INEQUALITY AND INFANT HEALTH: A MULTILEVEL APPROACH TO DISENTANGLING CORRELATES OF METROPOLITAN/NONMETROPOLITAN DISPARITIES IN LOW BIRTH WEIGHT INFANTS
Open Access
- Author:
- Smith, Patrice Johnelle
- Graduate Program:
- Rural Sociology
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- April 26, 2006
- Committee Members:
- Diane K Mc Laughlin, Committee Chair/Co-Chair
C Shannon Stokes, Committee Member
Leif Jensen, Committee Member
Kathryn Jo Brasier, Committee Member
Jonna Marie Kulikowich, Committee Member - Keywords:
- birth weight
rural
multilevel modeling - Abstract:
- To date, research has not adequately addressed geographic variation in birth weight due to individual- and structural-level characteristics in the US. If the health care needs of infants and children in nonmetropolitan areas are to be understood, an analytic approach capturing how both individual- and contextual-level inequalities operate is needed. This research utilizes multiple levels of rurality as one component of structural-level characteristics, along with individual-level characteristics, to examine variation in birth weights. Specifically, theoretical and empirical evidence is given for associations between biological, social, and behavioral characteristics and birth weight at the individual level, and residential, socioeconomic, social capital, social environmental, and health services characteristics and birth weight at the structural-level. With variation in birth weights across groups and places in the United States, it is important to understand which children are at risk of poor health outcomes and to identify how local conditions contribute to these outcomes. The ECLS-B merged with county-level data is used to examine this problem. Results from this research indicate that most of the variation in birth weight is attributable to individual-level characteristics, such as gestation, plurality status, and maternal smoking behavior during pregnancy. However structural-level characteristics help to explain some of the variation. Various measures of rurality indicate that rural residents tend to have higher birth weights. Other structural-level measures, such as the percentage of residents in the county that are black, the number of Olsen-Type establishments in the county, and the number of health care personnel all have associations with average birth weights and the mean likelihood of low birth weight.