NATIONAL CENTER Series 22 

For HEALTH STATISTICS Number 4 

VITAL and HEALTH STATISTICS 

DATA FROM THE NATIONAL VITAL STATISTICS SYSTEM 

visits for 

Medical and Dental Care 

During the Year Preceding 

Childbirth 

United States = 1963 Births 

Statistics on tbe volume and timing of visits to p~_2ysi-


cians and medical facilities and the frequency of


visits to dentists during the year preceding child- PRaPERw OF THE


birth by socioeconomic and demographic characteris- PUBLIWTIONS URANCE


tics of the mother. Based on data collected by the ED!TORW= Mwy


National i4atality Survey of”births in 1963.


Washington, D.C. May 1968 

U.S. DEPARTMENT OF 

HEALTH, EDUCATION, AND WELFARE Public Health Service 

Wilbur J. Cohen William H. Stewart 

Acting Secretary Surgeon General 
. d	 . . . ..n 

Public Health Service Publication No. 1000 -Seriee 22-No. 4 

For sale by the Superintendent of Doouments, U.S. Government Prfnttrxg Office 

Washfn@on, D. C., !20402 - Price 45 ceuts 
NATIONAL CENTER FOR HEALTH STATISTICS 

THEODORE D. WOOLSEY, Director 

PHILIP S.LAWRENCE, SC. L)., Associute Director 

OSWALD ,K.SAGEN, P~.D-,,Assistant Director /oY Health Statistics Development 

WALT R.SIMMONS,M.A.,Assistatit Director for Research and Scientific Development 

ALICE M. WATERHOUSE, M.D.,Me&’cal Consultant 

JAMES R.KELLY, D.D.S,,Dental Advisor 

LOUIS R. STOLCIS, M,A.,Executive Q/ficer 

DIVISION OF VITAL STATISTICS 

ROBERT D. GROVE, Ph.D.,))irqctoT 

ROBERT A. ISRAEL, M.S.,Deputy,Di?gcto? 

ARTHUR A, CAMPBELL, SpecialAssistanttotheDirecto? 

ROB ERT A. ISRAEL, M.S.,Acting Chic/, Mortality Statistics BYWZCh 

ARTHUR A. CAMPE? ELL, Actingc~ief,Natdity.Statistics
 ~~ad


ROBERT D. GROVE, Ph.D.,Acting Chief, Registration Methods Branch


PATIENCE LAURIAT, M.A.,Chief, Marriage and Diuotwe Sttitistics D?aach


ARN E B. NELSON, M.A.,chief,Vital Records Sw.xy Branch


ALICE M. HE TZEL, Chief,Statistical /?esources k ciian

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CONTENTS


Page 

Introduction ---------------------l---_-----A--------L~--------:------:


Selected l?indings ---------------------:-------------------------------`


Sources and Limitations ofData--------------------------.---------=----

Volume of Visits -------. --------s -----:7-----

Geographic Area -------------:---------------------------------.--=


Income


Education ~------


Age of Mother and Live-Birth Order


Time of First Visit for Me&cal Care


color ------------------------------------`------"---:---:-----------


Metropolitan Status ----------~------------:-----------------—-=----


Region ----------------------------------------7--------------------


Income ----------------------------------------------=-------------


Education


AgeofMother and Live-Birth Order ..-..=--- -,------ ------.- ,. ,.,


Relationship Between Time of First Visit andNu~erofVisits --:--------

,.. ,.,.


Dental Visits ------------------:-----------~--Y------------------------- .
 ,.


References -------------------------------------------,--------:------r"`


Detailed Tables ---------------------------J---------------------------

Appendix I. Technical Notes on Methods


Sample’Design -


Birth Certificate and Questionnaires


Collection ofData


Processing ofData


Nonresponse and Imputation ofMissing Data ---------------------------


Biti Records


Romding ofNumbers


Appendix II. Definitions ofCertsin Terms Used inT’hisReport


Demographic and Socioeconomic Terms--:----------------------------


Geo@aphic Terns


Me&cd Terms


Appendix III. Sowce Fores


Standard Certificate ofLiveBirth


Survey QuestiomaireforMotiers


Survey Questionnaire for Physicians


Survey Questionnaire forMedicalFacilities


Smvey QuestionnaireforDentists


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IN THIS REPORT statistics are pvesented on the medical care received 

duving the 12 months pviov to childbirth by mothevs who kud livebovn 

babies in 1963. Estimates on the avevage numbev of visits to physicians 

and to medical facilities and the percentage who made their first visit 

duying each 3-month peviod are given fov all mothers. Estimates of the 

)evcentage who visited a dentist dwing the year are @“ven only for 

mothers who had le~”timate bivths. 

These statistics are based on duta collected in a mail survey with questionnaires sent to the mother, the attending physician, the hospital where 

the bi~th took place, and to any othev physician, dentist, hospital ov 

other medical facility named by the first thvee sowces. In cases wheve 

there was no response to thvee mailed questionnaires, followups “by 

telephone ov by pevsonul intevview were attempted. 

The mothevs about whom information is presented in this repovt ave 

classified by age, num bev of live births, color, educational achievement, 

family income in 1962, geographic region, and metropolitan status. 

The mothers who had a livebovn child in 1963 made, on the avevage, 11.5 

visits fov medical care duving the 12 months jzriov to the birth of the 

child. Theve was little vayiation by age of mo thev, geographic ve~”on, 

or metropolitan status. Mothers made move visits fov first bivths than 

fov later bivths. The avevage number of visits was highest fov white 

mothevs and fov mothexs in high income ov education classifications. 

Women in these categories also began theiv medical cave earlier in the 

yeav thun the average woman. Mothevs of illegitimate babies made, on 

the avevage, fewev visits than mothevs of le~”timate babies in any educational or income class. Only 26 pevcent of the women vepovted huving 

visited a dentist during the 12 months. 

SYMBOLS 

Data notavailable 

Category non applicable . . . 

Quantity zero -

Quantity more than O but less than 0.05---- 0.0 

Figure does not meet standards of * reliability orprecision 
VISITS FOR 

MEDICAL AND DENTAL CARE 

DURING THE YEAR PRECEDING CHILDBIRTH 

,. Mary Gvace KovaY, Division of Vital Statistics 

INTRODUCTION 

! During the past few years an increasing 

amount of attention has been focused on the related problems of neonatal mortality, congenital 

malformations or other birth defects, and maternal mortality, It is generally accepted that adequate medical care during pregnancy would reduce 

the incidence of such problems. 

This report is an attempt to examine some of 

the variations in the timing and amount of medical 

care that women receive during the 12-month 

period preceding childbirth. No attempt is made 

to evaluate the quality of the care. The measures 

are the time of the first visit and the average 

number of visits made by women in certain socioeconomic or demographic groups. Estimates of 

the average number of visits are showg separately 

for visits to physicians and visits to medical 

facilities. In addition, there is a limited amount 

of data on the percentage of women who visited a 

dentist during the year. 

SELECTED FINDINGS 

During 1963 slightly over 4 million women 

had babies in the United States. The average 

woman made 11.5 visits for medical care during 

the year before her child was born. Approximately 

three-fourths of these visits were to physicians; 

the other one-fourth were to clinics, hospitals, or 

other medical facilities. 

On the average, white mothers made 12.2 

visits during the 12-month period and nonwhite 

mothers, 7.7. Thus, the average white mother had 

60 percent more visits than the average nonwhite 

mother. 

As the family income increased, the number 

of visits for medical care also increased. Women 

living in families with an income in 1962 under 

$3,000 made, on the average, 9.3 visits for medical care, while women living in families with an 

income of $10,000 or over averaged 13.7 visits. 

Among women in the lowest income group, 34 per-. 

cent of the visits were to medical facilities. 

Among women in the highest income group only 

17 percent of the visits were to medical facilities. 

The family income is not known for mothers of 

illegitimate children but these women made only 

7.1 visits each for medical care, and 51 percent 

of their visits were to medical facilities. 

The average number of visits was also higher 

for women who had completed more years of 

school. Women who had not gone beyond the eighth 

grade made 8.9 visits on the average, while those 

who had attended college made 13.6 visits. 

If the child selected in the sample ,was the 

first birth, the mother made more visits than 

the mother who had already had children. 

Almost 20 percent of the women made no 

visits either to a physician or to a medical facility until the third trimester of pregnancy. An 

additional 2 percent made no visits at all during 

the 12 months before childbirth. 
Data for dental visits are available only for 

mothers of legitimate births. Almost 73 percent 

of these women reported that they had not seen a 

dentist during the year before the baby was born. 

SOURCES AND LIMITATIONS 

OF DATA 

The 1963 National Natality Survey was designed primarily to collect data about exposure’ 

to radiation during the prenatal period. For that 

reason the questionnaire, was: d$.qigned to elicit 

information about the number and kinds of X-ray 

procedures and the dates when they were carried 

out. It was not designed to obtain information about 

the reason for the visit or the date of each visit. 

However,, the date of the first visit during the 

year before the child was born and the total number of visits during the year were among the 

questions asked of all physicians, medical facilities, and dentists; and this report is based on 

the answers to those questions. 

It’ i: ,unfortunate in some ways that the reason for the visit is not knovni since it would make 

possible a distinction’ between prenatal care and 

general medical care.” However, unless the definitions were drawn very carefully such a distinction 

might actually cause an underestimate of the 

amount of prenatal care since a pregnant woman 

who had a general medical condition, such as 

diabetes, might be coded as having a visit for 

the care” of her condition and thus excluded from 

a tabulation of visits for’ prenatal care when actually the two are so closely related that one 

cannot help but influence the other. The system 

used in this report at least has the advantage of 

clarity. The visits included are all visits made 

for whatever reason during the 12-month period 

prior to the birth of the baby. 

As part of the internal audits on the consistency” of the data, the estimates from the National 

Natality Survey were compared with the estimates 

obtained from another survey conducted by the 

National Center for Health Statistics, the Health 

Interview Survey. The Health Interview Survey is 

conducted by personal interview, a reliable adult 

in the household is the respondent, and the 

respondent is asked specifically about prenatal 

and postnatal care. The National Natality Survey 

is conducted by mail, the respondent for the 

number of visits to physicians is the physician 

himself, and the respondent is asked about any 

visits during the 12~month period prior to the 

birth. The estimated number of visits to physicians 

during the 12 months before childbirth from the 

National Natality Survey is 35,438,000 and the 

estimated number of visits to physicians for 

prenatal and postnatal care from the Health 

Interview Survey is 35,403,000.1 The closeness 

of the two estimates makes one confident that the 

data contained in this report can be used as a 

measure of prenatal care. . 

These data are based on information recorded 

on the certificate of birth and on questionnaires 

mailed to the mother, the hospital where the birth 

took place, the attending physician, and to any 

other hospital, physician, or deritist named by 

the first three sources. For reasons of State 

clearance and confidentiality, questionnaires were 

not mailed to mothers where it was either stated 

or inferred from the birth certificate that “the 

birth was illegitimate. Information which could be 

obtained only from the mother is therefore not 

available for such births. 

Information about the geographic region, 

metropolitan status, color, age of mother, and 

live-birth order was obtained from the birth 

certificate and is therefore available for all 

mothers. 

Because the name of the attending physician 

and the hospital (if any) where the birth took 

place were also obtained from the birth certificate, information about the date of the first visit 

and the number of visits is available for all 

mothers. 

Information about the family income, education of the mother, and the names of dentists 

whom she had visited, was obtained from the 

questionnaire which was sent to the mothers and 

is therefore available only ‘for mothers of legitimate births. 

Thus, the information about the timing and 

number of visits to physicians or medical institutions is relatively independent of the mother’s 

response since the primary sources for this type’ 

of information were the physician and the institution named on the birth certificate. The mother’s 

response was used mainly as a cross-check to 

make certain that no source of medical care was 

overlooked. 

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However, the mother’s response was the onlY 

source of names of dentists and if the mother was 

not sent or did not respond to the questionnaire, 

no information on dental care could be obtained. 

Since the data for dental visits are not available 

for mothers of illegitimate children, the section 

on dental visits includes legitimate births only. 

There is one other small group of mothers 

for whom data are not available. In the second 

6 months of 1963 Missouri withdrew from the 

# 

survey for technical reasms, therefore no questionnaires were mailed to 45 mothers who should 

have been included in the survey. In addition, 

questionnaires were not mailed to nine mothers 

who at the time of the survey were living outside 

the United States although they had given birth 

within the United States. Excluding Q&e 54 cases 

does not affect the number of visits per mo~her 

since all rates are based on the number of mothers 

with a known number of visits. It does inflate 

Table A. Number and percent distribution of surveyed mothers, physie,ians, tnedical 

facilities, and de~~ists by response status according CO CO1O% of moeher: United 

States, 1963 births 

Respondents by number of msiling 

“Source and Number II I 1 1“ ~oncolor of mother in the TotaL survey respondenlx 

Mother 

TotaL ,13,726 86.4 

??espondF??lt Second Third p:;:~l eiljts 

Tnail ma’il view 

Percent distribution 

White . . . . . . . ..- -P --------

Nonwhite 

Physician 

ToEal 

White ---...-P 

Nonwh.i.te -----------------

Medi.cal facility 

Total- . . ..--p..-..-

White ..” 

Nonwhi,te-. “.-”----

Dentist 

Total 

White 

Nonwhite 

lThere were 4,09~ births 

45.3 I 29,21 

48,0 28.5 

28.1 33.3 

--l--J= 

67.8 17.0 

55,2 22.7 177,4 15,3

78.5 3.5,(I

72,0 17,0 

6.8 5.1 13.6 . 

6.7 4.4 12,3 

7.3 9*.4 21,9 

9.0 � .P 6.9 

. . . 6.5 

. . . 10.8 

4.9 ,00? 2*4 - ..-

4,5 **V 2,4 

.6.7 #.!@ 4.3 

..; 209 

. . . 2’03 ZEIE ..* 3_2.9 

3,218 87,7 

508 78,1 

4,474 93.1-

4,012 93,5 

462 89.2 

4,432 97..6 

3,685 98.0 

747 95.7 

1,360 97.1 

1,275 97.7 

85 87.1 

se~ec~ed inthe sa~ple but 316 were i.llegikima~e and so the 

mot?aer was not .quezimi and 54 were excluded Zw Qther reasons. However, nwdical inquiries were sent in all cases where a medixal source of info?macion was .ide,ntified. 

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Table B. Average number of visits to physicians and medical facilities during the year 

before childbirth, by geographic region, metropolitan status, and color, and percent 

of births that were white: United States, 1963 births 

Average number of visits Percent 

Geographic region and of births 

metropolitan status that were 

Total White I Nonwhit6 white 

11.5 83.9 

Northeast 11.0 11.3 89.0 

North Central 11.9 12.2 90.3 

South 10.9 12.1 72.2 

West 12.8 13.4 88.8 

Area 

Metropolitan areas 

Nonmetropolitan areas 

the percentage ofmothers aboutwhominforrnation 

is missing, particularly in the North Central 

Region. 

As is true for all surveys and particularly 

for mail surveys, a certain proportion did not 

respond to the questionnaire. The problem was 

handled in a series of procedures. First, two 

followup questionnaires were sent at 2-week 

intervals, one by regular mail and one by certified mail. Second, if ‘tie mother’s usual place 

of residence was in one of the Census Bureau’s 

primary sampling units, interviewers employed 

by the 13ureau tried to interview the mother 

either by telephone or in person. No personal 

interview was attempted for medical sources. 

The results of these procedures are shown in 

table A. 

In order to reduce the effect of nonresponse, 

statistics derived from the survey of themothers 

were adjusted for nonresponse by imputing to 

nonrespondents the characteristics of “similar” 

respondents. The technique is discussed in Appendix I of this report and adetailed description 

can be found in an earlier report in this series.2 

No imputation for unit nonresponse was done for 

medical sources. 

11.7 83.7 

11.2 84.5 

VOLUME OF VISITS 

In the United States women who had aliveborn baby in 1963 visited a physicianor medical 

facility an average ofll,5 times during the year 

before the baby was born (tables B andl). Approximately 75 percent of the visits were to 

physicians, and the other 25 percent were tohospitals or other medical facilities. 

Geographic Area 

There was very little variationinthe average 

number of visits by geographic area. Among regions the average number of visits was highestin 

the West. Within each region therewas atendency 

for mothers in the metropolitan areasto average 

more visits than mothers in nonmetropolitan 

areas. This tendency was reversed in the West 

although the difference is notstatistically significant. 

Throughout the United States—in all four 

regions and in both metropolitan and nonmetropolitan areas—the average number of visits for 

medical care during the year before childbirth 

was significantly higher for white mothers than 
for nonwhite mothers (table B). For white mothers 

the average number of visits was 12.2, while for 

nonwhite mothers the average number of visits 

was 7.7. The largest difference was in the West 

where white mothers averaged 13.4 visits and 

nonwhite mothers, 8.2 visits. The smallest difference was in the Northeast where the average was 

11.3 for white mothers and 8.1 for nonwhite 

mothers. These two regions represent the extremes for white mothers; the average number 

of visits for nonwhite mothers was about the same 

in the Northeast and the West. 

The deviation in the average number of visits 

for nonwhite mothers was in the South. Although 

the averages in the other three regions were 

relatively constant with a range of 8.1-8.3, the 

average number of visits for nonwhite mothers in 

the South was 7.2. Since 56 percent of the nonwhite births in 1963 were in the South, the national 

estimate was heavily weighted by births in this 

region. Conversely, the level of medical care—as 

measured by the number of visits+ppears to be 

low in the South when color is not taken into account because the proportion of nonwhite births 

here was much higher than in any of the other 

three regions. The average number. of visits 

for white mothers in the South was approximately 

the same as in the North Ceiwral Region and 

higher than in the Northeast. 

Perhaps a word of caution is needed here. In 

1963 just under 2 percent of the births were outside hospitals with either a midwife or some 

other nonspecified person in attendance.3 For 

white births this figure is 0.4 percent, while for 

nonwhite births it is 9.7 percent. Almost all of 

these births were in the South. Since the definition 

of medical care used in this survey includes only 

visits to physicians or to medical facilities such 

as clinics or hospitals, all visits of midwives are 

excluded by definition. Although there is no estimate available of the number of visits made to or 

by midwives, it seems certain ,that inclusion of 

these visits would increase the averages, particularly for nonwhite births in the South. 

Income 

Geographic region, metropolitan status, and 

color are general demographic characteristics 

which are derived from entries on the birth certificate. One of the purposes of the natality sur ­

vey was to add to these demographic items certain 

socioeconomic items which cannot be obtained 

from the birth certificate. Probably the most 

important of these in terms of medical care is 

income. 

The income referred to in this report is the 

totai money income in 1962 from all sources for 

all members of the rainily who were living in the 

household at the time the baby was born. This is, 

of course, only a rough estimate of the resources 

available to famiIy members since it does not take 

into account nonmonetary income or the number of 

persons in the family who are dependent on the 

income. However, within the broad groups shown 

here it is a useful measure. 

In general, the number of visits per mother 

was higher in each succeeding income group 

(tables C and 2). Mothers living in families with 

an income under $3,000 in 1962 averaged 9.3 

visits to physicians or medical institutions during 

the year. Mothers in families with an income 

of $10,000 or more had 13.7 visits. The increase 

in the average number of visits was due to the 

greater number of visits to physicians; the average 

number of visits to medical facilities was somewhat smaller and the proportion of the visits which 

were to medical facilities decreased from 34 percent to 17 percent. 

The greatest change in the number of visits 

to either of the two specified sources of medical 

care was at the $5,000 level. At this point the 

average number of visits to physicians went from 

8.0 for those in the $3,000-$4,999 group to 10:2 

for those in the $5,000-$6,999 group. Visits to 

medical facilities decreased from 3.2 to 2.6 per 

mother. In conjunction with this, it should be 

noted that almost half (49 percent ) of the births 

for which income is known were to families with 

a 1962 income under $5,000. 

Although mothers of illegitimate babies were 

not queried, the institutions where the births took 

place were questioned, as were the attendants at 

the births. Both were asked for the names of 

other hospitals or physicians that the mother 

may have visited. Thus, it is possible to make an 

estimate of the number of visits which mothers 

of illegitimate babies had made for medical care. 

