Name of Report: Issue Brief: Healthy Mothers, Healthy Infants: Reducing Racial and Ethnic Disparities
Organizational Affiliation: Rhode Island KIDS COUNT
Author: N/A
Contact Information: Rhode Island KIDS COUNT, One Union Station, Providence , RI 02903, 401-351-9400 (telephone), rikids@rikidscount.org (e-mail)
www.rikidscount.org (website)
Date: January 2003
Pages: 12
Content Summary
This report summarizes the racial disparities in maternal and infant health in Rhode Island . It analyzes the trend of inferior health outcomes experienced by racial minorities. The report explores the role of RIte Care in improving access to and adequacy of prenatal care. It also explores the role of pre-conception intervention as a method for improving birth outcomes for all women. The report also addresses prenatal health, infant health, and at-risk-infants. It describes the Women's Health Screening and Referral Program (WHSRP). In addition, the rates of teen pregnancy and births to teenage mothers are examined. The report contains several graphs and charts that show the rates of disparate health outcomes. This report also includes several boxes that give the reader additional information regarding related issues including unintended pregnancies, the definition of cultural competence, and the universal newborn risk screening program. The report is effective at outlining the barriers and potential methods for improving the care provided to women of childbearing age and infants.
Major Findings
Research indicates that behavioral factors, cultural factors, physiological factors, system/provider bias or lack of cultural competence all contribute to the racial disparities in birth outcomes. The report describes how RIte Care has improved the adequacy of prenatal care provided for enrollees. In addition, it shows how RIte Care addressed the systemic barriers to health care access for pregnant women. The report also describes a variety of risk factors that affect pregnant women in Rhode Island , including: not taking folic acid prior to pregnancy, HIV, domestic violence, and the inability to meet basic needs. Rhode Island data indicates that young women and Black women are least likely to use folic acid prior to pregnancy. Folic acid is known to prevent birth defects. In addition, 41% of Hispanic women report food insecurity. White women are almost twice as likely as racial minority women to receive adequate prenatal care in Rhode Island , and Black and Native American women have the highest rates of low birthweight infants. In addition, Black women have the lowest rates of breastfeeding. Research indicates that policies that encourage breastfeeding,include: paid maternity leave, on-site workplace child care and opportunities during the work day to breastfeed or express milk. This report also shows that Black teens are the most likely to become pregnant and that Hispanic teens are the most likely to give birth. The report discusses factors that impact on or are correlated with disparate health access and outcomes, including: poverty, the high cost of housing in Rhode Island , the concentration of minorities in core urban areas, high teen drop out rates and inadequate access to publicly funded contraception for teens. The report concludes with five broad suggestions for reducing the racial disparities in maternal and infant health, including: "focus on high-poverty communities," "sustain and expand investments in income supports for low-income families," "focus on family support and infant development," "focus on access and cultural competence," and "focus on teens." Each of these areas includes more specific recommendations for improvement. Each is significant in addressing the racial differences in care provided by the health care system.
Related Issues
There may be larger systemic and educational barriers that result in reduced access to health care for minority women. A 2003 study addressed the role of insufficient health literacy and the inadequate means through which women of color are provided information related to their pregnancy (Anachebe S41). In addition, other studies have found that while poverty is a major cause for racial disparities there are other social forces that cause the racial disparities in birth outcomes. One study found that there appears to be the largest disparity among women who appear to be at lowest risk (Saftlas 418). Also, another study found that it is important to analyze this epidemiological paradox in which women of color with high socioeconomic status still experience poor birthing outcomes (Gould e681).