JMIR Publications

ABSTRACT

Background:

Incidence of Sudden Unexpected Infant Death (SUID) in the United States has persisted at roughly the same level since the mid-2000’s despite intensive prevention efforts. Disparities in outcomes across racial/socioeconomic lines also persist. These disparities are reflected in the spatial distribution of cases.

Objective:

We sought to characterize communities where SUID occurred in Cook County, IL from 2015-2019 and predict where it would occur in 2021-2025.

Methods:

This cross-sectional retrospective study used geocoded medical examiner data from 2015-2019 to identify SUID cases in Cook County, IL and aggregated them to census tracts, then to “communities” as the unit of analysis. We compared demographic factors in communities affected by SUID versus those unaffected. We used social vulnerability indicators from 2014 to train a prediction model for SUID Case Counts in each given community from 2015-2019. We applied indicators from 2020 to the trained model to make predictions for 2021-2025.

Results:

The analysis was based on 325 cases of SUID in 199 communities. Communities affected by SUID exhibited higher proportions of Black residents at 32% (IQR 6-79) vs. 3% (IQR 2-10) and lower proportions of White residents at 17% (IQR 4-49) vs. 60% (IQR 31-76). A map of communities in Cook County affected by SUID (2015-2019) showed clusters in the South and West regions of the county. Our predictive model showed moderate accuracy when assessed on the training data (Nagelkerke’s R2 of 70.2%). It predicted Austin (17), Englewood (14), Auburn Gresham (12), Chicago Lawn (12), and South Shore (11) to have the largest case counts for 2021-2025.

Conclusions:

Sharp racial and socioeconomic disparities in SUID incidence persisted within Cook County from 2015-2019. Our model and maps identified precise regions within the county for local health departments to target for intervention.