Document Detail


Neighborhood poverty and American Indian infant death: are the effects identifiable?
MedLine Citation:
PMID:  18504138     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Poor living conditions are posited as an underlying cause of American Indian (AI) infant mortality, which is unusually high in the postneonatal period. We explore whether the effects of neighborhood poverty on AI infant death are identifiable by using observational data.
METHODS: Vital records for infants born between 1990 and 1999 to AI women in a metropolitan area (n = 4751) are linked with tract-level poverty data. A counterfactual framework, an explicit causal contrast study design, and propensity score matching methods were used. For each comparison, we created exchangeable groups by matching infants with the same probability of exposure to poverty when one was exposed and the other was not.
RESULTS: Our results suggest that neighborhood poverty has little effect on AI infant death outcomes. Importantly, the study design makes transparent the challenge of identifying appropriate analytic comparison groups in studies of neighborhood poverty and health.
CONCLUSIONS: Collecting additional data will likely not overcome the fact that AIs with a high probability of living in poverty rarely reside in low-poverty neighborhoods. Yet, some of them must if a meaningful counterfactual comparison is to be made and the effects of neighborhood poverty on AI infant death are to be identified.
Authors:
Pamela Jo Johnson; J Michael Oakes; Douglas L Anderton
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2008-05-27
Journal Detail:
Title:  Annals of epidemiology     Volume:  18     ISSN:  1873-2585     ISO Abbreviation:  Ann Epidemiol     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-16     Completed Date:  2008-07-17     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  9100013     Medline TA:  Ann Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  552-9     Citation Subset:  IM    
Affiliation:
Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis 55414, USA. johns245@umn.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Educational Status
Female
Humans
Indians, North American / statistics & numerical data*
Infant
Infant Mortality / ethnology*
Marital Status
Maternal Age
Minnesota / epidemiology
Mothers
Poverty*
Prenatal Care
Social Conditions
Urban Health
Grant Support
ID/Acronym/Agency:
L60 MD002033-01/MD/NCMHD NIH HHS; R01 HL061573-01A1/HL/NHLBI NIH HHS; R01-HL61573/HL/NHLBI NIH HHS
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