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External factors LHDs cannot control (Context)
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Total LHD expenditure
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Raw number or per capita
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Population
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Total population of the county/area the LHD serves (number)
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Number of Medicaid births in the county
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Controls for need of services
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Core Based Statistical Area (CSBA) [28]
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3 levels: metropolitan, micropolitan, rural
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% of children under 18 living in poverty
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Social Disadvantage Index [29]
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Index of median HH income; % of households receiving public assistance; % unemployed
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% of persons 25+ with HS or more education in county
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% of county population that is African American
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% of county population that is Hispanic
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Per Capita number of nurses
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Per Capita number of midwives
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Per Capita number of doctors
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Inputs (LHD can control)
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Alternative Provider
|
Categorical variables for each MCH service area (linked to expenditure included); captures whether other entity is providing the service in the county area
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Executive Clinician
|
0-1; captures whether the executive at the LHD has a clinical degree or not
|
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LHD Service Approach Classification
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Categorical variable (4 levels) obtained through latent class analysis of self-reported LHD service provisions to the NACCHO profile survey [34]
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MCH Outcomes
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Teen pregnancy rate
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Number of births to girls age 15–19 over total number of girls age 15–19 (× 1000), smoothed (3 year average)
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Infant Mortality rate
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Number of infant deaths over total number of births, smoothed (3 year average)
|
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Late or no prenatal care rate
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Number of infants born that received no or late prenatal care over total births, smoothed (3 year average)
|
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Low birth weight rate
|
Number of infants born at low birth weight over total births, smoothed (3 year average)
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