Perinatal Health Inequalities in the Industrial Region of Estonia: A Birth Registry-Based Study

Usha Dahal (), Triin Veber, Daniel Oudin Åström, Tanel Tamm, Leena Albreht, Erik Teinemaa, Kati Orru and Hans Orru
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Usha Dahal: Institute of Family Medicine and Public Health, University of Tartu, 50411 Tartu, Estonia
Triin Veber: Institute of Family Medicine and Public Health, University of Tartu, 50411 Tartu, Estonia
Daniel Oudin Åström: Section of Sustainable Health, Umeå University, 901 87 Umea, Sweden
Tanel Tamm: Institute of Family Medicine and Public Health, University of Tartu, 50411 Tartu, Estonia
Leena Albreht: Environmental Health Department, Estonian Health Board, 10617 Tallinn, Estonia
Erik Teinemaa: Estonian Environmental Research Centre, 10617 Tallinn, Estonia
Kati Orru: Institute of Social Science, University of Tartu, 51003 Tartu, Estonia
Hans Orru: Institute of Family Medicine and Public Health, University of Tartu, 50411 Tartu, Estonia

IJERPH, 2022, vol. 19, issue 18, 1-17

Abstract: Despite the increasing number of studies on industrially contaminated sites (ICS) and their health effects, there are very few studies on perinatal health outcomes in ICSs. In the present study, we examined the perinatal health inequalities by comparing adverse birth outcomes (ABOs) in the oil shale industry region of Ida-Viru County in Estonia with national-level figures and investigated the effects of maternal environmental and sociodemographic factors. Based on the 208,313 birth records from 2004–2018, Ida-Viru ICS has a birth weight 124.5 g lower than the average of 3544 g in Estonia. A higher prevalence of preterm birth (4.3%) and low birth weight (4.8%) in Ida-Viru ICS is found compared to 3.3% on both indicators at the national level. Multiple logistic regression analysis shows the statistically significant association of ABOs with fine particle (PM 2.5 ) air pollution, mother’s ethnicity, and education throughout Estonia. However, in Ida-Viru ICS, the ABOs odds are remarkably higher in these characteristics except for the mother’s ethnicity. Furthermore, the ABOs are associated with the residential proximity to ICS. Thus, the Ida-Viru ICS has unequally higher odds of adverse perinatal health across the environmental and sociodemographic factors. In addition to reducing the air pollutants, policy actions on social disparities are vital to address the country’s unjustly higher perinatal health inequalities, especially in the Ida-Viru ICS.

Keywords: inequality; air pollution; socioeconomic status; industrially contaminated sites; adverse birth outcomes; preterm birth; low birth weight (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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