The objective is To assess the influence of racial and economic residential segregation of home or hospital neighborhoods on very preterm birth morbidity and mortality in neonates born very preterm. We constructed a retrospective cohort of n = 6461 infants born <32 weeks using 2010-2014 New York City vital statistics-hospital data. We calculated the racial and economic Index of Concentration at the Extremes for home and hospital neighborhoods. Neonatal mortality and morbidity were defined as death and/or severe neonatal morbidity. We estimated relative risks for the Index of Concentration at the Extremes measures and neonatal mortality and morbidity using log-binomial regression and the risk-adjusted contribution of the delivery hospital using Fairlie decomposition. Infants whose mothers live in neighborhoods with the greatest relative concentration of Black residents had a 1.6 times greater risk of neonatal mortality and morbidity than those with the greatest relative concentration of White residents (95% CI 1.2-2.1). The delivery hospital explained more than one-half of neighborhood differences. Infants with both home and hospital in high-concentration Black neighborhoods had a 38% adjusted risk of neonatal mortality and morbidity compared with 25% of those with both home and hospital high-concentration White neighborhoods.
Reference link- https://www.jpeds.com/article/S0022-3476(21)00293-6/fulltext