Geographic Hotspots for Low Birthweight: An Analysis of Counties With Persistently High Rates
| Autor: | Clare C. Brown PhD, MPH, Jennifer E. Moore PhD, RN, Holly C. Felix PhD, MPA, Mary K. Stewart MD, MPH, John M. Tilford PhD |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Inquiry: The Journal of Health Care Organization, Provision, and Financing, Vol 57 (2020) |
| Druh dokumentu: | article |
| ISSN: | 0046-9580 1945-7243 00469580 |
| DOI: | 10.1177/0046958020950999 |
| Popis: | This study evaluated persistency in county-level rates of low birthweight outcomes to identify “hotspot counties” and their associated area-level characteristics. Administrative data from the National Center for Health Statistics Birth Data Files, years 2011 to 2016 were used to calculate annual county-level rates of low birthweight. Counties ranking in the worst quintile (Q5) for ≥3 years with a neighboring county in the worst quintile were identified as hotspot counties. Multivariate logistic regression was used to associate county-level characteristics with hotspot designation. Adverse birth outcomes were persistent in poor performing counties, with 52% of counties in Q5 for low birthweight in 2011 remaining in Q5 in 2016. The rate of low birthweight among low birthweight hotspot counties (n = 495) was 1.6 times the rate of low birthweight among non-hotspot counties (9.3% vs 5.8%). The rate of very low birthweight among very low birthweight hotspot counties (n = 387) was twice as high compared to non-hotspot counties (1.8% vs 0.9%). A one standard deviation (6.5%) increase in the percentage of adults with at least a high school degree decreased the probability of low birthweight hotspot designation by 1.7 percentage points ( P = .006). A one standard deviation (20%) increase in the percentage of the population that was of minority race/ethnicity increased hotspot designation for low birthweight by 5.7 percentage points ( P |
| Databáze: | Directory of Open Access Journals |
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