How do state poverty policy and county urbanization levels relate to infant survival among Caucasians born above very-low-birthweight (Above-VLBW: 1500 grams or more)? This research adds to the literature an analysis of individual risk of infant death among Caucasians born Above-VLBW. The population chosen controls for infant race and represents 79% of the U.S. birth cohort studied, allowing for adequate sampling from each state and DC. Data (N=220,325) are randomly sampled from linked birth/infant death records for the 1984 birth cohort -- survivors roughly represent the current U.S. population of Caucasian 16-year-olds. Independent variables are parental (maternal age/education, marriage), healthcare (inadequate prenatal care), maternal residence at birth (County dichotomies -- urban, suburban, rural; State averages for percent of poverty population covered by Medicaid -- range: 20-100%). The dependent variable is dichotomous -- infant death or survival to 1-year of age. Logistic regression analyzes infant death odds given state & county variables and controlling for parental factors & prenatal care. Results show Caucasian Above-VLBW infant death risk to increase significantly with maternal residence in (1) rural counties (population less than 250,000); (2) states where Medicaid covers fewer of the poor. In conclusion, in the mid-1980s, nearly 80% of the U.S. birth population are found to have greater survival odds if born to a mother residing in counties with greater population density or in states providing Medicaid coverage to more low-income families. This social health policy research needs to be replicated among minority races and more current birth cohorts.
Learning Objectives: Participants in this session will learn to: 1. Identify research methods that assess how maternal residence at birth relates to infant health. 2. Evaluate important control variables that associate with individual risk of infant death. 3. Apply the use of policy research to daily social work practice in the area of maternal and child health
Keywords: Infant Health, Medicaid
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.