This study compares the incidence of low birth weight among mothers enrolled in Arizona's Health Start program to a sample of non-Health Start mothers with similar medical and social risk factors. A quasi-experimental design was used to match Health Start program participants to non-participants on the basis of similar medical and social risk factors. Health Start program data were linked to birth certificate data to create a sample of 5,480 pregnant women. A logistic regression analysis was conducted to predict the likelihood of having a normal birth weight (i.e., 2,500 g or more). The findings indicate that Health Start mothers had twice as better odds of having a normal birth weight than non-Health Start mothers, even after controlling for gestational age, adequacy of prenatal care, mother's history of preterm birth, weight gain during pregnancy, alcohol and cigarette use, mother's age, education and residency. Hispanic women in the program were three times as likely to have a normal birth weight baby when compared to Hispanics who were not in the program and twice as likely as non-participant Whites. And lastly, women in urban settings had better birth outcomes, especially Hispanic women. Evidence suggests that newborn infants of mothers enrolled in the Health Start Program had better birth weight outcomes even after controlling for the effects of possible confounders. However, the program seems to affect Hispanics and non-Hispanic Whites differently; in particular, Hispanics who are in the program demonstrated the best birth outcomes. One possible explanation for the general success of the program could be that program participants reported lower cigarette use during pregnancy. A limitation of this study is that that there could be reporting bias on the part of Health Start participants about their risks to enter into the program, which is difficult to verify.

OBJECTIVE: The objective of this paper was to describe results of a public health-administered, provincial dental survey of children aged 4-6 years old in British Columbia, and assess the changes in rates of dental caries geographically and by neighbourhood socio-economic status between baseline (2006/07) and follow-up data collection (2009/10). METHOD:The study design involved two retrospective cohorts of kindergarten children who received a public health-administered dental assessment in the years 2006/07 and 2009/10. Neighbourhood socio-economic status was measured by an index created from Canadian Census and Tax Filer data sets. The dental outcomes included previous decay experience, untreated visible decay, and urgent treatment needs. RESULTS:The analysis comprised dental outcomes for 35,602 kindergarten children in 2006/07 and 35,215 children in 2009/10. There was a modest decrease in dental decay rates between surveys, with rates of decay experience -previous and untreated -of 38.9% and 36.7% respectively. However, there were disparities, with almost 50% of children with dental decay in the most socio-economically disadvantaged neighbourhoods, and approximately 30% with dental decay in the least disadvantaged areas. CONCLUSION:The kindergarten dental survey had extensive coverage, was at the population level, and enabled analysis of change in early childhood dental decay rates over time and by geography. Although overall rates improved, dental health inequalities persisted in both survey years at both regional and neighbourhood levels.KEY WORDS: Dental caries; oral health; child; trends; surveillance; British Columbia La traduction du résumé se trouve à la fin de l'article.

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