Perinatal and infant health among rural and urban American Indians/Alaska Natives.
OBJECTIVE
We sought to provide a national profile of rural and urban American Indian/Alaska Native (AI/AN) maternal and infant health.


METHODS
In this cross-sectional study of all 1989-1991 singleton AI/AN births to US residents, we compared receipt of an inadequate pattern of prenatal care, low birthweight (< 2500 g), infant mortality, and cause of death for US rural and urban AI/AN and non-AI/AN populations.


RESULTS
Receipt of an inadequate pattern of prenatal care was significantly higher for rural than for urban mothers of AI/AN infants (18.1% vs 14.4%, P </=.001); rates for both groups were over twice that for Whites (6.8%). AI/AN postneonatal death rates (rural = 6.7 per 1000; urban = 5.4 per 1000) were more than twice that of Whites (2.6 per 1000).


CONCLUSIONS
Preventable disparities between AI/ANs and Whites in maternal and infant health status persist.
Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) Rural Health Research Center, Department of Family Medicine, University of Washington, Seattle, WA 98195-4696, USA.
Laura-Mae
LM
Baldwin
David C
DC
Grossman
Susan
S
Casey
Walter
W
Hollow
Jonathan R
JR
Sugarman
William L
WL
Freeman
L Gary
LG
Hart
D000293:Adolescent; D000328:Adult; D000413:Alaska / Q000453:epidemiology; D002423:Cause of Death; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007223:Infant; D007226:Infant Mortality; D007229:Infant Welfare / Q000208:ethnology*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D004930:Inuit / Q000706:statistics & numerical data*; D009309:National Center for Health Statistics, U.S.; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards; D011634:Public Health; D012307:Risk Factors; D012423:Rural Health; D014481:United States / Q000453:epidemiology; D014504:Urban Health