Poverty Among Women Delivering A Live Birth: Assessing Oklahoma's Need Janis E. Campbell, Ph.D. Kell

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Poverty Among Women Delivering A Live Birth
Assessing Oklahoma's NeedJanis E. Campbell,
Ph.D. Kelly M. Baker, MPH Sara R. DePersio, MD,
MPH
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PRAMS Survey Design

• Population-survey of mothers
• 4-6 months after delivery
• Birth certificates are sampled
• Stratified by birthweight
• Systematic random sample selected within each
  stratum

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PRAMS Responses

• 7 years of data used in this analysis
• April 1988-March 1995
• 71 overall response rate
• 11,750 mothers
• 9,540 respondents had information on poverty
  level (81.2)

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Goals of Analysis

• Examine prevalence of poverty among Oklahoma
  women delivering a live birth.
• Evaluate various risk factors for living in
  poverty and delivering a live birth
• Explore implications for public health.

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Oklahoma PRAMS Questions
Q49. a. How many babies, children, or teens who
are 17 years or younger live with you?
b. How many people who are 18 years or older
live with you? Q70. What was your familys
average monthly income, before taxes, when you
became pregnant? Include your income, your
husband or partners income, and any other
income you could use.
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Prevalence of Poverty Oklahoma 1988-1995
32 Poor 40 Non-Poor 185 FPL
28 Near-Poor 100-184 FPL
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Percent of Women Living Below 100 FPL and
Delivering a Live Birth by Race Oklahoma
1988-1995
61.0 (se 3.4)
49.4 (se 2.9)
27.7 (se 0.8)
27.3 (se 6.4)
se Standard Error
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Percent of Women Living Below 100 FPL and
Delivering a Live Birth by Age Oklahoma 1988-1995
60.3 (se 2.5)
41.4 (se 1.5)
25.0 (se 2.7)
22.2 (se 1.3)
17.4 (se 1.5)
se Standard Error
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Percent of Women Living Below 100 FPL and
Delivering a Live Birth by Education Oklahoma
1988-1995
65.5 (se 6.6)
55.4 (se 2.6)
34.4 (se 1.3)
25.1 (se 1.6)
5.71 (se 0.9)
Age 19 or older only
se Standard Error
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Percent of Women Living Below 100 FPL and
Delivering a Live Birth by Marital Status
Oklahoma 1988-1995
70.1 (se 1.8)
22.0 (se 0.8)
se Standard Error
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Source of Income for Women Delivering a Live
Birth and Living Below 100 FPL Oklahoma
1988-1995
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Comparison of Prenatal Care Issues by Poverty
Status Oklahoma 1988-1995
Prenatal Care Issue 184
FPL (se)
Pregnancy confirmed at 14 weeks or later 10.8
(1.0) 2.6 (0.4) Prenatal care began after 1st
Trimester 29.8 (1.4) 7.5 (0.7) Less than
adequate prenatal care (Kessner) 38.2 (1.6) 12.5
(0.9) Wanted earlier prenatal care 30.5
(1.4) 12.8 (0.9) Wanted more prenatal care 13.0
(1.1) 3.1 (3.1)
se Standard Error
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Comparison of Life Events Associated with
Poverty Oklahoma 1988-1995
Life Events 184 FPL (se)

Unintended at conception 61.7 (1.6) 30.5
(1.2) Physically abused by husband or partner
11.0 (1.0) 1.4 (0.3) Homeless 5.6 (0.7) 0.6
(0.2) Someone very close to you had a drug or
alcohol problem 28.9 (1.4) 10.8 (0.8) Very
depressed or very depressed and had to get help
after delivery 32.6 (2.7) 16.8 (1.8)
sestandard error in the 12 months
before delivery
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Poverty and Birth Outcomes Oklahoma 1988-1995
Outcome Percentage Standard Error
Low Birth Weight 100-184 FPL 5.5 (0.2) 185 FPL 4.5
(0.1) Pre-term Delivery (1.1) 100-184 FPL 7.4 (0.7) 185
FPL 7.4 (0.6)
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Location of Prenatal Care for Women Delivering a
Live Birth and Living Below 100 FPL Oklahoma
1988-1995

Location Percent Standard
Error
Private MD/HMO 43.8 (1.6) Hospital 22.9 (1.4) He
alth Department 17.2 (1.2) Indian Health
Services Facility 11.8 (1.0) Other 4.4 (0.7)
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Recommendations

• Further investigation of stresses and risks
  associated with poverty and pregnancy.
• Increase awareness among health care providers of
  the stresses and life events associated with
  poverty.
• Increase awareness among political leaders of the
  stresses and outcomes associated with poverty
  during pregnancy.