A Description of Infant Mortality in Henrico County, Virginia from 2000-2005 and Relationship to Environmental Factors
Mary ChurchAdvisor: R. Leonard Vance, PhD, CIH
Preceptor: Elizabeth Eustis Turf, PhD
Background: Infant mortality (IM) is an important health indicator of a community, reflecting the quality of care available to both mothers and infants, and the general social well being of an area. The United States continues to struggle with this problem and at the local level Henrico County has seen a worsening trend of IM over the past decade. The cause of IM is multi-factorial and related to medical, social, psychological, and environmental issues.
Objectives: The purpose of this study was to examine possible environmental issues/factors that might be contributing to infant deaths occurring in Henrico and to identify any clustering of cases in small areas. The geographic distribution of deaths was examined in relation to identified, large quantity generators of point source air pollution.
Methods: This is a quasi-ecological study of data obtained from the Virginia Department of Health and the Department of Environmental Quality. The data included all infant deaths occurring in Henrico County between January 1, 2000 and December 31, 2005. Univariate analyses were done to look at: cause of death; demographic characteristics of parents; and socioeconomic status by year to look for significant changes over the time period. Geographic Information Systems (GIS) were used to look at deaths by block group in regards to identified generators of point source air pollution. SAS 9.2 software was used for statistical analyses and ERSI ArcMap 9.2 was used for mapping.
Results: Out of the 22,754 livebirths in Henrico County between 2000 and 2005, 197 (8.6%) died within one year of birth, with an average IM Rate (IMR) of 8.6 deaths per 1,000 live births. Standardized mortality ratios comparing Henrico to Virginia as a whole, were increased for all race groups for all years, with the exception of 2003. The majority of infants who died were black (54.5%), below normal birthweight (71.2%), and male (57.1%). Mapping did not identify any clear clustering of deaths near pollution point sources due to the lack of sensitivity associated with use of block group rather than exact address, although qualitative review identified several areas of interest.
Conclusions: This study found no evidence of a relationship between the proximity of infant deaths in Henrico County to large quantity generators of point source particulate air pollution. However, it is recommended that this study be repeated using mapping by exact address to more clearly examine the areas of interest.
