Maternal and Child Health Journal

, Volume 16, Supplement 2, pp 250–257 | Cite as

Preconception Health of Reproductive Aged Women of the Mississippi River Delta

  • Connie L. Bish
  • Sherry Farr
  • Dick Johnson
  • Ron McAnally
Article

Abstract

Optimal preconception health (PCH) may improve maternal and infant outcomes, priority issues in Mississippi (MS). Our study objective was to compare the PCH of women in the MS Delta to other regions. We analyzed Behavioral Risk Factor Surveillance System data from 2005, 2007, and 2009, and limited analyses to 171,612 non-pregnant black and white women 18–44 years of age. Region was defined as 14 MS Delta counties (MS Delta), remainder of MS (MS non-Delta), Delta states (LA, AR, TN), and non-Delta US states. We calculated adjusted prevalence ratios (aPR) to assess associations between region and 16 indicators of optimal PCH, controlling for demographic characteristics. Healthy PCH factors such as consuming ≥5 fruits and vegetables daily and normal body mass index (18.5 kg/m2 to <25 kg/m2), respectively, were more prevalent in the MS non-Delta (aPR = 1.3; 95 % CI: 1.0,1.7 and aPR = 1.2; 95 % CI: 1.0,1.4), non-MS Delta (aPR = 1.5; 95 % CI: 1.2,2.0 and aPR = 1.3; 95 % CI: 1.1,1.5) and non-Delta states (aPR = 1.7; 95 % CI: 1.3,2.2 and aPR = 1.4; 95 % CI: 1.2,1.6) compared to the MS Delta. Physical activity levels were higher among non-Delta US states compared to the MS Delta (aPR = 1.3; 95 % CI: 1.1,1.4). Household income and race confounded the associations between region and PCH. Reproductive aged women in the MS Delta had poorer PCH, particularly for physical activity and nutrition, than women in other regions. MS Delta service providers and public health practitioners should consider implementing or enhancing lifestyle, nutrition, and physical activity interventions, with a special focus on reducing income-based and racial disparities.

Keywords

Preconception Health Reproductive Age Region BRFSS 

References

  1. 1.
    US Census Bureau. (2007). State rankings—statistical abstract of the United States, Persons below poverty level. http://www.census.gov/statab/ranks/rank34.html. Accessed September 30, 2012.
  2. 2.
    The Rural School and Community Trust. (2003). Why Rural Matters in Mississippi. http://files.ruraledu.org/states/ms.htm. Accessed September 30, 2012.
  3. 3.
    The rural school and community trust. (2003) Why Rural Matters. Percentage of State’s Population that is Rural. http://files.ruraledu.org/streport/pdf/imp1_2003.pdf. Accessed September 30, 2012.
  4. 4.
    Miller, K. (2010). Why Definitions Matter: Rural Definitions and State Poverty Rankings. http://www.rupri.org/Forms/Poverty and Definition of Rural.pdf. Accessed September 30, 2012.
  5. 5.
    Mississippi Quick Facts from the US Census Bureau: Selected counties. http://quickfacts.census.gov/qfd/states/28000.html. Accessed September 30, 2012.
  6. 6.
    2010 Census Data. http://2010.census.gov/2010census/data/index.php. Accessed September 30, 2012.
  7. 7.
    Mississippi statistically automated health resource system (MSTAHRS). Population tab. 2005, 2007, 2009 customized county and state US Census Data. http://mstahrs.msdh.ms.gov/. Accessed September 30, 2012.
  8. 8.
    The rural school and community trust. Facts and Figures about States with Low Rural Graduation Rates. http://www.ruraledu.org/articles.php?id=2757. Accessed September 30, 2012.
  9. 9.
    Mississippi statistically automated health resource system (MSTAHRS). Pregnancy tab for 10–19 year olds and Infant Mortality tab. http://mstahrs.msdh.ms.gov/. Accessed September 30, 2012.
  10. 10.
    Johnson, K., Posner, S. F., Biermann, J., Cordero, J. F., Atrash, H. K., Parker, C. S., et al. (2006). Recommendations to improve preconception health and health care—United States a report of the CDC/ATSDR preconception care work group and the select panel on preconception care. MMWR, 55, 1–23.PubMedGoogle Scholar
  11. 11.
    Broussard, D. L., Sappenfield, W. B., Fussman, C., Kroelinger, C. D., & Grigorescu, V. (2011). Core state preconception health indicators: a voluntary, multi-state selection process. Maternal and Child Health Journal, 15(2), 158–168.PubMedCrossRefGoogle Scholar
  12. 12.
    Bieler, G. S., Brown, G. G., Williams, R. L., and Brogan, D. J. (2010). Estimating model-adjusted risks, risk differences, and risk ratios from complex survey data. American journal of epidemiology. Advance Access published February 4, 2010.Google Scholar
  13. 13.
    SAS Procedures Guide. (1999). Cary, NC, SAS Institute Inc.Google Scholar
  14. 14.
    SUDAAN User’s Manual. (2003). Research Triangle Park. North Carolina, USA: Research Triangle Institute.Google Scholar
  15. 15.
    McCabe-Sellers, B. M., Bowman, S., Stuff, J. E., Champagne, C. M., Simpson, P. M., et al. (2007). Assessment of the diet quality of US adults in the Lower Mississippi Delta. American Journal of Clinical Nutrition, 86, 697–706.PubMedGoogle Scholar
  16. 16.
    Champagne, C. M., Bogle, M. L., McGee, B. B., et al. (2004). Dietary intake in the lower Mississippi delta region: Results from the foods of our delta study. Journal of the American Dietetic Association, 104, 199–207.PubMedCrossRefGoogle Scholar
  17. 17.
    Zoellner, J., Bounds, W., Connell, C., Yadrick, K., Crook, L., et al. (2010). Meaningful messages: Adults in the lower Mississippi delta provide cultural insight into strategies for promoting the mypyramid. Journal of nutrition education and behavior, 42, 41–50.PubMedCrossRefGoogle Scholar
  18. 18.
    McGee, B. B., Johnson, G. S., Yadrick, M. K., Richardson, V., Simpson, P. M., et al. (2011). Food shopping perceptions, behaviors, and ability to purchase healthful food items in the lower Mississippi delta. Journal of Nutrition Education and Behavior, 43(5), 339–348.PubMedCrossRefGoogle Scholar
  19. 19.
    Block, G. (2004). Foods contributing to energy intake in the US: data from NHANES III and NHANES 1999–2000. Journal of Food Composition and Analysis, 17, 439–447.CrossRefGoogle Scholar
  20. 20.
    Yadrick, K., Connell, C., Simpson, P. et al. (2005). Fats and sweets more available than fruits and vegetables in rural Mississippi Delta. FASEB journal : official publication of the Federation of American Societies for Experimental Biology. 19(2 suppl S):A978.Google Scholar
  21. 21.
    Connell, C. L., Zoellner, J. M., Yadrick, M. K., Chekuri, S. C., Crook, L. B. et al. (2011). Energy density, nutrient adequacy, and cost per serving can provide insight into food choices in the lower Mississippi delta. Journal of nutrition education and behavior 1–6.Google Scholar
  22. 22.
    Dubbert, P. M., Robinson, J. C., Sung, J. H., Ainsworth, B. E., Wyatt, S. B., et al. (2010). Physical activity and obesity in African Americans: the Jackson Heart Study. Ethnicity and Disease, 20(4), 383–389.PubMedGoogle Scholar
  23. 23.
    Parham, G. P., Scarinci, I. C. (2007) Strategies for achieving healthy energy balance among African Americans in the Mississippi Delta. Preventing chronic disease [electronic resource] 4(4). http://www.cdc.gov/pcd/issues/2007/oct/07_0076.htm. Accessed September 30, 2012.
  24. 24.
    Hovick, S. R., Johnson-Turbes, C. A., Freimuth, V. S., Chervin, D. D. (2011) Assessing perceptions of and responses to multiple health risks among the Southern poor. Preventing chronic disease [electronic resource] 8(1): A11. http://www.cdc.gov/pcd/issues/2011/jan/09_0222.htm. Accessed September 30, 2012.
  25. 25.
    Boothe, A. S., Brouwer, R. J., Carter-Edwards, L., & Ostbye, T. (2011). Levels and predictors of unmet social support for healthy behaviors among overweight and obese postpartum women: Results from the active mothers postpartum study. Journal of Womens Health, 20(11), 1677–1685.CrossRefGoogle Scholar
  26. 26.
    Cox, R. G., Zhang, L., Zotti, M. E., & Graham, J. (2011). Prenatal Care Utilization in Mississippi: Racial Disparities and Implications for Unfavorable Birth Outcomes. Maternal and Child Health Journal, 15(7), 931–942.PubMedCrossRefGoogle Scholar
  27. 27.
    Zhang, L., Cox, R. G., Graham, J., & Johnson, D. (2011). Association of maternal medical conditions and unfavorable birth outcomes: Findings from the 1996–2003 Mississippi linked birth and death data. Maternal and Child Health Journal, 15(7), 910–920.PubMedCrossRefGoogle Scholar
  28. 28.
    Wiltshire, J. C., Person, S. D., Kiefe, C. I., & Allison, J. J. (2009). Disentangling the influence of socioeconomic status on differences between African American and White women in unmet medical needs. American Journal of Public Health, 99(9), 1659–1665.PubMedCrossRefGoogle Scholar
  29. 29.
    Mississippi State Department of Health. Family Planning. http://msdh.ms.gov/msdhsite/_static/41,0,107.html#Services. Accessed September 30, 2012.
  30. 30.
    The MIME and DIME Programs: Challenges and Successes of Implementing Interpregnancy Care among High-Risk Mississippi Women. AMCHP Innovation Station. http://www.amchp.org/programsandtopics/BestPractices/InnovationStation/ISDocs/MIME-DIME.pdf. Accessed September 30, 2012.
  31. 31.
    National Healthy Start Association. http://www.nationalhealthystart.org/healthy_start_initiative/healthy_start_to_the_rescue. Accessed September 30, 2012.
  32. 32.
    Tougaloo College, Health and Wellness Center, Delta Health Partners. http://www.tougaloo.edu/health/dhp/index.htm. Accessed September 30, 2012.
  33. 33.
    Delta Health Alliance. Body and Soul http://www.deltahealthalliance.org/projects/eating-and-living-well/body-and-soul. Accessed September 30, 2012.
  34. 34.
    Mississippi State Department of Health. Chronic Disease Prevention. http://msdh.ms.gov/msdhsite/_static/43,0,91.html. Accessed September 30, 2012.
  35. 35.
    Mississippi State Department of Health. Chronic Disease Self-Management Program. http://msdh.ms.gov/msdhsite/_static/43,0,91,474.html. Accessed September 30, 2012.
  36. 36.
    Mississippi State Department of Health. http://www.msdh.state.ms.us. Accessed September 30, 2012.

Copyright information

© Springer Science+Business Media, New York (outside the USA)  2012

Authors and Affiliations

  • Connie L. Bish
    • 1
  • Sherry Farr
    • 1
  • Dick Johnson
    • 2
  • Ron McAnally
    • 2
  1. 1.Division of Reproductive HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaUSA
  2. 2.Mississippi State Department of HealthJacksonUSA

Personalised recommendations