scholarly journals Geovisualization and Spatial Analysis of Infant Mortality and Preterm Birth in Ohio, 2008-2015: Opportunities to Enhance Spatial Thinking

2020 ◽  
Vol 135 (4) ◽  
pp. 472-482
Author(s):  
Elisabeth Dowling Root ◽  
Emelie D. Bailey ◽  
Tyler Gorham ◽  
Christopher Browning ◽  
Chi Song ◽  
...  

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.

PEDIATRICS ◽  
1952 ◽  
Vol 9 (4) ◽  
pp. 515-516

ON THE basis of provisional data it appears that infant mortality in the United States has continued to improve in 1951, despite the fact that the birth rate has gone up again. The National Office of Vital Statistics, Public Health Service, has published in the Monthly Vital Statistics Bulletin for February 1952 an analysis of the telegraphic reports received from the various states for the year 1951. While the data are subject to correction [See Figure 1. in Source PDF.] and final figures will almost surely result in slight revisions, previous experience indicates that the general trend is quite accurate. Figure 1 presents the month by month comparison, throughout the year, for birth rate, death rate, and infant mortality rate. Marriage license rate is shown through November 1951. It will be noted that in every month of the year the birth rate was higher than in the corresponding month of 1950. The annual rate was 24.5 per 1000 population, 4.3% higher than in 1950 but 5% lower than the peak birth rate reached in 1947. Taking into account an estimate for births which were not reported it is thought that 3,833,000 births took place in 1951. This is the greatest number of births in one year in the history of our country.


PEDIATRICS ◽  
1949 ◽  
Vol 4 (5) ◽  
pp. 702-703

THERE are reprinted below certain charts from two publications of the National Office of Vital Statistics in the U. S. Public Health Service, FSA, "Monthly Vital Statistics Index" and "Current Mortality Analysis." From the former are the trends in birth rate and infant mortality rate. These are based on provisional data and may be subject to slight change when final figures are available. Birth rates are per 1000 estimated population excluding armed forces overseas; infant mortality rates are per 1000 live births, adjusted for the changing number of births. Attention is called to the persisting high birth rate and the gratifying continuing fall in infant mortality. [See Figure in Source Pdf] The variation charts (p. 703), from Current Mortality Analysis, are printed to indicate the present day seasonal changes in these diseases as well as to show the extent of the differences which may usually be expected from one year to the next. Although the charts are based on a 10% sample it may be expected that in general they come close to describing the actual situation in the country at large. It should be noted that the data represent death rates as reported on death certificates and therefore reflect only indirectly the prevalence of the disease. The three components of the variation charts are: (1) the dots which represent the values of the monthly death rates observed from the sample, (2) the central line which represents the expected death rate for a given cause of death in a particular area and (3) the shaded band above and below the central line.


2018 ◽  
Vol 6 (3) ◽  
pp. 1
Author(s):  
Kok Wooi Yap ◽  
Doris Padmini Selvaratnam

This study aims to investigate the determinants of public health expenditure in Malaysia. An Autoregressive Distributed Lag (ARDL) approach proposed by Pesaran & Shin (1999) and Pesaran et al. (2001) is applied to analyse annual time series data during the period from 1970 to 2017. The study focused on four explanatory variables, namely per capita gross domestic product (GDP), healthcare price index, population aged 65 years and above, as well as infant mortality rate. The bounds test results showed that the public health expenditure and its determinants are cointegrated. The empirical results revealed that the elasticity of government health expenditure with respect to national income is less than unity, indicating that public health expenditure in Malaysia is a necessity good and thus the Wagner’s law does not exist to explain the relationship between public health expenditure and economic growth in Malaysia. In the long run, per capita GDP, healthcare price index, population aged more than 65 years, and infant mortality rate are the important variables in explaining the behaviour of public health expenditure in Malaysia. The empirical results also prove that infant mortality rate is significant in influencing public health spending in the short run. It is noted that macroeconomic and health status factors assume an important role in determining the public health expenditure in Malaysia and thus government policies and strategies should be made by taking into account of these aspects.


