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Multiple environmental contexts and preterm birth risks
Citation:
LOBDELL, D. T. Multiple environmental contexts and preterm birth risks. Presented at Society for Pediatric and Perinatal Epidemiologic Resaerch, Montreal, QC, CANADA, June 20 - 21, 2011.
Impact/Purpose:
To address this, a United States county-level Multiple Environmental Domain Index (MEDI) was constructed with data representing five environmental domains: air, water, land, built, and sociodemographic. Here we report on the associations between county-level preterm birth risks (PTB) and domain-specific and overall indices for counties with population greater than 100,000 (n=457).
Description:
Human health is affected by simultaneous exposure to numerous stressors and amenities, but research often focuses on single exposure models. To address this, a United States county-level Multiple Environmental Domain Index (MEDI) was constructed with data representing five environmental domains: air, water, land, built, and sociodemographic. Here we report on the associations between county-level preterm birth risks (PTB) and domain-specific and overall indices for counties with population greater than 100,000 (n=457). Using principle component analysis, we created indices for each of the five domains, and an omnibus domain. Race combined and stratified linear regression was used to assess relationships between the overall and domain-specific indices and county-level PTB for 2002. County-level MEDI and the air domain indices were not associated with PTB. Increases in the water (e.g., percent on public water, number industrial discharge permits) and sociodemographic (e.g., poverty, housing conditions) domain indices were associated with increased PTB (beta coefficient (95 percent confidence intervals): 0.0043 (0.0028, 0.0059) and 0.0080 (0.0055, 0.0105) respectively), while increases in the land domain (e.g., percent farm land, radon) were associated with decreases in PTB (-0.0074 (-0.0090, -0.0057). Similar results were seen in racially-stratified models. This is the first attempt to bring together multiple domains of environmental quality to assess adverse birth outcomes. At the county level, the results of this study suggest a modest association between water and sociodemographic conditions and increased PTB. Future research will explore which components of these two domains may be driving this association. This abstract does not necessarily reflect Environmental Protection Agency policy.