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Primary Submission Category: Social/relational factors

It’s Who You Know: Bridging Ties in Low-Resourced Neighborhoods and Maternal and Infant Health

Authors:  Tim Bruckner, Brenda Bustos, Samantha Gailey,

Presenting Author: Tim Bruckner*

Background: Recent influential work in the US finds that bridging capital (i.e., friendships across socioeconomic strata) increases upward economic mobility over the life course. The potential role of these social connections on health, especially in low-income communities, remains relatively unexplored. We exploit a recent effort which made publicly available ZIP-level measures of bridging capital using Facebook information on >70 million Americans. We test in California (8 million births; 2005 to 2021) the relation between ZIP-level bridging capital on two perinatal health outcomes: fetal death and infant death. We focus on residents in ZIP-codes with very low median household incomes (HHI) as well as ZIP-codes with a high share of Black households—neighborhoods in which risks of fetal and infant death remain very high.

Methods: Generalized estimating equation methods controlled for individual-level covariates (e.g., maternal age, education, and public/private insurance type) as well as spatial clustering of observations.

Results: In ZIP-codes with the lowest quartile of HHI, we find strong protective associations between bridging capital and fetal and infant death. A one-standard deviation increase in bridging capital corresponds with a reduced odds of fetal death (odds ratio [OR]= 0.75; 95% Confidence Interval [CI]: 0.70 to 0.80, p<.001) and a reduced odds of infant death (OR=0.87; 95% CI: 0.82 to 0.93, p<.001). In ZIP-codes with the highest quartile of Black households, results similarly show strong and protective associations (OR for fetal death: 0.76, and OR for infant death: 0.79, all p<.001). Analyses restricted to Black persons only further show protective associations.

Conclusions: The potential of bridging ties (i.e., friends across socioeconomic strata) in promoting maternal and infant health, especially in neighborhoods with unacceptably high levels of fetal and infant death, should warrant much more scholarly consideration than it currently receives.