Top

Maternal and Child Health Journal

Published in:

Open Access 05-03-2024

An Application of Social Vulnerability Index to Infant Mortality Rates in Ohio Using Geospatial Analysis- A Cross-Sectional Study

Authors: Mounika Polavarapu, Topista N. Barasa, Shipra Singh, Matthew M. Orbain, Safa Ibrahim

Published in: Maternal and Child Health Journal | Issue 6/2024

Abstract

Background

Ohio ranks 43rd in the nation in infant mortality rates (IMR); with IMR among non-Hispanic black infants is three times higher than white infants.

Objective

To identify the social factors determining the vulnerability of Ohio counties to IMR and visualize the spatial association between relative social vulnerability and IMR at county and census tract levels.

Methods

The social vulnerability index (SVI_CDC) is a measure of the relative social vulnerability of a geographic unit. Five out of 15 social variables in the SVI_CDC were utilized to create a customized index for IMR (SVI_IMR) in Ohio. The bivariate descriptive maps and spatial lag model were applied to visualize the quantitative relationship between SVI_IMR and IMR, accounting for the spatial autocorrelation in the data.

Results

Southeastern counties in Ohio displayed highest IMRs and highest overall SVI_IMR; specifically, highest vulnerability to poverty, no high school diploma, and mobile housing. In contrast, extreme northwestern counties exhibited high IMRs but lower overall SVI_IMR. Spatial regression showed five clusters where vulnerability to low per capita income in one county significantly impacted IMR (p = 0.001) in the neighboring counties within each cluster. At the census tract-level within Lucas county, the Toledo city area (compared to the remaining county) had higher overlap between high IMR and SVI_IMR.

Conclusion

The application of SVI using geospatial techniques could identify priority areas, where social factors are increasing the vulnerability to infant mortality rates, for potential interventions that could reduce disparities through strategic and equitable policies.

Agency for Toxic Substances and Disease Registry, (n.d.) (2021). CDC/ATSDR Social Vulnerability Index (SVI). Retrieved September 10, from https://www.atsdr.cdc.gov/placeandhealth/svi/index.html

America’s Health Rankings (2021). Health of women and children report. Retrieved April 15, 2022, from https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/IMR_MCH/state/OH

Anselin, L. (1988). Spatial econometrics: Methods and models (Vol. 4). Springer Netherlands. https://doi.org/10.1007/978-94-015-7799-1

Anselin, L. (2001). Spatial econometrics, A companion to theoretical econometrics, 310–330.

Anselin, L., Syabri, I., & Kho, Y. (2009). Geo Da: An introduction to spatial data analysis; Manfred, M., Fischer, AG, Eds. In: Springer: Berlin, Germany, 73–89. https://doi.org/10.1007/978-3-642-03647-7_5

Archer, P. W., Munn, M. S., & Masho, S. W. (2017). Residential distance to public housing and its differential influence on infant mortality across race. Journal of Community Psychology, 45(1). https://doi.org/10.1002/jcop.21833

Artiga, S., Pham, O., Orgera, K., & Ranji, U. (2020). Racial disparities in maternal and infant health: An overview, Kaiser Family Foundation. Retrieved April 15, 2022, from https://www.kff.org/report-section/racial-disparities-in-maternal-and-infant-health-an-overview-issue-brief/

Auger, N., Bilodeau-Bertrand, M., & Costopoulos, A. (2016). Language and infant mortality in a large Canadian province. Public Health, 139, https://doi.org/10.1016/j.puhe.2016.06.011

Barry, V., Dasgupta, S., Weller, D. L., Kriss, J. L., Cadwell, B. L., Rose, C., Pingali, C., Musial, T., Sharpe, J. D., Flores, S. A., Greenlund, K. J., Patel, A., Stewart, A., Qualters, J. R., Harris, L., Barbour, K. E., & Black, C. L. (2021). Patterns in COVID-19 vaccination coverage, by social vulnerability and urbanicity - United States, December 14, 2020-May 1, 2021. MMWR Morbidity and Mortality Weekly Report, 70(22), 818–824. https://doi.org/10.15585/mmwr.mm7022e1CrossRefPubMedPubMedCentral

