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State of Alaska

Complete Health Indicator Report of Health Care - No Prenatal Care in First Trimester (HA2020 Leading Health Indicator: 21)

Definition

Percentage of infants born to pregnant women who did not receive prenatal care in the first trimester as a percentage of the total number of live births.

Numerator

Number of infants born to pregnant women who did not receive prenatal care in the first trimester.

Denominator

Number of live births.

Data Interpretation Issues

Alaska populations are from the [http://laborstats.alaska.gov/pop/popest.htm Alaska Department of Labor and Workforce Development, Research and Analysis]. The transition from the 1989 revision of the U.S. Standard Certificate of Live Birth to the 2003 revision has multiple implications for tracking rates of prenatal care in the United States. First, the timing of prenatal care item has changed. For data collected using the 1989 revision (all data prior to 2013), the item was recorded as the month of pregnancy that prenatal care began as reported by the mother. With the 2003 revision, the item was changed to request the date (day/month/year) of the first prenatal care visit, as recorded in the prenatal care or medical record. As a result of these modifications, rates of prenatal care timing and adequacy from the 2003 revision are not comparable to data collected using earlier birth certificate revisions.^1^ Alaska implemented the 2003 version of the birth certificate in 2013.[[br]] [[br]] ---- {{class .SmallerFont 1. Calculations | PeriStats | March of Dimes. [http://www.marchofdimes.org/peristats/calculationsp.aspx?id=23]. Accessed July 13, 2016. }}

Why Is This Important?

Access to quality healthcare is influenced by a number of factors, including: having health insurance, having access to care, and being able to afford care.^2^ Inadequate prenatal care--including late initiation of care, infrequent prenatal visits, or no care at all--is associated with poor infant and maternal outcomes, including low birth weight or preterm infants and for the mothers an increased risk for pregnancy-related mortality and complications of childbirth.^3^ [[br]] [[br]] ---- {{class .SmallerFont 2. DeVoe, Baez A, Angier H, Krois L, et al. Insurance plus Access Does not Equal Health Care: Typology of Barriers to Health Care Access for Low-Income Families. Ann Fam Med. 2007;5(6):511-518. [http://www.medscape.com/viewarticle/567154] Accessed October 19, 2016. 3. Young MB, Perham-Hester KA, Kemberling MM. Alaska Maternal and Child Health Data Book 2011: Alaska Native Edition. Anchorage, AK: A collaboration of the Alaska Department of Health and Social Services, Division of Public Health, and the Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center. October 2011. [http://anthctoday.org/epicenter/publications/prams/pramsFullVersion.pdf] Accessed October 19, 2016. }}

Healthy People Objective: Prenatal care beginning in first trimester

U.S. Target: 77.9 percent (or 22.1 percent not beginning prenatal care in the first trimester)
State Target: Healthy Alaskans 2020 Target: 19.0% with no prenatal care in first trimester

Other Objectives

Healthy Alaskans 2020 Indicator 21: Reduce the percentage of women delivering live births who have not received prenatal care beginning in the first trimester of pregnancy to 19% by 2020.

How Are We Doing?

