Racial and ethnic variation in low birthweight in the United States: individual and contextual determinants

Using the Linked Birth and Death data set for 1990, the County-City Plus for 1993, and Summary Tape Files (STF) for 1990, a. multilevel model is utilized to examine the influence of county and individual-level characteristics on low birthweight risk for white, black, Mexican, Cuban and Puerto Rican infants in the United Slates. Logistic regression results show that the racial and ethnic differences in low birthweight are not only the result of the individual-level characteristics of the mother, but also are a function of the characteristics of the county where the mother resides. Support for the contention that contextual factors work directly and indirectly to affect low birthweight risk was found. Separate racial/ethnic models indicate that the specific contextual variables that account for low birthweight risk vary across racial/ethnic groups. (C) 1999 Elsevier Science Ltd. All rights reserved.