Background: Although nativity and birth outcomes have been studied extensively, little attention has been given to nativity and health insurance coverage in relation to birth outcomes. This paper compares mother's characteristics and birth outcomes across health insurance categories for foreign and US-born mothers in New Jersey.
Methods: The 1997-98 birth certificate, hospital discharge, Medicaid and death certificate data was matched probabilistically using AUTOMATCH software. Health insurance status was classified into Medicaid, non-Medicaid insured and no insurance.
Abstract text: Births to foreign-born mothers increased by 16 fold between 1989 and 1998. Births to foreign-born constituted 24% of all births in 1997-98, yet 40% of the uninsured were foreign-born. Compared to US-born, foreign-born mothers were more likely to be married, non-Whites, Hispanic and to have self reported cigarettes, alcohol and substance use. Births to foreign-born mothers have lower rates of low and very low birthweight, preterm delivery, neonatal intensive care unit admissions, no prenatal care and infant mortality than US-born in each insurance category including the uninsured. Multivariate logistic regression confirms the favorable birth outcomes for foreign-born in each insurance category after controlling for cofounders such as mother's socio-economic, demographic, reproductive, prenatal care, medical risk and behavioral factors.
Conclusion: Differences in birth outcomes between foreign and US-born mothers can not be explained by traditionally measured risk factors. Selective migration and cultural practices may offer further clues as protective functions against poor birth outcomes.
Learning Objectives: At the conclusion of this session the participants will be able to: 1. Describe maternal characteristics and birth outcomes by nativity and health insurance. 2. Describe the relationship between birth outcomes and nativity across insurance categories. 3. Understand the role of unmeasured risk factors in explaining birth outcomes.
Keywords: Health Insurance, Birth Outcomes
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
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.