National Trends in the Perinatal and Infant Health Care of Rural and Urban American Indians (AIs) and Alaska Natives (ANs)

Funder:	Office of Rural Health Policy (ORHP)
Research center:	WWAMI Rural Health Research Center Phone: 206.685.0402
Lead researcher:	Laura-Mae Baldwin, MD, MPH , 206.685.4799, lmb@fammed.washington.edu
Project funded:	September 2003
Project completed:	December 2005
Topics:	American Indians and Alaska Natives Children Health disparities Maternal and child health Minority health

While there have been dramatic improvements in AI/AN maternal and child health, significant disparities persist between AI/AN and non-AI/AN populations in the U.S. This study examined trends in prenatal care use, low birth weight rate, and the neonatal and post-neonatal mortality rates in rural and urban AI/AN populations nationally between 1985 and 1997, and compared these trends in the white and African-American populations during the same time period. Additionally, trends in causes of death for rural and urban AI/AN populations nationally between 1985 and 1997 were examined and compared to the non-AI/AN population during the same time period. Trends in our study measures for AI/AN and non-AI/AN populations were analyzed by Census region, division, and Indian Health Service (IHS) Service Areas. The study used the National Linked Birth Death Data Set at three points in time: 1985-1987, 1989-1991, and 1995-1997, and compared rates of inadequate prenatal care, low birth weight, neonatal and post-neonatal death, and causes of death between rural and urban AI/ANs in each of the three time periods, as well as over time. Rates of these same outcome measures are provided for white and African-American populations during the same time periods for reference. A working paper has been drafted and an associated manuscript will be submitted to a relevant professional journal.

Publications

• National Trends in the Perinatal and Infant Health of Rural American Indians (AIs) and Alaska Natives (ANs): Have the Disparities Between AI/ANs and Whites Narrowed? (Final Report)
  Report Number: 111
  Date: 06 / 2008
  This study examines whether disparities in perinatal care and birth outcomes between rural American Indians and Alaska Natives (AI/ANs) and whites diminished during a period of policy and funding changes in maternal/child health.
• National Trends in the Perinatal and Infant Health of Rural American Indians (AIs) and Alaska Natives (ANs): Have the Disparities Between AI/ANs and Whites Narrowed? (Policy Brief)
  Date: 06 / 2008
  Brief overview of findings from a study examining trends in prenatal care receipt, low-birthweight rates, neonatal and postneonatal death rates, and cause of death among rural American Indians/Alaska Natives (AI/ANs) and whites between 1985 and 1997.
• Trends in Perinatal and Infant Health Disparities Between Rural American Indians and Alaska Natives and Rural Whites
  Citation: Baldwin LM, Grossman DC, Murowchick E, Larson EH, Hollow WB, Sugarman JR, Freeman WL, Hart LG. Trends in perinatal and infant health disparities between rural American Indians and Alaska Natives and rural whites. Am J Public Health. Apr 2009;99(4):638-646.