Ronsaville D S, Hakim R B
Health Care Financing Administration, Baltimore, Md. 21244, USA.
Am J Public Health. 2000 Sep;90(9):1436-43. doi: 10.2105/ajph.90.9.1436.
This study sought to estimate the rate of compliance with American Academy of Pediatrics guidelines for well child care in the first 6 months of life and to determine risks for inadequate care.
The study included 7776 infants whose mothers participated in both the 1988 National Maternal and Infant Health Survey and its 1991 longitudinal follow-up and whose mothers or pediatric providers supplied information about their medical care. Regression analysis was used to determine the probability of incomplete compliance with guidelines for well child care in relation to several socioeconomic risks.
Fifty-eight percent of White infants, 35% of African American infants, and 37% of Hispanic infants obtained all recommended well child care. African American race was the biggest risk for inadequate care (odds ratio = 1.7, 95% confidence interval = 1.5, 1.9), followed by low levels of maternal education, low income, and poor prenatal care. The risk for African American infants persisted across socioeconomic levels.
The racial disparities identified suggest that cultural barriers to seeking preventive care need further study and that programs aimed at reducing these barriers need to be developed.
本研究旨在估计婴儿出生后头6个月遵循美国儿科学会儿童健康保健指南的比例，并确定保健不足的风险因素。
该研究纳入了7776名婴儿，这些婴儿的母亲参与了1988年全国母婴健康调查及其1991年的纵向随访，且其母亲或儿科医疗服务提供者提供了有关其医疗保健的信息。采用回归分析来确定与多种社会经济风险相关的儿童健康保健指南不完全遵循的概率。
58%的白人婴儿、35%的非裔美国婴儿和37%的西班牙裔婴儿接受了所有推荐的儿童健康保健。非裔美国人种族是保健不足的最大风险因素（优势比=1.7，95%置信区间=1.5，1.9），其次是母亲教育水平低、收入低和产前保健差。非裔美国婴儿的风险在不同社会经济水平中持续存在。
所发现的种族差异表明，寻求预防性保健的文化障碍需要进一步研究，并且需要制定旨在减少这些障碍的项目。
