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Severe sociopolitical stressors and preterm births in New York City: 1 September 2015 to 31 August 2017
  1. Nancy Krieger1,
  2. Mary Huynh2,
  3. Wenhui Li3,
  4. Pamela D Waterman1,
  5. Gretchen Van Wye2,4
  1. 1 Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
  2. 2 Bureau of Vital Statistics, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York City, New York, USA
  3. 3 Statistical Analysis and Reporting Unit, Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene, New York City, New York, USA
  4. 4 Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, New York, USA
  1. Correspondence to Dr Nancy Krieger, Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA 02115, USA; nkrieger{at}hsph.harvard.edu

Abstract

Background Severe stressors can induce preterm birth (PTB; gestation <37 weeks), with such stressors including social and economic threats, interpersonal violence, hate crimes and severe sociopolitical stressors (ie, arising from political leaders’ threatening rhetoric or from political legislation). We analysed temporal changes in risk of PTB among immigrant, Hispanic and Muslim populations targeted in the US 2016 presidential election and its aftermath.

Methods Trend analysis of all singleton births in New York City from 1 September 2015 to 31 August 2017 (n=230 105).

Results Comparing the period before the US presidential nomination (1 September 2015 to 31 July 2016) to the post-inauguration period (1 January 2017 to 31 August 2017), the overall PTB rate increased from 7.0% to 7.3% (relative risk (RR): 1.04; 95% CI 1.00 to 1.07). Among Hispanic women, the highest post-inauguration versus pre-inauguration increase occurred among foreign-born Hispanic women with Mexican or Central American ancestry (RR: 1.15; 95% CI 1.01 to 1.31). The post-inauguration versus pre-inauguration PTB rate also was higher for women from the Middle East/North Africa and from the travel ban countries, although non-significant due to the small number of events.

Conclusion Severe sociopolitical stressors may contribute to increases in the risk of PTB among targeted populations.

  • ethnicity
  • health inequalities
  • policy
  • reproductive health
  • surveillance

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Footnotes

  • Contributors NK conceived the study and led writing of the manuscript. NK, PDW, MH, WL and GVW jointly designed the study’s analytic approach. PDW created the ICE variable. MH, WL and GVW accessed, cleaned and categorised the NYC DOHMH data. MH and WL ran the statistical analysis. NK, PDW, MH, WL and GVW interpreted the results. All authors provided critical feedback on the manuscript and reviewed and approved the final version prior to submission.

  • Funding This work was supported by the New York City Department of Health and Mental Hygiene.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This study was approved as exempt by both the Harvard TH Chan School of Public Health IRB (protocol IRB15-2304; 25 June 2015) and the New York City Department of Health and Mental Hygiene IRB (protocol 18-053; 23 April 2018).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data can be obtained only from the New York City Department of Health and Mental Hygiene, following their protocols for data sharing.

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