Place of residence and maternal health behaviours

W Sword, J Eyles, P DeLuca, M Heaman, D Kingston, S Buist, N Johnston, A Sprague
2015 European Journal of Public Health  
'Neighbourhood' is a relevant context for understanding health disparities yet few studies have examined neighbourhood effects on maternal health. Our study explored neighbourhood variation in maternal health behaviours in a Canadian city and determined the influence of neighbourhood characteristics on behaviours. Methods This population-based study used aggregate data from a perinatal database and Census of Canada. Health behaviours of interest were no first trimester visit, smoking in
more » ... smoking in pregnancy, and formula feeding. Data were geocoded to the neighbourhood level (census tract) in Hamilton, a large industrial city. Standardized rates for behaviours and neighbourhood-level variables were calculated, and maps were created to reveal spatial patterns. Regression analyses were done to predict each health behaviour against neighbourhood-level variables. An invitational meeting was held with stakeholders to discuss the implications of study findings. Results There were clear geographic spatial patterns for the health behaviours, with higher rates clustered in downtown and industrial areas of the city. In all three regression models, neighbourhood characteristics of (1) percent persons living in poverty, (2) percent females unemployed, (3) percent females with low education, and (4) percent immigrants were predictive of behaviours, with the first three characteristics having positive associations and the latter having a negative association. Conclusions Findings are consistent with other studies that suggest the relative importance of place of residence in determining health. The contextual factors influencing health behaviour are diverse and research is needed to understand their complex interplay and the underlying mechanisms by which neighbourhood impacts maternal health behaviours. Stakeholders recommended that residents be engaged and partnerships between neighbourhood and public health be strengthened to effect changes to promote healthy behaviours. The need for a broader policy approach also was identified.
doi:10.1093/eurpub/ckv173.038 fatcat:6hsyj7uyrfgxfp3ttqa4yy77ca