Work

Examining variation within Hispanic ethnicity: An intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) of birthweight inequities in New York City, 2012–2019

Year: 2025

Type: article

Abstract: Birthweight inequities in the United States have been persistent with variations observed across maternal age, race/ethnicity, education, and nativity status. However, the Hispanic/Latino population is often treated as a monolithic category, ignoring within-group diversity and heterogeneity of health outcomes. This study employed an intersectional MAIHDA (multilevel analysis of individual heterogeneity and discriminatory accuracy) to examine birthweight inequities among singleton births in New York City from 2012 to 2019 (n = 819,920 records of singleton births) by maternal age, race/ethnicity, education, and nativity status, with particular attention to within-group heterogeneity among Hispanic/Latino mothers. Birthweight was measured in grams and was considered continuous for analytical purposes. The analysis was conducted using both the aggregate "Hispanic" category and disaggregated into Hispanic subgroups, based on the country/region of birth as part of the racial/ethnic categories. We found that 2.7%-3.2% of the variation in birthweight means among NYC women lies between intersectional strata, suggesting both meaningful between-stratum birthweight inequities and a high-degree of between-person birthweight variation. The finding of between-stratum inequities is consistent with a difference of 384.7g. between strata with the highest and lowest predicted birthweight means. We found consistent additive inequity patterns in birthweight by maternal age, race/ethnicity, educational attainment, and nativity status. The latter explained 81.2% of the variation in birthweight inequities. While attention to subgroup differences is often limited by sample size, intersectional MAIHDA allows for the identification of between- and within-strata variations regardless of whether Hispanic ethnicity was treated as an aggregate or subgroup based on country/region of origin.

Source: SSM - Population Health

DOI: 10.1016/j.ssmph.2025.101759

Authors: Luisa N. Borrell, Christina I. Nieves, Clare R. Evans

Institutions: City University of New York, Universidad de Alcalá, University of Oregon

Language: English

Topic: Maternal and Neonatal Healthcare

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDGs: Reduced inequalities, Good health and well-being

Open Access status: gold

Estimated APC paid: $2,930