Birth outcomes and policy implications: An analysis of New York State counties

The purpose of this study is to assess differences among alternative measures of birth outcomes for their relevance in policy formulation, implementation, and evaluation. From 2004-2006 in New York State (NYS), 60 out of 1,000 females ages 15-44 gave birth. Five percent of these women received either late or no prenatal care. Eight percent of the infants of women who received late or no prenatal care were low birth weight (LBW), defined as weighing less than 2500 grams. In 2001, the mean hospital charge per infant born extremely prematurely was $239,749 compared with $4,788 for a term infant. Furthermore, the annual burden for preterm birth (before 37 weeks) cost an average of $51,600 per infant, totaling at least $26.2 billion for the United States as a whole. Therefore, finding the most appropriate and efficient interventions for the prevention of poor birth outcomes has, not only humanitarian, but also significant economic implications. Using a secondary data set at the county level, the analyses will tease out differences among LBW, very low birth weight (VLBW), and LBW, but not VLBW in NYS counties. Initial findings indicate that the creation of the LBW, but not VLBW weight category helped identify a set of predictors that led to unique recommendations different from the other weight categories. These analyses will aid public health nurses in the academic community, and hospital settings as they make policy and program recommendations for at-risk populations.