How bad is it?

This week, we were asked to further analyze the problem that is the focus of our final papers. This week's theme is "magnitude and indicators." In order to effectively tackle a public health problem, it is necessary to understand the magnitude of the problem. You need to know how many people are affects, to what degree, and what the costs of the problem are. Also, in order to track the problem (before, during and after intervention) you need to identify which variables serve as indicators. These indicator variables show whether the situation is improving, worsening, or staying the same.


Surveillance is used to keep track of indicators and determine the magnitude of the problem. In this case, hospital surveillance can be used to track the total # of live births and the # of infant deaths. Since the problem I am focusing on is a health disparity, the data collection would also have to include race and/or ethnicity.

I have collected some data that outlines the magnitude of this problem.
According to the Annie E. Casey Foundation: African-American infants in Baltimore City are 2.8 times more likely to die than white infants from 2006-2008.
According to the Maryland Babies Born Health Initiative: The percent of women receiving prenatal care in the first trimester of pregnancy has been dropping since 2000, reaching a low of 79.5% in 2007. Among white women in the state, 82% received early prenatal care, compared with 73.5% of Black women and only 63% of Hispanic women.
Also According to the Maryland Babies Born Health Initiative: African-American infants are at greater risk of poor infant health, with a disparity of nearly to 2:1 in prematurity rates, and over 2:1 in infant death rates. Between 2006 and 2007 the disparity in infant deaths increased to 3:1.
According to the Baltimore City Health Department: Short gestation and low birth weight are most responsible for the elevated infant mortality rate in Baltimore.
Also according to the Baltimore City Health Department: The infant mortality rate in Baltimore City is 11.3 deaths per 1000 live births. This is much higher than the US and Maryland averages. Much of this rate is driven by an even higher rate among African Americans.

In my paper, I will need to focus both on direct and indirect indicators. For example, low birth weight is a direct indicator of a high risk for infant mortality. Lack of prenatal care also contributes directly to a higher risk of infant mortality. On the other hand, SES may make a person less likely to receive prenatal care or have prenatal vitamins or sufficient food. Therefore, SES is an indirect indicator of infant mortality rate.

In order to write a strong research paper, it is important to evaluate the strength of your sources and consider any biases they may have. The Annie E. Casey foundation is a charity that seeks to improve health conditions for kids. In order to receive more funding it is in their best interest to use the rates that make the problem seem the most severe. The Maryland Babies Born Health Initiative probably uses fairly accurate numbers because they need to both give an accurate picture of the extent of the problem and continue to collect data that shows that their initiative is succeeding. The Baltimore City Health Department would probably like to minimize the problem in order to make it look like their department is doing a good job.

That's it for this week. Check back next week for more about infant mortality.