Grantee Research Project Results

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: The Center for Study of Neurodevelopment and Improving Children's Health
Center Director: Murphy, Susan K.
Title: Research Project A: Mapping Disparities in Birth Outcomes
Investigators: Miranda , Marie Lynn , Gelfand, Alan , Swamy, Geeta , Maxson, Pamela , James, Sherman
Current Investigators: Miranda , Marie Lynn , Gelfand, Alan , James, Sherman , Swamy, Geeta , Maxson, Pamela
Institution: Duke University
EPA Project Officer: Callan, Richard
Project Period: May 1, 2007 through April 30, 2012 (Extended to April 30, 2014)
RFA: Centers for Children’s Environmental Health and Disease Prevention Research (2005) RFA Text | Recipients Lists
Research Category: Human Health , Children's Health

Objective:

Project A’s central objective is to determine whether and to what extent joint exposures to socioeconomic and environmental stressors contribute to racial and ethnic health disparities in fetal growth restriction.

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:

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;
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
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.

This project evaluates a large number of factors in diverse populations, providing broad relevance for birth outcomes across time, space, and demography. Identifying social and environmental factors contributing to fetal growth restriction will improve our understanding of disease etiology and explain the racial disparity in disease incidence, leading to effective interventions against poor outcomes in all population groups. Of note, we have expanded our inquiry beyond fetal growth restriction to encompass a broader range of pregnancy outcomes.

Publications and Presentations:

Publications have been submitted on this subproject: View all 66 publications for this subproject | View all 163 publications for this center

Journal Articles:

Journal Articles have been submitted on this subproject: View all 36 journal articles for this subproject | View all 76 journal articles for this center

Supplemental Keywords:

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

Progress and Final Reports:

Main Center Abstract and Reports:

R833293 The Center for Study of Neurodevelopment and Improving Children's Health

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

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The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.