TABLE 1—
Studies Investigating Ethnic Density Among US Black Individuals
| Reference | Data Set | Sample | Outcome(s) | Area Unit | Ethnic Density Measure | Covariates | Method | Results |
| Adult mortality | ||||||||
| Blanchard et al.17 (2004) | National Health Interview Survey and the National Death Index (NDI; 1986–1994) | US-born Black respondents aged ≥ 18 years in the nonmetropolitan South, and metropolitan areas (658 680 person years) | Mortality (nonexternal causes of death, International Classification of Diseases codes 004–780 (US Department of Health and Human Services, 1990) | County; primary sampling unit actually used so smaller counties would have been combineda | % Black | Gender, age, marital status, education, equivalized income, employment, health, region, metropolitan status | Multilevel data and analysis | Black ethnic density was associated with reduced risk of mortality in nonmetropolitan South. In Metropolitan non–central city areas, Black ethnic density was not significantly associated with reduced risk of mortality. In metropolitan central city areas, ethnic density had a nonsignificant protective effect. |
| Cooper et al.58 (1997) | An inception cohort of all Medicare recipients aged ≥ 65 years with first diagnosis of colon or rectal cancer identified from Medicare Provider Analysis and Review (1990–1991) | Black persons aged ≥ 65 years | Colorectal cancer 2-year case fatality rates | County (n = 329) | % Black aged ≥ 18 years categorized in quartiles as: 2%–5%; 5.1%–8.5%; 8.6%–17.1%; 17.2%–62.4% | Age, gender, census region | Ecological study | 2-year case-fatality rates were lowest for Black persons in counties with lower Black ethnic density. |
| Cooper et al.59 (2001) | Ecological study using data from the National Center for Health Statistics (1989–1991) | Black persons aged < 65 years | Premature mortality (death before age 65 years) | MSA (n = 267) | % Black | Segregation, median income, inequality | Ecological study | Black ethnic density was associated with increased risk of premature mortality. |
| Erwin et al.60 (2010) | Health Information Tennessee and Tennessee County Health Rankings Report (2004–2006) | Not reported | All-cause mortality | Counties (n = 95); counties that had fewer than 20 Black deaths per year (n = 59) were joined and deaths summed, becoming “units” that added up to 20 Black deaths per year | % Black | Poverty, unemployment, education, population-to-physician ratio, violent crime, single-parent households, degree of urbanization or rurality | Ecological study | Correlations for the units (but not counties) showed statistically significant positive associations between mortality rates and Black ethnic density. In the multivariate regression, Black ethnic density at the county and unit level was associated with increased mortality rates, although with very small coefficients. |
| Fang et al.62 (1998) | New York mortality records (1988–1994) | Black men and women stratified by age 25–64 years and ≥ 65 years | All-cause mortality; coronary heart disease mortality | Zip code (n = 166) | % Black | Education, employment, % below poverty line, % born in South | Ecological study | For men and women aged ≥ 65 years, ethnic density was associated with reduced risk of all-cause mortality. For women aged 25–64 years, ethnic density was associated with reduced risk of coronary heart disease mortality but not all-cause mortality. For men aged 25–64 years, there was no association between ethnic density and mortality. |
| Franzini and Spears25 (2003) | Texas death certificates (1991) | Adults aged ≥ 25 years who had died from heart disease (n ≈ 50 000; % Black not reported) | Years of life lost because of heart disease | Census tract (n = 3788) and county (n = 247) | % Black | Gender, ethnicity, education; median house value, crime, % tenure | Cross-level interaction study with multilevel data and analysis | Black ethnic density measured at census-tract level but not at county level was associated with fewer years of life lost because of heart disease. |
| Hutchinson et al.63 (2009) | Philadelphia city vital statistics files; The Philadelphia Health Management Corporation 2004 Southeast Pennsylvania Community Health Database (1997–2000) | The entire Black population of Philadelphia | Age-adjusted Black mortality | Neighborhood (n = 68) | % Black (range: 0.21%–96.9%) | % university education, % renters, % unemployed, % male, poverty, social capital | Ecological study | There was a nonlinear relationship between Black ethnic density and age-adjusted Black mortality with reductions in mortality leveling off at densities of around 50%. Mortality was generally lower at higher densities and there was a significant interaction such that the effects of ethnic density were strongest in neighborhoods with high levels of social capital. |
