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Neighborhood context and infant birthweight among recent immigrant mothers: a multilevel analysis

Urquia ML, Frank JW, Glazier RH, Moineddin R, Matheson FI, Gagnon AJ. Am J Public Health. 2009; 99(2):285-93. Epub 2008 Dec 4.


Objectives — We compared the influence of the residential environment and maternal country of origin on birthweight and low birthweight of infants born to recent immigrants to urban Ontario.

Methods — We linked delivery records (1993–2000) to an immigration database (1993–1995) and small-area census data (1996). The data were analyzed with cross-classified random-effects models and standard multilevel methods. Higher-level predictors included 4 independent measures of neighborhood context constructed by factor analysis and maternal world regions of origin.

Results — Births (N = 22 189) were distributed across 1396 census tracts and 155 countries of origin. The associations between neighborhood indices and birthweight disappeared after we controlled for the maternal country of origin in a cross-classified multilevel model. Significant associations between world regions and birthweight and low birthweight persisted after we controlled for neighborhood context and individual characteristics.

Conclusions — The residential environment has little, if any, influence on birthweight among recent immigrants to Ontario. Country of origin appears to be a much more important factor in low birthweight among children of recent immigrants than current neighborhood. Findings of neighborhood influences among recent immigrants should be interpreted with caution.

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Keywords: Ethnicity and culture Social determinants of health Pediatric health

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