IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0237314.html
   My bibliography  Save this article

Regional variation in Black infant mortality: The contribution of contextual factors

Author

Listed:
  • Veni Kandasamy
  • Ashley H Hirai
  • Jay S Kaufman
  • Arthur R James
  • Milton Kotelchuck

Abstract

Background: Compared to other racial/ethnic groups, infant mortality rates (IMR) are persistently highestamong Black infants in the United States, yet there is considerable regional variation. We examined state and county-level contextual factors that may explain regional differences in Black IMR and identified potential strategies for improvement. Methods and findings: Black infant mortality data are from the Linked Birth/Infant Death files for 2009–2011. State and county contextual factors within social, economic, environmental, and health domains were compiled from various Census databases, the Food Environment Atlas, and the Area Health Resource File. Region was defined by the nine Census Divisions. We examined contextual associations with Black IMR using aggregated county-level Poisson regression with standard errors adjusted for clustering by state. Overall, Black IMR varied 1.5-fold across regions, ranging from 8.78 per 1,000 in New England to 13.77 per 1,000 in the Midwest. In adjusted models, the following factors were protective for Black IMR: higher state-level Black-White marriage rate (rate ratio (RR) per standard deviation (SD) increase = 0.81, 95% confidence interval (CI):0.70–0.95), higher state maternal and child health budget per capita (RR per SD = 0.96, 95% CI:0.92–0.99), and higher county-level Black index of concentration at the extremes (RR per SD = 0.85, 95% CI:0.81–0.90). Modeled variables accounted for 35% of the regional variation in Black IMR. Conclusions: These findings are broadly supportive of ongoing public policy efforts to enhance social integration across races, support health and social welfare program spending, and improve economic prosperity. Although contextual factors accounted for about a third of regional variation, further research is needed to more fully understand regional variation in Black IMR disparities.

