PM2077: Correlation of Socioeconomic Disadvantages to Newborn Health in a Coastal Community

Background: Children’s Hospital of The King’s Daughters (CHKD) in Norfolk Va, serves an area affected by redlining in the early 1900s. Redlining was created by the government-sponsored Home Owners’ Loan Corporation to rate neighborhoods on the desirability of refinancing a mortgage. Neighborhoods with a higher grade (typically majority white neighborhoods) benefited from increased public and private financial investment. Lower rated communities typically had a majority black population and today these communities suffer from a higher poverty rate, lower educational attainment and lack of health insurance.

Methods: An IRB approved, retrospective chart review was conducted on NICU patients from 2018-2021. Median income from 2020 was collated with the reviewed data. The association between continuous variables and race or year periods were assessed using t-test. The association between categorical variables and race of year periods were analyzed using chi-square or Fisher’s exact test. Generalized liner regression was conducted to tests the impact of multiple variables on the outcomes.

Results: Zip codes used for median income were identified for 443 Black or African Americans and 339 White Americans. Compared to our White population, our Black or African American maternal population had a significantly lower household income (mean diff 4399, 95% CI [3086.4, 5711.9], p< 0.001) and the NICU population had significantly lower birth weight (mean diff 339, 95% CI [169.6, 509.1], p< 0.001), head circumference at birth (mean diff 1.7, 95% CI [0.9, 2.5], p< 0.001) and gestational age (mean diff 1.5, 95% [0.7, 2.4], p< 0.001). The White maternal population had lower rates of maternal diabetes (OR=0.57, 95% CI [0.36, 0.91], p=0.016) and maternal hypertension (OR=0.53, 95% CI [0.38, 0.75], p< 0.001). There is a significant correlation identified between maternal hypertension and lower birth weight (p < 0.001), smaller head circumference (p=0.005) and lower gestational age (p=0.001).

Conclusion: The community surrounding CHKD has been significantly affected by a history of systemic racism that has given rise to socioeconomic disadvantages influencing neonatal outcomes in the present day. Our data supports that these disparities have a harmful effect on our minority neonatal population outcomes, specifically related to maternal hypertension. It is unlikely that these disparities will be resolved soon, but it is important to identify the impact they have on our NICU population. These findings support the need for increased social and financial support, both at the governmental and hospital-based level, to improve outcomes for infants born into this disadvantaged community.