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Laura-Mae Baldwin, MD, MPH, David C. Grossman, MD, MPH, Susan Casey, PhD, Walter Hollow, MD, Jonathan R. Sugarman, MD, MPH, William L. Freeman, MD, MPH and L. Gary Hart, PhD

Laura-Mae Baldwin, Susan Casey, and L. Gary Hart are with the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) Rural Health Research Center, Department of Family Medicine, University of Washington, Seattle. David C. Grossman is with the Department of Pediatrics, University of Washington, and the Harborview Injury and Prevention Research Center, Seattle. Walter Hollow is with the Native American Center of Excellence, University of Washington, Seattle. Jonathan R. Sugarman is with Qualis Health and the Department of Epidemiology, University of Washington, Seattle. At the time of this study, William L. Freeman was with the Indian Health Service, Rockville, Md.

Correspondence: Requests for reprints should be sent to Laura-Mae Baldwin, MD, MPH, WWAMI Rural Health Research Center, Department of Family Medicine, University of Washington, Box 354696, Seattle, WA 98195-4696 (e-mail: lmb{at}u.washington.edu).

Objectives. We sought to provide a national profile of rural and urban American Indian/Alaska Native (AI/AN) maternal and infant health.

Methods. In this cross-sectional study of all 1989–1991 singleton AI/AN births to US residents, we compared receipt of an inadequate pattern of prenatal care, low birthweight (< 2500 g), infant mortality, and cause of death for US rural and urban AI/AN and non-AI/AN populations.

Results. Receipt of an inadequate pattern of prenatal care was significantly higher for rural than for urban mothers of AI/AN infants (18.1% vs 14.4%, P .001); rates for both groups were over twice that for Whites (6.8%). AI/AN postneonatal death rates (rural = 6.7 per 1000; urban = 5.4 per 1000) were more than twice that of Whites (2.6 per 1000).

Conclusions. Preventable disparities between AI/ANs and Whites in maternal and infant health status persist.

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