2010 Progress Report: Research Project A: Mapping Disparities in Birth Outcomes

EPA Grant Number: R833293C001
Subproject: this is subproject number 001 , established and managed by the Center Director under grant R833293
(EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).

Center: Southern Center on Environmentally Driven Disparities in Birth Outcomes
Center Director: Miranda , Marie Lynn
Title: Research Project A: Mapping Disparities in Birth Outcomes
Investigators: Miranda , Marie Lynn , Gelfand, Alan , James, Sherman , Maxson, Pamela , Swamy, Geeta
Institution: Duke University
EPA Project Officer: Callan, Richard
Project Period: May 1, 2007 through April 30, 2012 (Extended to April 30, 2014)
Project Period Covered by this Report: May 1, 2010 through April 30,2011
RFA: Centers for Children’s Environmental Health and Disease Prevention Research (2005) RFA Text |  Recipients Lists
Research Category: Health Effects , Children's Health , Health

Objective:

Synthesis across SCEDDBO. Research Project A: Mapping Disparities in Birth Outcomes provides population-level research on health disparities in birth outcomes. Spatially-linking 1.7 million birth records with environmental, social, and host factor data layers allows for population-level analysis of potential co-factors identified in both the clinical obstetrics Research Project B: Healthy Pregnancy, Healthy Baby: Studying Racial Disparities in Birth Outcomes and mouse model Research Project C: Perinatal Environmental Exposure Disparity and Neonatal Respiratory Health studies. The data from Research Project A is spatially linked in GIS to the data from Research Project B.

The central objective of Project A is to determine whether and to what extent joint exposures to socioeconomic and environmental stressors contribute to racial and ethnic health disparities in poor pregnancy outcomes. Using a geographically-based nested study design moving from analysis of births for the entire State of North Carolina to six demographically and geographically distinct counties to a single health center and state-of-the-art Geographic Information Systems applications with Bayesian spatial hierarchical modeling and other advanced spatial statistical approaches, the specific aims are to:

  1. Spatially link detailed birth record, fetal death certificates, socioeconomic, environmental, tax assessor, community-based, and clinical obstetric data at highly resolved scales for the State of North Carolina from 1990-2003;
  2. Refine the concept of fetal growth restriction by a) developing a joint distribution for birthweight and gestation using bivariate modeling for live births and fetal deaths – both separately and jointly, and b) defining it in terms of fetal and infant mortality, rather than percentile cut points; and
  3. Determine whether and to what extent differential exposures to both environmental and social stressors help explain health disparities in fetal growth restriction among a) African-American women compared to Non-Hispanic white and Hispanic women, b) Older African-American women compared to younger African-American women, c) Hispanic women compared to Non-Hispanic white and African-American women, and d) Foreign born Hispanic women compared to US born Hispanic women.

Progress Summary:

We have linked the detailed birth record data to USEPA PM10, PM2.5, and ozone monitoring data in order to study the impact of maternal exposure to air pollution on birth weight. We are especially focused on refining exposure metrics to most effectively characterize meaningful exposures, as well as to capture any windows of vulnerability. Significant progress has been made on the relationship between birth outcomes and exposure to particulate matter and ozone separately, and the current focus is determining how to characterize joint exposure to both particulate matter and ozone.

A substantial amount of effort this year has been devoted to a novel project concerned with connecting the built environment to adverse pregnancy outcomes. Built environment data has been collected under the Community Assessment Project and, after preliminary analysis has focused on spatial layers capturing four primary attributes of the built environment: housing damage, property disorder, tenure, and vacancy. Connection has been made to pre-term birth and low birth weight.

Our project on racial residential segregation has now seen the completion of one paper which enables quantification of racial exposure/isolation at finer spatial scales within SMSA’s. Such a measure can be connected to measures of social and economic disadvantage at these scales to gain insight into how racial residential segregation has manifested itself across urban landscapes. In turn, this promises to reveal key insights into how to think about the spatial aspects of the social factors influencing health disparities.

