Early initiation and consistent use of prenatal care is linked with improved health outcomes. American Indian birthing people have higher rates of inadequate prenatal care (IPNC), but limited research has examined IPNC among people living on American Indian reservations. The current study uses birth certificate data from the state of Montana (n = 57,006) to examine predictors of IPNC. Data on the community context is integrated to examine the role of community health in mediating the associations between reservation status and IPNC. Results suggest that reservation-dwelling birthers are more likely to have IPNC, an association partially mediated by community health. Odds of IPNC are higher for reservation-dwelling American Indian people compared to reservation-dwelling White birthers, highlighting intersecting inequalities of race and place.

中文翻译：

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种族和地方问题：居住在保留地的美洲印第安人的产前护理中的不平等


尽早开始并持续使用产前护理与改善健康结果有关。美洲印第安人出生的人产前护理不足 (IPNC) 的比例较高，但对居住在美洲印第安人保留地的人们的 IPNC 进行了有限的研究。当前的研究使用蒙大拿州的出生证明数据 (n = 57,006) 来检查 IPNC 的预测因素。整合社区背景数据，以检验社区健康在调解保留状态与 IPNC 之间关联方面的作用。结果表明，居住在保留地的出生者更有可能患有 IPNC，这是一种部分由社区健康介导的关联。与居住在保留地的白人出生者相比，居住在保留地的美洲印第安人的 IPNC 几率更高，这凸显了种族和地方的交叉不平等。