Perinatal Outcomes and Nativity: Does Place of Birth Really Influence Infant Health?

ABSTRACT: In recent years nativity or nation of origin has become the focus of numerous pregnancy outcome studies. A recent research synthesis found that, although considerable heterogeneity in study designs hinders the development of broad generalizations concerning differences in pregnancy outcomes, migrant women were more likely to have better low‐birthweight and preterm birth outcomes than women born in the receiving country in most of the studies that could be incorporated in the meta‐analysis. Researchers considering studies of migration and pregnancy outcomes should incorporate more comprehensive measures of the migrant experience, as the dichotomous variable born or not born in the receiving country only opens the door to understanding the meaning of empirical observations concerning advantage or disadvantage in outcomes of pregnancy among migrant women. (BIRTH 38:4 December 2011)     

High Self-Reported Prevalence of Diabetes Mellitus, Heart Disease, and Stroke in 11 Counties of Rural Appalachian Ohio

ABSTRACT:  Context/Purpose: There is an epidemic of obesity and diabetes in the United States, especially in economically at-risk populations such as rural Appalachia. This survey determined the self-reported prevalence of obesity, diabetes mellitus, and associated macrovascular complications in 11 rural counties of Appalachian Ohio. The impacts of lifestyle, cardiovascular risk factors, income, and access to medical care were also determined. Methods: A telephone survey identical to the 2004 Behavioral Risk Factor Surveillance System (BRFSS) survey was conducted. Surveys were collected from 3,927 randomly selected residents 18 years of age and older in 11 counties of Appalachian Ohio and compared to published aggregate Ohio and national 2004 BRFSS data. Findings: The self-reported prevalence of diabetes (11.3%) was markedly higher in Appalachian Ohio counties surveyed compared to aggregate Ohio (7.8%) or national (7.2%) 2004 BRFSS data (P < .044). The prevalence of heart disease (7.6%) and stroke (4.1%) in these counties was slightly higher than aggregate Ohio or national 2004 BRFSS data. In persons with diabetes, the prevalence of heart disease was 2-fold higher (20.0%) and stroke 3-fold higher (11.4%) than among nondiabetics (P < .042) in the region and higher than aggregate Ohio and National 2004 BRFSS data. Lower-income levels and decreased access to medications and glucose monitoring supplies correlated with the increased risk for cardiovascular complications in this rural population (P < .042). Conclusion: The self-reported prevalence of diabetes mellitus and its associated macrovascular complications are much higher in rural Appalachian Ohio compared to aggregate Ohio and National 2004 BRFSS data.