{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:38:40Z","timestamp":1793723920951,"version":"4.6.1"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["P50MD015496"],"award-info":[{"award-number":["P50MD015496"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. Racial and Ethnic Health Disparities"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While there is growing evidence of the negative impact of neighborhood segregation on maternal and infant health, the evidence for stillbirth is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study of live births and stillbirths for 2007\u20132020 was conducted in greater Houston, TX, to examine the associations of racialized economic segregation, assessed using the Index of Concentrations at the Extremes (ICE), with stillbirth. Here, ICE contrasted census tract-level racial and economic privilege with disadvantage (i.e., high-income non-Hispanic White persons vs. low-income Persons of Color). Additionally, Oaxaca-Blinder decomposition methods were applied to examine the degree to which segregation and maternal risk factors explained observed racial disparities in stillbirth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of stillbirth was highest among non-Hispanic Black mothers (9.1\/1000) compared with Hispanic mothers (4.7\/1000), non-Hispanic White mothers (3.8\/1000), and mothers whose race or ethnicity was unknown or classified as other (3.7\/1000). In models adjusted for age, pre-pregnancy body mass index (BMI), smoking during pregnancy, and education, odds of stillbirth were reduced for non-Hispanic White mothers living in the most privileged neighborhoods (OR\u2009=\u20090.82, 95% CI 0.60, 1.12 for ICE tertile 3 vs. ICE tertile 1). In contrast, residing in more privileged neighborhoods did not confer the same benefit for mothers of other racial and ethnic groups. Based on the decomposition analysis, maternal age, education, pre-pregnancy BMI, smoking, and ICE explained 21.2% of the disparity in stillbirth between non-Hispanic Black and non-Hispanic White mothers; of which, having a high school education or less (12.3%), living in the most privileged neighborhoods (9.7%), and being obese (7.2%) contributed the most.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neighborhood privilege appears to confer benefits for White mothers but not for non-White mothers, potentially due to experiences of racial discrimination that offset economic advantages. While racialized economic segregation contributed modestly to Black-White disparities in stillbirth, much of the disparity remains unexplained by the factors examined. Future research should explore additional individual- and neighborhood-level contributors to these disparities while addressing inequities to reduce stillbirth risks across all populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40615-025-02511-9","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T09:47:14Z","timestamp":1752140834000},"page":"3461-3470","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Racialized Economic Segregation and Disparities in the Risk of Stillbirth"],"prefix":"10.1007","volume":"13","author":[{"given":"Amal","family":"Rammah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Drake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iman","family":"Moussa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina W.","family":"Whitworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Alvarez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9073-8898","authenticated-orcid":false,"given":"Elaine","family":"Symanski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"2511_CR1","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s12884-016-0800-8","volume":"16","author":"C Burden","year":"2016","unstructured":"Burden C, Bradley S, Storey C, Ellis A, Heazell AE, Downe S, Cacciatore J, Siassakos D. From grief, guilt pain and stigma to hope and pride - a systematic review and meta-analysis of mixed-method research of the psychosocial impact of stillbirth. BMC Pregnancy Childbirth. 2016;16:9.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"37","key":"2511_CR2","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.15585\/mmwr.mm6937a1","volume":"69","author":"SM Pruitt","year":"2020","unstructured":"Pruitt SM, Hoyert DL, Anderson KN, Martin J, Waddell L, Duke C, Honein MA, Reefhuis J. Racial and ethnic disparities in fetal deaths - United States, 2015\u20132017. MMWR Morb Mortal Wkly Rep. 2020;69(37):1277\u201382.