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Tobacco use during pregnancy among Iowa Medicaid mothers. Debra J Kane MCH Epidemiologist/CDC Assignee Iowa Department of Public Health 12 th Annual MCH EPI Conference 12/6/06. Acknowledgements . Bureau of Family Health Jane Borst Stephanie Trusty Kim Piper Lucia Dhooge
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Tobacco use during pregnancy among Iowa Medicaid mothers Debra J Kane MCH Epidemiologist/CDC Assignee Iowa Department of Public Health 12th Annual MCH EPI Conference 12/6/06
Acknowledgements • Bureau of Family Health • Jane Borst • Stephanie Trusty • Kim Piper • Lucia Dhooge • Bureau of Health Statistics • Jill France • Xia Chen • Bureau of Information Management • Diane Boden • Department of Human Services • Sally Nadolsky Kane et al., MCH EPI 12/06/06
Study background • Medicaid match in Iowa • Rich data base with innumerable options • Select a focus based on HI 2010 goals • Smoking among Medicaid mothers • Who are the mothers? • Where and how to reach smokers? Kane et al., MCH EPI 12/06/06
Study design and sample • Linked file for calendar year 2003 • Medicaid claims data • Birth certificate files • Mother match rate 95% • Infant match rate 98% • Cross-sectional study • Birth records with either mother or infant Medicaid claim • Analysis limited to blacks and whites Kane et al., MCH EPI 12/06/06
Descriptive Results • Healthy Iowans 2010 goal • 12% • Overall • 15.8%; n=38,139 • Non-Medicaid mothers • 10.7%; n=27,437 • Medicaid mothers • 28.8%; n=10,702 Kane et al., MCH EPI 12/06/06
Descriptive Results(n= 10,702) Kane et al., MCH EPI 12/06/06
Descriptive Results(n= 10,702) Kane et al., MCH EPI 12/06/06
Descriptive Results(n= 10,702) Kane et al., MCH EPI 12/06/06
Descriptive Results(n= 10,702) Kane et al., MCH EPI 12/06/06
Bivariate Results Kane et al., MCH EPI 12/06/06
Bivariate Results Kane et al., MCH EPI 12/06/06
Bivariate Results Kane et al., MCH EPI 12/06/06
Discussion • Who are smokers? • Whites • 18 - 34 years of age • Less than 12 years of education • Parity • Prenatal care access Kane et al., MCH EPI 12/06/06
Discussion • Where to reach smokers? • Family planning clinics • Des Moines area Planned Parenthood • WIC • Prenatal care Kane et al., MCH EPI 12/06/06
Limitations • Data sources not created for research • Birth certificate reliability • Smoking variable • Women who quit after becoming pregnant • Need to go to next level of analysis Kane et al., MCH EPI 12/06/06