The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65753

Sarah Andrea Burgard, MA, Departments of Sociology and Epidemiology, University of California, Los Angeles, 264 Haines Hall, 375 Portola Plaza, Los Angeles, CA 90095-1551, (310) 899-1176, sburgard@ucla.edu

In this analysis, I examine the extent and underlying causes of racial disparity in pregnancy-related care utilization in South Africa. I treat race as a social construct linked to an unequal pattern of social and economic opportunities and rewards that influence health and the use of health-related services. Using preventive health care during a pregnancy and birth can reduce maternal and child mortality and improve women’s reproductive health status. I explore the persistence of racial disparity in socioeconomic resources and women’s access to prenatal and delivery care, and the impact of racial inequality on service use in the years following the dismantling of institutionalized racial discrimination in South Africa. Data are from the 1998 Demographic and Health Survey and the 1996 census, and population-averaged two level logistic regression models are used to predict the likelihood that a woman will obtain early prenatal care, will deliver with the assistance of a doctor, and/or will deliver in a private hospital, once important resource differences are controlled. Results show that even after accounting for dramatic black/non-black inequality in parents’ education, mother’s employment status, household wealth, community of residence, and pregnancy wantedness, black women have odds of receiving these services that are only two-fifths to three-fifths as great as those of non-black women. Several potential explanations for the remaining gap are discussed, including poor measurement of included predictors, preferences not taken into account in this study, or the effects of discrimination against black women.

Learning Objectives:

• At the conclusion of the session, the participant (learner) in this session will be able to:
• 1. Recognize the key social and economic factors underlying race/ethnic inequality in South Africa
• 2. Discuss the relative importance of supply and demand for pregnancy-related services in South Africa, and
• 3. Identify several explanations for race/ethnic disparity in health service use that go beyond socioeconomic inequalities.

Keywords: Social Inequalities, Maternal Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.