Using an external exposome framework to examine pregnancy-related morbidities and mortalities

Implications for health disparities research

Tonny J. Oyana, Patricia Matthews-Juarez, Stephania A. Cormier, Xiaoran Xu, Paul D. Juarez

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: We have conducted a study to assess the role of environment on the burden of maternal morbidities and mortalities among women using an external exposome approach for the purpose of developing targeted public health interventions to decrease disparities. Methods: We identified counties in the 48 contiguous USA where observed low birthweight (LBW) rates were higher than expected during a five-year study period. The identification was conducted using a retrospective space-time analysis scan for statistically significant clusters with high or low rates by a Discrete Poisson Model. Results: We observed statistically significant associations of LBW rate with a set of predictive variables. However, in one of the two spatiotemporal models we discovered LBW to be associated with five predictive variables (teen birth rate, adult obesity, uninsured adults, physically unhealthy days, and percent of adults who smoke) in two counties situated in Alabama after adjusting for location changes. Counties with higher than expected LBW rates were similarly associated with two environmental variables (ozone and fine particulate matter). Conclusions: The county-level predictive measures of LBW offer new insights into spatiotemporal patterns relative to key contributory factors. An external framework provides a promising place-based approach for identifying “hotspots” with implications for designing targeted interventions and control measures to reduce and eliminate health disparities.

Original languageEnglish (US)
Article number13
JournalInternational Journal of Environmental Research and Public Health
Volume13
Issue number1
DOIs
StatePublished - Dec 22 2015

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Particulate Matter
Maternal Mortality
Birth Rate
Ozone
Smoke
Public Health
Obesity
Morbidity
Pregnancy
Mortality
Health
Research

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Using an external exposome framework to examine pregnancy-related morbidities and mortalities : Implications for health disparities research. / Oyana, Tonny J.; Matthews-Juarez, Patricia; Cormier, Stephania A.; Xu, Xiaoran; Juarez, Paul D.

In: International Journal of Environmental Research and Public Health, Vol. 13, No. 1, 13, 22.12.2015.

Research output: Contribution to journalArticle

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