Neighborhood context and infant birthweight among recent immigrant mothers: a multilevel analysis

Am J Public Health. 2009 Feb;99(2):285-93. doi: 10.2105/AJPH.2007.127498. Epub 2008 Dec 4.


Objectives: We compared the influence of the residential environment and maternal country of origin on birthweight and low birthweight of infants born to recent immigrants to urban Ontario.

Methods: We linked delivery records (1993-2000) to an immigration database (1993-1995) and small-area census data (1996). The data were analyzed with cross-classified random-effects models and standard multilevel methods. Higher-level predictors included 4 independent measures of neighborhood context constructed by factor analysis and maternal world regions of origin.

Results: Births (N = 22 189) were distributed across 1396 census tracts and 155 countries of origin. The associations between neighborhood indices and birthweight disappeared after we controlled for the maternal country of origin in a cross-classified multilevel model. Significant associations between world regions and birthweight and low birthweight persisted after we controlled for neighborhood context and individual characteristics.

Conclusions: The residential environment has little, if any, influence on birthweight among recent immigrants to Ontario. Country of origin appears to be a much more important factor in low birthweight among children of recent immigrants than current neighborhood. Findings of neighborhood influences among recent immigrants should be interpreted with caution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Birth Certificates
  • Censuses
  • Databases, Factual
  • Emigrants and Immigrants*
  • Female
  • Humans
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Male
  • Middle Aged
  • Mothers*
  • Odds Ratio
  • Ontario / epidemiology
  • Residence Characteristics*
  • Young Adult