The 130th Annual Meeting of APHA

Abstract #38317

Hector Balcazar, PhD¹, Curt Bay, PhD², Dean Coonrod, MD, MPH³, Patricia A Moore, DrPH, RN⁴, Jane Brady, RN, MS³, and Robert Russ, BS². (1) Department of Social and Behavioral Sciences, University of North Texas School of Public Health, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, 817-735-5430, hbalcaza@hsc.unt.edu, (2) Department of Academic Affairs, Maricopa Medical Center, 2601 East Roosevelt, Phoenix, AZ 85008, (3) Department of OB-GYN, Maricopa Medical Center, 2601 East Roosevelt, Phoenix, AZ 85008, (4) College of Nursing, Arizona State University, Arizona State University, Tempe, AZ 85287

In this article, we describe the methodology used to match a comprehensive neonatal clinical database (Neonatal Intensive Care Program of Arizona, (NICP)) with Arizona birth certificates, for the years 1994-1998, to evaluate a series of neonatal outcomes for high-risk Mexican American/Hispanic subgroups living in Arizona. We also explore the relationship between race/ethnicity and other risk factors as predictors of enrollment in the NICP program. We posed the hypotheses that White non-Hispanics (WNH), US-born Hispanics, and Mexico-born Hispanics would be differentially enrolled in NICP. The matching protocol proved to be successful. We undertook a representativeness analysis in order to determine if the 16,403 WNH and Hispanic/Mexican American NICP infants we were able to match with birth certificate data differed from those we were not able to match on selected demographic variables. Very few differences were found and we concluded that our matched sample is substantially representative of the NICP population for Hispanic and WNH babies. When we examined the relationship between enrollment in NICP and selected demographic factors, we identified several significant predictors, including: AHCCCS (Arizona's Medicaid), unmarried, education less than high school, less than 18 years of age, gestational age 20-27 weeks, less than 750 grams birth weight, presence of at least one medical risk factor, and being Mexico- or US-born Hispanic. When we adjusted for certain of these risk factors independently, we observed that the likelihood of enrollment for both US-born and Mexico-born Hispanics is substantially confounded by mother's insurance status, marital status, and education.

Learning Objectives:

• Identify steps of matching protocol that combines birth certificate and population based clinical data (NICP program) in the study.
• Develop a plan to assess the validity of matching protocol to identify infants who were enrolled in the NICP program.
• Identify medical and sociodemographic risk factors associated with predicting enrollment in NICP.

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Neonatal Intensive Care Program, Arizona Department of Health Services
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.