Socio-demographic and Geographic Predictors of Health Care Receipt among Mothers and Infants in central Pennsylvania and North Carolina
Open Access
- Author:
- Kundrat, Cara L.
- Graduate Program:
- Human Development and Family Studies
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- December 02, 2008
- Committee Members:
- Clancy Blair, Dissertation Advisor/Co-Advisor
Clancy Blair, Committee Chair/Co-Chair
Mark T Greenberg, Committee Member
Kathryn Bancroft Hynes, Committee Member
Marianne Messersmith Hillemeier, Committee Member - Keywords:
- geographic
socio-demographic
infant
mother
healthcare
health care
rural/non-metropolitan
race
SES - Abstract:
- One of the most important pathways to health is through health care. Yet disparities in health care remain a prevalent problem in the U.S. Prior research has established that socio-economic status (SES), race, and geographic location are predictive of health care receipt, but little research has explored the influence of these risk factors in relation to one another, especially among mothers and infants. In addition, little is known about the receipt of health care for mothers and their infants living in more rural areas. To extend previous research and address the dearth of research on health care for rural families, the focus of the present study was to examine the influence of a multitude of factors, including rurality, socio-economic status, and race, on maternal and infant health care services among a predominantly lower-income, non-metropolitan sample living in Pennsylvania and North Carolina. Findings indicated few differences in maternal and infant health care by rurality alone. As a whole, mothers and infants reported high frequencies of regular care. Risks associated with low socio-economic standing affected only White families living in more rural areas. These families were at risk for not receiving prenatal care or childbirth preparation services. Findings also indicated that families who are typically most at-risk were actually more likely to receive certain specialty health care services. For example, low-income families and Black families were more likely than families with higher economic standing and White families to receive post-birth home visits. No significant differences in infant well-care visits by income, race, or rurality were found. Mothers with an education beyond high school were almost twice as likely to report having a regular doctor for their child. Other significant predictors of maternal and infant health care receipt included factors that enabled or impeded receipt and factors that created a health care need. These factors included: personal transportation, travel time to reach the doctor, social support, maternal health risks, and whether the child was the mother’s first-born. First-time mothers were significantly more likely to receive childbirth classes and parent education videos. This study demonstrated that although some health care disparities may still exist for lower-income families in non-metropolitan areas, receipt of maternal and infant health care services are greatly improving for at-risk families. The study substantiates the efforts of maternal and infant health care programming and financial supports that are currently being implemented at the federal, state, and local level.