Neighborhood Walkability as a Risk Factor for Preterm Birth Phenotypes in Two Philadelphia Hospitals from 2013–2016

Theresa A. Kash, Rachel F. Ledyard, Anne M. Mullin and Heather H. Burris ()
Additional contact information
Theresa A. Kash: Center for Public Health Initiatives, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
Rachel F. Ledyard: Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
Anne M. Mullin: Tufts University School of Medicine, Boston, MA 02111, USA
Heather H. Burris: Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA

IJERPH, 2023, vol. 20, issue 11, 1-13

Abstract: A total of one in ten infants is born preterm in the U.S. with large racial disparities. Recent data suggest that neighborhood exposures may play a role. Walkability—how easily individuals can walk to amenities–may encourage physical activity. We hypothesized that walkability would be associated with a decreased risk of preterm birth (PTB) and that associations would vary by PTB phenotype. PTB can be spontaneous (sPTB) from conditions such as preterm labor and preterm premature rupture of membranes, or medically indicated (mPTB) from conditions such as poor fetal growth and preeclampsia. We analyzed associations of neighborhood walkability (quantified by their Walk Score ® ranking) with sPTB and mPTB in a Philadelphia birth cohort (n = 19,203). Given racial residential segregation, we also examined associations in race-stratified models. Walkability (per 10 points of Walk Score ranking) was associated with decreased odds of mPTB (aOR 0.90, 95% CI: 0.83, 0.98), but not sPTB (aOR 1.04, 95% CI: 0.97, 1.12). Walkability was not protective for mPTB for all patients; there was a non-significant protective effect for White (aOR 0.87, 95% CI: 0.75, 1.01), but not Black patients (aOR 1.05, 95% CI: 0.92, 1.21) (interaction p = 0.03). Measuring health effects of neighborhood characteristics across populations is key for urban planning efforts focused on health equity.

Keywords: walkability; preterm birth; pregnancy; racial disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/20/11/5932/pdf (application/pdf)
https://www.mdpi.com/1660-4601/20/11/5932/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:20:y:2023:i:11:p:5932-:d:1154160

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().