Skip to main content
Top
Published in: Maternal and Child Health Journal 4/2010

01-07-2010

Disparities in Initiation and Adherence to Prenatal Care: Impact of Insurance, Race-Ethnicity and Nativity

Authors: Marlene I. Bengiamin, John A. Capitman, Mathilda B. Ruwe

Published in: Maternal and Child Health Journal | Issue 4/2010

Login to get access

Abstract

We used the intersectionality framework to examine impact of racial/ethnic, immigration, and insurance differences on the timing of initiation of prenatal care (PNC) and subsequent adherence. In this cross sectional study independent variables were women’s race/ethnicity; nativity; age; education; and insurance. The dependent variables were late initiation and non-adherence to recommended number of PNC visits. We used multivariate analysis to evaluate the impact of the independent variables on late initiation and non-adherence. Analysis revealed that race/ethnicity/nativity (RE-N) was more consistently associated with late initiation and non-adherence for privately insured than publicly insured persons. While private insurance had a positive impact on initiation and adherence overall, its impact was greater for White women. Having private insurance coverage was most beneficial to White women. We contend that the intersectional approach provides promising avenues for expanding our knowledge of health disparities and of identifying new ways of going about eliminating the persistent and pervasive social inequalities and informing efforts to reduce them.
Literature
1.
go back to reference Murray, J., & Bernfield, M. L. (1988). The differential effect of prenatal care on the incidence of low birth weight among Blacks and Whites in a prepaid health care plan. New England Journal of Medicine, 319, 1385–1391.PubMedCrossRef Murray, J., & Bernfield, M. L. (1988). The differential effect of prenatal care on the incidence of low birth weight among Blacks and Whites in a prepaid health care plan. New England Journal of Medicine, 319, 1385–1391.PubMedCrossRef
2.
go back to reference Kogan, M. D., Alexander, G. R., Jack, B., & Allen, M. (1998). The association between adequacy of prenatal care utilization and subsequent pediatric care utilization in the United States. Pediatrics, 102(1), 25–30. July.CrossRefPubMed Kogan, M. D., Alexander, G. R., Jack, B., & Allen, M. (1998). The association between adequacy of prenatal care utilization and subsequent pediatric care utilization in the United States. Pediatrics, 102(1), 25–30. July.CrossRefPubMed
3.
go back to reference Swigonski, N. L., Skinner, C. S., & Wolinsky, F. D. (1995). Prenatal health behaviors as predictors of breast-feeding, injury, and vaccination. Archives of Pediatrics and Adolescent Medicine, 149, 380–385.PubMed Swigonski, N. L., Skinner, C. S., & Wolinsky, F. D. (1995). Prenatal health behaviors as predictors of breast-feeding, injury, and vaccination. Archives of Pediatrics and Adolescent Medicine, 149, 380–385.PubMed
4.
go back to reference Kotelchuck, M. (1994). An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index. American Journal of Public Health, 84, 1414–1420.CrossRefPubMed Kotelchuck, M. (1994). An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index. American Journal of Public Health, 84, 1414–1420.CrossRefPubMed
6.
go back to reference Howell, E. (2001). The impact of the medicaid expansions for pregnant women: A synthesis of the evidence. Medical Care Research and Review, 58(1), 3–30.PubMed Howell, E. (2001). The impact of the medicaid expansions for pregnant women: A synthesis of the evidence. Medical Care Research and Review, 58(1), 3–30.PubMed
7.
go back to reference Dubay, L., Joyce, T., Kaestner, R., & Kenney, G. (2001). Changes in prenatal care timing and low birth weight by race and socioeconomic status: Implications for the medicaid expansions for pregnant women. Health Services Research, 36(2), 373–403.PubMed Dubay, L., Joyce, T., Kaestner, R., & Kenney, G. (2001). Changes in prenatal care timing and low birth weight by race and socioeconomic status: Implications for the medicaid expansions for pregnant women. Health Services Research, 36(2), 373–403.PubMed
8.
go back to reference Kramer, M., Seguin, L., Lydon, J., & Goulet, L. (2000). Socio-economic disparities in pregnancy outcome: Why do the poor fare so poorly? Paediatric and Perinatal Epidemiology, 14(3), 194–210.CrossRefPubMed Kramer, M., Seguin, L., Lydon, J., & Goulet, L. (2000). Socio-economic disparities in pregnancy outcome: Why do the poor fare so poorly? Paediatric and Perinatal Epidemiology, 14(3), 194–210.CrossRefPubMed
9.
go back to reference Egerter, S., Braveman, P., & Marchi, K. (2002). Timing of insurance and use of prenatal care among low-income women. American Journal of Public Health, 92(3), 423–427.CrossRefPubMed Egerter, S., Braveman, P., & Marchi, K. (2002). Timing of insurance and use of prenatal care among low-income women. American Journal of Public Health, 92(3), 423–427.CrossRefPubMed
