Search

The article discusses a study conducted by the U.S. Centers for Disease Control and Prevention (CDC) to evaluate the possible health effects, use of alternative water resources and efficiency of the emergency response on the up to 12 days water interruption in two rural counties in Alabama in January 2010. The Alabama Department of Public Health (ADPH) asked the CDC's help in the probe. Based on the results, there are substantially higher cases of acute gastrointestinal illness (AGI) on households which lost both water service and water pressure.

Objectives: Our purpose was to evaluate institutional and organizational influences on cesarean section rates in Utah and to adjust such rates for differences in patient acuity.Study Design: Data on cesarean section rates were derived from the Utah Hospital Discharge Database and adjusted for patient acuity by correcting raw cesarean rates for those patients undergoing cesarean section meeting regional gestational age transport criteria.Results: When analyzed by means of 1-way analysis of variance, the following factors had a significant negative correlation (P < .05) with cesarean section rate: presence of a newborn intensive care unit and maternal-fetal medicine subspecialists, presence on the medical staff of obstetrician-gynecologist(s) as opposed to family physicians only, delivery volume >1500/y, urban location, and 24-hour in-house anesthesiology. When cesarean rates were corrected for acuity, facilities with maternal-fetal medicine specialists and a newborn intensive care unit had significantly lower rates (P < .001) and more uniform rates than otherwise similar institutions.Conclusions: More medically sophisticated physicians and institutions have lower cesarean rates when patient acuity is taken into account. [ABSTRACT FROM AUTHOR]

The study investigates racial disparities in perinatal mortality in women with early access to prenatal care in the U.S. Minorities including African Americans and Hispanic Americans experienced higher rates of intrauterine growth restriction, preeclampsia, preterm premature rupture of membranes, gestational diabetes, placenta previa, preterm birth and very-preterm birth, cesarean delivery, light vaginal bleeding and heavy vaginal bleeding compared with Caucasians.