Internal audits (see table 17) have shown that 

such procedures give a reasonably accurate 

measure, although it is possible that some visits 

which only the mother knew about were not counted. 

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Table C, Average number of visits to physicians and medical facilities and percentage 

Qf visits Ix physicians during the year before chi,~db~rth, by l,962! fa~i~y ~nc~~e: 

United States, 1963 births 

Average number of vLsi@ 

Percent 

of visi~s 1962 family income TO ccl 

Total TO rnedica.1 phyeic.ians l’~~slcians facilities ,, 

All incomes--.-.-------+------------ 11,5 8,7 2.9 7.5.1 

Under $3,000 ---.=---- =-..*.--* ---..”--- -“q 

$3,000-$4,999 . . . . . . . . .-=.---= . . ...-=.-

$520QCI-$6,99y .-?-------- -.-..”---.---”---- .-

J:; 

12.8 

M 

10.2 

;;; 

66*3 

72.3 

79.4 

$7,000-$92999 . . . . . . . . . . . . . . . . . . ..--.s-.. 13,5 11.1 n 82,8 

$lQ, Q?O m-id over-------------------------- 13.7 1;.; 2.3 82,9 

~llegltimate and un~nown ------------------

The estimated average number of visits during 

the year for mothers of illegitimate babies was 

7.1. This is significantly lower than the average 

for mothers of legitimate births, including those 

with a family income under $3,000 in 1962 

(table C), 

There were regional variations inthepattern 

of visits when the family wasclassified according 

to its income in 1962, Income seemed to make 

the most difference in the West, where mothers 

in families with incomes under $3,000 had 9,5 

visits and mothers in families with incomes of 

$10,000 and over had 17.3 visits, Income seemed 

to rnakethe least difference inthe North Central 

Region where the comptmable averages were 10,4 

and 12.6 (table 2). 

The number of visits per mother for each 

income group. was c~mparable for metropolitan 

and nonmetr~politan areasupto$10 ,000..However, 

atthatincome Ievelmothersinrnetropolitanareas 

averaged rnorevisits than those innonmetropol. 

itan areas (table 3), Although the averagenumber 

of visits for women in the Iowestincomegrou.p 

was alsoComparable, the prop,ortio~ of visitsto 

medical facilities was higher fcvrmothersliving 

in metropolitan areas than for mothers in nonmetropolitan areas. In metropolitan areas the 

mothers in families with a 1962 incom~ Waler 

$3,000 achieved their average of 9.3 visits by 5.6 

visits to physicians a~d 3.,7 visits to medical fa,. 

cilities; in nonmetropolitan areas the mothers in 

7.1 . 3,6 49,0 

low income families also averaged 9,3 visits, hut 

6,8 of these were to physicians and only 2.5t0 

medical facilities. 

As has already beenrnentioned, thedifference 

between white and nonwhite mothers in the average 

number of visits is statisticall.y signific.ant. Table 

4showsthe distribution ofmcxhersbyt heir 1962 

family income. It is immediately apparent that 

part of the difference between the two color groups, 

is due to the difference in income, and tahle, D 

shows how great that difference is, (My 12peKcent of the nonwhite women who had Iiveborn 

babies in 1963 are known to be memlxxs of tam. 

ilies with an income of $S,,000 or morq as. contrasted with “S3 percent of the white nmtherst It 

has already been shown that the average number 

of visits was higher in the upper income groups. 

Thus. it follows that. the average nurnbwr ofvisits 

would be lower for nonwhite mothers than for 

white mothers because of a difference in income. 

Despite this, all of the difference in the 

number of visits is rmt due to the income difference. Considering only mothers in. families with a 

1962 income under $3,000, for example,, white 

mothers averaged 10..4 visit.a, ~f which71 percent 

were to physicians; nonwhite mothers a,veraged 

6.8 visit;, of which 47 percent were to,physicians. 

In the $3,000-$4,999 income group the averages 

were 11.’8 for white mothers and 7./3 visits. for 

nonwhite mothers. In the. higher income groups 

the averages were closer, although the small 

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number of nonwhite mothers in the income groups 

above $5,000 makes valid statistical comparisons 

difficult. 

Education 

Closely related to income as a socioeconomic 

factor is education. In general, people in the 

upper income groups remain in school longer 

than those in the lower income groups, and this 

relationship should be kept in mind when the 

tables showing visits by educational level are examined. This is not to say, however, that income 

and education show a one-to-one correlation. In 

the first place, the income shown here is the 

income of the entire family unit living together at 

the time of the birth regardless of how many 

people were in that unit or their status in the 

labor force. Second, the women included in this 

survey were predominantly young—an estimated 

75 percent were under 30, and 50 percent were 

under 25—so that those at the higher educational 

levels might still be in the lower income groups 

if they (or their husbands) had not been in the 

labor force very long. 

Without exception, regardless of region, metropolitan status, or color, women with some 

Table D. Number and percent distribu cion 

of mothers by 1962 family income according to color: United States, 1963 

births 

1962 

family income E3EIE 

Number in thousands 

Total mothers - 4,097 II 3,439 I 658 

Percent distribution 

All incomes--- 100.0 ‘ 100.0 100.0 11-=­

Under .$3,000------ 20,0 ;;.: 38.0 

$3,000 -$4,999 25.2 22.9 

$5,000-$6,999 22.4 25:5 

$7, Qoo-$9,999----- 16.3 18.8 5:; 

$10,000 and over-- 7.5 8.6 1.8 

l~g~f-tiate and 

-e 8.6 5.1 27.2 

college training averaged more visits for medical 

care during the y;ar prior to childbirth than did 

women at any other educational level (tables 5-7). 

The nationaI average for these women was 13.6 

visits. Again without exception, women who had 

completed high school but who had no college 

education had the next highest average number 

of visits. Nationally the average for the high 

school graduates was 12.5 visits. Those women 

who had attended but not completed high school 

averaged 10.8 visits and, except in the North 

Central Region, their average number was higher 

than that for women who had no schooling or only 

an elementary education. Not all of these differences are statistically significant of course, but 

the pattern is consistent. Variability both for education and for income is least in the North Central 

Region and greatest in the West. 

Although the average number of visits to 

medical facilities decreased as the level of income increased, there was little evidence of such 

a decrease by leveI of education. The proportion 

of visits to medical facilities was lower with each 

succeedingly higher level of education only because the average number of visits to physicians 

was higher. In the Northeast and in the West women 

with some college training averaged more than 

twice as many visits to physicians during the year 

than women who had only elementary or no 

schooling. 

The statement made about income and coIor 

also holds for education and color. Although percent distributions by educational leveI of white 

and nonwhite mothers are different and thus affect 

the overall rates for the two groups, the differences are there even when education is controlled. 

At each educational leveI nonwhite mothers made 

only 60-70 percent as many visits as white 

mothers. And, except for mothers with some 

college education, they made less than half as 

many visits to physiii~ns. 

Age of Mother and Live-Birth Order 

Although the information on income and education was obtained only for legitimate births, 

such information as age of mother and live-birth 

order is available for alI mothers since it came 

from the birth certificate. Table 8 is a presentation 

of the number of visits per 1,000 mothers for 

these two variabIes. In general, the lower the 

birth order the more visits the mother made for 

7 
----------------------

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---------------------------------

----------------------------

--------------------------- ------------------------

--------------------------------

----------------------------

---------------------------------

-------------------------

---------------------------------

Table E. Cumulative percent distribution of mothersl according to time of first visit,


by geographic region and color: United States, 1963 births


3 Trimester of pregnancy No


months
 Geographic region and color before medical


care conception First Second Third


Percent distribution


United States


White--------- --------.


Nonwhite


Northeast


White---------


Nonwhite-------- -


North Central------------------------


White----------------------------.-------


Nonwhite---------------------------------


South


White--------


Nonwhite


West--------


White------------------------------------
 Nonwhite


22


20 

21


14


25


25


24


20 

24


11


22


22


23


62 81 99 1 

35 60 94 6 

.58I 79 I 991 1 

61 81 99 1“ 

33 63 98 2 

52 I 73 I 96 I 4 

60 97 3 

31 ;: 92 8 

59 78 98 1 

‘Excludes mothers whose date of first visit is unknown.


medicalcare.Exceptforfirstbirthsmost ofthe


difference
was duetothehigherrateofvisitsto


physicians;the rateforvisitsto medical care


facilities remainedrelatively
 constant.


When the age of the mother is considered


as an independentvariable,
theaveragenumber


of visitsis relatively constant. The exception
is


intheage groupunder20 inwhichmothersmade


an averageofonly10.6visits
permother—7.3 to


physiciansand 3.3 to medical facilities.
 Itis


likely
thatthelowoverallrateforthisage group


coupledwiththehigh rateof visitsto medical


facilities
 is due at leastin partto thehighil­


legitimacy
rateinthisagegroup.


TIME OF FIRST VISIT FOR 

MEDICAL CARE 

The,numberof visits tophysicians
ormedi­


cal facilities
 is one measure of medicalcare


which is availablefrom the survey.A second


measure oftheextentofmedicalcareisthetime


of the firstvisitduringthe year.In the1963


NationalNatalitySurvey physicians
and medical


facility
 sourceswere asked for the dateduring


the year beforethe birthof thechildwhen they


had firstseen the mother;theywere notasked


for thedatewhen shewas firstseenforprenatal


care.Thus, thetableswhichfollowdo notrelate

-----

solely to visits for prenatal care or even necessarily to visits to physicians who furnished 

the prenatal care, although less than 3 percent 

of the mothers named more than one physician. 

They do, however, indicate that the mother had 

at least been in contact with the medical profession by a given point in the year, or conversely that she had not had any contact until a 

certain point before childbirth. 

Among the 4 million women who gave birth to 

a liveborn child in the United States in 1963, it 

is estimated that 21 percent had seen a physician 

or had gone to a medical facility during the approximately 3 months before conception. An 

additional 35 percent had made one or more 

medical visits before the end of the first trimester 

of pregnancy, another 19 percent before the end 

of the second trimester, and about 20 percent of the 

mothers had their first visit for medical care 

during the third trimester. Approximately 2 percent had no care during the year and for 3 percent 

of the mothers information was not available 

(table 9). 

Because the percentage of mothers for whom 

the date of the first visit was unknown varies so 

much by region and color, those mothers have 

been excluded from table E to facilitate the comparisons. All mothers are shown in the detailed 

tables. 

Color —

White mothers had care earlier in pregnancy 

than nonwhite mothers. Between the beginning of 

the year and the end of the first trimester of 

pregnancy, 62 precent of the white mothers and 

only 35 percent of the nonwhite mothers were 

known to have had any form of care. By the end 

of the second trimester 81 percent of the white 

mothers and 60 percent of the nonwhite mothers 

were known to have had one or more visits to a 

physician or medical facility. By the time of the 

birth 99 percent of the white mothers and 94 percent of the nonwhite mothers had been seen. Therefore, it is estimated that approximately 1 percent 

of the white mothers and 6 percent of the nonwhite mothers had not been seen either by a physician or at a medical facility before the birth of 

the child. 

Metropolitan Status 

Although the average number of visits was 

approximately the same for women residing in 

metropolitan and nonmetropolitan areas, there 

is evidence in table 9 that the metropolitan women 

received care earlier than those outside metropolitan areas. White women living in metropolitan 

areas were more likely to make their medical 

visit during the first trimester of pregnancy than 

were white women living outside metropolitan 

areas. Nonwhite women living in metropolitan 

areas received care earlier and more of them 

were known to have received care than nonwhite 

women residing outside metropolitan areas. 

Region 

Among regions there was little difference in 

the time at which medical care was first sought 

except in the South. In the other three regions 

58-64 percent of the mothers had had some medical care by the end of the first trimester; in the 

South only 52 percent had received care by that 

time. By the time of the birth 99 percent of the 

mothers in the other three regions had receive – 

some care, while in the.S.o@-==~~e”@ 9-~er -

cent had had care by the time of tie birth. A 

large part. or this difference can be attributed to 

the high” proportion of births in the South which 

w-ere nonwhite (28 percent in the South as contrasted with 10-11 percent in the other regions). 

When the distributions according to time of first 

medical care of the white mothers are compared, 

there is little difference among the four regions; 

the differences are among the nonwhite mothers. 

By the end of the first trimester only 31 percent 

of the nonwhite mothers in the South and 34 percent in the Northeast had received care, while 45 

percent in the North Central Region and 46 percent 

in the West had received some care. 

Income, . 

Table 10 shows the mothers in each region 

classified according to the 1962 income of their 

families. As would be expected, women in the 

lower income groups not only had fewer visits 

during the year but also tended to start their medical care later in the year before childbirth. By 
the end of the first trimester of pregnancy, 43 

percent of the mothers in families with a 1962 

income under $3,000 had received some medical 

care and 76 percent of the mothers in families 

with an income of $10,000 or more in 1962 had had 

such care. Over four times as many women in the 

lowest income as women in the highest income 

group had received no care. Within each region 

the pattern was the same. Mothers in families 

with higher income started care earlier than 

mothers in families with lower income. 

Education 

As table 11 shows, mothers with higher levels 

of educational attainment also started their care 

earlier than mothers with less education. Since 

income and education are known to be closely related, the differences between women at various 

levels of educational attainment cannot be attributed solely to the mother’s education or lack of it. 

Tables 12 and 13 serve mainly to point out 

that for any given income or educational group the 

differences between metropolitan and nonmetropolitan areas are insignificant with regard to the 

time wtren tke mothers first received medical 

care. 

It has already been stated that the percent distributions according to the time during the year 

before childbirth when a doctor was first seen 

were quite different for white and nonwhite mothers. Tables 14 and 15 show white and nonwhite 

mothers classified by income and by education. 

The differences between the two groups cannot 

be attributed solely to differences in income or 

in education. Because the number of nonwhite 

mothers in the upper income groups is small, 

one must be careful in comparing these groups, 

but there is no doubt that white women in the 

lower economic groups received care earlier 

than nonwhite women in the same groups. For 

women in the lowest level—that is, women in 

families which had a total income under $3 ,000— 

almost half or 48 percent of the white women had 

received medical care by the end of the first 

trimester of their pregnancies; only 29 percent 

of the nonwhite women had been seen by a physician or at a medical facility. In this low income 

group, by the end of their pregnancies, 3 percent of 

the white women and 8 percent of the nonwhite 

women had received no care. 

When the educational groups are,examined the 

differences are even greater. Among women 

with no education beyond elementary school, .44 

percent of the white women and only 26 percent 

of the nonwhite women had received medical care 

by the end of the first trimester of pregnancy 

(that is, during the first 6 months of the year 

preceding birth). Within the same group 3 percent 

of the white women and 13 percent of the nonwhite 

women had no medical care at all during the year 

before childbirth. Among women who had some 

college education 74 percent of the white women 

and 49 percent of the nonwhite women had received 

medical care by the end of the first trimester. In 

all cases these figures exclude the illegitimate 

births. 

Age of Mother and Live-Birth Order 

Table 16 shows the trimester of the first 

medical contact by age of the mother and livebirth order. Since this knowledge is not dependent on a response to a questionnaire, mothers 

of illegitimate children are included. With the 

exception of mothers under 20 years of age, there 

was not a great deal of difference by age in the 

percentage of women who had seen a doctor or 

Wsited a medical facility by the end of the first 

trimester of pregnancy. About 22-23 percent of 

them had seen a doctor before conception and 35-40 

percent more saw a medical person during the 

first trimester of pregnancy; therefore by the end 

of the first trimester between 56 and 62 percent 

of them had received some care. For mothers 

under 20 years of age, only 43 percent had received medical care by the end of the first trimester— 16 percent during the 3 months before 

conception and another 27 percent during the first 

trimester. 

When the live-birth order of the child is considered without regard to the age of the mother, it 

appears that women having a first or second child 

sought care earlier than women having a third 

or fourth child. Women having a fifth or later 

10

child started medical care later thananyof the 

othefs and5 pefcem had no medical care at all. 

Among women having a first child+ women 

aged 25-29 received earlier care than any other 

group-I-79 percent by the end of the first trimestef. 

Among women who had already had at least one 

Iiveborn child, women aged 35 and over received care earlier than those in any other age 

group. Probably the changes with age and birth 

order alm reflect changes in the family income, 

A woman having a second child stage 30-34 years 

is mode likely to be in a higher income group 

than a woman having a second child at age 20-24, 

Relationship Betweeh Time bf First Visit 

arid Number of Visits 

- It would seem logical that worneti who had 

sought medical care early in the year before a 

child was born would make more visits than women 

who started their medical care in the second of 

third trimester of pregtiaficy, Table 17 shows that 

such women did make more visits. Among women 

who were kimwn to have first received medical 

care either during the 3 months before conceptiofi 

or dirrimg the first trimester of pregnancy, approx~mateiy 81 percent made 10 or more visits to 

a physician or a medical facility, Among women 

know to have first received medical care in the 

seccmd trimester, 49 percent made 10 or more 

vi~it~, Among women known to have started Yeceiving medical ea~e in the third trimester, only 

9 percent made 10 or more visits and 70 percwit 

made fewer than 5 visits, Women who received no 

medical care of course made no visits. The remaining women were reported to have received 

some care but the date of the first visit was not 

reported and in almost all eases the fiutribe~ of 

Visits was also not reported. 

The remainder of table 17 is Iirnitedtowoinen 

who were irit!ltidecl in the survey population. T&it 

is, the mothers of illegitimate lJi@Js are excluded 

as are die other women who were excluded from 

the survey for technical reasons. The percent 

dktributions are essentially the same for the two 

populations even though in the second group every 

mother had a ciwuice to name additional sources 

of care while the first grQtip includes the mothers 

Who were notasked any questions, 

DENTAL- VISITS 

In addition to the physicians and hospitals, 

dentists were sent questionnaires to d&ermtie 

the nutnbet of visits the mother had made to the 

dentist during the 12 months before her ~hi~dwas 

lmrn. However, since the dentist was not named 

on die birth certificate ~ there was rio way to 

trace the dentist if the mother was excluded from 

the survey or did not respond to her qtiestiLmnaire. The mothers who were not queried have 

therefore been excluded from the statistic~ on 

dental visits. Because the number of mothers reporting any dental cafe is so low there are no 

tables on the nimiber of Visits per 1,000 mothers. 

‘Tables 18-20 show only percent distributions, 

The must striking feature of these tables is 

the very high percentage of mothers who did fiot 

see a dentist at di during the year before Childbirth. Of the estimated 3,7 million women who 

had legitimate births in 1963 and who were in= 

eluded in the survey population, 73 percent reported that they liad riot seen a deritM dufing the 

previous 12 months. M& 26 percent reported 

visits and no infurmatiofi is available on the remaining Z percent. Of thdse who did see a dentisti 

28 percent made only one visit. 

A higher proportion of white mothers i%­

pdrted dental visits than nonwhite mothers; 28 . 

pe?%ent of the white mothers arid only 8 pefcent of 

the noilwhite mothers are known to have seen a 

dentist. The difference in the proportion who satv 

a dentist is significant. 

Womefi r-esiding outside metropolitan areas 

appeared less likdy to have visited a dentist 

than women living in rnemopolitan areas. %&i_& 

m.etrtqmlitan areas 71 percent of the mothers reported, that they had riot seen a dentist. Outside 

nietropcditan a~~s 77 percent reported that they 

had not seen a dentist. 

The regimial infm?rnatidn shown ill table F has 

been abstracted from table 18 because the regicnial 

pattern for dental ca~e is somewhat dii!feferit froiri 

that for medical care. The Northeast had the 

highest propdtitimi of women who reported dental 

visits, followed by the North Central Region, In 

the South the proportion of women who feported 

riO visits was high a.ild this is die region tvith the 

highest proportion of women tvith no medikal care. 
-------------------

----------------------------- ------------------------- ---------------------------------

----------------------------------

Table F. Percent distribution of mothers, by whether they visited a dentist during the 

year before childbirth, according to geographic region: United States, 1963 births G 

One or more visits 

All No Geographic region mothers visits Unknown 

United States 

Northeast


North Central


South


West


But in the West the proportion ofwomen withno 

dental care reported was also high, although the 

proportion with no reported medical care was 

low. This does not appear to result from either 

metropolitan status or color. 