In 2015, over one-fifth of Alaska women who delivered a live birth did not receive prenatal care beginning in the first trimester. The percentage was 20.2% for all Alaskans and 24.3% for Alaska Native women who delivered live births. Due to the changes on the birth certificate on the timing of the first prenatal care visit, rates from 2013 and later are more precise and not directly comparable to earlier years. Nearly 30% of women giving birth in the northern (28.2%) and southwest regions (28.6%) did not receive prenatal care beginning in the first trimester for the 5-year period of 2011-2015. In reviewing the 10-year average for 2006-2015 by boroughs and census areas, areas with approximately one-third or higher rates of not receiving prenatal care in the first trimester consisted of Kodiak Island Borough (38.6%), North Slope Borough (38.1%), Southeast Fairbanks census area (36.4%), and Yukon-Koyukuk census area (37.1%). In the Arctic Slope Regional Corporation area, 37.8% of women lacked early prenatal care, followed closely by the Aleut Corporation region with 36.7%. Although there has been improvement in the rate of prenatal care beginning in the first trimester of pregnancy, particularly among Alaska Native mothers, the rates for both all Alaskan mothers and Alaska Native mothers have not declined sufficiently to make the Healthy Alaskans 2020 objective of 19%. Alaska PRAMS surveyed women who recently delivered a live birth about their ability to obtain prenatal care when they wanted it, and asked them to list the corresponding reasons if they were unable to. During 2002-2011, the prevalence of Alaskan women who received prenatal care as early as they wanted it increased from 80.4% to 85.0%. The most common reason that Alaskan women gave for not getting prenatal care as early in their pregnancy as they wanted was because they didn't know they were pregnant (36.5%). Not having a Medicaid or Denali KidCare card (35.6%) or not being able to get an appointment when they wanted one (35.0%) were also common reasons given.^4^ The Adequacy of Prenatal Care Utilization (APNCU) index makes use of two types of prenatal care information obtained from birth certificate data: when prenatal care began (adequacy of initiation) and the number of prenatal visits from when prenatal care began until delivery (adequacy of received services). In 2015, only 58.4% of mothers of live births received adequate prenatal care.^5^ [[br]] [[br]] ---- {{class .SmallerFont 4. Newby-Kew AJ, DeLozier DP, Prince CB, Perham-Hester KA, Young MB. Alaska Maternal and Child Health Data Book 2014: Life Course Edition. Anchorage, AK. Maternal and Child Health Epidemiology Unit, Section of Women's, Children's, and Family Health, Division of Public Health, Alaska Department of Health and Social Services, September 2014. [http://dhss.alaska.gov/dph/wcfh/Documents/mchepi/pubs/databook/MCHDataBook2014toweb.pdf]. Accessed July 13, 2016. 5. Alaska Department of Health and Social Services, Division of Public Health, Health Analytics and Vital Records Section. Alaska Vital Statistics 2015 Annual Report. [http://dhss.alaska.gov/dph/VitalStats/Documents/PDFs/VitalStatistics_Annualreport_2015.pdf]. Accessed February 16, 2017. }}

Evidence-based Practices

As part of the Healthy Alaskans 2020 health improvement process, groups of Alaska subject matter experts met over a period of months in a rigorous review process to identify and prioritize strategies to address the 25 health priorities. Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs. '''Strategy 1:''' [[br]]Increase the number of women of childbearing age who report having access to health care providers who support them to plan their pregnancies. '''Evidence Base:''' [[br]]The Agency for Healthcare Research and Quality describes components of health care access as follows: Access to health care means having "the timely use of personal health services to achieve the best health outcomes" (source: Millman M, ed. Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Access to health care in America. Washington, DC: National Academy Press; 1993). Health care access is measured in several ways, including: # Structural measures of the presence or absence of specific resources that facilitate health care, such as having health insurance or a usual source of care. # Assessments by patients of how easily they are able to gain access to health care. # Utilization measures of the ultimate outcome of good access to care (i.e., the successful receipt of needed services). '''Source:''' [[br]]Agency of Healthcare Research and Quality. [http://www.ahrq.gov/research/findings/nhqrdr/nhqr08/Chap3.html Patient Safety]. In National Healthcare Quality Report, 2008 (Chapter 3). '''Strategy 2:''' [[br]]Increase the number of women who have their pregnancies confirmed by a health care provider in the first trimester. '''Evidence Base:''' [[br]]The Agency for Healthcare Research and Quality describes components of health care access as follows: Access to health care means having "the timely use of personal health services to achieve the best health outcomes" (source: Millman M, ed. Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Access to health care in America. Washington, DC: National Academy Press; 1993). Attaining good access to care requires three discrete steps: # Gaining entry into the health care system. # Getting access to sites of care where patients can receive needed services. # Finding providers who meet the needs of individual patients and with whom patients can develop a relationship based on mutual communication and trust. '''Source:''' [[br]]Agency of Healthcare Research and Quality. [http://www.ahrq.gov/research/findings/nhqrdr/nhqr08/Chap3.html Patient Safety]. In National Healthcare Quality Report, 2008 (Chapter 3). '''Strategy 3:''' [[br]]Improve systems and services that care for women with addictions (alcohol, drugs, tobacco). '''Evidence Base:''' [[br]]The Agency for Healthcare Research and Quality describes components of health care access as follows: Access to health care means having "the timely use of personal health services to achieve the best health outcomes" (source: Millman M, ed. Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Access to health care in America. Washington, DC: National Academy Press; 1993). Health care access is measured in several ways, including: # Structural measures of the presence or absence of specific resources that facilitate health care, such as having health insurance or a usual source of care. # Assessments by patients of how easily they are able to gain access to health care. # Utilization measures of the ultimate outcome of good access to care (i.e., the successful receipt of needed services). '''Source:''' [[br]]Agency of Healthcare Research and Quality. [http://www.ahrq.gov/research/findings/nhqrdr/nhqr08/Chap3.html Patient Safety]. In National Healthcare Quality Report, 2008 (Chapter 3).

