Disparities in Risk Factors and Birth Outcomes Among American Indians in North Dakota

Ramona A. Danielson, Jordyn T. Wallenborn, Donald K. Warne, Saba W. Masho

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objectives High infant mortality rates among American Indians in North Dakota contribute to a 20-year gap in average age at death compared to whites. Geographic- and race-specific health disparities data to drive policy making and interventions are not well disseminated. The current study examines prenatal risk factors and birth outcomes between American Indian and whites in North Dakota. Methods A retrospective descriptive analysis of North Dakota live births from 2007 to 2012 was conducted. Period prevalence and prevalence ratios were calculated. Results The infant mortality rate from 2010 to 2012 for infants born to American Indian women was 3.5 times higher than whites. Racial disparities existed in education, teen births, tobacco use during pregnancy, and breastfeeding initiation. Disparities widened for inadequate prenatal care, illegal drug use during pregnancy, and infant mortality from 2007–2009 to 2010–2012 and narrowed for sexually transmitted infections and alcohol use during pregnancy. Conclusions for Practice American Indians are disproportionately affected by poor pregnancy and birth outcomes in North Dakota. Future geographic-specific American Indian research is warranted to aid current and future public health interventions.

Original languageEnglish (US)
Pages (from-to)1519-1525
Number of pages7
JournalMaternal and Child Health Journal
Issue number10
StatePublished - Oct 1 2018
Externally publishedYes


  • American Indian
  • Birth outcomes
  • North Dakota
  • Racial disparities

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health


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