Neighborhood affluence protects against antenatal smoking: Evidence from a spatial multiple membership model

ABSTRACT

A spatial multiple membership model formalizes the effect of neighborhood affluence on antenatal smoking. The data are geocoded New Jersey birth certificate records linked to United States census tract-level data from 1999 to 2007. Neighborhood affluence shows significant spatial autocorrelation and local clustering. Better model fit is observed when incorporating the spatial clustering of neighborhood affluence into multivariate analyses. Relative to the spatial multiple membership model, the multilevel model that ignores spatial clustering produced downwardly biased standard errors; the effective sample size of the key parameter of interest (neighborhood affluence) is also lower. Residents of communities located in high-high affluence clusters likely have better access to health-promoting institutions that regulate antenatal smoking behaviors.

KEYWORDS:

• Health
• multi-level analysis
• markov chain
• neighborhood affluence
• prenatal smoking
• USA

JEL CLASSIFICATION:

• C11
• I12
• I14

Acknowledgments

This research received support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development: K99/R00 HD075860 (PI: Jennifer B. Kane). The authors thank Brian Frizzelle for geospatial analysis support. Opinions reflect those of the authors and not necessarily those of the granting agencies.

Notes

¹ This study focuses on 1999–2007 because income inequality, a key driver of the spatial concentration of neighborhood affluence, was high (relative to levels dating back to 1950) and remained relatively constant in the United States between 1999 and the start of the Great Recession (in December 2007) U.S. Census Bureau (2017). Historical Income Tables: Income Inequality. Washington D.C., U.S. Census Bureau.

Additional information

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development [K99/R00 HD075860].