DIAGNOSTIC CLUSTERS IN INFANTS AS CHILD HEALTH OUTCOMES - VARIATION AMONG SOCIOECONOMIC AREAS IN ONE COMMUNITY

Objectives were to examine geographic variation in rates of infant hos pitalization for diagnostic clusters in Monroe County (Rochester), New York and to assess these clusters as indexes of child health. ICD-9 c odes were used to cluster all 7,883 hospitalizations of infants (< 24 months) between 1985 and 1991 on the basis of their avoidability. Envi ronmentally sensitive clusters accounted for 63% of admissions. These clusters included environmental, environmental/constitutional, and oth er infectious disease. Disparities in morbidity between inner city and suburbs were greatest for the environmental cluster followed by the e nvironmental/constitutional, and other infectious disease clusters. Fo r the constitutional and quality indicator clusters, differences betwe en inner-city and suburban risk were minimal. Environmental interventi ons may be more important than improved health services to reducing ra cial and economic disparities in child health. Analysis of morbidity c lusters, ascertained from available administrative data bases and aggr egated for small geographic areas, may guide child health policy well.