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Individual Risk Versus Population Incidence: A Case Example With Congenital Heart Defects.

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This summary is machine-generated.

County-level median home value was linked to higher severe congenital heart defect (CHD) incidence in western Illinois. This highlights differences between ecological and individual-level socioeconomic status associations for severe CHDs.

Keywords:
congenital heart defectepidemiologyhealth services research

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Area of Science:

  • Public Health
  • Epidemiology
  • Socioeconomic Determinants of Health

Background:

  • Previous studies indicate a link between lower socioeconomic status (SES) neighborhoods and higher rates of severe congenital heart defects (CHDs).
  • These findings are often extrapolated to inform population health policies.
  • However, individual-level associations may not accurately reflect population-level trends.

Purpose of the Study:

  • To investigate the association between county-level median home value (as a proxy for SES) and the incidence of severe CHDs at the county level.
  • To determine if ecological-level associations differ from individual-level associations.

Main Methods:

  • Ecological analysis of statewide panel data from Illinois counties (July 2013-December 2021).
  • Severe CHDs in neonates were identified using the Adverse Pregnancy Outcomes Reporting System.
  • Multivariable Poisson models were used to estimate associations, stratified by census region.

Main Results:

  • A significant association was found in the western region of Illinois, where lower median home values were linked to higher severe CHD incidence (IRR: 1.96).
  • No association was observed between census tract-level median home value and individual severe CHD probability in the western region.
  • No significant associations were found in the south/central or northeast regions.

Conclusions:

  • Ecological and individual-level analyses reveal distinct associations between socioeconomic status and severe CHDs.
  • Findings underscore the importance of considering the ecological fallacy when developing public health policies.
  • Both ecological and individual-level data are valuable for informing evidence-based public health initiatives.