A comparison of low birth weight outcomes among Medicaid and non-Medicaid funded births in Minnesota

Low birth weight (LBW) and preterm birth rates are rising both in the U.S. and in Minnesota. Racial disparities in these rates are persistent and contribute to Minnesota's infant mortality rate. This study compares differing rates of LBW in Medicaid and non-Medicaid populations in Minnesota and associations with sociodemographic and pregnancy-related factors. A secondary data analysis was conducted on vital statistics data from the Center for Health Statistics at the Minnesota Department of Health linked with enrollment data from the Department of Human Services (DHS) for calendar years 1997 through 2003. Birth records contain demographic data such as race/ethnicity, mother's age, birthweight and gestation. Health Care claims data or Medicaid data includes race/ethnicity and some pregnancy risk factors. Birth records were matched with Medicaid eligibility files provided by DHS in an iterative linking process. Comparisons in birth weight outcomes and various maternal characteristics between populations were made to identify differences. Results indicate a rise in the LBW rates for both Medicaid and non-Medicaid populations and a higher overall LBW rate for Medicaid than non-Medicaid. Race-specific rates demonstrated that White LBW rates were higher in Medicaid than in non-Medicaid, but for all other races, Medicaid-financed births had rates of LBW that were either nearly equal to or lower than non-Medicaid rates. Discussion will explore why Medicaid is apparently effective in covering non-White births, a closer look at social factors among non-Medicaid births, and the policy implications of these findings for Maternal and Child Health programs.