title: Exploration of preterm birth rates using the public health exposome database and computational analysis methods.
abstract: Recent advances in informatics technology has made it possible to integrate, manipulate, and analyze variables from a wide range of scientific disciplines allowing for the examination of complex social problems such as health disparities. This study used 589 county-level variables to identify and compare geographical variation of high and low preterm birth rates. Data were collected from a number of publically available sources, bringing together natality outcomes with attributes of the natural, built, social, and policy environments. Singleton early premature county birth rate, in counties with population size over 100,000 persons provided the dependent variable. Graph theoretical techniques were used to identify a wide range of predictor variables from various domains, including black proportion, obesity and diabetes, sexually transmitted infection rates, mother's age, income, marriage rates, pollution and temperature among others. Dense subgraphs (paracliques) representing groups of highly correlated variables were resolved into latent factors, which were then used to build a regression model explaining prematurity (R-squared = 76.7%). Two lists of counties with large positive and large negative residuals, indicating unusual prematurity rates given their circumstances, may serve as a starting point for ways to intervene and reduce health disparities for preterm births.
authors.affiliation: Department of Public Health, University of Tennessee, Knoxville, TN 37996, USA. annekersh@gmail.com.
authors.forename: Anne D
authors.initials: AD
authors.lastname: Kershenbaum
authors.affiliation: Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN 37996, USA. langston@eecs.utk.edu.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Langston
authors.affiliation: Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA. rlevine@mmc.edu.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Levine
authors.affiliation: Department of Animal Science, Institute of Agriculture, University of Tennessee, Knoxville, TN 37996, USA. asaxton@utk.edu.
authors.forename: Arnold M
authors.initials: AM
authors.lastname: Saxton
authors.affiliation: Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee Health Science Center, Memphis, TN 38163, USA. toyana@uthsc.edu.
authors.forename: Tonny J
authors.initials: TJ
authors.lastname: Oyana
authors.affiliation: Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA. bkilbourne@mmc.edu.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Kilbourne
authors.affiliation: National Institute for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA. grogers3@utk.edu.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Rogers
authors.affiliation: Department of Political Sciences, Texas Tech University, Lubbock, TX 79409, USA. lisa.gittner@ttu.edu.
authors.forename: Lisaann S
authors.initials: LS
authors.lastname: Gittner
authors.affiliation: Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN 37996, USA. sbaktash@utk.edu.
authors.forename: Suzanne H
authors.initials: SH
authors.lastname: Baktash
authors.affiliation: Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Matthews-Juarez
authors.affiliation: Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee Health Science Center, Memphis, TN 38163, USA. pjuarez@uthsc.edu.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Juarez
mesh_terms: D016208:Databases, Factual; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008962:Models, Theoretical; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D011635:Public Health Administration; D012307:Risk Factors; D014481:United States / Q000453:epidemiology