Historically, the overall risk of infant mortality in the United States has declined. However, the rate of decline has slowed and even reversed in 2002 the most recent year reported. Further, racial and ethnic disparities have increased. Consequently, infant mortality remains a serious public health problem. Moreover, the cause of the racial and ethnic differentials has remained elusive. It is our view that effective theoretical tools, e.g. the proximate determinants model of infant mortality, are available, but that the statistical tools to fully operationalize these models are not. Ideally, these tools should accommodate direct and indirect (through the proximate determinants) effects, allow for non-linear effects, appropriately parameterize the proximate determinants (the most important of which are birth weight and gestational age), and account for """"""""hidden"""""""" heterogeneity in the birth cohort. The objective of this proposal is to continue development of Covariate Density Defined mixtures of logistic regression (and other GLMs) a statistical methodology that can operationalize the proximate determinants model. The objective of our previous work was to validate the statistical model, examine a number of issues concerning the structure of the proximate determinants component, and demonstrate the utility of the model for studying exogenous covariates. We will extend these results here to test specific assumptions concerning the """"""""causal"""""""" roll of birthweight with respect to infant mortality, i.e. how the """"""""structure"""""""" of the proximate determinants interacts with exogenous covariates and infant mortality. The """"""""causal"""""""" roll of birth weight has been questioned, an issue of extreme importance for designing interventions. The method we have developed is capable of statistically testing these assumptions. We will examine a number of potential covariates in the context of the proximate determinants model on a sample of ethnically diverse birth cohorts. We will develop and make available programs for conducting Covariate Density Defined mixtures of GLMs.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD037405-06
Application #
7371148
Study Section
Special Emphasis Panel (ZRG1-HOP-B (02))
Program Officer
Spittel, Michael
Project Start
2000-04-01
Project End
2010-02-28
Budget Start
2008-03-01
Budget End
2009-02-28
Support Year
6
Fiscal Year
2008
Total Cost
$207,878
Indirect Cost
Name
State University of New York at Albany
Department
Social Sciences
Type
Schools of Arts and Sciences
DUNS #
152652822
City
Albany
State
NY
Country
United States
Zip Code
12222
Gage, Timothy B; Lee, Furrina F; O'Neill, Erin K et al. (2016) Heterogeneity identified at birth and blood pressure in adulthood. Am J Hum Biol 28:545-54
Gage, Timothy B; Fang, Fu; O'Neill, Erin et al. (2013) Maternal education, birth weight, and infant mortality in the United States. Demography 50:615-35
Gage, Timothy B; Fang, Fu; O'Neill, Erin K et al. (2010) Racial disparities in infant mortality: what has birth weight got to do with it and how large is it? BMC Pregnancy Childbirth 10:86
Gage, Timothy B; DeWitte, Sharon (2009) What do we know about the agricultural demographic transition? Curr Anthropol 50:649-55
Gage, Timothy B; Fang, Fu; O'Neill, Erin et al. (2009) Maternal age and infant mortality: a test of the Wilcox-Russell hypothesis. Am J Epidemiol 169:294-303
Gage, Timothy B; Fang, Fu; Stratton, Howard (2008) Modeling the pediatric paradox: birth weight by gestational age. Biodemography Soc Biol 54:95-112
Fang, Fu; Stratton, Howard; Gage, Timothy B (2007) Multiple mortality optima due to heterogeneity in the birth cohort: a continuous model of birth weight by gestational age-specific infant mortality. Am J Hum Biol 19:475-86
Gage, Timothy B; Bauer, Michael J; Heffner, Nathan et al. (2004) Pediatric paradox: heterogeneity in the birth cohort. Hum Biol 76:327-42
Gage, T B (2003) Classification of births by birth weight and gestational age: an application of multivariate mixture models. Ann Hum Biol 30:589-604
Gage, Timothy B (2003) The evolution of human phenotypic plasticity: age and nutritional status at maturity. Hum Biol 75:521-37

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