Albrecht S L, Miller M K
College of Medicine, Department of Health Policy and Epidemology, University of Florida, Gainesville, USA.
Soc Biol. 1996 Spring-Summer;43(1-2):38-58. doi: 10.1080/19485565.1996.9988912.
Within SES categories in the United States, racial and ethnic minorities generally fare less well on a variety of health-related indicators than do majority groups. Important differences exist within subgroups, however, and at present, these differences are poorly understood. In this paper we address Hispanic subgroup (Cuban American, Mexican American. Puerto Rican, and Central/South American) differences in utilization of prenatal care. Data from the 1986 and 1987 national Linked Birth/Infant Death files are used to assess patterns of prenatal care utilization across subgroups. Using Kotelchuck's Adequacy of Prenatal Care Utilization Index, we find that when controlling for other factors, Cuban American and Puerto Rican women are more likely to obtain adequate care than are Hispanic women of Mexican or Central/South American origin. Other factors important in understanding utilization patterns include marital status, education level, birthplace, and region of the country. We conclude with a discussion of the relatively weak link between prenatal care and birth outcomes and identify important cultural factors that may be important in understanding why this relationship is not stronger.
在美国的社会经济地位(SES)类别中,种族和少数族裔群体在各种与健康相关的指标上的表现通常不如多数群体。然而,亚群体内部存在重要差异,目前对这些差异的了解甚少。在本文中,我们探讨了西班牙裔亚群体(古巴裔美国人、墨西哥裔美国人、波多黎各人和中/南美洲人)在产前护理利用方面的差异。利用1986年和1987年全国出生/婴儿死亡关联档案的数据来评估各亚群体产前护理利用模式。使用科特尔查克的产前护理利用充足性指数,我们发现,在控制其他因素后,古巴裔美国人和波多黎各裔女性比墨西哥或中/南美洲裔西班牙裔女性更有可能获得充分护理。其他对理解利用模式很重要的因素包括婚姻状况、教育水平、出生地和美国的地区。我们最后讨论了产前护理与出生结果之间相对薄弱的联系,并确定了一些重要的文化因素,这些因素可能对理解为什么这种关系不更强很重要。