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Childbearing Patterns Among Selected Racial/Ethnic Minority Groups - United States, 1990
Childbearing patterns in the United States reflect marked increases in and variation among different racial/ethnic groups. Groups with high rates of teenage childbearing traditionally have elevated risks for low birthweight (LBW (less than 2500 g (5 lb 8 oz))) and other poor birth outcomes associated with serious infant morbidity, permanent disability, and death. To characterize childbearing variations among American Indians/Alaskan Natives, Asians/Pacific Islanders, and Hispanic ethnic groups, CDC's National Center for Health Statistics analyzed data from U.S. birth certificates for 1990. This report compares patterns among these groups and relates them to selected birth outcomes; in addition, this report presents birth rates for subgroups of Asians/Pacific Islanders * for the first time.
Birth certificates are the primary source for monitoring childbearing patterns and maternal and infant health; data for this report were based on 1990 birth certificates. Data on mother's race and Hispanic ethnicity are reported separately on the birth certificate. Maternal race was reported from all states and Hispanic ethnicity from all but two states (New Hampshire and Oklahoma). Birth rates were computed on the basis of population counts from the 1990 census (1). Rates provided for subgroups of Asians/Pacific Islanders can be computed only in census years.
Overall, the fertility rate (births per 1000 women aged 15-44 years) in 1990 was 70.9 (Table 1). The fertility rate for Hispanics (107.7) was approximately 71% higher than that for white non-Hispanics (62.8). Fertility rates varied even more markedly among subgroups, from 40.8 (Japanese Americans) to 118.9 (Mexican Americans).
For teenagers (aged less than 20 years), birth rates were highest for Hawaiians, black non-Hispanics, and Hispanics (Table 1). In particular, rates for teenaged Mexican Americans, Puerto Ricans, ** black non-Hispanics, and Hawaiians were each two to three times the rates for white non-Hispanics, Cuban Americans, and Filipino Americans and up to 31 times the rates for Chinese Americans, Japanese Americans, and "other" Asians/Pacific Islanders. Rates for American Indian/Alaskan Native teenagers were approximately twice those for white non-Hispanic teenagers.
In 1990, Mexican American and Hawaiian women had the highest average number of children per woman (i.e., total fertility rate) (3.2 each). For these two groups, birth rates were high for every age group throughout the childbearing period (ages 10-49 years) (Table 1). In comparison, for black non-Hispanics, Puerto Ricans, and American Indians/Alaskan Natives, the average number of children per woman ranged from 2.2 to 2.5, reflecting a sharp decline in birth rates for women aged greater than or equal to 30 years; the average number of children for "other" Asians/Pacific Islanders was slightly higher (2.7). The average numbers of children for Chinese Americans (1.4) and Japanese Americans (1.1) were lower than those of any group -- 65% of replacement (i.e., 2.1 children -- the level considered necessary for a given generation to exactly replace itself (2)) for Chinese Americans and 53% for Japanese Americans. These averages reflect the low birth rates for these women aged 20-29 years -- generally the principal childbearing ages. Rates for both groups peaked at ages 30-34 years and were similar to those of all other groups for ages greater than or equal to 35 years.
Groups with low birth rates for teenagers (i.e., Chinese Americans, Japanese Americans, Filipino Americans, "other" Asians/Pacific Islanders, Cuban Americans, and white non-Hispanics) generally were characterized by relatively low proportions of births to unmarried mothers and relatively high proportions of births to mothers who have completed high school (Table 2).
The risk for LBW was lowest among Chinese American infants (4.7%) (Table 2), followed by white non-Hispanic, Cuban American, Japanese American, and Filipino American infants (6%-7%) -- levels that are consistent with their older age at childbearing, higher educational attainment, and early receipt of prenatal care (3). Rates of LBW also were low (6%-7%) for other racial/ethnic subgroups who are at higher risk (i.e., American Indians/Alaskan Natives, Hawaiians, "other" Asians/Pacific Islanders, Mexican Americans, and Central and South Americans). The prevalence of LBW was elevated for Puerto Rican (9%) and black non-Hispanic infants (13%).
Reported by: Natality, Marriage, and Divorce Statistics Br, Div of Vital Statistics, National Center for Health Statistics, CDC.
Editorial Note: From 1980 through 1990, the U.S. Asian/Pacific Islander population increased by 108%, more than twice the increase of the Hispanic population (53%) and nearly three times that of the American Indian/Alaskan Native population (38%) (1). In 1990, Hispanics, American Indians/Alaskan Natives, and Asians/Pacific Islanders together accounted for 19% of U.S. births, compared with 12% in 1980 (4), reflecting these total population increases and, for some groups, high birth rates.
