Prenatal care need and access: a GIS analysis.

Many municipalities provide special prenatal care services targeted to low-income women whose access to prenatal care is constrained. For such services to be successful and effective, they must be geographically targeted to the places where low-income, high-need mothers live. This paper presents a GIS analysis of prenatal care need and clinic services for low-income mothers in Brooklyn, NY. We analyze fine-grained geographic variation in need using data on the residential locations of recent mothers who lack health insurance or are covered by Medicaid. Spatial statistical methods are used to create spatially smoothed maps of the density of mothers and corresponding maps of the density of prenatal clinics. For these mothers, clinic density is positively associated with early initiation of prenatal care. Although clinic locations conform relatively well to the residential concentrations of high-need women, we identify several underserved areas with large numbers of needy women and few clinics available.