Access to Health Insurance and Prenatal Care on Low‐Income Pregnant Women's Nutritional Status

Abstract

Prenatal care, although necessary, is known as one of the most expensive services in health care system. As a result, it is unlikely that pregnant women can afford to visit a health care professional for the duration of their pregnancy unless they have satisfactory health insurance coverage. This may be problematic for low‐income pregnant women who cannot afford health insurance, as their limited access to prenatal health care can result in reduced intake of folic acid, lowering their overall nutritional status and adversely affecting their baby. The purpose of this study is to analyze whether access to health insurance and prenatal care among pregnant women are associated with their nutritional status, especially folic acid intake. The data come from the six repeated waves of the National Health and Nutrition Examination Survey (NHANES) from 2003–2014, and the study population includes women who are currently pregnant (n=746). The study estimates folic acid intake and overall nutritional status among pregnant women based on their access to health insurance and prenatal care using the multivariate regression models. Access to health insurance and prenatal care are positively associated with women's nutritional status during their pregnancy, specifically related to their folic acid intake. Furthermore, pregnant women without health insurance do not seem to have adequate access to prenatal care and her nutritional status during pregnancy. A large part of the nutritional status of pregnant women is their folic acid intake since it is a key nutrient in pregnant women's diet and also provides benefits to their health status and their baby. Without proper prenatal care, pregnant women are less likely to have its recommended intake. This study may shed light on the importance of proper access to prenatal care and adequate nutrition intake during women's pregnancy. Moreover, pregnant women, health insurance providers and health care providers could better work together in order to recognize the complementary effect of carefree access to prenatal care and healthy nutrient intake throughout pregnancy.