Am J Obstet Gynecol. 2014 Jun 20. pii: S0002-9378(14)00623-1. doi: 10.1016/j.ajog.2014.06.043. [Epub ahead of print]
Geographic Variation of Reproductive Health Indicators and Outcomes in the United States: Place Matters.
Author information
- Division of Reproductive Health, Centers for Disease Control and Prevention. Electronic address: wgc0@cdc.gov.
Abstract
The social determinants of health are the circumstances in which people are born, grow up, live, work, and age, as well as the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics. Reproductive health indicators and conditions germane to obstetricians and gynecologists vary across states and regions in the United States as well as within regions and states. The aim of this paper is to illustrate this variation using examples of gynecologic malignancies, sexually transmitted infections, teen birth rates, preterm birth rates and infant mortality. Using the example of infant mortality, the difficulties in "unpacking" the construct of place will be discussed and a special emphasis is placed on the interaction of race, place and disparities in shaping perinatal outcomes. Finally, readily-available and easy to use online data resources will be provided so that obstetricians and gynecologists will be able to assess geographic variation in health indicators and outcomes in their own localities.
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