Abstract

Purpose: National and state infant mortality rates have slowly declined over the last several years. Despite this reduction, San Bernardino County still has one of the highest infant mortality rates in California and racial disparities between Black and White infants not only persist but continue to widen. These disparities remain at the forefront of concern. Healthy People 2010 target objectives have yet to be reached, while national and state proposed plans have supported the statement that a community's largest health problem is initiated by its infant mortality. The purpose of this study was to investigate maternal factors through use of secondary analysis to determine which variables play the most significant role in events of adverse birth outcomes.

Method: This research utilized the California Department of Health Services Office of Vital Statistics birth cohort file which included all mothers who delivered in California between 1999 and 2001. Data was recorded on certificates of live birth and entered into data files. The infant cohort of mothers delivering between 1999 and 2001 contained a total of 1,590,876 participants of which 5.5% (n=86,736) were births in San Bernardino County. Of those 86,736 San Bernardino County mothers, 52.7% (n=45,670) were Hispanic, 9.4% (n=8,142) were Black, 32.3% (n=27,997) were White and 5.7% (n=4,927) were of other ethnic backgrounds. These birth cohort files were used to better understand the dynamic of infant mortality in San Bernardino County in an attempt to address ethnic disparities for developing strategies to decrease overall infant mortality and incidence of low birth weight and very low birth weight babies. Occurrences of death in infants less than one year of age were explored as were maternal sociodemographic factors in soliciting possible explanations for the observed increased trend. The analytic software used in this analysis was the Statistical Package for Social Sciences (SPSS) Version 12 and SAS 10.0 software.

Results: There were notable significant differences in adverse birth outcomes by race/ethnicity even after adjusting for traditional sociodemographic factors. The most significant contributors to adverse birth outcomes were length of gestation and maternal education. The most significant predictor of infant mortality was birth weight at time of delivery.

Conclusion: The outcome of this research readdresses the need for further studies in San Bernardino County. Geographic and ethnic disparities exist at higher levels in San Bernardino County than in the rest of California. While historical factors such as smoking, prenatal care, education, etc., do play some role in this observation, there is still a greater need for preventive measures in order to reach the goals outlined in the Healthy People 2010 Objectives.

School

School of Public Health

First Advisor

Susanne Montgomery

Second Advisor

Naomi Modeste

Third Advisor

Edward K. Fujimoto

Degree Name

Doctor of Public Health (DrPH)

Degree Level

Ph.D.

Year Degree Awarded

2006

Date (Title Page)

6-2006

Language

English

Library of Congress/MESH Subject Headings

Infant Mortality -- California -- San Bernardino County; Infant, Newborn; Infant, Very Low Birth Weight; Maternal Welfare; Maternal-Fetal Relations; California -- epidemiology; Pregnancy in Adolescence.

Type

Dissertation

Page Count

x; 107

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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