2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S67-S68
Author(s):  
Sylvia Becker-Dreps ◽  
Bryan Blette ◽  
Rafaela Briceno ◽  
Jorge Aleman ◽  
Michael G Hudgens ◽  
...  

Abstract Background Streptococcus pneumoniae causes an estimated 826,000 deaths of children in the world each year and many health facility visits. To reduce the burden of pneumococcal disease, many nations have added pneumococcal conjugate vaccines to their national immunization schedules. Nicaragua was the first country eligible for funding from the GAVI Alliance to introduce the 13-valent pneumococcal conjugate vaccine (PCV13), provided to infants at 2, 4, and 6 months of age. The goal of this study was to evaluate the population impact of the first five years of the program. Methods Numbers of visits for pneumonia, pneumonia-related deaths, bacterial meningitis, and infant deaths between 2008 and 2015 were collected from all 107 public health facilities in León Department. Vital statistics data provided additional counts of pneumonia-related deaths that occurred outside health facilities. Adjusted incidence rates and incidence rate ratios (IRRa) in the vaccine (2011–2015) and pre-vaccine periods (2008–2010) were estimated using official population estimates as exposure time. Results The IRRa for pneumonia hospitalizations was 0.70 (95% confidence interval [CI]: 0.66, 0.75) for infants, and 0.92 (95% CI: 0.85, 0.99) for one year olds. The IRRa for post-neonatal infant mortality was 0.56 (95% CI: 0.41, 0.77). In the population as a whole, ambulatory visits and hospitalizations for pneumonia, as well as pneumonia-related mortality and rates of bacterial meningitis were lower in the vaccine period. Conclusion Five years following program introduction, reductions were observed in health facility visits for pneumonia in immunized age groups and infant mortality, which would be hard to achieve with any other single public health intervention. Future study is warranted to understand whether the lack of a booster dose (e.g.,, at 12 months) may be responsible for the small reductions in pneumonia hospitalizations observed in one year-olds as compared with infants. Disclosures S. Becker-Dreps, Pfizer: Consultant and Grant Investigator, Consulting fee and Research grant; D. J. Weber, Pfizer: Consultant and Speaker’s Bureau, Consulting fee and Speaker honorarium


Author(s):  
Arthur Evariste KOUASSI ◽  
Ya Assanhoun Guillaume KOUASSI ◽  
Nogbou Andetchi Aubin AMANZOU

Infant mortality is a major health problem in developing countries. It is an important indicator of a country's public health as it goes hand in hand with socio-economic conditions and many others. Public health spending has been committed to reducing this scourge. This has led to the completion of numerous studies which have yielded mixed results. The main objective of this study is to test the effect of public health expenditure (% GDP) on the infant mortality rate, taking into account the role that institutional quality can play. To achieve this, we use two approaches which are the autoregressive vector panel model with exogenous variables (PVAR (X)) and the smooth threshold regression model (PSTR) on annual data covering the period 2002-2016 and covering 37 African countries. Sub-Saharan. Our main results through the PVAR (X) reveal that in the absence of institutional variables, public health expenditure has a negative and significant effect on the infant mortality rate, whereas, in the presence of the various institutional variables, this effect is still negative but is no longer significant. Our results show that the presence of institutions halves the weight of public health expenditure in explaining the infant mortality rate. In addition, our results show through the PSTR that there is a certain level of institutional qualities that these countries must achieve for public health expenditure to positively affect infant mortality rates. These thresholds oscillate for all the institutional variables around 7%. Taking institutional variables into account will help reduce infant mortality in Sub-Saharan African countries.


2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Eni Indrayani ◽  
Y Yamoto ◽  
Eti Sulastri

