Cargando…

Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Oyana, Tonny J., Matthews-Juarez, Patricia, Cormier, Stephania A., Xu, Xiaoran, Juarez, Paul D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730404/
https://www.ncbi.nlm.nih.gov/pubmed/26703702
http://dx.doi.org/10.3390/ijerph13010013
_version_ 1782412392450228224
author Oyana, Tonny J.
Matthews-Juarez, Patricia
Cormier, Stephania A.
Xu, Xiaoran
Juarez, Paul D.
author_facet Oyana, Tonny J.
Matthews-Juarez, Patricia
Cormier, Stephania A.
Xu, Xiaoran
Juarez, Paul D.
author_sort Oyana, Tonny J.
collection PubMed
description 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.
format Online
Article
Text
id pubmed-4730404
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-47304042016-02-11 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. Int J Environ Res Public Health Article 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. MDPI 2015-12-22 2016-01 /pmc/articles/PMC4730404/ /pubmed/26703702 http://dx.doi.org/10.3390/ijerph13010013 Text en © 2015 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons by Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Oyana, Tonny J.
Matthews-Juarez, Patricia
Cormier, Stephania A.
Xu, Xiaoran
Juarez, Paul D.
Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research
title Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research
title_full Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research
title_fullStr Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research
title_full_unstemmed Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research
title_short Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research
title_sort using an external exposome framework to examine pregnancy-related morbidities and mortalities: implications for health disparities research
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730404/
https://www.ncbi.nlm.nih.gov/pubmed/26703702
http://dx.doi.org/10.3390/ijerph13010013
work_keys_str_mv AT oyanatonnyj usinganexternalexposomeframeworktoexaminepregnancyrelatedmorbiditiesandmortalitiesimplicationsforhealthdisparitiesresearch
AT matthewsjuarezpatricia usinganexternalexposomeframeworktoexaminepregnancyrelatedmorbiditiesandmortalitiesimplicationsforhealthdisparitiesresearch
AT cormierstephaniaa usinganexternalexposomeframeworktoexaminepregnancyrelatedmorbiditiesandmortalitiesimplicationsforhealthdisparitiesresearch
AT xuxiaoran usinganexternalexposomeframeworktoexaminepregnancyrelatedmorbiditiesandmortalitiesimplicationsforhealthdisparitiesresearch
AT juarezpauld usinganexternalexposomeframeworktoexaminepregnancyrelatedmorbiditiesandmortalitiesimplicationsforhealthdisparitiesresearch