{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:01:50Z","timestamp":1792792910740,"version":"4.5.0"},"reference-count":38,"publisher":"American Public Health Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[1995,5]]},"abstract":"<jats:p> OBJECTIVES. The purpose of this study was to determine whether women's sociodemographic characteristics are independently associated with cesarean delivery. METHODS. A retrospective review was conducted of hospital discharge data for singleton first births in California in 1991. RESULTS. After insurance and personal, community, medical, and hospital characteristics had been controlled, Blacks were 24% more likely to undergo cesarean delivery than Whites; only among low-birthweight and county hospital births were Blacks not at a significantly elevated risk. Among women who resided in substantially non-English-speaking communities, who delivered high-birthweight babies, or who gave birth at for-profit hospitals, cesarean delivery appeared to be more likely among non-Whites and was over 40% more likely among Blacks than among Whites. CONCLUSIONS. The findings cannot establish causation, but the significant racial\/ethnic disparities in delivery mode, despite adjustment for social, economic, medical, and hospital factors, suggest inappropriate influences on clinical decision making that would not be addressed by changes in reimbursement. If practice variations among providers are involved, de facto racial differences in access to optimal care may be indicated. The role of provider and patient attitudes and expectations in the observed racial\/ethnic differentials should also be explored. <\/jats:p>","DOI":"10.2105\/ajph.85.5.625","type":"journal-article","created":{"date-parts":[[2008,11,29]],"date-time":"2008-11-29T13:18:52Z","timestamp":1227964732000},"page":"625-630","source":"Crossref","is-referenced-by-count":122,"title":["Racial\/ethnic differences in the likelihood of cesarean delivery, California."],"prefix":"10.2105","volume":"85","author":[{"given":"P","family":"Braveman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Egerter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Edmonston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Verdon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"p_1","doi-asserted-by":"crossref","unstructured":"Placek PJ, Taffel S, Moien M. Cesarean section delivery rates: United States, 1981. AmJPublic Health 1983;73:861-862.","DOI":"10.2105\/AJPH.73.8.861"},{"key":"p_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.78.5.562"},{"key":"p_3","first-page":"285","volume":"42","author":"Centers for Disease Control","year":"1993","journal-title":"MMWR Morb Mortal Wiy Rep."},{"key":"p_4","doi-asserted-by":"crossref","unstructured":"Williams RL, Chen P. Controlling the rise in cesarean section rates by the dissemination of information from vital records.AmJ Public Health 1983;73:863-867.","DOI":"10.2105\/AJPH.73.8.863"},{"key":"p_5","doi-asserted-by":"crossref","unstructured":"Gould JB, Davey B, Stafford RS. Socioeconomic differences in rates of cesarean section. NEnglJMed 1989;321:233-239.","DOI":"10.1056\/NEJM198907273210406"},{"key":"p_6","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.2.257"},{"key":"p_7","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.10.1361"},{"key":"p_8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03460010059031"},{"key":"p_9","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.10.1340"},{"key":"p_10","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.80.3.313"},{"key":"p_11","doi-asserted-by":"crossref","unstructured":"Taffel SM, Placek PJ, Moien M. One-fifth of 1983 US births by cesarean section.AmJ Public Health. 1985;75:190. Letter.","DOI":"10.2105\/AJPH.75.2.190"},{"key":"p_12","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.69.9.864"},{"key":"p_13","doi-asserted-by":"crossref","unstructured":"Stafford RS, Sullivan SD, Gardner LB. Trends in cesarean section use in California, 1983 to 1990. Am J Obstet GynecoL 1993;168:1297-1302.","DOI":"10.1016\/0002-9378(93)90384-U"},{"key":"p_14","first-page":"607","volume":"15","author":"Placek PJ","year":"1988","journal-title":"ObstetGynecolClnNorthAm."},{"key":"p_15","doi-asserted-by":"crossref","unstructured":"Jonas 0, Roder D, Chan A. The association of maternal and socioeconomic characteristics in metropolitan Adelaide with medical, obstetric and labour complications and pregnancy outcomes. Aust NZ J Obstet GynaecoL 1992;32:1-5.","DOI":"10.1111\/j.1479-828X.1992.tb01885.x"},{"key":"p_16","doi-asserted-by":"crossref","unstructured":"Thom MH, Chan KK, Studd JWW. Outcome of normal and dysfunctional labor in different racial groups. Am J Obstet GynecoL 1979;135:495-498.","DOI":"10.1016\/0002-9378(79)90438-1"},{"key":"p_17","first-page":"407","volume":"34","author":"Newton ER","year":"1989","journal-title":"J Reprod Med"},{"key":"p_18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198609043151005"},{"key":"p_19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198903163201106"},{"key":"p_20","doi-asserted-by":"crossref","unstructured":"DeMott MK, Sandmire HF. The Green Bay cesarean section study: the physician factor as a determinant of cesarean birth rates.Am J Obstet Gynecol 1990;162:1593-1602.","DOI":"10.1016\/0002-9378(90)90925-W"},{"key":"p_21","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500030064034"},{"key":"p_22","unstructured":"Carpenter MW, Soule D, Yates WT, Meeker CI. Practice environment is associated with obstetric decision making regarding abnormal labor. Obstet GynecoL 1987;70: 657-663."},{"key":"p_23","doi-asserted-by":"crossref","unstructured":"Fraser W, Usher RH, McLean FH, etal. Temporal variation in rates of cesarean section for dystocia: does \"convenience\" play a role? Am JObstet GynecoL 1987;156: 300-304.","DOI":"10.1016\/0002-9378(87)90272-9"},{"key":"p_24","unstructured":"1989-1990 Directory of Graduate Medical Education Programs. Chicago, Ill: American Medical Association; 1989."},{"key":"p_25","unstructured":"SAS User's Guide: Statistics, Version 5 Edition. Cary, NC: SAS Institute Inc; 1985."},{"key":"p_26","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.70.9.964"},{"key":"p_27","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.74.5.505"},{"key":"p_28","doi-asserted-by":"crossref","unstructured":"Dougherty CRS, Jones AD. Obstetric management and outcome related to maternal characteristics. Am J Obstet GynecoL 1988;158:470-474.","DOI":"10.1016\/0002-9378(88)90006-3"},{"key":"p_29","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03460170051032"},{"key":"p_30","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.84.1.82"},{"key":"p_31","first-page":"757","volume":"82","author":"Kjerulff KH","year":"1993","journal-title":"Obstet Gynecol"},{"key":"p_32","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03440170066038"},{"key":"p_33","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03420020107039"},{"key":"p_34","doi-asserted-by":"crossref","unstructured":"Bergner L. Race, health, and health services.AmJPublicHealth. 1993;83:939-941.","DOI":"10.2105\/AJPH.83.7.939"},{"key":"p_35","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.83.7.948"},{"key":"p_36","doi-asserted-by":"crossref","unstructured":"Gittelsohn AM, Halpern J, Sanchez RL. Income, race, and surgery in Maryland.Am JPublicHealt 1991;81:1435-1441.","DOI":"10.2105\/AJPH.81.11.1435"},{"key":"p_37","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500120075029"},{"key":"p_38","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199403173301107"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.85.5.625","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T18:59:43Z","timestamp":1652122783000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.85.5.625"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,5]]},"references-count":38,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1995,5]]}},"alternative-id":["10.2105\/AJPH.85.5.625"],"URL":"https:\/\/doi.org\/10.2105\/ajph.85.5.625","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,5]]}}}