Trends in Birth across High-Parity: DISCUSSION
The question of whether demographic trends have affected birth rates of parous mothers is of interest to researchers and policymakers, especially in the context of ensuring optimal and equitable allocation of resources. Perhaps the most important finding in this analysis is that overall, although total births declined over the study period among blacks as well as whites (by 10% and 9%, respectively), Hispanic women experienced an increase in total births of about 25%. These results are in agreement with projections made regarding the rise in birth contribution by the Hispanic subpopulation in the United States. The implications of these findings must be viewed in the context of future sectoral demands on the health sector.
About 63% of births to Hispanic women nationwide (and up to 75% in some states) occur among foreign-born Hispanics, many of whom may not qualify for health insurance coverage. Indeed, pregnant Hispanic women and their children fare the worst in terms of insurance coverage due to lower employer-supported insurance benefits as compared to whites. Data from the National Health Interview Survey (NHIS) show that each year, an estimated 3 million Hispanic/Latino children lack health insurance coverage. Following delivery, however, regardless of maternal citizenship, their neonates (who are automatically U.S. citizens) become qualified for public benefits, such as Medicaid and the State Children’s Health Insurance Program (SCHIP). Public-funded programs thus represent a significant source of insurance coverage for Hispanic children. For instance, in 2001, Hispanic children had a rate of Medicaid coverage of 34.9% compared to 15.3% of non-Hispanic white children. A recent study of SCHIP enrollees in Alabama, Florida, Kansas and New York (26% of enrollees nationwide) also found substantial numbers of enrollees were Hispanic or black children. It is axiomatic that as the Hispanic population increases, so will its need for access to healthcare services. Our results strongly suggest that the demand on Medicaid and other public-funded programs will continue to increase based on the current temporal increase in births among Hispanics.
Several reasons might explain the positive birth rate trend among Hispanics. Foremost among these is the dominant belief that childbearing forms an important component of family functions, and the rearing of children within the family is highly encouraged. Hispanic women, especially recent immigrants who are less acculturated and of low socioeconomic status, adhere strongly to the belief that frequent childbearing confers respect from their community, love and commitment from the father of the baby and is a guarantee that they will have someone to support and care for them at old age. viagra jelly online
Another reason for frequent childbearing may be the relatively low rate of contraceptive use among Latina women, possibly because of religious or cultural objections to contraception. Also linked to a low utilization of contraception is the “son preference” phenomenon, whereby the Hispanic woman will shy away from contraception and continue to become pregnant until she can deliver a son, even if the desired family size has been attained.
A limitation of this study is its inability to determine the influence of religious, cultural and socioeconomic factors on frequent births among the women. It would, for instance, be interesting to assess whether the influence of religious affiliation on family size varied by race/ethnicity of mothers. Unfortunately, this kind of information was not available in the dataset. It was also not possible for us to stratify our analysis according to attitude toward contraception among the racial groups. However, as the purpose of this paper was to look at birth rates and their trends over time, we hope that other studies can address the social etiologies of these trends.
Finally, our findings demonstrate variation in parity patterns among the main racial and ethnic populations in the United States. The results of this study may help care providers and health policy-makers formulate strategies that will serve as templates for optimizing resource allocation and thereby ensure the delivery of quality and equitable health services across the different racial/ethnic subpopulations in the United States. It is therefore noteworthy that women who are currently experiencing frequent childbearing, especially those of Hispanic origin, will require expanded health insurance coverage as a consequence.