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Low Birth Weight Rates in Two Counties of South Florida: Small-Area Variation and Temporal Trends
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ABSTRACTS (ACE)
AEP Vol. 17, No. 9 September 2007 : 723–751
used to identify TSCI cases. A total of 4,353 persons sustained a TSCI, with 1,726 resulting in death. Poisson regression was used to examine trend, and multiple logistic regression was used to identify risk factors for TSCI mortality. RESULTS: The rate of TSCI mortality was 27.4 per million population between 1981–1998. A 3% annual decrease in the TSCI mortality rate was found from 1981 through 1998 (p!0.0001). Specifically, TSCI mortality rates declined the most per year in motor vehicle crashes, males, and whites. Rates in South Carolina were higher than the United States, specifically for males and blacks. Adjusted for covariates, individuals of older ages, black race, with a cervical TSCI, and with a more severe injury were associated with higher odds of in-hospital mortality. Females had lower odds of in-hospital mortality than males (ORZ0.6, 95%CI: 0.4–0.9). CONCLUSION: Although rate is decreasing, TSCI mortality, especially MVC-related, is still a significant problem, with South Carolina having higher rates of TSCI mortality than the U.S. The association between gender and in-hospital mortality needs further exploration. doi: 10.1016/j.annepidem.2007.07.058
P55 MOTOR VEHICLE CRASHES AND INJURY AMONG HIGH SCHOOL AND COLLEGE AGED DRIVERS. MIAMI-DADE COUNTY, FL 2005 MX Bustamante, G Zhang, E O’Connell, D Rodriguez, R BorrotoPonce, Miami-Dade County Health Department, Miami, FL PURPOSE: To describe motor vehicle crashes and injury occurring among high school and college aged drivers in order to guide prevention efforts targeted toward reducing motor vehicle related injuries among the young population. METHODS: The 2005 crash data used in this study was obtained from the Florida Department of Highway Safety and Motor Vehicles. Data was analyzed using SAS by age, injury severity, alcohol/ drug involvement, restraint use, day of week, and time of day. RESULTS: There were 16,311 drivers between the ages of 15–24 involved in motor vehicle crashes. Of these, over a 1/3 were injured, 14% were unrestrained, and 1.5% were alcohol and/or drug related. Alcohol and/or drug use among college aged drivers 20– 24 years of age was higher than that in other age groups. The majority of crashes (38%) occurred between the hours of 12 PM and 5 PM. Friday and Saturday accounted for 30% of all crashes in this age group. High school and college aged drivers were less likely to use safety restraints compared to all other age groups. Those without restraints were 5 times more likely to suffer severe injuries. Drivers who were using alcohol and/or drugs were twice as likely to be unrestrained and three times more likely to be severely injured. Among those using alcohol and/or drugs 27% were not restrained. Over half of drivers using alcohol and/or drugs crashed between the hours of 12 AM and 5 AM. CONCLUSION: Interventions targeting 15–24 year olds should focus on increasing safety belt use in this age group. Furthermore, college based interventions should also aim to reduce impaired driving due to alcohol and/or drugs. Since the majority of crashes occurred between the hours of 12 PM and 5 PM, intervention campaigns should target students as they leave the school premises for lunch or after class. In addition, localities should make use of readily available data such as the Florida Department of Highway
Safety and Motor Vehicles crash database in order to enhance injury surveillance activities and program planning and evaluation. doi: 10.1016/j.annepidem.2007.07.059 METHODS P56 LOW BIRTH WEIGHT RATES IN TWO COUNTIES OF SOUTH FLORIDA: SMALL-AREA VARIATION AND TEMPORAL TRENDS N Kellier, T Niyonsenga, Stempel School of Public Health Florida International University, Miami, FL PURPOSE: Low birth weight (LBW) is a primary cause of infant mortality and morbidity. The main hypothesis is that infant LBW rates would decrease annually by 9% to meet Health People 2010 goal of 5% by 2010. Moreover, observed LBW rates would be comparable over