Spatiotemporal clusters of infant mortality risk factors in Georgia

Infant mortality rates (IMR) and other health disparities (e.g., low provider access; higher obesity rates) exist across rural America, especially in the southeastern United States. These disparities coincide with negative socioeconomic factors such as poverty and low household income. Georgia’s 2020 preterm birth rate was seventh highest among the 50 U.S. states, its rate of low birth weight (LBW) babies was fourth among states. Methods This study used a novel, combined spatiotemporal analysis to assess IMR and health trends in Georgia counties ( n = 159). We spatially regressed IMR on 14 biopsychosocial health variables and assessed IMR 2012–2022 longitudinal trends, rural versus urban or by Health Professional Shortage Area (HPSA) status, using a two-level hierarchical linear model. Results Analyses demonstrated significant associations between IMR and rural counties as well as counties that have high African American populations, high unemployment, and high uninsurance rates. Principal Care Provider Rates showed a negative spatial regression relationship. There was a −0.056 IMR slope for urban counties from 2015 to 2022, whereas the rural county IMR slope was 0.135. Conclusions Findings concur with previous research suggesting the need for coordinated county-specific socioeconomic development and corresponding increased health programs. Combined geospatial and multilevel models represent a novel approach to inform public health epidemiology.