Georgia Department of Public Health | OASIS Mapping Tools | PPOR Definitions

Presentation Information

Confidentiality rule:
Numbers based on 0-4 events are classified as a separate static class when a sub-county level geography (Census Tract or County Commission District) is chosen.This is done to assure confidentiality.
Not Reportable
Rates (and Percents) based on 1-9 events are not reported due to statistical reliability reasons.
Trendable Maps
Trendable maps are a series of choropleth maps showing change in spatial distribution of data in a selected area over selected period of time. Trendable maps share the same data class breaks which allows easy comparison between each map in the series.
Trendable Maps

Mapping Units:

Visible Layers:

Census Tracts 2020
Census Tracts are small, relatively permanent statistical subdivisions of a county or equivalent entity that are updated by local participants prior to each decennial census.
Census tracts generally have a population size between 1,200 and 8,000 people.  A census tract usually covers a contiguous area; however, the spatial size of census tracts varies widely depending on the density of settlement.  Census tract boundaries are delineated with the intention of being maintained over a long time so that statistical comparisons can be made from census to census.  Census tracts occasionally are split due to population growth or merged as a result of substantial population decline.
Census tract boundaries generally follow visible and identifiable features.  They may follow nonvisible legal boundaries, such as minor civil division (MCD) or incorporated place boundaries in some states and situations, to allow for census-tract-to-governmental-unit relationships where the governmental boundaries tend to remain unchanged between censuses.  State and county boundaries always are census tract boundaries in the standard census geographic hierarchy. Reference Source: U.S. Commerce Department, United States Census Bureau, February 2022.
Cities/Towns
A mix of both incorporated places (legal entities) and census designated places or CDPs (statistical entities). An incorporated place is established to provide governmental functions for a concentration of people. Places always nest within a state, but may extend across county and county subdivision boundaries. An incorporated place usually is a city, town, village, or borough, but can have other legal descriptions. CDPs are delineated to provide data for settled concentrations of population that are identifiable by name, but are not legally incorporated under the laws of the state in which they are located. Click on city/town name to highlight the boundary. Reference Source: U.S. Census, 2020.
County Commission Districts
For more information, see http://www.accg.org/. The districts were established in 2014, and were obtained from the Association of County Commissioners of Georgia (ACCG). Further processing was performed by the Office of Health Indicators for Planning (OHIP) of the Georgia Department of Public Health. History and role: In 1868 the state began creating the position of county commissioner to administer the general operations of the county. Today every county has a commissioner; many have a board of commissioners (BOC). As part of general county operations, the BOC must finance county programs. A BOC has the power to adopt ordinances, resolutions, or regulations relating to county property, county affairs, and the operation of local government (http://www.georgiaencyclopedia.org/nge/Article.jsp?id=h-589 ).
GA House Districts
Electoral districts from which State Representatives are elected. The Georgia Constitution requires not less than 180 Representatives apportioned by population from representative districts. Layer Source: https://www.legis.ga.gov/, Adopted 2023 – Effective for 2024 Elections.
GA Senate Districts
Electoral districts from which State Senators are elected. The Georgia Constitution limits the number to not more than 56 single member districts. Senate districts are apportioned based on population. Layer Source: https://www.legis.ga.gov/, Adopted 2023 – Effective for 2024 Elections.
Hospitals
Hospitals are inpatient medical facilities in Georgia. Click on the symbol to get the name. Updated 6.23.2025.
Interstates
Interstates are the freeways that are part of the Interstate Highway System in Georgia. The Interstate Highway System connects major cities within the United States. Click on the line to get the Interstate number. Layer Source: Esri, March 1, 2012.
Major Roads
Major roads are a combination of both federal and state highways connecting cities and towns. Click on the line to get the route number. Layer Source: Esri, March 1, 2012.
Perinatal Regions
The Perinatal Regions were established by the Department of Public Health in cooperation with the six teaching hospitals located in Atlanta, Albany, Augusta, Columbus, Macon and Savannah. The Regions reflect the hospital referral patterns for high risk pregnant women and newborns Each of the six hospitals has a Regional Perinatal Center which has contracts with the state and receives funding to care for high risk pregnant women and infants as well as to train staff from other hospitals in perinatal care especially for high risk patients. Reference Source: Georgia Department of Public Health, March 2005.
ZIP Code
Established by the U.S. Postal Service for distribution of mail. Zip codes do not generally respect political boundaries or census areas such as tracts. Zip codes usually do not have clearly identifiable boundaries, often serve a continually changing area, are changed periodically to meet postal requirements, and do not cover all land area in the U.S. Layer Source: Esri, June 1, 2020.