As can be seen from table 18, the high proportion of women in the West withno dental care 

during the 12-month period was not afunction of 

income. For each income group the proportion in 

the West withno dental care was higher than that 

for the United States as a whole. 

The amount of dental care,likemedical care, 

was greater as the size of the family’s income 

increased. Even so, where the family’s income 

was $10,000 or over, 52 percent ofthe mothers 

reported that they had not seena dentist during 

the 12 months before childbirth. 

The ideal situation in which the mother would 

have made two or more dental visits was not 

achieved by any income groupin any region. The 

closest was for the group of mothers who were 

members of families withan income in 1962 of 

$lO,OOOor over and who were livingin the Northeast. Approximately44percentofthose womenhad 

Total One ~r:r 

Percent distribution 

100 73 26 7 18 4 

100 68 33 7 25 

100 67 7 ; 

100 79 ?; :$ 4 

100 77 23 ; 17 1 

two or more visits to the dentist. In the North 

Central Region and inthe 

cent of the women in this 

two or more dental visits. 

The differences by 

residents of metropolitan 

areas were nonsignificant 

Southjust under40 perhighincome group made 

income group between 

and nonmetropolitan 

(table 19). 

However, the differences by income group 

between white and nonwhite mothers were, in 

general, significant. Even where the population 

base is so small that statistical significance cannot redemonstrated, thenumbers and percentages 

have been shown because the differences are so 

great. While the proportion of white mothers 

with no dental care goes fromahighof 86 percent 

for those with a family income under $3,000in 

1962 toa low of 51percentforthose with a family 

income of$lO,OOOor more—adifference of35percentage points—among nonwhite mothers the 

corresponding figures are 92 percent and 87percent— a difference of 5 percentage points. White 

mothers in low income families had almost no 

dental care. Nonwhite mothers received almost 

no dental care regardless of income (table 20), 

12

REFERENCES 

‘National Center for Health Statistics: Volume of Dhvsician visits, by place of visit and type of service, Lk”ted 

States, July 1963-June 1964. Vital and Health Statistics. PHS 

Pub. No. 1000-Series 1O-NO.18. Public Health Service. Washington. U.S. Government Printing Office, June 1965. 

2

National Center for Health Statistics: Methods and characteristics, National Natality Survey, United States, 1963. 

Vital and Health Statistics. PHS Pub. No. 1000-Series 22-No. 

3. Public Health Service. Washington. U.S. Government Printing Office, Sept. 1966. 

3

National Center for Health Statistics: VZM Statistics of 

the United States, 1963, Vol. I. Public Health Service. Washington. U.S. Government Printing Office, 1964. 

%cCarthy, P. J., ‘Sinmrons, W.R., and Game, J. L.: Replication Techniques for Estimating Variances From Complex 

Surveys. Paper presented at a joint session of the Epidemiology and’ Statistics Sections at the ninety-third meeting of 

the American Public Health 4 ssociation, Chicago, Ott. 18, 

1965. 

5

National Center for Health Statistics: Replication, an 

approach to the analysis of data from complex surveys. vital 

and Hea2th Statistics. PHS Pub. No. 1000-Series 2-No. 14. 

Public Health Service. Washington. U.S. Government Printing 

Office, Apr. 1966. 

6

U.S. Bureau of the Census: U.S.. Census of Population: 

1960. Number of Inhabitants, United States Summary. Final 

Report PC (1)-1A. Washington. U.S. Government Printing 

Office, 1961. pp. XXVII and XXVIII. 

—000 

13 
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DETAILED TABLES 

Page


Table 1.	 Number of mothers and number of visits to physicians and to medical facilities


per 1,000 mothers during the 12 months prior to birth, by geographic region,


metropolitan status, and color: United States, 1963 births 16


2.	 Number of mothers and number of visits to physicians aridto medical facilities


per 1,000 mothers during the 12 months prior to birth, by geographic region and


1962 family income: United States, 1963 births lg


3.	 Number of mothers and number of visits to physicians and to medical facilities


per 1,000 mothers during the 12 months prior to birth, by metropolitan status


and lg62 family income:,United States, 1963 births 19


4.	 Number of mothers and number of visits to physicians and to medical facilities


per 1,000 mothers during the 12 months prior to birth, by color and 1962 family


income: United States, 1963 births 20


5.	 Number of mothers and number of visits to physicians and to medical facilities


per 1,000 mothers during the 12 months prior to birth, by geographic region and


education of mother: United States, 1963 births 21


6.	 Number of mothers and number of visits to physicians and to medical facilities


per 1,000 mothers during the 12 months prior to birth,by metropolitan status and


education of mother: United States, 19.63births 22


7.	 Number of mothers and number of visits to physicians and to medical facilities


per 1,000 mothers during the 12 months prior to birth, by color and education of


mother: United States, 1963 births 23


8. Number of mothers and number of visits to physicians and to medical facilities


per 1,000 mothers during the 12 months prior to birth,by age of mother and live-


birth order: United States, 1963 births 24


9.	 Number and percent distribution of mothers, by time of first medical visit dur­


ing the 1.2months prior to birth according to geographic region, metropolitan


status, and color: United States, 1963 births 25


10.	 Number and percent distribution of mothers, by time of first medical visit during the 12 months prior to birth according to geographic region and 1962 family 

income: United States, 1963 births 27 

11.	 Number and percent distribution of mothers, by time of first medical visit during the 12 months prior to birth according to geographic region and education of 

mother: United States, 1963 births 28 

12. Number and percent distribution of mothers, by time of first medical visit dur­


ing the 12 months prior to birth according to metropolitan status and 1962 fam­


ily income: United States, 1963 births 29


13.	 Number and percent distribution of mothers, by time of first medical visit dur­


ing the 12 months prior to birth according to metropolitan status and education


of mother: United States, 1963 births 30


14.	 Number and percent distribution of mothers, by time of first medical visit dur­


ing the 12 months prior to birth according to color and 1962 family income:


United States, 1963 births 31


14

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------------------------

-----------------------

-----------------------

----------------------------------

DETAILED TABLES-Con.


Table 15. 

16.


17.


18.


19.


20.


Number and percent distribution of mothers, by time of first medical visit dur­


ing the 12 months prior to birth according to color and education of mother:


United States, 1963 births


Number and percent distribution,of mothers, by time of first medical visit dur­


ing the 12 months prior to birth according to age of mother and live-birth


order: United States, 1963 births


Number and percent distribution of mothers and of mothers in survey population,


by number of visits according to time they first received medical care during


the 12 months prior to birth: United States, 1963 births


Number and percent distribution of mothers in survey population, by whether they


had seen a dentist during the 12 months prior to birth according to geographic


region and 1962 family income: United States, 1963 births


Number and percent distribution of mothers in survey population, by whether they


had seen a dentist during the 12 months prior to birth according to metropolitan


status and 1962 family income: United States, 1963 births


Number and percent distribution of mothers in survey population, by whether they


had seen a dentist during the 12 months prior to birth according to color and


1962 family income: United States, 1963 births


Page


32


33


34


35


36


37


15

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Table 1. Number of mothers and number of visits to physicians and to medical facilities per 1,000


mothers during the 12 months prior to birth,by geographic region,metropolitan status,and color:


United States; 1963 births


Number Number of visits per 1,000


mothers
 of


mothers
 Geographic region, metropolitan status, and color


ALL REGIONS


All areas


Total


tiite


Nonwhite


Metropolitan areas


Total .-----------------------


Wite


Nonwhite


Nonmetropolitan areas


Total


~ite


Nonwhite


NORTHEAST


All areas


Total


Wite


Nonwhite


Metropolitan areas


Total


White


Nonwhite


Nonmetropolitan areas


Total------------------------------------------------


Wite


Nonwhite


NORTH CENTRAL


All areas


Total


Wite


Nonwhite


MetrODOlita~ areas


Total


~ite


Nonwhite


in 

thou- To To 

sands Total	 physi- medical


cians facilities


4,097 11,524 8,650 2,874


3,439 12,194 9,512 2,682


658 7,650 3,670 3,981


2,656 11,713 8,750 2,963


2,222 12,449 9,736 2,713


434 7,727 3,411 4,316


1,440 11,168 8,462 2,706


1,217 9,101 2,626


223 4,247 3,232


937 10,989 8,272 2,717


834 11,339 8,909 2,430


103 8,060 2,940 5,121


750 11,013 8,212 2,801


653 11,473 8>992 2,481


97 7,786 2,745 5,040


187 10,896 8,514 2,382


181 10,854 8,609 2,245
 * ?< * *


1,159 11,895 9,561 23334
 —


1,047 12,239 10,067 2,172


112 8,343 4,334 4,010


727 12,062 9,583 2,479


628 12,580 10,353 2,228


99 8,350 4,067 4,283


16

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------------------------ ---

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------------------------ ------------------------ ---

Table 1. Number of mothers and number of visits to physicians and to medical facilities per 1,000


mothers during the 12 months prior to birth,by geographic region,metropolitan status,and color:


United States, 1963 births—Con.


Number Number of visits per 1,000


of mothers


mothers
 Geographic region, metropolitan status, and color


t%l- To To


sands Total physi- medical


cians facilities


NORTH CENTRAL-Con.


Nonmetropolitan areas


Total 432 11,621 9,526 2,096


White ---------=---.--- 419 11,732 9,643 2,089


Nowhite 2 * * *


SOUTH


All areas


Total 1.316 10.893 7.644 3.249


White 950 12>149 9,045 3,105 

Nonwhite 366 7,164 3,486 3,678 

Metropolitan areas 

Total 671 11,347 7,956 3,391 

White 494 12,848 9,689 3,159 

Nonwhite 176 6,926 2,853 4,073 

Nonmetropolitan areas 

Total 646 10,396 7,302 3,094 

8,341 “3,045


4,189 3,238


White


Nonwhite


WEST


All areas


Total


White


Nonwhite


Metropolitan areas


Total


White


Nonwhite
 -----------------------”


Nonmetropolitan areas


Total


White


Nonwhite


456 11,386


190 7,428


685 1.2,809 9,534 3,276


608 13,364 10,138 3,226


76 8,248 4,561 3,687


508 12,747 9,442 3,305


446 13,272 10,051 3,222


62 8,939 5,029 3,910


177 12,990 9,798 3,191


163 13,615 10,378 3,237
 * “4 J< *


17

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Table 2. Number of mothers and number of visits to physiciansand to medical facilitiesper 1,000 

mothers during the 12 months prior to birth,by geographicregion and1962 family income: United 

States, 1963 births 

Number Number of visits per 1,000 

of mothers - . . mothers Geographicregion and 1962 family income in 

thou- To To 

sands Total physic- medical 

ians facilities 

All regions 

All incomes 4,097€ 11,524 8,650 2,874 — 

Under $3,000 820 9,327 6>182 3,145 

$3,ooo-$4.,999---------------------------------------------- 1,030 11,249 8,038 3,211 

$5,OOO-$6,999---------------------------------------------- 920 12,819 10,176 2,643 

$7,ooo-$9,999---------------------------------------------- 667 13’,451 11,133 2,318 

$10,000 and over 307 13,697 11,359 2,338 

Illegitimateand unknown 352 7,090 3,473 3,617 

Northeast 

All incomes 937 10,989 8.272 2,717 

Under $3,000 140 8,928 5,638 3,289 

3,ooo-$4,999---------------------------------------------- 218 10,044 6,628 3,415 

$5,OOO-$6,999---------------------------------------------- 236 11,920 9,536 2,384 

$7,ooo-$9,999---------------------------------------------- 199 12,783 10,824 ;,;;; 

$10,000 and over 83 12,193 10,486 

Illegitimateand unknown 62 7,880 3,773 4:107 

North Central 

All incomes 1,159 11,895 9,561 2,334 

Under $3,000 187 10,379 7,968 2,411 

$3,ooo-$4,999---------------------------------------------- 256 12,038 9,659 2,380 

$5,OOO-$6,999---------------------------------------------- 306 12,475 10,310 2,166 

$7,ooo-$9,999---------------------------------------------- 208 13,189 10,853 2,336 

$10,000 and over 12,570 10,662 1,908 

Illegitimateand unknownl,---------------------------------- 1?: 6,637 3,036 3,601 

South 

All incomes 1,316 10,893 7,644 3,249 

Under $3,000 363 8,817 5,408 3,409 

3,ooo-$4,999---------------------------------------------- 412 11,071 7,588 3,484 

$€5,OOO-$6,999---------------------------------------------- 208 13,484 10,455 3,029 

7,ooo-$9,999---------------------------------------------- 1;; 13,434 10,890 2,543 

i10,OOO and over 13,667 11,182 2,484 

Illegitimateand unknown 131 6,503 2,850 3,653 

West 

All incomes 685 12.809 9.534 3,276 

131 9,546 6,185 3,361 

144 12,198 8,593 3,605 

E~%:$f:;::i::z:::::::::::::::2::::::::::::::::z: 170 13,910 10,491 3,420 

7:ooo-$9:999---------------------------------------------- 130 14,898 12,287 2,610 

!10,000 and over 17,293 13,678 3,615 

Illegitimateand unknown :: 7,837 4,926 2,911 

lIncludesan es.timted 45,000 legitimatebirths in Missouri. 

18 
-----------------------------------------------

---------------------------- -------------------

-----------------------------------

------------------------------------------

-----------------------------------------------

--------------------------------------------

----------------------------------------------

-------------------------------------------

-----------------------------------

------------------------------------------

-----------------------------------------------

---------------------------- -------------------

-------------------------------------------

-----------------------------------

Ta:~h~l~Number of mothers and number of wisits to physiciansand to medical facilitiesper 1,000


during the 12 months prior &o birth, by metropolitanstatus and 1962 family income:


United States, 1963 births


Number Number ofm~fi~ per 1,000


of


mother:
 Metropolitanstatus and 1962 family income in


thou- To To


sands Total physi- medical
 cians facilities


All areas


All incomes----------------------------------------=-4,09; 11,524 8;650 2,874 .
 —


Under $3,000 82C 9,327 6,182 3,145


$3,000-$4,999 1,03C 11,249 8,038 3,211


$5,OOO-$6,999---------------------------------------------- 92C 12,819 10,176 2,643


$7,ooo-$9,999---------------------------------------------- 667 13,451 11,133 2,318


$10,000 and over--------------.------------—-------------- 307 13,697 11,359 2,338


Illegitimateand unknot 352 7,090 3,473 3,617


Metropolitanareas


All incomes 2>656 11,713 8,750 2,963


Under $3,000 429 9,324 5,641 3,684


$3,000-$4,999 612 11,116 7,718 3,398


$5,000-$6,999 625 12,948 10,395 2,554


$7,ooo-$9,999---------------------------------------------- 506 13,527 11,190 2,337


$10,000 and over 249 14,014 11,615 2,398


Illegitimateand unknown 236 6,769 2,997 3,772


Nonmetropolitanareas


All incomes 1,440 11,168 8,462 2.706


Under $3,000 391 9,329 6,793 2,536


$3,000-$4,999 419 11,443 8,503 2,940


$5,OOO-$6,999---------------------------------------------- 294 12,542 9,707 2,.835


$7,ooo-$9,999---------------------------------------------- 161 13,214 10,955 2,259


$10,000 and over 59 12>334 10,254 2,081,


Illegitimateand unhm 117 7,904 4,684 3,220


,’ 

19

------------------------------------------

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------------------------------------

-----------------------------------------------

-------------------------------------------

-----------------------------------

----------------------------------------

--------------------

-------

-----------------------------------

Table 4. Number Of mothers and number Of visits to physicians and to medical facilities per 1,000


mothers during the 12 months prior to birth, by color and 1962 family income: United States,


1963 births


kunber !’umberofm~;:~ per 1,000


of


lothers
 Color and 1962 family income in
 To To thou-


sands rotal physi- medical


cians Facilities


Total


All incomes


Under $3,000-----------------------------------------------


$3,ooo-$4,999----------------------------------------------


$5,OOO-$6,999----------------------------------------------


$7,ooo-$9,999----------------------------------------------


$10,000 and over


Illegitimate and unknown


White


All incomes------------------------------------------


Under $3,000-----------------------------------------------


$3,ooo-$4,999----------------------------------------------


$5,OOO-$6,999----------------------------------------------


$7,000-$9,999


$10,000 and over


Illegitimate and unknown


Nonwhite


All incomes------------------------------------------


Under $3,000-----------------------------------------------


$3,ooo-$4,999----------------------------------------------


$5,000-$6,999 “-----


$7,000-$9,999----------..-..---..--..-” -


$10,000 and over---------.---”----.------------------


Illegitimate and unknown


4,097 11,524 8,650 2,874 

820 9,327 6,182 3,145 

1,030 11,249 8,038 3,211 

920 12,819 10,176 2,643 

667 13,451 11,133 2,318 

307 13,697 11,359 2,338 

352 7,090 3,473 3,617 

3,439 12,194 9,512 2,682 

570 10,362 7,392 2,969 

879 11,809 8,790 3,019 

876 12,919 10,334 2,586 

645 13>407 11>151 2>256 

295 13,825 11,498 2,328 

174 7,582 4,812 2,770 

658 7,650 3,670 3,981


250 6,802 3,229 3,573


151 7,840 3,456 4,384


44 10,742 6,902 3,840


* * * *


* * * *


179 6,669 2,329 4,340


20

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------------------------------- ------------------------------------ --------------------------------------- ---------------------------------------------------- -----------------------------------

-------------------------------

------------------------------- ------------------------------------ --------------------------------------- ---------------------------------------------------- -----------------------------------

-------------------------------

------------------------------- ------------------------------------ --------------------------------------- ---------------------------------------------------- ----------------------------------

---------------- -------

------------------------------- ------------------------------------ --------------------------------------- ---------------------------------------------------- -----------------------------------

-------------------------------

------------------------------- ------------------------------------ --------------------------------------- ---------------------------------------------------- -----------------------------------

Table 5. Number of mothers and number of visits to physiciansand to medical facilitiesper 1,000


mothers during the 12 months PriOr to birth, by geographic region and education of mother:


United States, 1963 births


Number Nu&ber of visits per 1,000 

of mothers 

mothers
 Geographicregion and education of mother in


thou- To To


sands Total physi- medics1


cians facilities


All regions


All educationallevels 4,097 11,524 8,650 2,874


None or elementaryeducation 488 8,894 5,996 2,898


High school nongraduate 928 10,777 7,911 2,866


High school graduate 1,598 12,464 9,704 2,760


College


Illegitimateand unknown


Northeast


All educationallevels


None or elementaryeducation


High school nongraduate


High school graduate


College


Illegitimateand unknown


North Central


All educationalIevela


None or elementaryeducation


High school nongraduate


High school graduate


College


Illegitimateand unknownl


South


All educationallevels --z-----


None or elementaryeducation


High school nongraduate


High school graduate


College


Illegitimateand unknown


West


All educationallevels


None or elementaryeducation


High school nongraduate


High school graduate


College


Illegitimateand unknown


SIncludesan estimated45,000 legitimatebirths “inMissouri.


730 13,615 10,757 2,859


352 7,090 3,473 3,617


937 10,989 8,272 2,717


7,783 4,960 2,823


9,877 6,655 3,222


11,673 9,164 2,510


13,281 11,178 2,103


7,880 3,773 4,107


11.,895 9,561 2,334


11,195 8,533 2,662


10,897 8,731 2,166


12,552 10,370 2,183


13,099 10,638 2,462


6,637 3,036 3,601


10,893 7,644 3,249


243 8,550 5,668 2,882


327 10,419 7,325 3,094


418 12,238 8,868 3,371


197 13,674 1;,;;; 3,449


131 6,503 3 3,653


685 12,809 9,534 3,276


8>559 5,256 3>303


1;; 12>593 9,470 3,124


263 13,918 10,632 3,285


1;; 1;,;;; 1:,& 3,497


9 > 2,911 

. 