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"9774","key":"2511_CR3","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1016\/S0140-6736(10)62233-7","volume":"377","author":"V Flenady","year":"2011","unstructured":"Flenady V, Koopmans L, Middleton P, Fr\u00f8en JF, Smith GC, Gibbons K, Coory M, Gordon A, Ellwood D, McIntyre HD, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet. 2011;377(9774):1331\u201340.","journal-title":"Lancet"},{"key":"2511_CR4","doi-asserted-by":"crossref","unstructured":"Group SCRNW. Association between stillbirth and risk factors known at pregnancy confirmation. JAMA 2011; 306(22).","DOI":"10.1001\/jama.2011.1798"},{"issue":"1","key":"2511_CR5","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1097\/AOG.0000000000000052","volume":"123","author":"MW Varner","year":"2014","unstructured":"Varner MW, Silver RM, Rowland Hogue CJ, Willinger M, Parker CB, Thorsten VR, Goldenberg RL, Saade GR, Dudley DJ, Coustan D, et al. Association between stillbirth and illicit drug use and smoking during pregnancy. Obstet Gynecol. 2014;123(1):113\u201325.","journal-title":"Obstet Gynecol"},{"issue":"4","key":"2511_CR6","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1053\/j.semperi.2011.02.019","volume":"35","author":"CJ Rowland Hogue","year":"2011","unstructured":"Rowland Hogue CJ, Silver RM. Racial and ethnic disparities in United States: stillbirth rates: trends, risk factors, and research needs. Semin Perinatol. 2011;35(4):221\u201333.","journal-title":"Semin Perinatol"},{"key":"2511_CR7","doi-asserted-by":"publisher","first-page":"108516","DOI":"10.1016\/j.envres.2019.05.047","volume":"176","author":"A Rammah","year":"2019","unstructured":"Rammah A, Whitworth KW, Han I, Chan W, Symanski E. PM(2.5) metal constituent exposure and stillbirth risk in Harris County, Texas. Environ Res 2019; 176:108516.","journal-title":"Environ Res"},{"key":"2511_CR8","doi-asserted-by":"publisher","first-page":"105067","DOI":"10.1016\/j.envint.2019.105067","volume":"131","author":"A Rammah","year":"2019","unstructured":"Rammah A, Whitworth KW, Han I, Chan W, Hess JW, Symanski E. Temperature, placental abruption and stillbirth. Environ Int. 2019;131: 105067.","journal-title":"Environ Int"},{"issue":"1","key":"2511_CR9","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1093\/epirev\/mxp001","volume":"31","author":"MR Kramer","year":"2009","unstructured":"Kramer MR, Hogue CR. Is segregation bad for your health? Epidemiol Rev. 2009;31(1):178\u201394.","journal-title":"Epidemiol Rev"},{"issue":"5","key":"2511_CR10","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/S0033-3549(04)50068-7","volume":"116","author":"DR Williams","year":"2001","unstructured":"Williams DR, Collins C. Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Rep. 2001;116(5):404\u201316.","journal-title":"Public Health Rep"},{"key":"2511_CR11","doi-asserted-by":"publisher","first-page":"100417","DOI":"10.1016\/j.ssmph.2019.100417","volume":"8","author":"R Mehra","year":"2019","unstructured":"Mehra R, Keene DE, Kershaw TS, Ickovics JR, Warren JL. Racial and ethnic disparities in adverse birth outcomes: differences by racial residential segregation. SSM Popul Health. 2019;8: 100417.","journal-title":"SSM Popul Health"},{"key":"2511_CR12","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.socscimed.2017.09.018","volume":"191","author":"R Mehra","year":"2017","unstructured":"Mehra R, Boyd LM, Ickovics JR. Racial residential segregation and adverse birth outcomes: a systematic review and meta-analysis. Soc Sci Med. 2017;191:237\u201350.","journal-title":"Soc Sci Med"},{"key":"2511_CR13","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.jpeds.2021.03.049","volume":"235","author":"T Janevic","year":"2021","unstructured":"Janevic T, Zeitlin J, Egorova NN, Hebert P, Balbierz A, Stroustrup AM, Howell EA. Racial and economic neighborhood segregation, site of delivery, and morbidity and mortality in neonates born very preterm. J Pediatr. 