geographical areas in the counties and among race/ ethnic groups. This study focused on LBW rates over 8 years at the small area level, the zip code, within each county. The purpose is to estimate the trends, quantify the magnitude of the small area variation and identify geographic area with high rates. METHODS: This study utilized data from Florida Department of Health extracted from birth records for residents of Miami-Dade and Broward counties born in calendar years 1998 to 2005. For each zip code area within the counties, the number of LBW cases and the total number of births were provided yearly. The Poisson approximation to the Binomial distribution was used for statistical analyses and inference. Spatial statistical methods included the spatial scan statistic to detect clusters. Maps were used to highlight geographical variation and clusters of areas with high LBW rates. RESULTS: Descriptive results showed that for Miami-Dade County, LBW rates varied over time from 74.1 G 26.9 to 100.1 G 108.2 cases per 1000 births while in Broward County, they varied from 78.1 G 21.9 to 87.5 G 29.6 cases per 1000 births. There was no decreasing trend over both counties. For both counties, LBW rates exhibited non-negligible amount of small-area variation as captured by the coefficients of variation (CV). CV values ranged from 34.5% to 124.7% for Miami-Dade, and from 21.0% to 33.8% for Broward, with less variation within Broward County areas. CONCLUSION: In this multi-ethnic population of South Florida, LBW rates vary significantly at the small-area level and over time. There is no decrease in rates over time as expected. The rationale of this study is to focus further analysis on factors such as poverty, maternal social support, and smoking levels at the zip code level to explain the observed variation and the area-specific temporal trends. doi: 10.1016/j.annepidem.2007.07.060
P57 PREVALENCE AND CORRELATES OF SEXUAL RISK BEHAVIORS BY GENDER AMONG MULTI-ETHNIC ADOLESCENTS T Niyonsenga, WM Hlaing, Stempel School of Public Health Florida International University, Miami, FL PURPOSE: Risky sex and its related behaviors (initiation of sex, alcohol, and drugs, school performance, delinquency) among
ABSTRACTS (ACE)
AEP Vol. 17, No. 9 September 2007 : 723–751
used to identify TSCI cases. A total of 4,353 persons sustained a TSCI, with 1,726 resulting in death. Poisson regression was used to examine trend, and multiple logistic regression was used to identify risk factors for TSCI mortality. RESULTS: The rate of TSCI mortality was 27.4 per million population between 1981–1998. A 3% annual decrease in the TSCI mortality rate was found from 1981 through 1998 (p!0.0001). Specifically, TSCI mortality rates declined the most per year in motor vehicle crashes, males, and whites. Rates in South Carolina were higher than the United States, specifically for males and blacks. Adjusted for covariates, individuals of older ages, black race, with a cervical TSCI, and with a more severe injury were associated with higher odds of in-hospital mortality. Females had lower odds of in-hospital mortality than males (ORZ0.6, 95%CI: 0.4–0.9). CONCLUSION: Although rate is decreasing, TSCI mortality, especially MVC-related, is still a significant problem, with South Carolina having higher rates of TSCI mortality than the U.S. The association between gender and in-hospital mortality needs further exploration. doi: 10.1016/j.annepidem.2007.07.058
P55 MOTOR VEHICLE CRASHES AND INJURY AMONG HIGH SCHOOL AND COLLEGE AGED DRIVERS. MIAMI-DADE COUNTY, FL 2005 MX Bustamante, G Zhang, E O’Connell, D Rodriguez, R BorrotoPonce, Miami-Dade County Health Department, Miami, FL PURPOSE: To describe motor vehicle crashes and injury occurring among high school and college aged drivers in order to guide prevention efforts targeted toward reducing motor vehicle related injuries among the young population. METHODS: The 2005 crash data used in this study was obtained from the Florida Department of Highway Safety and Motor Vehicles. Data was analyzed using SAS by age, injury severity, alcohol/ drug involvement, restraint use, day of week, and time of day. RESULTS: There were 16,311 drivers between the ages of 15–24 involved in