Environmental context is an important predictor of health behavior. Understanding its effect on cannabis use among pregnant women has not been well understood. To our knowledge, this is the first study that examines the association between subjective neighborhood context and cannabis use among pregnant women and explores the mediating effect of stress levels. Data are from the Life-Course Influences on Fetal Environments Study (LIFE), a retrospective cohort of postpartum African American women in Metropolitan Detroit, Michigan (2009–2011).
Our results suggest that all three measures of perceived neighborhood context, including social disorder, social cohesion and trust, and danger and safety, are significantly associated with prenatal cannabis use. Worse perceptions of neighborhood environment increase the odds of prenatal cannabis use even after adjustment for age, income, marital status, education level, and social support. Moreover, stress levels mediate the association between perceived neighborhood danger and safety scale and prenatal cannabis use.
In other words, women with negative perceptions about their neighborhood safety experience higher stress levels, which are associated with increased use of cannabis during pregnancy. Future prospective studies are warranted to understand the causal associations between individual correlates and social and physical environmental factors of prenatal cannabis use.
