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. 2009 Apr;99(4):638-46.
doi: 10.2105/AJPH.2007.119735. Epub 2008 Aug 13.

Trends in perinatal and infant health disparities between rural American Indians and Alaska natives and rural Whites

Laura-Mae Baldwin  1 , David C Grossman, Elise Murowchick, Eric H Larson, Walter B Hollow, Jonathan R Sugarman, William L Freeman, L Gary Hart
Affiliations

Trends in perinatal and infant health disparities between rural American Indians and Alaska natives and rural Whites

Laura-Mae Baldwin et al. Am J Public Health. 2009 Apr.

Abstract

Objectives: We examined disparities in perinatal care, birth outcomes, and infant health between rural American Indian and Alaska Native (AIAN) persons and rural Whites over time.

Methods: We compared perinatal and infant health measures for 217 064 rural AIAN births and 5 032 533 rural non-Hispanic White births.

Results: Among American Indians and Alaska Natives, unadjusted rates of inadequate prenatal care (1985-1987, 36.3%; 1995-1997, 26.3%) and postneonatal death (1985-1987, 7.1 per 1000; 1995-1997, 4.8 per 1000) improved significantly. However, disparities between American Indians and Alaska Natives and Whites in adjusted odds ratios (AORs) of postneonatal death (1985-1987, AOR = 1.55; 95% confidence interval [CI] = 1.41, 1.71; 1995-1997, AOR = 1.46; 95% CI = 1.31, 1.64) and adjusted risk ratios (ARRs) of inadequate prenatal care (1985-1987, ARR = 1.67; 95% CI = 1.65, 1.69; 1995-1997, ARR = 1.84; 95% CI = 1.81, 1.87) persisted.

Conclusions: Despite significant decreases in inadequate prenatal care and postneonatal death among American Indians and Alaska Natives, additional measures are needed to close persistent health gaps for this group.

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Figures

FIGURE 1
FIGURE 1
Comparison of rates for rural American Indians and Alaska Natives and rural Whites for (a) inadequate pattern of prenatal care, (b) first-trimester prenatal care, (c) low-birthweight, (d) infant death, (e) neonatal death, and (f) postneonatal death: National Linked Birth and Infant Death Data, 1985–1987, 1989–1991, and 1995–1997. Note. See Table 2 for exact percentages and confidence intervals (represented here by vertical lines). A number of confidence intervals are too narrow to be visible on this figure.
See this image and copyright information in PMC

References

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