Organizational Affiliation: The George Washington University Medical Center; Center for Health Services Research and Policy and the National Association of Community Health Centers
Author: Samara Viner-Brown
Date: 2002
Contact Information: Samara Viner-Brown Chief Data and Evaluation Division of Family Health 3 Capitol Hill Room 302 Providence, RI 02908
Pages: 123
Content Summary
This report is organized around several major priorities. The issues related to each priority are organized with analyses of trends in Rhode Island from 1999 to 2004. Each issue is also accompanied by charts and graphs to further illustrate the trends.
The first priority is reducing and managing pregnancy risks. The related issues include family planning/birth control, identification of risks among women receiving pregnancy tests, pregnancies/births/ fertility rates, prenatal care, tobacco use during pregnancy, and cesarean section deliveries. The report also analyzes issues related to infants including infant mortality, low birth weight, and multiple gestation birth.
The second priority is to provide education, support and environmental risk reduction to families. This priority addresses breastfeeding, lead poisoning, hospitalizations among children, and asthma. The third priority is to assure the health, safety and optimal development of children in child care which is addressed by child care and immunization. The fourth priority is to improve the nutritional status of children which is addressed by children in the WIC program, food security, school breakfast, and oral health.
The fifth priority is to improve the health, safety and optimal development of adolescents including areas such as homeless children, children and domestic violence, child abuse and neglect, child injuries, children’s mental health, and child deaths.
The sixth, seventh, and eighth priorities are to improve the health, safety and optimal development of adolescents, reduce and manage pregnancy risks, and to strengthen partnership between school, neighborhood, and home. The issues related to these priorities are school-based health, teen family planning/averted pregnancies, teen pregnancy, teen risk behaviors, sexually transmitted disease, homeless youth, school attendance/suspensions, mobility, high school graduation, teens not in school and not working, juveniles referred to family court, teen deaths, children with special health care needs, genetic counseling, prevention of birth defects, congenital anomalies, and children with disabilities.
Major Findings
One of the major findings of this report is that Blacks have the lowest rate of prenatal care (79.9%) while Whites have the highest (91.1%). From 1997 to 2001 the rate of entry improved among all racial minorities except Native Americans. In addition, smoking in general during pregnancy has decreased among all racial and ethnic groups except Asians. However, Asians (5.4%) and Hispanics (5.1%) have the lowest rates of maternal smoking while Blacks have the highest rate (14.8%).
In 2002 the Black rate of infant death was 16.7 which was roughly 2.8 times the 5.9 rate among Whites. Blacks have consistently had the highest low birth weight rates (11.8%) while the lowest rates were seen among Asians (1.1%).
Whites and Hispanic/Latinos have the highest breastfeeding rates while Blacks and Asians have the lowest rates. In addition, Hispanics were less likely than Whites to have completed the appropriate childhood vaccination series. The highest rates of lead poisoning 15.5% were found among Blacks. Similarly asthma hospitalization was highest among Blacks (3.4%) was roughly three times the rate for Whites (1.1%).
Both Hispanic/Latino and Black teens had consistently higher rates of pregnancy compared to White teens. Similarly, both Black teens and Hispanic/Latino teens were found to have higher rates of Chlamydia than Whites. Hispanic/Latino boys had the lowest graduation rate compared to all other racial and gender groups.
Unaddressed issues or concerns
A 2002 article found that minority women were at an elevated risk for physical abuse compared to White women. African-Americans compared to Whites, suffered from the most severe and frequent abuse. In addition, women who did not use any form of birth control were most likely to be involved in an abusive relationship (Rickert 1005). The implications of this study are profound because of the potential effects of intimate partner abuse on pregnant women and children. Addressing racial disparities within this indicator would have great significance for maternal and child health outcomes of minorities.
Reference List
Rickert, VI., CM Wiemann, SD Harrykissoon, AB Berenson, & E. Kolb. “The Relationship among Demographics, Reproductive Characteristics, and Intimate Partner Violence.” American Journal of Obstetrics and Gynecology. 187 (2002): 1002-7.
How to Access Report
Samara Viner-Brown, Chief of Data and Evaluation, Division of Family Health, 3 Capitol Hill Room 302 Providence, RI 02908