Onion D K, Meyer D L, Wennberg D E, Soule D N
J Rural Health. 1999 Winter;15(1):108-12. doi: 10.1111/j.1748-0361.1999.tb00604.x.
Many studies in the United States during the past two decades have reported consistently lower cesarean section rates in women of lower socioeconomic status as defined by census tract, insurance status, or maternal level of educational attainment. This study sought to determine whether cesarean section rates in predominantly rural northern New England are lower for lower, compared with higher socioeconomic groups, as they are reported nationally and in more urban areas. Age-adjusted, primary cesarean section rates for privately insured, Medicaid and uninsured women were calculated using 1990 to 1992 uniform hospital discharge data for Maine, New Hampshire and Vermont. Age-adjusted cesarean section rates for insured women (15.71 percent) were significantly higher than those for Medicaid (14.35 percent) and uninsured (12.85 percent) women. These differences in the cesarean section rate between the insured and poorer populations in northern New England are much less than those reported elsewhere in the country.
在过去二十年里，美国许多研究始终报告称，根据普查区、保险状况或母亲教育程度划分，社会经济地位较低的女性剖宫产率较低。本研究旨在确定，与社会经济地位较高的群体相比，新英格兰北部以农村为主地区社会经济地位较低群体的剖宫产率是否如全国及更多城市地区报告的那样更低。利用缅因州、新罕布什尔州和佛蒙特州1990年至1992年统一的医院出院数据，计算了私人保险、医疗补助和未参保女性的年龄调整后的初次剖宫产率。参保女性的年龄调整后剖宫产率（15.71%）显著高于医疗补助女性（14.35%）和未参保女性（12.85%）。新英格兰北部参保人群与较贫困人群之间的剖宫产率差异远小于美国其他地区报告的差异。