| Inagami et al.64 (2006) | New York City mortality records (1999–2000) | Black men and women stratified by age: 25–64 years and ≥ 65 years | All-cause mortality | Zip code (n = 160) | % Black; higher density considered as areas with ≥ 70% | Education, employment, % poverty, % immigrant | Ecological study | For men and women aged ≥ 65 years, living at higher densities was associated with reduced risk of mortality. For men and women aged 25–64 years, ethnic density was not associated with mortality. |
| Jackson et al.51 (2000) | National Longitudinal Mortality Study (1978–1995), and NDI (1979-1989) | Black men and women (n ≈ 26 300) separated into age categories: 25–44 y; 45–64 y; ≥ 65 y | All-cause mortality | Census tracta | % Black categorized as: ≤ 0.10; 0.10–0.30; 0.30–0.70; 0.70–1.00 | Age, family income | Multilevel data without multilevel analysis | For Black men and women aged 25–44 years, higher Black densities were associated with increased risk of mortality. In older age groups there was no association between ethnic density and mortality. |
| LeClere et al.52 (1997) | National Health Interview Survey linked to the NDI (1986–1990) | N = 346 917 total sample: n = 20 843 Black men; n = 30 151 Black women | All-cause mortality | Census tract (n = 5919) | % Black categorized in empirical quartiles: 0.5%; > 0.5%–2.8%; > 2.8%–17%; > 17% | Ethnicity, age, income to needs, education, marital status, median income, education, poor households, female-headed households | Cross-level interaction study using multilevel data without multilevel analysis | High Black ethnic density was associated with increased mortality for men and women in the total sample, but there was no evidence of significant interaction terms between race and ethnic density. |
| Rodriguez et al.43 (2007) | Retrospective cohort study using data from the US Renal Data System (1995–2003) | Black patients with end-stage renal disease who had survived for at least 90 d (n = 153 627) | Mortality | Zip code (n = 13 622) | % Black categorized as: < 10%; 10%–24%; 25%–49%; 50%–74%; ≥ 75% | Age, gender, employment, health, census division, median income, % family in poverty, social class, tenure, % occupied, education | Multilevel data and analysis | There was no association between Black ethnic density and mortality. |
| Adult physical morbidity | ||||||||
| Chang19 (2006) | Behavioral Risk Factor Surveillance System (2000) | Non-Hispanic Black adults living in MSA with > 10% Black residents (n = 8800) | BMI | MSA (n = 130) | % Black (range: 10.0%–51.3%) | Age, gender, marital status, education, household income, health care, population size, median income, % poverty, region | Multilevel data and analysis | Increasing Black ethnic density was associated with increased BMI. |
| Chang et al.20 (2009) | Southeastern Pennsylvania Household Health Survey, Philadelphia (2002, 2004) | Adults aged ≥ 18 years (n = 6698) of whom 38.3% were Black | BMI and obesity | Census tract (n = 384) | % Black categorized as: < 20%; 20%–60%; > 60% | Age, gender, race/ethnicity, education, household income, marital status, % poverty, population size, physical disorder (vacant residential properties, vacant lots, housing code violations, fires on property, median residential sales price), social disorder/crime, park area, recreation centers, supermarkets, % commercial parcels, billboards | Cross-level interaction with multilevel data and analysis | For women, there was an association between Black ethnic density and higher BMI and obesity but this disappeared with adjustment for physical disorder. There were no associations between Black ethnic density and BMI and obesity for men. |
| Cooper et al.58 (1997) | An inception cohort of all Medicare recipients aged 65+ with first diagnosis of colon or rectal cancer identified from Medicare Provider Analysis and Review (1990–1991) | Black persons aged ≥ 65 years (n = 329) | 3-year colorectal cancer incidence | County (n = 329) | % Black aged ≥ 18 years categorized in quartiles: 2%–5%; 5.1%–8.5%; 8.6%–17.1%; 17.2%–62.4% | Age, gender, census region | Ecological study | Lower incidence of colorectal cancer was found in high-density areas. |
| Cozier et al.21 (2007) | Black Women’s Health Study (1995–2001) | Black women aged 21–69 years at baseline (n = 36 099) | Hypertension | Census block group (n = 20 192) | % Black in quintiles | Age, BMI, physical activity, education, family income, number of household members, smoking, alcohol, median income | Multilevel data and analysis | No association was found between Black ethnic density and hypertension. |