10.
go back to reference Braveman, P., Marchi, K., Sarnoff, R., Egerter, S., & Rittenhouse, D. (2003). Promoting access to prenatal care: Lessons from the California experience. Washington, DC: The Henry J. Kaiser Family Foundation. Braveman, P., Marchi, K., Sarnoff, R., Egerter, S., & Rittenhouse, D. (2003). Promoting access to prenatal care: Lessons from the California experience. Washington, DC: The Henry J. Kaiser Family Foundation.
11.
go back to reference Gortmaker, S. L. (1979). The effects of prenatal care upon the health of the newborn. American Journal of Public Health, 69(7), 653–660.CrossRefPubMed Gortmaker, S. L. (1979). The effects of prenatal care upon the health of the newborn. American Journal of Public Health, 69(7), 653–660.CrossRefPubMed
12.
go back to reference Greenberg, R. S. (1983). The impact of prenatal care in different social groups. American Journal of Obstetrics and Gynecology, 145(7), 797–801.PubMed Greenberg, R. S. (1983). The impact of prenatal care in different social groups. American Journal of Obstetrics and Gynecology, 145(7), 797–801.PubMed
13.
go back to reference Showstack, J., Budetti, P. R., & Minkler, D. (1984). Factors associated with birth weight: An exploration of the roles of prenatal care and length of gestation. American Journal of Public Health, 74(9), 1003–1008.CrossRefPubMed Showstack, J., Budetti, P. R., & Minkler, D. (1984). Factors associated with birth weight: An exploration of the roles of prenatal care and length of gestation. American Journal of Public Health, 74(9), 1003–1008.CrossRefPubMed
14.
go back to reference Department of Health and Human Services (DHHS). (2003). National healthcare disparities report. Rockville, MD: Department of Health and Human Services, Agency for Healthcare Research and Quality. Department of Health and Human Services (DHHS). (2003). National healthcare disparities report. Rockville, MD: Department of Health and Human Services, Agency for Healthcare Research and Quality.
15.
go back to reference Alexander, G. R., Kogan, M. D., & Nabukera, S. (2002). Racial differences in prenatal care use in the United States: Are disparities decreasing? American Journal of Public Health, 92(12), 1970–1975.CrossRefPubMed Alexander, G. R., Kogan, M. D., & Nabukera, S. (2002). Racial differences in prenatal care use in the United States: Are disparities decreasing? American Journal of Public Health, 92(12), 1970–1975.CrossRefPubMed
16.
go back to reference Goldenberg, R. L., & Rouse, D. J. (1998). Prevention of premature birth. New England Journal of Medicine, 339(5), 313–320.CrossRefPubMed Goldenberg, R. L., & Rouse, D. J. (1998). Prevention of premature birth. New England Journal of Medicine, 339(5), 313–320.CrossRefPubMed
17.
go back to reference Ickovics, J. R., Kershaw, T. S., Westdahl, C., Rising, S. S., Klima, C., Reynolds, H., et al. (2003). Group prenatal care and preterm birth weight: Results from a matched cohort study at public clinics. Obstetrics and Gynecology, 102, 1051–1057.CrossRefPubMed Ickovics, J. R., Kershaw, T. S., Westdahl, C., Rising, S. S., Klima, C., Reynolds, H., et al. (2003). Group prenatal care and preterm birth weight: Results from a matched cohort study at public clinics. Obstetrics and Gynecology, 102, 1051–1057.CrossRefPubMed
18.
go back to reference Kogan, M. D., Alexander, G. R., Kotelchuck, M., & Nagey, D. A. (1994). Relation of the content of prenatal care to the risk of low birth weight. Maternal reports of health behavior advice and initial prenatal care procedures. JAMA, 271(17), 1340–1345.CrossRefPubMed Kogan, M. D., Alexander, G. R., Kotelchuck, M., & Nagey, D. A. (1994). Relation of the content of prenatal care to the risk of low birth weight. Maternal reports of health behavior advice and initial prenatal care procedures. JAMA, 271(17), 1340–1345.CrossRefPubMed
19.
go back to reference McCormick, M. C., & Siegel, J. E. (2001). Recent evidence on the effectiveness of prenatal care. Ambulatory Pediatrics, 1(6), 321–325.CrossRefPubMed McCormick, M. C., & Siegel, J. E. (2001). Recent evidence on the effectiveness of prenatal care. Ambulatory Pediatrics, 1(6), 321–325.CrossRefPubMed
20.
go back to reference Alexander, G. R., & Korenbrot, C. C. (1995). The role of prenatal care in preventing low birth weight. The Future Children, 5(1), 103–120.CrossRef Alexander, G. R., & Korenbrot, C. C. (1995). The role of prenatal care in preventing low birth weight. The Future Children, 5(1), 103–120.CrossRef
21.
