Perinatal and infant health among rural and urban American Indians/Alaska Natives.

Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) Rural Health Research Center, Department of Family Medicine, University of Washington, Seattle, WA 98195-4696, USA.
American Journal of Public Health (Impact Factor: 4.23). 09/2002; 92(9):1491-7. DOI: 10.2105/AJPH.92.9.1491
Source: PubMed

ABSTRACT We sought to provide a national profile of rural and urban American Indian/Alaska Native (AI/AN) maternal and infant health.
In this cross-sectional study of all 1989-1991 singleton AI/AN births to US residents, we compared receipt of an inadequate pattern of prenatal care, low birthweight (< 2500 g), infant mortality, and cause of death for US rural and urban AI/AN and non-AI/AN populations.
Receipt of an inadequate pattern of prenatal care was significantly higher for rural than for urban mothers of AI/AN infants (18.1% vs 14.4%, P </=.001); rates for both groups were over twice that for Whites (6.8%). AI/AN postneonatal death rates (rural = 6.7 per 1000; urban = 5.4 per 1000) were more than twice that of Whites (2.6 per 1000).
Preventable disparities between AI/ANs and Whites in maternal and infant health status persist.


Available from: Lawrence Gary Hart, May 30, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives. We described American Indian/Alaska Native (AI/AN) infant and pediatric death rates and leading causes of death. Methods. We adjusted National Vital Statistics System mortality data for AI/AN racial misclassification by linkage with Indian Health Service (IHS) registration records. We determined average annual death rates and leading causes of death for 1999 to 2009 for AI/AN versus White infants and children. We limited the analysis to IHS Contract Health Service Delivery Area counties. Results. The AI/AN infant death rate was 914 (rate ratio [RR] = 1.61; 95% confidence interval [CI] = 1.55, 1.67). Sudden infant death syndrome, unintentional injuries, and influenza or pneumonia were more common in AI/AN versus White infants. The overall AI/AN pediatric death rates were 69.6 for ages 1 to 4 years (RR = 2.56; 95% CI = 2.38, 2.75), 28.9 for ages 5 to 9 years (RR = 2.12; 95% CI = 1.92, 2.34), 37.3 for ages 10 to 14 years (RR = 2.22; 95% CI = 2.04, 2.40), and 158.4 for ages 15 to 19 years (RR = 2.71; 95% CI = 2.60, 2.82). Unintentional injuries and suicide occurred at higher rates among AI/AN youths versus White youths. Conclusions. Death rates for AI/AN infants and children were higher than for Whites, with regional disparities. Several leading causes of death in the AI/AN pediatric population are potentially preventable. (Am J Public Health. Published online ahead of print April 22, 2014: e1-e9. doi:10.2105/AJPH.2013.301598).
    American Journal of Public Health 04/2014; DOI:10.2105/AJPH.2013.301598 · 4.23 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the impact of Aboriginal status, active cigarette smoking and smoking cessation during pregnancy on perinatal outcomes.
    The Medical journal of Australia 09/2014; 201(5):274-8. DOI:10.5694/mja13.11142 · 3.79 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: To examine the impact of gender norms on American Indian (AI) adolescents' sexual health behavior. Methods: The project collected qualitative data at a reservation site and an urban site through 24 focus groups and 20 key informant interviews. Results: The reasons that AI youth choose to abstain or engage in sexual intercourse and utilize contraception vary based on gender ideologies defined by the adolescent's environment. These include social expectations from family and peers, defined roles within relationships, and gender empowerment gaps. Conclusions: Gender ideology plays a large role in decisions about contraception and sexual activity for AI adolescents, and it is vital to include re-definitions of gender norms within AI teen pregnancy prevention program.
    American journal of health behavior 11/2014; 38(6):807-815. DOI:10.5993/AJHB.38.6.2 · 1.31 Impact Factor