Gentrification and Prevalence of Preterm Birth in Atlanta Open Access

Zlotorzynska, Maria (2014)

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Objective: To characterize neighborhood gentrification in Atlanta and investigate its association with preterm birth (PTB).

Methods: The study examined birth outcomes among singleton, live births to women residing in DeKalb and Fulton counties between 2000 and 2007. PTB was defined as birth occurring before 37 weeks of gestation. Gentrification at the census tract level was characterized using data from the US Census Bureau. Census tracts were first defined as "gentrifiable" at the beginning of the intercensal period on the basis of median household income (MHI) and the proportion of buildings built before 1970. The extent of gentrification in these tracts was then quantified based on the relative change between 1990 and 2000 in five variables: (1) proportion of adults over 25 with a college education; (2) proportion of labor force in professional/managerial occupations; (3) MHI; (4) median house value for all owner-occupied units; (5) median rent. Generalized estimating equations were used to model the association between PTB risk and gentrification, adjusting for individual-level maternal characteristics. The study population was split into two birth cohorts, those occurring in 2000-2003 and those occurring in 2004-2007.

Results: Among women residing in gentrifiable areas, gentrification was not significantly associated with PTB in either cohort, after adjusting for covariates. However, among women who gave birth between 2004 and 2007, living in a high gentrification area was protective as compared to living in a low gentrification area for non-Hispanic white women and for women with some college education.

Conclusion: While residence in a highly gentrified area was not associated with increased PTB, the beneficial effects of living in such areas were not equitably distributed. These findings may be the result of high population turnover in areas with highest gentrification. More work is needed to characterize residential mobility patterns and to determine the extent to which displacement from gentrifying areas affects health outcomes.

Table of Contents

Introduction 1
Background and Literature Review 3
Preterm Birth as a Public Health Issue 3
Neighborhood Effects and Health 4
Gentrification 6
Drivers of Gentrification 7
Measurement of Gentrification 9
Consequences of Gentrification and Potential Implications for Health 13
Health Effects of Gentrification 17
Methods 21
Data Sources 21
Study Sample 21
Definition of Exposure 21
Definition of Outcome 22
Additional Covariates 23
Statistical Analysis 23
Results 25
Descriptive Statistics 25
Modeling 28
Discussion 31
References 37
Tables 44
Appendix: IRB Approval Letter 52

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