1. 1 ◄ ◄ Maternal and Infant Health data for California Choose one vital records indicator:  Preterm birth (birth prior to 37 weeks of pregnancy among singletons)  Extremely preterm birth (birth prior to 32 weeks of pregnancy among singletons)  Term low birthweight (birthweight less than 2,500 grams among term singletons)  Very low birthweight (birthweight less than 1,500 grams among singletons)  Infant mortality (death prior to 12 months of age)  Neonatal mortality (death prior to 28 days of age)  Perinatal mortality (fetal deaths after 28 weeks gestation plus infant deaths prior to 7 days of age)  Postneonatal mortality (death between 28 days and 12 months of age)  Fertility (births per 1,000 women of childbearing age)  Sex ratio at birth (the ratio of males to females among live newborns) Choose one year:  1996  1997  1998  1999  2000  2001  2002  2003  2004  2005  2006 Choose one geographic unit:  County  Census tract Maternal and infant health data query To create a table, chart, or map, select from the following list of options: Submit your selection x x x QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us MATERNAL AND INFANT HEALTH Prematurity and Growth Retardation Infant Mortality Fertility Sex Ratio at Birth Innovative Approaches to Birth Outcomes Surveillance Resources Maternal and Child Health Frequently Asked Questions about Birth Outcomes ◄ ◄

2. 2 Modify your query Data Sources & Limitations Information Map Chart►►Table  See these data calculated in other ways (explanation of methods here ◄):◄ Produce estimates for areas where data are sparse ◄◄ Continuous rate maps that ignore county or tract boundaries◄◄  See related data (population information)  Request more maternal and infant health information from CEHTP ◄ ◄ Maternal and Infant Health data query ►► Data Sources & Limitations QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us MATERNAL AND INFANT HEALTH Prematurity and Growth Retardation Infant Mortality Fertility Sex Ratio at Birth Innovative Approaches to Birth Outcomes Surveillance Resources Maternal and Child Health Frequently Asked Questions about Birth Outcomes

3. 3 ◄◄ Maternal and Infant Health data query Alternative methods for looking at health outcome rates on maps The most common form of health mapping involves calculation of rates for specific geographic unites (counties, census tracts, etc.). Each rate is then assigned to a category represented by a color as dictated by the map legend. Many alternative approaches to health outcome mapping exist, two of which are currently available through the CHETP Portal. Learn about spatial models that produce estimates for areas where data are sparse ◄◄ Learn about continuous rate maps that ignore county or tract boundaries ◄◄ QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us HEALTH DATA Asthma Maternal and Infant Health Cancer Heart Attacks Metadata

4. 4 ◄◄ Alternative methods for looking at health outcome rates on maps Spatial models that produce estimates for areas where data are sparse Why might I be interested in looking at maps like this? Maps of this kind can be helpful if: Areas of the map that interest you have been suppressed because the numbers are too small for the calculation of rates Many of the high and low values that you see in the map are potentially related to random variations rather than genuine geographic disparities The geographic scale that interests you is larger than the units you have; that is, you believe that groups of counties may be put together to demonstrate a regional trend, or a group of census tracts may be put together to show trends within counties What is the name of the method we are using? This approach to mapping is a type of hierarchical Bayesian modeling originally proposed by Besag, York, and Molié (the “BYM approach”). These researchers were motivated by the general problem of image reconstruction, in which random noise needs to be filtered to reveal an underlying image (potentially a disease map but also a satellite or microscopic image). What is the reasoning behind this method? A computer algorithm calculates the degree to which outcomes in spatial units (counties or tracts) appear to be influenced by the outcomes in their neighboring units. Once this is known, the rate for each unit can be updated using information from surrounding units. Units with lots of information (for example, those with large populations), are generally left alone, while those with less information are allowed to be informed by the rates of their neighbors. What results can be considered a “best guess” of what the rates would look like if there were no random variation cluttering up the map image. What else should I know about this method? This method has difficulty representing single counties or tracts with substantially high or low rates (“outliers”) unless the populations in those units are large. Unless these high or low rates are part of a regional trend, they tend to be adjusted towards the population average. QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us HEALTH DATA Asthma Maternal and Infant Health Cancer Heart Attacks Metadata

5. 5 ◄◄ Alternative methods for looking at health outcome rates on maps Continuous rate maps that ignore county or tract boundaries QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us HEALTH DATA Asthma Maternal and Infant Health Cancer Heart Attacks Metadata Why might I be interested in looking at maps like this? Maps of this kind can be helpful if: Only part of the county or region that interests you has people living in it, and you would like to see only that part represented The areas that interest you do not correspond the boundaries of counties or tracts that we have available You are interested in thinking about risk as something that gradually increases and decreases across space, rather than abruptly changing at the boundaries between counties and/or tracts You are not interested in numbers that can describe rates attached to specific geographies, such as counties or tracts What is the name of the method we are using? This approach to mapping calculates a locally-weighted estimator (“loess”) function that is part of a class usually referred to as “non-parametric functions.” What is the reasoning behind this method? Risks for health outcomes are assumed to vary continuously and can be calculated for any point in space; at each point, nearby outcomes are allowed to have more influence in the function’s value than outcomes from farther away. A computer algorithm calculates values for this function at regular intervals (e.g. every half-mile) and then “connects the dots” so the values can be viewed when superimposed on a map. What else should I know about this method? This method is only possible when individual records describing events (such as birth outcomes) and their point locations (such as maternal addresses) are available. Data for which only ZIP codes, census tracts, or cities of residence are known are less amenable to this type of analysis.

