Neighborhood Gun Violence and Birth Outcomes in Chicago
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Neighborhood Gun Violence and Birth Outcomes in Chicago Nana Matoba1 · Margarita Reina2 · Nikhil Prachand2 · Matthew M. Davis3 · James W. Collins1 Published online: 18 June 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Objectives To examine the association between gun violence and birth outcomes among women in Chicago. Methods Using a 5-year set of birth files (2011–2015) merged with census and police data, birth outcomes including low birth weight (LBW, BW < 2500 g), preterm birth (PTB, < 37 weeks gestation), and small-for-gestational-age (SGA, BW < 10th percentile) were examined among non-Hispanic (NH) white, NH black, and Hispanic women in Chicago. Gun violence rates were categorized into tertiles. Multilevel, multiple logistic regression examined the effects of gun violence and race/ ethnicity on birth outcomes. Results Of 175,065 births, 10.6% of LBW, 10.6% of PTB, and 9.1% of SGA occurred in high violence tertile. Using white women in low violence tertile as reference, the OR for LBW among black women ranged 1.9–2.1 across all tertiles, and 0.8–1.2 among Hispanic women. OR for PTB for black women were 1.6–1.7 and 1.0–1.2 for Hispanic women, and OR for SGA for black women were 1.6–1.7 and for Hispanic women 0.9–1.0. Conclusions for Practice In Chicago, race/ethnicity was associated with birth outcomes, regardless of the level of exposure to gun violence, in 2011–2015. The differences in racial/ethnic composition across the violence exposure levels suggest that, rather than gun violence alone, residential segregation and the geographic inequities likely contribute to disparate birth outcomes. Keywords Racial disparities · Preterm birth · Low birth weight · Gun violence
Significance What is already known on this subject? The striking racial/ ethnic disparity in birth outcomes in this country are not fully explained by individual level risk factors. With a growing body of literature on contextual factors’ effects on health, there is an emerging evidence on the health effects of violence, but the results on birth outcomes have been inconsistent.
* Nana Matoba n‑[email protected] 1
Division of Neonatology, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University, 225 E. Chicago Ave., Box #45, Chicago, IL 60611, USA
2
Chicago Department of Public Health, Chicago, IL, USA
3
Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
What this study adds? Race/ethnicity is strongly associated with birth outcomes, regardless of the amount of exposure to gun violence. We speculate that this reflects the high degree of segregation in the city, and lifelong health disparities therein.
Introduction Low birth weight (LBW, birth weight < 2500 g), preterm birth (PTB, birth at < 37 weeks gestation) and small for gestational age (SGA, birth weight for
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