Hispanic Women and Their Children: A Methodological Framework That Links Datasets from Multiple Population-LEVEL DATA Sources in Florida

Introduction: In 2013, 1 out of 3 deliveries in Florida were of Hispanic women. To better understand the structural, social, and cultural contexts associated with health outcomes, we developed a 15-year linked data repository of 38 health indicators (e.g. inadequate prenatal care, neonatal intensive care, infant mortality) on all Florida women and children. The repository annually links population-level datasets from three state agencies serving women and children: the Department of Health, the Agency for Health Care Administration and the Department of Children and Families. Method: We compared three important maternal and infant health status indicators in three race/ethnicity groups--Hispanic, African American and Caucasian—among women whose pregnancies were funded by Medicaid. For instance, we examined rates of inadequate prenatal care, neonatal intensive care, and infant mortality in over 200,000 Medicaid deliveries in Florida between 2012 and 2013. Currently, these are the most recently published estimates. Population estimates for the 2014 calendar year will be available in June 2016. Results: Among Medicaid women in 2013, Hispanics showed a significantly lower percent of inadequate prenatal care (14.8%), compared to African American (18.1%) and Caucasian (15.8%) women. Among Medicaid women in 2012, a lower rate of Hispanic infants required neonatal intensive care (8.9%) compared to African American (14.5%) and Caucasian (9.3%) infants. Finally, among Medicaid women in 2012, the Hispanic infant mortality rate per 1,000 live births was substantively lower than that of African Americans and Caucasians (5.1 vs. 10.3 and 6.5, respectively). Conclusion: This linked, annually updated data repository allows state officials and health policy researchers to investigate service delivery, utilization patterns, and care quality to understand why Hispanic women in Medicaid fare much better than African American and Caucasian women on three important maternal and child health status indicators.