The 130th Annual Meeting of APHA

Abstract #38390

Ingrid Morton Mitchell, MS¹, Markos Ezra, PhD¹, and Lakota K. Kruse, MD, MPH². (1) Maternal and Child Health Epidemiology, New Jersey Department of Health and Senior Services, P.O. 364, Trenton, NJ 08625-0364, 609 292-5656, Ingrid.Morton-Mitchell@doh.state.nj.us, (2) Division of Family Health Services, New Jersey Department of Health and Senior Services, P O Box 364, Trenton, NJ 08625

Background: Before August 1997, pregnant immigrant mothers could take advantage of publicly funded health centers to meet many of their health care needs. The reform in Medicaid policies excluded coverage to the undocumented pregnant mother by increasing adherence to rules regarding the provision of non-emergent public health care services. Since data on documentation status of immigrant mothers is unavailable, this paper will examine Foreign-born uninsured immigrant mothers as the closest available proxy of the undocumented mother to determine if changes in health care use and birth outcomes occurred after the reform in policies. Methods: The New Jersey Birth Certificate, Electronic Birth Certificate, Hospital Discharge, Death Certificate and Medicaid Eligibility files from 1996 to 1999 were linked to create the data source. Mothers who reported a birthplace outside of the United States were included. Prenatal care source, utilization and birth outcomes were examined by year and month to determine whether changes occurred after the reform in Medicaid policies. Results: Variables used as proxies to represent undocumented mothers produced counts similar to those previously estimated in New Jersey. Variations in prenatal care source were found in uninsured immigrant mothers and the number of uninsured immigrant mothers decreased after the reform in policies. Additionally, moderate elevations in the use of early prenatal care were observed. Conclusion: The information obtained lays the foundation for developing surveillance systems aimed at monitoring uninsured immigrant mothers. Improving the accuracy of data collection in the identification of insurance, place of birth and payer type would improve the ability to track and monitor health care use and birth outcomes to this group.

Learning Objectives:

• Identify combinations of variables that can be used as a proxy for the undocumented immigrant mother.
• Describe a procedure for tracking uninsured immigrant mothers birth outcomes.
• Develop a template that states can use to identify uninsured immigrant mothers. 4.Develop a surveillance system to monitor uninsured immigrant mother's birth outcomes.

Keywords: Maternal and Child Health, Immigrant Women

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.