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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
ELECTRONIC ARTICLES

The Health Status of Southern Children: A Neglected Regional Disparity

Jeffrey Goldhagen, Radley Remo, Thomas Bryant, Peter Wludyka, Amy Dailey, David Wood, Graham Watts and William Livingood
Pediatrics December 2005, 116 (6) e746-e753; DOI: https://doi.org/10.1542/peds.2005-0366
Jeffrey Goldhagen
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Radley Remo
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Thomas Bryant III
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Peter Wludyka
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Amy Dailey
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David Wood
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Graham Watts
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William Livingood
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    Fig 1.

    Infant mortality rate by state, 1999. Source of data: Annie E. Casey Foundation. 2002 Kids Count Data Book: State Profiles of Well-Being. Baltimore, MD: Annie E. Casey Foundation; 2002.

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    Fig 2.

    Low birth weight rate by state, 1999. Source of data: Annie E. Casey Foundation. 2002 Kids Count Data Book: State Profiles of Well-Being. Baltimore, MD: Annie E. Casey Foundation; 2002.

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    Fig 3.

    Composite health score by state. Source of data: Annie E. Casey Foundation. 2002 Kids Count Data Book: State Profiles of Well-Being. Baltimore, MD: Annie E. Casey Foundation; 2002.

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    Fig 4.

    ANOM decision chart for deviation of regional means from overall the mean (0). Level of significance: .001. Adapted from SAS ANOM chart using SAS 9.1 (SAS Institute, Cary, NC). - - - indicates the decision limit (defines statistical significance, similar to the function of confidence interval; limits vary for each region because of the number of states in each region [minimum n: 9; maximum n: 16]).

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    Fig 5.

    Standardized scores by health indicator. Source of data: 2002 Kids Count Report. Prepared by the Institute for Health, Policy and Evaluation Research, Duval County Health Department, January 2004.

Tables

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    TABLE 1.

    State Composite Score Rank for CHI

    RankStateScore*
    1New Hampshire1.62
    2Massachusetts1.61
    3Vermont1.35
    4Maine1.25
    5Washington1.20
    6Minnesota1.10
    7Rhode Island1.10
    8Connecticut1.08
    9Utah1.06
    10Oregon1.05
    11Hawaii1.02
    12Iowa1.02
    13California0.91
    14New Jersey0.87
    15North Dakota0.74
    16New York0.70
    17Alaska0.54
    18Wisconsin0.54
    19Nebraska0.40
    20Virginia0.33
    21Pennsylvania0.22
    22Ohio0.10
    23Michigan0.09
    24Kansas0.03
    25Montana−0.05
    26Colorado−0.06
    27Idaho−0.17
    28Delaware−0.21
    29South Dakota−0.23
    30Arizona−0.24
    31Nevada−0.25
    32West Virginia−0.30
    33Texas−0.31
    34Illinois−0.32
    35Florida−0.34
    36Kentucky−0.35
    37Missouri−0.39
    38Maryland−0.44
    39Indiana−0.45
    40Oklahoma−0.87
    41North Carolina−0.94
    42Wyoming−0.96
    43New Mexico−1.01
    44Georgia−1.05
    45Tennessee−1.19
    46Arkansas−1.35
    47South Carolina−1.76
    48Louisiana−1.85
    49Alabama−2.12
    50Mississippi−2.69
    • ↵* Standard scores range from −3 to 3, 3 SD below and above the mean of 0.

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    TABLE 2.

    Comparison of Composite Health Index Scores of Deep South to the Remaining States in the Census Bureau–Defined South

    RegionNo. of StatesHealth Score Mean95% CIt ScoreP
    Deep South9−1.4774−1.9378, −1.0170−3.991.0001
    Rest of South7−0.3089−.5714, −.0464
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    TABLE 3.

    Pairwise Comparison of the Deep South to Each of the Other Regions

    ControlMean DifferenceSESignificanceUpper Bound
    Northeast and Mid-AtlanticDeep South2.2669*0.29882.1626 × 10−52.8910
    MidwestDeep South1.5267*0.28242.4315 × 10−52.1164
    WestDeep South1.7108*0.29392.2233 × 10−52.3245
    • Dunnett t tests treat 1 group as a control and compare all other groups against it.

    • ↵* The mean difference is significant at the .05 level.

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    TABLE 4.

    Variables With Statistical Association to CHI Through Multiple-Regression Analysis

    Termβ Coefficient*SEP95% CI of Coefficient
    Intercept0.45410.1005<.00010.2515, 0.6566
    Not attending school or working−0.60530.0900<.0001−0.7865, −0.4240
    No parent working full-time0.23760.0822.00590.0720, 0.4032
    Deep South−1.02990.2624.0003−1.5586, −0.5011
    New Midwest−0.79030.1538<.0001−1.1002, −0.4804
    Percent black−0.33580.0968.0012−0.5310, −0.1407
    • ↵* Positive β scores equal relative good health, and negative β scores equal relative poor health.

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    TABLE 5.

    Variables With Statistical Associations Revealed Through Independent Bivariate Analysis

    VariablesRAdjusted R2Significance
    Living in the South0.69140.478.0001
    Percent of population who are black0.68700.461.0001
    Percent of teens not attending school and not working0.57710.333.0001
    Percent of children living with parents who do not have full-time, year-round employment0.14140.020.164
    Living in the New Midwest0.0316−.020.828
    • Sources of data: Annie E. Casey Foundation. 2002 Kids Count Data Book: State Profiles of Well-Being. Baltimore, MD: Annie E. Casey Foundation; 2002; and US Census Data, 2000.

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Pediatrics
Vol. 116, Issue 6
December 2005
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The Health Status of Southern Children: A Neglected Regional Disparity
Jeffrey Goldhagen, Radley Remo, Thomas Bryant, Peter Wludyka, Amy Dailey, David Wood, Graham Watts, William Livingood
Pediatrics Dec 2005, 116 (6) e746-e753; DOI: 10.1542/peds.2005-0366

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The Health Status of Southern Children: A Neglected Regional Disparity
Jeffrey Goldhagen, Radley Remo, Thomas Bryant, Peter Wludyka, Amy Dailey, David Wood, Graham Watts, William Livingood
Pediatrics Dec 2005, 116 (6) e746-e753; DOI: 10.1542/peds.2005-0366
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