| Do et al.23 (2007) | National Health and Nutrition Examination Survey III (1988–1994) | Adults aged ≥ 20 years at time of interview (n = 2188 Black women and n = 1854 Black men) | BMI | Census tract (n ≈ 160) | % Black | Ethnicity, age, employment status, education, nativity, marital status, disadvantage, education | Cross-level interaction study using multilevel data and analysis | Black ethnic density was associated with increased BMI. |
| Mellor and Milyo33 (2004) | Current Population Survey (1995, 1997, and 1999) | Black persons aged 25–74 years (n = 7120) | Self-rated health | County (n = 217) | % Black | Age, household income, ethnicity, gender, marital status, health insurance, education, mean county income, region | Multilevel data and analysis | Black ethnic density was not associated with self-rated health after adjustment for region. |
| Park et al.35 (2008) | Cross-sectional survey conducted by New York City government via Academic Medicine Development Company (2000–2002) | Black Caribbean residents of New York City (n = 638) | BMI | Half-mile radius around home (unique to each participant)a | % Black | Age, gender, education, income, nativity, % residents below poverty line | Multilevel data and analysis | There was a marginally significant (P = .06) positive association between Black ethnic density and BMI. |
| Robert and Reither41 (2004) | Americans’ Changing Lives (1986) | Adults aged ≥ 25 years (n = 3617) of whom n = 778 were Black women and n = 396 were Black men | BMI | Census tracta | % Black | Race, age, marital status, employment, education, income, assets, socioeconomic disadvantage, income inequality | Cross-level interaction with multilevel data and analysis | There was no association between Black ethnic density and BMI for men and women. Interaction terms were not significant. |
| Robert and Ruel42 (2006) sample A | Americans’ Changing Lives (1986) | Black adults aged ≥ 60 years (n = 382) | Self-rated health | County (n = 102) | % Black | Age, gender, education, income, assets, segregation, % poverty | Multilevel data and analysis | There was no association between Black ethnic density and self-rated health. |
| Robert and Ruel42 (2006) sample B | National Survey of Families and Households (1987–1988) | Black adults aged ≥ 60 years (n = 290) | Self-rated health | County (n = 204) | % Black | Age, gender, education, income, assets, segregation, % poverty | Multilevel data and analysis | County-level ethnic density was associated with better self-rated health. |
| Usher57 (2007) | Cross-sectional surveys from Birmingham, Alabama (2000–2001) | Black respondents (n = 310) | Self-rated health | Census tracta | % ethnic minority | Gender, age, education, income, employment, marital status, residence, trust | Multilevel data without multilevel analysis | There was no association between ethnic density and self-rated health. |
| White and Borrell46 (2006) | New York Social Indicators Survey (1999–2002) | Adults (n = 2845) of whom 25.6% were Black | Self-rated health | Zip code (n = 170) | % Black categorized as: 0%–5.3%; > 5.3%–35%; >35% | Age, gender, ethnicity, education, income, health insurance, perception of neighborhood, SES | Cross-level interaction study using multilevel data and analysis | High Black ethnic densities were associated with increased risk of poor self-rated health in total sample. However, interaction term between ethnicity and ethnic density was not significant. |
| Health behaviors | ||||||||
| Baker and Hellerstedt48 (2006) | Birth certificates from Minnesota’s 7-county metropolitan area (1990–1999) | Singleton birth of US-born Black (n = 23 649) and foreign-born Black (n = 4287) mothers | Alcohol and tobacco use during pregnancy | Census tracta | The proportion of Black women aged ≥ 15 y relative to the total population, categorized as: 0%–10%; 11%–20%;21%–33% | Age, marital status, education, prenatal care | Multilevel data without multilevel analysis | Foreign-born Black mothers were more likely to use substances at higher levels of Black ethnic density. |
| Bell et al.15 (2007) | National Center for Health Statistics natality detail files (2002) | Black mothers of singleton births (n = 403 842) | Maternal smoking during pregnancy | MSA (n = 216) | % Black | Age, parity, marital status, education, segregation, total population, state cigarette tax, % poverty, region | Multilevel data and analysis | Black ethnic density was associated with lower risk of smoking during pregnancy. |
| Datta et al.22 (2006) | Black Women’s Health Study (1995) | Black women (n = 41 726) including 1% mixed race and 1.8% Hispanic Black | Smoking prevalence (exsmokers excluded from analysis) | Census tract (n = 14 559) | % Black divided into quartiles | Education, marital status, age, social class | Multilevel data and analysis | % Black was not associated with smoking in fully adjusted models. |