Base Layers:

Base layers are background information to provide contextual references for local-level maps. They are especially suited for tract-level maps and give real-world reference to maps you create in OASIS. There are six toggle-able (on/off) base layers:
Aerial Photograph
World Imagery provides one meter or better satellite and aerial imagery (ESRI).
Simple Street
Light Gray Canvas provides a neutral background with minimal colors, labels, and features allowing the choropleth maps to come to the foreground (ESRI).
Socioeconomic (SES) Vulnerability
Socioeconomic (SES) Vulnerability refers to the socioeconomic status domain/subset of the CDC’s Social Vulnerability Index (SVI) 2020. Socioeconomic vulnerability ranks census tracts within Georgia on 5 factors: below 150% poverty, unemployed, housing cost burden, no high school diploma, and no health insurance. Percentile ranking values range from 0 to 1, with higher values indicating greater vulnerability/lower socioeconomic status. Quintiles of the percentile rankings were used to create class breaks (Very Low, Low, Average, High and Very High SES Vulnerability). Keep in mind that “Very Low” SES Vulnerability equates to a High SES status. For more information see https://www.atsdr.cdc.gov/placeandhealth/svi/index.html. For data dictionary click here.
Street and Place Names
National Geographic World Map, developed by National Geographic and Esri, is designed to be used as a general reference map for informational and educational purposes (ESRI).
Street Map
World Street Map includes highways, major roads, minor roads, one-way arrow indicators, railways, water features, cities, parks, landmarks, building footprints, and administrative boundaries, overlaid on shaded relief for added context (ESRI).
Street Topographical
World Topo Map includes administrative boundaries, cities, water features, physiographic features, parks, landmarks, highways, roads, railways, and airports overlaid on land cover and shaded relief imagery for added context (ESRI).

Data Classification Methods:

Quantiles: splits the data into equal-sized groups, for example dividing all 159 counties into 5 groups from smallest number to largest. Roughly 32 counties will be in each group.
Natural Breaks (Jenks): looks for clusters in the data and groups similar values together, so each group has numbers that are more alike. For example, if mapping counts by county, Fulton may stand out by itself and be the only county in its group.
Which to use? That depends on what questions you’re trying to answer, and the distribution of the underlying data. Quantiles usually produces more compelling maps when using the Trendable Maps feature on OASIS. Jenks is useful to highlight natural patterns in the data and outliers. In sum:
Quantiles: Showing Overall Spatial Patterns Across Areas
  • Good for showing distribution evenness or making comparisons between groups.
  • Pros: Simple, balanced categories.
  • Cons: Can place very different values in the same class if data are skewed.
Natural Breaks (Jenks): Highlighting Areas With Distinctly High or Low Values
  • Best when data has uneven distribution or natural groupings.
  • Pros: Highlights natural patterns in the data.
  • Cons: Uneven class sizes; harder to interpret or compare across maps.

Definitions:

Data Classes
Also referred to as "class breaks" or groupings of data.
Cohort
A group of people sharing a common temporal demographic experience who are observed through time. For example, the birth cohort of 1940 is the people born that year. Another example is school class cohort. In this case, Birth Cohorts are used. This means that in a given cohort year, all fetal deaths and births are accounted for. However any infant deaths that are linked to live births may have occurred in the cohort year or up to one year after. E.g. the 2014 birth cohort will include linked infant deaths that occurred in both 2014 and 2015.
Early Fetal Death
A fetal death occurring between 20 and 27 weeks of gestation.
Early Neonatal Period
The period from birth to 6 days of age.
 
Educational Level
The last grade of formal education completed. A sample calculation is Percentage of Live Births to Females with Less than High School Education - The total number of live births to females with less than a high school education, per 100 total live births. Formula = [Total Number of Live Births to Females with Less than High School Education / Total Number of Live Births] * 100. Select both Less than 9th and 9-11th grade to obtain Less than High School education.
Ethnicity
Hispanic or Latino includes persons of Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race. Non-Hispanic + Hispanic may not equal the total number of events due to persons of unknown ethnicity.
Fetal Death
Death prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such expulsion or extraction the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles
 
