Connecting concentrated disadvantage and birth outcomes to enhance program targeting
Methods: County-level Census (2010) and American Community Survey (2008-2012) data were obtained for five variables: % households in poverty, % female-headed households, % unemployment, % receiving public assistance, and % <18 years. Z-scores were computed for each variable, averaged into a composite CD z-score, and then classified into CD quartiles. Illinois death certificate (2009-2011) and birth certificate (2010) data were used to compute the rates of: low birth weight (LBW), very low birth weight (VLBW), infant mortality (IM), less than adequate prenatal care (PNC), and teen birth (for 15-19 year olds) in each CD quartile. Binomial regression was used to assess the differences between CD quartiles.
Results: All five outcomes yielded a dose-response association with CD quartile. Counties in the highest CD quartile had significantly higher rates of poor outcomes than counties in the lowest CD quartile (LBW RR=1.25 [1.18–1.32]; VLBW RR=1.45 [1.26–1.67]; IM RR=1.37 [1.11–1.69]; <Adequate PNC RR= 1.54 [1.49–1.59]; Teen birth RR=2.10 [1.97–2.22]).
Conclusions: County-level CD is associated with a wide array of birth outcomes and may be a useful metric to inform geographic targeting of MCH programs.
Describe the value of concentrated disadvantage as a measure of community economic well-being Discuss the association of birth outcomes and concentrated disadvantage at the county-level
Keyword(s): MCH Epidemiology
Qualified on the content I am responsible for because: I received my PhD in maternal and child epidemiology from the University of Illinois at Chicago School of Public Health in 2014. I have worked as an MCH epidemiologist for the Illinois Department of Public Health since 2013.
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.