Health Program Information

A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_21_Prenatal.pdf].


Related Indicators

Relevant Population Characteristics

Pregnant teens 15-19 years of age, mothers with low level of education, race other than White, Hispanic ethnicity, being unmarried, lower socio-economic status, and women who lack health insurance are less likely to get early prenatal care.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Having health insurance improves availability of prenatal care services. Lack of health insurance affects both the timing and frequency of prenatal care visits, resulting in poor pregnancy outcomes such as premature birth, low birth weight, and complicated delivery. Availability of family planning services is another system factor that reduces the risk of unintended pregnancy. If a pregnancy is planned, a woman is more likely to seek early and adequate prenatal care.

Related Health Care System Factors Indicators:


Risk Factors

The risk factors for late entry identified by the Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) and from the birth certificate are: - women less than 20 years of age - women with less than 12 years of education - non-White women - Hispanic women - unmarried women - women with an annual household income less than $15,000/year - unintended pregnancy - women who had no private insurance prior to conception

Related Risk Factors Indicators:


Health Status Outcomes

Prenatal care can improve birth outcomes and prevent medical complications and their costs associated with premature births, low birth weight births, and maternal and infant mortality and morbidity.



Graphical Data Views

Percentage of women delivering live births who have not received prenatal care beginning in first trimester of pregnancy, all Alaskans and Alaska Natives, 2001-2020

::chart - missing::
confidence limits

Alaska ComparisonsYearPercentage of women not receiving prenatal care in first trimesterLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 40
All Alaskans200019.4%18.7%20.2%1,8829,677
All Alaskans200119.1%18.3%19.9%1,8419,635
All Alaskans200219.6%18.8%20.4%1,8599,509
All Alaskans200319.9%19.1%20.7%1,9079,602
All Alaskans200418.9%18.2%19.7%1,8529,776
All Alaskans200519.5%18.7%20.2%1,98410,196
All Alaskans200618.7%18.0%19.4%1,99910,687
All Alaskans200719.7%18.9%20.4%2,10410,688
All Alaskans200820.2%19.4%21.0%2,20610,924
All Alaskans200919.7%18.9%20.4%2,03210,322
All Alaskans201021.3%20.5%22.0%2,24810,571
All Alaskans201122.5%21.7%23.3%2,45110,897
All Alaskans201223.4%22.6%24.2%2,46910,560
All Alaskans201320.5%19.8%21.3%2,21210,774
All Alaskans201421.7%20.9%22.5%2,35910,875
All Alaskans201520.2%19.4%20.9%2,19310,864
Alaska Native people200029.7%27.9%31.6%7122,394
Alaska Native people200127.8%26.0%29.6%6632,383
Alaska Native people200229.8%27.9%31.7%6872,306
Alaska Native people200329.2%27.4%31.0%6942,377
Alaska Native people200429.0%27.2%30.8%7152,466
Alaska Native people200528.2%26.5%29.9%7482,654
Alaska Native people200627.3%25.6%29.0%7172,628
Alaska Native people200730.2%28.4%31.9%8142,700
Alaska Native people200832.2%30.5%34.0%9082,816
Alaska Native people200927.1%25.5%28.7%7762,865
Alaska Native people201027.3%25.7%29.0%7682,810
Alaska Native people201125.5%23.8%27.1%6972,738
Alaska Native people201227.1%25.5%28.8%7372,716
Alaska Native people201324.5%22.8%26.2%5822,376
Alaska Native people201425.3%23.6%27.1%6012,372
Alaska Native people201524.3%22.5%26.0%5592,302
Healthy Alaskans Goal201319.0%
Healthy Alaskans Goal201419.0%
Healthy Alaskans Goal201519.0%
Healthy Alaskans Goal201619.0%
Healthy Alaskans Goal201719.0%
Healthy Alaskans Goal201819.0%
Healthy Alaskans Goal201919.0%
Healthy Alaskans Goal202019.0%

Data Notes

Data from before 2013 were obtained using the 1989 revision of the U.S. Standard Certificate of Live Birth in which only the month in which prenatal care began was collected. Data from before 2013 may not be comparable to the information from 2013 and later based upon the 2003 revision of the certificate that requested the date of the first prenatal care visit.