Suggested Citation

  • Veni Kandasamy & Ashley H Hirai & Jay S Kaufman & Arthur R James & Milton Kotelchuck, 2020. "Regional variation in Black infant mortality: The contribution of contextual factors," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-15, August.
    • Handle: RePEc:plo:pone00:0237314
    DOI: 10.1371/journal.pone.0237314
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237314
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0237314&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0237314?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Mehra, Renee & Boyd, Lisa M. & Ickovics, Jeannette R., 2017. "Racial residential segregation and adverse birth outcomes: A systematic review and meta-analysis," Social Science & Medicine, Elsevier, vol. 191(C), pages 237-250.
    2. Chung, Haejoo & Muntaner, Carles, 2006. "Political and welfare state determinants of infant and child health indicators: An analysis of wealthy countries," Social Science & Medicine, Elsevier, vol. 63(3), pages 829-842, August.
    3. Bernet, Patrick M. & Gumus, Gulcin & Vishwasrao, Sharmila, 2018. "Effectiveness of public health spending on infant mortality in Florida, 2001–2014," Social Science & Medicine, Elsevier, vol. 211(C), pages 31-38.
    4. Bird, Sheryl Thorburn, 1995. "Separate black and white infant mortality models: Differences in the importance of structural variables," Social Science & Medicine, Elsevier, vol. 41(11), pages 1507-1512, December.
    5. Wallace, M.E. & Mendola, P. & Liu, D. & Grantz, K.L., 2015. "Joint effects of structural racism and income inequality on small-for-gestational-age birth," American Journal of Public Health, American Public Health Association, vol. 105(8), pages 1681-1688.
    6. Douglas Massey & Jonathan Tannen, 2015. "A Research Note on Trends in Black Hypersegregation," Demography, Springer;Population Association of America (PAA), vol. 52(3), pages 1025-1034, June.
    7. Christopher, G.C. & Simpson, P., 2014. "Improving birth outcomes requires closing the racial gap," American Journal of Public Health, American Public Health Association, vol. 104(S1), pages 10-12.
    8. Siddiqi, Arjumand & Jones, Marcella K. & Bruce, Donald J. & Erwin, Paul C., 2016. "Do racial inequities in infant mortality correspond to variations in societal conditions? A study of state-level income inequality in the U.S., 1992–2007," Social Science & Medicine, Elsevier, vol. 164(C), pages 49-58.
    9. Roland G. Fryer Jr., 2007. "Guess Who's Been Coming to Dinner? Trends in Interracial Marriage over the 20th Century," Journal of Economic Perspectives, American Economic Association, vol. 21(2), pages 71-90, Spring.
    10. Houston, D. & Li, W. & Wu, J., 2014. "Disparities in exposure to automobile and truck traffic and vehicle emissions near the Los Angeles-long beach port complex," American Journal of Public Health, American Public Health Association, vol. 104(1), pages 156-164.
    11. Krieger, N. & Waterman, P.D. & Spasojevic, J. & Li, W. & Maduro, G. & Van Wye, G., 2016. "Public health monitoring of privilege and deprivation with the index of concentration at the extremes," American Journal of Public Health, American Public Health Association, vol. 106(2), pages 256-263.
    12. Robert Kaestner & Won Chan Lee, 2005. "The effect of welfare reform on prenatal care and birth weight," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 497-511, May.
    13. Currie, Janet & Grogger, Jeffrey, 2002. "Medicaid expansions and welfare contractions: offsetting effects on prenatal care and infant health?," Journal of Health Economics, Elsevier, vol. 21(2), pages 313-335, March.
    14. Bird, S.T. & Bauman, K.E., 1995. "The relationship between structural and health services variables and state-level infant mortality in the United States," American Journal of Public Health, American Public Health Association, vol. 85(1), pages 26-29.
    15. Chae, David H. & Clouston, Sean & Martz, Connor D. & Hatzenbuehler, Mark L. & Cooper, Hannah L.F. & Turpin, Rodman & Stephens-Davidowitz, Seth & Kramer, Michael R., 2018. "Area racism and birth outcomes among Blacks in the United States," Social Science & Medicine, Elsevier, vol. 199(C), pages 49-55.
    16. Jones, M.R. & Diez-Roux, A.V. & Hajat, A. & Kershaw, K.N. & O'Neill, M.S. & Guallar, E. & Post, W.S. & Kaufman, J.D. & Navas-Acien, A., 2014. "Race/ethnicity, residential segregation, and exposure to ambient air pollution: The Multi-Ethnic Study of Atherosclerosis (MESA)," American Journal of Public Health, American Public Health Association, vol. 104(11), pages 2130-2137.
