Original ArticlesA Descriptive and Geospatial Analysis of Environmental Factors Attributing to Sudden Unexpected Infant DeathDrake, Stacy A. PhD, MPH, RN*; Wolf, Dwayne A. MD, PhD†; Yang, Yijiong BM, MHA*; Harper, Sherhonda PhD, MHA, RN‡; Ross, Jennifer MD†; Reynolds, Thomas PhD§; Giardino, Eileen R. PhD, FNP-BC, RN*Author Information From the *The University of Texas Health Science Center at Houston, Cizik School of Nursing; †Harris County Institute of Forensic Sciences, Houston, TX; ‡Hurricane Harvey Recovery Director, Americares, Stamford, CT; §The University of Texas Health Science Center at Houston School of Public Health, Houston, TX. Manuscript received September 19, 2018; accepted November 3, 2018. The study was in part supported by a grant from Partners, The University of Texas Health Science Center at Houston Cizik School of Nursing. The authors report no conflict of interest. Reprints: Stacy A. Drake, PhD, MPH, RN, The University of Texas Health Science Center at Houston, 6901 Bertner Ave, #593, Houston, TX 77030. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: June 2019 - Volume 40 - Issue 2 - p 108-116 doi: 10.1097/PAF.0000000000000455 Buy Metrics Abstract This study examined medicolegal death investigation records and autopsy reports of a medical examiner's office to identify the circumstances surrounding sudden unexpected infant deaths (SUID) and geospatial analyses to pinpoint areas of infant death concentration. Analysis of 732 records of SUID deaths occurring in a 10-year span resulted in the conclusion that environmental factors associated with the sudden death were to some extent modifiable. Co-sleeping (sharing a sleeping surface, or bed-sharing) on various surfaces (mattress, pallet, couch) occurred in 53.4% of the infant deaths. Geographic areas where the largest number of deaths occurred were characterized as areas of high poverty level. The inclusion of additional information at the time of investigation (eg, alcohol and tobacco use of co-sleepers, illness of others in household, exceptions to normal sleep routine of infant) may aid in identifying modifiable circumstances to reduce infant mortality attributable to sudden infant death. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.