Increasing parks and recreation spending to reduce county low birth weight incidence: Evidence from national birth records

• In Event: 1-010 - Neighborhood Geocoding

Abstract

Local governments play an integral role in providing health-relevant services (e.g., parks and recreation [PRS]) to their residents, yet the population health implications are frequently overlooked (Bradley et al., 2016; McCullough & Leider, 2016). Public goods and services may be particularly beneficial to groups who otherwise would lack access, such that increases in provision could reduce health disparities. The present study examined how changes in local government expenditures on PRS influence county incidence of low birth weight (< 2500 grams) and black-white disparities in low birth weight.
Data for individual birth records were collected through the National Vital Statistics System, and three-year county aggregates were computed for five periods from 1992-2014. Local government expenditures were assessed via the U.S. Census Bureau quinquennially from 1997 to 2012, and values were adjusted to 2012 dollars per capita. See Figure 1 for timeline of measurement occasions. County median income and population were also derived from U.S. Census Bureau sources for periods that corresponded with birth outcomes. In a sample of 956 counties with a total of 3619 observations, bias-corrected county by period fixed effects models were fit using bootstrap samples to derive linear estimates of the impact of PRS expenditures on low birth weight outcomes. Time-varying covariates included the lagged dependent variable, local government expenditures (total, health, hospitals, and housing), median income, racial demographics, and population change (i.e., change from prior period as % of total population).
Model results for county low birth weight incidence are shown in Table 1. Results indicate that, independent of county and time fixed effects, changes in median income, and changes in population characteristics, an increase in PRS expenditures of $50 per capita was estimated to reduce the county incidence of low birth weight by .12 cases per 100 births (p = .005). PRS expenditures were not significantly associated with the black-white gap in LBW (estimated impact for $50 increase in PRS = -.11 cases per 100 births, 95% CI: -.37, .14).
Increasing parks and recreational services represents a novel policy through which local governments can reduce low birth weight incidence. State and federal governments should consider increasing the number of grant programs to local governments to correct the substantial geographic differences in availability of PRS (Joassart-Marcelli, 2010). Such initiatives have the potential to reduce the societal costs that stem from low birth weight (e.g., elevated infant mortality risk, developmental delays, adulthood cardiovascular disease risk; Barker, 1995).

Authors

• David Stuart Curtis, Auburn University
  Presenting Author

• Thomas E Fuller-Rowell, Auburn University