Biggs, E. N., Maloney, P. M., Rung, A. L., Peters, E. S., & Robinson, W. T. (2021). The relationship between social vulnerability and COVID-19 incidence among Louisiana census tracts. Frontiers in Public Health, 8, https://doi.org/10.3389/fpubh.2020.617976

Braudt, D. B., Lawrence, E. M., Tilstra, A. M., Rogers, R. G., & Hummer, R. A. (2019). Family socioeconomic status and early life mortality risk in the United States. Maternal and Child Health Journal, 23(10). https://doi.org/10.1007/s10995-019-02799-0

Centers for Disease Control and Prevention. (n.d.) National Environmental Public Health Tracking Network Data Explorer. Retrieved September 20, 2021, from https://ephtracking.cdc.gov/DataExplorer/

Chi, G., & Zhu, J. (2020). Spatial regression models for the social sciences. SAGE Publications, Inc. https://doi.org/10.4135/9781544302096

Dasgupta, S., Bowen, V. B., Leidner, A., Fletcher, K., Musial, T., Rose, C., Cha, A., Kang, G., Dirlikov, E., & Pevzner, E. (2020). Association between social vulnerability and a County’s risk for becoming a COVID-19 hotspot — United States, June 1–July 25, 2020. MMWR Morbidity and Mortality Weekly Report, 69(42). https://doi.org/10.15585/mmwr.mm6942a3

Ely, D. M., & Driscoll, A. K. (2021). Infant mortality in the United States, 2019: Data from the period linked birth/infant death file. National Vital Statistics Reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 70(14), 1–18.

Fareed, N., Swoboda, C. M., Lawrence, J., Griesenbrock, T., & Huerta, T. (2022). Co-establishing an infrastructure for routine data collection to address disparities in infant mortality: Planning and implementation. BMC Health Services Research, 22(1), 4. https://doi.org/10.1186/s12913-021-07393-1CrossRefPubMedPubMedCentral

Flanagan, B. E., Gregory, E. W., Hallisey, E. J., Heitgerd, J. L., & Lewis, B. (2011). A social vulnerability index for disaster management. Journal of Homeland Security and Emergency Management, 8(1).

Fotheringham, A. S., Charlton, M. E., & Brunsdon, C. (1998). Geographically weighted regression: A natural evolution of the expansion method for spatial data analysis. Environment and Planning a, 30(11), 1905–1927.CrossRef

Freese, K. E., Vega, A., Lawrence, J. J., & Documet, P. I. (2021). Social vulnerability is associated with risk of covid-19 related mortality in U.S. counties with confirmed cases. Journal of Health Care for the Poor and Underserved, 32(1). https://doi.org/10.1353/hpu.2021.0022

Getis, A. (2007). Reflections on spatial autocorrelation. Regional Science and Urban Economics, 37(4). https://doi.org/10.1016/j.regsciurbeco.2007.04.005

Hacker, K. A., Briss, P. A., Richardson, L., Wright, J., & Petersen, R. (2021). COVID-19 and chronic disease: The impact now and in the future. Preventing Chronic Disease, 18. https://doi.org/10.5888/PCD18.210086

Islam, S. J., Nayak, A., Hu, Y., Mehta, A., Dieppa, K., Almuwaqqat, Z., Ko, Y., Patel, S., Goyal, A., Sullivan, A., Lewis, T. T., Vaccarino, V., Morris, A. A., & Quyyumi, A. A. (2021). Temporal trends in the association of social vulnerability and race/ethnicity with county-level COVID-19 incidence and outcomes in the USA: An ecological analysis. British Medical Journal Open, 11(7). https://doi.org/10.1136/bmjopen-2020-048086

