State-specific trends in U.S. live births to women born outside the 50 states and the District of Columbia--United States, 1990 and 2000.

Persons born outside the 50 states and the District of Columbia (DC) comprised an estimated 11.1% (31.1 million) of the U.S. population in 2000, and approximately one fifth of all U.S. births in 2000 were to women in this population. Racial/ethnic disparities in U.S. health outcomes are of public health concern, and the increasing cultural and linguistic diversity of the U.S. population poses challenges to the delivery of maternal and child health services. This report presents state-specific comparisons of live births in 1990 and 2000 to women born outside the 50 states and DC and compares maternal characteristics and live-birth outcomes for these women with those of state-born mothers (i.e., women born inside the 50 states and DC). The findings indicate that women born outside the 50 states and DC had better birth outcomes than their state-born racial/ethnic counterparts. However, a larger percentage of these women began prenatal care later and had other problems accessing health care, which might reflect economic, cultural, and language barriers. The U.S. public health system and maternal healthcare providers should understand and address the health needs of an increasingly diverse population.