Online Program

Connecting concentrated disadvantage and birth outcomes to enhance program targeting

Tuesday, November 3, 2015

Amanda Bennett, PhD, Office of Women's Health and Family Services, Illinios Department of Public Health, Chicago, IL
Background: Identifying target communities for public health programs is challenging when local-level health data is unavailable or unreliable.  Concentrated disadvantage (CD), one of 59 AMCHP-recommended life course indicators, measures local community economic wellbeing.  This study examined the relationship between CD and birth outcomes to determine whether CD is a reasonable proxy to inform geographical targeting of maternal and child health programs.

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.

Learning Areas:

Program planning

Learning Objectives:
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

Presenting author's disclosure statement:

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.

Back to: 4382.0: Data & Epi Poster Session