A spatial measure of neighborhood-level racial isolation applied to low birthweight, preterm birth, and birthweight in North Carolina

Research on racial residential segregation (RRS) and birth outcomes has focused on RRS at a broad geographic scale, in an aspatial framework, and in northern US cities. We developed a spatial measure of neighborhood level racial isolation of blacks. We examined the association between this new measure and low birthweight, preterm birth, and birthweight in the southern state of North Carolina. Natality data were obtained from the North Carolina Detailed Birth Record 1998–2002 files. Using multiple regression with cluster corrected standard errors, infants born to black and white mothers living in black isolated neighborhoods had, on average, decreased birthweight, and increased odds of low birthweight and preterm birth compared to their counterparts in less isolated areas. White mothers in predominantly black neighborhoods experienced greater increases in odds of each poor birth outcome than did black mothers. Black isolation may be proxying concentrated socioeconomic disadvantage, including disamenities in the built environment.