Sims, M., Sims, T. L., & Bruce, M. A. (2008). The Journal of the National Black Nurses Association, 19, 12-18.
It is a widely known and well-accepted fact that low birth weight (LBW) is one of the primary factors contributing to racial/ethnic health disparities in the United States and that the LBW rate for African Americans is twice that of whites. Recent studies have focused on the community level risk factors for LBW, such as income, residential segregation, neighborhood income, and lifespan mortality rates. This article reported on the relationship among socioeconomic position, LBW, race, and ethnicity and used data from the 1992-1994 Vital Statistics and 1990 Census. The results revealed that more African Americans live in poor neighborhoods, have more LBW infants, and have more risk factors for LBW, including late initiation of prenatal care and teen births, than Latinos and whites. They also found that Latinos have increasing LBW rates, which are associated with a greater concentration of poor Latinos in high-poverty, inner-city neighborhoods. Within that Latino group, the worst outcomes were among Puerto Ricans. Concentrated poverty has increased significantly since these early 1990s data were collected, and we need to pay more attention to its relationship with LBW rates and risk factors.
The findings of this study that unequivocally support the relationship between poverty concentration and LBW are particularly worrisome in the current economic environment, with more poor families segregated in poorer neighborhoods with overcrowding, poor nutrition, smoking, alcohol and substance abuse, inadequate prenatal care, teen pregnancy, violence, and increased mortality-all of which contribute to increasing the healthcare disparities of some of our most vulnerable populations. All nurses, regardless of their practice setting, must be aware of how neighborhood segregation and concentrated poverty further compound the already high individual risk factors for LBW. Those of you who work in neighborhood healthcare centers live this reality every day. Nurses are the best advocates for our patients. This article is a wake-up call to us all.
Comment by
Judy Beal