Neighborhoods, Race and Health: Neighborhood Distress and Maternal Health in Pittsburgh

Racial disparities in maternal health outcomes continue to exist today despite controlling for individual differences in factors such associo‐economic status. In particular, Black women are much more likely to experience adverse birth outcomes than women who are White (e.g. infant mortality rate is 13.5 vs. 5.6; low birth weight is 13.6% vs. 7.6%). The racial difference is even greater in Pittsburgh, which has one of the highest infant mortality rates in the nation. The present study shifts the lens to the neighborhood ‐ specifically, neighborhood distress ‐ as a potential way to explain these racial discrepancies in maternal health. A very large share of Black families is affected by neighborhood distress as compared to White families. According to an Annie E. Casey Foundation report, approximately one in four Black children live in "severely distressed neighborhoods" in 2000 compared to just more than 1% of White children (O'Hare& Mather, 2003). These neighborhoods are characterized by high levels of poverty, unemployment, single‐mother families, and high school dropouts. Some studies show that living neighborhoods characterized by this type of distress are associated with adverse health outcomes (Ludwig et al., 2011; Krieger et al., 2005; Orr et al., 2003).Given this relationship between neighborhood distress and health, the Black‐White difference in exposure to distress may be important for explaining racial disparities in health. The present study examines the relationship between neighborhood distress and racial disparities in maternal health, going beyond prior research by using local level data to create a more nuanced measure of neighborhood distress. Data from the Pittsburgh Neighborhood and Community Information System are aggregated to the census tract level  and combined with Census and American Community Survey data to measure neighborhood distress. In addition to the more traditional census variables used to measure distress, we examine data on vacancy, foreclosure, and crime. Tract‐level data for births (2005‐09) from the Allegheny County Health Department are used to estimate the infant mortality rate and low‐birth weight outcomes. Findings include maps that show health outcomes overlaid onto the neighborhoods by race and measures of distress. Preliminary findings show that adverse health outcomes in Pittsburgh are spatial concentrated into neighborhoods with higher levels of violent crime, which also contain a majority Black population. In addition, the percent of child poverty is highly correlated with the percent Black population at the census tract level (0.61). The relationship between different measures of neighborhood distress and adverse maternal health outcomes will be discussed.