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Five domains of environmental quality and infant mortality
Citation:
JAGAI, J. S., L. C. Messer, K. Rapazzo, AND D. T. LOBDELL. Five domains of environmental quality and infant mortality. Presented at 140th Annual Meeting of the American Public Health Association (APHA), San Francisco, CA, October 27 - 31, 2012.
Impact/Purpose:
In order to account for multiple ambient environmental conditions, we constructed an Environmental Quality Index (EQI) for health research. We used U.S. county level data representing five environmental domains (air, water, land, built and sociodemographic) and principal components analysis to construct the EQI and domain specific indices for each county (n=3141).
Description:
The relationship between environmental conditions and human health varies by environmental media. In order to account for multiple ambient environmental conditions, we constructed an Environmental Quality Index (EQI) for health research. We used U.S. county level data representing five environmental domains (air, water, land, built and sociodemographic) and principal components analysis to construct the EQI and domain specific indices for each county (n=3141). Infant mortality (1M) data was taken from U.S. linked births/infant deaths data for 2002 (4,027,479 birth records; 27,527 infant deaths). We used fixed slope, random intercept multilevel logistic models, adjusted for maternal age, education, marital status, and infant sex, to assess relationships between county-level EQI and domain specific indices with 1M. Residence in a county with poor environmental quality (4th quartile) compared to the best quality (1st quartile) was not associated with 1M (odds ratio (OR)= 0.98; 95% confidence interval (95%CI): 0.91, 1.07). When examining domain specific indices and 1M, residence in counties with the worst air and built environment conditions, compared to residence in counties with best conditions, was associated with increased odds of 1M (air: OR=1.04, 95%CI: 0.96, 1.14; built: OR=1.09, 95%CI: 1.02, 1.17). However, the opposite relationship was estimated for water, land, and sociodemographic domains (OR=0.89,95%CI: 0.84,0.94; OR=0.77, 95%CI: 0.73, 0.82; OR=0.88,95%CI: 0.82, 0.95, respectively). Race-stratified models were run and results will be presented. We combined data for multiple environmental domains to construct one index representing overall county-level environmental conditions. The EQI quantifies the environmental burden counties face and the domain specific indices provide policy makers and planners with information regarding the primary stressors in the area. We demonstrate the use of the Environmental Quality Index for health research by assessing relationships with 1M;domain-specific models showed mixed associations with infant mortality. This abstract does not necessarily reflect EPA policy.