Raymond Tamara, Johnson Jane, Hogans-Mathews Shermeeka
College of Medicine, Florida State University College of Medicine, Tallahassee, USA.
Health Policy, Florida Association of Centers for Independent Living, Tallahassee, USA.
Cureus. 2024 Jun 30;16(6):e63539. doi: 10.7759/cureus.63539. eCollection 2024 Jun.
Background The infant mortality rate is defined as the number of infant deaths for every 1000 live births. In 2020, the infant mortality rate was 5.8% in the state of Florida, compared to 7.0% in 2000. Although infant mortality rates have declined in the state of Florida, disparities influencing these rates exist across varying Florida counties, with the widest differences being compared between the healthiest versus unhealthiest counties in Florida. Many factors can contribute to high infant mortality rates in certain counties, including income inequality, access to and quality of healthcare, race/ethnicity, obesity, and disadvantaged socioeconomic status (SES). Methods This study utilized data from Florida Health Charts on infant mortality rates in the state of Florida and the Pregnancy and Young Child Profiles in 10 counties to examine how certain risk factors impact infant mortality outcomes in the state of Florida. These 10 counties consist of five healthiest and five unhealthiest counties, as determined by the 2022 County Health Rankings data. T-tests were used to evaluate the relationship between county health status and several county health indicators. Results The average infant mortality rate from 2011 to 2020 differed significantly among healthy and unhealthy counties (p-value=0.0000). Median household income, individuals below the poverty level, and those aged zero to 17 years old were found to differ significantly by county health status (p-values 0.0000, 0.001, and 0.009, respectively). However, mothers having no high school education, births with first-trimester care, births with adequate care, and births with late or no prenatal care were not statistically significant. Conclusion Our study suggests that counties more likely to have fewer resources than other counties, such as those considered unhealthy, are more impacted by a higher infant mortality rate. The unhealthy counties in this study were found to have lower average median household income, higher rates of no high school education among mothers, and less prenatal care in comparison to healthy counties.
背景
婴儿死亡率的定义是每1000例活产婴儿中的死亡数。2020年，佛罗里达州的婴儿死亡率为5.8%，而2000年为7.0%。尽管佛罗里达州的婴儿死亡率有所下降，但不同的佛罗里达县之间存在影响这些死亡率的差异，佛罗里达州最健康与最不健康的县之间差异最大。许多因素可能导致某些县的婴儿死亡率较高，包括收入不平等、医疗保健的可及性和质量、种族/族裔、肥胖以及社会经济地位低下（SES）。
方法
本研究利用了佛罗里达健康图表中关于佛罗里达州婴儿死亡率以及10个县的怀孕和幼儿概况的数据，以研究某些风险因素如何影响佛罗里达州的婴儿死亡结果。根据2022年县健康排名数据，这10个县包括五个最健康的县和五个最不健康的县。使用t检验来评估县健康状况与几个县健康指标之间的关系。
结果
2011年至2020年期间，健康县和不健康县的平均婴儿死亡率存在显著差异（p值 = 0.0000）。发现家庭收入中位数、贫困线以下的个人以及0至17岁的人群在县健康状况方面存在显著差异（p值分别为0.0000、0.001和0.009）。然而，没有高中学历的母亲、接受孕早期护理的分娩、接受充分护理的分娩以及接受晚期或无产前护理的分娩在统计学上并不显著。
结论
我们的研究表明，与其他县相比，资源可能较少的县，如那些被认为不健康的县，更容易受到较高婴儿死亡率的影响。与健康县相比，本研究中不健康的县家庭收入中位数较低，母亲中没有高中学历的比例较高，产前护理较少。
