi.org/10.1186/1476-072x-12-32

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