The Impact of the State Children’s Health Insurance Program’s Unborn Child Ruling Expansions on Foreign-Born Latina Prenatal Care and Birth Outcomes, 2000–2007

Drewry, Jonathan; Sen, Bisakha; Wingate, Martha S.; Bronstein, Janet; Foster, E. Michael; Kotelchuck, Milton

doi:10.1007/s10995-014-1650-5

Cited by 26 publications

(24 citation statements)

References 28 publications

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“…We did not find evidence that state expansions in coverage for immigrant women affected measures of health at birth or infant mortality. Lack of improvement on these outcomes is consistent with previous research that examined a subset of these state policy options, 20 as well as the findings of reviews on the effectiveness of prenatal care. 30,31,33 We did find evidence of an increase in cesarean deliveries among immigrant women with low education that was associated with the coverage expansions, but it is unclear whether this change is ultimately beneficial or harmful for mothers and infants.…”

Section: Resultssupporting

confidence: 86%

“…Jonathan Drewry and colleagues used natality data and a difference-in-differences design to compare prenatal care use and subsequent birth outcomes among immigrant Latinas in six states that implemented the option before 2004. 20 The authors found an increase in the adequacy of prenatal care use among single women with less than a high school education, but no significant changes among the overall sample. They did not detect changes in birth outcomes such as birthweight and preterm birth associated with the expansions.…”

mentioning

confidence: 92%

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State And Federal Coverage For Pregnant Immigrants: Prenatal Care Increased, No Change Detected For Infant Health

Wherry

Fabi

Schickedanz³

et al. 2017

Health Affairs

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Expanded health insurance coverage for pregnant immigrant women who are in the United States lawfully as well as those who are in the country without documentation may address barriers in access to pregnancy-related care. We present new evidence on the impact of states' public health insurance expansions for pregnant immigrant women (both state-funded and expansions under the Children's Health Insurance Program) on their prenatal care use, mode of delivery, and infant health. Our quasi-experimental design compared changes in immigrant women's outcomes in states expanding coverage to changes in outcomes for nonimmigrant women in the same state and to women in nonexpanding states. We found that prenatal care use increased among all immigrant women following coverage expansion and that cesarean section increased among immigrant women with less than a high school diploma. We found no effects on the incidence of low birthweight, preterm birth, being small for gestational age, or infant death. State public insurance programs that cover pregnant immigrant women appear to have improved prenatal care utilization without observable changes in infant health or mortality.

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Section: Resultssupporting

confidence: 86%

mentioning

confidence: 92%

State And Federal Coverage For Pregnant Immigrants: Prenatal Care Increased, No Change Detected For Infant Health

Wherry

Fabi

Schickedanz³

et al. 2017

Health Affairs

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“…12,13 Our study corroborates these important findings related to prenatal care access, which a growing body of literature links to improved health and economic indicators in the subsequent generation. 28 Moreover, because we are able to specifically isolate immigrant women who gain coverage through Oregon's expansion, we are better able to measure related health outcomes.…”

Section: Discussionsupporting

confidence: 86%

“…11–13 In response, Oregon began piloting a program to expand access to prenatal care for all recent and unauthorized immigrant women in 2008 called CAWEM Plus (Citizen/Alien Waived Emergent Medical Care). In this study, we refer to this program as Emergency Medicaid Plus.…”

Section: Introductionmentioning

confidence: 99%

Expanding Prenatal Care to Unauthorized Immigrant Women and the Effects on Infant Health

