The purpose of this study is to assess the prevalence of low birth weight among non-Hispanic Blacks and non-Hispanic Whites along the rural/urban continuum, as well as the combined effect of being both non-Hispanic Black and residing in a completely rural county. Degree of social isolation and lack of support are proposed mechanisms for explaining disparities in low birth weight for Blacks in rural counties.

Using data from the National Longitudinal Survey of Youth 1979 (NLSY79) and the National Longitudinal Survey of Youth 1979 Child (NLSY79-C) datasets, logistic regression models were used to estimate the odds of low birth weight. Key variables employed in these models include race/ethnicity, a five category measure of counties by degree of rural versus urban residence, interaction terms for race by county categorization, measures of the degree of community level support or isolation, household composition as a measure of the family support structure, access to medical care, maternal SES, birth characteristics, and maternal pregnancy behavior.

Results demonstrate that Blacks have much higher odds of low birth weight than Whites and living in a completely rural county exacerbates disadvantage in birth weight outcomes for non-Hispanic Blacks but not for non-Hispanic Whites. The community and household level support measures have little mediating effect on the magnitude of the negative birth weight outcomes found for non-Hispanic Blacks in the most rural counties. However, the first order effect for non-Hispanic Blacks was almost completely explained by the presence of the father in the household when interaction effects for race and place of residence were also included in the model.