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Alaska Health Analytics and Vital Records], Division of Public Health, Alaska Department of Health and Social Services


Percentage of women delivering live births who received adequate prenatal care, all Alaskans and Alaska Natives, 2006-2015

::chart - missing::

The measure shown in the graph is women who were categorized as receiving Adequate or Adequate Plus care.
Alaska ComparisonsYearPercentage of women delivering live birthsNumer- atorDenom- inator
Record Count: 20
All Alaskans200657.6%6,32910,996
All Alaskans200755.6%6,14011,052
All Alaskans200852.0%5,94511,440
All Alaskans200949.2%5,56811,317
All Alaskans201052.9%6,06811,470
All Alaskans201153.9%6,16911,441
All Alaskans201257.1%6,37411,166
All Alaskans201354.9%6,29111,452
All Alaskans201456.6%6,45211,398
All Alaskans201558.4%6,59711,293
Alaska Native people200643.8%1,1832,698
Alaska Native people200738.9%1,0792,775
Alaska Native people200838.9%1,1242,888
Alaska Native people200942.4%1,2532,956
Alaska Native people201045.0%1,3002,891
Alaska Native people201143.7%1,2372,830
Alaska Native people201249.8%1,3952,803
Alaska Native people201351.8%1,2722,455
Alaska Native people201450.9%1,2362,429
Alaska Native people201552.1%1,2422,382

Data Notes

Adequacy of Prenatal Care Utilization (APNCU) index classifies the adequacy of initiation as follows: pregnancy months 1 and 2, months 3 and 4, months 5 and 6, and months 7 to 9. To classify the adequacy of received services, the number of prenatal visits is compared to the expected number of visits for the period between when care began and the delivery date. The expected number of visits is based on the American College of Obstetricians and Gynecologists prenatal care standards for uncomplicated pregnancies and is adjusted for the gestational age when care began and for the gestational age at delivery. A ratio of observed to expected visits is calculated and grouped into four categories - Inadequate (received less than 50% of expected visits), Intermediate (50%-79%), Adequate (80%-109%), and Adequate Plus (110%). The final APNCU index measure combines these two dimensions into a single summary score.^5^

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Alaska Health Analytics and Vital Records], Division of Public Health, Alaska Department of Health and Social Services


Percentage of women delivering live births who have not received prenatal care beginning in first trimester of pregnancy, by race, Alaska, 2001-2020

