Association between perceived security of the neighbourhood and small-for-gestational-age birth
Article first published online: 4 AUG 2008
© 2008 The Authors, Journal Compilation © 2008 Blackwell Publishing Ltd.
Paediatric and Perinatal Epidemiology
Volume 22, Issue 5, pages 467–477, September 2008
How to Cite
Auger, N., Daniel, M., Platt, R. W., Wu, Y., Luo, Z.-C. and Choinière, R. (2008), Association between perceived security of the neighbourhood and small-for-gestational-age birth. Paediatric and Perinatal Epidemiology, 22: 467–477. doi: 10.1111/j.1365-3016.2008.00959.x
- Issue published online: 4 AUG 2008
- Article first published online: 4 AUG 2008
- small-for-gestational age;
- social perception
Evidence points to an association between a mother's place of residence and her newborn's health, independent of individual characteristics. Neighbourhood constructs such as immigrant density, deprivation and crime have all been separately associated with birth outcomes. Little research has considered the joint influence of variables representing a spectrum of neighbourhood constructs. Subjective vs. objective measures of neighbourhood constructs (e.g. reported vs. perceived crime) are often not considered. We sought to evaluate the relationship between neighbourhood measures of reported crime, neighbourhood perceived security, immigrant density, material/social deprivation, residential stability and the odds of small-for-gestational-age (SGA) birth in an urban setting in Canada. Neighbourhood was defined as police districts (n = 49). We linked Montreal livebirths 1997–2001 (n = 98 330) to police district crime measures, survey data on perceived security, and 2001 census data. We used multi-level analysis to calculate odds ratios (OR) for neighbourhood effects on SGA birth accounting for individual characteristics.
Mothers residing in neighbourhoods with the most favourable perception had a lower odds of SGA birth than neighbourhoods with the least favourable perception [OR 0.87, 95% CI 0.77, 0.97]. Mothers in neighbourhoods with lower proportions of immigrants had lower odds of SGA birth relative to neighbourhoods with the highest proportion of immigrants. Reported crime, residential stability and material/social deprivation (accounting for neighbourhood perception) were not associated with SGA birth. Immigrant density and subjective perceptions of neighbourhood security are associated with SGA birth. Public health strategies to improve fetal growth should target neighbourhoods with low perceived security and high immigrant density.