2021;235:116\u201323.","journal-title":"J Pediatr"},{"issue":"4","key":"2511_CR14","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1007\/s10995-021-03189-1","volume":"26","author":"L Dyer","year":"2022","unstructured":"Dyer L, Chambers BD, Crear-Perry J, Theall KP, Wallace M. The Index of Concentration at the Extremes (ICE) and pregnancy-associated mortality in Louisiana, 2016\u20132017. Matern Child Health J. 2022;26(4):814\u201322.","journal-title":"Matern Child Health J"},{"issue":"1","key":"2511_CR15","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1097\/AOG.0000000000005023","volume":"141","author":"P Balascio","year":"2023","unstructured":"Balascio P, Moore M, Gongalla M, Regan A, Ha S, Taylor BD, Hill AV. Measures of racism and discrimination in preterm birth studies. Obstet Gynecol. 2023;141(1):69\u201383.","journal-title":"Obstet Gynecol"},{"issue":"5","key":"2511_CR16","doi-asserted-by":"publisher","first-page":"644","DOI":"10.2307\/2086918","volume":"15","author":"A Yankauer","year":"1950","unstructured":"Yankauer A. The relationship of fetal and infant mortality to residential segregation: an inquiry into social epidemiology. Am Sociol Rev. 1950;15(5):644\u20138.","journal-title":"Am Sociol Rev"},{"issue":"5","key":"2511_CR17","doi-asserted-by":"publisher","first-page":"573","DOI":"10.2307\/2088915","volume":"23","author":"A Yankauer","year":"1958","unstructured":"Yankauer A, Allaway NC. The relation of indices of fetal and infant loss to residential segregation: a follow-up report. Am Sociol Rev. 1958;23(5):573\u20138.","journal-title":"Am Sociol Rev"},{"issue":"4","key":"2511_CR18","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1515\/ijdhd-2012-0056","volume":"11","author":"RA Brown","year":"2012","unstructured":"Brown RA, Hogue C, Kramer M. Social and economic determinants of stillbirths in Georgia. International Journal on Disability and Human Development. 2012;11(4):369\u201375.","journal-title":"International Journal on Disability and Human Development"},{"key":"2511_CR19","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.healthplace.2018.04.005","volume":"51","author":"AD Williams","year":"2018","unstructured":"Williams AD, Wallace M, Nobles C, Mendola P. Racial residential segregation and racial disparities in stillbirth in the United States. Health Place. 2018;51:208\u201316.","journal-title":"Health Place"},{"issue":"1","key":"2511_CR20","doi-asserted-by":"publisher","first-page":"e0262962","DOI":"10.1371\/journal.pone.0262962","volume":"17","author":"A Larrabee Sonderlund","year":"2022","unstructured":"Larrabee Sonderlund A, Charifson M, Schoenthaler A, Carson T, Williams NJ. Racialized economic segregation and health outcomes: a systematic review of studies that use the Index of Concentration at the Extremes for race, income, and their interaction. PLoS ONE. 2022;17(1): e0262962.","journal-title":"PLoS ONE"},{"issue":"4","key":"2511_CR21","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1080\/01419870050033676","volume":"23","author":"DS Massey","year":"2000","unstructured":"Massey DS, Fischer MJ. How segregation concentrates poverty. Ethn Racial Stud. 2000;23(4):670\u201391.","journal-title":"Ethn Racial Stud"},{"issue":"2","key":"2511_CR22","doi-asserted-by":"publisher","first-page":"256","DOI":"10.2105\/AJPH.2015.302955","volume":"106","author":"N Krieger","year":"2016","unstructured":"Krieger N, Waterman PD, Spasojevic J, Li W, Maduro G, Van Wye G. Public health monitoring of privilege and deprivation with the index of concentration at the extremes. Am J Public Health. 2016;106(2):256\u201363.","journal-title":"Am J Public Health"},{"issue":"4","key":"2511_CR23","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.annepidem.2018.01.012","volume":"28","author":"CL DeSisto","year":"2018","unstructured":"DeSisto CL, Hirai AH, Collins JW, Jr., Rankin KM. Deconstructing a disparity: explaining excess preterm birth among U.S.-born black women. Ann Epidemiol 2018; 28(4):225\u2013230.","journal-title":"Ann Epidemiol"},{"key":"2511_CR24","unstructured":"Tex. Admin. Code 181.7(a). In.; 1976."},{"key":"2511_CR25","doi-asserted-by":"crossref","unstructured":"Tex. Admin. Code 181.1(10). In.; 1976.","DOI":"10.1136\/bjsm.10.3.181"},{"issue":"2","key":"2511_CR26","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/0029-7844(95)00386-X","volume":"87","author":"GR Alexander","year":"1996","unstructured":"Alexander GR, Himes JH, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstet Gynecol. 1996;87(2):163\u20138.","journal-title":"Obstet Gynecol"},{"key":"2511_CR27","volume-title":"Modern Epidemiology","author":"KJ Rothman","year":"2015","unstructured":"Rothman KJ, Greenland S, Lash TL. Modern Epidemiology. 