(P10-015-24) Neighborhood Structural and Social Determinants of Health (SSDoH) Predict Pregnancy Anemia in Chicago

Objectives: Anemia affects an estimated 9% of pregnant people in the US and is associated with complications including preterm birth, peripartum hemorrhage, and maternal and fetal mortality. Anemia affects nearly 2-3 times more pregnant people of color compared with white pregnant people. Social and structural determinants of health (SSDoH) are place-based characteristics that can directly harm health, inhibit healthy behaviors, and diminish access to resources necessary for health. SSDoH may help explain racial and ethnic disparities in prenatal anemia in part due to psychosocial stress and differences in food environment and diet.

Methods: Electronic health record data for 6,164 pregnant patients in 2015-2019 from a public urban hospital (UI Health, Chicago, IL) was merged using geocoded home locations with community area economic, crime, and food environment variables obtained from a publicly available database (Chicago Health Atlas). Geographic distribution of anemia (defined using CDC trimester-specific hemoglobin cutoffs) by community area was explored with mapping and descriptive statistics. Community characteristics predictive of elevated anemia burden were evaluated with Pearson correlation coefficients.

Results: Patient were ages 12-17 y (18%), 18-24 y (55%), 25+ y (27%); 55% were non-Hispanic Black/African American, 20% non-Hispanic White, 19% Hispanic; 67% were insured by Medicaid. Prevalence of anemia at any time in pregnancy was 20.3%. Prevalence by trimester (T) was 9.4% (1^st T, n=4575), 19.2% (2^nd T, 3974), and 36.8% (3^rd, 775). Patients came from all 77 Chicago community areas. Correlations of community area poverty rate, number of homicides, and low supermarket access with anemia prevalence were 0.088, 0.08, and 0.037, respectively (p < 0.01).

Conclusions: Prenatal anemia prevalence was high and varied with SSDoH measures across Chicago neighborhoods. Future research will develop multilevel models to quantify contributions of individual and community characteristics to risk of prenatal anemia.

Funding Sources: RKC is supported by the UIC BIRCWH (Building Interdisciplinary Careers in Women’s Health) Program, UIC College of Medicine / NIH.