The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

3309.0: Monday, November 17, 2003 - 3:35 PM

Abstract #63378

Racial disparities in the use of pregnancy-related medical care among Medicaid women

Norma I. Gavin, PhD1, E. Kathleen Adams, PhD2, Nancy D. Berkman, PhD1, and M. Beth Benedict, DrPH, JD3. (1) Health, Social and Economics Research, Research Triangle Institute, P.O. Box 12194, Research Triangle Park, NC 27709, 919 541-7384,, (2) Rollins School of Public Health, Emory University, 1518 Clifton Road, N.E., Atlanta, GA 30322, (3) Office of Research, Development, and Information, Centers for Medicare and Medicaid Services, 7500 Security Blvd., Mail Stop: c3-19-07, Baltimore, MD 21244-1850

We investigated demographic, Medicaid enrollment and medical risk factors associated with racial disparities in health service use during pregnancy among women with Medicaid-covered deliveries in four racially diverse states. Multivariate regression techniques were used with Medicaid claims and enrollment data supplemented with data from birth certificates and the Area Resource File. The study included 52,336 women in Florida and 32,455 women in New Jersey delivering in FY95; 51,247 women in Georgia delivering in CY95; and 81,859 women in Texas delivering in CY97. Significant unexplained disparities in health service use were found for black, Hispanic, and Asian-Pacific Islander women compared to white women. Women of all minority groups had fewer regular prenatal services, and black women had more emergency room visits. The determinants of care were generally the same for all racial/ethnic groups although the magnitude of the associations differed significantly by race/ethnicity for several factors. The positive association of longer Medicaid enrollment was significantly lower for black and Hispanic women compared to white women. For black women, college experience had a greater positive association with whether the women received early and adequate prenatal care and any prenatal multiple vitamins prescriptions. The results suggest that elimination of barriers to early enrollment is not sufficient to eliminate the racial disparities in regular pregnancy-related care. Targeted outreach and education on the value of early and adequate prenatal care also need to be provided for low-income minority women of child-bearing ages.

Learning Objectives:

Keywords: Prenatal Care, Minority Health

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.

Population Practice: The Common Thread

The 131st Annual Meeting (November 15-19, 2003) of APHA