Maternal and Child Health, Maternal and Child Health, USUS--Mexico BorderMexico Border

Sam Notzon, Ph.D.Sam Notzon, Ph.D.Director, International Statistics ProgramDirector, International Statistics Program

National Center for Health StatisticsNational Center for Health Statistics

Definitions:Definitions:Data refer to the US side only of the Data refer to the US side only of the USUS--Mexico borderMexico borderBorder region defined as 44 US counties Border region defined as 44 US counties within 62 miles or 100 kilometers of the within 62 miles or 100 kilometers of the borderborderData are from birth and death Data are from birth and death certificates for residents of the border certificates for residents of the border counties, plus US Censuscounties, plus US CensusBirth and death certificate data have Birth and death certificate data have some disadvantages, but several some disadvantages, but several important advantages important advantages

U.S. Counties Included U.S. Counties Included in Border Regionin Border Region

2000 Population55.1 million6.6 million

U.S.-Mexico Border Region

Population Growth, USA and Population Growth, USA and USUS--Mexico Border 1990Mexico Border 1990--20002000

13

19

0

5

10

15

20

USA Border

Perc

ent

Source: 1990, 2000 Census.

6,553,7666,553,7665,432,3055,432,305BorderBorder

281,421,906281,421,906248,709,873248,709,873USAUSA

2000200019901990

Population Growth, USPopulation Growth, US--Mexico Border Mexico Border 19901990--20002000

19

48

3

0

10

20

30

40

50

Border Hispanic Non-HispanicWhite (NHW)

Perc

ent

Source: 1990, 2000 Census.

Fertility Rate, USA and Fertility Rate, USA and USUS--Mexico Border 2004Mexico Border 2004

66

8475 73 75

103

0

20

40

60

80

100

120

USA Border AZborder

CAborder

NMborder

TXborder

Birt

hs p

er 1

000

wom

en 1

5-44

Source: National natality data, NCHS/CDC.

Total Fertility Rate, USA and Total Fertility Rate, USA and USUS--Mexico Border 2004Mexico Border 2004

2.0

2.52.3 2.2 2.2

3.0

0

1

2

3

USA Border AZ border CA border NMborder

TX border

Com

plet

ed n

umbe

r of

birt

hs p

er w

oman

Source: National natality data, NCHS/CDC.

Total Fertility Rate, Total Fertility Rate, USUS--Mexico Border 2004Mexico Border 2004

2.5

3.0

1.7

0

1

2

3

Border Hispanic NHW

Com

plet

ed n

umbe

r of

birt

hs p

er w

oman

Source: National natality data, NCHS/CDC.

Risk Factors for Pregnant Risk Factors for Pregnant Women and InfantsWomen and Infants

Teen pregnancy/childbirth Teen pregnancy/childbirth Pregnancy/childbirth at age 35+Pregnancy/childbirth at age 35+Low socioeconomic statusLow socioeconomic statusMaternal smoking, drinkingMaternal smoking, drinkingAccess to prenatal careAccess to prenatal careMaternal health conditionsMaternal health conditionsMaternal nutritionMaternal nutrition

Early Teen Birth Rate, USA and Early Teen Birth Rate, USA and USUS--Mexico Border 2004Mexico Border 2004

40

58

8

23

0

10

20

30

40

50

60

USA Border Hispanic NHW

Per 1

000

wom

en u

nder

age

18

Source: National natality data, NCHS/CDC.

Birth Rate for Women 35+, USA and Birth Rate for Women 35+, USA and USUS--Mexico Border 2004Mexico Border 2004

32 322827

0

10

20

30

40

50

60

USA Border Hispanic NHW

Per 1

000

wom

en a

ge 3

5+

Source: National natality data, NCHS/CDC.

Percent of Mothers with Less ThanPercent of Mothers with Less Than12 Years of Education, USA and 12 Years of Education, USA and

USUS--Mexico Border 2004Mexico Border 2004

32

42

7

22

0

10

20

30

40

50

USA Border Hispanic NHW

Perc

ent

Source: National natality data, NCHS/CDC.

Percent of Mothers Beginning Prenatal Care in Percent of Mothers Beginning Prenatal Care in First Trimester, USFirst Trimester, US--Mexico Border, 2004Mexico Border, 2004

±

LegendNA

58.2 - 65.9

67.0 - 70.4

75.4 - 81.9

87.6 - 88.4

Percent* of Mothers Who Smoked Percent* of Mothers Who Smoked During Pregnancy, USA and During Pregnancy, USA and

USUS--Mexico Border 2004Mexico Border 2004

2

1

9

10

0

2

4

6

8

10

12

USA Border Hispanic NHW

Perc

ent

Source: National natality data, NCHS/CDC. *Excludes data for California and other states.

Percent Low Birth Weight, USA and Percent Low Birth Weight, USA and USUS--Mexico Border 2004Mexico Border 2004

7.0 6.8 6.9

8.1

0

2

4

6

8

10

USA Border Hispanic NHW

Perc

ent

Source: National natality data, NCHS/CDC.

Infant Mortality Rate, USA and Infant Mortality Rate, USA and USUS--Mexico Border, 2004Mexico Border, 2004

6.8

4.95.6

4.6

5.7 5.3

0

2

4

6

8

10

USA Border counties

Per 1

000

live

birt

hs

Total Hispanic NHW

Source: National natality and mortality files, NCHS/CDC.

Hispanic ParadoxHispanic Paradox

Why do Hispanic mothers, infants Why do Hispanic mothers, infants and children have such good and children have such good health despite their low income, health despite their low income, low education, and other low education, and other disadvantages?disadvantages?

MCH Data QualityMCH Data QualityBirth weight: Birth weight:

Very few birth certificates do not contain Very few birth certificates do not contain this informationthis informationAccuracy of birth weight data is certainly Accuracy of birth weight data is certainly good enough to be confident of the percent good enough to be confident of the percent low birth weight low birth weight

Infant mortality:Infant mortality:Border figures are similar to national rates Border figures are similar to national rates for Hispanics and nonfor Hispanics and non--Hispanic WhitesHispanic WhitesBorder Hispanic rate may be affected by Border Hispanic rate may be affected by women crossing border to give birth in USwomen crossing border to give birth in US

Childhood HealthChildhood Health

Beyond the first year of life, the Beyond the first year of life, the leading cause of childhood death is leading cause of childhood death is injuriesinjuries, for both the border and , for both the border and the USAthe USA

Within the injury category, motor Within the injury category, motor vehicle crashes is the leading causevehicle crashes is the leading cause

Childhood obesity and type 2 Childhood obesity and type 2 diabetes are increasing concerns diabetes are increasing concerns on the borderon the border

Percent Cesarean Section Deliveries, Percent Cesarean Section Deliveries, USA and USUSA and US--Mexico Border 2004Mexico Border 2004

31.3 32.5

28.629.1

0

10

20

30

40

USA Border Hispanic NHW

Perc

ent

Source: National natality data, NCHS/CDC.

Cesarean Section Rate, US-Mexico Border 2004

Legendusborder_counties99County pop density_excel_cesar.2000_POP_D / <None>

0.000000000

0.000000000 - 24.8000000

24.8000001 - 28.8000000

28.8000001 - 34.2000000

34.2000001 - 37.5000000

37.5000001 - 46.0000000

az_nm_tx_ca_alone

Thanks!Thanks!

Sam NotzonSam NotzonNational Center for Health StatisticsNational Center for Health Statistics

Email: Email: SNotzon@cdc.govSNotzon@cdc.govTel: 301Tel: 301--458458--44024402