21

--

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----- --------------------

--------------------------

-------------------------------

------------------------------------

------------------- ------------

------------------- -------

--------------------------

-------------------------------

---------------------------

---------------------------------------

-----------------------------------

Table .6.Number of mothers and number of visifisto physiciansand to medical facil,iti.es
 per 1,000


mothers during the 12 months pxiQr to birth, by metropolitan status and educationof mothex:


Uniged States, 1963 births


W.:yr 

nothers
 Metropolitanstatus and educationof mother in


thon­


sands


All areas 

All educationallevels.“--------....-------.-...-7---- 4,097 

None or.elernentaryeducation 488


High school m~ngr~ate-.-..-.--.-----....--...----.-.--””- 928


High school graduate 1,598


college“.-., -.-..-....s --m..F
 .-..-. ----.- 730


‘flleg!itimate
 and unknown-,---e-.-- 352


Metropolitanareas


All educ.a~icmalevels “2,656


None cm elementaryed~stion----.------.-.--------..----.-” 260


High school nongraduate 591


Ilighschool graduate .----?---” .--0 1,064


S3.Qllege “.....-..-
 -z--.---- -p------. 505


Illegitimateand unknown--”=----- 236


Nwnmetropolitanareas


AU educationallevels 1,440


‘Noneor elementaryeducation .... 229


Wigh schooLnoograduate-..---.--"-------"---------""-"----" 337


High school gxaduate 533


College----.----.--.-.---..---F---------------------------- 225


Illegitimateand unknm 117


Numberof visits per 1,000


mothers


To TCI 

r0ti31 physi- medical 

cians facilities 

11,524 8,650 2,874


8,894 5,996, 2,898


10,777 7,911 2,866


12,464 9,704 2,760


13,615 10,757 2,859


7,090 3,473 3,6X7


11,713 8,750 2,963


9,150 5,805 3,346


10,993 7,916 3,078


12,575 9,841 2,734


13,795 10,967 2,828


6,769 2,997 3,772


11,168 8,462 2,706


8,591 6,221 2,370


10,389 7,904 2,486


12,245 9,433 2,812


13,209 10,2EK2 2,927


7,904 4,684 3,220


22

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-------------------------------

----------------------------------------------------

-----------------------------------

-------

-------------------------

------------------------------------

---------------------------------------

----------------------------------------------------

---------------------------------

-------------------------------

-------------------------------

---------------------- ----------

--------------------------- ---

----------------------------------------------------

-----------------------------------

Table 7. Number of mothers and number of visits to”physiciansand to iaedicalfacilitiespec 1,000


mothers during the 12 months PrLor to birth, by color and education of mother: united States,


1963 births -


Number


of


mothers
 color and education of mother


tl%l­


sands


Total 

All educationallevels ‘4,097 

None or elementaryeducation 488


High school nongraduate--.----.--.-.-.---.-..-...."-------- 928
 ,.


High school graduate-----------------------------y--------- 1.,598


College 730


Illegitimateand unknown 352


White


All educational levels---”.--”--
 ----.-”-.“..” -..-- 3,439


None or elementaryeducation ------.! ~375


High school nongradmte 767


High school graduate 1,451


College 673


Illegitimateand unknown L74


Nonwhite


All educa~ionallevels 658


None or elementaryeducation 114


High school nongraduate-.-...” 161


High school.graduate “--------- 147


College 58


Zllegitimateand unknown 179


. . 

Number of visita per 1,000


mothers


To 

Total	 physi­


cians


11,524 8,650 2,874
 —


8,894 5,996 2,898


10,777 7,911 2,866


12,464 9,704 2,760


13,615 10,757 2,859


7,090 3,473 3,617


12,194 9,512 2,682


9;554 6,747 2,807


“11
,483 8,791 2,693


12,794 10,205 2,589


13,945 11,155 2,791


7,582 4,812 2,770


7,650 3,670 3,981 

6,371 3,122 3,249 

7,239 3,506 3,733 

9,127 4,628 4,499 

9,590 5,903 3,687 

6,669 2,329 4,340 

23

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-----------------------------------------------------

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-----------------------------------------------------

--------------------------------------------

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------------------------------------------------------ -------------------

--------

-----------------------------------------------------

--------------------------------------------

-------------------------------------------

----

--------------------------------------------

Table 8. Number of mothers and number of visits to physicians and to medical facilities per 1,000


mothers during the 12 months prior to birth, by age of mother and, live-birth order: United


States, 1963 births


Number Number of visits per 1,000


mothers - -
 of


mothers
 Age of mother and live-birth order


All ages


All orders-------------------------------------------


First


Second-----------------------------------------------------


Third


Fourth


Fifth or higher


Under 20 years


All orders


Firat


Second-----------------------------------------------------


Third or higher


20-24 years


All orders


First


Second


Third


Fourth


Fifth or higher


25-29 years


All orders-------------------------------------------


Firat


Second--------


Third


Fourth


Fifth or higher


30-34 years


AH orders


First


Second--.---------------------.---------


Third --------------.----------------p--------------


Fourth


Fifth or higher


35 years and over


All orders


First-..------..---.---------.-----.-.-----------------


Second-----------------------------------------------------


Third ----------------------.-----------.-------------------


Fourth----------.----------.-----------.-----------.-------


Fifth or higher


t%l- To To 

sands Total physi- medical 

cians facilities 

4,097 11.524 8.650 2.874 

1,145 12,839 9,596 3,243 

963 11,834 9,106 2,728 

745 11,571 8,822 2,749 

516 10,600 7,981 2,618 

727 9,559 6,765 2,794 

594 10,587 7,259 3,328 

419 11,126 7,841 3,284 

131 9,883 6,316 3,567 

44 6>945 3,963 2,982 

1.454 11.719 8.674 3,045 

521 13,598 10,065 ;,;;; 

482 11,594 9,055 

267 10,408 7,348 3;060 

131 8,802 6,073 2,729 

53 7,515 3,919 3,596 

1,024 11,878 9,209 2,669 

129 14,471 12,066 2,405 

247 12,829 10,127 2,702 

239 12,267 9,698 2,568 

200 1:,;;; 8,220 2,591 

210 a 6,591 3,003 

610 11,173 8,787 2,386 

56 14,917 12,300 2,617 

12,756 9,603 3,153 

11,460 9,510 1,950 

11,337 ;,;;; 2,422 

9,422 > 2,324 

415 11,790 8.922 2,868 

20 11,757 9,578 2,180 

31 13,429 11,968 1,462 

15,488 11,944 3,544 :: 12,169 9,354 2,814 

226 10,145 7,232 2,913 

24

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-------------------------------

----------------------------

----------------------------------

-------------------------------

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----------------------------

----------------------------------

-------------------------------

----------------------------

----------------------------------

-------------------------------

----------------------------

----------------------------------

-------------------------------

----------------------------

----------------------------------

-------------------------------

----------------------------

---------------------------------- -------------------------------

Table 9. Number and percent distribution of mothers, by time of first medical visit during the


12 months prior to birth according to geographic region,metropolitan status, and color: United


States, 1963 births


Number Time of first medical visit


of


Geographic region,metropolitan status, mothers


and color in months No 

thou- before medics 1 Unsands .Ln= , , 

care known 

! 

,ALL REGIONS,


All areas Percent distribution


Total 4,09; 21.3 35.1 19.1 19.6 2.0 3.0
 — — —


White 3,43s 22.8 38.1 18.4 17.3 2.0 

Nonwhite 65$ 13.7 19.0 23.0 31.3 ::2 7.9 

Metropolitan areas 

Total 2,65! 2!1.4 36.7 18.5 19.4 1.5 2.6 

White 2,221 22.7 40.0 17.5 16.6 1.9 

Nonwhite 434 14.5 19.3 23.1 34.0 ;:3 6.2 

Nonmetropolitan areas 

Total 1,442 21..2 32.1 20.3 19.8 2.9 3.7 

White 

Nonwhite 

1,218 22? 

22.9 

12.1 

34.7 

18.2 

19.9 

22.6 

18.7 

26.1 ;:; 2.3 

11.3 

NORTHEAST


All areas


Total 937 20.2 37.6 20.4 19.9 1.0 0.8
 -—


White 

Nonwhite 

834 

102 

21.0 

13.9 

39.9 

18.9 

19.4 

28.8 

18.2 

33.9 

0.9 

2.0 

0.6 

2.6 

Metropolitan areas 

Total 750 20.4 37.6 20.3 19.6 1.1 0.9 

White 653 21.4 40.7 18.9 17.4 0.6 

Nonwhite 97 13.8 17.4 29.5 34.4 ;:!? 2.8 

Nonmetropolitan areas 

Total 187 19.5 37.5 20.9 21.0 0.5 0.6 

White 181 19.7 37.4 21.1 20.8 0.5 0.6 

Nonwhite * * * * * * * 

NORTH CENTRAL


All areas


Total 1,159 23.9 36.4 17.1 15.9 0.8 5.8


White 1,047 24.2 38.3 17.1 14.7 0.7 

Nonwhite 112 20.7 18.7 17.3 27.5 2.4 

Metropolitan areas 

Total 727 22.,7 38.3 15.0 16.4 0.9 6.7 

White 628 23.0 41.4 15.2 14.3 0.6 

Nonwhite 99 20.4 18.5 13.9 29.3 2.7 12:: 

25

----------- ----------

-------------------------------

----------------------

-------------------------------

----------------------------

-----

----------------------------

---------------------------------- -----------

----------------------------

---------------------------------- -------------------------------

----------------------------

-------------------------------

----------------------------

----------------------------------

Table 9. Number and percent distributionof mothers, by time of first medical visLc durLng the


12 months prior to birth according to geographicregion, metropolitanstatus, and color: United


States, 1963 births-Con.


Number Time of first medical visit 

of 1 1 8 

Geographicregion,metropolitanstatus, mothers 

and color ill 

thOUsands 

NORTH CENll?AL-Con.


Nonmetropolitanareas Percent distribution


Total--...-.”--- - 432 25.9 33.1 20.6 15.3 ,0’7 4*4


White-.--“.
.--...“”------+--..-k----.-.- 419 26.0 33,5 19.9 15.3 0.7 4.6 

Nonwhite 9( * 9( ‘1< 7’< * * 

SOUTH


All areas


“---------“-------“ 1,316 19.6 31.1 19.9 22.4 3.9 3,1 

,. 

~ite-.-.--.-..-w 950 2;.: 36,1 18.8 18.4 .2.5 ‘:.;. 

Nonwhite 366 . 18,3 22.9 32.7 7.5 * 

Metropolitanareas 

Total 671 21.8 32.1 20.0 22.1 2.6 1.3 

Total-4.-.”-----


White ..”...---,.”
 .....- ...”a .... 8.9 M.4 23.8 40.4 $:; 4*.5 

NonmeWopoli.tanareas 

Total 646 17.3 30,1 1969 22.7 5.2 4.9 

White ~onw~i~e...----.---.- . . ..-.w 

456 

190 

20,L 

10.5 

35.1 

18.2 

L9.O 

22*L 

21,5 

25*5 J:: k; 

--”------.--..,---- .,-” ;;; 26,4 36.9 18.6 L5.6 0,2


Nonwhite-..-.S ..........- ....-.


m 

All areas 

Total 685 2L.8 36,9 19.2 19.9 1,4 0.7 

White 67; 21.8 38.7 18.7 19.0 1.3 ,0.5 

Nonwhite 21.9 22,6 23.5 26.8 2“5 2.7 

Metropolitanareaa 

Total 508 20.4 38.8 18.7 20.1 1,2 0.8 

White”----”-----’--------’--------------- 446 20.2 40.6 L7.7 19.8 1..1 :3; 

Nonwhite 62 22.0 26,3 25.9 22,3 1.7 

Nonmetropolitanareas 

Total 177 25.7 31’4 20,8 19,4 2,2 O*5 

White .163 ....’.”------

26,1 33,6 21,.4 17.~ L*8 . 

Nonwhite,--..-”-... -“.*-----*....- 9e * 7’6 * +< ‘/t


.,, 

26

---------------------

----------------------- ---------------

----------------------- ----------------

----------------------

----------

----------------------- --------------

------------

----------------------- ---------------

--------

---------

----------------------- --------------- .

Table 10. Numbetiand percent distributionaf mothers, by time q~,ftis~medica~ visit during the


H mon~hs prior co birth according to geographic region arid1.962family income: UnCeed Stites9


1963 births


lw.m$er Time Of first medical visi~, 

Geographicregion mothers mon;hs and 1962 family income No befme t::u~ Imdkil. 

sands cep~ion First cafe ‘m-F7=7=

AU, regions 

All incomes 4,097
 —


Under $3,000--------------------------- 820


$3,000-$4,999-------------------------- 1,030


$5,000-$6,999 -..----..------,-.--4--
 .-~e.. 920


$7,000-$9,999------4------------Z-X---- 667


$10,000 and over 307


I~~egitimateand Unknown 352


‘Noztheas%


k~~ i~COmeS----d-~--------.-”---- !J37 

Under $3,000--------------------------- 140


$3,000-$&,99g-rn------------d----------- 218


$5,000-$6,999---------<---------------­


$~,~oo-$9,g99----------------d--------d


$10,000 and ova-r
 XL~egitimateand unknown


North CencraL 

All incomes


Undet $3,000---------------------------


$3,000-$4$999----------------’


$5,000-$6,999--------------------------


$7,~~~-$9,999-dd-----------d-d----+----


$10,000 atidover
 Illegitimateand uzdamwnl


sods 

AIL ~ncomes--”----ddd 

Undeti$3,000.-.--.-w.-~---+.-.,
 ----.-z.-


$3,000-$4,999------------------------­


$5,~o~-$6,~gg-*-----------------------­


$7,000-$9,999
..........-zz-e---.-_-.*.d


$LO,O(IJafidover
 l~legiti~~e and unknown


~ 

AIL incomes---dddddd-----d---d-”.


Uridez$3,000 s-.-+e~<-.4..---­
 i.<


3,000”$4,9!39 “-d-------~---,.,-----,
 -.4z--ti


5,000-$6,999 .,-.-~.+-+.-
 ..”----


!7,000-$9,999--------------------------


$i0,00IJand aver
 Illegitimateand titiknom
 .


236


1.99


:;


L,159


187


256


306


208


1!:


L.316


35*L 19.1 19.6 2*C — 

15,9 26.6 25,9 26,2 4*4 

20.8 33,8 22,6 20,2 2,1 

24.0 42.9 %6,4 1562 1,3 

27.7 44,9 L3,6 12.3 : 1,1 

2~.3 48,0 11.,s 10,9 1,0 

10,7 8,1 17,4 35.3 . 

20.2 37.6 20.4 1“9.9 1.0 

X3.5 29.5 .25.7 29.8 

17.9 32.7 25.2 2’2.4 

22.L 45.9 16=7 14,3 

24.3 43.5 L5,9 1;;; 

27.3 4;.: L5.9 

14,L . 26.2 43.9’ 

23,9 36.4 1.7.L 15.9
 -


22.7 27.6 23.9 22,9 

27,7 33,6 ;;,.: 15.2 

24.5 45.7 L4.2 

27.8 44.0 16:0 11..7 

2;.; 53,9 9.2 LO*4 . 4.7 10.5 22.9 

19.6 3L*3_ L9d9 22.4 

11.9 26.5 25.9’ 25.7 

19s 33.9 21..5 22.3 

26.7 38.8 w .2 13.8 

33.6 ;l.~ 9.7 12.3 

3;.; 9=4 IS’*5 

* 8:4 1.7.1. 40,6


2L.&K 36.9 ’19
*2 W .9
 -


L9.7 22.4 28.9 2&..3 

16.6 35.3’ 24A M*5 

22.Z 3“%.8 MS*L M*9 

26,g 51.3 10.1 LL,O 

27+8 53,4 11,1 7.8 

2(7,0 1.3.L 23.5 33,8 

lInclUdes an estimated45,000 legitimate’bir~’nsin ~LSSOtlri..

-----------

----------------

---------------

----------------

---------------

----------------

-----------

----------------

--------------------------------

---------------

----------------

-------------------

---------------

.-

Tabl& 11. Number and percent distribution of mothers: by time of first medical visit during the


12 months prior to birth according to geographic regzon and education of mother: United States,


1963 births


Geographic region and education


of mother


All regions


All educational levels-----------


None or elementary education


High school nongraduate


High school graduate-------------------


College--------------------------------


Illegitimate and unknown


Northeast


All educational levels-----------


None or elementary education-----------


High school nongraduate


High school graduate-------------------


College--------------------------------


Illegitimate and unknown


North Central


All educational levels-----------


None or elementary education-----------


High school nongraduage


High school graduate-------------------


College--------------------------------
 Illegitimate and unknown~--------------


South


All educational levels-----------


None or elementary education


High school nongraduate


High school graduate-------------------


College


Illegitimate and unknown


All educational levels-----------


None or elementary education-----------


High school nongraduate


High school graduate


College--------------------------------


Illegitimate and unknown


Number


of


mother:


in 

thOUsands 

4,097


488


928


Time of first medical visit


months No 

before c:- medics 1

, 

care k$wn 

ception F7=i-== First


Percent distribution


21.3 35.1 19.1 19.6 2.0 3.0


15.0 24.6 24.6 28.9 ;.; 

20.9 31.9 20.8 23.0 M 

1,598 22.6 42.3 18.5 15.4 0:8 0.4


73C 28.6 43.4 15.5 10.5 1.9


352 10.7 8.1 17.4 35.3 2!::


1% 

937 20.2 37.6 20.4 19.9 1.0 0.8 

14.9 24.6 27.4 31.9 1.2 

423 

168 

17.2 

21.1 

26.5 

33.4 

44.1 

43.2 

21.9 

17.6 

20.0 

25.3 

15.8 $; 

1.2 

0.; 

62 14.1 9.8 26.2 4::; 5.9 

1,159 23.9 36.4 17.1 15.9 0.8 5.8 

2% 

21.2 

24.2 

31.2 

34.0 :;.; 23.5 

22.6 

2.4 

0.; 

493 25.3 42.4 20:0 11.8 k; 0.4 

210 

114 

30.2 

7.3 

44.5 

4.7 

12.8 

10.5 

10.7 

22.9 

1.0 5;:: 

1,316 19.6 31.1 19.9 22.4 3.9 3.1
 -


243 13.0 22.3 23.6 29.2 

327 19.1 28.8 25.1 21.8 ::: N 

418 21.1 40.6 17’.6 19.0 1.7 

197 32.7 40.8 13.6 3.0 

131 8.6 8.4 17.1 4;:: 25.3 

J: 

685 21.8 36.9 19.2 19.9 1.4 0.7 

14.5 24.6 27.6 30.8 1.3 

23.9 33.0 17.1 23.2 2.0 

263 22.1 41.9 18.9 16.0 0.8 

155 23.4 45.3 16.4 12.4 2.5 

46 20.0 13.1 23.5 38.8 

lIncludes an esti~ted 45,000 legitimate births in Missouri.


28

----------------------

-----------------------

---------------

----------------------

-----------------------

---------------

----------------------

----------------------

-----------------------

---------------

.

Table 12. Number and percent distribution of mothers, by time Of first medical visit during the


12 months prior to birth according to metropolitanstatus and 1962 family income:UnitedStates,


1963 births


Nu~ner Time of first medical visit


Metropolitan status mothers months
 and 1962 family income in 

thou- before 

sands c:- k%n 

ception Fi=i==im~~’ First


All areas Percent distribution


All incomes 4,097 21.3 35.1 19.1 19.6 2.0 3.0
 —


! Under $3,000---7----------------------- 820 15.9 26.6 25.9 26.2 4.4 1.0 

$3,000-$4,999-------------------------- 1,030 20.8 33.8 22.6 20.2 2.1 0.6 

$5,000-$6,999-------------------------- 920 24.0 42.9 16.4 15.2 1.3 0.2 

$7,000-$9,999-------------------------- 667 27.7 44.9 13.6 12.3 1.1 0.5 

$10,000 and over 307 28.3 48.0 11.5 10.9 1.0 0.3 

Illegitimateand unknown 352 10.7 8.1 17.4 35.3 28.6 

Metropolitan areas 

All incomes 2,656 21.4 36.7 18.5 19.4 1.5 2.6 

Under $3,000--------------------------- 429 15.1 27.2 26.0 27.8 3.0 1.0 

$3,000-$4,999-------------------------- 612 20.5 33.2 22.5 21.0 2.0 0.8 

$5,000-$6,999-------------------------- 625 23.2 44.0 16.5 15.2 1.0 0.2 

$7,000-$9,999-------------------------- 506 27.3 45.6 13.3 12.1 1.2 0.4 

$10,000 and over 249 27.2 51.5 11.8 8.7 0.5 0.4 

Illegitimateand unknown 236 11.3 8.7 17.7 38.5 23.8 

Nonmetropolitanareas 

All incomes 1,440 21.2 32.1 20.4 :9.8 2.9 3.6 

Under $3,000--------------------------- 391 16.7 26.0 25.9 -“24;4’ 6.o 1.0 

$3,000-$4,999----’ 419 21.1 34.6 22.8 19.0 2.1 0.2 

$5iO00-$6,999-------------------------- 294 25.6 40.7 16.1 15.2 2.1 0.3 

$7,000-$9,999-------------------------- 161 28.7 42.7 14.5 12.8 0.6 0.6 

$10,000 and over 59 32.9 33.4 10.2 20.2 . 3.2 

Illegitimateand unknown 117 9.4 6.8 16.8 28.6 38.3 

‘ .. 

