title: Poor prenatal care in an urban area: a geographic analysis.
abstract: Poor prenatal care increases the risk of having a premature or low-birth-weight infant. Rates of poor prenatal care vary spatially, influenced not only by individual mothers' characteristics but also by social neighborhood context and proximity to healthcare services. The aim of this article is to identify and map the spatial patterns of prenatal care and to analyze the spatial and social origins of such inequalities. Our study concerns 30,338 individuals who received antenatal care in a highly urbanized French district: Seine-Saint-Denis. The geographical distribution of poor prenatal care is revealed by exploratory spatial data analysis tools. This spatial clustering is related to the contextual characteristics of neighborhoods (deprivation index). For this purpose a geographic information system is used, in conjunction with a field survey. The analyses and the survey reveal local particularities that hinder the take-up of healthcare services by pregnant women.
authors.affiliation: Medicine, Science, Health and Society Research Center (CERMES), CNRS 8169, INSERM U750, School for Advanced Studies in Social Sciences (EHESS), 94801 Paris, France. Electronic address: charreire@vjf.cnrs.fr.
authors.forename: Hélène
authors.initials: H
authors.lastname: Charreire
authors.affiliation: Department of Medicine, Population Epidemiology Center (CEP), University of Burgundy, France.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Combier
mesh_terms: D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D011204:Poverty Areas; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D011787:Quality of Health Care; D012111:Residence Characteristics; D012923:Social Class; D014504:Urban Health