266845 Five domains of environmental quality and infant mortality

Wednesday, October 31, 2012 : 9:10 AM - 9:30 AM

Jyotsna Jagai, MS, MPH, PhD , Office of Research and Development, Environmental Public Health Division, U.S. Environmental Protection Agency, Research Triangle Park, NC
Lynne C. Messer, PhD , Duke Global Health Institute, Center for Health Policy and Inequalities Research, Duke University, Durham, NC
Kristen Rappazzo , Dept. of Epidemiology, University of North Carolina, Chapel Hill, Chapel Hill, NC
Danelle Lobdell, PhD , Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC
The relationship between environmental conditions and human health varies by environmental media. In order to account for multiple ambient environmental conditions, we constructed an Environmental Quality Index (EQI) for health research. We used county-level data for the United States representing five environmental domains (air, water, land, built and sociodemographic) and principal components analysis to construct the EQI and domain specific indices for each county (n=3141). Infant mortality (IM) data was taken from U.S. linked births/infant deaths data for 2002 (4,027,479 birth records; 27,527 infant deaths). We used fixed slope, random intercept multilevel logistic models, adjusted for maternal age, education, marital status, and infant sex, to assess relationships between county-level environmental quality and domain specific indices with IM. Residence in a county with poor environmental quality (4th quartile) compared to the best quality (1st quartile) was not associated with IM (odds ratio (OR)=0.98; 95% confidence interval (95%CI): 0.91, 1.07). Using domain specific indices and IM, residence in counties with the worst air and built environment conditions, compared to residence in counties with the best conditions, was associated with increased odds of IM (air: OR=1.04, 95%CI: 0.96, 1.14; built: OR=1.09, 95%CI: 1.02, 1.17). The opposite relationship was observed for water, land, and sociodemographic domains (OR=0.89, 95%CI: 0.84, 0.94; OR=0.77, 95%CI: 0.73, 0.82; OR=0.88, 95%CI: 0.82, 0.95, respectively). Race-stratified models were also run and results will be presented. We combined data for multiple environmental media to construct one index representing overall county-level environmental conditions. The EQI quantifies the environmental burden counties face and the domain specific indices provide policy makers and planners with information regarding the primary environmental stressors in the area. We demonstrate the use of the EQI for health research by assessing relationships with IM; domain-specific models showed mixed associations with infant mortality.

This abstract does not necessarily reflect EPA policy.

Learning Areas:
Biostatistics, economics
Environmental health sciences
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Describe the distribution of county-level environmental quality across the United States. 2. Compare how this distribution varies by environmental domain. 3. Explain how infant mortality is associated with environmental quality and by environmental domain.

Keywords: Environmental Health, Indicators

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a researcher with expertise in maternal and child health. I have helped to conceptualize and conduct the analysis for this project.
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.