Project Description:
In this project, we are using statewide, administrative databases to examine questions of health and family dynamics for two groups of individuals. Our data for this project come from several Tennessee state records, over periods of up to 28 years. These records include the Birth records of all 82,000+ TN births per year (1980-2008), Hospital Discharge Records (approximately 1 million per year, 1996-2007), as well as Marriage (75,000 per year, 1990-2002) and Divorce (40,000/yr, 1990-2002) records. In addition, we are "linking" such records together to examine various individual issues (e.g., a child's recurrent hospitalizations over time) and family issues (divorce within particular families). So far, we have examined several issues using these data. First, we have used the Birth, Hospital Discharge, and Divorce databases to examine the amount, timing, and correlates of divorce among families of children with Down syndrome. Second, we examined hospitalizations in the child with Down syndrome's first two years of life. A full 50% of infants with Down syndrome are hospitalized, for heart-related and for respiratory problems. From these data, Down syndrome should be considered a high-risk health condition, at least during the child's earliest years. By detailing characteristics of family and child health in Down syndrome, our research is beneficial for conceptualizing and implementing a variety of social and medical services. Third, we examined adverse birth outcomes in Down syndrome. Newborns with DS experience significantly higher rates of low birthweight, preterm delivery and small-for-gestational age. Predictors of these adverse birth outcome in the general population, ie, mom's education, race and age do not predict in the DS population. Fourth, infant mortality in DS is 74 per 1000. Over half of the deaths occurred in the post-neonatal period. Newborns with DS who died in the first day had significantly lower birthweight, 5 minute APGAR scores and gestational age. Fifth, families with children with Down syndrome or spina bifida are more likely to have a child after the one with the condition and have larger families regardless of maternal age or education.
Keyword(s):
Down syndrome, spina bifida, families, divorce, health, infancy
