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332794
Assessment of birth characteristics in an American Indian community: Impact of multi-race identification


Tuesday, November 3, 2015

Nancy Reifel, DDS, MPH, School of Dentistry, Division of Public Health and Community Dentistry, University of California, Los Angeles, Los Angeles, CA
Felicia Schanche Hodge, DrPH, School of Nursing, University of California, Los Angeles, Los Angeles, CA
Paul Robinson, PhD, Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA
Background A needs assessment for a Tribal home visiting program in two counties with rural and urban American Indian/Alaska Native (AIAN) populations required information on prenatal care, low birthweight, and teen mothers. State birth certificate files are a comprehensive data source. Forty-four percent of AIANs identified as TWO OR MORE RACES in the 2010 Census (25% of this category). Published state birth tables were unsuitable as data is by race of mother, AIAN ONLY and TWO OR MORE RACES.

Methods Birth records of babies (AIAN alone or in combination) in the geographic area were selected from 3 years of state birth files. Tribal staff designated 7 regions based on programmatic needs. Counts and % of AIAN births by region for birth characteristics were calculated for all AIAN births (ALL) and AIAN ONLY mother (AIAN MOTHER). Variation by region was mapped using ArcGIS.

Results  4907 of 5015 records had complete data. 947 (19.3%) were AIAN MOTHER. Percentage by region ranged from 12.6% to 34.5%. Cases with first trimester care: ALL=77.1%, AIAN MOTHER=72.0%. Percentage point differences by region for ALL compared to AIAN MOTHER ranged from +8.1% to -6.4%. Low birthweight: ALL=7.2%, AIAN MOTHER=7.4%, Difference by region: +2.4% to -4.1%. Teen mother: ALL=14.8%, AIAN MOTHER=16.3%, Difference by region: +8.4% to -5.6%. There was no consistent pattern for Difference by region.

Conclusions Program planning in AIAN communities should use data that includes AIAN in combination with other races. There is regional variation of birth characteristics that is not predictable from AIAN only data.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Program planning

Learning Objectives:
Explain how limiting racial categories to AIAN ALONE and TWO OR MORE RACES affects the ability of Native Communities to conduct needs assessments.

Keyword(s): Community Health Assessment, Native Americans

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-investigator of multiple interventions and program assessments related to community health that have been carried out in American Indian Communities. I am currently the evaluator of a Tribal Maternal, Infant and Early Childhood Home Visiting program site.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4382.0: Data & Epi Poster Session