3rd ed. Philadelphia: Wolters Kluwer Health; 2015.","edition":"3"},{"issue":"1","key":"2511_CR28","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s12982-021-00100-9","volume":"18","author":"E Rahimi","year":"2021","unstructured":"Rahimi E, Hashemi Nazari SS. A detailed explanation and graphical representation of the Blinder-Oaxaca decomposition method with its application in health inequalities. Emerg Themes Epidemiol. 2021;18(1):12.","journal-title":"Emerg Themes Epidemiol"},{"issue":"2","key":"2511_CR29","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1097\/GRF.0000000000000349","volume":"61","author":"EA Howell","year":"2018","unstructured":"Howell EA. Reducing disparities in severe maternal morbidity and mortality. Clin Obstet Gynecol. 2018;61(2):387\u201399.","journal-title":"Clin Obstet Gynecol"},{"issue":"4","key":"2511_CR30","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1037\/hea0000242","volume":"35","author":"DR Williams","year":"2016","unstructured":"Williams DR, Priest N, Anderson NB. Understanding associations among race, socioeconomic status, and health: patterns and prospects. Health Psychol. 2016;35(4):407\u201311.","journal-title":"Health Psychol"},{"key":"2511_CR31","volume-title":"Unequal treatment: confronting racial and ethnic disparities in health care Washington","author":"Institute of Medicine","year":"2003","unstructured":"Institute of Medicine. Unequal treatment: confronting racial and ethnic disparities in health care Washington. D.C.: National Academies Press; 2003."},{"issue":"5","key":"2511_CR32","doi-asserted-by":"publisher","first-page":"S47","DOI":"10.1016\/j.ajog.2005.01.073","volume":"192","author":"CJR Hogue","year":"2005","unstructured":"Hogue CJR, Bremner JD. Stress model for research into preterm delivery among black women. Am J Obstet Gynecol. 2005;192(5):S47\u201355.","journal-title":"Am J Obstet Gynecol"},{"issue":"1","key":"2511_CR33","first-page":"101","volume":"16","author":"AI Vines","year":"2006","unstructured":"Vines AI, Baird DD, McNeilly M, Hertz-Picciotto I, Light KC, Stevens J. Social correlates of the chronic stress of perceived racism among Black women. Ethn Dis. 2006;16(1):101.","journal-title":"Ethn Dis"},{"issue":"10","key":"2511_CR34","doi-asserted-by":"publisher","first-page":"2229","DOI":"10.1016\/j.socscimed.2004.10.023","volume":"60","author":"KE Pickett","year":"2005","unstructured":"Pickett KE, Collins JW Jr, Masi CM, Wilkinson RG. The effects of racial density and income incongruity on pregnancy outcomes. Soc Sci Med. 2005;60(10):2229\u201338.","journal-title":"Soc Sci Med"},{"issue":"1","key":"2511_CR35","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1089\/heq.2017.0045","volume":"2","author":"CFT Prather","year":"2018","unstructured":"Prather CFT, Jeffries WL 4th, Marshall KJ, Howell AV, Belyue-Umole A, King W. Racism, African American women, and their sexual and reproductive health: a review of historical and contemporary evidence and implications for health equity. Health Equity. 2018;2(1):249\u201359.","journal-title":"Health Equity"},{"key":"2511_CR36","doi-asserted-by":"crossref","unstructured":"Larrabee Sonderlund A, Schoenthaler A, Thilsing T. The association between maternal experiences of interpersonal discrimination and adverse birth outcomes: a systematic review of the evidence. Int J Environ Res Public Health 2021; 18(4).","DOI":"10.3390\/ijerph18041465"},{"key":"2511_CR37","unstructured":"Liu SR, D'Anna-Hernandez K, Sandman CA, Davis EP, Glynn LM. Discrimination and adverse birth outcomes among Latina women: The protective role of social support. Cultur Divers Ethnic Minor Psychol 2023."},{"key":"2511_CR38","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.psyneuen.2018.09.031","volume":"100","author":"G Valsamakis","year":"2019","unstructured":"Valsamakis G, Chrousos G, Mastorakos G. Stress, female reproduction and pregnancy. Psychoneuroendocrinology. 2019;100:48\u201357.","journal-title":"Psychoneuroendocrinology"},{"key":"2511_CR39","doi-asserted-by":"crossref","unstructured":"Grzeszczak K, Lanocha-Arendarczyk N, Malinowski W, Zietek P, Kosik-Bogacka D. Oxidative stress in pregnancy. Biomolecules 2023; 13(12).","DOI":"10.3390\/biom13121768"},{"issue":"1","key":"2511_CR40","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1093\/ije\/dyaa252","volume":"50","author":"AM Neophytou","year":"2021","unstructured":"Neophytou AM, Kioumourtzoglou M-A, Goin DE, Darwin KC, Casey JA. Educational note: addressing special cases of bias that frequently occur in perinatal epidemiology. Int J Epidemiol. 