Maternal and child health journal
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Matern Child Health J · Apr 2012
Factors associated with parent report of access to care and the quality of care received by children 4 to 17 years of age in Georgia.
We examined factors associated with health care access and quality, among children in Georgia. Data from the 2007 National Survey of Children's Health were merged with the 2008 Area Resource File. The medically underserved area variable was appended to the merged file, restricting to Georgia children ages 4-17 years (N = 1,397). ⋯ Compared to children who had continuous and adequate private insurance, there were lower odds of perceiving received care as higher/moderate versus lower quality among children who were never/intermittently insured or who had continuous and inadequate/adequate public insurance. Being in excellent/very good health and living in safe/supportive neighborhoods were positively associated with quality; non-white race/ethnicity and federal poverty level were negatively associated with quality. Assuring continuous, adequate insurance may positively impact health care access and quality.
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Matern Child Health J · Apr 2012
Cesarean delivery on maternal request: a western North Carolina perspective.
Cesarean delivery on maternal request (CDMR), a primary cesarean without medical indication for a singleton, term pregnancy, has been identified by physicians as one factor in the increasing rate of cesarean delivery despite nationwide efforts to the contrary. The purpose of this project was to better understand women's preferences and motivations for their desired mode of delivery. A 62-item survey was administered to pregnant women asking for their delivery preference, their reasons, sources of information, feelings about this pregnancy, and opinions about delivery options. ⋯ The majority of patients believed CDMR should be an "informed choice"; other opinions varied by delivery preference. The majority of women preferred vaginal deliveries suggesting little contribution of CDMR to the increasing cesarean rate. Contrary to physicians' beliefs, the women's primary objective was their infants' health rather than their own well-being.
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Matern Child Health J · Apr 2012
Parent-reported prevalence of autism spectrum disorders in US-born children: an assessment of changes within birth cohorts from the 2003 to the 2007 National Survey of Children's Health.
The prevalence of autism spectrum disorders (ASD) from the 2007 National Survey of Children's Health (NSCH) was twice the 2003 NSCH estimate for autism. From each NSCH, we selected children born in the US from 1990 to 2000. We estimated autism prevalence within each 1-year birth cohort to hold genetic and non-genetic prenatal factors constant. ⋯ The magnitude of most birth cohort-specific differences suggests continuing diagnosis of children in the community played a sizable role in the 2003-2007 ASD prevalence increase. While some increase was expected for 1997-2000 cohorts, because some children have later diagnoses coinciding with school entry, increases were also observed for children ages ≥ 7 years in 2003. Given past ASD subtype studies, the 2003 "autism" question might have missed a modest amount (≤ 33 %) of ASDs other than autistic disorder.
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Matern Child Health J · Apr 2012
The impact of tobacco control policies on disparities in children's secondhand smoke exposure: a comparison of methods.
To examine the impact of cigarette excise taxes and smoke-free legislation on tobacco use among households with school-age children and adolescents as well as disparities in children's secondhand smoke exposure. We compare the results from models using causal inference techniques to those from cross-sectional models. We linked families of 6-17-year-olds from the 2003 (N = 67,607) and 2007 (N = 62,768) contacts of the National Survey of Children's Health with state-level cigarette excise taxes and smoke-free legislation total score (0 [none]-32 [very strong]) in 2001 and 2005. ⋯ In contrast, in adjusted cross-sectional models, a higher smoke-free legislation total score was associated with a lower prevalence of household tobacco use. Stronger cigarette excise taxes decrease tobacco use among households with school-age children and adolescents, but smoke-free legislation at the state level does not change parental smoking. Since cross-sectional models cannot assess the direction of causality, evaluations should employ causal inference methods to help inform policy decisions to reduce disparities in adult smoking and, ultimately, protect children from secondhand smoke.
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Matern Child Health J · Apr 2012
The Black and White of infant back sleeping and infant bed sharing in Florida, 2004-2005.
Not using the infant back sleep position is an established risk factor for sudden unexpected infant death (SUID). Infant bed sharing may also increase SUID risk, particularly under certain circumstances. Both of these infant sleeping behaviors are disproportionately higher among Black mothers. ⋯ The infant sleeping behaviors shared no common independent maternal characteristics. Father acknowledgement on the birth certificate was a strong contributor to racial differences in infrequent back sleeping while breastfeeding, trimester of entry to prenatal care, and maternal depression revealed notable racial differences for bed sharing. Behavior-specific and race-specific public health messages may be an important public health strategy for reducing risky infant sleeping behaviors and decreasing SUIDs.