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APHA Scientific Session and Event Listing

Recorded presentation

Marianne M. Hillemeier, PhD, MPH¹, Carol S. Weisman, PhD², Gary A. Chase, PhD², Cynthia H. Chuang, MD³, and Sara A. Baker, MSW². (1) Health Policy and Administration, The Pennsylvania State University, 116 Henderson, University Park, PA 16802, 814-863-0873, mmh18@psu.edu, (2) Department of Health Evaluation Sciences, Pennsylvania State College of Medicine, 600 Centerview Drive, A210, Hershey, PA 17033, (3) General Internal Medicine, Pennsylvania State College of Medicine, 500 University Drive, UPC-1 Suite 300, Hershey, PA 17033

This study investigates how preconceptional health is associated with health care use. METHODS: RDD survey of 2,002 Central Pennsylvania women ages 18-45. The survey assessed health status, health risks, pregnancy history, health care access/use, and sociodemographics. Health measures included chronic conditions, infections, mental health, health behaviors, and psychosocial stress. Health care use measures included having a regular physical examination in the past year, seeing an OB/GYN in the past two years, and talking to a health care professional in the past year about planning for pregnancy. RESULTS: In factor analyses, health status and health risk variables clustered in five factors: cardiovascular risks (hypertension, high cholesterol, diabetes, obesity); biopsychosocial components of stress; substance use (tobacco, drugs, alcohol); safety and hygiene (intimate partner violence and douching); and healthy behaviors (physical activity, fruit/vegetable consumption). Scale scores created from these factors varied significantly by sociodemographics, reproductive life stage (preconceptional versus interconceptional), and health insurance status. Multiple logistic regression analyses show that cardiovascular risks and healthy behaviors increase the likelihood of receiving a regular exam, and cardiovascular risks decrease the likelihood of seeing an obstetrician-gynecologist. Age, reproductive stage, and health insurance also predicted utilization. CONCLUSIONS: The health care needs of preconceptional women are diverse and vary by sociodemographic variables. Among health status indicators, only cardiovascular risks and healthy behaviors are associated with health care use, controlling for sociodemographics and health insurance. No health variables predicted receiving counseling on pregnancy planning. Preconceptional women with specific health care needs may not be receiving appropriate health care.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Identify five clusters of health status and health risk variables relevent to preconceptional health and risk of adverse birth outcome
• Describe variation in health status and health risk by socioeconomic status, reproductive life stage, and health insurance status.
• Discuss the relationship between health risks and health care use.

Keywords: Reproductive Health, Pregnancy Outcomes

Related Web page: www.womenshealthcoe.psu.edu/cepawhs.htm

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation