206747 Testing the Weathering Hypothesis of disparities in birth outcomes

Monday, November 9, 2009: 9:30 AM

Kathryn Luchok, PhD , South Carolina Access Initiative, Columbia, SC
Jihong Liu, ScD , Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
Kamala Swayampakala, MSPH , Arnold School of Public Health, Health Sciences Research Core, University of South Carolina, Columbia, SC
Joshua R. Mann, MD, MPH , Department of Family and Preventive Medicine, University of South Carolina, School of Medicine, Columbia, SC
Robert Moran, PhD , Arnold School of Public Health, Health Sciences Research Core, University of South Carolina, Columbia, SC
Persistent disparities exist in birth outcomes between African-Americans and European-Americans in the US, with low birth weight and prematurity at least two times higher for African-Americans. The Weathering Hypothesis generates great interest as a model for understanding these disparities, but is difficult to test.

South Carolina possesses one of the best data systems for linking socioeconomic data bases with health and vital records, allowing a test of the Weathering Hypothesis by building a model on how preexisting health conditions and socioeconomic status affect birth outcomes across age and race/ethnic groups. We linked birth records for three years (2004-2006; N=168,572) with billing data from Medicaid and one large health plan, and hospital discharge data for three years prior to delivery. Basic demographics are determined from birth records. Outcomes (prematurity and low birth weight), are determined from birth and hospital discharge records. To approximate socioeconomic factors we overlaid a geocode of census tract information then developed statistical models to examine the independent effects of mother's health conditions as well as potential joint effects of mother's health and SES conditions on birth outcomes. We describe data linking and model building; by November we will have full analysis results.

Effective strategies to reduce racial disparities in birth outcomes need to include actions that improve women's health throughout the life-course. This study will determine which factors are most highly related to poor birth outcomes across racial/ethnic groups, and may shed light on the direction intervention strategies should take to reduce these disparities.

Learning Objectives:
Explain a method of data linking to test the Weathering Hypothesis. Describe factors that relate to health disparities in birth outcomes.

Keywords: Birth Outcomes, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an equal co-PI of this study, holding a PhD in health behavior and education, specializing in maternal and child health with over 20 years of research experience.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.