Biological Mechanisms

Exposure to acute and chronic stress is one of the hypothesized pathways through which neighborhood context may affect birth outcomes. At the individual level, a growing body of empirical evidence, based on methodologically rigorous studies of pregnant women of different racial-ethnic, socioeconomic, and cultural backgrounds, supports the premise that mothers experiencing high levels of psychological or social stress during pregnancy are at significantly increased risk for preterm birth (relative risk = 1.5 to 2.0), even after adjustment for other biomedical, sociodemographic, and behavioral risk factors (Pearl et al., 2001; Rauh and Culhane, 2001). In addition, adverse neighborhood conditions, such as crime, homelessness, and tax de linquency, were significantly associated with the risk of urogenital tract infection, one of the leading causes of preterm birth (Collins and David, 1997; Roberts, 1997), during pregnancy, even after adjustment for individual-level risk factors (Elo et al., 2001).

Stress both at the individual level and at the neighborhood level may affect preterm birth through physiological pathways (see Chapter 6 for a discussion). The plausibility of the influences of the direct neuroendocrine and the neuroendcorine-immune interaction pathways suggests that stressful exposures may have physiological consequences over and above their possible influences on health-related behaviors. As evidence accumulates that individual-level stressful exposures can become annoying ("get under the skin"), it is not hard to imagine that dangerous and rundown neighborhoods may exert a similar effect. It is therefore possible that neighborhoods can influence health outcomes through direct physiological dysregulation.

Gaining Weight 101

Gaining Weight 101

Find out why long exhausting workouts may do more harm than good. Most of the body-building workout and diet regimens out there are designed for the guys that gain muscle and fat easily. They focus on eating less and working out more in order to cut the excess fat from their bodies while adding needed muscle tone.

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