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Reasons for the Increasing Hispanic Infant Mortality Rate: Florida, 2004–2007

Abstract  

Assess whether the 55% increase in Florida’s Hispanic infant mortality rate (HIMR) during 2004–2007 was real or artifactual.
Using linked data from Florida resident live births and infant deaths for 2004–2007, we calculated traditional (infant Hispanic
ethnicity from death certificates and maternal Hispanic ethnicity from birth certificates) and nontraditional (infant and
maternal Hispanic ethnicity from birth certificate maternal ethnicity) HIMRs. We assessed trends in HIMRs (per 1,000 live
births) using Chi-square statistics. We tested agreement in Hispanic ethnicity after implementation of a revised 2005 death
certificate by using kappa statistics and used logistic regression to test the associations of infant mortality risk factors.
Hispanic was defined as being of Mexican, Puerto Rican, Cuban, Central/South American, or other/unknown Hispanic origin. During 2004–2007
traditional HIMR increased 55%, from 4.0 to 6.2 (Chi-square, P < 0.001) and nontraditional HIMR increased 20%, from 4.5 to 5.4 (Chi-square, P = 0.03). During 2004–2005, agreement in Hispanic ethnicity did not change with use of the revised certificate (kappa = 0.70
in 2004; kappa = 0.76 in 2005). Birth weight was the most significant risk factor for trends in Hispanic infant mortality
(OR = 1.33, 95% CI = 1.10–1.61). Differences in Hispanic reporting on revised death certificates likely accounted for the
majority of traditional HIMR increase, indicating a primarily artifactual increase. Reasons for the 20% increase in nontraditional
HIMR during 2004–2007 should be further explored through other individual and community factors. Use of nontraditional HIMRs,
which use a consistent source of Hispanic classification, should be considered.

  • Content Type Journal Article
  • Pages 1-9
  • DOI 10.1007/s10995-011-0891-9
  • Authors
    • Erin K. Sauber-Schatz, Division of Family Health Services, MCH Practice and Analysis Unit, Florida Department of Health, 4052 Bald Cypress Way Bin A13, Tallahassee, FL 32399-1721, USA
    • William Sappenfield, Division of Family Health Services, MCH Practice and Analysis Unit, Florida Department of Health, 4052 Bald Cypress Way Bin A13, Tallahassee, FL 32399-1721, USA
    • Leticia Hernandez, Division of Family Health Services, MCH Practice and Analysis Unit, Florida Department of Health, 4052 Bald Cypress Way Bin A13, Tallahassee, FL 32399-1721, USA
    • Karen M. Freeman, Bureau of Community Health Assessment, Florida Department of Health, 4052 Bald Cypress Way Bin A05, Tallahassee, FL 32399-1721, USA
    • Wanda Barfield, Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE MS K-20, Atlanta, GA 30341-3717, USA
    • Diana M. Bensyl, EIS Field Assignments Branch, Scientific Education and Professional Development Program Office, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-92, Atlanta, GA 30333, USA
    • Journal Maternal and Child Health Journal
    • Online ISSN 1573-6628
    • Print ISSN 1092-7875
Posted in: Journal Article Abstracts on 11/15/2011 | Link to this post on IFP |
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