# 

. . 

1, 

29 

, -% 

. . 
-----------

----------------

-------------------

--------------------------------

---------------

----------------

-------------------

--------------

---------------

----------------

-------------

---------------

Table 13. Number and percent distribution of mothers, by time of first medical visit during the


.12ntotichsprior tO birth according to metropolitan status and education of mother: united


states, 1963 births


Time of first medical visit
 Number


of I Metropolitan status and education mothers 3 

of mother in nonths Trimester of pregnancy No 

thou- before medical 

sands con- caze First I Secondl Third ceDtion I I I I I 

Percent distribution


21.3 35.1 19.1 19.6 2,0


unk­


nown


3.0
 —


5.4 1.6


2.9 0..5


0.8 0.4


1.9 0.2


. 28,6


~ 2.6 

3,8 1,1 

1.9 0,6 

0.9 0.6, 

1,6 0.2 

. 23.4 

2.9 3,7


2*L 

O*3


.


0.5 ,


38.9


All areas 

All educational levels----------- 4,097 

None or elementary education 488 15.0 24,6 24.6 28.9 

High school nongraduate 928 20,9 31.9 20.8 23.0 

Ilighschool graduate 1,598 22.6 42.3 18.5 15.4 

College 730 28.6 43.4 15.5 10,5 

Illegitimate and unknown 352 10.7 8.1 17.4 35.3 

Metropolitan areas 

All educational levels----------- 2,655 21.4 36.7 18.5 1964 

None or elementary education----------- 260 15.5 24.9 25.7 29.0 

High schooL nongraduate 591 20.1 34.1 21’.1 22.2 

High school graduate 1,064 22,5 43.3 17*5 15.2 

College.........--------- 505 28.3 44,8 13.9 11.3 

Il~egitimate and unknot 234 11.4 8.7 17.8 38.7 

NonmetropoLitan areas 

All educational levels----------- 1,442 21.2 32.1 20.3 19.8 

None or elementary education------------


High school nongraduaee


High $choo’Lgraduate-------------------


College-----------!---------


IILegiti.ma~eand unknown


229 14.4 24.3 23,3 28.8 7.1 

337 22,2 28.0 20.3 24,4 4.8 

533 22.7 40,3 20.5 15.9 0.6 

225 29.2 40.2 19*O 8,6 2.6 

118 9.3 6.8 16.7 28.4 . 

30

----

----

-----------------------

--------------

----------------------

-------------------

--------------------------

-----------------------

----------------------

------

-----

---------

--------------------------

-----------------------

---------------

Table 14. Number and peticemtdistributionof mothers, by time OE Eirst medi,ealvisit du~ing the


12 months prior to birth according to color and 1962 family income: UtiitedStatesj 1963 births


Time of fiti~tmedical visit
 Nutaa


Color and 1962 family income mothers ~~~th~ Trimester of pregnancy in
 No’
 Un­
 thou- before medicaL kaowci
 sands Co?s- care 

ception Fi’Jxt Second Third -


Total


All.incomes---.-.--..-.­
 ....-..-.


Utidex$3,000.--”..”.-..-..-.---..””
 .....


$3,000-$4,999 --.-..--”-..
 “-.--,-..-W.


$5,000-$6,999 -------6.“---------
 ---.,----


$7,000-$9,999
----” .........--..=-..


$10,000 and over


iXLegiti,mate
and unknown


.White .


All incomes


Under $3,000 “-.......


$3,000-$4,.999
 -“-------.......----------


$5,000-$6,999 --”--....tiw--..---
 ~.----.ti


$7,000-$9,999


$10,000 and OVCIE 

I~legiEimateand unknot-..-..-........


Nonwhite


All incomes


Wdez $3,000--.e~-ti.-e­
 ~w.---...w.


$3,000-$4,999 -----.---”tiw
 : .“-”....ti


$5,000-$6,999 --+-..----
 -*-------


$7,000-$9,999


$10,000 and over 

ELlegi.timate
and unknown


Pezcenc distzilnttion 

4,097 21.3 35.1 19.1 19.6 2.0, 3.0 - - -

820 15.9 26.6 25.g 26.2 4.4 L.o 

1,030 20.8 33.8 22.6 20.2 2.1 0.6 

920 24.0 42.9 16.4 15.2 1.3 0.2 

667 27*I 44.9 13.6 1.2.3 1.1 0.5 

307 28.3 48.0 11,5 10.9 1..0 0’3 

352 10.7 8.1 17.4 35.3 28s6 ~ 

3,439 22.8 38.1 18.4 17.3 1.3 2.0 

570 18.0 30,2 25.5 23.0 2.9 0.3 

$79 21.5 36.0 22.5 18.1 1..5 0,5 

876 24.4 43.2 16.4 14.6 1.1 0,2 

645 27.2 45.1 13.7 12.7 0.8 0.5 

295 29.2 48.2 11’3 10.6 (3,3 0.3 

174 9*7 6,.5 13.5 37.4 . 3249 

65$ 13.7 19.0 .23.0 3i.3 5.2 7.~
 -


250 10.9 26.9 33.3 7.9 2.6 

151 16.6 .23J 32.4 5.5 1.3 

44 L6.2 14.7 27,8 5.1 

* * * * * . 

* * * * *


179 11.6 21.2 33.2 24.4


31

-----------

----------------

---------------

----------------

-------------------

--------------------------------

---------------

-----------

----------------

-------------------

---------------

Table 15. Number and percent distribution of mothers, by time of first medical visit during the


12 months prior to birth accordingto color and educationof mother: United States, 1963 births


Number Time of first medical visit


of


mothers 3
 Color and education of mother in months Trimester of pregnancy No


thOU- before medics1 Unknown sanda con- care First Second Third ceptionI 1 1 I I 

Total Percent distribution


All educationallevels 4,097 21.3 35.1 19.1 19.6 2.0 3.0


None or elementary education----------- 488 15.0 24.6 24.6 28.9 5.4 1.6


High school nongraduate 928 20.9 31.9 20.8 23.0 2.9 0.5


High school graduate------------------- 1,598 22.6 42.3 18.5 15.4 0.8 0.4


College-------------------------------- 730 28.6 43.4 15.5 10.5 1.9 0.2


Illegitimate and unknown 352 10.7 8.1 17.4 35.3 28.6


White


All educational levels----------- 3,439 22.8 38.1 18.4 17.3 1.3 2.0


None or elementary education----------- 375 16.6 27.2 24.9 27.7 3.1 0.5


High school nongraduate 767 21.9 34.3 20.1 21.2 2.1 0.4


High school graduate 1,451 23.5 43.7 17.9 14.0 0.6 0.4


College 673 29.1 44.7 15.1 9.3 1.5 0.3


Illegitimate and unknown 174 9.7 6.5 13.5 37.4 32.9


Nonwhite


All educational levels----------- 658 13.7 19.0 23.0 31.3 5.2 7.9


None or elementary education 114 9.9 15.9 23.4 33.0 12.8 5.0


High school nongraduate 161 15.9 20.5 24.0 31.8 6.8 1.1


High school graduate 147 13.4 27.8 24.9 29.9 3.2 0.7


College-------------------------------- 58 22.2 27.1 19.5 24.5 6.8


Illegitimate and unknown 179 11.6 9,6 21.2 33.2 24.4


32

-----------------------

----------------------------------

----------------------------------

---------------------------------

------------------------

-----------------------

----------------------------------

------------------------

-----------------------

----------------------------------

---------------------------------

----------------------------------

--------------------------------- ------------------------

----------------------------------

----------------------------------

---------------------------------

------------------------

----------------------------------

---------------------------------

----------------------------------

--------------------------------- ------------------------

----------------------------------

----------------------------------

---------------------------------

------------------------

Table 16. Number and percent distribution of mothers, by time of first medical visit during the


12 months prior to birth according to age of mother and live-birthorder: United States, 1963
 births


— 

Time of first medical visit
 Number


of


mother:
 Age of mother and live-birthorder in months


thou- before 

sands LLIJJ. U .lionwm~~’ I I 2’

All ages Percent distribution


All orders — 4,09’ 21.3 — 35.1 — 19.1 19.6 2.0 3.0
 — — —


First 1,14! 19.3 40.1 19.1 17.2 3.3


Second--------------------------------- 96: 24.1 37.4 17.8 16.3 M 2.7


‘Third 74! 22.3 35.7 17.9 21.0 1.2


Fourth 51[ 19.2 35.2 21.7 20.1 ?:;


Fifth or higher 72” 21.4 23.4 20.5 25.8 ;:; 4.3


Under 20 years


All orders 591 16.4 26.7 25.8 24.1 2.3 4.7


First 41! 14.2 ;;.: 25.9 23.5 3.9


Second--------------------------------- 132 24.6 26.9 23.7 ::: J:;
 Third or higher 4/ 12.7 L4:7 21.4 30.4 6.1


20-24 years


All orders 1,451 21.6 34.7 20.0 18.5 L.8 3.3 

First 521 20.8 44.0 17.7 13.6 

Second 482 25.5 33.6 19.0 16.7 ;:; Third 26; 20.1 29.2 20.2 26.6 

Fourth 131 13.7 23.2 26.9 27.8 ::: Fifth or higher 5: 21.9 9.8 32.3 20.7 8.7 

25-29 years


All orders----------------------- 1.02~ 23.1 39.1 16.8 17.4 1.8 

First 12: 26.2 53.1 2.4 

Second---------------------------------

Third 

247 

23; 

22.1 

24.1 

47.6 

41.6 

1;:: 

16.7 

1;:: 

15.5 

1.1 

Fourth 20C 21.4 38.1 19.2 19.8 w Fifth or higher 21C 23.1 18.7 21.6 27.5 4.3 

30-34 years


All orders----------------------- 61c 21.5 35.6 16.0 22.6 2.2 

First 56 24.0 44.2 10.3 21.5 

Second 

Third 1<: 

20.5 

24.7 

55.7 

37.0 1;:; 

12.7 

21.1 

3.; 

Fourth 117 18.2 41.2 19.8 18.1 

Fifth or higher 236 21.1 24.0 17.7 28.8 ;:; 

35 years and over


All orders----------------------- 415 22.5 37.4 17:0 17.8 3.3 

First 26.1 37.0 5.2 16.1 15.7 

Second--------------------------------- 24.1 55.1 17.3 

Third 23.5 48.7 1::: 11.7 

Fourth 26.5 40.1 21.7 3.5 

Fifth or higher 20.5 30.5 18.8 2;:; 3.6 

33

------------------------------

-----------------------------

-------- -------- -------- ------

-------------------------------------

-----------------------------------

--------- ---------

--------

-----

-------------------------------------

--------- --------

-------------------- ----

Table 17. Number and percent distri.butimof mothers and of mothers in survey population, by ntimi 

ber of visits accordingtO time they first received medical caxe during the 12 mcmths prior.tD 

birth: United States, 1963 births 

Time of first medical visit 

All 3 

Bothers months I 

Number of visits in before 

con- Second Third No tllou- Un­ ception txi- tri- medica1 ~nom sands or mester mester care 

I first 

trimester


Number 2n thousands 

All mottwsma 4,097I 2,310 I 783 I 802 [ 801 121 

Percent distribution 

Total visits 100.0 100,0 100,0 100,0 100.0 100.0 

No Visi$s . . . . . . . . 2.0 . 100.0 . 

1-4 visits-----.---..---..-.q------------------ 19.3 5.4 13.0 69.8 Z*& 

5-9 visits 18.5 12.8 37.9 20,3 . 0.8 

10-14 visits 28.7 36,8 34.6 ‘6.7 . 

15 visits or ~Qre ------------------------------ 28.3 44.4 14.2 2.4 1.7 

Unknown-....-.+.................--------..--.-”.- 3.4 0.6 0.2 0.8 . 95.1 

Number in thousands 

McKhers in survey popu~ation.-- . . ..-.-... 3,744 2,244 I 722 I 6781. 80~ 20 

Percent dist~ibution 

Total visits ---.-.-.”-- 100.0 100.0 100.0 100.0 100.0 00.0 

-

15 visits or more ------------------------------ 29.7 44.8 14.3 2.h 3,0 

No visits. . . . . . . . . ..----.,- -..”. . . . . ---.” 2.1 . . . 100.0 . 

1-4 visiEs ---”.-.. -e------ . . . . . . . . -------- 17.9 5,0 12,7 69.2 - 2,9 

5-9 visi~a 18.4 12.7. 37,5 21,0 - 1.5 

10-14 visits . . . . . . . . . ..”------ 29.8 36.9 3.5.3 6,8 - . 

Unknown------e-- .-”------- 2,2 ~ 0.6 0.2 I0,6 . 92,6 
----------------------------------------

----------- --------------------

--------------------------------------------

--------

--------------

----------------

---------- ----

-------- -----

--------------------------------------------

-------------------------------------

-----------------------------------------

------------------- ----

---------------------------------------------

--------

--------------------

--------------------------------------------

---------------------------------------

----------------------------------------

-------------------------------- -----

------------------------ ------------

----------------------------------------

----------------------------------------

---------------------------------------------

---------------------------

-------- ---------------- ----

------------------------- -------

Table 18, Number and percent distribution Of mothers in sumey population?,by whether Eheyhad
 seen a dentist during the 12 monEhs prior to birth according to geogz-aphxcregion and 1962 farn.


ilY income: United States, 1963 births


~umber


of


uothers
 Geographicregion and 1962 family Lncome


tl%l­


sands


All regions


All incomes 3,744 72,8 7.2 18,4 ~ 

Under $3,000 “--------- -...,- 820 88.0 5.7 5,8 0,6 

$3,000-$4,999 1,030 79*5 6.3 12,5 1,7 

68.1 8.0 21,9 2,0 

Percent distribution 

of mOthers 

NO Two 

Vis$ts One irisits tJnto visit 9r kwwn 

dentist more


$5,000-$6,999 --”,------- ----”--,.-
 ---p-----“.------”


$7,000-$9,999
---------------------” “---”---


$10,000 and over--.--.--------------.
 ---v


Northeast


All incomes ----------------..--------”


Under $3,000 ----”------.-----------------:--


$3,000-$4,999


$5,000-$6,999 ----.--”


920


667


30,7


875


140


218


236


59.8 9,7 29.3 1.2 

52,2 7,1 .37,7 3.1 

66.0 7.5 25,0 1,5 

84,8 7.8 7.4 . 

74,2 7,0 16.5 2*2 

62,1 8,0 28,6 1,3 

56.3 8,1 34,7 0,9 

47,3 5.3 IF3,6 3,8 

69,3 744 21,2 2,0 

82.9 8,1 7,9 1.1 

76.0 5,3 16.9 1,9 

69,1 7,0 22,3 1,7 

57.9 10,4 29.3 2,4 

49,3 6,8 39,3 4.6 

79.1 7.5 12,0 1,5 

90,8 5,0 3,4 0,8 

/33,6 7.0 7,7 1,7 

70,9 12.6 13,5 3,0 

58.7 8,1 32.3 0,8 

54,8 6,9 38,3 

76,1 6,1 16,7 1,1 

90.7 1,7 7,6 . 

81.9 4,9 12.6 0,7 

71,3 4,2 22,1 2,4 

69,3 12,5 18.2 . 

59,7 10,1 2%. 8 3,4 

$7,ooo-$9,999---------------.------------p--------------- 199


$10,000 and over 83


North Central


All incomes --------------”--- 1,046


Under $3,000 187


$3,000-$4,999 -.-,------------------------
----.- 256


$5,000-$6,999 --”-------------
 -.------ 306


$7,000-$9,999. 208


$10,000 and over 89


South


All incomes 1,185


TJnder$3,000 ---.---- 363


$3,ooo-$4,999-------------------------------------------- 412


$5,OOO-$6,999-------------------------------------------- 208


$7,000-$9,999 ------.- 130


$10,000 and over -
 72


All incomes 638


Under $3,000 131


$3,000-$4,999 --p--.---------p- 144


$5,OOO-$6,999-------------------------------------------- 170


.$7,000 -$9,999 -.------ -----.-. 130


$10,000 and wer ----”---- 63

---------------------------------------------

Table 19. Number and percent distribution of mothers in survey population, by whether they had


seen a dentist during the 12 months Prior to birth according to metropolitan status and 1962


fsmily income: United-States, 1963 bikths


Metropolitan status and 1962 family income


All areas


All incomes----------------------------------------


Under $3,000---------------------------------------------


$3,ooo-$4,999--------------------------------------------


$5,OOO-$6,999--------------------------------------------


$7,ooo-$9,999--------------------------------------------


$10,000 and over-----------------------------------------


Metropolitan areas


All incomes----------------------------------------


Under $3,000---------------------------------------------


$3,ooo-$4,999--------------------------------------------


$5,OOO-$6,999--------------------------------------------


$7,ooo-$9,999--------------------------------------------


$10,000 and over-----------------------------------------


Nonmetropolitan areas


All incomes----------------------------------------


Under $3,000


$3,ooo-$4,999--------------------------------------------


$5,OOO-$6,999--------------------------------------------


$7,ooo-$9,999--------------------------------------------


$10,000 and over----------------------------------------­


percent distribution


Jumber of mothers


of


uothers


No Two 

tRl- 7isits One visits Un- aands to visit or known 

Ientist more 

3,744 72.8 7.2 18.4 1.6
 — -


820 88.0 5.7 5.8 0.6 

1,030 79.5 6.3 12.5 1.7 

920 68.1 8.0 21.9 2.0 

667 59.8 9.7 29.3 1.2 

307 52.2 7.1 37.7 3.1 

2,421 70.8 7.4 20.3 1.5 

429 88.2 5.5 5.6 0.7 

612 80.1 5.9 12.4 1.6 

625 67.2 8.6 22.4 1.8 

506 58.5 9.7 30.4 1.4 

249 51.7 6.7 39.1 2.5 

1,324 76.5 6.9 15.0 1.6 

391 87.7 5.8 5.9 0.5 

419 78.6 6.8 12.8 1.8 

294 70.1 6.7 20.7 2.5 

161 63.7 9.8 25.9 0.6 

59 54.1 8.7 31.7 5.5 

36

----------------------------------------

---------------------------------------------

-----------------------------------------

----------------------------------------

---------------------------------------------

-----------------------------------------

--------------------------------------

---------------------------------------------

-----------------------------------------

Table 20. Number and percent distributionof mothers in survey population,by whether they had


seen a dentist during the 12 months prior to birth according to color and 1962 family income:


United States, 1963 births


Number


of


mothers
 Color and 1962 family income in


thou-


sands


Total


All incomes 3,744


Under $3,000 820


$3,ooo-$4,999--------------------------------------------1,030


$5,OOO-$6,999-------------------------------------------- 920


$7,ooo-$9,999-------------------------------------------- 667


$10,000 and over 307


White


All incomes 3,265


Under $3,000


$3,ooo-$4,999--------------------------------------------


$5,OOO-$6,999--------------------------------------------


$7,ooo-$9,999--------------------------------------------


$10,000 and over


Nonwhite


All incomes


Under $3,000 

$3,ooo-$4,999--------------------------------------------

$5,OOO-$6,999--------------------------------------------

$7,ooo-$9,999--------------------------------------------

$10,000 and over 

570


879


876


645


295


479


250


151


44


*


*


Percent distribution


of mothers
 -

No Two 

visits One or 

visit more k%rn 

JeZist visits 

72.8 7.2 18.4 1.6


88.0 5.7 5.8 0.6


79.5 6.3 12.5 1.7


68.1 8.0 21.9 2.0


59.8 9.7 29.3 1.2


52.2 7.1 37.7 3.1


70.2 7.6 20.6 1.6 

86.2 5.7 7.h 0.6 

77.2 6.7 14.5 1.6 

67.4 8.0 22.4 2.1 

59.1 10.0 29.9 1.0 

50.7 7.4 38.7 3.2 

90.6 4.7 3.3 1.4 

91.9 5.5 2.0 0.7 

92.4 3.9 1.2 2.5 

82.6 6.5 10.8 

* * * * 

* * * * 

37

APPENDIX I 

TECHNICAL NOTES ON METHODS 

This report presents estimates of visits for medical care made during the year prior to childbirth by 

women having liveborn infants during 1963. It is based 

on data collected,. during the 1963 National Natality 

Survey. The survey, which was conducted by the Division of Health Records Statistics (in part under contract with the Division of Radiological Health) was 

designed primarily to provide national estimates of 

the amount and type of exposure to ionizing radiation 

experienced by women during pregnancy. In the course 

of obtaining the radiation data, information about the 

number of visits the mother had made to physicians, 

medical facilities, and dentists; and the date of the 

first visit made during the year before the child was 

born were also obtained. This report is based on the 

responses to the questions concerning the number of 

visits and on the information furnished hy the mother 

about certain socioeconomic and demographic characteristics of her family. 