The findings in this report indicate wide variations in childbearing patterns among different U.S. racial/ethnic groups. These differences reflect a broad range of factors and determinants, including variations in maternal income and education; access to health care, family-planning assistance, and health insurance; and other socioeconomic factors. For example, completion rates for high school are inversely associated with teenage birth rates and risk for LBW and directly associated with receipt of early prenatal care (3).
Despite the presence of multiple risk factors for many pregnant women, the risk for a poor birth outcome can be abated through such factors as adequate maternal nutrition and low rates of tobacco and alcohol use. For example, Mexican Americans and "other" Asians/Pacific Islanders generally have good birth outcomes despite low educational attainment and less timely receipt of prenatal care, and for Mexican Americans, high teenage birth rates. Good outcomes may be due in part to low smoking rates for these groups -- in 1989, 4%-6% were smokers, compared with approximately 20% of all mothers (5,6). Despite high teenage birth rates and less prenatal care, infants of Hawaiian mothers were at relatively low risk for LBW -- reflecting the possible protective effect of weight gain of 31-45 pounds during pregnancy: Hawaiians were less likely than any other group to gain less than 16 pounds and more likely to gain greater than or equal to 31 pounds.
Although LBW has been a principal means for assessing pregnancy outcome, it may not adequately indicate infant health status for some populations. However, revision of the standard birth certificate in 1989 has increased the availability of data, including more extensive measures of medical risk factors during pregnancy and abnormal outcomes for the infant, that can be used to assess more precisely pregnancy risk and pregnancy outcome (5). For example, American Indian/Alaskan Native infants have low rates of LBW but elevated rates of fetal alcohol syndrome and assisted ventilation; their mothers have above average rates of tobacco and alcohol use (7). In addition, the prevalence of selected conditions (e.g., obesity, diabetes, hypertension, and anemia) is disproportionately higher among American Indians/Alaskan Natives; these maternal and infant conditions increase the risk for adverse outcomes (including infant death) of pregnancy (8-10).
The impact of medical and lifestyle risk factors (e.g., tobacco use, poor maternal nutrition) may be attenuated and the pregnancy outcome for many women improved with early prenatal education targeted toward specific needs of diverse populations. This and similar analyses can assist in the development of strategies toward achieving the national health objectives for the year 2000 in maternal and infant health (objectives 14.4-14.14) (11).
References1.Bureau of the Census. Race and Hispanic origin. Washington, DC: US Department of Commerce, 1991. (1990 Census profile no. 2). 2.McFalls JA Jr. Population: a lively introduction. In: Population bulletin. Washington, DC: Population Reference Bureau, Inc, 1991. (Vol 48, no. 2). 3.Taffel SM. Prenatal care -- United States, 1969-75. Washington, DC: US Department of Health and Human Services, Public Health Service, NCHS, 1978. (Vital and health statistics; series 21, no. 33). 4.NCHS. Advance report of final natality statistics, 1990. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1993. (Monthly vital statistics report; vol 41, no. 9, suppl). 5.NCHS. Advance report of new data from the 1989 birth certificate. Hyattsville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1992. (Vital and health statistics; vol 40, no. 12, suppl). 6.Ventura SJ. New insights in maternal and infant health from the 1989 birth certificate (Abstract). In: Program and abstracts of the 1992 annual meeting of the Population Association of America. Denver: Population Association of America, 1992:183. 7.Martin JA, Taffel SM. American Indian and Alaskan Native maternal and infant health: new information from the 1989 U.S. certificate of live birth (Abstract). In: Abstracts of the 120th annual meeting of the American Public Health Association. Washington, DC: American Public Health Association, 1992:329. 8.Broussard BA, Johnson A, Himes JH, et al. Prevalence of obesity in American Indians and Alaska Natives. Am J Clin Nutr 1991;53:1535-42S. 9.CDC. Prenatal care and pregnancies complicated by diabetes -- U.S. reporting areas, 1989. MMWR 1993;42:119-22. 10.NCHS. Vital statistics of the United States, 1989. Vol 2. Mortality. Washington, DC: US Department of Health and Human Services, Public Health Service, CDC (in press). 11. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives. Washington, DC: US Department of Health and Human Services, Public Health Service, 1991; DHHS publication no. (PHS)91-50213.
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