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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Curt Bay, PhD1, Dean Coonrod, MD, MPH2, Hector Balcazar, PhD3, Patricia A Moore, DrPH, RN4, Robert Russ, BS1, Jane Brady, RN, MS2, and Christine M Lopopolo, MD5. (1) Department of Academic Affairs, Maricopa Medical Center, 2601 East Roosevelt, Phoenix, AZ 85008, 604-344-5366, curt.bay@hcs.maricopa.gov, (2) Department of OB-GYN, Maricopa Medical Center, 2601 East Roosevelt, Phoenix, AZ 85008, (3) Department of Social and Behavioral Sciences, University of North Texas School of Public Health, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, (4) College of Nursing, Arizona State University, Arizona State University, Tempe, AZ 85287, (5) Phoenix Integrated Residency in Obstetrics and Gynecology, 2601 E Roosevelt, Phoenix, AZ 85008
Introduction: Federal welfare reform, enacted in August, 1996, mandated that prenatal care would no longer be provided to undocumented immigrants. The law was implemented in Arizona in July, 1997. It was hypothesized that the resulting decrease in prenatal care would lead to poorer neonatal outcome (enrollment in a neonatal intensive care program-NICP). Using the NICP database for 1994-999, we linked Arizona birth certificate data for White non-Hispanic, US-born Mexican-American, and Mexico-born Mexican-American mothers. Only singleton births were included. A dichotomous index of prenatal care (PNC) was calculated from birth certificate data, using the Adequacy of Prenatal Care Utilization Index: inadequate PNC vs intermediate, adequate, or adequate plus PNC. Neonatal outcome was operationalized by enrollment in the NICP. A mediational analysis was planned to test the impact of welfare reform on PNC, and, in turn, on neonatal outcome. A substantial increase was noted in the proportion of babies of Mexico-born Mexican-American mothers enrolled in NICP during the 18 months following implementation of welfare reform; however this group also experienced a slight improvement in PNC during the same period. This anomalous finding obviated the planned mediational analysis. However, two other recently published studies also have reported no decline in use of PNC by foreign-born mothers following welfare reform in California, New York City, and Texas. Possible reasons for no decline in PNC among mothers for whom funding for PNC was precluded by welfare reform are discussed.
Learning Objectives:
Keywords: Welfare Reform, Health Care Access
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Neonatal Intensive Care Program, Arizona Department of Health Services
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.