Feto-Infant Mortality Rate (FIMR) and Perinatal Periods of Risk (PPOR)
Feto-infant mortality rate (FIMR) is defined as the number of fetal deaths (>= 20 weeks gestation & 200+ grams) plus the number of infant deaths (200+ grams) divided by the total number of fetal deaths (>= 20 weeks gestation & 200+ grams) plus live births (200+ grams) and expressed as a rate per 1,000. Being a birth cohort measure, infant deaths are linked to live births of a given cohort year. This means that for example, the 2014 Rate of FIMR will have only 2014 Live Births and Fetal Deaths in the denominator, whereas the numerator has Infant Deaths from both 2014 and 2015 that were linked to 2014 Live Births (in addition to 2014 fetal deaths).
PPOR Examples of Suggested Causes Examples of Suggested Interventions
Women's Health Unintended Pregnancy, Poor Nutrition, No Prenatal Care, Substance Abuse/Smoking, First or 4th-or-higher birth, Untreated STD's, < 2 year birth interval. Pre-conceptual, peri-conceptual and early prenatal interventions which affect the mother's health and increase birthweight. Examples include assuring good nutritional status including folic acid intake.
Maternal Care Prenatal Care not matched to need. Prenatal, intra-partum and postpartum services which directly affect the maternal outcome by reducing excessive maternal and fetal mortality and morbidity. Assuring an appropriate match between need and content of prenatal care.
Newborn Care Group B Strep untreated. Intra-partum, early neonatal, and postpartum services which directly affect the newborn outcome by reducing excessive early neonatal mortality and morbidity. These are chiefly biomedical interventions.
Infant Care No Parenting Skills Education, No Immunizations, No breastfeeding, Injury: Falls, burns, etc, Child Abuse / neglect, No Monitoring Growth / Development. Post discharge services which directly affect the infant outcome by reducing excessive post discharge mortality and morbidity. For example, SIDS and injury prevention through health education.
PPOR Methodology
Formula
Women's Health = [Number of Feto-Infant deaths related to Women's Health / (Births 200+ grams + Fetal Deaths >= 20 weeks and 200+ grams)] * 1,000
Maternal Care = [Number of deaths occurring to fetuses related to Maternal Care / (Births 200+ grams + Fetal Deaths >= 20 weeks and 200+ grams)] * 1,000
Newborn Care = [Number of infant deaths related to Newborn Care / (Births 200+ grams + Fetal Deaths >= 20 weeks and 200+ grams)] * 1,000
Infant Care = [Number of infant deaths related to Infant Care / (Births 200+ grams + Fetal Deaths >= 20 weeks and 200+ grams)] * 1,000
Socio-Economic Status (SES) Groups
SES groups commonly used in PPOR: for each Race: 1) 20+ years of age & 13+ years of education, 2) 20+ years of age & <13 years of education, 3) <20 years of age & <13 years of education.
Late Fetal Death
A fetal death occurring on or after 28 weeks of gestation.
Late Neonatal Period
The period after birth 7 through 27 days of age.
Neonatal Period
The period from birth to 27 days of age.
Perinatal Periods of Risk (PPOR)
Fetal death and infant death rates organized by intervention strategies in order to facilitate local health planning (see feto-infant mortality rate).
Postneonatal Period
The period after birth 28 through 364 days of age.
Race
Per the Federal Office of Management and Budget, Directive 15 (1997),
  • White is a person having origins in any of the original peoples of Europe, the Middle East or North Africa;
  • Black or African-American is a person having origins in any of the black racial groups of Africa;
  • Asian is a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam;
  • American Indian/Alaska Native is a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment;
  • Native Hawaiian or Other Pacific Islander is a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands;
  • Multiracial is a person declaring 2 or more of these races.
Socioeconomic (SES) Vulnerability
Socioeconomic (SES) Vulnerability refers to the socioeconomic status domain/subset of the CDC’s Social Vulnerability Index (SVI) 2020. Socioeconomic vulnerability ranks census tracts within Georgia on 5 factors: below 150% poverty, unemployed, housing cost burden, no high school diploma, and no health insurance. Percentile ranking values range from 0 to 1, with higher values indicating greater vulnerability/lower socioeconomic status. Quintiles of the percentile rankings were used to create class breaks (Very Low, Low, Average, High and Very High SES Vulnerability). Keep in mind that “Very Low” SES Vulnerability equates to a High SES status. For more information see https://www.atsdr.cdc.gov/placeandhealth/svi/index.html. For data dictionary click here.

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