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The use of missing birth record data as a marker for adverse reproductive outcomes: a geocoded analysis of birth
Adrienne J Headley1, Mark C Fulcomer, Matthew M Bastardi
1Department of Obstetrics and Gynecology, Jersey Shore University Medical Center, Neptune, NJ, USA.
Insights
Missing birth record data impacts understanding adverse reproductive outcomes (AROs) and infant health disparities. Geocoding strategies may help identify socioeconomic factors linked to AROs in at-risk communities.
Area of Science:
- Reproductive Health
- Public Health Data Quality
- Health Disparities Research
Background:
- Adverse reproductive outcomes (AROs) disproportionately affect Black American infants, contributing to U.S. infant mortality.
- Inaccurate birth record data quality, particularly missing data for AROs, hinders efforts to address infant mortality and health disparities.
- Existing racial disparities in birth record reporting suggest a need for innovative data analysis strategies.
Purpose of the Study:
- To analyze missing birth record data extent in New Jersey areas with high preterm birth rates.
- To evaluate associations between missing birth record data and other AROs.
- To explore geocoding applications for understanding maternal socioeconomic status (SES) risk factors and ARO resource allocation.
Main Methods:
- Geocoding techniques using ZIP codes, census tracts, and block-groups to infer socioeconomic status (SES).
- Analysis of birth record data to quantify missing information for AROs, focusing on preterm birth.
- Statistical evaluation of relationships between data completeness and ARO prevalence.
Main Results:
- Significant extent of missing birth record data identified in high-rate preterm birth areas.
- Associations observed between missing data and other adverse reproductive outcomes.
- Geocoding approaches show potential for linking SES indicators to AROs despite data gaps.
Conclusions:
- Addressing missing birth record data is crucial for accurate ARO surveillance and reducing infant health disparities.
- Geocoding strategies offer a promising avenue for inferring SES-related risks and guiding resource allocation for vulnerable populations.
- Further research is needed to refine geocoding methods and improve birth data completeness.
Abstract:
Adverse reproductive outcomes (AROs) disproportionately affect black American infants and significantly contribute to the U.S. infant mortality rate. Without accurate understanding of AROs, there remains little hope of ameliorating infant mortality rates or eliminating infant health disparities. However, despite the importance of monitoring infant mortality rates and health disparities, birth record data quality is not assured. Racial disparities in the reporting of birth record data have been documented, and missing birth record data for AROs appears to be disproportionate. Due to the extent of missing birth record data, innovative strategies have been developed to evaluate relationships between maternal socioeconomic status (SES) and community-based ARO rates. Because addresses convey aggregate information about income level, education and occupation, ZIP codes, census tracts and census block-groups have been applied to geocoding efforts. The goals of this study are to: 1) analyze the extent of missing birth record data for New Jersey areas with high rates of an ARO (preterm birth), 2) evaluate associations between the extent of missing birth record data and other AROs, and 3) consider how geocoding strategies could be applied to provide a basis for understanding maternal SES risk factors and ARO resource allocation for at-risk communities.
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