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Race, Place, and Space: Ecosocial Theory and Spatiotemporal Patterns of Pregnancy Outcomes

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Recapturing Space: New Middle-Range Theory in Spatial Demography

Part of the book series: Spatial Demography Book Series ((SPDE,volume 1))

Abstract

Since John Snow’s geographic analysis of Cholera in London in the mid-nineteenth century, the intersection of social stratification and spatial patterns in population health have interested social and health scientists. Over the past two decades theorizing about the social determinants of population health has evolved, while somewhat independently a neighborhood-effects, place, and health literature has emerged. These two themes may be complementary, but much current literature is limited to cross-sectional analysis of arbitrarily bounded neighborhoods and point-in-time health measures. In this chapter I aim to ‘spatialize’ aspects of Kriegers’ ecosocial theory, as motivated by empirical analysis of race-specific patterns in poor pregnancy outcomes among black and white women in Georgia. Three spatial themes are explored. The question of ‘how local is local’ is asked by considering women’s neighborhoods as defined at multiple scales of census geography as well as with egocentric neighborhoods. The accumulation of socio-spatial ‘exposures’ across the life course is considered through the lens of the weathering hypothesis for accelerated aging and perinatal health. Finally the independent contribution of neighborhood trajectories and temporal dynamics on pregnancy outcomes is explored.

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Notes

  1. 1.

    Approximate inflation-adjusted cutpoints used for decennial census years: 1990: <$25,000; 2000: <$30,000.

  2. 2.

    Cutpoints for decennial census were approximately inflation-adjusted to the 2007 values: 1990: <$20,000 or >$65,000; 2000: <$30,000 or > $85,000.

  3. 3.

    Percent of households who moved in past 5-years as captured in the 1990 or 2000 decennial census. Percent of households who moved in past 1-year as captured in 2005–2009 ACS. Census Bureau working paper suggests that patterns of mobility are similar when comparing the 5-year definition from decennial census, and the 5-year pooled estimate of 1-year mobility from the ACS (Benetsky and Koerber 2012).

  4. 4.

    While the index or analysis pregnancies are solely for women residing in the 28-county Atlanta MSA at the time of delivery, the cumulative measure took account of all pregnancies in the state between 1994 and 2007.

  5. 5.

    Sensitivity analyses were conducted excluding and/or controlling for an indicator for which women had measures extrapolated; final results were robust to these assumptions.

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Authors and Affiliations

  1. Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA

    Michael R. Kramer

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Correspondence to Michael R. Kramer .

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Editors and Affiliations

  1. Department of Sociology, Mississippi State University, Ridgeland, Mississippi, USA

    Frank M. Howell

  2. Brooklyn College and Graduate Center, City University of New York, Brooklyn, New York, USA

    Jeremy R. Porter

  3. Department of Sociology & Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA

    Stephen A. Matthews

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Kramer, M.R. (2016). Race, Place, and Space: Ecosocial Theory and Spatiotemporal Patterns of Pregnancy Outcomes. In: Howell, F., Porter, J., Matthews, S. (eds) Recapturing Space: New Middle-Range Theory in Spatial Demography. Spatial Demography Book Series, vol 1. Springer, Cham. https://doi.org/10.1007/978-3-319-22810-5_14

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