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Preconception Health Indicators: A Comparison Between Non-Appalachian and Appalachian Women

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Abstract

To compare preconception health indicators (PCHIs) among non-pregnant women aged 18–44 years residing in Appalachian and non-Appalachian counties in 13 U.S. states. Data from the 1997–2005 Behavioral Risk Factor Surveillance System were used to estimate the prevalence of PCHIs among women in states with ≥1 Appalachian county. Counties were classified as Appalachian (n = 36,496 women) or non-Appalachian (n = 88,312 women) and Appalachian counties were categorized according to economic status. Bivariate and multivariable logistic regression models examined differences in PCHIs among women by (1) Appalachian residence, and (2) economic classification. Appalachian women were younger, lower income, and more often white and married compared to women in non-Appalachia. Appalachian women had significantly higher odds of reporting <high school education (adjusted odds ratio (AOR) 1.19, 95 % confidence interval (CI) 1.10–1.29), fair/poor health (AOR 1.14, 95 % CI 1.06–1.22), no health insurance (AOR 1.12, 95 % CI 1.05–1.19), no annual checkup (AOR 1.12, 95 % CI 1.04–1.20), no recent Pap test (AOR 1.20, 95 % CI 1.08–1.33), smoking (AOR 1.08, 95 % CI 1.03–1.14), <5 daily fruits/vegetables (AOR 1.11, 95 % CI 1.02–1.21), and overweight/obesity (AOR 1.05, 95 % CI 1.01–1.09). Appalachian women in counties with weaker economies had significantly higher odds of reporting less education, no health insurance, <5 daily fruits/vegetables, overweight/obesity, and poor mental health compared to Appalachian women in counties with the strongest economies. For many PCHIs, Appalachian women did not fare as well as non-Appalachians. Interventions sensitive to Appalachian culture to improve preconception health may be warranted for this population.

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Acknowledgments

We thank Drs. Ruben Smith and Charlan Kroelinger (Division of Reproductive Health, Centers for Disease Control and Prevention); Dr. Larry Smith (Mississippi State Department of Health); Drs. Deborah Rosenberg and Kristin Rankin (University of Illinois, Chicago) for technical assistance and expertise. This study was supported in part by an appointment to the Applied Epidemiology Fellowship Program administered by the Council for State and Territorial Epidemiologists (CSTE) and funded by the Centers for Disease Control and Prevention (CDC) Cooperative Agreement Number 5U38HM000414.

Author information

Authors and Affiliations

  1. Mississippi State Department of Health, Jackson, MS, USA

    Vanessa L. Short

  2. Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Reena Oza-Frank

  3. Ohio Department of Health, State Maternal and Child Health Epidemiologist, 246 North High Street, Columbus, OH, 43215, USA

    Elizabeth J. Conrey

  4. Centers for Disease Control and Prevention, Atlanta, GA, USA

    Elizabeth J. Conrey

  5. Department of Pediatrics, The Ohio State University, Columbus, OH, USA

    Reena Oza-Frank

Authors
  1. Vanessa L. Short
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  2. Reena Oza-Frank
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  3. Elizabeth J. Conrey
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Correspondence to Elizabeth J. Conrey.

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CDC Disclaimer Statement: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

At the time of this study, Short was a CDC/CSTE Applied Epidemiology Fellow at The Pennsylvania Department of Health, Harrisburg, PA, USA and Oza-Frank was a CDC/CSTE Applied Epidemiology Fellow at The Ohio Department of Health, Columbus, OH, USA.

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Short, V.L., Oza-Frank, R. & Conrey, E.J. Preconception Health Indicators: A Comparison Between Non-Appalachian and Appalachian Women. Matern Child Health J 16 (Suppl 2), 238–249 (2012). https://doi.org/10.1007/s10995-012-1129-1

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