School of Public Health

Permanent URI for this communityhttp://hdl.handle.net/1903/1633

The collections in this community comprise faculty research works, as well as graduate theses and dissertations.

Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.

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    Neighborhood Level Disadvantage, Race/Ethnicity and Infant Mortality in Washington DC
    (2010) Amutah, Ndidi N.; Anderson, Elaine A; Hofferth, Sandra L; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    This study examines the effects of neighborhood level disadvantage and individual level characteristics such as race/ethnicity on infant mortality. Social determinants of health theory and ecological theory were used to construct a neighborhood advantage index for Washington DC. Secondary analyses were conducted using linked birth/death certificate and census data from the DC State Center for Health Statistics. Live births (55,938) and infant deaths (607) occurring in Washington DC from 2001-2007 were examined. Multilevel modeling techniques were utilized to determine the relationship between individual and neighborhood level factors on infant mortality. The research questions were: (a) Do women who are comparable on factors such as maternal education and marital status experience different rates of infant mortality by race? (b) Do women living in areas of high disadvantage experience higher rates of infant mortality than women living in areas of low disadvantage? (c) Does the effect of race/ethnicity on infant mortality change if the mother lives in a place of high disadvantage versus low disadvantage? (d) Does having an infant born preterm or low birth weight increase the risk of infant mortality? Whites have the lowest rates of infant mortality (2.8/1000), followed by Hispanics (7.4/1000), with Blacks having the highest rates (15.2/1000) after adjusting for age, education, and marital status. These findings are consistent with previous research affirming a relationship between race/ethnicity and infant mortality. Infants born in disadvantaged neighborhoods are 1.63 times more likely to die before their first birthday than those born in advantaged neighborhoods. The odds for infant mortality compared to Whites decreases especially for Blacks (5.39 to 3.10; 42% change), living in disadvantaged communities even when race/ethnicity was interacted with the neighborhood disadvantage index. This suggests that disadvantage has different consequences for different race/ethnicity populations living in those neighborhoods. The importance of place (disadvantaged or advantaged neighborhood) in relation to infant mortality at the neighborhood level in addition to improving individual level factors is discussed for program development and policymakers. Implications for health disparities, maternal and child health, social support and future public health research are presented.
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    Stressor Events, Resources, and Depressive Symptoms in Rural, Low-Income Mothers
    (2008-08-11) Waldman, Joanna; Braun, Bonnie; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    This study, based on stress theory, sought to understand whether resources moderate the effects of stressors on depressive symptoms over time among a sample of rural, low-income mothers. Both quantitative and qualitative methods were utilized to explain the phenomena under investigation. Results revealed that higher numbers of stressors were associated with higher levels of depressive symptoms. At time one, resources were found to moderate the effects of stressors on depressive symptoms, with higher levels of resources and higher levels of stress producing the greatest level of depressive symptoms. At time two, resources did not moderate the effects of stressors on depressive symptoms. This study found that resources do not always serve a protective function. One explanation appears to be the "hidden cost" of resources revealed in the mothers' interviews. Recommendations for future research and practical applications are discussed.