Journal Article

Preterm Birth: The Interaction of Traffic-related Air Pollution with Economic Hardship in Los Angeles Neighborhoods

Ninez A. Ponce, Katherine J. Hoggatt, Michelle Wilhelm and Beate Ritz

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 162, issue 2, pages 140-148
Published in print July 2005 | ISSN: 0002-9262
Published online July 2005 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwi173
Preterm Birth: The Interaction of Traffic-related Air Pollution with Economic Hardship in Los Angeles Neighborhoods

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Preterm birth may be affected by the interaction of residential air pollution with neighborhood economic hardship. The authors examined variations in traffic-related pollution exposure—measured by distance-weighted traffic density—using a framework reflecting the social and physical environments. An adverse social environment was conceptualized as low socioeconomic status (SES) neighborhoods—census tracts with concentrated poverty, unemployment, and dependence on public assistance. An adverse physical environment was depicted by the winter season, when thermal inversions trap motor vehicle pollutants, thereby increasing traffic-related air pollution. Los Angeles County, California, birth records from 1994 to 1996 were linked to traffic counts, census data, and ambient air pollution measures. The authors fit multivariate logistic models of preterm birth, stratified by neighborhood SES and third pregnancy trimester season. Traffic-related air pollution exposure disproportionately affected low SES neighborhoods in the winter. Further, in these poorer neighborhoods, the winter season evidenced increased susceptibility among women with known risk factors. Health insurance was most beneficial to women residing in neighborhoods exposed to economic hardship and an adverse physical environment. Reducing preterm births warrants a concerted effort of social, economic, and environmental policies, focused on not only individual risk factors but also the reduction of localized air pollution, expansion of health-care coverage, and improvement of neighborhood resources.

Keywords: air pollution; premature birth; socioeconomic factors; CI, confidence interval; DWTD, distance-weighted traffic density; OR, odds ratio; SES, socioeconomic status

Journal Article.  5585 words.  Illustrated.

Subjects: Public Health and Epidemiology

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