Future Activities:

We plan to continue working on each of the areas described in the progress report/summary of accomplishments section. Achieving a better understanding of exposure to air toxins, particularly particulate matter and ozone, is a central focus of our future efforts. We recently began the process of linking participants in Project B with their associated birth certificate record. This linkage will not only allow us to explore issues of data accuracy in the detailed birth record, but also allow us to begin implementing the methods of synthesizing categorical data.


Journal Articles on this Report : 10 Displayed | Download in RIS Format

Other subproject views: All 66 publications 37 publications in selected types All 36 journal articles
Other center views: All 162 publications 76 publications in selected types All 75 journal articles
Type Citation Sub Project Document Sources
Journal Article Anthopolos R, James SA, Gelfand AE, Miranda ML. A spatial measure of neighborhood level racial isolation applied to low birthweight, preterm birth, and birthweight in North Carolina. Spatial and Spatio-temporal Epidemiology 2011;2(4):235-246. R833293 (2009)
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  • Journal Article Berrocal VJ, Gelfand AE, Holland DM, Burke J, Miranda ML. On the use of a PM2.5 exposure simulator to explain birthweight. Environmetrics 2011;22(4):553-571. R833293 (2009)
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  • Journal Article Chang HH, Reich BJ, Miranda ML. Time-to-event analysis of fine particle air pollution and preterm birth: results from North Carolina, 2001-2005. American Journal of Epidemiology 2012;175(2):91-98. R833293 (2010)
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  • Journal Article Gray SC, Edwards SE, Miranda ML. Assessing exposure metrics for PM and birth weight models. Journal of Exposure Science and Environmental Epidemiology 2010;20(5):469-477. R833293 (2008)
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  • Journal Article Gray SC, Gelfand AE, Miranda ML. Hierarchical spatial modeling of uncertainty in air pollution and birth weight study. Statistics in Medicine 2011;30(17):2187-2198. R833293 (2010)
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  • Journal Article Miranda ML, Swamy GK, Edwards S, Maxson P, Gelfand A, James S. Disparities in maternal hypertension and pregnancy outcomes: evidence from North Carolina, 1994-2003. Public Health Reports 2010;125(4):579-587. R833293 (2008)
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  • Journal Article Miranda ML, Edwards SE, Myers ER. Adverse birth outcomes among nulliparous vs. multiparous women. Public Health Reports 2011;126(6):797-805. R833293 (2010)
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  • Abstract: Public Health Reports-Abstract
  • Journal Article Miranda ML, Anthopolos R, Edwards SE. Seasonality of poor pregnancy outcomes in North Carolina. North Carolina Medical Journal 2011;72(6):447-453. R833293 (2010)
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  • Journal Article Schwartz SL, Gelfand AE, Miranda ML. Joint Bayesian analysis of birthweight and censored gestational age using finite mixture models. Statistics in Medicine 2010;29(16):1710-1723. R833293 (2008)
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  • Journal Article Swamy GK, Edwards S, Gelfand A, James SA, Miranda ML. Maternal age, birth order, and race: differential effects on birthweight. Journal of Epidemiology and Community Health 2012;66(2):136-142. R833293 (2009)
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  • Supplemental Keywords:

    data fusion, meta analysis, disparities, spatial disaggregation, spatial interpolation, spatial modeling, racial residential segregation;

    Relevant Websites:

    http://cehi.snre.umich.edu/projects/sceddbo/Exit EPA Disclaimer

    Progress and Final Reports:

    Original Abstract
  • 2007
  • 2008
  • 2009 Progress Report
  • 2011 Progress Report
  • 2012
  • Final Report

  • Main Center Abstract and Reports:

    R833293    Southern Center on Environmentally Driven Disparities in Birth Outcomes

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R833293C001 Research Project A: Mapping Disparities in Birth Outcomes
    R833293C002 Research Project B: Healthy Pregnancy, Healthy Baby: Studying Racial Disparities in Birth Outcomes
    R833293C003 Research Project C: Perinatal Environmental Exposure Disparity and Neonatal Respiratory Health
    R833293C004 Community Outreach and Translation Core
    R833293C005 Geographic Information System and Statistical Analysis Core