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Low birthweight (LBW)—1 of the 3 leading causes of US infant mortality—indicates current and future child health as well as maternal health. Compared with babies of normal weight, very LBW babies are more likely to have health problems such as respiratory distress syndrome, brain bleeding, patent ductus arteriosus, or necrotizing enterocolitis. Adults who were LBW babies may be at greater risk for such health conditions as diabetes and heart disease. LBW commonly occurs because of preterm birth or fetal growth restriction and is associated with such maternal behaviors as smoking, alcohol and drug use, poor nutrition, and weight gain.
“About 1 in 3 children born prematurely needs special school services at some point during their school years. The Institute of Medicine says these services cost an estimated $2,200 per year per child.” —March of Dimes
Primary Care Physicians
Primary care physicians, an indicator of availability of health care providers, offer direct patient care and counsel patients on the appropriate use of specialists and advanced treatment options. Primary care physicians are typically the first point of contact with the health care system for patients and provide critical preventive care, ongoing care, and referrals to specialists. Primary care physician availability has a documented influence on health; more primary care physicians have been linked to better health outcomes including lower rates of low birthweight, lower all-cause mortality, and longer life spans.
Oral health is a vital part of overall health and a window into a patient’s general health. Many underlying conditions such as nutritional deficiencies, microbial infections, and immune disorders have oral manifestations that dentists identify in oral examinations. Periodontal disease is associated with diabetes, cardiovascular disease, and adverse pregnancy outcomes. Nearly one-third of US adults have untreated tooth decay, and despite steady growth in working dentists, the Health Resources and Services Administration projects the dentist shortage will continue to grow as baby boomers retire. The most significant US oral health care disparities exist in rural communities.
Accessible and effective preventive care can reduce hospitalizations for many preventable infectious diseases, asthma attacks, diabetes, and hypertension. Preventable hospitalizations reflect the efficiency of a population’s use of primary care and the quality of the primary health care received. Preventable hospitalizations are more common among the uninsured and often occur because of failure to treat conditions early in an outpatient setting. High rates of preventable hospital admissions can indicate problems with a population’s access to primary health care and deficiencies in the quality of outpatient care. They burden the health care system financially, with $30.8 billion attributed to preventable hospitalizations in 2006.