TABLE 3.
Prevalence and adjusted risk ratios of SMM (no transfusion) by HOLC Score and maternal race and ethnicity; California, 1997–2017 (n = 2,007,297)
| Deliveries | SMM Cases | SMM Prevalence per 10,000 Deliveries | Model 1, RR (95% CI) | Model 2, RR (95% CI) | Model 3, RR (95% CI) | Model 4, RR (95% CI) | |
|---|---|---|---|---|---|---|---|
| Non-Hispanic black (n = 227,685) | |||||||
| HOLC Grade A + B | 33,439 | 279 | 83 | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| HOLC Grade C | 122,129 | 1108 | 91 | 1.12 (0.97, 1.29) | 1.14 (0.99, 1.31) | 1.12 (0.97, 1.28) | 1.08 (0.93, 1.24) |
| HOLC Grade D | 72,117 | 696 | 97 | 1.20 (1.03, 1.39) | 1.23 (1.06, 1.43) | 1.18 (1.02, 1.37) | 1.13 (0.97, 1.32) |
|
| |||||||
| Hispanic (n = 1,438,932) | |||||||
| HOLC Grade A + B | 162,369 | 800 | 49 | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| HOLC Grade C | 771,152 | 4071 | 53 | 1.09 (1.00, 1.18) | 1.10 (1.01, 1.20) | 1.07 (0.99, 1.17) | 1.04 (0.96, 1.14) |
| HOLC Grade D | 505,411 | 2841 | 56 | 1.16 (1.06, 1.27) | 1.18 (1.08, 1.29) | 1.13 (1.04, 1.24) | 1.09 (1.00, 1.20) |
|
| |||||||
| Non-Hispanic Asian/Pacific Islander (n = 334,982) | |||||||
| HOLC Grade A + B | 73,522 | 391 | 53 | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| HOLC Grade C | 177,958 | 1001 | 56 | 1.14 (1.01, 1.28) | 1.15 (1.02, 1.29) | 1.12 (0.99, 1.26) | 1.07 (0.95, 1.22) |
| HOLC Grade D | 83,502 | 452 | 54 | 1.08 (0.94, 1.24) | 1.09 (0.94, 1.25) | 1.04 (0.90, 1.19) | 0.99 (0.85, 1.14) |
|
| |||||||
| Non-Hispanic American Indian/Alaskan Native (n = 5698) | |||||||
| HOLC Grade A + B | NR | NR | 87 | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| HOLC Grade C | NR | NR | 75 | 0.98 (0.43, 2.22) | 1.03 (0.45, 2.34) | 0.93 (0.40, 2.13) | 0.87 (0.37, 2.06) |
| HOLC Grade D | NR | NR | 68 | 0.86 (0.33, 2.24) | 0.89 (0.34, 2.31) | 0.81 (0.31, 2.13) | 0.77 (0.28, 2.06) |
Note: Model 1: adjusted for maternal age, education, insurance type and nativity. Model 2: adjusted for covariates in Model 1 and parity, birth type. Model 3: adjusted for covariates in Model 2 and having any comorbidities. Model 4: adjusted for covariates in Models 1–3, as well as Neighbourhood Deprivation Index. Home Owner Loan Corporation (HOLC) Grade: A = Best, B = Still Desirable, C = Definitely Declining, D = Hazardous. NR, not reported; Sample sizes are not reported for some cells due to having fewer than 12 observations per data use agreement with the state of California.