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Mortality, Ethnicity, and Urbanization Among Children Aged 1-4 Years on the US-Mexico Border
Jill A McDonald1, Lindsey Brantley2, Leonard J Paulozzi3
11 Department of Public Health Sciences, College of Health and Social Services, New Mexico State University, Las Cruces, NM, USA.
Insights
Child mortality rates for Hispanic children along the US-Mexico border were higher than for non-Hispanic white children. However, this difference disappeared when accounting for county urbanization, with nonmetropolitan areas showing increased risks.
Area of Science:
- Pediatric Public Health
- Epidemiology
- Border Health Disparities
Background:
- Child mortality data along the US-Mexico border is limited.
- Understanding disparities in child mortality is crucial for public health interventions.
Purpose of the Study:
- To compare mortality rates of Hispanic children in US-Mexico border counties with non-Hispanic white children in the same region.
- To investigate the influence of county urbanization levels on child mortality rates.
Main Methods:
- Examined mortality data for children aged 1-4 years from 2001-2015.
- Compared mortality rates between Hispanic and non-Hispanic white children across different county urbanization levels (metropolitan to nonmetropolitan).
Main Results:
- Border Hispanic children had higher overall mortality rates (28.3/100,000) compared to US Hispanic (24.7) and border non-Hispanic white children (23.2).
- When stratified by urbanization, these differences were not significant.
- Mortality rates in noncore nonmetropolitan counties were double those in large central metropolitan counties, primarily due to injury.
- Nonmetropolitan border county mortality rates increased after 2010.
Conclusions:
- Factors like poverty and reduced access to care in noncore nonmetropolitan counties may increase risks for injury and disease.
- Further research is needed to identify and address preventable risk factors in these communities to reduce child deaths.
Objectives:
Little is known about the mortality of children along the US-Mexico border. The objective of our study was to determine whether mortality rates among Hispanic children along the border ("border Hispanic children") exceeded mortality rates among non-Hispanic white children along the border.
Methods:
We examined mortality rates from 2001-2015 for children aged 1-4 years in US-Mexico border counties and in the United States overall. We compared mortality rates among Hispanic and non-Hispanic white children by county urbanization level (large central, medium, and small metropolitan; micropolitan nonmetropolitan; and noncore nonmetropolitan).
Results:
During 2001-2015, 1811 children aged 1-4 years died in the border region. The mortality rate per 100 000 children among border Hispanic children (28.3; 95% confidence interval [CI], 26.8-29.9) exceeded the mortality rate of US Hispanic children (24.7; 95% CI, 24.3-25.1) and border non-Hispanic white children (23.2; 95% CI, 20.8-25.6). When stratified by county urbanization level, however, mortality rates of border Hispanic children were not significantly different from mortality rates of US Hispanic or border non-Hispanic white children. Mortality rates in noncore nonmetropolitan counties were twice those in large central metropolitan counties, with injury mortality accounting for most of the excess. Mortality rates increased in nonmetropolitan border counties after 2010.
Conclusions:
Increased risk for injury and disease in noncore nonmetropolitan counties might be related to poverty, reduced access to care, or poorer quality of care. Future research should identify the remediable risk factors in such communities as the next step in preventing deaths among children aged 1-4 years.
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