What does economic connectedness actually measure?

A major strength of the study by Bruckner¹ and colleagues is that it examines both foetal death and infant death rather than live-born outcomes alone. This design provides a more complete view of perinatal loss. It also makes a related interpretive issue particularly important to clarify.

In the Methods, economic connectedness is clearly defined as a community-level measure derived from ZIP Code Tabulation Area (ZCTA) social capital data. The authors state that community-level economic connectedness reflects the average individual economic connectedness among residents with below-median socioeconomic-status in that ZCTA and that they treat it as a structural characteristic of ZCTAs. On that basis, the study analyses an area-level structural exposure in relation to perinatal outcomes. The evidence presented, therefore, concerns whether differences in community social structure are associated with differences in foetal death and infant death.

Yet in the ‘How this study might affect research, practice or policy’ section, the…

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