PRENATAL-CARE USE IN NONMETROPOLITAN AND METROPOLITAN AMERICA - RACIAL ETHNIC-DIFFERENCES

Pregnant women in nonmetropolitan communities are believed to use pren atal care services at lower rates than are metropolitan residents due to higher levels of poverty, lower levels of insurance coverage, and d eclining numbers of local hospitals and physicians. Yet scarce data ex ist on actual patterns of prenatal care use in nonmetropolitan areas. This study provides national estimates of prenatal care use among Afri can American, White, and Hispanic women who delivered in 1988 in nonme tropolitan and metropolitan areas of the United States. This study fin ds that nonmetropolitan residents are no more likely than metropolitan residents to go without care, to enter care late, or to make fewer vi sits. Nonmetropolitan residents are more likely to receive ''inadequat e'' prenatal care as measured by the Kotelchuck Adequacy of Prenatal C are Utilization Index, with Hispanic residents having the highest rate s of inadequate care. These findings are consistent with recent state- level reports, and they suggest the need to target prenatal care polic ies for populations in greatest need.