::chart - missing::
confidence limits

Race: Alaska Native, Asian/Pacific Is, Black, WhiteYearPercentage of MothersLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 64
Alaska Native people200029.7%27.9%31.6%7122,394
Alaska Native people200127.8%26.0%29.6%6632,383
Alaska Native people200229.8%27.9%31.7%6872,306
Alaska Native people200329.2%27.4%31.0%6942,377
Alaska Native people200429.0%27.2%30.8%7152,466
Alaska Native people200528.2%26.5%29.9%7482,654
Alaska Native people200627.3%25.6%29.0%7172,628
Alaska Native people200730.2%28.4%31.9%8142,700
Alaska Native people200832.2%30.5%34.0%9082,816
Alaska Native people200927.1%25.5%28.7%7762,865
Alaska Native people201027.3%25.7%29.0%7682,810
Alaska Native people201125.5%23.8%27.1%6972,738
Alaska Native people201227.1%25.5%28.8%7372,716
Alaska Native people201324.5%22.8%26.2%5822,376
Alaska Native people201425.3%23.6%27.1%6012,372
Alaska Native people201524.3%22.5%26.0%5592,302
Asian/Pacific Islander200022.2%18.8%25.5%131591
Asian/Pacific Islander200122.4%19.1%25.7%135603
Asian/Pacific Islander200222.4%19.2%25.7%141628
Asian/Pacific Islander200324.6%21.3%28.0%155629
Asian/Pacific Islander200426.2%22.9%29.5%178680
Asian/Pacific Islander200529.6%26.3%32.9%218737
Asian/Pacific Islander200622.4%19.6%25.3%184820
Asian/Pacific Islander200725.8%22.7%28.8%205796
Asian/Pacific Islander200825.9%22.9%28.8%216835
Asian/Pacific Islander200928.2%25.1%31.2%232824
Asian/Pacific Islander201031.2%28.2%34.2%287920
Asian/Pacific Islander201136.6%33.6%39.7%353964
Asian/Pacific Islander201234.9%32.0%37.8%3541,014
Asian/Pacific Islander201333.0%30.0%35.9%319968
Asian/Pacific Islander201431.4%28.5%34.2%3261,040
Asian/Pacific Islander201532.3%29.4%35.1%3371,044
Black200018.5%14.9%22.1%82444
Black200117.5%13.9%21.2%73417
Black200215.6%12.0%19.1%62398
Black200317.7%13.7%21.7%63356
Black200414.1%10.4%17.7%49348
Black200517.1%13.3%20.8%65381
Black200615.2%11.8%18.7%63413
Black200719.0%15.3%22.7%82432
Black200819.9%15.9%23.9%77387
Black200919.5%15.6%23.4%76390
Black201016.8%13.1%20.5%66393
Black201126.8%22.8%30.8%125466
Black201224.4%20.0%28.8%91373
Black201322.6%18.8%26.3%109483
Black201423.2%19.4%27.0%112483
Black201521.9%18.1%25.7%100456
White200015.1%14.2%16.0%9296,150
White200115.4%14.5%16.3%9466,135
White200215.6%14.7%16.5%9436,052
White200315.8%14.9%16.7%9676,128
White200414.3%13.4%15.1%8816,174
White200514.7%13.8%15.6%9266,299
White200615.1%14.3%16.0%1,0036,626
White200714.7%13.9%15.6%9656,558
White200814.6%13.7%15.4%9886,778
White200914.9%14.0%15.8%9176,143
White201017.4%16.4%18.3%1,1076,372
White201118.8%17.8%19.7%1,2406,615
White201219.7%18.7%20.6%1,2436,319
White201317.3%16.4%18.2%1,1746,788
White201418.6%17.7%19.5%1,2436,686
White201516.8%15.9%17.7%1,1346,740


Percentage of women delivering live births who received adequate prenatal care, by race, Alaska, 2006-2015

::chart - missing::

The measure shown in the graph is women who were categorized as receiving Adequate or Adequate Plus care.
Race: Alaska Native, Asian/Pacific Is, Black, WhiteYearPercentage of women delivering live birthsNumer- atorDenom- inator
Record Count: 40
Alaska Native people200643.8%1,1832,698
Alaska Native people200738.9%1,0792,775
Alaska Native people200838.9%1,1242,888
Alaska Native people200942.4%1,2532,956
Alaska Native people201045.0%1,3002,891
Alaska Native people201143.7%1,2372,830
Alaska Native people201249.8%1,3952,803
Alaska Native people201351.8%1,2722,455
Alaska Native people201450.9%1,2362,429
Alaska Native people201552.1%1,2422,382
Asian/Pacific Islander200651.4%448872
Asian/Pacific Islander200752.1%440845
Asian/Pacific Islander200846.6%440945
Asian/Pacific Islander200945.4%427941
Asian/Pacific Islander201046.8%4881,042
Asian/Pacific Islander201147.7%4911,030
Asian/Pacific Islander201250.2%5581,111
Asian/Pacific Islander201346.6%5231,121
Asian/Pacific Islander201451.8%6431,241
Asian/Pacific Islander201552.7%6281,191
Black200659.1%253428
Black200753.5%242452
Black200844.0%186423
Black200938.8%181466
Black201047.3%218461
Black201151.2%262512
Black201254.9%229417
Black201354.1%276510
Black201454.5%278510
Black201561.7%292473
White200663.6%4,3136,782
White200763.3%4,2666,740
White200858.5%4,1297,059
White200953.9%3,6696,809
White201057.7%4,0236,974
White201159.5%4,1306,943
White201261.5%4,1116,682
White201357.4%4,1727,273
White201459.8%4,2107,040
White201561.4%4,3067,013

