Appalachian infant death rates point to healthcare deficit

June 6, 2012

Infant death rates in Appalachia remain significantly higher than much of the rest of the country, and are especially high in the central Appalachian region, according to Penn State health policy researchers.

The percentage of in the United States declined throughout the 20th century, including in Appalachia. However, according to recent data there continue to be more white infant deaths in Appalachia than throughout much of the rest of the nation.

"Infant mortality is viewed as an overall marker of public health in general, so the infant mortality rate is very important," said Marianne M. Hillemeier, associate professor of and administration and . "It's followed in the U.S. very closely, and it's followed internationally as an important indicator of overall health."

According to the Centers for Disease Control, as of 2005 the United States ranks 30th in the world for infant mortality.

Two-thirds of infant deaths occur in the first 28 days of life, but if a child dies before his or her first birthday, it is still considered an infant death. Many infants who don't survive are born prematurely, said Hillemeier. Although the causes of preterm labor are not well understood, better prenatal health care and more education for mothers-to-be can be helpful. The availability of physicians in rural areas is low, which may contribute to the higher number of infant deaths in Appalachia.

Hillemeier; Nengliang Yao, graduate student in health policy and administration; and Stephen A. Matthews, associate professor of sociology, anthropology and demography, analyzed the data for 13 obtained from the National Center for Vital Statistics and the Area Resource File, a national health resource information database. The Appalachian Regional Commission designated 420 of the 1,100 counties in these states, and eight independent cities in Virginia, as the Appalachian area. Limiting their analysis to the Appalachian states minimized potential disparities created by differing state health policies.

The researchers analyzed data from 1976 to 1980 and 1996 to 2000. During both time periods the Appalachian region had significantly fewer physicians throughout the region than in the non-Appalachian area. In the 1970s, the central Appalachian region had approximately one doctor for every 2,000 residents, compared to the non-Appalachian region, which had almost one doctor for every 500 people. Numbers improved in the 1990s, but central Appalachia was still far behind -- there was one doctor for every 1,000 people in central Appalachia, but the non-Appalachian region jumped to having nearly one doctor for every 350 residents.

"The Appalachian population was overwhelmingly white non-Hispanic during the late 1970s, and this population remained in the majority through the end of the study period," the researchers noted in the current issue of the Journal of Rural Health.

The U.S. 2000 census indicated that eighty-nine percent of the Appalachian population was white. Studying the white population removed some confounding factors, Yao explained, allowing a tighter focus on the availability of healthcare in the region.

The white infant improved overall by about 6 percent, but Appalachian infant deaths were significantly higher than non-Appalachian infant deaths for both time periods.

They further analyzed the data by examining the five Appalachian subregions, which are divided from north to south.

"It is worth noting that the central subregion of Appalachia has a significantly higher than the other subregions," said Yao. "Central Appalachia, which includes West Virginia and eastern Kentucky, suffers most from poverty and isolation."

The researchers also found that poverty was and remains significantly higher in the Appalachian counties than in the non-Appalachian counties in the respective states. The central Appalachia subregion is in even worse shape, with the 1999 white poverty level 7 percent higher than in the other four subregions.

"Eliminating or reducing the poverty rates in this region could be helpful in improving infant ," said Yao. He hopes that this study is also a step in the direction of helping to improve healthcare policies in the Appalachian region.

Explore further: Pediatricians in Appalachia less likely to recommend HPV vaccine

Related Stories

Pediatricians in Appalachia less likely to recommend HPV vaccine

September 28, 2011
(Medical Xpress) -- Pediatricians in Appalachia are less likely than doctors in other areas to encourage parents to have their children receive the human papillomavirus (HPV) vaccine, according to a new study.

Network created to address obesity, chronic health issues in Appalachian region

April 29, 2011
According to the Centers for Disease Control and Prevention, residents of many Appalachian counties are three times more likely to die from diabetes than someone living in other counties in the same state, or in most other ...

Infant mortality linked to subsequent risk of stillbirth finds new US study

September 21, 2011
Women whose first pregnancy ended in infant death are significantly more likely to have a subsequent stillbirth finds new research published today (21 September) in BJOG: An International Journal of Obstetrics and Gynaecology.

Recommended for you

Blowing smoke? E-cigarettes might help smokers quit

July 26, 2017
People who used e-cigarettes were more likely to kick the habit than those who didn't, a new study found.

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

Safety of medical devices not often evaluated by sex, age, or race

July 25, 2017
Researchers at Yale and the University of California-San Francisco have found that few medical devices are analyzed to consider the influence of their users' sex, age, or race on safety and effectiveness.

Why you should consider more than looks when choosing a fitness tracker

July 25, 2017
A UNSW study of five popular physical activity monitors, including Fitbit and Jawbone models, has found their accuracy differs with the speed of activity, and where they are worn.

Dog walking could be key to ensuring activity in later life

July 24, 2017
A new study has shown that regularly walking a dog boosts levels of physical activity in older people, especially during the winter.

Study finds 275,000 calls to poison control centers for dietary supplement exposures from 2000 through 2012

July 24, 2017
U.S. Poison Control Centers receive a call every 24 minutes, on average, regarding dietary supplement exposures, according to a new study from the Center for Injury Research and Policy and the Central Ohio Poison Center, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.