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Because of the magnitude of women's health issues within the larger context of public health and healthcare systems, this paper was written to help define the current status of women's health in Wisconsin. Utilizing critical women's health areas identified by the Wisconsin Women's Health Foundation and the Wisconsin Division of Public Health, 16 specific measures of women's health were chosen for this analysis. The most recent data available for each measure were collected with Wisconsin data being compared to national averages as well as to Healthy People 2010: Objectives for Improving Health targets. Wisconsin women fare better than national averages in nine of the selected health measures; however, there are still many improvements to be made in order to meet Healthy People 2010 targets. The areas where the most improvements are needed include binge drinking, tobacco use, diabetes, and stroke mortality. Other significant findings include the lack of uniformly collected data in the areas of domestic violence, osteoporosis, and mental illness.

Purpose: The purpose of this study is to identify disparities in maternal smoking between Wisconsin and United States women and to determine differences that explain the higher percentage of pregnant women who smoke in Wisconsin compared to the United States., Methods: 1997 Wisconsin and US birth certificate data were compared and stratified by age, education, and race/ethnicity. The relative risks (the risk of Wisconsin women smoking during pregnancy compared to US women smoking during pregnancy) were calculated by direct standardization to the 1997 US distribution for these characteristics., Results: In 1997, 17.9% of Wisconsin women smoked during pregnancy, compared with 13.2% nationally (relative risk [RR] = 1.4; Wisconsin women were 40% more likely to smoke than US women). Age and education adjusted RRs among Wisconsin women aged 20 and older were 2.3 (American Indian), 2.8 (Hispanic), and 2.2 (non-Hispanic black), while the RR was 1.2 for non-Hispanic white mothers. Among women 20 and older, the crude RR for Wisconsin was 1.5; adjusting for age, education, and race/ethnicity only slightly decreased the RR to 1.4., Conclusions: The percentage of women who smoke during pregnancy in Wisconsin continues to be above the national rate and the Healthy People 2000 goal of 10% or less. Disparities with the US average are particularly great for minority women in Wisconsin. Adjusting for age, education and ethnicity does not explain Wisconsin's higher prenatal smoking rate.

Purpose: Smoking during pregnancy can be harmful to the fetus. This paper examines trends in smoking during pregnancy in the United States and Wisconsin from 1990-1996. In addition, percentage change in smoking prevalence during pregnancy by selected maternal characteristics and in all Wisconsin counties is compared for the periods 1990-1992 and 1994-1996., Methods: Data from the National Center for Health Statistics and Wisconsin resident birth certificates were compared to examine overall smoking trends for pregnant women from 1990-1996. For Wisconsin, 3-year averages (1990-1992 and 1994-1996) were calculated to provided more stable estimates. The percentage change in smoking prevalence was examined by selected maternal characteristics, such as age, marital status, race, prenatal care and education, and by county of residence., Results: Smoking rates for pregnant women in the United States have gradually decreased, from 18.4% in 1990 to 13.6% in 1996. From 1990 to 1996, maternal smoking in Wisconsin declined from 22.9% to 18.2% (significant at P < .001). In Wisconsin, smoking rates during pregnancy were higher in both 1990-1992 and 1994-1996 among women who were younger, unmarried, American Indian, or African American; received late or no prenatal care and did not graduate from high school. Out of 72 Wisconsin counties, 63 showed a decrease in smoking rates for pregnant women., Conclusions: Smoking prevalence during pregnancy in Wisconsin is above the Healthy People 2000 and Wisconsin Public Health Agenda for the Year 2000 goals of less than 10% of women smoking during pregnancy. Public health must continue its initiative to encourage healthy life styles for pregnant women.

Infant mortality is a powerful indicator for assessing the health of a population, and the extent to which society invests in its children. This paper examines infant mortality trends in the United States and Wisconsin among the African American and white populations from 1980 to 1998. Data from the National Center for Health Statistics and Wisconsin Birth and Infant Death Reports were used to examine overall infant mortality trends from 1980 to 1998 for African American and white infants. The overall infant mortality rate in Wisconsin decreased steadily from 10.3 infant deaths per 1000 live births in 1980 to 7.2 in 1998. White infant mortality followed this trend, declining from 9.6 in 1980 to 5.6 in 1998. African American infant mortality has remained about the same since 1980 at 18 infant deaths per 1000 live births, even though the overall percentage of African American live births in Wisconsin increased from 6% in 1980 to 10% in 1998. The ratio of African American to white infant mortality rates in Wisconsin increased from 2 to 1 in 1980 to 3.2 to 1 in 1998. While the Wisconsin African American infant mortality rate remained even since 1980, the US rate declined from 22.2 in 1980 to 14.1 in 1998. The Wisconsin African American rate in 1998, 17.9, surpassed the national rate. The use of 5-year running averages to smooth out year-to-year fluctuations showed statistically significant declines in Wisconsin white infant mortality rates and no change in Wisconsin African American infant mortality rates. These trends show the importance for Wisconsin to sustain its current efforts to reduce black infant mortality. At the same time, Wisconsin-based research efforts to determine strategies and factors that work should continue and influence the future design of systems, programs, and policies to eliminate the disparity.