Impact of pre-conception health care: evaluation of a social determinants focused intervention.
The purpose of this study was to evaluate the outcomes of the social determinants component of a multiple determinants model of pre- and inter-conception care. Health department vital statistics and infectious disease data on birth and factors influencing birth outcomes were analyzed for participants in a program designed to mitigate the effects of social class and stress in contrast to a matched comparison group and other relevant populations. The program showed promising results related to reducing infant mortality and reducing other high-risk factors for poor birth outcomes, including low birth weight and sexually transmitted disease. Social determinant interventions, designed to mitigate the impact of social class and stress, should be considered with efforts to reduce infant mortality, particularly the disparities associated with infant mortality. Additional research should be conducted to refine replicable social determinant focused interventions and confirm and generalize these results.
Livingood
William C
WC
Institute for Health, Policy and Evaluation Research, Duval County Health Department, 900 University Blvd North, Suite 604, Jacksonville, FL 32211, USA.
Brady
Carol
C
Pierce
Kimberly
K
Atrash
Hani
H
Hou
Tao
T
Bryant
Thomas
T
D001741:Black or African American / Q000208:ethnology; D001724:Birth Weight; D019090:Case Management / Q000458:organization & administration*; D016009:Chi-Square Distribution; D005260:Female; D005431:Florida / Q000453:epidemiology; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D017146:Models, Organizational; D009937:Organizational Objectives; D016742:Preconception Care / Q000458:organization & administration*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology; D015397:Program Evaluation; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000517:prevention & control; D012923:Social Class; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000208:ethnology / Q000517:prevention & control