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

Author

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  • 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
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    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. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    10. 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.
    11. 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.
    12. 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.
    13. 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.
    14. 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.
    15. 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.
    16. 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.
    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.
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