Racial disparities in outcomes of military and civilian births in California

• Published in: Archives of pediatrics & adolescent medicine Vol. 150; no. 10; p. 1062
• Main Authors: Barfield, W D, Wise, P H, Rust, F P, Rust, K J, Gould, J B, Gortmaker, S L
• Format: Journal Article
• Language: English
• Published: United States 01.10.1996
• Subjects: California; Continental Population Groups; Female; Health Benefit Plans, Employee - statistics & numerical data; Humans; Infant Mortality; Infant Welfare; Infant, Low Birth Weight; Infant, Newborn; Maternal Health Services - statistics & numerical data; Maternal Health Services - supply & distribution; Military Personnel; Pregnancy; Pregnancy Outcome; Prenatal Care; United States
• ISSN: 1072-4710
• DOI: 10.1001/archpedi.1996.02170350064011

To examine racial disparities in prenatal care utilization, birth weight, and fetal and neonatal mortality in a population for whom financial barriers to health care services are minimal. Using linked birth, fetal death, and infant death certificate files, we examined prenatal care utilization, birth weight distribution, and fetal and neonatal mortality rates for all white and black births occurring in military hospitals in California from January 1, 1981, to December 31, 1985. These patterns were compared with the experience of their civilian counterparts during the same time period. Black mothers had higher percentages of births occurring in teenaged and unmarried mothers than did white mothers in military and civilian populations. First-trimester prenatal care initiation was lower for blacks in the military (relative risk, 0.79; 95% confidence interval, 0.75-0.82) and civilian (relative risk, 0.51; 95% confidence interval, 0.50-0.52) populations. However, the scale of the disparity in prenatal care utilization was significantly smaller (P < .001) in the military group. Rates of low birth weight and fetal and neonatal mortality among blacks were elevated in the military and civilian groups. However, the racial disparity in low birth weight was significantly smaller in the military group (P < .01 and P < .001, respectively). In populations with decreased financial barriers to health care, racial disparities in prenatal care use and low birth weight were reduced. However, the persistence of significant disparities suggests that more comprehensive strategies will be required to ensure equity in birth and neonatal outcome.