The basic source of data was the birth certificate. 

The survey was conducted principally with sources of 

information identified on the birth record which served 

as the primary sampling unit and, occasionally, with 

secondary sources reported by a primary source.g Since 

the mailing addresses of these sources were usually 

reported on the birth record, the mail survey was the 

principal method of data collection, supplemented by 

personal interviews where feasible. 

Sample Design 

The sampling frame for the 1963 National Natality 

Survey was the file of microfilms of birth records received each month by the National Center for Health 

Statistics from the 54 birth-registration areas of the 

United States. As a general rule, for each registration 

area these microfilm images are assigned a number 

prior to or during filming of the birth record. Each 

thousand consecutive images are defined as a “reel” 

and assigned a reel number starting from zero. Within 

each reel, the images are numbered from 1 to 1,000. 

The sampling for the survey was based on a probability design which made use of these preassigned reel 

and image numbers on the birth records, Each reel 

of the microfilm copies of the birth certificates’ constituted a primary sampling unit. Within each reel one 

record was chosen on a random selection basis. Thus, 

a sample of 1 out of 1,000 births was selecte’d from 

the monthly shipment of records from the registration 

areas. 

The national sample included a total of 4,096 births 

for the year 1963. Of these 4,096 births, 214 were 

reported as illegitimate on the birth record. However, 

legitimacy is reported in only 35 of the 54 registration 

areas in the United States. Hence, a procedure was 

developed to infer legitimacy on the basis of indirect 

evidence on the birth certificate for the 19 registration 

areas not reporting this item. Thus, if on the birth 

record the surname of the father was different from 

the surname of the child or if the surname of the 

f&her was not reported on the birth record, the birth 

was imputed as illegitimate. On the basis of this procedure 102 births in the sample were inferred to be 

illegitimate in addition to those mentioned above. 

These 316 illegitimate births plus an additional 

54 births were excluded from the survey of mothers. 

(The State of Missouri withdrew from the survey after 

June 1963. Thus, 45 births selected in the sample 

from Missouri for the period July through December 

1963 were excluded from the survey. Nine additional 

births were excluded from the survey either because 

residence was outside the United States or because 

no usable mailing address was available.) Thus, the 

final sample included in the survey of mothers was 

3,726 births. Table I shows the size of the original 

sample drawn from the birth records and the final 

sample of mothers to whom questionnaires were 

mailed. 

In contrast with the survey of mothers, in which 

illegitimate births were excluded, medical inquiries 

were sent in all instances where a medical source of 

information was identified. Hence, statistics which did 

38 
------------------------------------------

---------------------------------------------

-----------------------------------------------------

-------- ---------------- ------------------------ ---------------- -------- -----

---------------------------------

Table I. Total number of births in the United States and the number in the survey of mothers: 

National Natality Survey, 1963 

Item Size 

Total count of births in the United states 4,098,000 

Number of births selected in the smple 4,096 

Number of births excluded from survey: I 

Number of illegitimate births 316 

Number of births from Missouri.: July-December 1963-------------------------------- 45 

Other 9 

Number of births included for the survey of mothers 3,726 

not require information provided by the mother relate 

to all births selected in the sample. 

Birth Certificate and Questiomaires 

Facsimiles of the &andard certificate of live 

birth and of the questionnaire used in the survey are 

shownin Appendix III. 

Although notall States use thestandard certificate, 

most do include the basic information which is used in 

this report. The major exception is legitimacy (item 

23) which is not reported in19States. The procedure 

which was developed to overcome this omission has 

been discussed under sample design. 

The questionnaire sent to the mother was primarily 

designed to obtain names and addresses ofanyphysiciarss and medical facilities whichshehadvisitedduring 

the year before the birthofherchild in addition to those 

named on the birth certificate. Themother’s questionnaire was also the only source of names of dentists. In 

addition, there were six questions concerning the parents’ employment status, their educational attainment, 

and the family’s income. 

The questionnaires sent tophysicians andtomedica.1 facilities were essentially alike. The respondent 

was asked whether the mother had received anyexamination or treatment by X-ray during the 12 months 

preceding the birth of her child. If she had, he was 

asked for details about tie X-ray procedures. Whether 

the mother had received an X-ray examination ornot, 

the respondent was asked to report the number of 

times the mother had been seen for medical care 

during the 12 months, and the dates of the first and 

last visits during that period. 

The questionnaire sent to dentists was similarto 

that sent to physicians and medical facilities except 

that fewer questions were asked about the X-ray examinations. 

Collection af Data 

Data for the 1963 National Natality Survey were 

collected primarily by mail. Using the addresses given 

on the birth certificate, questionnaires were sent to 

the mother, the physician who delivered the baby, and 

the medical facility where the baby was born. 

For mothers, followup procedures consisted of a 

certified mailing 2 weeks after the initial mailing and 

a regular first-class mailing 3 weeks after the certified mail. Telephone or personal interviews were 

conducted by Bureau of the Census interviewers with 

mothers who did not respond after all tbree mailings 

and who lived in one of the field survey areas of the 

current population survey program of the Bureauof 

the Census. These procedures resulted in a response 

rate of 86.4 percent from mothers included in the 

survey (table II). 

Followup procedures forphysicians, dentists, and 

institutions were similar to those for mothers, with 

two differences: (1) the first followup was by firstclass mail, and the second followup was by certified 

mail, (2) no telephone or personal interviews were 

conducted after the three mailings. The total response 

rate from these sources washigherthan90 percent. 

Reporting of visits to physicians and medical 

facilities was relatively independent of the mother 

since the primary source was named on the birth 

certificate and secondary sources were elicited on 

the questionnaire sent to the named primary sources. 

Internal audits and hand tallies showed that this 

method was effective in obtaining names of additional physicians and medical facilities which had 

given the mother care. Even if the mother failed 

to respond to the questionnaire or failed to list a 

source of medical care, the names could still be 

obtained from the primary sources where not only was 

39

------------------------

---------------------------------

------------------------------

------------------------------- --------------------------------

--------- -------------------- --------- ---

Table 11. Response received from mothers physicians, snedical facilities, and dentists, by 

mailing waves: Na&.onal Natali.ty Survey, 1963 

Response status 

Number included in survey 

Total response 

Response to original mail----------------------------
 Response to second mail


Response to third roil


Response to interview


Total . . . . . . . 

the response rate high but the quality of the informationwas excellent, 

However, the identification of dentists was completely dependent on the names being reported by the 

mother. As a result there is no usable information 

on dental visits for those mothers who were not sent 

questionnaires. 

Processing of Data 

The completed questionnaires were edited and 

coded in accordance with predetermined specifications. The questionnaires were checked lmthfor completeness and for consistency of response. If the 

reported data were inadequate for certain essential 

items, further mail inquiries were made for these 

specific items. 

After the edited and coded data had been transcribed onto punchcards the data were processed 

on electronic computers. The computer processing 

included consistency checks to eliminate errors in 

editing, coding, or processing interval edits, assignment of weights, and imputation for missing data.2 

Nonresponse and Imputation of Missing Data 

Failure to obtain response represents one of the 

main sources of error ina survey. The extent ofnonresponse and imputation of missing data in the 1963 

National Natality Survey are discussed belowin terms 

of the sources of information used in the survey to 

obtain information. 

Mothers. —A total of 508 mothers, or 13.6 percent, had not responded after all followup procedures 

were completed. Included in the 508 are 28 respondents 

who returned the questionnaires substantially incomplete; for the purposes of processing the data, these 

respondents, were treated in the same manner as unit 

nonrespondents. A large proportion of this nonresponse 

t 1 I 1 

Mothers Physicians f!$~~;es Dentists 

3,726 4,474 4,432 1,360 

Percent 

86.4 93.1 97.6 97.0 

45.3 66.5 7704 81.2 

29.0 17.6 15.3 11.5 

6.8 9.0 4.9 4.3 

5.1 . . . . . . . . . 

I 13.6] 6.9 I 2.4 I 3.0 

was accounted for by mothers in the younger ages. Almost 57.6 percent of the 508 mothers not responding, 

compared with 45.0 percent of the respondents, were 

less than 25years ofage. 

Besides these mothers who represented “unitnonresponse”’ in the survey, missing information on returned questionnaires also affects the quality of data 

derived from the survey. Nonresponse toitemsonquestionnaires returned by mothers was minimal inmost 

instances and accounted for no more than 3.1 percent 

for any single item. Table III shows the percent not 

ascertained for specified items by age of mother and 

live-birth order. The principal problem of incompleteness in the returned questionnaires arose from failure 

to obtain information about the total income of the 

family, a problem which was found disproportionately 

among mothers under 25 years of age and among 

mothers who were having their first child or their 

fifth child or more. 

In order to reduce the effect ofnonresponse onthe 

estimates, statistics derivedfromthesurveyofmothers 

were adjusted for unit nonresponse by imputing tononrespondents the characteristics of ’’similar” respondents. Similar respondents were mothers whoresponded 

to later mailings within each of the 24 age-of-mother, 

coIor, and live-birth-order ”groups. Two ‘assumptions 

are inherent in this imputation procedure. The three 

birth record characteristics—age of mother, color, 

and live-birth order—are available for responding 

as well as nonresponding mothers and are related to 

the socioeconomic variables on the questionnaire sent 

to mothers; and the nonrespondents would be more 

like those who responded to the later mailings than 

those who responded to the first mailing. The latter 

assumption is based on the pattern of response by 

mailing waves observed in relation to the educational 

and income level of the respondents. 

Thus, an array of known values was established 

Lnthe computer using the respondents to later mailings 

40 
------------------

--------------- ------------------

------------------

------------------ ------------

------------------------

----------------------- ------------------------ ----------------------- ---------

Table III. percent of 

tnother 

Age o~n~ther 

live-birth order 

Total 

Age of mother 

Under 20 years 

20-24 years 

25-29 years 

30-34 years 

respondents forwhorn specified ite= were not ascertained, by age of 

and live-birth order: National Natality Survey, 1963 

Total Father’s 

number of Family Education Education g;:;~t employment 

respondents income of mother of father status status 

Percent not ascertained 

3,218 3.1 0.2 0.8 0.1 0.7 

373 6.2 0.3 008 

1, ;3; 0I 0.6 . 0.8 ::: 0.3 0.1 0.3 

486 3.3 0.6 ;:: 0.4 1.4 

35 years and over 337 3.9 0.3 1.2 0.3 

Live-birth order 

First 864 4.2 0..2 

Second 777 2.1 

Third 595 2.4 0.; ::: Fourth 409 0.5 l.O 

Fifth birth and over 573 ::; 0.9 1.4 0.5 

within the 24 homogeneous groups as theknownpopulation of similar respondents from which values were 

imputed to the nonresponse records. Values in the 

cells of the array were continually replaced by successive known values as the file ofrecords was processed; as anonrespcmse record was read, values from 

the appropriate cell of the array were imputed to the 

nonresponse record. 

Data are also adjusted for item nonresponse. 

Imputation procedures for missing data on questionnaires returned by mothers were basedonthepremise that “the presence of several correlated variables 

permits a reasonably good prediction of the missing 

variable. . . .“3 

Thus, missing data for items on employment of 

father, education of father, and family income were 

imputed on the computer on the same principle as for 

unit nonresponse, that is, imputation was made by 

assigning within homogeneous groups the characteristics of respondents to later mailings with known 

data to those respondents with missing data. The array 

by age of mother, color, and live-birth order used 

for imputation of unit nonresponse was also used for 

imputation of missing data on employment of father. 

Missing information on education of father was imputed using age of father and education of mother. 

Missing information on family income was imputed 

using age and education of father. 

Missing data on employment status of mother 

during pregnancy for three cases and on education 

of mother for eight cases were imputed arbitrarily. 

Physicians, dentists, and med;cal facilities. — 

The nonresponse rate for medical and dental sources 

was much lower than that for mothers. Ox’dy6.9 percent of the physicians, 3.0 percent of the dentists, and 

2.4 percent of the medical facilities included in the 

survey did not respond after all followup procedures 

were completed. 

All items on the questionnaires returned byphysicians, dentists, and medical facilities were complete 

with the exception of 1 instance of the type of equipment used, 2 relating to the primary body area, and 

12 relating to the number of films. 

No imputation for unit nonresponse was undertaken because of the relatively low nonrespcmse rate 

and the high probability of a given examination being 

reported by more than one source. The few cases 

enumerated above for which information was missing 

were adjusted manually with the aid of professional 

medical opinion. 

Birth Records 

With the exception of color of child for births 

selected from New Jersey, age of father, andcompleted 

weeks of pregnancy, information on the birth irecord 

was in most cases complete. During 1962, the item 

on color of child was removed from the New Jersey 

birth record. Although this item was replaced in!late 

1962, almost all births occurring during 1963 were 

registered on birth records not containing the question 

on color. ‘Thus, information on color of child was missing on approximately 100 records from New Jersey 

selected in the sample. Imputation for color of child 

was carried out by means ofa procedureusing detailed 

geographic information on place of residence of mother 

41 
Table IV. Color, age, and live-birth order groups used in ratio estimation: Nati,onal Natality Survey, 1963 

Live-birth Group Color and age order 

White 

1 

2 

Under 20 years 

Under 20 years 

1 

2-1-

20-24 years 1 

i 20-24 years 2 

5 20-24 years 3+ 

6 25-29 years 1 

7 25-29 years 

8 25-29 years 3-: 

9 25-29 years 5+ 

30-34 years 1-2 

;: 30-34 years 3-4 

12 30-34 years 5+ 

13 35 years and over 1-4 14 35 years and over 5+ 

and proportion of nonwhite population in that location 

according to the 1960 census. 

In addition, information on completed weeks of 

pregnancy was unknown on 214 birth records; number 

of previous fetal deaths was unknown for 92 records; 

and age of father was missing on255 records. Imputation for these items was also carried outon the computer by substituting known values within thehomogeneous groups created by the age, color, and live-birthorder array described earlier. For items such as birth 

weight, sex of child, and birthplace of mother, where 

the number of unknown cases was small, imputation 

was made arbitrarily. 

Estimation 

Statistics baeed on the survey are estimates prepared by the use of a post-stratified ratio estimation 

procedure. The purpose of ratio estimation is to take 

into account available relevant information in the 

estimation process, thereby reducing the variability 

of the estimate. This procedure was carried out for 

each of the 24 groups shown above. 

For each group, the ratio of the number of birtis 

in the United States in 1963 (based on a 50-percent 

sample) to the number of births in the sample wae determined.3 These 24 ratios comprised the sample 

weights used in estimating national totals for each of 

the 24 groups. The effect of this ratio adjustment was 

to make the estimates from the sample consistent with 

the complete count of births for eachofthe groups used 

in the estimation procedure. 

Group Color and age 

Live-birth 

order 

Nonwhite 

15 

16 

Under 20 years 

Under 20 years 

1 

2+ 

20-24 years 1-2 

20-24 years 3+ 

25-29 years 1-2 

25-29 years 3-4 

25-29 years 5+ 

30-34 years 1-4 

30-34 years 5+ 

24 35 years and over All 

Thus, estimates of characteristics fromthe sample 

are produced using the following formula: 

/= 22!5 -fI /=2; ~ -f i=l y, 1=1 yi 

where 

x’is the estimate of the number of births with a particular characteristic in group i 

Xlis the count of sample births withthe characteristic 

in group i 

y, is the count of all sample births in group i and 

Yi is the total number of births in group i based 

on the 50-percent sample. 

Reliability of Estimates 

Since the statistics derived from this survey are 

estimates based on a sample, they may differ from 

the figures that would have been obtained had acensus 

covering all births in 1963 been conducted using the 

same questionnaires and procedures. In addition to 

sampling errors survey results are subject tomeasurement errors which include, among others, those 

errors resulting from errors in conceptual formulation, ambiguities in definitions and in the questionnaire construction, coding errors, biases due to nonresponse or incomplete response, mistakes in editing, 

and tabulation errors. 

The probability design of the sample forthesurvey makes possible the calculation of sampling errors. 

The standard error is ameasure of the sampling vari42 
-------

-------

-------

-------

-------

-------

Table IV. Approximate standard errors for esti- were created from these groups. A half sample was 

mated numbers shown in this report formed by randomly selecting one group from eachof 

the 20 pairs. This process was repeated until 20 

Relative 

Size of estimate error error variance estimates were derived. The composition 

of the20 half samples was determined byan orthogonal 

plan. 

25,000------------------ 16.8 4,200 After the composition of each of the half samples 

50,000------------------ 12.0 

75,000------------------

6,000 

7,350 was determined, allthe estimation procedures used to 

standard standard “replicate half samples” were formed from which 

100,000------------------ ::! 8,500 produce the final estimates from the entire sample 

250,000------------------ 12,500 were applied separately to each of the resulting half 

500,000------------------ ::: 16,500 samples. 750,000------------------ 2.5 18,750 An estimated variance .S~/ of an estimated sta- 1,000,000---------------”--- 2.0 20,000 

1,500,000------------------ 1.5 22,500 tistic xl of the parameter Xis obtained by applying 

ation in the survey statistics that occurs hy chance 

because only a sample rather than theentirepopulation is surveyed. The chances are about 680utof 100 

that an estimate from the sample differs from the 

value obtained from a survey of the entire population 

byless than the standard error. The chances are about 

95 out of 100 that the difference is less t.han twice the 

standard error. The standard error of a difference 

between two sample estimates is approximately the 

square root of the sum of squares of each standard 

error considered separately. This formula represents 

the actual standard error quite accurately for the 

difference between separate and uncorrelated characteristics, although it is only a rough approximation 

inmost other cases. 

The variance of astatistic depends notonly on the 

design of the sample, butalso onthedistribution of the 

statistic itselfi the variance is greater for measurements which are highly variable from one individual 

to another, and lower for measurements which areless 

variable. Since the estimates of the sampling error 

are obtained from the sample data, theyarethemselves 

subject to sampling error, which may be large in 

some instances. 

Estimates ofsampling variability for the statistics 

derived from this survey were based on 20 random 

half-sample replications. 4 This technique yields overall 

variability through observation of variability among 

random subsamples of the total sample. It reflects 

both the error that arises from sampling and apart 

of the measurement error, but it does not measure 

any systematic biases in the data. A general discussion of the development and evaluation of a replication technique for estimating variance has been published elsewhere.s However, the procedures and 

computations required to estimate varisnces by this 

method in the 1963 National Natality Survey are briefly 

described below. 

For the survey, each record from the entire file 

of records was assigned systematically to a random 

group betweenl and 40. Twenty pairs ofrandom groups 

the following formula: 

20 

s:,= -1_ z (x, ‘/-% ’)2 

20 1=1 

where 

x’ is the estimate of Xbasedonthe entire sample, and 

X! is the estimate of Xbasedon half sample i. 

