Racial differences in prenatal care use in the United States: are disparities decreasing?
OBJECTIVE
We examined trends and racial disparities (White, African American) in trimester of prenatal care initiation and adequacy of prenatal care utilization for US women and specific high-risk subgroups, e.g., unmarried, young, or less-educated mothers.


METHODS
Data from 1981-1998 US natality files on singleton live births to US resident mothers were examined.


RESULTS
Overall, early and adequate use of care improved for both racial groups, and racial disparities in prenatal care use have been markedly reduced, except for some young mothers.


CONCLUSIONS
While improvements are evident, it is doubtful that the Healthy People 2000 objective for prenatal care will soon be attained for African Americans or Whites. Further efforts are needed to understand influences on and to address barriers to prenatal care.
Alexander
Greg R
GR
School of Public Health, Department of Maternal and Child Health, the University of Alabama at Birmingham, 35294, USA. alexandg@uab.edu
Kogan
Michael D
MD
Nabukera
Sara
S
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006306:Health Surveys; D006801:Humans; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D006278:Medicare; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011247:Pregnancy; D011264:Pregnancy Trimesters; D011295:Prenatal Care / Q000706:statistics & numerical data* / Q000639:trends; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*