title: Explaining ethnic disparities in preterm birth in Argentina and Ecuador.
abstract: Little is understood about racial/ethnic disparities in infant health in South America. We quantified the extent to which the disparity in preterm birth (PTB; <37 gestational weeks) rate between infants of Native only ancestry and those of European only ancestry in Argentina and Ecuador are explained by household socio-economic, demographic, healthcare use, and geographic location indicators. The samples included 5199 infants born between 2000 and 2011 from Argentina and 1579 infants born between 2001 and 2011 from Ecuador. An Oaxaca-Blinder type decomposition model adapted to binary outcomes was estimated to explain the disparity in PTB risk across groups of variables and specific variables. Maternal use of prenatal care services significantly explained the PTB disparity, by nearly 57% and 30% in Argentina and Ecuador, respectively. Household socio-economic status explained an additional 26% of the PTB disparity in Argentina. Differences in maternal use of prenatal care may partly explain ethnic disparities in PTB in Argentina and Ecuador. Improving access to prenatal care may reduce ethnic disparities in PTB risk in these countries.
authors.affiliation: a Departments of Health Management and Policy, Economics, and Preventive & Community Dentistry, and Public Policy Center , University of Iowa , Iowa City , IA , USA.|b National Bureau of Economic Research , Cambridge , MA , USA.
authors.forename: George L
authors.initials: GL
authors.lastname: Wehby
authors.affiliation: c Center of Medical Education and Clinical Investigation/Centro de Educación Médica e Investigación Clínica (CEMIC) , Buenos Aires , Argentina.
authors.forename: Mariela
authors.initials: M
authors.lastname: Pawluk
authors.affiliation: d Department of Health Management and Policy , University of Iowa , Iowa City , IA, USA.
authors.forename: Kwame A
authors.initials: KA
authors.lastname: Nyarko
authors.affiliation: c Center of Medical Education and Clinical Investigation/Centro de Educación Médica e Investigación Clínica (CEMIC) , Buenos Aires , Argentina.|e Latin American Collaborative Study of Congenital Anomalies/Estudio Colaborativo Latinoamericano de Malformaciones Congénitas (ECLAMC) , Buenos Aires , Argentina.
authors.forename: Jorge S
authors.initials: JS
authors.lastname: López-Camelo
mesh_terms: D000328:Adult; D001118:Argentina / Q000453:epidemiology; D004484:Ecuador / Q000453:epidemiology; D005006:Ethnicity; D005191:Family Characteristics; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007231:Infant, Newborn; D011159:Population Surveillance; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology* / Q000208:ethnology*; D011295:Prenatal Care; D055815:Young Adult
keywords: Child health; ethnic disparities; health inequalities; preterm birth; racial disparities