Association between Neighborhood-Level Racial Segregation and Low Birth Weight among Black Infants: A Systematic Review and Meta-Analysis

Abstract

The association between neighborhood-level racial segregation and low birth weight among Black infants was systematically reviewed and meta-analyzed. Seven major databases (e.g., PubMed, PsycINFO) were searched, and ten additional search strategies were performed. After scanning and coding search results, a random effects meta-analysis using the log odds ratio metric was performed for studies with comparable effects sizes, and a systematic review comparing articles addressing this association was written. Heterogeneity, moderators, publication bias, and sensitivity were assessed. Quality indicators for each article were discussed in the narrative review. A total of 6,212 articles were retrieved yielding seven articles included in the systematic review. Three articles featuring eight independent studies were eligible and included in the meta-analysis. The mean effect size was statistically significant (OR = 1.13, 95% CI [1.07, 1.19], p = 0.00) and represented a positive association between low birth weight and Black isolation. These results lacked heterogeneity (Q=8.34, df = 7, p = 0.30, I2 = 16.1%; τ2 = 0.00) and thus no moderator analysis was conducted. There was no evidence of publication bias, and results from sensitivity analyses substantiated the robustness of the findings. Racial isolation appears not only to be statistically significantly associated with low birth weight after individual and neighborhood-level adjustments but also may explain racial differences in low birth weight at the neighborhood level. Results suggest Black isolation is positively associated with low birth weight for Black infants. Future research must endeavor to understand racial isolation as a process and how it shapes health.