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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.134403v1 99/1/138    most recent Submit a response View responses View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Leibowitz, A. A. Articles by Belin, T. Search for Related Content PubMed PubMed Citation Articles by Leibowitz, A. A. Articles by Belin, T. Related Collections Insurance Health Policy HIV/AIDS Other Maternal and Infant Health Prevention Men's Health

Arleen A. Leibowitz, PhD, Katherine Desmond, MS and Thomas Belin, PhD

Arleen A. Leibowitz is with the Department of Public Policy, School of Public Affairs, and the Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles. Katherine Desmond is with the Center for HIV Identification, Prevention and Treatment Services, University of California, Los Angeles. Thomas Belin is with the Department of Biostatistics, School of Public Health, and the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles.

Correspondence: Requests for reprints should be sent to Arleen A. Leibowitz, Department of Public Policy, UCLA School of Public Affairs, Box 951656, Los Angeles, CA 90095-1656 (e-mail: arleen{at}ucla.edu).

Objective. We sought to determine whether lack of state Medicaid coverage for infant male circumcision correlates with lower circumcision rates.

Methods. We used data from the Nationwide Inpatient Sample on 417 282 male newborns to calculate hospital-level circumcision rates. We used weighted multiple regression to correlate hospital circumcision rates with hospital-level predictors and state Medicaid coverage of circumcision.

Results. The mean neonatal male circumcision rate was 55.9%. When we controlled for other factors, hospitals in states in which Medicaid covers routine male circumcision had circumcision rates that were 24 percentage points higher than did hospitals in states without such coverage (P < .001). Hospitals serving greater proportions of Hispanic patients had lower circumcision rates; this was not true of hospitals serving more African Americans. Medicaid coverage had a smaller effect on circumcision rates when a hospital had a greater percentage of Hispanic births.

Conclusions. Lack of Medicaid coverage for neonatal male circumcision correlated with lower rates of circumcision. Because uncircumcised males face greater risk of HIV and other sexually transmitted infections, lack of Medicaid coverage for circumcision may translate into future health disparities for children born to poor families covered by Medicaid.

This article has been cited by other articles:

				B. J. Morris, S. A. Bailis, J. H. Waskett, T. E. Wiswell, and D. T. Halperin MEDICAID COVERAGE OF NEWBORN CIRCUMCISION: A HEALTH PARITY RIGHT OF THE POOR Am J Public Health, June 1, 2009; 99(6): 969 - 971. [Full Text] [PDF]

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