Place Really Does Matter: Using Area-Based Measures to Investigate Associations Between Poverty and Low Birth Weight In Arizona (CSTE Health Disparities Pilot Project)

BACKGROUND:  Life course elements (e.g. socioeconomic status, environmental exposures, stress) are associated with gestational growth and birth weight.  Low birth weight is closely related to premature birth and they share many of the same poor health outcomes, including respiratory difficulties, cerebral palsy, hearing and vision loss, feeding and digestive issues, and intellectual disabilities.  These health consequences, in addition to disparities experienced by racial and ethnic minorities, make low birth weight an important health outcome to understand.  For this project, associations between having a low birth weight child and living in areas of high poverty in Arizona, living in U.S.-Mexico border regions of Arizona, or being a racial or ethnic minority are being assessed.  Prematurity will also be investigated.  It is hypothesized that these socioeconomic factors (poverty, geography, and race/ethnicity) will be associated with low birth weight.

METHODS:  Birth record data for the state of Arizona are geocoded annually, resulting in X,Y coordinates for most records.  Records from 2000 and 2010 that did not match to at least the census tract level through the software used are being assessed and hand geocoded whenever possible.  All geocoded records will be mapped to the census tract level using ArcGIS and merged with poverty level and border status for each census tract within Arizona.  Analyses will include investigation of low birth weight, premature births, census-tract poverty level, border and non-border regions, and race/ethnicity.

RESULTS:  (PENDING) The birth records dataset contains 84,867 birth records from 2000 (97.6% with complete race/ethnicity data) and 87,055 from 2010 (99.2% with complete race/ethnicity data).  It is expected that babies born to mothers who reside in areas of high poverty, border areas, and mothers who are of a racial or ethnic minority group will have higher rates of low birth weight than mothers without those factors.

CONCLUSIONS:  (PENDING) Expected results can be used to inform state policies and outreach for improving birth outcomes for those groups with disproportionate low birth weight and prematurity rates in Arizona.