go back to reference U.S. Commission on Civil Rights. (1999). The health care challenge: Acknowledging disparity, confronting discrimination, and ensuring equality: Vol. I, the role of governmental and private health care programs and initiatives. Washington: U.S. Commission on Civil Rights. U.S. Commission on Civil Rights. (1999). The health care challenge: Acknowledging disparity, confronting discrimination, and ensuring equality: Vol. I, the role of governmental and private health care programs and initiatives. Washington: U.S. Commission on Civil Rights.
22.
go back to reference Quinn, K. (2000). Working without benefits: The health insurance crisis facing Hispanic Americans. Cambridge, Mass.: Abt Associates. Quinn, K. (2000). Working without benefits: The health insurance crisis facing Hispanic Americans. Cambridge, Mass.: Abt Associates.
23.
go back to reference Kaiser Commission on Medicaid and the Uninsured. (2000). Immigrants’ health care: Coverage and access. Washington: Kaiser Family Foundation. Kaiser Commission on Medicaid and the Uninsured. (2000). Immigrants’ health care: Coverage and access. Washington: Kaiser Family Foundation.
24.
go back to reference Guinier, L., & Torres, G. (2003). The miner’s canary: Enlisting race, resisting power, transforming democracy (The Nathan I. Huggins Lectures). Harvard University Press. Guinier, L., & Torres, G. (2003). The miner’s canary: Enlisting race, resisting power, transforming democracy (The Nathan I. Huggins Lectures). Harvard University Press.
25.
go back to reference Torres, R. D., Mirón, L. F., & Inda, J. (1999). Race, identity, and citizenship: A reader. Cambridge, USA, Oxford, UK: Blackwell Publishers. Torres, R. D., Mirón, L. F., & Inda, J. (1999). Race, identity, and citizenship: A reader. Cambridge, USA, Oxford, UK: Blackwell Publishers.
27.
go back to reference LaVeist, T. A., Keith, V. M., & Gutierrez, M. L. (1995). Black/White differences in prenatal care utilization: An assessment of predisposing and enabling factors. Health Services Research, 30(1 Pt 1), 43–58.PubMed LaVeist, T. A., Keith, V. M., & Gutierrez, M. L. (1995). Black/White differences in prenatal care utilization: An assessment of predisposing and enabling factors. Health Services Research, 30(1 Pt 1), 43–58.PubMed
28.
go back to reference Bengiamin, M, Capitman, J. A., Paul, C. M., Riordan, D. G., & Curtis, K. A. (2005). Healthy people 2010: A 2005 profile of health status in the San Joaquin Valley. Fresno, CA: California State University, Fresno. Bengiamin, M, Capitman, J. A., Paul, C. M., Riordan, D. G., & Curtis, K. A. (2005). Healthy people 2010: A 2005 profile of health status in the San Joaquin Valley. Fresno, CA: California State University, Fresno.
29.
go back to reference Capitman, J., Bengiamin, M., Curtis, K., & Iqbal, S. (2005). Birth patterns in the San Joaquin Valley: Adequate care and pre-term births. Proceedings of the 26th annual California research symposium. California State University, Fresno, CA. Capitman, J., Bengiamin, M., Curtis, K., & Iqbal, S. (2005). Birth patterns in the San Joaquin Valley: Adequate care and pre-term births. Proceedings of the 26th annual California research symposium. California State University, Fresno, CA.
30.
go back to reference Galbraith, A. (2005). Out-of-pocket financial burden for low-income families with children: Socioeconomic disparities and effects of insurance. Health Services Research. Galbraith, A. (2005). Out-of-pocket financial burden for low-income families with children: Socioeconomic disparities and effects of insurance. Health Services Research.
32.
go back to reference Almeida, R. V. (1998). The dislocation of women’s experience in family therapy. Journal of Feminist Family Therapy, 10(3), 1–19. Almeida, R. V. (1998). The dislocation of women’s experience in family therapy. Journal of Feminist Family Therapy, 10(3), 1–19.
33.
go back to reference Miller, B. D. (1992). Wife-beating in India: Variations on a theme. In D. Ayers Counts, J. K. Brown, & J. C. Campbell (Eds.), Sanctions and sanctuary: Cultural perspectives on the beating of wives (pp. 173–184). Boulder, San Francisco & Oxford: Westview Press. Miller, B. D. (1992). Wife-beating in India: Variations on a theme. In D. Ayers Counts, J. K. Brown, & J. C. Campbell (Eds.), Sanctions and sanctuary: Cultural perspectives on the beating of wives (pp. 173–184). Boulder, San Francisco & Oxford: Westview Press.
34.
go back to reference Sood, S. (1990). Violence against women. Jaipur, India: Arihant Publishers. Sood, S. (1990). Violence against women. Jaipur, India: Arihant Publishers.
Metadata
Title
Disparities in Initiation and Adherence to Prenatal Care: Impact of Insurance, Race-Ethnicity and Nativity
Authors
Marlene I. Bengiamin
John A. Capitman
Mathilda B. Ruwe
Publication date
01-07-2010
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 4/2010
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-009-0485-y

Other articles of this Issue 4/2010

Maternal and Child Health Journal 4/2010 Go to the issue