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Chicago Neighborhood Context and Racial/Ethnic Disparities in Maternal Diabetes

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Abstract

Objectives

To determine if rates of maternal diabetes vary by race, ethnicity, and neighborhood hardship.

Methods

We conducted a secondary analysis of live births in Chicago from 2010 to 2017. Our sample was restricted to Non-Hispanic White, Non-Hispanic Black, Mexican, Non-Hispanic Asian, and Other Hispanic mothers between the ages of 15 and 50, with singleton births. The addresses of mothers were geocoded to specific neighborhoods, which we stratified into tertiles using the Economic Hardship Index. We used generalized logit mixed models to examine the interaction between race/ethnicity, neighborhood economic hardship, and maternal diabetes.

Results

In our cohort of 299,053 mothers, 4.75% were diagnosed with gestational diabetes. Asian mothers had the highest frequency of gestational diabetes (8.3%), followed by Mexican mothers (6.8%). Within their respective racial/ethnic groups, Asian and Mexican mothers living in medium hardship neighborhoods had the highest odds of gestational diabetes compared to the reference group (OR 2.80, 95%CI 2.53, 3.19; OR 2.30, 95%CI 2.12, 2.49 respectively). Overall rates of preexisting diabetes were 0.9% and were highest among Mexican and Black mothers (1.26% and 1.06%, respectively). Asian mothers in medium hardship neighborhoods had the greatest odds of preexisting diabetes, among all Asian mothers and compared to the reference (OR 4.71 95% CI 3.60, 6.16).

Conclusions

For racial and ethnic minoritized mothers, gestational and preexisting diabetes do not increase in a step-wise fashion with neighborhood hardship; rates were often higher in low and medium hardship neighborhoods.

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Data Availability

Data are available upon request to the Chicago Department of Public Health .

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Funding

Anika Lucas was a fellow in the American Kidney Fund Clinical Scientist in Nephrology Program. The authors otherwise declare no other funds, grants, or other support were received during the preparation of the manuscript.

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Authors and Affiliations

  1. Department of Medicine, Duke University School of Medicine, Durham, NC, USA

    Anika Lucas

  2. Durham Veterans Affairs Medical Center, Durham, NC, USA

    Anika Lucas

  3. Data Science and Analytics, University of Chicago Medicine, Chicago, IL, USA

    Sophia Mlawer

  4. Department of Public Health, Chicago, IL, USA

    Kingsley Weaver

  5. Department of Public Health Los Angeles County, Los Angeles, CA, USA

    Julia Caldwell

  6. General Internal Medicine, University of Chicago Medicine, Chicago, IL, USA

    Arshiya Baig, Lindsay Zasadazinski & Milda Saunders

Authors
  1. Anika Lucas
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  2. Sophia Mlawer
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  3. Kingsley Weaver
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  4. Julia Caldwell
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Contributions

All authors contributed to the study’s conception and design. Statistical analysis was performed by Sophia Mlawer. The first draft of the manuscript was written by Anika Lucas, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Anika Lucas.

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Ethics Approval

The study was approved by the Chicago Department of Public Health and University of Chicago Institutional Review Board (IRB). Because this study was a secondary analysis of de-identified data, informed consent from participants was waived by the IRB.

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The authors declare no competing interests.

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Lucas, A., Mlawer, S., Weaver, K. et al. Chicago Neighborhood Context and Racial/Ethnic Disparities in Maternal Diabetes. J. Racial and Ethnic Health Disparities (2023). https://doi.org/10.1007/s40615-023-01892-z

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  • DOI: https://doi.org/10.1007/s40615-023-01892-z

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