Hawks Rebecca Mahn, McGinn Aileen P, Bernstein Peter S, Tobin Jonathan N
Department of Obstetrics & Gynecology, NYU Langone Medical Center, 550 First Ave, New York, NY, 10016, USA.
Department of Epidemiology & Population Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, USA.
Matern Child Health J. 2018 Aug;22(8):1103-1110. doi: 10.1007/s10995-018-2494-1.
Objective To measure the association of preconception health insurance status with preconception health among women in New York City, and examine whether this association is modified by race/ethnicity. Methods Using data from the New York City Pregnancy Risk Assessment Monitoring System 2009-2011 (n = 3929), we created a "Preconception Health Score" (PHS) capturing modifiable behaviors, healthcare services utilization, pregnancy intention, and timely entry into prenatal care. We then built multivariable logistic regression models to measure the association of PHS with health insurance status and race/ethnicity. Results We found PHS to be higher among women with private insurance (7.3 ± 0.07) or public insurance (6.3 ± 0.08) before pregnancy than no insurance (5.9 ± 0.09) (p < .001). However, when stratified by race/ethnicity, the positive association of PHS with insurance was absent in the non-white population. Conclusions for Practice Having health insurance during the pre-pregnancy period is associated with greater health among white women, but not among black or Hispanic women in NYC.
目的 评估纽约市女性孕前健康保险状况与孕前健康之间的关联，并探究这种关联是否因种族/族裔而有所不同。方法 利用纽约市2009 - 2011年妊娠风险评估监测系统的数据（n = 3929），我们创建了一个“孕前健康评分”（PHS），用于衡量可改变的行为、医疗服务利用情况、妊娠意愿以及及时开始产前护理的情况。然后，我们构建了多变量逻辑回归模型，以评估PHS与健康保险状况及种族/族裔之间的关联。结果 我们发现，孕前有私人保险（7.3 ± 0.07）或公共保险（6.3 ± 0.08）的女性的PHS高于无保险女性（5.9 ± 0.09）（p < 0.001）。然而，按种族/族裔分层后，非白人人群中PHS与保险之间不存在正相关关系。实践结论 在纽约市，孕前拥有健康保险与白人女性的更好健康状况相关，但与黑人或西班牙裔女性无关。