The government’s efforts to r Maternal Mortality Rate (MMR) and the Infant Mortality Rate (IMR) in Indonesia in reality still far away from the expected target, so as to accelerate the decline in maternal and infant mortality is to implement planning and prevention of complications of childbirth (P4K) through the installation of childbirth stickers on all pregnants house because it is expected to find a best way to save the pregnants, childbirth, post partum, and newborn babyThis aim of this study is to determine how the implementation of mounting stickers and Prevention Program Planning Maternity Complications (P4K) in the Work Area Public Health Center of Buluspesantren II Kebumen in 2013.This research uses descriptive method with a sampling of the total sampling.Analysis of data using univariate data analysis. It is descriptive statistical techniques. Based on research conducted, P4K stickers implementation is not good, as many as 75 respondents (76, 5%) good implementation P4K stickers, showed that all respondents, amounting to 98 pregnant women (100%) have a good level of knowledge, a majority of 23 respondents (23.5%), all respondents (98 pregnant) do not experience obstacles in the implementation of the sticker P4K Keywords: Pregnant, Knowledge, P4K Sticker


PEDIATRICS ◽  
1992 ◽  
Vol 90 (6) ◽  
pp. 835-845
Author(s):  
Myron E. Wegman

Between 1990 and 1991, provisional data show that the infant mortality rate decreased again, from 9.1 to 8.9, a decline of 2% in contrast to the 7% decline from 1989 to 1990. Birth, death, and marriage rates were also lower, but the divorce rate stayed at about the same level as in 1990. Natural increase in the population, excess of births over deaths, was less than 2 million, 4% less than the increase in 1990. Detailed analysis of changes and of the influence of factors like age and race requires final data; at the time of preparation of this report final birth and death data were available only through 1989. For a variety of reasons, including staff shortages and delays in receipt of state data by the National Center for Health Statistics (NCHS), final data for 1990, which would usually have been available in late August 1992, are not expected before early 1993. Unlike recent years, the decline in the infant mortality rate was only in the neonatal component, which decreased 3.6%. Postneonatal mortality increased, for the first time in many years, by 1.6%, suggesting that the decline in the total is related more to therapeutic advances in neonatology than to improved prevention. Internationally, newly independent Latvia was added to the list of countries with rates less than 15, but Costa Rica was deleted. With the reunification of Germany the list shrank to 28 and, by default, the United States moved up from 21st to 20th. Some 12.5 million births, less than 9% of the world total, took place in countries with under-5 mortality rates of less than 20 per 1000. At the other end of the scale, 42% of the world's births occurred in countries with under-5 mortality rates of more than 140 per 1000. The median under-5 mortality rate for those countries in 1990 was 189 per 1000, meaning that almost 20% of the infants born alive in these countries died before their fifth birthday.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 792-803 ◽  
Author(s):  
Myron E. Wegman

A new low in the infant mortality rate was reached again in 1993, at 828.8 deaths per 100 000 live births, a decline of 2% from 848.7 in 1992. Births, marriages, and divorces were all lower, both in number and rate. Deaths and the death rate, however, both increased and, more significantly, the age-adjusted death rate increased. A likely explanation is the occurrence of influenza epidemics in early and late 1993. The rate of natural increase declined 8%, to a level of 6.9 per 1000 population. Final figures on births for 1992 indicate that, for the first time in many years, birth rates to teen-agers declined, more among black mothers than white. Increase in birth rate among older mothers continued at a somewhat slower rate than recently; older mothers tended to be better educated than the general population in their age groups. Total fertility rates were higher among mothers of Hispanic origin than among non-Hispanic blacks who, in turn, had higher rates than non-Hispanic whites. Among Hispanics the highest rates were in those of Mexican origin. Unlike recent years, birth rates to unmarried mothers did not increase in 1992. Prenatal care coverage improved, with more mothers seeking care early and fewer receiving late or no care. Electronic and fetal monitoring was performed on more than three-quarters of all births and ultrasound on more than half. Life expectancy decreased slightly, in contrast to recent years. Among major causes of death, increases were recorded in 1993 for chronic obstructive pulmonary diseases, pneumonia and influenza, and HIV infection, the latter having the largest percentage increase. Internationally, infant mortality rates in most other industrialized countries declined further in 1992. Comparatively, as in 1991, 21 other countries had infant mortality rates lower than the United States.