Rules to determine the approximate standard errors 

for estimates presented in this report are as follows: 

1. Estimates of UWe~tes. —Approximate standard errors of estimates of aggregates, such as 

the number of births with a given characteristic, are given in table IV. 

2.	 Estimatesof percentages in a percent distm-­

bution.-Approximate standard errors for percentages are determined in one of the two 

following ways, depending upon the source of the 

base of the percentage: 

a.	 Where both numerator and denominator are 

estimates from the sample data, such as the 

percentage of wives in the Northeast Region 

Table v. Approximate standarderror for estimated p~%centageashown in this report 

Estimated percentage


Base of


percentage 2 

or 50 

98 ii!IalI 

Standard error


30,000 2.0 3.1 :.: 6.4 

50,000 1.5 2.4 .2: 5.0 ;:: 

loo,boo------- L.7 2:3 3.1 3.5 3.8 

250,000 ;:+ 1.5 1.9 2.2 2.4 

5oo,boo------- 0.5 M 1.4 1.6 1.7 

l,ooo,boo------- 0.5 ;:: 

2,000,000 R 0.4 0.5 $~ ::: M 

3,000,000 0.2 0.4 0.7 

4,000,000 0.2 %? 0.4 0:5 0:5 0.6 

43

---------------------------------------------

---------------------------------------------

---------------------------------------------

---------------------------------------------

---------------------------------------------

---------------------------------------------

Table VI. Relative stanckird errors of number of visits for medical care per 1,000 mothers 

Number of visits per 1,000 mothers 

50,000


2,000 29.5


4,000 22.9


6,000 18.1


8,000 14.4


lo,ooo 11.4


12,000 9.1


Number of mothers in base 

100,000 250,000 500,000 1,000,000


5.9 4.9 

4.7 4.0 

3.1


M 2.4


2.4 1.8


1.8 1.4
 I 

3.


L


who had their third child in1963, theapproximate standard errors are given in table V. 

b.	 Where the denominator is avalue foundinl 

of the 24 ratio-estimate cells shown onpage 

42 and is therefore not subject to sampling 

error, the relative standard error of the 

percent is equivalent tothe relative standard error of the numerator, which can be 

obtained directly from table IV. 

Diffevencebetween two sample estimates. —The 

standard error of a difference isapproximately 

the square root of the sum of the squaresof 

each standard error considered separately. 

This formula will represent the actual standard 

error quite accurately for the difference between separate anduncorrelatedcharacteristics 

although it is only a rough approximation in 

most cases. 

4. Estimate of u mean. —Approximate standard 

errors for a mean depend on the source of the 

base for the mean. V?hen the denominator is an 

estimate from sample data, such as thenumber 

of women who were high school graduates, the 

approximate standard errors can be found in 

table VI. 

Rounding of Numbers 

The original tabul~.ions on which thedata in this 

report are based show figures tothenearest,whole unit. 

In the published tables, estimates of aggregates are 

rounded to the nearest thousand although they are not 

necessarily accurate to that detail. AH percentages, 

ratios, and averages were computed using unrounded 

figures. 

000 

44 
-------

-----------

-----------

APPENDIX II 

DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT 

Demographic and Sociotxonomic Terms 

Information is from the birth certificate or the 

mother query. 

Age of mother. —Age of mother is recorded or 

derived from entries on the birth certificate. Age in 

this report refers to age at last birthday. 

Color. —Color is recorded or derived from entries 

on the birth certificate for color or race as white or 

nonwhite. The category “white” includes births to 

parents classified as white, Mexican, or Puerto Rican. 

Nonwhite births include births to parents classified as 

Negro, American Indian, Chinese, Japanese, Aleut, 

Eskimo, Hawaiian, or part-Hawaiian. 

Live- bivth o?’dev. —Live-birth order is derived 

from entries on the birth certificate and refers to the 

number of children born alive to the mother. 

Education of mothw. — Education of the mother 

is obtained from querying the mother. The categories 

shown in this report refer to the highest grade of 

regular school attended. A regular school is one which 

advances a person toward an elementary or high school 

diploma or toward a college, university, or professional 

school degree. Thus, education in schools outside the 

regular system such as vocational, trade, or business 

schools is not included. 

Family income. -Family income is obtained from 

querying the mother. The categories shown in this 

report refer to the total income received during the 

preceding calendar year by all persons related to 

each other by blood, marriage, or adoption and living 

in the same household at the time the baby was born. 

Income from all sources such as wages, salaries, help 

from relatives, unemployment compensation, and so 

forth, is included. 

Geographic Terms 

Information is derived from entries on the birth 

certificate. Both region and metropolitan status refer 

to the mother’s usual place of residence. 

Regt”on.-l?or the purpose of classifying the population by geographic area, the States are grouped into 

four regions. These r#@ons, which correspond to fiose 

used by the Bureau 6f the Census, are as follows: 

Re@”on States Im.eluded 

Northeast	 Maine, New Hampshire, Vermont, 

Massachusetts, Rhode island, 

Connecticut, New York, New Jersey, 

Pennsylvania 

North Central---- Michigan, Ohio, Indiana, Illinois, 

Wisconsin, Minnesota, Iowa, 

Missouri, North Dakota, 

South Dakota, Nebraska, Kansas 

South	 Delaware, Maryland, District of 

Columbia, Virginia, West Virginia, 

North Carolina, South Carolina, 

Georgia, Florida, Kentucky, 

Tennessee, Alabama, Mississippi, 

Arkansas, Louisiana, Oklahoma, 

Texas 

West	 Montana, Idsho, Wyoming, Colorado, 

New Mexico, Arizona, Utah, Nevada, 

Alaska, Washington, Oregon, 

California, Hawaii 

Metropolitan si!du.s. —For the purpose of classifying the population by metropolitan status, the definition which was set up by the Office of Statistical Standards, U.S. Bureau of the Budget, for the 1960 census 

was used.6 The classification is done by counties. The 

counties are either inside or outside standard metropolitan statistical areas (metropolitan State economic 

areas in New England), and all places within the county 

are given the county designation. 

Medical Terms 

Information is from the physician, dentist, and 

medical facility questionnaires. 

Visit. —Visit is defined by the physician’s (hospital’s or dentist’s) response that he had seen the mother 

during the 1-year period and the number of times he 

had seen her. Accuracy was insured by asking for the 

45 
,: 

1. 

dates of the first and the last visit, If both were not Medical ~acWy,-Medical facility is a hospital, 

within the l-year period the respondent was again clinic, or other institution ~hich the mother visited 

questioned to obtain the correct number of visits during the year. .,, 

within the specified period, Dentist,-All dentists named by the mother or by 

Physician.—Physicians signing the birth certifi- any other source were queried, The primary source 

cate were queried unless their address was that of for identifying dentists was the dktxtory of the Anx?rithe hospital in which the birth occurred. Also, all can Dental Association. 

physicians named by any primary source were queried. Tvitnestev, -Trimester is compmed by Wmptmiwg 

The primary source for identifying physicians was the date when the mother was first seen with the date 

the directory of the American Medical Association. of birth. 

46 
� 

APPENDIX 111 

SOURCE FORMS 

Standard Certificate of Live Birth 

F.*III ,..v,”uI


B“d?xl Bum” h. @G-S2742


r... “. CERTIFICATE OF LIVE BIRTM *,mTx~n .“, .-, . ..-. 

FLACC#lRTM OF .2. :S$AAERESlnENCE OF MOTHER j~cr:Nd&a mofhcr LitW

o. COUNTY 

b. CITY, ToWN. OR LOCA1lOti c. CITY. TOWA OR LOCATION 

c. NAMEOF (Ifnotin hospital, gibe atmt odd,w) d. sTREET ADDRESS 

HosPITAL OR 

INSC7UTION 

d. IS PM.- >F BIRTH INSIDE cm LIMITS? ,. IS RESIDENCEINSIDE CITY LIMITS? f. IS RESIDENCEON A FARM? 

NO � YES o NO � YEE n NO tl —~ 

3, NAM. Ivrd Middle Led 

(Tvpe or 1 7)11110 

i 4, SEX 5.. 7NIS BIRTH 5b. IF TWIN OR TRIPLET. WAS CHILD BORN 6. DATE Month Dar Y4ir 

SINUS o TWIN � TRIPLET D 1s70 2D � 3D � BI%H 

7. NAME Fir8t ,Wdd& LuXt 8, COL&R OR RdCE 

t 

[ 9. AGE (At lime of(hia blrlh) 10. BIRTHPLACE (Slok or forcim counw) I la. USUALOCCUPATION Ilb, KIND OF sUS1F41!SSOR lN2wTitY

YEARS 

: 12. MAIDEN NAME Fir61 Middle Lwt 13. COLOR OR RACE 

, 

? 14. AGE (At lime OJ IhJa birlh) 15. BIRTHPLACE(Staft Or!orciw Coznlru) 16. PREVIOUSDELIVERIESTo MOTHER (Bo NOT hdude (Ma bltth) 

YEARS . . #’w mm”” b, ?/W Immb OTNER .k&- ,. MW M.” }CIO1 d.mlh. OTHER childfn, ::: ;C:;bcn OLi** b.t em (Jeluwth hth dud &t A .VY 

~. INFORMANT on . mo U,i”c? tin!, ok U.ws!im)? 

3. MOTHER5 MAILING ADDRESS 

18a. SIC?iATLNEE 18b. A’17ENDAN7 AT BIRTH 

I htrcbv urli v 

(hut this ch/Id M.D. � D. 0. D MIDWIFEn OTHER (SPCciJtI) 

,008 yhy :% 

on !Ec. ADDREES 18,?. DATE S!6NED 

t(.fed .6wc. 

9. DATE RECD. BY LOCALREG. 20, REGIS7RAR3 SIGNATURE 21. DATE on WHICH GIVEN NAME ADbtD 

BY (Rtvbmr) 

FOR MEDICAL AND HEALTH USE 0?4LY 

(Th& uc(ion .WST be filkd OIU) 

!.% LENGTH OF PREGNANCY 22b, WEIGHT AT BIRTH Z1 LEGITIMATE 

$0J44:ETED LB. oz. YES a No � 

(SPACEFOR ADDITION OF MEDICAL ANO HEhLTH ITEMS BY INDIVIDUAL sTA722i 

47 
Survey Questionnaire for Mothers 

— 

,/’” ‘% 

\ DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

t 

%* / PUBLIC HEALTH SERVICE WASHINGTON %5, D. C. 

@ u., 

r


L


The U. S. Public Health Service is &oing a national stutiyto fimi out hou


much ard what kinas of medical and dental care women are receiting auring


the year before the birth of a chila. Nothing is known about the extent


of the caxe receives by expectant mothers, even though Buch care is of the


greatest importance for the future health”of both mother smd baby. A


knowledge of what is actually happening throughout the Nation till go a


long way in helping to improve the health of mothers and babies.


The information needed for this study will be basea on the experience of 

the mothers of k,OOO babies out of the l million born during 1963. These 

mothers were selected as a random sample of all mothers who have a baby, 

ard you are one of those so selected. We are therefore asking you to answer 

the questions on the following pages of this form, ad to return it to us 

in the enclosed envelope which requires no postage.


Please notice that Ln the first part of the form the questions ask about


every tioctor,dentist, hospital, or clinic from which you receives any care


ihn?ingthe entire year before your baby was born. Your answers shoulfinot


be just for-ca~connectea with pregnancy, but for any and all medical


antidental care or checkups auring these E months.


All information about you a?xiyour baby willbe kept completely confidential.


Your answers will be used for health resesxch only anfifor no other purpose. 

As you might expect, it is particularly important that we receive your 

answera sdl those of all the other 4.,000mothers, since each of you really


represents 1,000 mothers.


Your cooperation In this study is deeply appreciate.


Sincerely yours,


O. K. Sagen, %. D., Chief 

National Vital Statistic Division


National Center for”Health Statistics


“Name of Child 

Date of Birth File Number 

b 

48

CONFIDENTIALITY has b... .s; ur. d th. individual .s publish. d in th. Fred. ral Regist. r May 20. 1959 

FORM APPROVED€

iWDGE,T BUXEAU NO 68. S821€

SURVEY OF MEDICAL AND DENTAL CARE 

PART I. SOURCES OF MEDICAL AND DENTAL CARE DURINGONE-YEAR PERIODBEFORE CHlLDBlRTH 

L. Please provide the information requested 3. Were you seen by a dentist during this 

below about the physician, chiropractor or one-year pericd? 

midwife who attended you at the recent 

birth of your child. DYES � UO (Go o. t. Question 4) 

J 

Complete a section below 

Address for each dentist. 

I city (Am, and S&e 

Address E.. many times were you seen by this


doctor during the me-year period? I


City (tom) and.State


?. Were you seen by any other physician


or chiropractor during the one-year b’ow many times were you see. by this


period before the recent birth of dentist during the one-year period?


your child?


� YEs � UO (Go on to Question 3) Name 

1 Address


Complete a section below fcn- II
 aach doctor or chiropractor.
 City (&m) and State


Name 

How many times were you seen by this


dentist during the one-year period?
 Address
 —


I
 4.	 During this one-year pericd, were you treated


or examined in a clinic or hospital not


reported above? (Include health checkup. at


flow many times were you see” by this work, visits to mobile hea Ith units. etc. ) 

~doctor during the cme.year period? 

I

I � YES DIIO (G. .. to next page) 

Name 1 

Complete a section below for each 

place whe=e you were treated or examined. 

II 

~ INme Row many times were,.you seen by this 

doctor during the one-year period? 

Name 

Address Nam 

III


City (t.mn) and State Address


II


Row many times were you =ee” by this City (tom) and State


doctor during the me-year period?


S.442S-19m(P. X. 2) 

63 PIJIME GO ON Z’ORIRT’II— 
-----------------

----------

--------------

-----------------

--------------

PARTIL RELATED INFOI?MATION 

1. Were yau emplayed outside YQUP hame at any time U. Was yaur husband employed at th~ time of your


duving youP recent pregnancy? child% binth?


DFULL-TI12E? OYES (An.wer and ❑ Bo (G.aon ,. DYES z Was he working 

a. 

b. 

b below) Question 2) 

Did yau wark full-time at all during


yqur recent pregnancy?


DYES D21Q


1


When did you stop warklng full-time?


~


Did you work part-time at all during


your recent prsgmncy?


DYES igito 

1 

When did you stap working part-time? 

! Itcm t h I 

I 

Dar I Year 

2. Wnat waa the higheat grade (Qr year) of regular


scbanl that yau ever attended? 

(Circle hi~hest grad. attended) 

MOUE O 

EL EHEIWA12Y SCHCIOL---- 12385678 

ILlfjll SCtlO,OL L 2 > ~


CO LLEGE $ z s a s 6+


Did YOU COMPLETE this grade? ❑ YE S ~M o 

What was the highest grade Car year) of regular


sch~l that your husband ev.arattended?
 (Circle highest &rade attended) 

llOllE O 

ELEMENTARY SCHOOL---- 1 2 3 4 5 6 7 8 

HIGH SCHQM,----------- 1 2 3 4 

COLLEGE 1 2 Y L S 6+ 

Did he COMPLETE this grade? l_JYES Dno


ES-4425.19 (p,** 3] 

-63 

(check on.> { ❑ FAI?T-l I ME? 

Ull o 

5. What kind of work was yaur husband doing at the 

~ime qf your child!s bi~th? (If he was not 

warkiv$ then, please @ive information for hiq 

Iaat jqb), 

GIVE FUL4 DESCRIPTION (Fer example: grocery 

clerk, auto mechaqic, elemefttarx school teacher) 

6. What was the total incmne of your family during 

1962? fInqlude aSI income such as wage,, salaries, 

unemployment com~ensation, help from relativeq, 

etc. . received by all members QE the fam$ly living 

with You mhen Your baby was born) 

I-JIOIIE ~S4.00Q - s8,999 

❑ UtiQER s*,000 ❑ $S, 000- S6.?99 

D,$l. oUQ- s1,999 ~$7, aoo -$9.999 

IJS?.CLOO - s2#999 0$10,000-$14,999 

i_Js3,aaff - s3.999 U$15.001) OR OVER 

7.	 Where did you live when your kby was born? 

(’Please &ive your home add . ...) 

Number ad Street 

City (tom) atm State 

Countx 

Is this place and city lot (or in an


apartment building),?


ffYE,s IJII
a

“(Name and address of ~er.%an completin$ thi.$ form) 

HEASE U2E BACK PAGE FOR COMNZNTS


50 
Survey Questimn,aire for physicians 

,,,’ . . 

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARti 

p~aLic HRiiLTH SERVICE , WASHINGTQW q, D, C. 

,, 

*%,.T*, %%> 

$ ,.* 

. . : : : %’ @ .?” !!+a ** ‘@
 “s.

r 

L 

Your ewe%stanceiE neededin a smallbu% impcmtant$amplem.uweyconauctea 

by the U, S. PublicHealthService@.th the apprcwalQ~youT StateHealth 

Degsrtment. The primarypurposeof this surveyis +JOestimatehow often 

rnothe?.% are exposed@ $@ul.z%ngradiation@ ttaeyear precedinga ~irt”h.


The SurveyWill .%lsoprQwL~susefuldata on%he etint to wbich expectant


rnq@ersavailthemselvesof mediealcaxe. The mother~Qnvhom aata are


being colkmtedwere N.ek&fieclfrom arsnaom sampleof aboutib,000birtihs


out @? the 4 milJLonQcmJJ?ring
 in the UnitedStateaduring1963. 

J%CQPti.R& %CI0UrrQCQrdS8the mOthernSZI!2abe10??Va6
 seen or treateiiby


YOU at .wnetime ihringthe yeexpxi.Qrta the receubbirth of her child,


We askyQur coQpera$iQnin answeringthe gzea13ions
 on the fbUowing pages,


WhiQh.reJ@t@tQ the X&iGal.care she receivedawing the Qne-yearperiod


preceding&iMbirth. T& exact datescoveredlaythisperiodare shown


belQw. Infcmm?ktrkn
 is neeaeameach~oaur.e tioionizirgradiationthis


WQman experiencedduringthis FeriQ&2irrespectiveof its relat?svsship


tQ pregnancy.


Stncethe survey2s based an only a sal eampleofmothers2 it is particu.


lsz?lytmportautthatwe chkainfull informationon each. Apostage.fyee


envelopeLa enclosedfor yQW cQnve&ence in repl~ng. you maybe ass~eti


ths$ yQur reportWillhe held in stri.c%est confidencearia.
 used only for


statiat%calrecearch.


YQur cooperationin this studyis &eeplyappreciate.


National

zEziiiGVital Sta$istitcs
 Division


NationalCenteri?QrHealthStatistics


Nmne of Mother Maiden Nama 

,Address Ptace ofRirth Q.f Child 

City.. State Date of Bii Ch File kmher 

FI?Rl,QCi CQVERED I!Y Tlil$ S.URYEY: F RQR To 

T. 
CO MFIDEIITIALITY h.a b.. n � ssur. d the individual as Published 1. the Fed. rel Re’a18t. r Hay 20, 1959 

FORM APPROVED,


BUDQET BUREAU NO, 68. R82s


SURVEY OF RADIOLOGICAL EXAMINATIONS 

PART 1. RADIOLOGICAL EXAMINATIONS OR TREATMENTS DURING ONE-YEAR PERIOD BEFORE CHILDBIRTH 

TO YOUP knowledge, was the mother examined cm treated by X-ray OP fluOrOscOPe at anY time during 

the one-year pericd before childbirth as specified at the bottcm of the preceding page? 

� NO (Skip to Part IX on Iast page) 

IJ Y ES +	 How many radiological examinations or treatments. 

did ahe receive during this one-year period? 

(number) (Complete section(s)below, then to on to lastpage) 

\


�	 Complete a separate section be low for EACH radiological examinat ion or treatment performed during 

the ONE-YEAR PERIOD, whether or not related to pregnancy. 

� If the SAME TYPE of procedure was performed MORE THAN ONCE, please report .E4CHSEPARATELY. 

� If more than one procedure was performed on the SAME DATE, please report EACH SEPARATELY. 

