Purpose. Birth outcomes for women of Mexican-origin in the U.S. are often superior to other ethnic groups despite fewer economic resources, reduced access to health insurance, and limited prenatal care provisions. This health advantage typically diminishes by the second generation; however, recent studies suggest it may be regained by the third generation. The objectives of this exploratory study are to investigate generational variation in prenatal health by examining the demographic characteristics, health behaviors, and health care utilization patterns of pregnant women of Mexican-origin and to identify factors that contribute to disparities within and between generations.

Methods. Two waves of the California Health Interview Survey (CHIS 2001 and 2003) were merged to compare three groups of women of Mexican-origin who reported to be pregnant at the time of each survey on measures associated with low birth weight. The sample included first-generation women born in Mexico (n=211), second-generation women born in the U.S. with at least one parent born in Mexico (n=61), and third- or subsequent generation U.S. born women who reported to be of Mexican ethnicity and whose parents were not born in Mexico (n=29). Regression techniques, non-parametric tests, and inferential statistics were used to analyze the data.

Findings. Women born in Mexico were significantly older, had lower levels of educational attainment, and were more likely to be living at 0-99% of the federal poverty level when compared with other groups. Educational attainment and poverty level were significantly associated with English proficiency among Spanish speakers. While there was little difference in the work status of second- and third-generation respondents, the majority of first-generation women were not working at the time of the interview. Despite socioeconomic disadvantage, Mexican-born women were significantly more likely to report better overall health and less lifetime smoking when compared to other groups. Many also reported chronic physical problems, food insecurity and hunger due to poverty. Third-generation women smoked and consumed alcohol more often than other groups but were less likely to be food insecure. Access to a usual source of care, medical and dental insurance coverage, and the frequency of doctor visits increased with generational status. However, first-generation women, who were less likely to use all forms of public assistance when compared to other groups, were significantly more likely to enroll in the Women, Infants, and Children (WIC) program when controlling for poverty level.

Implications. This exploratory study of CHIS data confirms patterns previously observed among first and second-generation women of Mexican-origin and presents new information about trends among the third- and subsequent generation. Health behaviors represent important sites for intervention among the third-generation while WIC continues to be an important resource for poor women without access to usual medical care. While a substantive body of prior research has identified a number of risk factors for poor birth outcomes, significant disparities within and between ethnic groups in the U.S. have yet to be fully explained. Additional research is necessary to determine the mechanisms that underlie markers such as language, culture, and socioeconomic status.