motor vehicle crashes. Of these, over a 1/3 were injured, 14% were unrestrained, and 1.5% were alcohol and/or drug related. Alcohol and/or drug use among college aged drivers 20– 24 years of age was higher than that in other age groups. The majority of crashes (38%) occurred between the hours of 12 PM and 5 PM. Friday and Saturday accounted for 30% of all crashes in this age group. High school and college aged drivers were less likely to use safety restraints compared to all other age groups. Those without restraints were 5 times more likely to suffer severe injuries. Drivers who were using alcohol and/or drugs were twice as likely to be unrestrained and three times more likely to be severely injured. Among those using alcohol and/or drugs 27% were not restrained. Over half of drivers using alcohol and/or drugs crashed between the hours of 12 AM and 5 AM. CONCLUSION: Interventions targeting 15–24 year olds should focus on increasing safety belt use in this age group. Furthermore, college based interventions should also aim to reduce impaired driving due to alcohol and/or drugs. Since the majority of crashes occurred between the hours of 12 PM and 5 PM, intervention campaigns should target students as they leave the school premises for lunch or after class. In addition, localities should make use of readily available data such as the Florida Department of Highway
Safety and Motor Vehicles crash database in order to enhance injury surveillance activities and program planning and evaluation. doi: 10.1016/j.annepidem.2007.07.059 METHODS P56 LOW BIRTH WEIGHT RATES IN TWO COUNTIES OF SOUTH FLORIDA: SMALL-AREA VARIATION AND TEMPORAL TRENDS N Kellier, T Niyonsenga, Stempel School of Public Health Florida International University, Miami, FL PURPOSE: Low birth weight (LBW) is a primary cause of infant mortality and morbidity. The main hypothesis is that infant LBW rates would decrease annually by 9% to meet Health People 2010 goal of 5% by 2010. Moreover, observed LBW rates would be comparable over geographical areas in the counties and among race/ ethnic groups. This study focused on LBW rates over 8 years at the small area level, the zip code, within each county. The purpose is to estimate the trends, quantify the magnitude of the small area variation and identify geographic area with high rates. METHODS: This study utilized data from Florida Department of Health extracted from birth records for residents of Miami-Dade and Broward counties born in calendar years 1998 to 2005. For each zip code area within the counties, the number of LBW cases and the total number of births were provided yearly. The Poisson approximation to the Binomial distribution was used for statistical analyses and inference. Spatial statistical methods included the spatial scan statistic to detect clusters. Maps were used to highlight geographical variation and clusters of areas with high LBW rates. RESULTS: Descriptive results showed that for Miami-Dade County, LBW rates varied over time from 74.1 G 26.9 to 100.1 G 108.2 cases per 1000 births while in Broward County, they varied from 78.1 G 21.9 to 87.5 G 29.6 cases per 1000 births. There was no decreasing trend over both counties. For both counties, LBW rates exhibited non-negligible amount of small-area variation as captured by the coefficients of variation (CV). CV values ranged from 34.5% to 124.7% for Miami-Dade, and from 21.0% to 33.8% for Broward, with less variation within Broward County areas. CONCLUSION: In this multi-ethnic population of South Florida, LBW rates vary significantly at the small-area level and over time. There is no decrease in rates over time as expected. The rationale of this study is to focus further analysis on factors such as poverty, maternal social support, and smoking levels at the zip code level to explain the observed variation and the area-specific temporal trends. doi: 10.1016/j.annepidem.2007.07.060
P57 PREVALENCE AND CORRELATES OF SEXUAL RISK BEHAVIORS BY GENDER AMONG MULTI-ETHNIC ADOLESCENTS T Niyonsenga, WM Hlaing, Stempel School of Public Health Florida International University, Miami, FL PURPOSE: Risky sex and its related behaviors (initiation of sex, alcohol, and drugs, school performance, delinquency) among