The Miracle of Two Minneapolises in Prenatal Care

While looking around for some data for another project, I ran into Minneapolis Health Department’s Reports. There’s a lot of great data there, but not all of it is necessarily in amazing condition for people to build off of. One data set, entitled Minneapolis Birth Data, caught my attention. Locked away in mostly tabular PDFs are a lot of interesting numbers that tell you how Minneapolis’ neighborhoods fare by way of birth statistics: with a demographic overview of mothers’ race, age, education, marital status; what trimester they began prenatal care (if at all); how adequate that care was; what their baby’s birth weight was; and whether the birth was premature.

After extracting some of the data, I made a map of the report from 2009-2011. In map form, the data is both shocking, and sadly not surprising when you know about the racial and socio-economic demographics of Minneapolis’ neighborhoods. A familiar pattern emerges, where the whitest and richest neighborhoods have a better overall access to prenatal care (West Calhoun, for instance, had 43 kids between the survey period of 2009-2011, and 100% are listed as receiving adequate care. Jordan, on the other hand, had 523 births, and 60.2% are listed as adequate, 30.1% as intermediate.

Explore the map by clicking below. I highly recommend also clicking on the neighborhoods to explore some of the demographic and gestational data.

Explore the map

births_explore

According to the reports, adequacy of care is defined as follows:

This prenatal care utilization index was created using the recommended Prenatal
Care Visit Schedule by the American College of Obstetrics and Gynecology.
Factors used were gestational age, time prenatal care began, and the number of
prenatal care visits obtained from the actual birth certificate. This index provides
a standardized method for assessing the quality and amount of prenatal care.

#bragMPLS

People like to rave about the virtues of Minneapolis in our cherished national media sources. Minneapolis is great for millennials, Minneapolis has low unemployment, we are healthy, we have great parks, or we are basically a “miracle”. On the other hand, Minneapolis is the city with the largest racial unemployment disparity, and one of the worst racial poverty disparities, and we also have a huge racial disparity in low-level arrests.

Taken with the map above, it seems our racial disparities begin even in prenatal care. If we hope to be “one Minneapolis”, we better step up the game. On the other hand, these are pre-Affordable Care Act numbers. What will the next report hold in store?

Data

Cleaned data is available in CSV format on Github, and more reports are available on the Minneapolis Health Department website.

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12 Responses to The Miracle of Two Minneapolises in Prenatal Care

  1. Janne Flisrand
    Janne February 20, 2015 at 11:06 am #

    More of these posts, please! I also want to know what we could do about it — are there transportation or land use policies that could begin to address these disparities in the long term, while other intervention policies that could work on it in the short-term?

  2. Ryan Johnson
    Ryan Johnson February 20, 2015 at 11:40 am #

    Also, someone on Facebook commented that the map was hard to read for people red-green colorblindness, so I made an alternate version with different colors that works better: http://goo.gl/NCFdfw.

    • Ryan Johnson
      Ryan Johnson February 22, 2015 at 2:20 pm #

      Someone posted this to reddit, where a commenter asked about education. I made another slice of that data. With the data available, that’s somewhat tricky, as the data seems to more reliably mark mothers’ education of greater than high school– building a map based on education of less than high school or even just high school grads results in some holes.

      Anyway, here’s the map: http://goo.gl/Qo1gAA. Looks familiar.

  3. Paul Strebe February 20, 2015 at 1:04 pm #

    Wow — excellent work! Thank you for reminding us of this other side. BTW, what app did you use to modify the Google map?

  4. Ben February 20, 2015 at 2:16 pm #

    I noticed another pattern, adequacy of care seems to be correlated with the marriage percentage.

    • Rosa February 22, 2015 at 10:55 pm #

      marriage is generally correlated with higher income, which would make it make sense that adequate medical care would track about the same.

  5. ClaireB February 20, 2015 at 2:28 pm #

    Wow, haskell!

  6. Will Shetterly February 22, 2015 at 12:45 pm #

    You seem to be conflating race and class. Are there neighborhoods where rich black Minneapolitans get worse care than rich white Minneapolitans, or where poor black Minneapolitans get worse care than poor white Minneapolitans? I live on the border of Standish and Corcoran, which means my neighbors are of many races, but none of them are wealthy.

  7. Janne Flisrand
    Janne February 22, 2015 at 1:21 pm #

    Will — There is clearly a myriad of factors going on here. I do want to share some of the ample research that, “Racial and ethnic minorities tend to receive lower-quality health care than whites do, even when insurance status, income, age, and severity of conditions are comparable, says a new report from the National Academies’ Institute of Medicine. The committee that wrote the report also emphasized that differences in treating heart disease, cancer, and HIV infection partly contribute to higher death rates for minorities.”

    This is one older study I found with a quick google search. News reports have reported going, consistent findings.

    Source:
    http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=10260

    • Will Shetterly February 22, 2015 at 2:41 pm #

      I agree that there are many factors. For example, white poverty is more rural than black poverty, and while rural hospitals may not have some of the resources that urban ones do, they tend to be smaller and allow for more personalized care. I’ve been to the L. A. County Hospital, where poor Californians go, and I’ve been to the clinic in Bisbee, Arizona, and I would take the latter over the former any day.

      Also, that 2002 study is a general study. If black Minneapolitans are getting worse care than white Minneapolitans from the same class and neighborhood, it’d be nice to have something more specific to show that.

  8. Beth-Ann Bloom February 22, 2015 at 2:02 pm #

    The story is likely to be more complicated than access to insurance. Since Medical Assistance is readily available to pregnant women in MN, poor women are very likely to have access to funding to cover prenatal care.

    They may not have sick leave to cover time off for clinic visits, education that makes them value medical care, child care for their other children during an appointment, transportation, or friends and family who think prenatal care is valuable (all you do is pee in a cup and get poked for blood). They may be afraid of forced intervention for drug and alcohol abuse, shaming about cultural practices, or an abusive partner.

    Data presented like this is essential to improving access. I encourage you to keep it up!

  9. Rosa February 22, 2015 at 10:56 pm #

    Good work putting this together, and thank you for posting it.

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