Disparities in Infant Health Among American Indians and Alaska Natives in US Metropolitan Areas.
Authors: Grossman DC., Baldwin LM., Casey S., Nixon B, Hollow W, Hart LG
Publication Year: 2002
Last Updated: 2016-02-08 13:03:33
Keywords: health disparities, disparities, pediatrics, youth, young, healthcare, infant health, infant, american indian, alaska native, ai/an, metropolis, urban health
Objective: To determine geographic variation in urban American Indian & Alaska Native (AI/AN) rates of infant mortality, low birth weight, prenatal care use, and maternal-child health care service availability.
Objective: To determine geographic variation in urban American Indian and Alaska Native (AI/AN) rates of infant mortality, low birth rate,
Methods: This was a retrospective cohort study using data from the 1989 to 1991 birth-death linked database from the National Center for Health Statistics. We examined births from the metropolitan areas with a minimum of 300 AI/AN births during the study period. Key outcomes of interest included rates of low birth weight, neonatal mortality, postneonatal mortality, and women receiving inadequate prenatal care using the modified Kessner index. To determine the type of health services tailored to AI/AN mothers residing in these urban areas, we conducted a telephone survey of the 36 urban Indian health programs operating in 1997 using a semi structured survey. Items in the survey included questions about the availability of prenatal and infant health care.
Results: During the 1989 to 1991 study period, there were 72,730 singleton births to AI/AN mothers and/or fathers residing in urban areas, representing 49% of all AI/AN births in the United States. Overall 14.4% of urban AI/AN births were to women who received inadequate care during pregnancy, 5.7% of pregnancies resulted in low birth weight infants, and 11.0 infants died per 1000 live births. Death rates for the neonatal period (5.5 per 1000 births) and postneonatal period (5.4 per 1000 births) were similar. Marked disparity in these indicators exist between pregnancies to AI/AN and white women. Among the 54 metropolitan areas, 46 had a rate ratio (AI/AN: white) for inadequate care of ?1.5 (range 0.9-8.5). The mean rate ratios for neonatal and postneonatal mortality were 1.6 (range 0.3-4.0) and 2.0 (0.5-5.5). There was also
Conclusions: Considerable variation also exists among rates of AI/ANs between metropolitan areas.
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