Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #103449

Ellen J. Stein, MD, MPH, MA, Maternal Child and Adolescent Health Section, San Francisco Department of Public Health, 30 Van Ness, Suite 260, San Francisco, CA 94102, 415-575-5672, Ellen.Stein@sfdph.org, Al Geller Abramowitz, MS, Maternal and Child Health Section, San Francisco Department of Public Health, 30 Van Ness, Suite 260, San Francisco, CA 94102, Janet Brown, MSc, Community Assessment, Planning and Education Unit, Alameda County Public Health Department, 1000 Broadway, Suite 500, Oakland, CA 94607, and Anand Chabra, MD, MPH, Maternal, Child and Adolescent Health, San Mateo County Health Department, 225 37th Avenue, San Mateo, CA 94403.

Background: Nine counties surrounding San Francisco Bay joined the MCH Bay Area Data Collaborative (BADC), bringing greater statistical power to analytic studies. Enabling counties without sufficient numbers for sub-analyses (e.g., by race/ethnicity) to pool data, the BADC enhances efforts to study disparities in regional perinatal health outcomes.

Methods: Analysis of 2001 county and regional perinatal mortality and morbidity outcome rates, using ANOVA to determine county variances from regional mean. Analysis of disparities in regional and county fetal and infant mortality (FIM) rates using the Perinatal Periods of Risk (PPOR) model for three years of regionally pooled data. PPOR model excludes fetal/infant deaths <500 gms and fetal deaths <24 weeks, using comparison groups to calculate excess/preventable FIM deaths.

Data Source: California Department Health Services Birth Master File (288,170 births), and Birth Cohort File (2,210 fetal and infant deaths linked to births) for SF Bay Region, 1999-2001.

Results: Regional FIM rate of 9.3 per 1,000; county rates from 5.2 to 12.6; with Black/White FIM rate disparities of 22.1 vs. 7.6, and similar county level disparities for 2001. The PPOR model applied to regional data 1999-2001 decreases variability and demonstrates severe racial/ethnic disparities; Black FIM rates are twice those of all other racial/ethnic groups.

Conclusion: Preliminary PPOR analysis indicates major Black/White disparities in FIM rates. Excess black deaths may be reduced by focusing on different identified risk periods between the counties. Successful strategies can be shared for improvement in other regions and counties. Regional collaboration provides power to develop evidence-based public health interventions.

Learning Objectives:

• Understand how the San Francisco Bay Area Data Collaborative optimizes research findings and develops prevention strategies by creating a regional database to serve its richly heterogeneous, urban population.
• Analyze maternal and child health perinatal outcome data with increased reliability, validity, and generalizability. Utilize regional analyses for grant proposals, resource development, quality improvement, and innovative programming.
• Develop an evidence-based Regional Public Health Action Plan to reduce disparities in perinatal outcomes.

Keywords: Infant Mortality, Emerging Health Issues

Related Web page: www.citymatch.org/PPOR/

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation