Abstract
Objectives In the United States, significant ethnic and racial health and healthcare disparities exist among our most vulnerable populations, new mothers and newborns. We sought to determine disparities in socioeconomic status, perinatal health, and perinatal healthcare for black mothers and their newborns cared for in well-baby nurseries compared with white mother/baby pairs in Pennsylvania. Methods A retrospective analysis of a merged data set containing birth and clinical discharge records was conducted. Perinatal data from 44,105 black mothers and their singleton newborns, ≥35 weeks gestational age cared for in Pennsylvania well-baby nurseries from 1998–2002 were compared with 88,210 white mother/baby pairs. Results Black mothers were younger and were much more likely to receive Medicaid or be uninsured compared with white mothers. They were less likely to be college-educated, married, or have prenatal care beginning in the first trimester. Infants born to black mothers were less likely to be delivered via Cesarean section, but were more likely to be born between 35 and 38 weeks gestation and be of low birth weight. Conclusions Numerous significant disparities exist for black mothers and their newborns cared for in well-baby nurseries in Pennsylvania. Since most newborns are cared for in this setting as opposed to intensive care environments, recognition of the differences that exist for this group when compared to well newborns of white mothers can help to improve healthcare and its delivery to this population. Federal and local initiatives must continue efforts to eliminate racial disparities.
Abbreviations
- AAP:
-
American Academy of Pediatrics
- PDOH:
-
Pennsylvania Department of Health
- PHC4:
-
Pennsylvania Health Care Cost Containment Council
- LOS:
-
Length of stay
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Acknowledgements
Dr. Paul is supported by grant R40 MC 06630 from the Maternal Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services. A Penn State College of Medicine Dean’s Feasibility Grant as well as a grant from the Children’s Miracle Network awarded to Dr. Paul also supported this work. Co-author, Erik Lehman, MS, had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The authors thank Maxine Vance and Rosalind German for their review and editorial comments, and Edward Hain from the Pennsylvania Healthcare Cost Containment Council (PHC4) for his extensive technical assistance. Additional assistance was provided by Craig Edelman from the Pennsylvania Department of Health. PHC4, who provided the clinical discharge records, is an independent state agency responsible for addressing the problem of escalating health costs, ensuring the quality of healthcare, and increasing access to health care for all citizens regardless of ability to pay. PHC4 provided their data in an effort to further PHC4’s mission of educating the public and containing health care costs in Pennsylvania. PHC4, its agents, and staff, have made no representation, guarantee, or warranty, express or implied, that the data: financial, patient, payor, and physician specific information provided to this entity, are error-free, or that the use of the data will avoid differences of opinion or interpretation. The authors of this manuscript conducted this analysis without the assistance of PHC4, which bears no responsibility or liability for the results of the analysis.
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Paul, I.M., Lehman, E.B., Suliman, A.K. et al. Perinatal Disparities for Black Mothers and Their Newborns. Matern Child Health J 12, 452–460 (2008). https://doi.org/10.1007/s10995-007-0280-6
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DOI: https://doi.org/10.1007/s10995-007-0280-6