Elisabeth Dowling Root1,2, Emelie D Bailey3, Tyler Gorham4, Christopher Browning5, Chi Song6, Pamela Salsberry7. 1. 2647Department of Geography, The Ohio State University, Columbus, OH, USA. 2. 12306Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA. 3. 12306Ohio Colleges of Medicine Government Resource Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA. 4. 2650Nationwide Children's Hospital, Columbus, OH, USA. 5. 2647Department of Sociology, The Ohio State University, Columbus, OH, USA. 6. 2647Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA. 7. 2647Division of Health Behavior and Health Promotion, Center for Health Outcomes, Policy, and Evaluation Studies, College of Public Health, The Ohio State University, Columbus, OH, USA.
Abstract
OBJECTIVES: Geovisualization and spatial analysis are valuable tools for exploring and evaluating the complex social, economic, and environmental interactions that lead to spatial inequalities in health. The objective of this study was to describe spatial patterns of infant mortality and preterm birth in Ohio by using interactive mapping and spatial analysis. METHODS: We conducted a retrospective cohort study using Ohio vital statistics records from 2008-2015. We geocoded live births and infant deaths by using residential address at birth. We used multivariable logistic regression to adjust spatial and space-time cluster analyses that examined the geographic clustering of infant mortality and preterm birth and changes in spatial distribution over time. RESULTS: The overall infant mortality rate in Ohio during the study period was 6.55 per 1000 births; of 1 097 507 births, 10.3% (n = 112 552) were preterm. We found significant geographic clustering of both infant mortality and preterm birth centered on large urban areas. However, when known demographic risk factors were taken into account, urban clusters disappeared and, for preterm birth, new rural clusters appeared. CONCLUSIONS: Although many public health agencies have the capacity to create maps of health outcomes, complex spatial analysis and geovisualization techniques are still challenging for public health practitioners to use and understand. We found that actively engaging policymakers in reviewing results of the cluster analysis improved understanding of the processes driving spatial patterns of birth outcomes in the state.
OBJECTIVES: Geovisualization and spatial analysis are valuable tools for exploring and evaluating the complex social, economic, and environmental interactions that lead to spatial inequalities in health. The objective of this study was to describe spatial patterns of infant mortality and preterm birth in Ohio by using interactive mapping and spatial analysis. METHODS: We conducted a retrospective cohort study using Ohio vital statistics records from 2008-2015. We geocoded live births and infant deaths by using residential address at birth. We used multivariable logistic regression to adjust spatial and space-time cluster analyses that examined the geographic clustering of infant mortality and preterm birth and changes in spatial distribution over time. RESULTS: The overall infant mortality rate in Ohio during the study period was 6.55 per 1000 births; of 1 097 507 births, 10.3% (n = 112 552) were preterm. We found significant geographic clustering of both infant mortality and preterm birth centered on large urban areas. However, when known demographic risk factors were taken into account, urban clusters disappeared and, for preterm birth, new rural clusters appeared. CONCLUSIONS: Although many public health agencies have the capacity to create maps of health outcomes, complex spatial analysis and geovisualization techniques are still challenging for public health practitioners to use and understand. We found that actively engaging policymakers in reviewing results of the cluster analysis improved understanding of the processes driving spatial patterns of birth outcomes in the state.
Authors: Carmen Giurgescu; Shannon N Zenk; Barbara L Dancy; Chang G Park; William Dieber; Richard Block Journal: J Obstet Gynecol Neonatal Nurs Date: 2012-10-02
Authors: Elisabeth Dowling Root; Louis Gonzales; David E Persse; Paul R Hinchey; Bryan McNally; Comilla Sasson Journal: Resuscitation Date: 2013-01-11 Impact factor: 5.262