    17. Reagan, Patricia B. & Salsberry, Pamela J., 2005. "Race and ethnic differences in determinants of preterm birth in the USA: broadening the social context," Social Science & Medicine, Elsevier, vol. 60(10), pages 2217-2228, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jason Reece, 2021. "More Than Shelter: Housing for Urban Maternal and Infant Health," IJERPH, MDPI, vol. 18(7), pages 1-17, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Daniel Kim & Adrianna Saada, 2013. "The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review," IJERPH, MDPI, vol. 10(6), pages 1-40, June.
    2. Do, D. Phuong & Frank, Reanne & Iceland, John, 2017. "Black-white metropolitan segregation and self-rated health: Investigating the role of neighborhood poverty," Social Science & Medicine, Elsevier, vol. 187(C), pages 85-92.
    3. Hope Corman & Dhaval Dave & Nancy E. Reichman, 2018. "Evolution of the Infant Health Production Function," Southern Economic Journal, John Wiley & Sons, vol. 85(1), pages 6-47, July.
    4. Yanrong Qiu & Kaihuai Liao & Yanting Zou & Gengzhi Huang, 2022. "A Bibliometric Analysis on Research Regarding Residential Segregation and Health Based on CiteSpace," IJERPH, MDPI, vol. 19(16), pages 1-21, August.
    5. Ana I. Balsa & Patricia Triunfo, 2012. "The Effectiveness of Prenatal Care in a Low Income Population: A Panel Data Approach," Documentos de Trabajo/Working Papers 1204, Facultad de Ciencias Empresariales y Economia. Universidad de Montevideo..
    6. Dora L. Costa, 2015. "Health and the Economy in the United States from 1750 to the Present," Journal of Economic Literature, American Economic Association, vol. 53(3), pages 503-570, September.
    7. Grineski, Sara E. & Collins, Timothy W. & Morales, Danielle X., 2017. "Asian Americans and disproportionate exposure to carcinogenic hazardous air pollutants: A national study," Social Science & Medicine, Elsevier, vol. 185(C), pages 71-80.
    8. Jeffers, Noelene K. & Berger, Blair O. & Marea, Christina X. & Gemmill, Alison, 2023. "Investigating the impact of structural racism on black birthing people - associations between racialized economic segregation, incarceration inequality, and severe maternal morbidity," Social Science & Medicine, Elsevier, vol. 317(C).
    9. Marianne Bitler & Hilary W. Hoynes, 2006. "Welfare Reform and Indirect Impacts on Health," NBER Working Papers 12642, National Bureau of Economic Research, Inc.
    10. Mehra, Renee & Boyd, Lisa M. & Ickovics, Jeannette R., 2017. "Racial residential segregation and adverse birth outcomes: A systematic review and meta-analysis," Social Science & Medicine, Elsevier, vol. 191(C), pages 237-250.
    11. Borrell, Luisa N. & Kodali, Hanish & Rodriguez-Alvarez, Elena, 2021. "Interracial/ethnic marriage and adverse birth outcomes: The effect of neighborhood racial/ethnic composition," Social Science & Medicine, Elsevier, vol. 270(C).
    12. Marianne P. Bitler & Jonah B. Gelbach & Hilary W. Hoynes, 2005. "Welfare Reform and Health," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
    13. Hope Corman & Dhaval M. Dave & Dhiman Das & Nancy E. Reichman, 2013. "Effects Of Welfare Reform On Illicit Drug Use Of Adult Women," Economic Inquiry, Western Economic Association International, vol. 51(1), pages 653-674, January.
    14. Anders Larrabee Sonderlund & Mia Charifson & Antoinette Schoenthaler & Traci Carson & Natasha J Williams, 2022. "Racialized economic segregation and health outcomes: A systematic review of studies that use the Index of Concentration at the Extremes for race, income, and their interaction," PLOS ONE, Public Library of Science, vol. 17(1), pages 1-27, January.
    15. Kamble, Vaibhav, 2021. "Health Returns to Birth Weight: Evidence from Developing Countries," MPRA Paper 105150, University Library of Munich, Germany.
    16. Marianne P. Bitler & Jonah B. Gelbach & Hilary W. Hoynes, 2005. "Welfare Reform and Health," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
    17. Jahn, Jaquelyn L. & Chen, Jarvis T. & Agénor, Madina & Krieger, Nancy, 2020. "County-level jail incarceration and preterm birth among non-Hispanic Black and white U.S. women, 1999–2015," Social Science & Medicine, Elsevier, vol. 250(C).
    18. Altman, Molly R. & Oseguera, Talita & McLemore, Monica R. & Kantrowitz-Gordon, Ira & Franck, Linda S. & Lyndon, Audrey, 2019. "Information and power: Women of color's experiences interacting with health care providers in pregnancy and birth," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    19. Raoul S. Liévanos, 2019. "Racialized Structural Vulnerability: Neighborhood Racial Composition, Concentrated Disadvantage, and Fine Particulate Matter in California," IJERPH, MDPI, vol. 16(17), pages 1-24, September.
    20. Ana Inés Balsa & Patricia Triunfo, 2012. "¿Son los cuidados prenatales efectivos? Un enfoque con datos individuales de panel," Documentos de Trabajo (working papers) 0612, Department of Economics - dECON.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0237314. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.