2021;50(1):337\u201345.","journal-title":"Int J Epidemiol"},{"issue":"1\u201318","key":"2511_CR41","first-page":"e13","volume":"33","author":"AT Forde","year":"2019","unstructured":"Forde AT, Crookes DM, Suglia SF, Demmer RT. The weathering hypothesis as an explanation for racial disparities in health: a systematic review. Ann Epidemiol. 2019;33(1\u201318): e13.","journal-title":"Ann Epidemiol"},{"issue":"1","key":"2511_CR42","doi-asserted-by":"publisher","first-page":"19214","DOI":"10.1038\/s41598-022-23719-3","volume":"12","author":"J Dunne","year":"2022","unstructured":"Dunne J, Tessema GA, Gebremedhin AT, Pereira G. Bias in the association between advanced maternal age and stillbirth using left truncated data. Sci Rep. 2022;12(1):19214.","journal-title":"Sci Rep"},{"key":"2511_CR43","doi-asserted-by":"crossref","unstructured":"Burris HH, Valeri L, James-Todd T: Statistical methods to examine contributors to racial disparities in perinatal outcomes. In: Seminars in Perinatology: 2022: Elsevier; 2022: 151663.","DOI":"10.1016\/j.semperi.2022.151663"},{"issue":"1","key":"2511_CR44","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1093\/ije\/dyy149","volume":"48","author":"ME Wallace","year":"2019","unstructured":"Wallace ME, Crear-Perry J, Green C, Felker-Kantor E, Theall K. Privilege and deprivation in Detroit: infant mortality and the Index of Concentration at the Extremes. Int J Epidemiol. 2019;48(1):207\u201316.","journal-title":"Int J Epidemiol"},{"issue":"2","key":"2511_CR45","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1111\/j.1365-3016.2010.01096.x","volume":"24","author":"PJ Lupo","year":"2010","unstructured":"Lupo PJ, Symanski E, Chan W, Mitchell LE, Waller DK, Canfield MA, Langlois PH. Differences in exposure assignment between conception and delivery: the impact of maternal mobility. Paediatr Perinat Epidemiol. 2010;24(2):200\u20138.","journal-title":"Paediatr Perinat Epidemiol"},{"issue":"2","key":"2511_CR46","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1007\/s11524-016-0116-z","volume":"94","author":"N Krieger","year":"2017","unstructured":"Krieger N, Feldman JM, Waterman PD, Chen JT, Coull BA, Hemenway D. Local residential segregation matters: stronger association of census tract compared to conventional city-level measures with fatal and non-fatal assaults (total and firearm related), using the Index of Concentration at the Extremes (ICE) for racial, economic, and racialized economic segregation, Massachusetts (US), 1995\u20132010. J Urban Health. 2017;94(2):244\u201358.","journal-title":"J Urban Health"},{"issue":"4","key":"2511_CR47","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1016\/j.fertnstert.2023.01.026","volume":"119","author":"AD Williams","year":"2023","unstructured":"Williams AD. The problem with neighborhoods: methodological issues with arbitrary administrative areas. Fertil Steril. 2023;119(4):661\u20132.","journal-title":"Fertil Steril"}],"container-title":["Journal of Racial and Ethnic Health Disparities"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40615-025-02511-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40615-025-02511-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40615-025-02511-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:19:38Z","timestamp":1783523978000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40615-025-02511-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,9]]},"references-count":47,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["2511"],"URL":"https:\/\/doi.org\/10.1007\/s40615-025-02511-9","relation":{},"ISSN":["2197-3792","2196-8837"],"issn-type":[{"value":"2197-3792","type":"print"},{"value":"2196-8837","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,9]]},"assertion":[{"value":"3 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 May 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 July 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study, a secondary data analysis that involved human participants, was approved by the Institutional Review Boards at Baylor College of Medicine (Protocol H-49359) and Texas DSHS (Protocol 22\u2013001). Written consent was not required or obtained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}