Provider and patient influences on the formation of socioeconomic health behavior disparities among pregnant women

Socially advantaged individuals are better positioned to benefit from advances in biomedicine, which frequently results in the emergence of social inequalities in health. I use survey and in-depth interviews with pregnant women and their health care providers from four Midwestern clinics in the United States, conducted in 2009 and 2010. I compare socioeconomic differences in intake of two new prenatal supplements: Vitamin D and omega-3 fatty acid. Although socioeconomic differences in omega-3 fatty acid supplementation emerged, there were no differences in the use of vitamin D. I argue that providers may have contributed to the prevention of a health disparity in vitamin D supplementation by implementing an aggressive uniform protocol. These results suggest that providers not only serve as a conduit for the dissemination of new biomedical information, the strength and uniformity of their recommendations have the potential to prevent or exacerbate socioeconomic differences in health behaviors.

► Advances in biomedical information can precipitate the emergence of disparities in health behaviors.
► Providers serve as a conduit for new information when they translate it into professional recommendations.
► Clinic-level protocol and provider recommendations may contribute to differences in patient decisions about health behaviors.
► Using data from a mixed-method study of pregnant women living in the United States, I explore use of two new supplements.
► The strength and uniformity of provider recommendations may prevent or exacerbate the formation of health disparities.