Economics at your fingertips  

Estimating Educational Differences in Low-Risk Cesarean Section Delivery: A Multilevel Modeling Approach

Andrea M. Tilstra ()
Additional contact information
Andrea M. Tilstra: University of Colorado

Population Research and Policy Review, 2018, vol. 37, issue 1, 117-135

Abstract: Abstract U.S. rates of cesarean section, and in particular, low-risk cesarean section (LRC) births rose dramatically across the late 1990s and early 2000s, and have since remained high. Although previous research explores how trends in LRC vary between states and across maternal characteristics, within-state heterogeneity has not yet been accounted for, nor has the extent to which maternal and county characteristics might interact to shape the likelihood of a LRC birth. Using U.S. county-level birth data for years 2008–2010 from the restricted National Vital Statistics Systems Cohort Linked Birth-Infant Death Files and the Area Health Resource Files, I conduct race-stratified multilevel analyses to explore the association between the mother’s education, the income of the county in which she gives birth, and the odds of LRC delivery. I find that regardless of race/ethnicity, less education at the individual level and lower income at the county level are associated with higher odds of LRC delivery. There are also persistent racial disparities in these relationships. Non-Hispanic black mothers have the highest overall odds of LRC delivery, yet the effect of both education and county income is greatest for non-Hispanic white mothers. The results highlight the importance of analyzing both individual resources and contextual effects of the county when assessing birthing processes, as both contribute to a mother’s access to and knowledge of natal care.

Keywords: United States; C-sections; Fertility; Education; Contextual effects; BID files; AHRF (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: Track citations by RSS feed

Downloads: (external link) Abstract (text/html)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link:

Ordering information: This journal article can be ordered from
http://www.springer. ... es/journal/11113/PS2

Access Statistics for this article

Population Research and Policy Review is currently edited by D.A. Swanson

More articles in Population Research and Policy Review from Springer, Southern Demographic Association (SDA)
Bibliographic data for series maintained by Sonal Shukla ().

Page updated 2019-11-06
Handle: RePEc:kap:poprpr:v:37:y:2018:i:1:d:10.1007_s11113-017-9452-2