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.
Baldwin
Laura-Mae
LM
Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) Rural Health Research Center, Department of Family Medicine, University of Washington, Seattle, WA 98195-4696, USA.
Grossman
David C
DC
Casey
Susan
S
Hollow
Walter
W
Sugarman
Jonathan R
JR
Freeman
William L
WL
Hart
L Gary
LG
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