 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
|
| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Kristen S. Marchi, MPH1, Paula Braveman, MD, MPH2, Catherine Cubbin, PhD1, and Susan Egerter, PhD1. (1) Department of Family and Community Medicine, University of California, San Francisco, 500 Parnassus Avenue, MU-3 East, Box 0900, San Francisco, CA 94143-0900, (415) 476-6620, kmarchi@itsa.ucsf.edu, (2) Family and Community Medicine, University of California, San Francisco, 500 Parnassus Avenue, MU-3 East, Box 0900, San Francisco, CA 94143
Background: Healthy People 2010 goals include eliminating health disparities, including large gaps in maternal and infant health and health care. There is widespread recognition that closing these gaps will require more effective strategies, including ongoing monitoring to assess the impact of policies and programs on disparities and to guide formulation and implementation of new policies. Apart from racial/ethnic breakdowns of vital statistics, however, routine monitoring of social disparities has generally been limited. This study is part of a multi-stage effort to develop methods for ongoing monitoring of disparities in maternal and child health. The first stage used California data to develop a template for state-level monitoring of socioeconomic and racial/ethnic disparities in selected maternal and infant health indicators. The next stage involves testing that approach’s relevance and feasibility in several other states. Methods: We will use 1997 and 1998 data from CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS) from seven geographically diverse states (Arkansas, Colorado, Florida, Illinois, New York State (excluding NYC), South Carolina, and Washington State) to replicate the methods developed in California. PRAMS is an ongoing population-based mail/telephone survey of postpartum women (annual n per state for our analyses: 1,500- 3,200 births). Socioeconomic measures include income, and maternal and paternal education and occupation. We will describe socioeconomic and racial/ethnic disparities in unintended childbearing, delayed prenatal care, and non-initiation of breastfeeding in each of the seven states, using rates, rate differences, and relative risks to examine socioeconomic and racial/ethnic disparities, and also examining summary measures of socioeconomic disparities. We will consult experts in each state to (a) determine if and how the findings can be useful to guide policy and (b) make recommendations about routine, policy-oriented monitoring over time. Anticipated challenges in some states include insufficient subgroup numbers and limitations in measurement of some socioeconomic measures. Implications: This study will test the relevance and feasibility of methods developed in California and demonstrate how PRAMS (now covering 32 states) could be used for ongoing monitoring of socioeconomic and racial/ethnic disparities in maternal and infant health in ways that are useful to guide policy to reduce disparities.
Learning Objectives:
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.