No abstract

In 2001, the nation experienced its first bioterrorism attack, in the form of anthrax sent through the U.S. Postal Service, and public health professionals were challenged to communicate with a critical audience, U.S. postal workers. Postal workers, the first cohort to receive public health messages during a bioterrorist crisis, offer a crucial viewpoint that can be used in the development of best practices in crisis and emergency risk communication. This article reports results of qualitative interviews and focus groups with 65 postal workers employed at three facilities: Trenton, New Jersey; New York City; and Washington, DC. The social context and changing messages were among the factors that damaged trust between postal workers and public health professionals. Lessons learned from this attack contribute to the growing body of knowledge available to guide communications experts and public health professionals charged with crisis and emergency risk communication with the public.

This paper analyzes the experiences of an Early Head Start (EHS) program in adopting and implementing an infant mental health (IMH) approach in its work with community families. Through qualitative methods (participant observation, qualitative interviews, and case studies), we examined the strategies used, and the challenges encountered, by program staff as they applied IMH principles in their home-visiting interventions with families whose lives involve significant economic, social, and psychological stressors. Our study identified four elements crucial to an effective IMH initiative: (1) teamwork, especially the use of transdisciplinary teams to review family cases, (2) reflective supervision, (3) development of an integrated and empathic understanding of the child's needs and the parent's challenges in meeting those needs, and (4) a dynamic ecological understanding of children, families, and communities in which psychosocial and socioeconomic factors are viewed as mutually important and interactive. We argue that each of these elements both builds on and enhances long-standing dimensions of this EHS program's family support approach, creating an innovative and integrated model of IMH and family support that could prove of value in many community-based programs serving children and families whose emotional health is affected by everyday experiences of economic and social inequality.

Racial differences in school readiness are a form of health disparity. By examining, from the perspective of low-income minority families participating in an Early Head Start study, community and policy environments as they shape and inform lived experiences, we identified several types of social and economic dislocation that undermine the efforts of parents to ready their children for school. The multiple dislocations of community triggered by housing and welfare reform and "urban renewal" are sources of stress for parents and children and affect the health and development of young children. Our findings suggest that racial differences in school readiness result not from race but from poverty and structural racism in American society.