Johnson, D. L., Carlo, W. A., Rahman, A. K. M. F., Tindal, R., Trulove, S. G., Watt, M. J., & Travers, C. P. (2023). Health insurance and differences in infant mortality rates in the US. JAMA Network open, 6(10), e2337690. https://doi.org/10.1001/jamanetworkopen.2023.37690CrossRefPubMedPubMedCentral

Kim, D., & Saada, A. (2013). The social determinants of infant mortality and birth outcomes in western developed nations: A cross-country systematic review. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph10062296CrossRefPubMedPubMedCentral

Leifheit, K. M., Schwartz, G. L., Pollack, C. E., et al. (2020). Severe housing insecurity during pregnancy: Association with adverse birth and infant outcomes. International Journal of Environmental Research and Public Health, 17(22). https://doi.org/10.3390/ijerph17228659

Longley, P. (Ed.). (2005). Geographical information systems: Principles, techniques, management, and applications (2nd ed., abridged). John Wiley & Sons.

Martinson, M. L., & Reichman, N. E. (2016). Socioeconomic inequalities in low birth weight in the United States, the United Kingdom, Canada, and Australia. American Journal of Public Health, 106(4). https://doi.org/10.2105/AJPH.2015.303007

Mohamoud, Y. A., Kirby, R. S., & Ehrenthal, D. B. (2019). Poverty, urban-rural classification and term infant mortality: A population-based multilevel analysis. BMC Pregnancy and Childbirth, 19(1). https://doi.org/10.1186/s12884-019-2190-1

Muennig, P., Jiao, B., & Singer, E. (2018). Living with parents or grandparents increases social capital and survival: 2014 General Social Survey-National Death Index. SSM - Population Health, 4, https://doi.org/10.1016/j.ssmph.2017.11.001

Murphy, S. L., Kochanek, K. D., Xu, J., & Arias, E. (2021). Mortality in the United States, 2020. Nchs Data Brief. (427):1–8.

Nayak, A., Islam, S. J., Mehta, A., Ko, Y. A., Patel, S. A., Goyal, A., Sullivan, S., Lewis, T. T., Vaccarino, V., Morris, A. A., & Quyyumi, A. A. (2020). Impact of social vulnerability on COVID-19 Incidence and outcomes in the United States. MedRxiv: The preprint server for health sciences, https://doi.org/10.1101/2020.04.10.20060962

Neelon, B., Mutiso, F., Mueller, N. T., Pearce, J. L., & Benjamin-Neelon, S. E. (2021). Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States. Plos One, 16(3 March). https://doi.org/10.1371/journal.pone.0248702

Ohio Department of Health, (n.d.) (2022). Infant Vitality. Retrieved April 15, from https://odh.ohio.gov/know-our-programs/infant-vitality

Ohio Department of Health (2020). 2019 Infant mortality annual report. Retrieved April 15, 2022, from https://odh.ohio.gov/know-our-programs/infant-and-fetal-mortality/reports/2019-ohio-infant-mortality-report

Ohio Equity Institute (2021). Ohio.gov. Retrieved April 15,2022, from https://odh.ohio.gov/know-our-programs/infant-vitality/oei

Ohio Department of Health (2017). 2017–2019 State Health Improvement Plan. Retrieved April 10, 2022, from https://odh.ohio.gov/static/SHIP/2017-2019/Ohio-2017-19-State-Health-Improvement-Plan.pdf

Orgera, K., Garfield, R., & Rudowitz, R. (2021). Tracking social determinants of health during the COVID-19 Pandemic. Kaiser Family Foundation. Retrieved April 15, 2022, from https://www.kff.org/coronavirus-covid-19/issue-brief/tracking-social-determinants-of-health-during-the-covid-19-pandemic/

Pabayo, R., Cook, D. M., Harling, G., Gunawan, A., Rosenquist, N. A., & Muennig, P. (2019). State-level income inequality and mortality among infants born in the United States 2007–2010: A cohort study. Bmc Public Health, 19(1). https://doi.org/10.1186/s12889-019-7651y

