Does time since immigration modify neighborhood deprivation gradients in preterm birth? A multilevel analysis.

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  • Author(s): Urquia ML;Urquia ML; Frank JW; Moineddin R; Glazier RH
  • Source:
    Journal of urban health : bulletin of the New York Academy of Medicine [J Urban Health] 2011 Oct; Vol. 88 (5), pp. 959-76.
  • Publication Type:
    Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Springer Country of Publication: United States NLM ID: 9809909 Publication Model: Print Cited Medium: Internet ISSN: 1468-2869 (Electronic) Linking ISSN: 10993460 NLM ISO Abbreviation: J Urban Health Subsets: MEDLINE
    • Publication Information:
      Publication: 2006- : New York, NY : Springer
      Original Publication: Cary, NC : Oxford University Press for the New York Academy of Medicine, c1998-
    • Subject Terms:
      Emigration and Immigration* ; Poverty Areas*; Premature Birth/*epidemiology; Adolescent ; Adult ; Birth Certificates ; Female ; Hospitals ; Humans ; Ontario/epidemiology ; Pregnancy ; Premature Birth/ethnology ; Time Factors ; Young Adult
    • Abstract:
      Immigrants' health is jointly influenced by their pre- and post-migration exposures, but how these two influences operate with increasing duration of residence has not been well-researched. We aimed to examine how the influence of maternal country of birth and neighborhood deprivation effects, if any, change over time since migration and how neighborhood effects among immigrants compare with those observed in the Canadian-born population. Birth data from Ontario hospital records (2002-2007) were linked with an official Canadian immigration database (1985-2000). The outcome measure was preterm birth. Neighborhoods were ranked according to a neighborhood deprivation index developed for Canadian urban areas and collapsed into tertiles of approximately equal size. Time since immigration was measured from the date of arrival to Canada to the date of delivery, ranging from 1 to 22 years. We used cross-classified random effect models to simultaneously account for the membership of births (N = 83,233) to urban neighborhoods (N = 1,801) and maternal countries of birth (N = 168). There were no differences in preterm birth between neighborhood deprivation tertiles among immigrants with less than 15 years of residence. Among immigrants with 15 years of stay or more, the adjusted absolute risk difference (ARD%, 95% confidence interval) between high-deprived (tertile 3) and low-deprived (tertile 1) neighborhoods was 1.86 (0.68, 2.98), while the ARD% observed among the Canadian-born (N = 314,237) was 1.34 (1.11, 1.57). Time since migration modifies the neighborhood deprivation gradient in preterm birth among immigrants living in Ontario cities. Immigrants reached the level of inequalities in preterm birth observed at the neighborhood level among the Canadian-born after 14 years of stay, but neighborhoods did not influence preterm birth among more recent immigrants, for whom the maternal country of birth was more predictive of preterm birth.
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    • Grant Information:
      CIHR IOP-44972 Canada Canadian Institutes of Health Research
    • Publication Date:
      Date Created: 20110420 Date Completed: 20120208 Latest Revision: 20211020
    • Publication Date:
      20240628
    • Accession Number:
      PMC3191215
    • Accession Number:
      10.1007/s11524-011-9569-2
    • Accession Number:
      21503816