Table 1. Individual-, County-, and State-Level Characteristics of the Sample.
| Characteristic | Neonates, No. (%) | P Value | |
|---|---|---|---|
| With NAS (n = 23 377) | Without NAS (n = 4 544 586) | ||
| Individual Level | |||
| Girls | 10 757 (46.0) | 2 216 340 (48.8) | <.001 |
| Race/ethnicity | |||
| Non-Hispanic white | 16 767 (71.7) | 2 328 723 (51.2) | <.001 |
| Non-Hispanic black | 2017 (8.6) | 464 336 (10.2) | |
| Hispanic | 1665 (7.1) | 800 758 (17.6) | |
| Other or unknown | 2928 (12.5) | 950 769 (20.9) | |
| Primary payer | |||
| Public | 19 026 (81.4) | 1 860 850 (40.9) | <.001 |
| Private | 3159 (13.5) | 2 375 452 (52.3) | |
| Uninsured or self-pay | 1192 (5.1) | 308 284 (6.8) | |
| Preterm delivery | 4332 (18.5) | 383 917 (8.4) | <.001 |
| County of Residence Levela | |||
| Rurality | |||
| Metropolitan | 20 323 (86.9) | 4 036 258 (88.8) | <.001 |
| Rural adjacent | 1128 (4.8) | 282 784 (6.2) | |
| Rural remote | 1926 (8.2) | 225 544 (5.0) | |
| Unemployment rateb | |||
| Top quartile | 8135 (34.8) | 1 118 260 (24.6) | <.001 |
| Other quartiles combined | 15 242 (65.2) | 3 426 326 (75.4) | |
| Substance use treatment programs for pregnant and postpartum women | |||
| Present | 19 983 (85.5) | 3 773 161 (83.0) | <.001 |
| Absent | 3394 (14.5) | 771 425 (17.0) | |
| State Level | |||
| Punitive policy statusc | |||
| No policy | 12 650 (54.1) | 2 356 001 (51.8) | <.001 |
| ≤1 y | 598 (2.6) | 275 606 (6.1) | |
| >1 y | 10 129 (43.3) | 1 912 979 (42.1) | |
| Reporting policy statusc | |||
| No policy | 12 520 (53.6) | 2 487 109 (54.7) | <.001 |
| ≤1 y | 2646 (11.3) | 225 790 (5.0) | |
| >1 y | 8211 (35.1) | 1 831 687 (40.3) | |
| State | |||
| Arkansas | 174 (0.7) | 230 133 (5.1) | <.001 |
| Arizona | 1610 (6.9) | 896 506 (19.7) | |
| Colorado | 1271 (5.4) | 751 843 (16.5) | |
| Utah | 4065 (17.4) | 401 651 (8.8) | |
| Nevada | 6702 (28.7) | 730 146 (16.1) | |
| Kentucky | 7181 (30.7) | 814 370 (17.9) | |
| Maryland | 1085 (4.6) | 416 256 (9.2) | |
| Massachusetts | 1289 (5.5) | 303 681 (6.7) | |
Abbreviation: NAS, neonatal abstinence syndrome.
a
Birth hospital county was used if neonate county of residence was unavailable (20 062 neonates [8.8%]).
b
Quartiles of county percentage of unemployment were divided as fourth quartile (highest), 8.1% to 29.9% unemployment; all other quartiles, 0.8% to 8.0% unemployment.
c
No policy represents a state-year that did not have the policy in effect or the year in which a policy went into effect; ≤1 y, the first full calendar year after the policy went into effect; and >1 y, more than 1 full calendar year after the policy went into effect.