James E Kucik1, Wendy N Nembhard, Pamela Donohue, Owen Devine, Ying Wang, Cynthia S Minkovitz, Thomas Burke. 1. James E. Kucik and Owen Devine are with the Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Wendy N. Nembhard is with the Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa. Pamela Donohue is with the Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD. Ying Wang is with the Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Albany, NY. Cynthia S. Minkovitz is with the Department of Population, Family and Reproductive Health, and Thomas Burke is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Abstract
OBJECTIVES: We examined the association between survival of infants with severe congenital heart defects (CHDs) and community-level indicators of socioeconomic status. METHODS: We identified infants born to residents of Arizona, New Jersey, New York, and Texas between 1999 and 2007 with selected CHDs from 4 population-based, statewide birth defect surveillance programs. We linked data to the 2000 US Census to obtain 11 census tract-level socioeconomic indicators. We estimated survival probabilities and hazard ratios adjusted for individual characteristics. RESULTS: We observed differences in infant survival for 8 community socioeconomic indicators (P < .05). The greatest mortality risk was associated with residing in communities in the most disadvantaged deciles for poverty (adjusted hazard ratio [AHR] = 1.49; 95% confidence interval [CI] = 1.11, 1.99), education (AHR = 1.51; 95% CI = 1.16, 1.96), and operator or laborer occupations (AHR = 1.54; 95% CI = 1.16, 1.96). Survival decreased with increasing numbers of indicators that were in the most disadvantaged decile. Community-level mortality risk persisted when we adjusted for individual-level characteristics. CONCLUSIONS: The increased mortality risk among infants with CHDs living in socioeconomically deprived communities might indicate barriers to quality and timely care at which public health interventions might be targeted.
OBJECTIVES: We examined the association between survival of infants with severe congenital heart defects (CHDs) and community-level indicators of socioeconomic status. METHODS: We identified infants born to residents of Arizona, New Jersey, New York, and Texas between 1999 and 2007 with selected CHDs from 4 population-based, statewide birth defect surveillance programs. We linked data to the 2000 US Census to obtain 11 census tract-level socioeconomic indicators. We estimated survival probabilities and hazard ratios adjusted for individual characteristics. RESULTS: We observed differences in infant survival for 8 community socioeconomic indicators (P < .05). The greatest mortality risk was associated with residing in communities in the most disadvantaged deciles for poverty (adjusted hazard ratio [AHR] = 1.49; 95% confidence interval [CI] = 1.11, 1.99), education (AHR = 1.51; 95% CI = 1.16, 1.96), and operator or laborer occupations (AHR = 1.54; 95% CI = 1.16, 1.96). Survival decreased with increasing numbers of indicators that were in the most disadvantaged decile. Community-level mortality risk persisted when we adjusted for individual-level characteristics. CONCLUSIONS: The increased mortality risk among infants with CHDs living in socioeconomically deprived communities might indicate barriers to quality and timely care at which public health interventions might be targeted.
Authors: Miriam Kuppermann; Lee A Learman; Elena Gates; Steven E Gregorich; Robert F Nease; James Lewis; A Eugene Washington Journal: Obstet Gynecol Date: 2006-05 Impact factor: 7.661
Authors: Adolfo Correa; Janet D Cragan; James E Kucik; Clinton J Alverson; Suzanne M Gilboa; Renu Balakrishnan; Matthew J Strickland; C Wes Duke; Leslie A O'Leary; Tiffany Riehle-Colarusso; Csaba Siffel; Don Gambrell; Debra Thompson; Michael Atkinson; Jamuna Chitra Journal: Birth Defects Res A Clin Mol Teratol Date: 2007-02
Authors: Quanhe Yang; Huichao Chen; Adolfo Correa; Owen Devine; T J Mathews; Margaret A Honein Journal: Birth Defects Res A Clin Mol Teratol Date: 2006-10
Authors: Elizabeth A Howell; Paul Hebert; Samprit Chatterjee; Lawrence C Kleinman; Mark R Chassin Journal: Pediatrics Date: 2008-02-11 Impact factor: 7.124
Authors: Ying Wang; Gang Liu; Mark A Canfield; Cara T Mai; Suzanne M Gilboa; Robert E Meyer; Marlene Anderka; Glenn E Copeland; James E Kucik; Wendy N Nembhard; Russell S Kirby Journal: J Pediatr Date: 2015-01-29 Impact factor: 4.406
Authors: Rie Sakai-Bizmark; Laurie A Mena; Hiraku Kumamaru; Ichiro Kawachi; Emily H Marr; Eliza J Webber; Hyun H Seo; Scott I M Friedlander; Ruey-Kang R Chang Journal: Health Serv Res Date: 2019-03-27 Impact factor: 3.402
Authors: Kara A Bjur; Chung-Il Wi; Euijung Ryu; Chris Derauf; Sheri S Crow; Katherine S King; Young J Juhn Journal: Mayo Clin Proc Date: 2019-01 Impact factor: 7.616
Authors: Jesse E Hansen; Nicolas L Madsen; Laurie Bishop; David L S Morales; Jeffrey B Anderson Journal: Pediatr Cardiol Date: 2018-05-17 Impact factor: 1.655