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Show Figure 9 shows the trend of entry into prenatal care in the study areas for Medicaid births. Surprisingly, rates of first trimester care were generally higher over the period for Weber County residents, increasing from about 74% in 1985 to 76% in 1989. Rates of first trimester care were often 10 percentage points below these levels in Salt Lake County during the period. Comparing these low-income populations, Weber County residents demonstrate a tendency for early entry into prenatal care programs. The inadequacy of prenatal care actually received by Weber County Medicaid recipients sharply contrasts with recipients' early entry into the program. Figure 10 data illustrate the proportion of women receiving fewer than six prenatal visits ~ a measure of care adequacy. Salt Lake County and the balance of the state show a gradual improvement over the period. Conversely, Weber County appears to have experienced fairly dramatic growth in the proportion of women having fewer than six prenatal visits. By 1989, 18.7% of Medicaid births in Weber County involved fewer than six prenatal visits ~ double the percentage for Salt Lake County and the balance of the state. Conclusion Weber County experienced high and rising infant mortality during the late 1980's, a time when other areas of Utah saw a declining rate of infant death. The numbers of deaths due to diseases of early infancy suggest that public health problems of low birthweight and premature birth were excessive in Weber County during the period studied. Though the proportion of births covered by the Medicaid program in Weber County in 1989 was similar to that found in other areas of the state, Medicaid expansion in Weber County during the late 1980's was much less pronounced than elsewhere in Utah. Even within the Medicaid-covered population, infant mortality, low birthweight, and premature birth occurred at a greater rate in Weber County than in Salt Lake County and the balance of Utah. Figure 9 78 76-74 -72 -70 -68 -66 ¦ 64 -62 -60 " 58 " 56 " 54 -52 " 50 84 Percent of Mothers Receiving First Trimester Care: Utah Medicaid Births, 1985-89 Salt Lake County Weber County Balance of State 85 86 87 Year 88 89 90 132 INFANT MORTALITY |
