Programs that increase LARC use among young, low-income women may contribute to declines in fertility rates, abortion rates and births among high-risk women.
Having a pre-pregnancy BMI above 29 greatly increases the risk for both inadequate and excessive weight gain. Unfortunately, obesity, like the other major risk factors identified here (maternal education and parity) are not modifiable after a given pregnancy begins. To address these problems, a sustained approach to women's health, education, and well-being across the lifespan will be required, rather than a reliance upon targeted interventions during pregnancy.
ABSTRACT.Objective. This study examined the factors that affect children's receipt of recommended wellchild and dental visits using nationally representative data.Methods. We analyzed the Child Public Use File of the 1999 National Survey of America's Families, including 35 938 children who were younger than 18 years. Bivariate and multivariate analyses were conducted to examine the relationship between dependent variables, including receipt of well-child visits as recommended by the American Academy of Pediatrics' periodicity schedule and dental visits as recommended by the American Academy of Pediatric Dentistry and Bright Futures, and independent variables, including health status and sociodemographic and economic indicators.Results. Overall, 23.4% of children did not receive the recommended well-child visits, whereas 46.8% did not receive the recommended number of dental visits. The factors that predict nonreceipt of care differed for wellchild and dental care and with child's age. Logistic regression reveals that children who were young (<10 years old), uninsured, non-Hispanic white, had a parent who was less than college educated, or in poor health were least likely to meet the recommendations for wellchild care. Children who did not meet the dental recommendation were more likely to be black, uninsured, from families with low incomes, have a parent who was less than college educated, and have postponed dental care in the last year. These risk factors increased with children's age.Conclusions. A substantial proportion of US children do not receive preventive care according to professionally recommended standards, particularly dental care. Publicly insured children experience higher rates of recommended well-child visits; however, much improvement is needed among public programs in providing recommended dental care, especially among adolescents and children in poor general health. Pediatrics 2002;110(6). URL: http://www.pediatrics.org/cgi/content/ full/110/6/e73; child, dental health services, multivariate analysis, preventive health services, professional organizations.
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