Data Notes

Adequacy of Prenatal Care Utilization (APNCU) index classifies the adequacy of initiation as follows: pregnancy months 1 and 2, months 3 and 4, months 5 and 6, and months 7 to 9. To classify the adequacy of received services, the number of prenatal visits is compared to the expected number of visits for the period between when care began and the delivery date. The expected number of visits is based on the American College of Obstetricians and Gynecologists prenatal care standards for uncomplicated pregnancies and is adjusted for the gestational age when care began and for the gestational age at delivery. A ratio of observed to expected visits is calculated and grouped into four categories - Inadequate (received less than 50% of expected visits), Intermediate (50%-79%), Adequate (80%-109%), and Adequate Plus (110%). The final APNCU index measure combines these two dimensions into a single summary score.^5^

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Alaska Health Analytics and Vital Records], Division of Public Health, Alaska Department of Health and Social Services


Percentage of women delivering live births who have not received prenatal care beginning in first trimester of pregnancy, by Alaska Public Health Regions, all Alaskans, 2011-2015 (5-year average)

::chart - missing::
confidence limits

Percentage of women not receiving prenatal care in first trimesterLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 9
Anchorage20.8%20.3%21.4%4,64622,301
Gulf Coast21.5%20.4%22.7%1,1035,121
Interior21.5%20.6%22.3%1,8988,845
Mat-Su20.9%19.9%21.9%1,3576,495
Northern28.2%26.6%29.9%8022,840
Southeast16.5%15.4%17.6%7004,236
Southwest28.6%27.2%30.0%1,1784,122
Healthy Alaskans Goal19.0%
Statewide21.9%21.3%22.0%11,68953,977

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Alaska Health Analytics and Vital Records], Division of Public Health, Alaska Department of Health and Social Services


Percentage of women delivering live births who have not received prenatal care beginning in first trimester of pregnancy, by Boroughs/Census Areas, all Alaskans, 2006-2015 (10-year average)

::chart - missing::
confidence limits

Percentage of women who have not received prenatal care in first trimesterLower LimitUpper LimitNoteNumer- atorDenom- inator
Record Count: 30
Aleutians East Borough18.9%13.1%24.6%33175
Aleutians West CA30.0%25.1%34.9%99330
Anchorage Municipality30.9%29.5%32.3%1,2964,189
Bethel CA23.3%15.1%31.5%24103
Bristol Bay Borough23.7%17.7%29.7%46194
Denali Borough27.1%24.4%29.9%269991
Dillingham CA19.2%18.6%19.8%3,06715,968
Fairbanks North Star Borough22.6%16.8%28.4%45199
Haines Borough27.2%21.4%33.1%61224
Hoonah-Angoon CA12.2%11.2%13.2%4743,890
Juneau City and Borough19.4%18.5%20.4%1,3196,790
Kenai Peninsula Borough14.4%12.8%16.0%2561,780
Ketchikan Gateway Borough16.8%15.3%18.4%3582,125
Kodiak Island Borough38.6%36.6%40.6%8742,266
Kusilvak CA20.8%16.2%25.4%63303
Lake and Peninsula Borough20.7%20.0%21.4%2,60712,595
Matanuska-Susitna Borough18.9%18.6%19.3%8,19943,334
Nome CA24.5%22.7%26.3%5502,244
North Slope Borough38.1%35.8%40.4%6521,713
Northwest Arctic Borough27.0%25.0%29.0%5211,932
Petersburgh Borough20.7%16.5%24.9%75362
Prince of Wales-Hyder CA26.9%23.8%30.0%212789
Sitka City and Borough14.2%12.1%16.3%1511,066
Skagway Municipality20.0%12.0%28.0%Data are unreliable.1995
Southeast Fairbanks CA36.4%33.6%39.3%4031,106
Valdez-Cordova CA18.2%16.1%20.4%2211,212
Wrangell City and Borough14.5%9.8%19.1%32221
Yakutat City and Borough27.8%18.0%37.7%2279
Yukon-Koyukuk CA37.1%33.9%40.4%322867
Alaska Total20.8%21.0%20.5%22,278107,169

Data Notes

Rates based upon less than 20 cases are unreliable.

