The objectives of this research are to examine the impact of residential segregation on concentrated poverty, access to prenatal care, and individual perinatal risk factors and subsequent birthweight among women who gave birth in New York City. This study will utilize secondary data which includes the 1991 and 1992 NYC birth records, 1990 U.S. Census data, NYC Health Department data and physician licensure data. A multi- level statistical analysis will be used to determine individual and neighborhood-level effects of low birthweight under differing levels of residential segregation within a major metropolitan city. The proposed study has three distinct aims: 1) to measure and examine the residential segregation indexes of dissimilarity and isolation across the five NYC boroughs and its impact on the neighborhood context in which women live; 2) to test a multi-level model of the effects of perinatal risk factors and neighborhood conditions on birthweight of infants in boroughs with varying levels of residential segregation; and 3) to consider the intervention and policy implications of residential segregation and its impact on neighborhood conditions that facilitate or hinder appropriate maternal and child health care in NYC. The conceptual model proposed will show connections between variables specified at three levels, borough, neighborhood and individual, by using a multi-level logistic regression analysis to estimate the probability of a woman giving birth to a low birthweight infant under differing neighborhood conditions and levels of segregation while controlling for individual risk factors.
