Disparities in Preconception Health Indicators — Behavioral Risk Factor Surveillance System, 2013–2015, and Pregnancy Risk Assessment Monitoring System, 2013–2014


Results

Depression (BRFSS)

Depression was self-reported by women and defined as ever being told by a health care provider that they had a depressive disorder. During 20142015, among nonpregnant women, the overall prevalence of depression was 21.9% (Table 1). For all reporting areas combined, the prevalence of this indicator varied significantly by age group, race/ethnicity, and insurance status. Prevalence by age group ranged from 19.2% in the youngest age group (1824 years) to 23.1% in the oldest age group (3544 years). Prevalence of depression was 14.8% among women who identified themselves as other race/ethnicity, 15.5% among Hispanic women, 16.2% among non-Hispanic black women, and 27.0% among non-Hispanic white women. Prevalence of reported depression was lower among uninsured women (20.3%) compared with insured women (22.3%). By reporting area, the lowest prevalence estimate was 13.6% (Hawaii), and the highest estimate was 35.1% (Oregon); the median was 25.9% (Supplementary Table S1, https://stacks.cdc.gov/view/cdc/cdc:49859).

Diabetes (BRFSS)

Diabetes was self-reported by women and defined as ever being told by a health care provider that they had diabetes (excluded if occurring only during pregnancy or borderline/prediabetes). During 20142015, among nonpregnant women, the estimated overall prevalence of diabetes was 3.1% (Table 1). For all reporting areas combined, the prevalence of this indicator varied significantly by age group and race/ethnicity, but not by insurance status. Prevalence by age group ranged from 1.0% in the youngest age group (1824 years) to 5.3% in the oldest age group (3544 years). Prevalence of diabetes was 2.4% among women who identified themselves as other race/ethnicity, 2.6% among non-Hispanic white women, 3.6% among Hispanic women, and 4.5% among non-Hispanic black women. By reporting area, the lowest prevalence estimate was 1.9% (Utah), and the highest estimate was 5.0% (Alabama); the median was 3.1% (Supplementary Table S2, https://stacks.cdc.gov/view/cdc/cdc:49860).

Hypertension (BRFSS)

Hypertension was self-reported by women and defined as ever being told by a health care provider that they had hypertension (excluded if occurring only during pregnancy or borderline/prehypertension). During 2013 and 2015, among nonpregnant women, the estimated overall prevalence of hypertension was 10.9% (Table 1). For all reporting areas combined, the prevalence of this indicator varied significantly by age group and race/ethnicity, but not by insurance status. Prevalence by age group ranged from 5.0% among the youngest age group (1824 years) to 17.0% among the oldest age group (3544 years). Prevalence of hypertension was 8.0% among women who identified themselves as other race/ethnicity, 9.5% among Hispanic women, 10.2% among non-Hispanic white women, and 18.3% among non-Hispanic black women. By reporting area, the lowest prevalence estimate was 7.0% (Minnesota), and the highest estimate was 19.2% (Mississippi); the median was 9.9% (Supplementary Table S3, https://stacks.cdc.gov/view/cdc/cdc:49861).

Current Cigarette Smoking (BRFSS)

Current cigarette smoking was self-reported by women and defined as current cigarette smoking (at the time of the survey) every day or some days among women who had ever smoked 100 or more cigarettes in their lifetime. During 20142015, among nonpregnant women aged 1844 years, the estimated overall prevalence of current cigarette smoking was 16.9% (Table 1). For all reporting areas combined, the prevalence of this indicator varied significantly by age group, race/ethnicity, and insurance status. Prevalence of current cigarette smoking by age group ranged from 13.4% (1824 years) to 19.5% (2534 years). Prevalence of current cigarette smoking was lowest among Hispanic women (8.9%), followed by women who identified themselves as other race/ethnicity (11.3%), non-Hispanic black women (15.6%), and highest among non-Hispanic white women (21.1%). Current cigarette smoking was less prevalent among insured women (16.1%) compared with uninsured women (21.0%). By reporting area, the lowest prevalence estimate was 8.4% (California), and the highest estimate was 33.7% (West Virginia); the median was 18.8% (Supplementary Table S4, https://stacks.cdc.gov/view/cdc/cdc:49862).

Normal Weight (BRFSS)

Normal weight was defined as having a body mass index of 18.524.9 kg/m2 (as determined by self-reported weight and height). During 20142015, among nonpregnant women aged 1844 years, the estimated overall prevalence of normal weight was 44.9% (Table 1). For all reporting areas combined, the prevalence of this indicator varied significantly by age group, race/ethnicity, and insurance status. Prevalence of normal weight by age group was 57.0% (1824 years), 42.7% (2534 years), and 37.9% (3544 years). Prevalence of normal weight was 57.6% among women who identified themselves as other race/ethnicity, 49.0% among non-Hispanic white women, 37.2% among Hispanic women, and 30.0% among non-Hispanic black women. Normal weight was more prevalent among insured women (46.1%) than uninsured women (38.6%). By reporting area, the lowest prevalence estimate was 33.0% (Mississippi), and the highest estimate was 53.9% (Massachusetts); the median was 44.2% (Supplementary Table S5, https://stacks.cdc.gov/view/cdc/cdc:49863).