PEDIATRICS ◽  
1996 ◽  
Vol 98 (6) ◽  
pp. 1007-1019 ◽  
Author(s):  
Bernard Guyer ◽  
Donna M. Strobino ◽  
Stephanie J. Ventura ◽  
Marian MacDorman ◽  
Joyce A. Martin

Recent trends in the vital statistics of the United States continued in 1995, including decreases in the number of births, the birth rate, the age-adjusted death rate, and the infant mortality rate; life expectancy at birth increased to a level equal to the record high of 75.8 years in 1992. Marriages and divorces both decreased. An estimated 3 900 089 infants were born during 1995, a decline of 1% from 1994. The preliminary birth rate for 1995 was 14.8 live births per 1000 total population, a 3% decline, and the lowest recorded in nearly two decades. The fertility rate, which relates births to women in the childbearing ages, declined to 65.6 live births per 1000 women 15 to 44 years old, the lowest rate since 1986. According to preliminary data for 1995, fertility rates declined for all racial groups with the gap narrowing between black and white rates. The fertility rate for black women declined 7% to a historic low level (71.7); the preliminary rate for white women (64.5) dropped just 1%. Fertility rates continue to be highest for Hispanic, especially Mexican-American, women. Preliminary data for 1995 suggest a 2% decline in the rate for Hispanic women to 103.7. The birth rate for teenagers has now decreased for four consecutive years, from a high of 62.1 per 1000 women 15 to 19 years old in 1991 to 56.9 in 1995, an overall decline of 8%. The rate of childbearing by unmarried mothers dropped 4% from 1994 to 1995, from 46.9 births per 1000 unmarried women 15 to 44 years old to 44.9, the first decline in the rate in nearly two decades. The proportion of all births occurring to unmarried women dropped as well in 1995, to 32.0% from 32.6% in 1994. Smoking during pregnancy dropped steadily from 1989 (19.5%) to 1994 (14.6%), a decline of about 25%. Prenatal care utilization continued to improve in 1995 with 81.2% of all mothers receiving care in the first trimester compared with 78.9% in 1993. Preliminary data for 1995 suggests continued improvement to 81.2%. The percent of infants delivered by cesarean delivery declined slightly to 20.8% in 1995. The percent of low birth weight (LBW) infants continued to climb in 1994 rising to 7.3%, from 7.2% in 1993. The proportion of LBW improved slightly among black infants, declining from 13.3% to 13.2% between 1993 and 1994. Preliminary figures for 1995 suggest continued decline in LBW for black infants (13.0%). The multiple birth ratio rose to 25.7 per 1000 births for 1994, an increase of 2% over 1993 and 33% since 1980. Age-adjusted death rates in 1995 were lower for heart disease, malignant neoplasms, accidents, and homicide. Although the total number of human immunodeficiency virus (HIV) infection deaths increased slightly from 42 114 in 1994 to an estimated 42 506 in 1995, the age-adjusted death rate for HIV infection did not increase, which may indicate a leveling off of the steep upward trend in mortality from HIV infection since 1987. Nearly 15 000 children between the ages of 1-14 years died in the United States (US) in 1995. The death rate for children 1 to 4 years old in 1995 was 40.4 per 100 000 population aged 1 to 4 years, 6% lower than the rate of 42.9 in 1994. The 1995 death rate for 5-to 14-year-olds was 22.1,2% lower than the rate of 22.5 in 1994. Since 1979, death rates have declined by 37% for children 1 to 4 years old, and by 30% for children 5 to 14 years old. For children 1 to 4 years old, the leading cause of death was injuries, which accounted for an estimated 2277 deaths in 1995, 36% of all deaths in this age group. Injuries were the leading cause of death for 5-to 14-year-olds as well, accounting for an even higher percentage (41%) of all deaths. In 1995, the preliminary infant mortality rate was 7.5 per 1000 live births, 6% lower than 1994, and the lowest ever recorded in the US. The decline occurred for neonatal as well as postneonatal mortality rates, and among white and black infants alike. Sudden infant death syndrome (SIDS) rates have dropped precipitously since 1992, when the American Academy of Pediatrics issued recommendations that infants be placed on their backs or sides to sleep to reduce the risk of SIDS. SIDS dropped to the third leading cause of infant death in 1994, after being the second leading cause of death since 1980. Infant mortality rates (IMRs) have also declined rapidly for respiratory distress syndrome since 1989, concurrent with the widespread availability of new treatments for this condition.


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