Academic journal article Centro Journal

Boricuas, Barrios and Birth Outcomes: Residential Segregation and Preterm Birth among Puerto Ricans in the United States

Academic journal article Centro Journal

Boricuas, Barrios and Birth Outcomes: Residential Segregation and Preterm Birth among Puerto Ricans in the United States

Article excerpt

(ProQuest: ... denotes formulae omitted.)

Puerto Rican women living in the United States (US) are at higher risk for adverse perinatal outcomes than other Latinas (Acevedo-Garcia, Soobader and Berkman 2007; Rosenberg, Raggio and Chiasson 2005). Indeed, among all other racial/ethnic groups in the United States, Puerto Ricans come closest to rivaling the very high rates of low birthweight, preterm birth, and neonatal infant mortality that have been documented among non-Hispanic Black women (Martin et al. 2007; Mathews and MacDorman 2010).1 In part, these circumstances may reflect the relatively low levels of educational attainment and especially the high poverty rate among the Puerto Rican population. Low socioeconomic status (SES) is typically associated with both poor health generally and poor perinatal outcomes specifically, and the health gradient in SES contributes substantially to racial disparities in both general health and birth outcomes (Fiscella and Williams 2004). Puerto Ricans have the highest poverty rate among all Latino groups in the US: approximately 25 percent of Puerto Ricans families had incomes below the federal poverty line in both 2000 and 2010, roughly equal to the poverty rate among non-Hispanic Blacks (Orrenius and Zavodny 2011).

Yet low SES does not fully account for the relatively high rates of adverse perinatal outcomes among Puerto Ricans. Puerto Rican women have higher rates of low birthweight than other Latinas at every level of educational attainment (Acevedo-Garcia et al. 2007; Rosenberg et al. 2005). Indeed, although higher levels of attainment are associated with better birth outcomes among Puerto Rican women, the rate of low birthweight among those with 16 or more years of education is nonetheless similar to that among Mexicanancestry women who have not completed high school (Acevedo-Garcia et al. 2007). Moreover, family income is not significantly associated with either low birthweight or infant mortality among Puerto Rican women (Landale and Oropesa 2001; Landale, Oropesa and Gorman 1999).

Similar findings for non-Hispanic Black women, who have relatively high rates of adverse birth outcomes at every level of educational attainment (Kramer and Hogue 2008; Schoendorf et al. 1992), have prompted scholars to investigate contextual factors that may contribute to adverse perinatal outcomes (Metcalf et al. 2011; Miranda, Maxson and Edwards 2009). A substantial number of studies have shown that both metropolitan residential segregation (Ellen 2000; Bell et al. 2006; Osypuk and Acevedo-Garcia 2008; Kramer et al. 2010; Britton and Shin 2013) and neighborhood racial composition (Baker and Hellerstedt 2006; Debbink and Bader 2011; Mason et al. 2009; Grady 2006; Grady and McLafferty 2007) are robustly associated with an increased risk of poor birth outcomes among non-Hispanic Black women. Prior research is less conclusive about why residential segregation is associated with poor birth outcomes (but see Ellen 2000; Grady and Ramirez 2008), but many scholars have suggested that this association reflects the concentration of poverty in non-Hispanic Black neighborhoods in highly segregated metropolitan areas (Osypuk and Acevedo-Garcia 2010). Fewer studies have investigated these relationships among Hispanic women-and none have focused specifically on the relationship between metropolitan residential segregation and poor birth outcomes in a national sample of Puerto Rican women.

Although Puerto Ricans are US citizens and thus face fewer restrictions on migration to the US mainland than immigrant groups from elsewhere in Latin America, scholars have nonetheless examined island-born Puerto Rican migrants' adaptation to life on the mainland through the lens of assimilation theory (Gordon 1964). Given the pronounced linguistic, cultural and socioeconomic differences between the island and the mainland, islandborn Puerto Ricans face many of the same challenges that other immigrant groups do. …

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