| Shaw et al.44 (2010) | The 2000 US linked birth and infant death data set (2000–2001) | Singleton births of non-Hispanic Black mothers (n = 581 151) | Maternal smoking during pregnancy | County (n = 2215) | % Black, categorized as: 0%–0.99%; 1%–4.99%; 5%–14.99%; 15%–49.99%; ≥50% | Age, parity, marital status, education, nativity, median income | Multilevel data and analysis | Increasing Black ethnic density was associated with reduced risk of smoking. |
| Xue et al.47 (2007) | Longitudinal study of young people at risk for drop out in public school in Flint, Michigan (1994–1995) | Ninth graders (n = 824) who had grade point averages below 3 in eighth grade (of which n = 681 Black students) | Smoking prevalence | Census block group (n = 143) | % Black categorized as: < 10%; 10%–90%; > 90% | Gender, age, ethnicity, parent/peer substance use, social activities, neighborhood disadvantage | Cross-level interaction study using multilevel data and analysis | Higher ethnic density was associated with reduced smoking during adolescence for Black youths. |
| Infant mortality | ||||||||
| LaVeist65 (1992) | Vital Statistics reports (1981–1985) | Black infants | Postneonatal mortality | Central city (n = 176) | % Black | Black political power, education, segregation, single mothers, total population, birth weight | Ecological study | There was no evidence of an association between Black ethnic density and postneonatal mortality. |
| Shaw et al.44 (2010) | The 2000 US linked birth and infant death data set (2000–2001) | Non-Hispanic Black singleton births (n = 581 151) | Infant mortality, low birth weight, preterm birth, smoking during pregnancy | County (n = 2215) | % Black, categorized as: 0%–0.99%; 1%–4.99%; 5%–14.99%; 15%–49.99%; ≥ 50% | Age, parity, marital status, education, nativity, median income | Multilevel data and analysis | There was no significant association between ethnic density and infant mortality for Black mothers. |
| Yankauer67 (1950) | New York vital data of pregnancy and infant wastage (1945–1997) | Non-White births (96% Black) | Fetal mortality, neonatal mortality, postneonatal mortality, total Infant mortality | Health area (n = 318) | % of non-White live births, categorized as: < 5%; 5%–9%; 10%–24%; 25%–49%; 50%–74%; ≥ 75% | Ecological study | Total infant mortality, fetal mortality, and neonatal mortality were found to increase with increasing ethnic density. No association was found with postneonatal mortality. | |
| Yankauer and Allaway66 (1958) | New York vital data of pregnancy and infant wastage (1954–1955) | Non-White births (95.6% Black) | Fetal mortality, neonatal mortality, postneonatal mortality | Health area (n = 415) | % non-White live births | Ecological study | Fetal and neonatal mortality were found to increase with increasing density, but no association was found for postneonatal mortality. | |
| Other birth outcomes | ||||||||
| Baker and Hellerstedt48 (2006) | Birth certificates from Minnesota’s 7-county metropolitan area (1990–1999) | Singleton births of US-born Black (n = 23 649) and foreign-born Black (n = 4287) mothers | Low birth weight, preterm delivery | Census tracta | The proportion of Black women aged ≥ 15 years relative to the total population: 0%–10%; 11%–20%; 21%–33% | Age, education, marital status, prenatal care, substance use | Multilevel data without multilevel analysis | Living at high density was associated with increased risk of preterm delivery for US-born Black infants. No association was found between Black ethnic density and preterm delivery and low birth weight for foreign-born or low birth weight among US-born Black infants. |
| Bell et al.15 (2007) | Public-use birth files issued by the National Center for Health Statistics (2002) | US-born Black mothers of singleton births (n = 434 376) | Birth weight, preterm delivery, fetal growth restriction | MSA (n = 225) | % Black residents | Age, medical complications, previous preterm birth, smoking, marital status, education, prenatal care, segregation, total population, education | Multilevel data and analysis | There was no association between Black ethnic density and birth weight, preterm delivery, and fetal growth restriction. |
| Buka et al.18 (2003) | Project on Human Development in Chicago Neighborhoods (1994–1996) | Black respondents (n = 65 923) | Birth weight | Neighborhood clusters (equivalent to large census tract; N = 343) | % births to Black mothers (range: 0% to > 90%) | Age, gender, marital status, education, parity, smoking, prenatal care, SES, social support | Multilevel data and analysis | There was no association between Black ethnic density and birth weight. |
| Ellen50 (2000) | National linked birth and death files (1990) | Mothers of Black (n = 563 539) and non-Black (n = 2 479 624) ethnic origin | Low birth weight | MSA (n = 252) | % Black | Age, education, ethnicity, segregation, total population, median income, % Hispanic | Cross-level interaction study using multilevel data without multilevel analysis | Black ethnic density had an adverse effect on health. This detrimental effect was greater for Black persons, as indicated by interaction terms. |
