Online Program

Using the perinatal periods of risk and life course theory to address health disparities

Monday, November 4, 2013

Nikki Keene Woods, PhD, MPH, Public Health Sciences, Wichita State University, Wichita, KS
Background: Maternal and infant health outcome disparities continue to exist globally despite advancements in technology and increased spending in healthcare. Despite increased efforts and research, few population-level successes have been reported. Methods: Fetal and infant death data in Kansas from 2005-2009 was analyzed to describe the Perinatal Periods of Risk (PPOR). PPOR data is used for analyzing trends to inform community-based prevention strategies to address health disparities. Four prevention areas using fetal and infant mortality birth weight and time of death data were identified: 1) Maternal Health/Prematurity (MH/P), 2) Maternal Care (MC), 3) Newborn Care (NC), and 4) Infant Health (IH). Linked birth-death cohort data was combined from birth/death certificate data. The reference group included 2000-2002 data from the US with the following characteristics: 20 or more years of age, 13 or more years of education, non-Hispanic Caucasian women, and residents of the US at time of birth. Results: The excess fetal-infant mortality rates were 10.7 for African Americans compared to 2.3 for Caucasians and 3.8 for Hispanics. Excess fetal-infant mortality rates for African Americans were 4.8 for MH/P, 2.3 for MC, and 3.0 for IH. Caucasians rates were 0.5, 0.3, and 1.1; Hispanic rates were 1.0, 0.9, and 1.7 respectively. Conclusions: Excess mortality in the MH/P risk period was due primarily to high rates of very low birth weight babies for non-Hispanic African Americans. Interventions based on the Life Course Theory are needed to improve the preconception health of African American women to reduce health disparities globally.

Learning Areas:

Diversity and culture
Environmental health sciences
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Explain social determinants of health through the life course theory in relation to maternal and infant health. Describe the health disparities that still exist related to maternal and infant health.

Keyword(s): Maternal and Child Health, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of multiple maternal/infant research studies focused on improving birth outcomes and reducing health disparities. My scientific interests include a behavioral and life course theory approach to improving population-level health.
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.