336467
Social determinants of health and disparities in prenatal care during the Great Recession in Washington and Florida
Methods: Data from 678,235 birth certificates were linked to local community (county/local health jurisdiction) and state characteristic data to carry out cross-sectional pooled time series analyses. Predictors of late or no entry to PNC (late/no PNC) among pregnant women in the states of Washington and Florida were identified and compared. A simulated triadic relationship among time (within recession-related periods), social characteristics, and PNC by clustering individual predictors into three scenarios representing low, average, and high degrees of social disadvantage was also explored.
Results: Individual and community indicators of need (e.g., maternal Medicaid enrollment, unemployment rate) increased during the Recession. Associations between late/no PNC and individual-level characteristics (including disparate associations among race/ethnicity groups) did not shift greatly. In contrast, maternal WIC enrollment exhibited a protective association against late/no PNC.
Conclusions: Our findings provide a compelling picture of the important roles that individual characteristics—particularly low education and young age—play in late/no PNC among pregnant women. Simulated scenarios show a high combined impact on PNC among women who have multiple disadvantages. Finally, WIC may have played a valuable role in reducing late/no PNC, and its effectiveness during the Great Recession should be further explored.
Learning Areas:
Provision of health care to the publicPublic health or related nursing
Public health or related research
Learning Objectives:
Compare roles that individual characteristics played in late or non-initiation of prenatal care (PNC) among pregnant women during the Great Recession.
Describe combined impacts on initiation of prenatal care among women with multiple disadvantages.
Keyword(s): Maternal and Child Health, Prenatal Care
Qualified on the content I am responsible for because: I recently completed my PhD and carried out this research for my dissertation. During my PhD I completed extensive coursework in research methods and statistics as well as study of maternal child health epidemiology and approaches to data visualization. My dissertation research was funded by NIH-funded Multidisciplinary Predoctoral Clinical Research Training Program (TL1) Trainee and I was mentored by active practice-based public health services and systems researchers.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.