An ecological analysis of racial differences in low birthweight: implications for maternal and child health social work.

This study attempted to gain a better understanding of the effect of ecological and individual risk factors on infant health for black and white women in a large metropolitan city. The study examined the association among neighborhood economic indicators, neighborhood quality, access to prenatal care, and individual perinatal risk factors and subsequent birthweight among 78,415 black and 60,346 white residents of New York City in 1991 and 1992. Multivariate analyses indicated the continuing importance of factors such as smoking and being uninsured as individual-level risk factors for low-birthweight babies, particularly among black women. The implications of these findings emphasize the need for socially and ecologically focused policies that can reduce individual-level risks for low birthweight in the future.