Perinatal Periods of Risk Analysis of Infant Mortality in Jackson County, Missouri

Cai, Jing; Hoff, Gerald L.; Archer, Rex; Jones, Larry D.; Livingston, Paula; Guillory, V. James

doi:10.1097/01.phh.0000267685.31153.a6

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…These distributions provided the starting point for the multiple steps of the formula. An online calculator can be found at http://www.citymatch.org, and a description of the calculations is presented in the appendix of Cai et al 4 We used Chi-square tests to measure statistical significance, with values of p,0.05 being considered significant.…”

Section: Methodsmentioning

confidence: 99%

“…Despite Kansas City being the largest city in Missouri and the 40th largest city in the country, it has been unable to include any racial/ ethnic groups other than non-Hispanic white and nonHispanic black populations in its PPOR analyses, 2,3 even when combining data with Jackson County, the second most populous county in Missouri, 4 or using multiple years' worth of data.…”

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confidence: 99%

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Excess Hispanic Fetal-Infant Mortality in a Midwestern Community

et al. 2009

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SynopSiSobjective. We assessed excess fetal-infant mortality for Hispanic, non-Hispanic white, and non-Hispanic black populations in five contiguous counties of Missouri and Kansas.Methods. We conducted a perinatal periods of risk (PPOR) assessment of fetal-infant mortality using electronic linked birth-death record files from 2001 through 2005. We generated an internal reference group in accordance with established PPOR protocol. We used Kitagawa analysis to determine whether excess deaths were due to birthweight distribution (a higher frequency of prematurity or growth retardation) or to higher mortality rates once born at that birthweight (birthweight-specific mortality).Results. We found the excess fetal-infant death rates for Hispanic and nonHispanic white populations to be similar and considerably lower than that for non-Hispanic black populations. Among Hispanic children, we judged 21.6% of fetal-infant mortality to be excess in relation to the reference population. Within the PPOR matrix, Hispanic excess mortality rates were distributed differently from those of non-Hispanic white and non-Hispanic black populations. Among Hispanic children, 93.6% of the excess mortality could be explained by low birthweight and birthweight-specific mortality, with the greatest contribution attributable to low birthweight.Conclusion. The excess fetal-infant mortality experience of Hispanic people in the five-county region was similar to that of the non-Hispanic white population, but was distributed differently in the PPOR model, which has significance regarding interventions targeting reductions in fetal-infant mortality.

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Excess Hispanic Fetal-Infant Mortality in a Midwestern Community

et al. 2009

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“…Despite its benefits, this methodology has only been used in few localities in the US. 21–23 Additionally, there is limited literature that utilized this methodology as an evaluation tool to examine changes in factors that contributed to disparities in infant mortality. The purpose of this CBPR was to: a) identify factors influencing the racial disparity in infant mortality; b) implement a CDC-funded REACH US initiative targeting health disparities by improving prenatal care attendance through interventions selected by community members; and c) evaluate a 10-year community wide effort and examine changes in the factors influencing racial disparities in Richmond City.…”

Section: Introductionmentioning

confidence: 99%

Addressing perinatal disparities using community‐based participatory research: data into action

Masho

Varner

Singleton

et al. 2011

Journal Community Psychology

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Striking racial disparities in infant mortality exist in the United States, with rates of infant death among African Americans (AA) nearly twice the national average. Community-based participatory research (CBPR) approaches have been successful in fostering collaborative relationships between communities and researchers focused on developing effective and sustainable interventions and programs targeting needs of the community. The current paper details use of the Perinatal Period of Risk (PPOR) model as a method to engage communities by identifying factors influencing racial disparities in infant mortality and examining changes in those factors over a ten year period.

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Perinatal Periods of Risk: Phase 2 Analytic Methods for Further Investigating Feto-Infant Mortality

Sappenfield

Peck

Gilbert

et al. 2010

Matern Child Health J

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The perinatal periods of risk (PPOR) methods provide a framework and tools to guide large urban communities in investigating their feto-infant mortality problem. The PPOR methods have 11 defined steps divided into three analytic parts: (1) Analytic Preparation; (2) Phase 1 Analysis-identifying the opportunity gaps or populations and risk periods with largest excess mortality; and (3) Phase 2 Analyses-investigating these opportunity gaps. This article focuses on the Phase 2 analytic methods, which systematically investigate the opportunity gaps to discover which risk and preventive factors are likely to have the largest effect on improving a community's feto-infant mortality rate and to provide additional information to better direct community prevention planning. This article describes the last three PPOR epidemiologic steps for investigating identified opportunity gaps: identifying the mechanism for excess mortality; estimating the prevalence of risk and preventive factors; and estimating the impact of these factors. While the three steps provide a common strategy, the specific analytic details are tailored for each of the four perinatal risk periods. This article describes the importance, prerequisites, alternative approaches, and challenges of the Phase 2 methods. Community examples of the methods also are provided.

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Perinatal Periods of Risk Analysis of Infant Mortality in Jackson County, Missouri

Cited by 8 publications

References 7 publications

Excess Hispanic Fetal-Infant Mortality in a Midwestern Community

Excess Hispanic Fetal-Infant Mortality in a Midwestern Community

Addressing perinatal disparities using community‐based participatory research: data into action

Perinatal Periods of Risk: Phase 2 Analytic Methods for Further Investigating Feto-Infant Mortality

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