The Open Women's Health Journal

2010, 1 : 55-61
Published online 2010 July 08. DOI: 0.2174/1874291201004010055
Publisher ID: TOWHJ-4-55

Neighborhood Socioeconomic Characteristics, Birth Outcomes and Infant MortalityamongFirstNations and Non-First Nations in Manitoba, Canada

Zhong-Cheng Luo , Russell Wilkins2 , Maureen Heaman , Patricia Martens , Janet Smylie , Lyna Hart , Spogmai Wassimi , Fabienne Simonet1 , Yuquan Wu1 and William D. Fraser
Department of Obstetrics and Gynecology, Sainte-Justine Hospital, Bureau 4986, 3175, chemin CôteSainte-Catherine, Montreal, Quebec, Canada H3T 1C5, Canada;

ABSTRACT

Objective:

Little is known about the possible impacts of neighborhood socioeconomic status on birth outcomes and infant mortality among Aboriginal populations. We assessed birth outcomes and infant mortality by neighborhood socioeconomic status among First Nations and non-First Nations in Manitoba.

Study Deign:

We conducted a retrospective birth cohort study of all live births (26,176 First Nations, 129,623 non-First Nations) to Manitoba residents, 1991-2000. Maternal residential postal codes were used to assign four measures of neighborhood socioeconomic status (concerning income, education, unemployment, and lone parenthood) obtained from 1996 census data.

Results:

First Nations women were much more likely to live in neighborhoods of low socioeconomic status. First Nations infants were much more likely to die during their first year of life [risk ratio (RR) =1.9] especially during the postneonatal period (RR=3.6). For both First Nations and non-First Nations, living in neighborhoods of low socioeconomic status was associated with an increased risk of infant death, especially postneonatal death. For non-First Nations, higher rates of preterm and small-for-gestational-age birth were consistently observed in low socioeconomic status neighborhoods, but for First Nations the associations were less consistent across the four measures of socioeconomic status. Adjusting for neighborhood socioeconomic status, the disparities in infant and postneonatal mortality between First Nations and non-First Nations were attenuated.

Conclusions:

Low neighborhood socioeconomic status was associated with an elevated risk of infant death even among First Nations, and may partly account for their higher rates of infant mortality compared to non-First Nations in Manitoba.

Keywords:

North-south residence, Aboriginal health, first nations, neighborhood socioeconomic status, birth outcome, infant mortality..