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Alaska Health Analytics and Vital Records], Division of Public Health, Alaska Department of Health and Social Services


Percentage of women delivering live births who have not received prenatal care beginning in first trimester of pregnancy, by Native Regional Corporations, all Alaskans, 2011-2015 (5-year average)

::chart - missing::
confidence limits

Percentage of women not receiving prenatal care in first trimesterLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 13
AHTNA Inc.24.2%18.0%30.4%44182
Aleut Corp.36.7%30.3%43.1%80218
Arctic Slope Regional Corp.37.8%34.5%41.1%314831
Bering Straits Native Corp.25.6%23.0%28.2%2771,080
Bristol Bay Native Corp.25.6%22.3%28.8%176688
Calista Corp.28.5%27.0%30.1%9043,168
Chugach Alaska Corp..24.4%21.3%27.6%176721
Cook Inlet Region Inc.21.0%20.5%21.4%6,68731,918
Doyon Ltd.21.4%20.6%22.3%1,8958,834
Koniag Inc.17.6%15.3%19.9%1871,063
NANA Regional Corp.22.2%19.5%24.9%202910
Sealaska Corp.16.4%15.3%17.6%6944,218
Alaska21.7%21.3%22.0%11,68953,977

Data Notes

There were 53 births not receiving prenatal care in the first trimester of pregnancy out of 146 live births that could not be classified into a Native Regional Corporation.

Data Source

[http://dhss.alaska.gov/dph/VitalStats/Pages/default.aspx Alaska Health Analytics and Vital Records], Division of Public Health, Alaska Department of Health and Social Services

References and Community Resources

'''References:''' 1. Calculations | PeriStats | March of Dimes. [http://www.marchofdimes.org/peristats/calculationsp.aspx?id=23]. Accessed July 13, 2016. 2. DeVoe, Baez A, Angier H, Krois L, et al. Insurance plus Access Does not Equal Health Care: Typology of Barriers to Health Care Access for Low-Income Families. Ann Fam Med. 2007;5(6):511-518. [http://www.medscape.com/viewarticle/567154] Accessed October 19, 2016. 3. Young MB, Perham-Hester KA, Kemberling MM. Alaska Maternal and Child Health Data Book 2011: Alaska Native Edition. Anchorage, AK: A collaboration of the Alaska Department of Health and Social Services, Division of Public Health, and the Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center. October 2011. [http://anthctoday.org/epicenter/publications/prams/pramsFullVersion.pdf] Accessed October 19, 2016. 4. Newby-Kew AJ, DeLozier DP, Prince CB, Perham-Hester KA, Young MB. Alaska Maternal and Child Health Data Book 2014: Life Course Edition. Anchorage, AK. Maternal and Child Health Epidemiology Unit, Section of Women's, Children's, and Family Health, Division of Public Health, Alaska Department of Health and Social Services, September 2014. [http://dhss.alaska.gov/dph/wcfh/Documents/mchepi/pubs/databook/MCHDataBook2014toweb.pdf]. Accessed July 13, 2016. 5. Alaska Department of Health and Social Services, Division of Public Health, Health Analytics and Vital Records Section. Alaska Vital Statistics 2015 Annual Report. [http://dhss.alaska.gov/dph/VitalStats/Documents/PDFs/VitalStatistics_Annualreport_2015.pdf]. Accessed February 16, 2017. '''Resources:''' Alaska Department of Health and Social Services, Division of Public Health, Health Analytics and Vital Records Section. Alaska Vital Statistics 2015 Annual Report. [http://dhss.alaska.gov/dph/VitalStats/Documents/PDFs/VitalStatistics_Annualreport_2015.pdf].

More Resources and Links

Alaska and national goals may be found at the following sites:

Alaska health promotion resources may be found at the following site:

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Maps of health indicators for various subdivisions of Alaska may be found at the following site:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

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Page Content Updated On 03/13/2017, Published on 03/13/2017
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Content updated: Mon, 13 Mar 2017 14:43:28 AKDT
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Content updated: Mon, 13 Mar 2017 14:43:28 AKDT