STILLBIRTHS IN THE STATE OF GEORGIA: A STUDY OF THE SOCIAL AND ECONOMIC DETERMINANTS OF THE OCCURRENCE OF STILLBIRTHS IN GEORGIA COUNTIES FROM 1994 TO 2006 Open Access

Brown, Robert A. (2011)

Permanent URL: https://etd.library.emory.edu/concern/etds/79407x312?locale=en
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Abstract

STILLBIRTHS IN THE STATE OF GEORGIA:
A STUDY OF THE SOCIAL AND ECONOMIC DETERMINANTS OF
THE OCCURRENCE OF STILLBIRTHS
IN GEORGIA COUNTIES FROM 1994 TO 2006
BY ROBERT A. BROWN


PURPOSE: To examine the effects of area-level social and economic factors upon the occurrence
of stillbirths in the counties of the state of Georgia from 1994 to 2006.
METHODS: The study is an ecological, over time study of fetal death and birth data of the
counties in Georgia. Fetal death and live births data were obtained from the Georgia Division of Public Health. These data were merged with census and racial residential
segregation data from census data sources and the Population Studies Center of the University of
Michigan. Stillbirths were selected from the fetal death data, having gestation of greater than or
equal to twenty weeks. Non-Hispanic black and white mothers were selected for analysis from
the fetal death and live births data. Multivariate logistic regression was used to estimate the odds
of having a stillbirth among the black and white mothers of Georgia counties, controlling for
their individual-level attributes. The study examined 1,419,767 birth outcomes (12,114
stillbirths and 1,407,653 live births) from the counties of the state of Georgia.
RESULTS: The study sample included 4,748 stillbirths among white mothers and 7,366 stillbirths
among black mothers. The results of the logistic regression revealed a twofold (aOR=2.05; 95%
CI: 1.969, 2.143) higher odds of having a stillbirth among Georgia black mothers than the odds
of having a stillbirth among Georgia white mothers. Residential segregation above the median
was significantly associated with decreased risk of stillbirth, after controlling for individual-level
and other ecological variables.
CONCLUSIONS: This study revealed the much higher odds (OR: 2.05 to 2.07) of having a
stillbirth among black mothers than the odds of having one among white mothers, controlling for
other individual-level and contextual factors. These results speak to the enduring nature of race
in shaping African Americans' life chances, specifically for this study with regard to the viability
of black infants.

Table of Contents


TABLE OF CONTENTS

INTRODUCTION AND BACKGROUND

....................................................................................9

RESEARCH OBJECTIVES, PROPOSED STUDY QUESTION, AND NULL HYPOTHESES ........12

LITERATURE REVIEW .......................................................................................................14

STUDY DESIGN ...................................................................................................................26

DATA LAYOUT ...................................................................................................................30

ANALYTICAL METHODS ....................................................................................................30

DATA ANALYSIS OF STILLBIRTHS IN GEORGIA ................................................................30

Univariate Analysis ............................................................................................................30

Bivariate Analysis ..............................................................................................................30

Multivariate Analysis .........................................................................................................30

RESULTS ............................................................................................................................35

DISCUSSION ........................................................................................................................37

STRENGTHS AND LIMITATIONS .........................................................................................38


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Document Outline
  • By Robert A. Brown
  • Table of Contents
  • List of Tables
  • List of Figures
  • Introduction and Background
  • My null hypotheses are as follows (from the following models):
  • My Theoretical Expectations:
  • Literature Review
  • Socioeconomics-Based Analyses
  • Study Design
  • Analytical Methods
  • Data Layout
  • Figure 4. Infant, Neonatal, and Postneonatal mortality rates, United States, 1950-2006.41F
  • Data Analysis of Stillbirths in Georgia
  • Univariate Analysis
  • Bivariate Analysis
  • Multivariate Analysis
  • Results
  • Discussion
  • Strengths and Limitations
  • Table 1.Table of Stillbirths and Live Births
  • in Georgia annually from 1994 to 2006
  • Table 2. Table of Stillbirths in Georgia from 1994 to 2006
  • by race across Georgia counties44F
  • Table 3. Table of Individual-Level Variables for Live Births and Stillbirths in Georgia (After Selection Criteria of Non-Hispanic blacks and Whites with Gestation >= 20 weeks)

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