Document Type

Honors Thesis


Neonatal opioid withdrawal syndrome (NOWS) is a serious health issue in which an infant withdraws from intrauterine opioid exposure. Due to the opioid epidemic, the prevalence of NOWS increased in the United States. To determine if there are disparities in the NOWS population, social determinants of health (SDOH), race, and ethnicity were examined, as they have not been studied in NOWS previously. The Child Opportunity Index (COI), assessed SDOH factors on a community level. Data from the 2018-2019 Texas Inpatient Discharge Data set identified 1,262 infants diagnosed with NOWS and affected by Maternal Opioid Use (MO). Infants affected by MO were included in the study as there were no clear differences in potential SDOH between these infants, since both had intrauterine opioid exposure. A majority of the infants were white (75%), non-Hispanic (60%), lived in urban areas (78%), and had Medicaid (80%). Most infants had low (28%) or very low (22%) COI levels. However, the COI was statistically significantly lower for infants who were Hispanic, lived in rural areas, or had non-private insurance (p<0.001); but there were no differences based upon race. Future research should explore opportunities to address COI disparities among infants with NOWS and infants affected by MO.

Publication Date




Faculty Mentor of Honors Project

Kristin Gigli Hittle



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