BACKGROUND AND OBJECTIVE: Despite improvements in congenital heart disease (CHD) survival over the past 4 decades, ethnic disparities persist. Several studies have shown higher postoperative CHD adjusted mortality in black and Hispanic children. Others noted that non-English-speaking language at home was associated with appointment noncompliance, which the parents attributed to misunderstanding and living too far from a health center. The purpose of this study was to determine the effect of home distance to a cardiac center, or having a Latin American-born parent, on first-year mortality in infants with severe CHD. METHODS: Infants with severe CHD, having an estimated first-year mortality >25%, born 1996-2003, were identified from the Texas Birth Defects Registry and linked to state and national vital records. We examined the effects of defect type; birth weight; gestational age; extracardiac anomalies; infant gender; maternal race/ethnicity, marital status, and education; residence in a Texas county bordering Mexico; home distance to cardiac center; and parental birth country on first-year survival. RESULTS: Overall first-year survival was 59.9%, and no race/ethnic differences were noted; however, survival was significantly (P < .05) lower for Hispanic infants with hypoplastic left heart syndrome. Neither home distance to a cardiac center nor parental birth country was related to first-year survival; however, survival was noted to be lower in Texas counties bordering Mexico, counties that have high rates of poverty. CONCLUSIONS: Further studies are needed to determine if these disparities in survival of infants with severe CHD are attributable to delays in referral to a cardiac center.
BACKGROUND AND OBJECTIVE: Despite improvements in congenital heart disease (CHD) survival over the past 4 decades, ethnic disparities persist. Several studies have shown higher postoperative CHD adjusted mortality in black and Hispanic children. Others noted that non-English-speaking language at home was associated with appointment noncompliance, which the parents attributed to misunderstanding and living too far from a health center. The purpose of this study was to determine the effect of home distance to a cardiac center, or having a Latin American-born parent, on first-year mortality in infants with severe CHD. METHODS:Infants with severe CHD, having an estimated first-year mortality >25%, born 1996-2003, were identified from the Texas Birth Defects Registry and linked to state and national vital records. We examined the effects of defect type; birth weight; gestational age; extracardiac anomalies; infant gender; maternal race/ethnicity, marital status, and education; residence in a Texas county bordering Mexico; home distance to cardiac center; and parental birth country on first-year survival. RESULTS: Overall first-year survival was 59.9%, and no race/ethnic differences were noted; however, survival was significantly (P < .05) lower for Hispanic infants with hypoplastic left heart syndrome. Neither home distance to a cardiac center nor parental birth country was related to first-year survival; however, survival was noted to be lower in Texas counties bordering Mexico, counties that have high rates of poverty. CONCLUSIONS: Further studies are needed to determine if these disparities in survival of infants with severe CHD are attributable to delays in referral to a cardiac center.
Authors: Eric M Delmelle; Cynthia H Cassell; Coline Dony; Elizabeth Radcliff; Jean Paul Tanner; Csaba Siffel; Russell S Kirby Journal: Birth Defects Res A Clin Mol Teratol Date: 2013-09-02
Authors: Elizabeth Radcliff; Eric Delmelle; Russell S Kirby; Sarah B Laditka; Jane Correia; Cynthia H Cassell Journal: Matern Child Health J Date: 2016-01
Authors: James E Kucik; Cynthia H Cassell; Clinton J Alverson; Pamela Donohue; Jean Paul Tanner; Cynthia S Minkovitz; Jane Correia; Thomas Burke; Russell S Kirby Journal: Am J Public Health Date: 2014-07-17 Impact factor: 9.308
Authors: James E Kucik; Wendy N Nembhard; Pamela Donohue; Owen Devine; Ying Wang; Cynthia S Minkovitz; Thomas Burke Journal: Am J Public Health Date: 2014-09-11 Impact factor: 9.308
Authors: Cora Peterson; Elizabeth Ailes; Tiffany Riehle-Colarusso; Matthew E Oster; Richard S Olney; Cynthia H Cassell; David E Fixler; Suzan L Carmichael; Gary M Shaw; Suzanne M Gilboa Journal: JAMA Pediatr Date: 2014-04 Impact factor: 16.193
Authors: Kristin M Sommerhalter; Tabassum Z Insaf; Tugba Akkaya-Hocagil; Claire E McGarry; Sherry L Farr; Karrie F Downing; George K Lui; Ali N Zaidi; Alissa R Van Zutphen Journal: Birth Defects Res Date: 2017-11-01 Impact factor: 2.344
Authors: Peter N Dean; Kimberly E McHugh; Mark R Conaway; Diane G Hillman; Howard P Gutgesell Journal: Pediatr Cardiol Date: 2013-05-31 Impact factor: 1.655
Authors: Cynthia H Cassell; Anne Krohmer; Dara D Mendez; Kyung A Lee; Ronald P Strauss; Robert E Meyer Journal: Birth Defects Res A Clin Mol Teratol Date: 2013-09-02