Sugarman J R, Brenneman G, LaRoque W, Warren C W, Goldberg H I
Indian Health Service, Portland Area's Division of Research, Evaluation, and Epidemiology.
Public Health Rep. 1994 Mar-Apr;109(2):243-50.
Although more than two-thirds of American Indians and Alaska Natives (AI) live outside reservations and Tribal lands, few data sets describe social and maternal-child health risk factors among urban AI. The Indian Health Service sponsored a special effort to survey mothers of AI infants as part of the 1988 National Maternal and Infant Health Survey (NMIHS), a comprehensive national study conducted by the National Center for Health Statistics, Centers for Disease Control. The authors analyzed questionnaires completed by mothers residing in selected locations served by urban Indian health programs and compared the data with those for women of other races residing in metropolitan areas. After adjusting the sample for non participating States, the response rate in the Urban Indian Over sample was 60.8 percent (763 of 1,254). More than 45 percent of AI and black respondents, compared with 15 percent of white respondents, reported an annual household income of less than $10,000. About half of AI and black women, compared with nearly three-quarters of white women, reported having insurance or health maintenance organization coverage during pregnancy. Despite having a similarly low rate of health insurance coverage and low household income, AI respondents were far less likely than black respondents to have Medicaid coverage. A higher proportion of AI women than of black or white women reported difficulties in obtaining prenatal care, and AI women were less likely to obtain prenatal care. AI women were also less likely than white women to obtain prenatal care in the first trimester. Although a similar proportion of Al and white women reported that they consumed alcohol during the year before pregnancy, a higher proportion of Al drinkers than of white drinkers reported consuming one or more drinks weekly after finding out they were pregnant. The proportion of unwanted pregnancies was higher among Al women than among white women, but lower than among black women. Al and black women had a higher prevalence of depressive symptoms than did white women.The data suggest that urban Al mothers experience a disproportionate burden of economic, social, and behavioral risk factors for adverse pregnancy outcome.In spite of some data limitations, the Urban Indian Over sample of the NMIHS provides important information about social and health risk factors among urban Al mothers.
尽管超过三分之二的美国印第安人和阿拉斯加原住民居住在保留地和部落土地之外，但很少有数据集描述城市地区美国印第安人的社会和母婴健康风险因素。作为1988年全国孕产妇和婴儿健康调查（NMIHS）的一部分，印第安卫生服务局发起了一项特别行动，对美国印第安婴儿的母亲进行调查，该调查是由疾病控制中心的国家卫生统计中心进行的一项全面的全国性研究。作者分析了居住在城市印第安卫生项目服务的选定地点的母亲填写的问卷，并将数据与居住在大都市地区的其他种族女性的数据进行了比较。在对未参与调查的州的样本进行调整后，城市印第安人超样本的回复率为60.8%（1254人中的763人）。超过45%的美国印第安人和黑人受访者报告家庭年收入低于1万美元，而白人受访者这一比例为15%。约一半的美国印第安和黑人女性报告在孕期有保险或健康维护组织的覆盖，而白人女性这一比例接近四分之三。尽管医疗保险覆盖率和家庭收入同样较低，但美国印第安受访者获得医疗补助的可能性远低于黑人受访者。报告在获得产前护理方面有困难的美国印第安女性比例高于黑人和白人女性，且美国印第安女性获得产前护理的可能性较小。美国印第安女性在孕早期获得产前护理的可能性也低于白人女性。尽管美国印第安和白人女性中报告在怀孕前一年饮酒的比例相似，但发现怀孕后每周饮用一杯或多杯酒的美国印第安饮酒者比例高于白人饮酒者。意外怀孕的比例在美国印第安女性中高于白人女性，但低于黑人女性。美国印第安和黑人女性抑郁症状的患病率高于白人女性。数据表明，城市地区的美国印第安母亲在不良妊娠结局的经济、社会和行为风险因素方面承受着不成比例的负担。尽管存在一些数据限制，但NMIHS的城市印第安人超样本提供了有关城市美国印第安母亲的社会和健康风险因素的重要信息。
