Multilevel Intersectional Social Drivers of Health and Nulliparous Term, Singleton, Vertex Cesarean Delivery

The authors aimed to investigate how the intersection of neighborhood social determinants—specifically socioeconomic disadvantage, food access, and walkability—affects the likelihood of nulliparous term, singleton, vertex (NTSV) cesarean deliveries. Their analysis revealed that low walkability significantly increased the risk of cesarean delivery, particularly when combined with socioeconomic disadvantage or low food access, although the associations did not vary by race or ethnicity. Overall, the study highlights the importance of neighborhood characteristics in influencing cesarean delivery outcomes.