Geographic Hotspots for Low Birthweight: An Analysis of Counties With Persistently High Rates
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 cou...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-10-01
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| Series: | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| Online Access: | https://doi.org/10.1177/0046958020950999 |
| _version_ | 1819210268742254592 |
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| author | Clare C. Brown PhD, MPH Jennifer E. Moore PhD, RN Holly C. Felix PhD, MPA Mary K. Stewart MD, MPH John M. Tilford PhD |
| author_facet | Clare C. Brown PhD, MPH Jennifer E. Moore PhD, RN Holly C. Felix PhD, MPA Mary K. Stewart MD, MPH John M. Tilford PhD |
| author_sort | Clare C. Brown PhD, MPH |
| collection | DOAJ |
| description | 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 < .001). Given the association between low birthweight and chronic conditions, hotspot counties should be a focus for policy makers in order to improve health equity across the life course. |
| first_indexed | 2024-12-23T06:08:29Z |
| format | Article |
| id | doaj.art-8d258ad7e92e478ab370979bd225765a |
| institution | Directory Open Access Journal |
| issn | 0046-9580 1945-7243 |
| language | English |
| last_indexed | 2024-12-23T06:08:29Z |
| publishDate | 2020-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| spelling | doaj.art-8d258ad7e92e478ab370979bd225765a2022-12-21T17:57:31ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95801945-72432020-10-015710.1177/0046958020950999Geographic Hotspots for Low Birthweight: An Analysis of Counties With Persistently High RatesClare C. Brown PhD, MPH0Jennifer E. Moore PhD, RN1Holly C. Felix PhD, MPA2Mary K. Stewart MD, MPH3John M. Tilford PhD4University of Arkansas for Medical Sciences, Little Rock, USAUniversity of Michigan Medical School, Ann Arbor, USAUniversity of Arkansas for Medical Sciences, Little Rock, USAUniversity of Arkansas for Medical Sciences, Little Rock, USAUniversity of Arkansas for Medical Sciences, Little Rock, USAThis 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 < .001). Given the association between low birthweight and chronic conditions, hotspot counties should be a focus for policy makers in order to improve health equity across the life course.https://doi.org/10.1177/0046958020950999 |
| spellingShingle | Clare C. Brown PhD, MPH Jennifer E. Moore PhD, RN Holly C. Felix PhD, MPA Mary K. Stewart MD, MPH John M. Tilford PhD Geographic Hotspots for Low Birthweight: An Analysis of Counties With Persistently High Rates Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| title | Geographic Hotspots for Low Birthweight: An Analysis of Counties With Persistently High Rates |
| title_full | Geographic Hotspots for Low Birthweight: An Analysis of Counties With Persistently High Rates |
| title_fullStr | Geographic Hotspots for Low Birthweight: An Analysis of Counties With Persistently High Rates |
| title_full_unstemmed | Geographic Hotspots for Low Birthweight: An Analysis of Counties With Persistently High Rates |
| title_short | Geographic Hotspots for Low Birthweight: An Analysis of Counties With Persistently High Rates |
| title_sort | geographic hotspots for low birthweight an analysis of counties with persistently high rates |
| url | https://doi.org/10.1177/0046958020950999 |
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