| Masi et al.29 (2007) | The Illinois Department of Public Health Electronic Birth Certificate Database (1991) | Non-Hispanic Black singleton births (n = 25 087) | Birth weight, preterm delivery, small for gestational age | Census tract (n = 688) | Ethnic density classified as: < 10% Black and < 20% Hispanic; < 10% Black and ≥ 20% Hispanic; 10%–90% Black and ≥ 20% Hispanic; 10%–90% Black and < 20% Hispanic; > 90% Black | Gender, smoking, parity, education, maternal age, economic disadvantage, crime | Multilevel data and analysis | None of the outcomes measured were significantly associated with ethnic density. |
| Mason et al.30 (2009) | Birth records for Wake and Durham counties, North Carolina (1999–2001) | Non-Hispanic Black mothers (n = 9833) | Preterm delivery | Census tracts (n = 158), block groups (n = 390), blocks (n = 5838) | % Black | Age, education, parity, prenatal care, marital status, smoking, index of neighborhood deprivation | Multilevel data and analysis | A nonstatistically significant adverse ethnic density effect was found for preterm delivery at census tract, block group, and block. |
| Mason et al.31 (2010) | New York City birth records (1995–2003) | Non-Hispanic Black singleton births (n = 249 785): n = 21 064 Black African births; n = 86 961 Black Caribbean births; n = 141 760 Black American births | Preterm birth | Census tracts: n = 1452 tracts with Black African births; n = 1797 tracts with Black Caribbean births; n = 1885 tracts with Black American births | Proximity-weighted ethnic density—which allows the ethnic composition of the areas surrounding the mother’s residence to influence her estimated exposure in proportion to their distance from her; 10th and 90th percentile of ethnic density were also calculated: African 10th percentile: 0.2%; African 90th percentile: 7.0%; Caribbean 10th percentile: 2.3%; Caribbean 90th percentile: 39.5%; US-born 10th percentile: 13%; US-born 90th percentile: 70.1% | Maternal age, education, parity, nativity, tobacco use, prepregnancy weight, health insurance payment type, residential stability, standardized index of neighborhood deprivation | Multilevel data and analysis | Increased Black African density was associated with increased risk of preterm birth for African-born mothers. Detrimental ethnic density effects were also found for US-born women, and the effect was stronger in more deprived neighborhoods. No associations with ethnic density were found for the births from Caribbean-born mothers. |
| Mason et al.32 (2011) | New York City birth records (1995–2003) | Singleton births (n = 887 887): n = 237 528 non-Hispanic White births; n = 256 673 non-Hispanic Black births | Preterm birth | Census tracts (n = 2202) | Proximity-weighted ethnic density—which allows the ethnic composition of the areas surrounding the mother’s residence to influence her estimated exposure in proportion to their distance from her; ethnic density dichotomized at 25%; also modeled as a continuous variable with a squared term to allow for nonlinearities | Maternal age, education, nativity, parity, tobacco use, prepregnancy weight, prenatal care received in the first 120 d of gestation, health insurance payment type, residential stability, standardized index of neighborhood deprivation | Multilevel data and analysis | For Black women, living in an ethnic neighborhood (> 25% ethnic density) was associated with increased risk of preterm birth. |
| Messer et al.53 (2010) | Durham and Wake counties, North Carolina, birth records (1999–2001) | Black women from Durham County (n = 4275); Black women from Wake County (n = 5558) | Preterm birth | Census tract (Durham N = 53; Wake N = 105) | Percentage Black, categorized as: Durham County: 4.5%–18.8%; 19.2%–37.0%; 40.0%–65.0%;68.6%–97.8%; Wake County: 0.7%–6.8%; 7.1%–15.2%; 15.3%–28.2%; 28.3%–92.7% | Education, marital status, maternal age, deprivation | Multilevel data and analysis | There was a nonsignificant adverse association between ethnic density and preterm birth in both Durham and Wake counties. |
| Nkansah-Amankra et al.34 (2010) | South Carolina Pregnancy Risk Assessment and Monitoring System (2000–2003) and the 2000 US Census | White and Black women (n = 8064) with live births (48% Black) | Low birth weight; preterm birth | Census tracta | % Black, categorized as: predominantly White (5%–10% African-American population); mixed majority African American population (10%–50% African-American population); predominantly African-American (< 50%–90% African-American population). | Stressful life events, marital status, maternal age, income, education, % below poverty level, household crowding, % below high-school education for adults aged 25+ | Multilevel data and analysis | Black mothers living in mixed racial census tract (10%–50% census tract residents) were at > 2-fold risk of having low birth weight babies because of emotional stress. Mothers with the same stress but living in predominantly Black census tracts were at > 4-fold risk of having low birth weight. |
