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The Black-White Disparity in Sexually Transmitted Diseases During Pregnancy: How Do Racial Segregation and Income Inequality Matter?

Noah, Aggie, J.*†; Yang, Tse-Chuan‡§; Wang, Wei-lin†¶

Sexually Transmitted Diseases: May 2018 - Volume 45 - Issue 5 - p 301–306
doi: 10.1097/OLQ.0000000000000820
Original Studies

Background We investigate the roles of residential racial segregation and income inequality for the black-white disparity in acquiring sexually transmitted diseases (STD) during pregnancy in a multilevel framework.

Methods The analytic sample consisted of non-Hispanic white (n = 79,271) and non-Hispanic black (n = 17,669) mothers from 2012 population birth data from Pennsylvania. We used the 2009 to 2013 American Community Survey for neighborhood characteristics of mothers; we used multilevel models.

Results First, neighborhood-level factors are important for understanding this disparity because racial segregation and income inequality are significantly associated with acquiring STD during pregnancy, regardless of race. Second, racial segregation moderates the relationships between race/ethnicity and the acquisition of STD during pregnancy. White mothers are more vulnerable to neighborhood segregation than black mothers, and black mothers are less likely to acquire STD during pregnancy than white mothers if they reside with co-ethnics. Third, mothers residing in the most socioeconomically disadvantaged neighborhoods—as indicated by both absolute and relative measures of income inequality—have the highest odds of acquiring STD during pregnancy, regardless of race.

Conclusions Neighborhood-level segregation and income inequality are important for understanding the acquisition of STDs during pregnancy. Our findings have important implications for future research and for place-specific prevention and intervention to reduce the racial disparity in STD during pregnancy.

White mothers are more vulnerable to acquiring sexually transmitted disease during pregnancy when living in racially segregated neighborhoods. Neighborhood SES is linked to higher odds of acquiring sexually transmitted disease during pregnancy.

From the *School of Social Transformation, Arizona State University, Tempe, AZ; †Population Research Institute, Pennsylvania State University, University Park, PA; ‡Department of Sociology, §Center for Social and Demographic Analysis, University at Albany, State University of New York, Albany, NY; and ¶Department of Agricultural Economics, Sociology, and Education, Pennsylvania State University, University Park, PA

Revised and Resubmitted February 13, 2018 for publication in Sexually Transmitted Diseases.

Sources of Funding: The authors would like to acknowledge support from the Population Research Institute (PRI) at The Pennsylvania State University and the Center for Social and Demographic Analysis (CSDA) at the University at Albany. PRI (R24 HD041025-11) and CSDA (R24 HD044943-09) receive core support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

Conflict of interest: None declared.

The study was previously presented at the annual meeting of Population Association of America.

Correspondence: Aggie J. Noah, PhD, School of Social Transformation, Arizona State University, Wilson Hall 125, Tempe, AZ 85287. E-mail: Aggie.Noah@asu.edu.

Received for publication September 23, 2017, and accepted February 17, 2018.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (http://www.stdjournal.com).

© Copyright 2018 American Sexually Transmitted Diseases Association