Published In

Environmental Health Perspectives

Document Type

Article

Publication Date

3-2012

Subjects

Sustainable development -- Environmental aspects, Environmental health, Logistic regression analysis -- Data processing, Correlation (Statistics)

Abstract

Background: The built environment, a key component of environmental health, may be an important contributor to health disparities, particularly for reproductive health outcomes.Objective: In this study we investigated the relationship between seven indices of residential built environment quality and adverse reproductive outcomes for the City of Durham, North Carolina (USA).

Methods: We surveyed approximately 17,000 residential tax parcels in central Durham, assessing > 50 individual variables on each. These data, collected using direct observation, were combined with tax assessor, public safety, and U.S. Census data to construct seven indices representing impor­tant domains of the residential built environment: housing damage, property disorder, security measures, tenure (owner or renter occupied), vacancy, crime count, and nuisance count. Fixed-slope random-intercept multilevel models estimated the association between the residential built environ­ment and five adverse birth outcomes. Models were adjusted for maternal characteristics and clus­tered at the primary adjacency community unit, defined as the index block, plus all adjacent blocks that share any portion of a line segment (block boundary) or vertex.

Results: Five built environment indices (housing damage, property disorder, tenure, vacancy, and nuisance count) were associated with each of the five outcomes in the unadjusted context: preterm birth, small for gestational age (SGA), low birth weight (LBW), continuous birth weight, and birth weight percentile for gestational age (BWPGA; sex-specific birth weight distributions for infants delivered at each gestational age using National Center for Health Statistics referent births for 2000-2004). However, some estimates were attenuated after adjustment. In models adjusted for individual-level covariates, housing damage remained statistically significantly associated with SGA, birth weight, and BWPGA.

Conclusion: This work suggests a real and meaningful relationship between the quality of the residential built environment and birth outcomes, which we argue are a good measure of general community health.

Description

This is the publisher's final PDF. The article was originally published in Environmental Health Perspectives and is available online at: http://www.ncbi.nlm.nih.gov/pubmed/22138639

DOI

10.1289/ehp.1103578

Persistent Identifier

http://archives.pdx.edu/ds/psu/11493

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