Using 1990 national MCH objectives to assess health status and risk in an American Indian community.

The authors used data from birth records to assess changes in health risks and health status of American Indians (AI) living in Umatilla County, OR, from 1973 to 1986. They compared the AI health risks and health status with those of other persons (non-AI) living in Umatilla County, and assessed the progress of both AI and non-AI populations toward selected 1990 national health objectives. This AI population is likely to achieve the 1990 national health objective calling for less than 5 percent of births to be low birth weight (LBW); the LBW rate decreased from 5.0 percent in 1977-80 to 4.1 percent in 1984-86. However, the population is not likely to achieve the 1990 objective calling for at least 90 percent of women to begin prenatal care during the first trimester, even though the proportion of AI women who began prenatal care in the first trimester increased from 42.3 percent in 1973-76 to 62.6 percent in 1984-86. The Yellowhawk Indian Health Center began offering clinical services to AI in Umatilla County in 1976. Compared with non-AI women, AI women closed large gaps in key health risk and health status indicators during the period from 1973 to 1986. For example, from 1973 to 1976, 14.6 percent of AI mothers compared with 6.3 percent of non-AI mothers began prenatal care in the last trimester. By 1984 to 1986, only 9.0 percent of AI and 7.9 percent of non-AI mothers began prenatal care in the last trimester. Several other desirable health indicators improved more for AI than for non-AI from 1973 to 1986. These indicators included receiving at least one prenatal care visit during pregnancy, beginning prenatal care before the last trimester, and a larger proportion of mothers more than 18 years of age.Data from vital records can be used to monitor the health status of minority populations in small areas, such as counties. Clinic personnel serving minority groups can incorporate national and local health objectives into their strategy for improving community health.