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Does rural residence affect access to prenatal care in Oregon?
Beth Epstein1, Therese Grant, Melissa Schiff
1Oregon Department of Human Services, Public Health Division, Office of Family Health, Portland, Oregon, USA.
Summary
Maternal residence location was not linked to delayed prenatal care initiation or access barriers. However, distinct risk profiles emerged across urban, large rural, and small rural areas, suggesting targeted interventions may be beneficial.
Area of Science:
- Public Health
- Maternal Health
- Rural Health Disparities
Background:
- Late initiation of prenatal care impacts policy and resource allocation.
- Understanding the influence of maternal residential location is crucial for targeted interventions.
Purpose of the Study:
- To examine the association between rural residence and late initiation of prenatal care.
- To identify how social and demographic factors influence prenatal care access.
- To explore the relationship between residence status and self-reported barriers to early prenatal care.
Main Methods:
- Observational study using 2003 Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) data (N=1,508).
- Maternal residence categorized using Rural-Urban Commuting Area (RUCA) codes: urban, large rural, small/isolated rural.
- Multivariate logistic regression and Cochran-Mantel-Haenszel tests analyzed associations.
Main Results:
- No significant association found between residence category and late prenatal care initiation.
- Residence category was not significantly associated with self-reported barriers to prenatal care access.
- Distinct maternal risk profiles observed: urban (older, nonwhite), large rural (younger, unmarried, unintended pregnancy), small rural (tobacco use).
Conclusions:
- Maternal residence category does not appear to be a direct predictor of late prenatal care initiation or access barriers.
- Identified differences in risk profiles by location suggest potential for targeted public health programs.
- Tobacco education in small rural areas is a potential intervention focus based on observed risk profiles.
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