| Phillips et al.37 (2009) | The Black Women’s Health Study (1995–2003) | Singleton births of Black mothers aged ≥ 21 years in 1995, and < 45 years at time of birth (n = 6410) | Self-reported spontaneous and medically induced preterm births | Block groupa | % Black residents, categorized as: < 14.4%; 14.4%–82.75%; > 82.75% | Age, education, marital status, BMI, smoking during pregnancy, relative income, income incongruity | Multilevel data and analysis | There was no association between ethnic density and preterm birth. However, there was an interaction between ethnic density and relative income. Women living at low ethnic density had lower risk of preterm birth overall if they had a high relative income. Women at high density had a higher relative risk of overall preterm birth if they had a high relative income. |
| Pickett et al.38 (2002) | Case–control study using the University of California, San Francisco Perinatal Database (1980–1990) | Singleton births of Black mothers (n = 417) | Preterm delivery | Census tracta | % Black | Health insurance, education, % unemployed, median household income, change in % Black | Multilevel data and analysis | Black ethnic density was not significant in the final model predicting preterm delivery. |
| Reichman et al.40 (2009) | Fragile Families and Child Well-Being study (1998–2000) | Infants of unmarried Black mothers who were either aged ≥ 18 years, or considered emancipated minors (n = 1871) | Birth weight in grams, low birth weight | Census tract (n = 1181) and city (n = 20) | % Black for census tract both continuous and categorized as: < 20%; 20%–39%; 40%–59%; 60%–79%; ≥ 80% | Age, mother’s age, father’s age, nativity, martial, relationship status, mother’s education, father’s education, father’s employment status, mother’s health insurance, parity, proportion poor in census tract, proportion poor in city | Multilevel data and analysis | A linear measure of Black ethnic density at census tract level was negatively associated with birth weight in grams. However, this was not significant when city-level ethnic density was included. Mothers living at densities of 80% or higher Black had increased risk of preterm birth. However, densities between 40% and 79% were not significant. Black ethnic density at city level was associated with lower birth weight. |
| Roberts56 (1997) | Vital records for the 6-county Illinois segment of the Chicago metropolitan area (1990) | Births of residents of the 6-county area (n = 131 457) | Low birth weight | Illinois Department of Health community areas (n = 77) | % Black | Age, marital status, education, prenatal care, parity, alcohol, smoking, SES, age structure, rental cost | Multilevel data without multilevel analysis | Increasing Black ethnic density was associated with reduced risk of low birth weight. |
| Shaw et al.44 (2010) | The 2000 US linked birth and infant death data set (2000–2001) | Singleton births of non-Hispanic Black mothers (n = 581 151) | Infant mortality, low birth weight, preterm birth, smoking during pregnancy | County (n = 2215) | % Black categorized as: 0%–0.99%; 1%–4.99%; 5%–14.99%; 15%–49.99%; ≥ 50% | Age, parity, marital status, education, nativity, median income. | Multilevel data and analysis | A nonlinear relationship between ethnic density and low birth weight and preterm birth was found, whereby relatively small increases in Black ethnic density was associated with increased risk of low birth weight and preterm birth for Black mothers. |
| Walton45 (2009) | US natality file (2000) | Singleton births to Black mothers (n = 434 326) living in MSAs with > 5000 Black residents and a total population of ≥ 100 000 | Low birth weight | MSA (n = 228) | % Black | Age, parity, education, medical complications, marital status, previous preterm birth, adequacy of prenatal care, nativity, smoking during pregnancy, alcohol use during pregnancy, residential isolation, residential clustering, education, log of population size, median household income, % Black in poverty | Multilevel data and analysis | In models adjusting for residential isolation or residential clustering, Black ethnic density was associated with increased risk of low birth weight. |
Note. BMI = body mass index, defined as weight in kilograms divided by the square of height in meters; MSA = metropolitan statistical area; SES = socioeconomic status.
a
N not reported.