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AJPH First Look, published online ahead of print Nov 13, 2008
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American Journal of Public Health, 10.2105/AJPH.2008.134403


Research and Practice

Determinants and Policy Implications of Male Circumcision in the United States

Arleen A. Leibowitz 1*, Katherine Desmond 2, Thomas Belin 2

1 UCLA School of Public Affairs
2 UCLA

* To whom correspondence should be addressed. E-mail: arleen{at}ucla.edu.


   Abstract

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 417282 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.

Key Words: Insurance, Health Policy, HIV/AIDS, Maternal and Infant Health, Men's Health, Prevention




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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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AJPH Online, 27 Dec 2008 [Full text]



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