PRENATAL CARE: Lacking Among Poor, Privately Insured in California
A study of more than 10,000 low-income childbearing women in California between 1994 and 1995 revealed that "low-income women are the mainstream maternity population" and that "more than one third of privately insured childbearing women had low incomes." The study, published in the American Journal of Public Health, involved in-person interviews with women during their delivery stays at 19 California hospitals. It found that 46% of all childbearing women "lived in absolute poverty," while 19% were near poor -- meaning that nearly two-thirds of those giving birth in the state were low-income. Additionally, 3% of poor and 2% of near poor women lacked insurance throughout pregnancy; 13% of poor and 59% of near poor women were privately insured. The study concluded that "low income is associated with significantly elevated risks of untimely prenatal care, and that the increased risk ... is not confined to women in absolute poverty or to those lacking private insurance." Only women whose incomes topped 300% of the poverty level and were privately insured met Healthy Goals 2000 objective that a minimum of 90% of women receive first-trimester prenatal care. The study's researchers urged against focusing on efforts to increase timely prenatal care solely on women who are uninsured, covered by Medicaid or receive care at public clinics, as "women with incomes 101% of the poverty level to 200% of the poverty level were three times as likely to lack timely care and women with incomes 201% to 300% of the poverty level were more than twice as likely." The study concludes that promoting early prenatal care will require "multisectoral, communitywide activities beyond the scope of those historically undertaken by the private medical sector," as well as "systematic public policies and oversight to ensure that prevailing standards of health care are actually received by the maternity population" (Braveman et al., June 1999 issue).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.