� In reporting NUMBER OF EXPOSURES, please include those which may have been technically 

unsatisfactory. 

� If necessary, continue on a separate sheet. 

SECTION 1. FIRST RADIOLOGICAL EXAMINATION OR TREATMENT DURING ONE-YEAR PERIOD 

/ 1. Type of radiological : � IA GNo STIC RADIOGRAPHY � DIAGNOSTIC FLUOROSCOPE 

equipment used? : � 10IAGHOs TIC PHOTO FLUOROGRAPHY OX-RAY THERAPY (check . ..) 

Date of 

;amirq,tion


treatment? 2. Primary area of


bcdy exposed?


3. Type of service : � PELVI METRy � IN TRAVEN0Lf5 PYELOGRAM 

mcmth) 

rendered to mother? : � PLACEHTOGRAPHY � OTHER (specify) (check	 one) 

: DROLITINE cHEsT 

( 

(day) 4. Number of exposures? ~ (include those technically .“satisf.ctory) (nwnber) 

(year) 5. Place where 

Nme of physician, hospital or clinic 

~ “’” 1 “’iAT-


52 

.“ 
-------

SFCTlf’IN2. .— SECOND 

---- ..—.. RADIOLOGICAL ..-—— —. EXAM,INATION OR TREATMENT DURINGONE-YEAR PERIOD

/ 1. Type of radiological ~ � DIAGNOSTIC .VADloGRAPHY � EIIAGHOSTIC FLUOROSCOPE 

equipment used? : � DIAGNOSTIC PHOTOFLUOROGRAPHY OX-RAY THERAPY 

(check one)€

Date of


examination


,rtrsatment? 2. Primary area of


bcdy exposed?


3. Type of service : lJpELvtrn ETRy jJIHTRAVEHOUS pYELoGRAM 

(m.mth) 

rendered to mother? : � IPLACENTOGRApHY DOTHER (.p.. ify)

(check one) 

: � ROuTltIE cHEsT 

(day) 4. Number of exposures? ~ ~number) (includethose technically unsatisfactory) 

5. Place where (year) 

Name of physician, hospita I or clinic 

““ l“Di*T-


SECTION3. THIRDRADIOLOGICAL EXAMINATION OR TREATMENT DURINGONE-YEAR PERlOD 

1. Type of radiological ~ � DIAGNOSTIC RADIOGRAPtIY � cIIAGHOSTIC FLUOROSCOPE 

equipment used? : � iOIAGMOSTIC PHOTO FLUOROGRAPHY OX-RAY THERAPY (check one) 

Date of 

exatinati on


jrtreatment? 2. Primary area of


bcdy exposed?


3. Type of service : OPELVInETRy lJlfITRAvEHOUS pYELOGRAtI 

rendered to mnther? (month) (check one) : lZPLACEtITOGRApIiy l_JOTHER {specify) 

; � ROUTINE CHEST 

{ 

(day) U. Number of exposures? : (include those technically unsatisfactory] 

(mntber) 

5. Place where ; � 00NE AT MY OWN OFFICE ~’ examination or 

OR Name of physician, ho.spitel or clinic treatment W* 

performed? % Address 

\ Ci ty-.Stz3 te 

SECTION4. FOURTH RADIOLOGICAL EXAMINATION OR TREATMENT DURINGONE-YEAR PERlOD 

. 00 IACHOSTIC RADIOGRAPHY aOIAGKOSTIC FLUOROSCOPE 

I 1. Type of radiological j 

equipment used? : RDIAGH05TIC PHOTOFLUOROGRAPHY OX-RAY THERAPY (check one) 

Date of 

examinati cm


,rtreatment? 2. Primary area of


bcdy exposed?


3. Type of service ~ lJPELv IHETRy OIHTRAVENOUS PYELOGRAM 

rendered to mnther? th) (check one) : OPLACEHTOGRApHY DoTHER (specify) (,no” 

j � ROuTINE CHEST 

{ 

(day) 4, Number of exposures? ~ (include those technically unsatisfactory) 

(number) 

(year) 5. Place where ; OEIONE AT MY OWN OFFICE 

examination or OR Name of physician, hospital or clinic treatment was 

* performed? Address 

\ City-State 

,,, . ..”. . .– .-– . . ,- . ----

53 
PART II. MEDICAL CARE RECEIVED BY MOTHER DURINGONE-YEAR PERIODBEFORE CHlLDBlRTH 

.. How many times did you see this patient during the 5, If you referred this patient t~ another physician, 

one-year peric.d? (It exact number not known, or to a hospital or clinic, please give n?imes and 

please give best estimate) addresses of physiciafis or institutions to which 

referred. 

Number of times 

!,	 On what date did you see her for the first time 

during the one-year period? 

Month ‘ID, Car ~ 

1 

1,	 On what date did you see her for the last time 

during the one-year period? 

Month , Day ~Y= ~ ~ 

19 

6, If this patient was seen or treated during the 

1, If this patient was referred to you, please give one-year 

or clinic 

period by any other 

not reported above 

physician, hospital 

or on the previous names and addresses of referring physician, clinics page, please give names and addresses, or hospitals. 

Nan. 

Address 

City. Sfate 

~ 

Name Name 

Address Address 

City. St.4ti+ Ci ty.State 

(Name ofperscm .mnpletin,g this form) 

COMMENTS 
Survey Questionnaire for Medical Facilities 

*$+’””%, ,07 

.s - DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE ~ } 

%. ~’ 

@ @ PUBLIC HEALTH SERVICE WASHINGTON %s,D. C. %. “’.,+” 

r


L 

Your assistanceis neededin a smallbut importantsamplesurveyconducted


by the U. S..PublicHealthServicewith the approvalof”yourStateHealth


Department .
 The primarypurposeof this surveyis to estimatehow often


mothersare exposedto ionizingradiationin the year precedinga birth.


The surveytill alsoproviaeusefuldata on the extentto which expectesrt


mothersavail.themselws of medicalcare. The motherson whom data are


being collectetl
 were identifiedfrcm a ranaomsampleof about4,000births


out or the kmillion occur,ringin,
 %he Unites States awing L$163. 

Accordingto our recoras,the mothernametibeqowwas seen or treateaat


your institutionat sometime auringthe year prior to the recentbirth of


her chila. We ask your cooperationin answeringthe questionson the


follo?dngpages,whichrelateto the medicalcare she receiveCi iiuring
the


one-yeaxperioa preceding chilcibirth.The exactdates covereaby this


Perioa me shownbelow. lhformationis neeiteaon each exposureto ionizing


radiationthiswoman experiencett ati~ this pertofi,
irrespecti~ of its


relationshipto pregnancy.


Sincethe surveyis bases on only a smallsampleof mothers,it is particu­


larlyimportantthat we obtainfull informationon each. A postage-free


envelopeis enclosesfor your conveniencein replying. You maybe assurea


thatyour reportwillbe hela in strictestconfidenceanflused.only for


statisticalresearch. )


Your cooperationin this studyis aeeplyappreciate. i 

Sincerelyyours,


o .%r&


NationalVital StatisticsDiflsion


NationalCenterfor HealthStatistics


I


Name of Mother Maiden Name 

Address Place of Birth of Child 

City-State Date of Birth File Number


PERIOD COVERED BY THIS SURVEY: FROM TO 
CONFIDENTIALITY has be. . � 8sur8d th. Indlvldu.1 . . p. bll shad [n the F.d*ral Regiat. r May 20, 1959 

FORM APPROVED, 

8uD06T BUREA” NO, 68.R82J 

SURVEY OF RADIOLOGICAL EXAMINATIONS 

PART 1. RADIOLOGICAL EXAMINATIONS OR TREATMENTS DURING ONE-YEAR PERlOO BEFORE CHILDBIRTH 

To your knowledge, was the mother examined or t rested by X-ray or fluoroscope at any time during 

the one-year pericd before childbirth as specified at the bottom of the preceding page? 

D N O (Skip to Part II on fast page) 

l_J Y Es - How many radiological examinations or treatments. 

did she receive during this one-year period? 

(Complete section(s) below, then go on to last page) (number) 

�	 Complete a separate sect ion be low for EACH radiological examinat ion or treatment performed during 

the ONE-YEAR PERIOD, whether or not related to pregnancy. 

� If the S4ME TYPE of pro.ed”.e w=. ~erformed MORE THAN ONCE, please report EACH SEPARATELY. 

� If more than one procedure was performed o“ the SAME DATE, please report EACH SEPARATELY. 

�	 In reporting NUMBER OF EXPOSURES, please include those which may have been technically 

unsatisfactory, 

� If necessary, continue on a separate sheet. 

. . 

SECTION 1. FIRST RADIOLOGICAL EXAMINATION OR TREATMENT OURING ONE-YEAR PERIOD 

1. Type of radiological ~ � Diagnostic RADIOGRAPHY � DIAGNOSTIC FLUOROSCOPE 

equipment	 used ? : � DIAGNOSTIC PHoTOFLUOROGRAPHY ~ X-RAY THEii APY (check one) 

Date of 

xaminat ion 2. Primary area of treatment	 ? body exposed? 

3. Type of service ; lJPCLVl H6TRY DIM TRAV~NOUS PYELOGRAM 

rendered to mother? 

month) (check one) j lJPLAc Et1701sRAPHY DOTHER (specify) 

; � ROUTIME CHEST 

(day) I+. Numter of exposures? : (i..l.de those technically uns>, t is factory) 

(“”n?l>, r) 

(year) 5. Place where 

Name of physician, hospital .? clinic 

~ ‘=’” 1 ‘D:;AT-: 

56 
SECTION2. SECOND Radiological EXAMINATION OR TREATMENT OURINGONE-YEAR PERlOO 

1. Type of radiological ~ � DIAGNOSTIC RadiOgraphy � OIAGHOSTIC FLuo RoscDPY 

equipment used? ; � DIAGNOSTIC PHOTO FLUOROGRAPHY DX-RAY THERAPY (check one] 

Date of 

examinat iot I 2, Primary area of r Treatment? bcdy exposed? 

3. Type of service ; UPELVIME78Y flIHTRAVENOUS pYELOGRAM 

(mmth). 

rendered to mother? j � PLACENTOGRApHY � OTfl ER (specify) (check one) 

j � RDUTINE CHEST 

( 

(<lay) 4. Number of exposures? : (include those tech”icelly u“satisfactc.ry) 

(number) 

(y.rlr) 5. Place where 

Name of physician, hospital or clinic 

=“” l“D;;AT~ 

SECTION 3. THIRD RADIOLOGICAL EXAMINATION OR TREATMENT DURING ONE-YEAR PERIOO 

1. Type of radiological ; � DIAGNOSTIC RADIOGRAPHY � DIAGNOSTIC FLUOROSCOPE 

I equipment used ? ; O DIAGNOSTIC PHOTOFLUOROGRAPHY � X-RAY THERAPY (check one) 

Date of 

examination 2. Primary area of r treatment? body exposed? 

3. Type of service E � PELVIHE7Ry DIN TRAVENOUS PYELOGRAM 

rendered to mother? 

(month) (check one) ; lIlp LAcENTOGRAp HY DoTHER (.p.. ifYj 

! � R0uT8HE CM EST 

(day) 4. Number of exposures? } (inclu,l. th..c Crchnicn 1lY unsa t is factury> 

(nuntl,. r) 

(year) 5. Place where j � OOHE AT THIS INSTITUTION 

Name of physician, hospital or clinic 

~ ““ i “1====-= 

SECTION4. FOURTH RAOIOLOGICAL EXAMINATION OR TREATMENT DURINGONE-YEAR PERlOO 

1. Type of radiological I � OIAGHOSTIC Radiography � OIAGMOSTIC FLUOROSCOPY, 

equipment used? : oOIAGHOSTIC PHDTOFLUOROGRAPHY OX-RAY THERAPY (check one) 

Date of 

examination 2. Primary area of r treatment? body exposed? 

3. Type of service : aPELV1. ETRy IJINTRAVEMDUS pYELOGRAM 

(month) 

rendered to morher? ~ � IPLACEtITOGRAPHY l_JOTHER f.p.ciry)

(check one> 

: � ROUT IKE cHEsT 

((lay) 4. Number of exposures? ~ (incl.,Je th... technically un. atisf.?crory) 

(n.ntl,er) 

— 

(year) 5. Place where ; ODONE AT THIS INSTITUTION 

examination or’ OR Name of physician, hospital or clinic 

treatment was % —— performed? Addr cs. 

City.State 

S-4425.7 (p.,. 2) (OVER) 63
 5.7
PART II, MEDICAL CARE RECEIVED BY MOTHER DURINGONE-YEAR PERIODBEFORE CHlLOBlRTH 

.,	 How many times was the patient seen at your 5, If your institution referred this patient to 

institution during the one-year period? another hospital or clinic or to a private 

(If exact number not known, please &?i.e best estimate)	 physician, please give names and addresses of 

physicians or institutions to which referred. 

Y 

) 

.,	 On wh+t date was she seen for the first time 

during the one-year period? 

lNaM 1,	 On what date was she seen for the last time Address 

during the one-year period? 

City-State 

Month I Da Y I Year 

19— 6, If this r)atient was seen or treated durin~ the 

one-year period by any other hospital, cl~nic or k, If this patient was referred to your institution, physician not reported above or on the previous please give names and addresses of referring page, please give names and addresses. hospitals, clinics or private physicians. 

~ 

~ 

\ (Namo ofpers.n .c.npleting this form) 

,’ 

COMMENTS 

PHS. 4425.7 (page 3)


4.63


58 
Survey Questionnaire for Dentists 

1 

- /’” %.O ~. 

h 

* DEPARTMENT OF HEALTH. EDUCATION> AND WELFARE ~ : 

%*@ .s 

@%. ~, ~ ,+”’ PUBLIC HEALTH SERVICE WASHINGTON 25, D. C. 

. r 

L


Your assistanceis neededin a smallbut importantsamplesurveyconducted


by the U: S. RiblicHealthSezncice
with the approvalof your StateHealth


D3pariment.The primarypurposeof this wrvey is to estimatehow often


mothersaxe exposedto ionizingradiationin the year precedinga birth.


The surveywill alsoprovideusefuldata on the extentto whiche~ctant


mothers’
availthemselvesof dentalcare. The motherson whom data are


being collectediwereidentifiedfrom a randomBampleof about4,000births


out of’the 4 millionoccurringin the UnitedStatesduring1963.


Accordingto our records,the mothernsmedbelowwas seenor treatedby 

you at some_Mme duringthe year prior to the recentbirth of her .cbild. 

We ask your cooperationin answering the questionson the back of this 

letter,whichrelateto the dentalcare she receiveddurtigthe one-year 

periodprecedingchildbirth.!’theexact datescovereaby this periodare


shown%elow.


Sincethe surveyis based on only a smallsampleof mothers,it is psrticu-


I.axlv
tiortant thatwe obtainfull informationon each. A postage-free 

enveiope-isenclosedfor your convenience in replying..You&y*- assured 

thatyour reportwfllbe held in strictestconfidencesad used only for 

statisticalresearch. 

Your cooperationin this stiuly,is
 deeplyappreciated.


:K~:~* 

.,Chief 

Nationalvital StatisticsDivis%on


NationalCenterfor HealthStatistics


D


Name of Mother Maiden Name 

Address Place of%irth of Child


Date of Birth File Number


i PER1OD COVERED BY THIS SURVEY: FROM TO 1 

59


.— 
CO II FIDEMTIALI’TY ha. been assured the individual .s publi. hed In the Federal Register May 20, 1959 

FORM APPROVED 

BUDGET BUREAU NO 68-X823


SURVEY OF DENTAL X-RAY EXAMINATIONS 

PART 1. DENTAL X-RAY EXAMINATIONS DURING ONE-YEAR PERIOD BEFORE CHILDBIRTH 

To your knowledge, did the patient receive any dental X-ray examinations during the one-year


period before childbirth as specified at the bottom of the preceding page?


❑ HO (Skip toPart II below) 

❑ YES ~	 How many dental X-ray examinations did she 

receive during this one-year period? 

(number)


➤ Complete a separate section below for EACH dental X-ray examination that the patient received 

during the ONE-YEAR PERIOD before the birth of her child. 

b In reporting NUMBER OF EXPOSURES, include those which may have been technically unsatisfactory. 

“b If necessary, continue on a separate sheet. 

.. \ . . . . . . . . . .> . 

Date of Examination Type(s) of X-ray Exposures (check .11 that apply) Wmbe r of Exposure 

l_JFULL nOu TH ❑ BITE ulNG 

(month -day. year) ❑ OTHER + (specify typ.j (number) 

❑ FULL Hou TH j_JBITE wltIG 

(month.day-ye.r) (nwnber) 

~OTIIER - (specify type) 

OF ULL MOUTH ❑ BITE WIRG 

(month-day .year) (number) ❑ OTHER _ (specify type) 

PART II. DENTAL CARE RECEIVED BY MOTHER DURINGONE-YEAR PERIODBEFORE CHlLDBlRTH 

1. About how many times did you see the patient 4. If the patient was seen by another dentist or 

during the one-year ?eriod? dental clinic during the one-year period, please


give names and addresses below.
 r 2.	 When did you see her for the first time during


the one-year pericd?


Month I Day I Year 

19—


3.	 When did you see her for the-last time during


the one-year p,ericd?
 Address


Mm th I Day I Year 

City-State


19—


PIIS-+425 .13 (Paaa 2) 

(.63 

— (Name of person completin& this form)


COMMENTS: 

60 
OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH Statistics 

Public Health Service Publication No. 1000 

Seties 1. 

Series 2. 

Series 3. 

Series 4. 

SeYies 10. 

Sevies 11. 

Series 12. 

Series 13. 

SeTies 20. 

Seties 21. 

SeYies 22. 

PYo,grams and collection pYoceduYes.— Reports which describe the general progrhms of the National 

Center for Health Statistics and its offices and ‘&visions, data collection methods used, definitions, 

and other material necessary for understanding the data. 

Data evaluation and methods YeseaYch. —Studies of new statistical methodology including experimental tests of new survey methods, studies of vital statistics collection methods, new analytical 

techniques, objective evaluations of reliabili~ of collected data, contributions to statistical theory. 

Analytical studies. —Reports presenting analytical or interpretive studies based on vital and health 

statistics, carrying the analysis further than the expository types of reports in the other series. 

Documents and committee Yeports. —Final reports of major committees concerned with vital and 

health statistics, and documents such as recommended model vital registration laws and revised birth 

and death certificates. 

Data from the Health Interview Survey. —Statistics on illness, accidental injuries, disabiliW, use of 

hospital, medical, dental, and other services, andotherhealth-related topics, based on data collected 

in a continuing national household interview survey. 

Data f%om the Health Examination SuYvey. —Data from direct examination, testing, and measurement of national samples of the population provide the basis for two types of reports: (1) estimates 

of the medically defined prevalence of specific diseases in the United States and the distributions of 

the population with respect to physical, physiological, and psychological characteristics; and (2) 

analysis of relationships among the various measurements without reference to an explicit finite 

universe of persons. 

Data from the Institutional Population Surveys.— Statistics relating to the health characteristics of 

persons in institutions, and on medical, nursing, and personal care received, based on national 

samples of establishments providing these services and samples of the residents or patients. 

Data from the Hospital Discharge Swvey. —Statistics relating to discharged patients in short-stay 

hospitals, based on a sample of patient records in a national sample of hospitals. 

Data on moYtality.—Various statistics on mortality other than as included in annual or monthly 

reports— special analyses by cause of death, age, and other demographic variables, also geographic 

and time series analyses. 

Data on natality, mavviage, &divoYce. —Various statistics onnatality, marriage, and divorce other 

than as included in annual or monthly reports— special analyses by demographic variables, also 

geographic and time series analyses, studies of fertility. 

Data from the National Natality and Movtality Szwveys. —Statistics on characteristics of births and 

deaths not available from the vital records, based on sample surveys stemming from these records, 

including such topics as mortality by socioeconomic class, medical experience in the last year of 

life, characteristics of pregnancy, etc. 

For a list of titles of reports published in these series, write to: office of Information 

National Center for Health Statistics 

U.S. Public Health Service 

Washington, D.C. 20201