Disparities in Access to Prenatal Care: Perpetuation of Poverty and Inequality through the Healthcare System
Iris Cardenas
2017
This analysis addresses the disparity in prenatal health outcomes between the City of Paterson and Wayne Township in New Jersey. It guides the reader through the experiences of a hypothetical pregnant woman living in Paterson to examine the institutional and non-institutional factors that prevent this pregnant woman, and others like her, from accessing appropriate prenatal care. This paper also discusses the relationship between the inability to access proper prenatal care and the perpetuation of poverty and inequality. Lastly, it calls for local reforms to concentrate efforts in deconstructing community barriers.
Health outcomes for people of different racial backgrounds in the United States are widespread, affecting minorities even before they are born. Several studies show health outcome disparities between minorities and whites: national statistics highlight that minority groups have poorer health, i.e., blacks have higher infant mortality rates (Brooks, 1998; Bach, 2003; as cited in Johnson, 2011), and white, black, and Hispanic expectant mothers receive vastly different prenatal care (Stewart, 2008). Race and ethnicity, as indicators of health status in the United States, raises many issues—yet few health research studies have delved into this dilemma’s less obvious factors: community resources and location.
Infant mortality is preventable. The Prenatal Care Task Force (2008) reported that infant mortality is one outcome of inappropriate, or lack of, prenatal care; other outcomes are lowbirth-weight babies and pre-term births (p55-56). These outcomes are related and often precede each other: premature births highly lead to low birth weight in newborns, which in turn, contributes to infant mortality (Prenatal Care Task Force, 2008, p. 55-56). When a prematurely born baby survives, they are at higher risk of developing lifetime medical complications such as cerebral palsy, breathing problems, visual and hearing impediments, intellectual disability, cognitive delays, and behavioral problems (Martin, 2012; Prenatal Care Task Force, 2008, p.56). Despite these medical outcomes, premature birth in the United States prevails. The American Congress of Obstetricians and Gynecologists (ACOG) stated that in 2008 “more than half a million babies were born prematurely” (Martin, 2012).
Researchers observe that race and economic resources frequently align with outcomes of prenatal care. The Maternal and Child Health Journal published an article in 2003 attesting that the percentage of black women giving birth to low weight babies was almost twice the percentage of low-birth-weight babies born to white mothers (Reichman, Hamilton, Hummer & Padilla, 2008). Researchers often attribute health birth outcomes to the mother’s socioeconomic status, level of education, number of prenatal visits, and the trimester in which she entered prenatal care (Dobie, Hart, Fordyce, Andrilla, Rosenblant, 1998, p 51). These inferences highlight individual-level barriers to proper health care, suggesting that individuals’ financial stability dictates, to a certain extent, their level of health.
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