The overall situation with respect to the health of Long Island’s youth is further reflected by information concerning maternal and perinatal care.  A variety of factors, including low birth weight, mothers who receive no or late prenatal care, and poverty,   place children at greater medical, developmental, and social risk.  Broadly based national epidemiological research suggests that there are significant relationships among poverty, prenatal care, low birth weight, and infant mortality. Information from the New York State Department of Health provides us with a profile of Long Island with respect to a range of key factors.

For instance, Nassau and Suffolk Counties, overall, fall near or below the NYS rates for low birth weight, late or no prenatal care, and infant mortality.

On the other hand, the overall rates for the two Long Island Counties, mask wide disparities that exist across communities (based on zip codes).  The following chart shows, for each indicator, the difference between the average of the top and bottom 10% of communities. Illustratively, the chart shows that the mean percent of hospitalizations paid for patients covered by Medicaid or with no insurance in the most advantaged communities (“Top”) was only 3.3%, while the percent covered by Medicaid or with no insurance in the least advantaged communities (“Bottom”) was 60.2%.  Similarly, the infant death rate in the “top 10% of communities” was a mere .1 death per 1,000 births (or 1 death per 10,000 births), while in “bottom” 10% of communities, the infant death rate was an average of 4.8 deaths per 1,000 births (or 48 deaths per 10,000 births).

In this context, we can also see the impact of poverty on infant risk.  The following chart shows that the communities with the higher levels of poverty also experience the greater incidences of low birth weight births, pregnancies with late or no prenatal care, and significantly higher rates of infant mortality.

Given these patterns, we constructed a more comprehensive “infant risk scale” comprised of eight interrelated indicators of maternal and infant conditions bearing on the medical, developmental and social prospects of new borns.  The scale includes standardized measures of the percent of births with low weight, percent of births that are to single mothers, percent of births that are Medicaid or self-pay, percent of births with late or no prenatal care, number of infant deaths, rate of infant deaths (per 1,000 births), teen pregnancy rate, and teen birth rate.  By “standardizing” the measurements, each community’s raw score is related to the overall Long Island average and placed in relation to the spread of scores across communities. This approach allows the different measurements to be combined into a single scale.  The resulting scale has a midpoint of zero (which is the overall mean for Long Island).  Each s score indicates how far above or  below the Island’s mean that community lies.  The differences between communities can thus be directly compared on a common and uniform scale.   The resulting scale has a very strong reliability coefficient (Cronbach’s alpha = .9).  We utilized the risk scale to differentiate between Long Island communities with high and low incidences of infant risk.
 
It can readily be seen in the above chart that there is a wide disparity between low- and high-incidence communities with respect to infant risk.  The chart distinguishes between the 15 communities (about 10% of all communities) with the lowest infant risk scores and the 15 communities (10%) with highest infant risk scores.  The community with the lowest incidence is 1.2 units below the mean for Long Island as a whole.  The community with the highest incidence of infant risk is 2.8 units above the Long Island average; an extremely large gap.  It should also be noted that while the communities with the lowest infant risk scores tend to be affluent and predominantly White, the communities with the highest infact risk scores tend to poor and predominantly minority.  Unfortunately, such disparity in medical risk also extends to Long Island’s adult population.