Presenter Profile
Gina Lowell, MD, MPH
Director of Community Health for Pediatrics
Rush University Children’s Hospital
gina_lowell@rush.edu
Gina Lowell MD, MPH is a general academic pediatrician at Rush University Children’s Hospital in Chicago with specialty interests in childhood injury, child abuse and neglect, and early relational health. Her injury prevention experience includes longitudinal clinical research and advocacy to examine and prevent microwave-related burn injuries in young children. She is currently engaged in Sudden Unexpected Infant Death prevention research and collaboratives, and serves as PI for the CDC-funded SUID Case Registry for Cook County. As Director of Community Health for Pediatrics she focuses on developing and promoting maternal-child health initiatives that support Chicago’s communities through addressing the intersectional impact of generational trauma and the social and structural determinants of health on maternal-child health equity. She completed her MD at Rush Medical College, Pediatric Residency at the University of Chicago, and General Academic Pediatrics Fellowship and MPH at the University of Illinois at Chicago.
Presentations
Connecting Data to “Close the Loop” with Birth Hospitals to Prevent SUID
Gina Lowell, MD, MPH
Rojin Ahadi, MPH
Meredith Reynolds, MD
Christie Lawrence, DNP, RNC-NIC
Kyran Quinlan, MD, MPH
Each year in the US, about 3,400 infants die from Sudden Unexpected Infant Death (SUID). In Cook County IL, SUID occurs on average nearly once a week. Education and prevention opportunities exist for hospitals who birth these infants, yet birth hospitals rarely hear when an infant they discharged dies from SUID. We leveraged access to available data sources to calculate SUID rates of Cook County birth hospitals and their geographical proximity with those communities most impacted by SUID.
Data from the Cook County Medical Examiner’s Office for SUIDs that occurred between 1/1/2019 and 12/31/2021 were analyzed for hospital of birth. The Illinois Department of Public Health (IDPH) provided resident live birth data by Cook County birth hospital for the 11 birth hospitals with the greatest number of infants discharged who subsequently died from SUID during this time frame. SUID rates (cases/1,000 resident live births) were calculated for each birth hospital. SUIDs in Cook County during this time period were mapped using RStudio and compared with Chicago Health Atlas data visualizing community areas of high economic hardship and with mapping of Cook County birth hospitals.
From 2019-2021, the eleven hospitals included in this analysis delivered between less than 1,000 to over 35,000 infants per birth hospital. SUID rates for birth hospitals ranged from 0.34 to 6.8 cases per 1,000 resident live births. Geographical distribution of SUIDs showed high concentration in areas geographically associated with those birth hospitals with the highest SUID rates, and with those community areas experiencing high economic hardship. The birth hospital with the highest SUID rate was 3 times that of the birth hospital with the second highest SUID rate, and 20 times that of the birth hospital with the lowest SUID rate. The birth hospital with the highest SUID rate experienced a pandemic-related closure of its labor and delivery unit, as did the birth hospital with the 7th highest SUID rate.
Birth hospitals in community areas most impacted by SUID experience variably and disproportionately high SUID rates. SUID occurs in areas of high economic hardship where closures of labor and delivery units reflect disinvestment and deepen inequitable access to trusted care. No system currently exists for birth hospitals to learn of SUIDs that happened to babies they discharged. Describing this data is the first step towards “closing the loop” with birth hospitals. Leveraging different public health data sources to describe these disparities creates opportunities to reach stakeholders at birth hospitals invested in preventing SUID through sharing data, clinical practices, hospital policies, community approaches and passion to promote safe sleep during the critical opportunity birth hospitals have surrounding the birth of a baby.
1. Recall 3 data sources used to illuminate the SUID rates for infants discharged from Cook County birth hospitals.
2. Understand the non-uniformity of SUIDs experienced by infants discharged from Cook County birth hospitals serving communities with varying economic hardship.
3.Consider how historical disinvestment, economic hardship and the pandemic intersect to impact hospital systems serving communities most impacted by SUID.