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The Proximity of Spatial Clusters of Low Birth Weight and Risk Factors: Defining a Neighborhood for Focused Interventions

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Abstract

Background

Low birth weight (LBW) is associated with significant mortality and morbidity and remains a significant preventable problem. Risk factors include socioeconomic, demographics, and characteristics of the environment. Spatial analysis can uncover unusual frequencies of health problems in neighborhoods, eventually leading to insights for targeted interventions.

Objectives

This study's goals were to 1. Evaluate the geographic distribution of spatial clusters of LBW births and maternal risk factors. 2. Determine the spatial relationship between risk factors and LBW.

Methods

This study obtained data on LBW newborns and risk factors from 19,013 births over 5 years (2012–2016) for Escambia County Census Tracts, extracted from FloridaCharts.com. Software was used to detect significant spatial clusters; these clusters were then plotted on a map. Poisson regression determined the statistical relationship between Census Tract risk factors and LBW. A separate analysis of the LBW cluster controlling for risk factors was also performed.

Results

All risk factor clusters resided in similar locations as the LBW cluster. The multiple Poisson regression model containing all risk factors fully explained the LBW cluster. On bivariate Poisson regression all risk factors in the Census Tract were significantly related to LBW whereas in multivariable Poisson regression, the proportion of births to African American women in the Census Tract remained significant after adjusting for other risk factors (p < 0.001).

Conclusions for Practice

Clusters of LBW and risk factors were located in the same region of the county, with the proportion of births to African American women in the Census Tract remaining significant on multiple Poisson Regression. Targeted interventions should be directed at the geographic level.

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Acknowledgements

We appreciate the collaboration between the authors and Theresa Chmiel BA, Executive Director at Escambia County Healthy Start Coalition.

Funding

The authors do not have any financial relationship with any industry and no industry sponsored this research. This research had no funding other than time provided by the University of Florida College of Medicine.

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Author notes

  1. Riley Livingston

    Present address: Department of Pediatrics, University of Alabama, Pediatric Hospital Medicine, Lowder Building, 1600 7th Avenue South, Birmingham, 35233-1771, AL, UK

Authors and Affiliations

  1. Department of Pediatrics, University of Florida, College of Medicine, Studer Family Children’s Hospital, 5153 North Ninth Avenue, Pensacola, FL, 32504, USA

    James J. Burns & Riley Livingston

  2. Department of Mathematics and Statistics, University of West Florida, Building 4, Room 336, 1111 University Parkway, Pensacola, USA

    Raid Amin

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  1. James J. Burns
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Correspondence to James J. Burns.

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Burns, J.J., Livingston, R. & Amin, R. The Proximity of Spatial Clusters of Low Birth Weight and Risk Factors: Defining a Neighborhood for Focused Interventions. Matern Child Health J 24, 1065–1072 (2020). https://doi.org/10.1007/s10995-020-02946-y

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