6. 6 Modify your query Data Sources & Limitations Information Map ChartTable  See these data calculated in other ways (explanation of methods here ◄):◄ Produce estimates for areas where data are sparse ◄◄ Continuous rate maps that ignore county or tract boundaries◄◄  See related data (population information)  Request more maternal and infant health information from CEHTP Data Sources & Limitations ◄ ◄ Maternal and Infant Health data query QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us MATERNAL AND INFANT HEALTH Prematurity and Growth Retardation Infant Mortality Fertility Sex Ratio at Birth Innovative Approaches to Birth Outcomes Surveillance Resources Maternal and Child Health Frequently Asked Questions about Birth Outcomes

7. 7 Modify your query Data Sources & Limitations Information Map ChartTable  See these data calculated in other ways (explanation of methods here ◄):◄ Produce estimates for areas where data are sparse ◄◄ Continuous rate maps that ignore county or tract boundaries◄◄  See related data (population information)  Request more maternal and infant health information from CEHTP ◄◄ Maternal and Infant Health data query Data Sources & Limitations QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us MATERNAL AND INFANT HEALTH Prematurity and Growth Retardation Infant Mortality Fertility Sex Ratio at Birth Innovative Approaches to Birth Outcomes Surveillance Resources Maternal and Child Health Frequently Asked Questions about Birth Outcomes

8. 8 Modify your query Data Sources & Limitations Information Map ChartTable  See these data calculated in other ways (explanation of methods here ◄):◄ Produce estimates for areas where data are sparse ◄◄ Continuous rate maps that ignore county or tract boundaries◄◄  See related data (population information)  Request more maternal and infant health information from CEHTP Data Sources & Limitations ◄ ◄ Maternal and Infant Health data query QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us MATERNAL AND INFANT HEALTH Prematurity and Growth Retardation Infant Mortality Fertility Sex Ratio at Birth Innovative Approaches to Birth Outcomes Surveillance Resources Maternal and Child Health Frequently Asked Questions about Birth Outcomes

9. 9 Modify your query Data Sources & Limitations Information Map ChartTable  See these data calculated in other ways (explanation of methods here ◄):◄ Produce estimates for areas where data are sparse ◄◄ Continuous rate maps that ignore county or tract boundaries◄◄  See related data (population information)  Request more maternal and infant health information from CEHTP Data Sources & Limitations ◄ ◄ Maternal and Infant Health data query QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us MATERNAL AND INFANT HEALTH Prematurity and Growth Retardation Infant Mortality Fertility Sex Ratio at Birth Innovative Approaches to Birth Outcomes Surveillance Resources Maternal and Child Health Frequently Asked Questions about Birth Outcomes

10. 10 Modify your query Data Sources & Limitations Information Map ChartTable  See these data calculated in other ways (explanation of methods here ◄):◄ Produce estimates for areas where data are sparse ◄◄ Continuous rate maps that ignore county or tract boundaries◄◄  See related data (population information)  Request more maternal and infant health information from CEHTP Data Sources & Limitations ◄ ◄ Maternal and Infant Health data query QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us MATERNAL AND INFANT HEALTH Prematurity and Growth Retardation Infant Mortality Fertility Sex Ratio at Birth Innovative Approaches to Birth Outcomes Surveillance Resources Maternal and Child Health Frequently Asked Questions about Birth Outcomes

11. 11 Modify your query Data Sources & Limitations Information Map ChartTable  See these data calculated in other ways (explanation of methods here ◄):◄ Produce estimates for areas where data are sparse ◄◄ Continuous rate maps that ignore county or tract boundaries◄◄  See related data (population information)  Request more maternal and infant health information from CEHTP ◄◄ Maternal and Infant Health data query Data Sources & Limitations QUICK LINKS CEHTP Home About CEHTP Environmental Hazards Environmental Exposures Health Other Data Tools and Services Concepts in Tracking Publications & Resources Contact Us MATERNAL AND INFANT HEALTH Prematurity and Growth Retardation Infant Mortality Fertility Sex Ratio at Birth Innovative Approaches to Birth Outcomes Surveillance Resources Maternal and Child Health Frequently Asked Questions about Birth Outcomes