Consideration of social and environmental determinants of maternal and perinatal health in the geographic information systems era: a primer.

Social and environmental exposures influence health outcomes across the lifespan, including during the perinatal period. Negative exposures such as neighborhood deprivation, air pollution, and violence, as well as positive exposures such as greenspace, neighborhood cohesion, and walkability, interact to affect many complex health outcomes. Understanding the impact of neighborhood environmental exposures on health is required to design effective interventions to improve health impacts of the places shaping people's daily lives. In the era of geographic information systems (GIS), analyses delineating relationships between area-level exposures and health outcomes have become technically feasible for many public health researchers. In this primer, with a focus on maternal and perinatal health as members of the Pregnancy, Postpartum, and Postnatal Health Enhancing Quality and Access to Achieve Equitable Maternal and Infant Health (P3EQUATE) Health Equity Research Network (HERN) Social Determinants of Health Working Core, we put forth a stepwise approach to performing analyses of area-level exposures and health outcomes with considerations to promote scientific rigor.