All ETDs from UAB

School

School of Public Health

Document Type

Dissertation

Department (new version)

Public Health

Date of Award

2001

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

In 1994 there were marked differences in rates of low birth weight (LBW) infants at the county level in Alabama despite the relatively high overall level of prenatal participation by eligible women (approximately 70%) in the Women Infants and Children (WIC) program. Because LBW has a multifactorial etiology, regardless of how it is defined, this study examined the question of whether there were differences in WIC program and participant characteristics in Alabama counties with overall low rates of LBW compared with counties with high overall rates of LBW in 1994. When county-level data for WIC program characteristics were examined for Black and White women combined, in counties with prevalence rates of LBW infants (a) births to women participating in WIC comprised a higher proportion of the overall births, (b) more WIC participants were assigned a primary risk code for anemia, (c) more WIC food vouchers were cashed in small independent stores, and (d) fewer WIC nutritionists were employed. Similar differences were not observed when county-level data for black and white WIC participants were examined separately. When county-level data for WIC participant characteristics were examined for Black and White women combined, in counties with a high rate of LBW infants (a) more WIC participants were >30 years of age and were single, and fewer women had <12 years of education, (b) fewer WIC participants smoked, (c) more WIC participants had high prepregnancy body mass indexes (BMI), (d) more WIC participants had low (<15 pounds) prenatal weight gain, and (e) more WIC participants were anemic (Hgb ≤ 10 g/dl) at the time of entry into the WIC program. Similar differences were not observed when county-level data were examined for Black and White births separately. When county-wide contextual data (i.e. not just for WIC participants) were examined for high versus low prevalence rates of the LBW infants by county groups, the counties with high prevalence rates of LBW infants were consistently found to have more characteristics that reflected a higher level of socioeconomic risk. Similarly, two indexes of increased or unmet health care needs were higher in counties with high prevalence rates of LBW infants. Similar differences were not observed when county-level contextual data for black or white high versus low prevalence rates of LBW infant county groups were examined separately. Suggestions were made regarding (a) the potential application of the findings to current WIC program policies and procedures, (b) the strengths and limitations of the present study, and (c) recommendations for future studies.

ProQuest Publication Number

Document on ProQuest

ProQuest ID

3006588

ISBN

978-0-493-15916-4

Comments

DrPH

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