Where We Work

Preterm birth is one of the most dramatic and shocking examples of race and place inequality in this country.
John Capitman, Executive Director, Central Valley Health Policy Institute

In California, the simple ZIP code is a veritable divining rod of preterm birth — the highest rates of prematurity correspond to areas where those with the lowest socioeconomic status reside. PTBi-CA works San Francisco and Fresno Counties, and the city of Oakland, to close the gap in preterm birth disparities and improve outcomes for mothers and their babies. 


What's in a neighborhood?


People living in poor neighborhoods often have increased exposure to violence and environmental contamination, reduced access to healthy food and transportation, and lack safe places to live and exercise. Living conditions where fundamental necessities are in constant flux cause toxic levels of stress. Chronic stress, in turn, causes women to be more at risk for preterm birth and also for chronic illnesses such as heart disease, asthma, diabetes and obesity.

Fresno County in the California Central Valley has an infant mortality rate that is double the state average, and a preterm birth rate on par with some of the poorest countries in the world. An astounding 40 percent of all preterm babies in Fresno were born in a 2- by 5-mile sector with high poverty and poor access to health care. 


In San Francisco, one in six preterm births occur in the city's most impoverished neighborhoods: Bayview-Hunters Point, Candlestick Point, Portola, and VIsitacion Valley. A woman in Bayview-Hunters Point is nearly three times more likely to have a preterm birth than a woman living in the Presidio.