Swartz

Hainmueller

Lawrence

et al. 2017

Obstetrics &Amp; Gynecology

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Objective To measure the result of access to prenatal care on unauthorized and low-income, new legal permanent resident immigrant women and their offspring. Methods We used a difference-in-difference design that leverages the staggered rollout of Emergency Medicaid Plus by county from 2008 to 2013 as a natural experiment to estimate the effect on health service utilization for women and health outcomes for their infants. Regular Medicaid pregnancies were used as an additional control in a triple difference design. Results Our sample included pregnancies covered by Emergency Medicaid (34,319), Emergency Medicaid Plus (12,344), and Medicaid (163,537). After expansion of access to prenatal care, there was an increase in prenatal visits (7.2 more visits, 95% CI 6.46 to 7.98), receipt of adequate prenatal care (28% increased rate, CI 26 to 31), rates of diabetes screening (61% increased rate, CI 56 to 65) and fetal ultrasounds (74% increased rate, CI 72 to 77). Maternal access to prenatal care was also associated with an increased number of well-child visits (0.24 more visits, CI 0.07 to 0.41), increased rates of recommended screenings and vaccines (0.04 increased probability, CI 0.002 to 0.074), and reduced infant mortality (-1.04 per 1000, CI -1.45 to -0.62) and rates of extremely low birth weight (<1000g) (-1.5 per 1000, CI -2.58 to -0.53). Conclusion Our results provide evidence of increased utilization and improved health outcomes for unauthorized immigrants and their children who are United States citizens after introduction of prenatal care expansion in Oregon. This study contributes to the debate around reauthorization of the Children's Health Insurance Program in 2017.

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“…Chelsea is a diverse, low-income community: 24% of the population lives below the federal poverty level, 44% were born outside the United States, and 68% speak a language other than English at home (16). However, health insurance coverage is high (16), and all low-income pregnant women in Massachusetts qualify for health insurance, regardless of immigration status (17). …”

Section: Methodsmentioning

confidence: 99%

Food Insecurity and Cardiovascular Health in Pregnant Women: Results From the Food for Families Program, Chelsea, Massachusetts, 2013–2015

et al. 2016

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BackgroundFood insecurity, uncertainty about the ability to acquire adequate food, is associated with cardiometabolic disease in pregnant women. Whether food insecurity interventions improve cardiometabolic health is unknown.MethodsWe conducted a retrospective analysis of women who visited the obstetrics clinic in a community health center from 2013 through 2015. Patients could be referred to the Food for Families (Food for Families) program, which connects food insecure women to food resources. We hypothesized that participation in Food for Families would be associated with better blood pressure and blood glucose trends during pregnancy. We used a propensity score–matched design to reduce bias from differential entry into Food for Families.ResultsEleven percent of women who visited the obstetrics clinic were referred to Food for Families. In propensity score–matched analyses, we found no difference in baseline systolic blood pressure (SBP) between those who were referred and enrolled in Food for Families (113.5 mm Hg), those who were referred and did not enroll in Food for Families (113.9 mm Hg), and those who were not referred to Food for Families (114 mm Hg) (P = .79). However, during pregnancy, women who were referred to and enrolled in Food for Families had a better SBP trend (0.2015 mm Hg/wk lower, P = .006). SBP trends did not differ between women who were referred and did not enroll in Food for Families and those who were not referred. We observed no differences in blood glucose trends between groups (P = .40).ConclusionsFood for Families participation was associated with better blood pressure trends in pregnant women but no differences in blood glucose trends. Food insecurity reduction programs may improve cardiovascular health for vulnerable pregnant women, and this topic deserves further study incorporating randomized program entry.

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The Impact of the State Children’s Health Insurance Program’s Unborn Child Ruling Expansions on Foreign-Born Latina Prenatal Care and Birth Outcomes, 2000–2007

Cited by 26 publications

References 28 publications

State And Federal Coverage For Pregnant Immigrants: Prenatal Care Increased, No Change Detected For Infant Health

State And Federal Coverage For Pregnant Immigrants: Prenatal Care Increased, No Change Detected For Infant Health

Expanding Prenatal Care to Unauthorized Immigrant Women and the Effects on Infant Health

Food Insecurity and Cardiovascular Health in Pregnant Women: Results From the Food for Families Program, Chelsea, Massachusetts, 2013–2015

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