Paremoer, L., Nandi, S., Serag, H., & Baum, F. (2021). Covid-19 pandemic and the social determinants of health. The BMJ. https://doi.org/10.1136/bmj.n129CrossRefPubMedPubMedCentral

Pies, C., Barr, M., Strouse, C., Kotelchuck, M., & Best Babies Zone Initiative Team. (2016). Growing a best babies zone: Lessons learned from the pilot phase of a multi-sector, place-based initiative to reduce infant mortality. Maternal and Child Health Journal, 20(5), 968–973. https://doi.org/10.1007/s10995-016-1969-1CrossRefPubMed

Reece, J. (2021). More than shelter: Housing for urban maternal and infant health. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph18073331CrossRefPubMedPubMedCentral

Root, E. D., et al. (2020). Geovisualization and spatial analysis of infant mortality and preterm birth in Ohio, 2008–2015: Opportunities to enhance spatial thinking. Public Health Reports, 135(4). https://doi.org/10.1177/0033354920927854

Sadruddin, A. F. A., et al. (2019). How do grandparents influence child health and development? A systematic review. Social Science and Medicine. https://doi.org/10.1016/j.socscimed.2019.112476CrossRefPubMed

Scharber, H. (2014). Policy brief. Journal of Health and Social Behavior, 55(3), 265–265. https://doi.org/10.1177/0022146514547328CrossRefPubMed

Shapira, G., de Walque, D., & Friedman, J. (2021). How many infants may have died in low-income and middle-income countries in 2020 due to the economic contraction accompanying the COVID-19 pandemic? Mortality projections based on forecasted declines in economic growth. BMJ open, 11(9), e050551. https://doi.org/10.1136/bmjopen-2021-050551

Steinman, K. J., & Balistreri, K. S. (2018). Racial/ethnic health disparities in Ohio: Diabetes, Ohio Colleges of Medicine Government Resource Center. Retrieved April 15, 2022, from https://grc.osu.edu/sites/default/files/inline-files/Diabetes_2017OMAS.pdf

Stevens, A. B., Akah, H., Aly, R., Carroll, B., Reat, Z., & McGee, A. R. (2017). A new approach to reduce infant mortality and achieve equity. Health Policy Institute of Ohio for the Ohio Legislative Service Commission Retrieved April 15, 2022, from https://www.lsc.ohio.gov/documents/reference/current/SDOIM_FinalCombined.pdf

Toledo Lucas County Health Department, (n.d.). Retrieved from https://lucascountyhealth.com/

Wang, S., & Wu, J. (2020). Spatial heterogeneity of the associations of economic and health care factors with infant mortality in China using geographically weighted regression and spatial clustering. Social Science and Medicine, 263. https://doi.org/10.1016/j.socscimed.2020.113287

World Health Organization, (n.d.). Social determinants of health. Retrieved April 15 (2022). from https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

Title: An Application of Social Vulnerability Index to Infant Mortality Rates in Ohio Using Geospatial Analysis- A Cross-Sectional Study
Authors: Mounika Polavarapu
Topista N. Barasa
Shipra Singh
Matthew M. Orbain
Safa Ibrahim
Publication date: 05-03-2024
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 6/2024
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-024-03925-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

An Application of Social Vulnerability Index to Infant Mortality Rates in Ohio Using Geospatial Analysis- A Cross-Sectional Study

Abstract

Background

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2024

Correction: The Child Friendly Cities Initiative-Minneapolis Model

The Relation of Maternal Psychosocial Risk Factors to Infant Safe Sleep Practices

The Association of Prenatal Diagnoses with Mortality and Long-Term Morbidity in Children with Specific Isolated Congenital Anomalies: A European Register-Based Cohort Study

Multidisciplinary Workup for Stillbirth at a Tertiary-Care Hospital in Northeast Mexico: Findings, Challenges and Perspectives

Parenting Stress, Community Support, and Unmet Health Care Needs of Children in the US

Breastfeeding Intentions among Pregnant Women Enrolled in a Healthy Start Program in Arkansas