Neighborhood Attributes Associated with Poor Diet and Inadequate Weight Gain during Pregnancy

Barbara A. Laraia, University of North Carolina at Chapel Hill
Lynne Messer, U.S. Environmental Protection Agency
Jay S. Kaufman, University of North Carolina at Chapel Hill
Nancy Dole, University of North Carolina at Chapel Hill
David A. Savitz, University of North Carolina at Chapel Hill

Neighborhood factors have been associated with health outcomes, mainly in US northern urban areas. To estimate relationships between neighborhood attributes, health behaviors and health indicators in pregnancy, residential and commercial areas were assessed in the context of the Pregnancy, Infection and Nutrition study. A 39-item instrument used in Baltimore, MD was adapted for a southern urban area. Confirmatory factor analysis was used to test previously identified scales of physical incivilities, (i.e., neighborhood condition), and territoriality, (i.e., display symbolic and physical boundaries). Neighborhood attributes distinguished areas in which low-income pregnant white and black women live. Logistic regression, controlling for several individual level socio-demographic measures, found that high levels of neighborhood territoriality were independently associated with poor diet quality, and high incivility was associated with inadequate weight gain among pregnant women. These findings suggest neighborhood characteristics are relevant to the study of reproductive health indicators and, possibly, to the design of interventions.