Recommended Physical Activity (BRFSS)

Participating in recommended levels of physical activity each week was defined as getting at least 150 minutes per week of moderate-intensity activity, at least 75 minutes per week of vigorous-intensity activity, or a combination of moderate-intensity and vigorous-intensity activity (where vigorous activity minutes are multiplied by two) totaling at least 150 minutes per week, according to self report (32). During 2013 and 2015, among nonpregnant women, the estimated overall prevalence of participating in the recommended level of physical activity was 50.4% (Table 1). For all reporting areas combined, the prevalence of this indicator varied significantly by age group, race/ethnicity, and insurance status. Prevalence of recommended physical activity by age group ranged from 53.3% (1824 years) to 49.7% (25–34 years) and 49.0% (3544 years). Prevalence of recommended physical activity was 53.8% among non-Hispanic white women, 50.3% among women who identified themselves as other race/ethnicity, 46.0% among Hispanic women, and 42.8% among non-Hispanic black women. Meeting physical activity recommendations was more prevalent among insured women (51.8%) than uninsured women (44.0%). By reporting area, prevalence estimates ranged from a low of 39.6% (Mississippi) to 61.8% (Oregon); the median was 51.5% (Supplementary Table S6, https://stacks.cdc.gov/view/cdc/cdc:49864).

Recent Unwanted Pregnancy (PRAMS)

Recent unwanted pregnancy was defined as a pregnancy among women who reported that just before they got pregnant with their most recent live-born infant, they did not want to be pregnant then or at any time in the future. During 2013–2014, among women aged 1844 years with a recent live birth, the estimated overall prevalence of women who reported that the pregnancy was unwanted was 6.1% (Table 2). For all reporting areas combined, the prevalence of this indicator varied significantly by age group, race/ethnicity, and insurance status. Specifically, the lowest prevalence of recent unwanted pregnancy was reported by women aged 2534 years (4.9%), compared with 6.4% among those aged 1824 years and 9.8% among those aged 3544 years. In addition, 5.0% of non-Hispanic white women reported that the pregnancy was unwanted, compared with 6.0% of women who identified themselves as other race/ethnicity, 6.4% of Hispanic women, and 11.6% of non-Hispanic black women. Recent unwanted pregnancy was less prevalent among insured women (5.8%) compared with uninsured women (7.3%). Prevalence estimates ranged from a low of 3.4% (Washington) to a high of 10.9% (Arkansas); the median was 6.0% (Supplementary Table S7, https://stacks.cdc.gov/view/cdc/cdc:49865).

Prepregnancy Multivitamin Use (PRAMS)

Multivitamin use during the month before pregnancy was defined as taking a multivitamin, prenatal vitamin, or folic acid supplement every day of the month before pregnancy. During 20132014, among women aged 1844 years with a recent live birth, the estimated overall prevalence of women who reported multivitamin use during the month before pregnancy was 33.6% (Table 2). For all reporting areas combined, the prevalence of this indicator varied significantly by age group, race/ethnicity, and insurance status. Specifically, prevalence of prepregnancy multivitamin use was highest among women aged 3544 years (45.4%), followed by women aged 2534 years (37.4%), and lowest among women aged 1824 years (17.9%). In addition, prepregnancy multivitamin use was highest among non-Hispanic white women (37.8%) and women who identified themselves as other race/ethnicity (31.7%) and lowest among Hispanic women (26.2%) and non-Hispanic black women (21.6%). Multivitamin use during the month before pregnancy was more prevalent among insured women (37.4%) than uninsured women (17.1%). By reporting area, the lowest prevalence estimate was 23.3% (Georgia), and the highest estimate was 41.2% (Massachusetts); the median was 34.3% (Supplementary Table S8, https://stacks.cdc.gov/view/cdc/cdc:49866).

Postpartum Use of Contraception (PRAMS)

Postpartum use of a most or moderately effective method of contraception was defined as current use of one or more of the following birth control methods by women or their husbands or partners: male or female sterilization, implant, intrauterine device, injectable, pill, patch, or vaginal ring. The most effective methods (i.e., male or female sterilization, implant, and intrauterine device) have a failure rate that is <1% with typical use, and moderately effective methods (shot, pill, patch, ring or diaphragm) include those with typical failure rates of 18%–28%. Diaphragm was not a response option in these data (33). During 20132014, among women aged 1844 years with a recent live birth, the estimated overall prevalence of self-reported use of a most or moderately effective contraceptive method was 56.9% (Table 2). For all reporting areas combined, the prevalence of this indicator varied significantly by age group and race/ethnicity, but not by insurance status. Specifically, 64.9% of women aged 1824 years reported using a most or moderately effective contraceptive method, compared with 55.1% of those aged 2534 years and 50.6% of those aged 3544 years. In addition, 64.9% of non-Hispanic black women reported using a most or moderately effective contraceptive method, compared with 59.3% of Hispanic women, 56.8% of non-Hispanic white women, and 44.6% of women who identified themselves as other race/ethnicity. Prevalence estimates ranged from a low of 40.2% (New York City) to a high of 72.4% (Georgia); the median was 59.1% (Supplementary Table S9, https://stacks.cdc.gov/view/cdc/cdc:49867).



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