Minority Health and Health Equity Archive
Permanent URI for this collectionhttp://hdl.handle.net/1903/21769
Welcome to the Minority Health and Health Equity Archive (MHHEA), an electronic archive for digital resource materials in the fields of minority health and health disparities research and policy. It is offered as a no-charge resource to the public, academic scholars and health science researchers interested in the elimination of racial and ethnic health disparities.
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Item Disparities in Infant Health Among American Indians and Alaska Natives in US Metropolitan Areas(2002) Grossman, D. C.; Baldwin, L.-M.; Casey, S.; Nixon, B.; Hollow, W.; Hart, L. G.Abstract available at publisher's website.Item Risk Factors for Low Birth Weight Infants of Hispanic, African American, and White Women in Bexar County, Texas(2008) Tierney-Gumaer, Rosalie; Reifsnider, ElizabethOBJECTIVES: The aim of this study was to compare the risk factors in women who delivered an infant of low birth weight (LBW, <2,500 g) versus women who delivered an infant weighing >2,500 g in a large metropolitan county (Bexar) in South Texas. DESIGN: An exploratory case comparison design was used to identify factors related to LBW outcomes in women receiving prenatal care. SAMPLE: The cases were obtained from community hospitals. A stratified random sample was selected from a population of 38,064 infant births, of which 2,910 were identified as LBW. The final sample size was N=321 (<2,500 g, n=151; >or=2,500 g, n=170). MEASUREMENTS: Dependent variable of infant birth weight; independent variables of maternal age, maternal race/ethnicity, education, smoking, prior pregnancy history, timing of and number of prenatal visits, prepregnancy body mass index and weight gain during pregnancy, and past medical history and medical problems during pregnancy. RESULTS: Independent variables found to be predictive of LBW in this study included maternal race/ethnicity, timing of first prenatal visit, number of prenatal visits, prior pregnancy history, and maternal weight gain. CONCLUSIONS: This study confirmed previous findings that African American women are at a higher risk for LBW deliveries and demonstrated that Anglo and Hispanic women have similar rates of LBW deliveries.Item Racial Disparities in Medicaid Enrollment and Prenatal Care Initiation Among Pregnant Teens in Florida(2008) Kuo, Tzy-Mey; Gavin, Norma I.; Adams, E Kathleen; Ayadi, M FemiBACKGROUND: Teens and racial and ethnic minority women are less likely to initiate prenatal care (PNC) in the first trimester of pregnancy than their counterparts. OBJECTIVE: This study examines the impact of Medicaid program changes in the late 1990s on the timing of Medicaid enrollment and PNC initiation among pregnant teens by race and ethnicity. RESEARCH DESIGN: Using Medicaid enrollment and claims data and a difference-in-differences method, we examine how the patterns of prepregnancy Medicaid enrollment, PNC initiation, and racial and ethnic disparities in PNC changed over time after controlling for person- and county-level characteristics. SUBJECTS: We included 14,089 teens in Florida with a Medicaid-covered delivery in fiscal years 1995 and 2001. MEASURES: Prepregnancy enrollment was defined as enrollment 9 or more months before delivery; late or no PNC was defined as initiation of PNC within 3 months of delivery or not at all. RESULTS: For teens enrolled in traditional welfare-related categories, the proportion with prepregnancy Medicaid enrollment increased and the proportion with late or no PNC declined from 1995 to 2001. Teens enrolled under the Omnibus Budget Reconciliation Act (OBRA) expansion category in 2001 were less likely than welfare-related teen enrollees to have prepregnancy coverage but were more likely to initiate PNC early. Racial disparities were found in PNC initiation among the 1995 welfare-related group and the 2001 expansion group but were eliminated or greatly reduced among the 2001 welfare-related group. CONCLUSIONS: Providing public insurance coverage improves access to care but is not sufficient to meet Healthy People 2010 goals or eliminate racial and ethnic disparities in PNC initiation.Item Acculturation and Cigarette Smoking Among Pregnant Hispanic Women Residing in the United States(2007) Detjen, M. Gabrielle; Nieto, F. Javier; Trentham-Dietz, Amy; Fleming, Michael; Chasan-Taber, LisaObjectives. We explored whether higher levels of acculturation were associated with higher rates of cigarette smoking among pregnant Hispanic women residing in the United States. Methods. We evaluated data from the Latina Gestational Diabetes Mellitus Study, a prospective study of 1231 Hispanic prenatal care patients conducted from 2000 to 2004 in Massachusetts. Self-reported data on acculturation, cigarette smoking, and covariates were collected by bilingual interviewers using a questionnaire. We conducted logistic regression multivariate analyses to examine the impact of acculturation level on the odds of smoking. Results. Overall, 21% of women reported smoking during pregnancy. Acculturation was associated with elevated smoking rates in pregnant Hispanic women. US-born Hispanic women who preferred English had more than twice the odds of smoking compared with Puerto Rican or foreign-born Hispanic women who preferred Spanish (odds ratio [OR]=2.76, 95% confidence interval [CI] 1.36, 5.63). Conclusions. Our findings suggest that higher-acculturated Hispanic women living in the United States are more likely to smoke cigarettes during pregnancy than are less-acculturated Hispanic women. These results will inform interventions aimed at reducing cigarette smoking during pregnancy among US Hispanic women.Item An Approach to Studying Social Disparities in Health and Health Care(2004) Braveman, Paula A.; Egerter, Susan A.; Cubbin, Catherine; Marchi, Kristen S.Objective. We explored methods and potential applications of a systematic approach to studying and monitoring social disparities in health and health care. Methods. Using delayed or no prenatal care as an example indicator, we (1) categorized women into groups with different levels of underlying social advantage; (2) described and graphically displayed rates of the indicator and relativegroup size for each social group; (3) identified and measured disparities, calculating relative risks and rate differences to compare each group with its a priori most-advantaged counterpart; (4) examined changes in rates and disparities over time; and (5) conducted multivariate analyses for the overall sample and “atrisk” groups to identify particular factors warranting attention. Results. We identified at-risk groups and relevant factors and suggest ways to direct efforts for reducing prenatal care disparities. Conclusions. This systematic approach should be useful for studying and monitoring disparities in other indicators of health and health care.Item Racial Differences in Prenatal Care Use in the United States: Are Disparities Decreasing?(2002) Alexander, Greg R.; Kogan, Michael D.; Nabukera, SaraObjectives. We examined trends and racial disparities (White, African American) in trimester of prenatal care initiation and adequacy of prenatal care utilization for US women and specific high-risk subgroups, e.g., unmarried, young, or less-educated mothers. Methods. Data from 1981–1998 US natality files on singleton live births to US resident mothers were examined. Results. Overall, early and adequate use of care improved for both racial groups, and racial disparities in prenatal care use have been markedly reduced, except for some young mothers. Conclusions. While improvements are evident, it is doubtful that the Healthy People 2000 objective for prenatal care will soon be attained for African Americans or Whites. Further efforts are needed to understand influences on and to address barriers to prenatal care.