People who live in socioeconomically deprived neighborhoods are about 20 percent less likely to conceive compared to those living in neighborhoods with more resources, according to a recent study from Oregon State University. The researchers measured “fecundability,” or the monthly probability of getting pregnant without the use of fertility treatments.
Neighborhoods were compared based on a measure of the socioeconomic resources in a neighborhood known as the area deprivation index score. Even among a relatively affluent, highly educated population, it was found that people living in more deprived neighborhoods had lower fecundability rates than people living in higher-opportunity neighborhoods.
“The world of fertility research is beginning to examine factors associated with the built environment. There are dozens of studies looking at how your neighborhood environment is associated with adverse birth outcomes, but the pre-conception period is heavily under-studied from a structural standpoint,” explained study lead author Mary Willis. “Turns out, before you’re even conceived, there may be things affecting your health.”
Public health research in the last decade has highlighted social determinants of health and that where you live is the greatest predictor for overall life expectancy, based on income, health care access, employment rates, education level and access to safe water.
“But the concept that your neighborhood affects your fertility hasn’t been studied in depth,” said Willis. “In addition, the world of infertility research is largely focused on individual factors, so when I came into this study as an environmental epidemiologist, I was thinking we should look at it as a structural problem.”
The study leveraged data from the Pregnancy Study Online (PRESTO). The experts analyzed the outcomes of 6,356 individuals between the ages of 21 and 45, who were attempting to conceive without the use of fertility treatment.
The majority of people in the cohort were white, had completed a four-year college education and earned more than $50,000 a year.
Study participants filled out online surveys every eight weeks for up to 12 months, answering questions about menstrual cycle characteristics and pregnancy status. During the study period, 3,725 pregnancies were documented.
The participants were compared across different area deprivation index rankings at both the national and within-state levels, which used socioeconomic indicators including educational attainment, housing, employment and poverty.
The results showed that individuals in the most-deprived neighborhoods had a reduction in fecundability of about 20 percent compared with those in the least-deprived neighborhoods. The most-deprived neighborhoods saw a reduction in fecundability of up to 25 percent.
“The fact that we’re seeing the same results on the national and state level really shows that neighborhood deprivation can influence reproductive health, including fertility,” Willis said.
Fertility treatments are costly, and are often limited to families with significant resources. Investing in deprived neighborhoods to address socioeconomic disparities could lead to positive benefits for fertility.