To better understand the social determinants of preterm birth, research efforts have shifted from women’s individual level characteristics toward their exposure to contextual markers. The Index of Concentration at the Extremes (ICE) is a novel measure of spatial social polarization that quantifies the extremes of both privilege and deprivation. Our population-based study adds to the limited published literature on the relation of ICE to preterm birth rates among African-American and non-Latinx white women. We found that the high degree of both racial and income polarization within communities was associated with preterm birth rates even among those who received adequate prenatal care.

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