Birth outcomes of Native Americans in Massachusetts: Policy implications of using either race or ethnicity on birth certificates

APHA Scientific Session and Event Listing

3192.0: Monday, November 05, 2007 - 12:30 PM

Abstract #157179

James Kenneth West, PhD and Malena Orejuela-Hood, MPH. Center for Health Information, Statistics, Research, and Evaluation-Division of Research and Epidemiology, Massachusetts Department of Public Health, 250 Washington Street, Sixth Floor, Boston, MA 02108, 617-624-5639, James.K.West@state.ma.us

Native Americans in Massachusetts, who make up less than 1% of the population, suffer the worst health outcomes, including birth outcomes, of any race group in the state. We have found that “for most birth indicators, Native Americans had poorer outcomes than Massachusetts as a whole.” This issue must be addressed in policy and programs. The first step in developing successful policies and programs is understanding the demographics of the target population. For example, how many births, fetal deaths, and infant deaths are there each year. There are many reasons why counting is not straightforward. The Massachusetts birth certificate contains information that may yield insight. The parent worksheet, which is used to fill out the birth certificate, gives “American Indian” as a race category, and “Native American” as an ethnicity category. Further, when a mother indicates that her ethnicity is Native American, she is asked for her tribal affiliation. We have found that birth outcomes vary by whether mothers choose American Indian as a race and/or Native American as ethnicity. Mothers who chose “Native American” as their ethnicity and not their race, generally had the worst outcomes [of the three possibilities: American Indian by race only; Native American by ethnicity only; or both]. We will explore the meaning of the different choices, and we will examine how tribal affiliation interacts with these choices in birth outcomes. With this information, we can begin to explore how policies and programs can be designed to improve birth outcomes.

Learning Objectives:

Name two reasons why birth indicators for Native Americans are not routinely reported in Massachusetts annual birth reports.
Discuss how tribal affiliation impacts birth outcomes in Massachusetts.
List three policies that could address poor birth outcomes among Native Americans.
Evaluate birth outcomes for sub-groups among Native Americans.
Name three factors that possibly contribute to poor birth outcomes for Native Americans.

Keywords: Native Americans, Birth Outcomes

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Maternal Child Health

The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA