Trends in maternal and child health outcomes: where does Wisconsin rank in the national context?
BACKGROUND
The infant mortality rate (IMR), low birth weight (LBW) rate, and first trimester entry into prenatal care (PNC) are indicators that reflect the health of a population.


OBJECTIVE
To examine these indicators in Wisconsin from 1979 through 2001 and compare them to those of the United States, looking at trends and relative rank compared with other states.


METHODS
Three-year averages for IMR, LBW, and PNC were analyzed for the periods 1979-1981, 1984-1986, 1989-1991, 1994-1996, and 1999-2001 from data sources published by the Centers for Disease Control and Prevention. Wisconsin's rank relative to other states was compared for the overall, black, and white populations.


RESULTS
Wisconsin's overall IMR was consistently at, or slightly better than, the national IMR. From 1979-1981 to 1999-2001, the US black IMR decreased by 37.4%, while the Wisconsin black IMR declined 12.4%; thus, Wisconsin's rank among the states fell from third best to 32 among 34 states with a sufficient number of black births. LBW rates for Wisconsin's black population were consistently at least twice that of the white population. In 1979-1981, early entry into PNC for all Wisconsin women (82.9%) was significantly higher than that of the US population (74.1%). Wisconsin's early PNC entry rates improved slightly; as other states also improved, Wisconsin's ranking dropped. Wisconsin's relative ranks for IMR, LBW, and PNC declined for all 3 indicators from 1979-1991 to 1999-2001.


CONCLUSIONS
Birth outcome disparities in Wisconsin pose challenges for physicians, public health, and private agencies; all must collaborate and act to improve health, housing, employment, education, and the social capital and support that makes up the fabric of our society.
Kvale
Katherine M
KM
Bureau of Community Health Promotion, Division of Public Health, Department of Health and Family Services, Madison, WI 53701-2659, USA. kvalekm@dhfs.state.wi.us
Mascola
Maria A
MA
Glysch
Randall
R
Kirby
Russell S
RS
Katcher
Murray L
ML
D001723:Birth Rate / Q000208:ethnology / Q000639:trends*; D005260:Female; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011295:Prenatal Care / Q000706:statistics & numerical data*; D014798:Vital Statistics; D014922:Wisconsin