Neighborhood Disadvantage and Neighborhood Affluence: Associations with Breastfeeding Practices in Urban Areas

Yourkavitch, Jennifer; Kane, Jennifer B.; Miles, Gandarvaka

doi:10.1007/s10995-017-2423-8

Cited by 25 publications

(24 citation statements)

References 27 publications

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“…Finally, the results of the spatial regression models in Table 2 confirm much of the existing literature on breastfeeding initiation, continuation, and community characteristics (Grubesic & Durbin, 2016; Ruffin & Renaud, 2015; Yourkavitch, Kane, & Miles, 2018), suggesting that less diverse locales with higher levels of education, lower levels of unemployment, and more IBCLCs initiate and continue to breastfeed at rates higher than rates of their peers. When interpreting these results, it is important to reiterate that they are representative for the overall state but not for individual mothers.…”

Section: Discussionsupporting

confidence: 71%

A Spatial Analysis of Breastfeeding and Breastfeeding Support in the United States: The Leaders and Laggards Landscape

Grubesic

Durbin

2019

J Hum Lact

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Background: To better track progress in achieving the Healthy People 2020 goals, the Centers for Disease Control and Prevention (CDC) publishes an annual Breastfeeding Report Card (BRC) that represents a compilation of data on breastfeeding practices in all states. With data drawn from the CDC National Immunization Survey, the BRC provides an especially valuable source of information about geographic trends in breastfeeding and related support activities. Research aim: This study aimed to identify important geographic trends in both breastfeeding practices and support structures in the United States, highlighting their spatial disparities. Methods: Exploratory spatial data analysis, including local indicators of spatial association, is combined with spatial regression models to highlight geographic variations in breastfeeding practices and support. Results: Geographic variation in both breastfeeding practices and allied support exists within the United States. Geographic hot spots of breastfeeding are found in the western and northeastern sections of the United States, and cool spots are located primarily in the Southeast. Regression results suggested that unemployment and demographic diversity are negatively associated with breastfeeding rates, whereas higher education and the presence of International Board Certified Lactation Consultants® (IBCLCs®) are positively connected to persistent breastfeeding practices. Further, although the availability of professional support (IBCLC) strengthened nationwide between 2011 and 2016, the availability of mother-to-mother support (La Leche League) softened. Conclusion: Although breastfeeding initiation rates continue to increase in the United States, rates of exclusive breastfeeding at 3 and 6 months remain low, displaying significant geographic variation. The ability to pinpoint lagging regions can help to efficiently allocate additional breastfeeding support resources and interventions.

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Section: Discussionsupporting

confidence: 71%

A Spatial Analysis of Breastfeeding and Breastfeeding Support in the United States: The Leaders and Laggards Landscape

Grubesic

Durbin

2019

J Hum Lact

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“…significantly increased. No effect on Any BF at 3&6 mo Low Yourkavitch et al [ 47 ] Data sets Design: Retrospective Data: New Jersey birth certificate and medical records data EBF sample, N = 26,287: W = 60%;AA = 10%;H = 20%; A/PI = 10%. Any BF, N = 54,117:W = 43%;AA = 13%;H = 33%; A/PI = 12% Neighborhood (NBHD) disadvantage versus affluence EBF decreased as NBHD disadvantage increased only for Asian, AA, and H. EBF increased as NBHD affluence increased for H and W. Any BF decreased as NBHD disadvantage increased among H and W. Low a 8 laws: 1) BF exempt from indecency laws, 2) laws allowing women to BF in public/private locations, 3) laws to exempt BF women from jury duty, 4) laws to encourage BF awareness campaigns, 5) laws allowing a reasonable unpaid breaktime from work to express milk, 6) laws requiring a sanitary space at work to express milk, 7) enforcement of workplace pumping laws and 8) enforcements of public BF laws.…”

Section: Resultsmentioning

confidence: 99%

“…The last study, a retrospective observational design by Yourkavitch et al [ 47 ], assessed the relationship between living in neighborhoods with different levels of disadvantage and affluence and BF outcomes. The study used 2006 birth certificate data linked to census tracks in New Jersey.…”

Section: Resultsmentioning

confidence: 99%

Impact of breastfeeding interventions among United States minority women on breastfeeding outcomes: a systematic review

Segura‐Pérez

Hromi‐Fiedler²,

Adnew³

et al. 2021

Int J Equity Health

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Background In the U.S., strong ethnic/racial, socioeconomic, demographic, and geographic breastfeeding (BF) inequities persist, and African American and Hispanic women are less likely to meet their breastfeeding goals compared to White women. This systematic review (SR) was designed to answer the question: What is the impact of breastfeeding interventions targeting ethnic/racial minority women in the U.S. on improving BF initiation, duration and exclusivity rates? Methods The SR was conducted following the Institute of Medicine Guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The study protocol was developed and registered a priori in PROSPERO (ID#CRD42020177764). The electronical databases searched was MEDLINE All (Ovid). Search strategies were led by the team’s expert public health librarian using both controlled vocabulary and free text queries and were tested against a validated set of relevant papers included in existing reviews. The GRADE methodology was used to assess the quality of the studies. Results We included 60 studies that had randomized (n = 25), observational (n = 24), quasi-experimental (n = 9), or cross-sectional (n = 2) designs. The studies focused on populations that were multi-ethnic/racial (n = 22), only Hispanic (n = 24), only Black (n = 13), and only American Indian (n = 1). The study interventions were classified following the socioecological model: macrosystem/policy level (n = 6); community level (n=51), which included healthcare organizations (n = 34), The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (n = 9), and community organizations/public health institutions (n = 8); and interpersonal level (n = 3). Conclusions Policy and community level interventions delivered through WIC, healthcare facilities, and community agencies) are likely to improve BF outcomes among women of color. The combination of interventions at different levels of the socioecological model has not been studied among minority women in the U.S. Implementation science research is needed to learn how best to scale up and sustain effective BF interventions, taking into account the needs and wants of minority women. Thus, it is strongly recommended to conduct large scale implementation research studies addressesing how to strengthen the different health and social environments surrounding women of color in the U.S. to improving their BF outcomes.

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“…Race is associated with breastfeeding rates in the United States. [1][2][3][4][5][6] Populations in the American South suffer from high rates of infant mortality 7,8 and chronic illness. [9][10][11] The South also has some of the nation's greatest racial and/or ethnic breastfeeding disparities.…”

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confidence: 99%

Addressing Racial Inequities in Breastfeeding in the Southern United States

Merewood

Bugg²,

Burnham

et al. 2019

Pediatrics

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BACKGROUND: Race is a predictor of breastfeeding rates in the United States, and rates are lowest among African American infants. Few studies have assessed changes in breastfeeding rates by race after implementing the Ten Steps to Successful Breastfeeding (hereafter referred to as the Ten Steps), and none have assessed the association between implementation and changes in racial disparities in breastfeeding rates. Our goal was to determine if a hospital-and community-based initiative in the Southern United States could increase compliance with the Ten Steps, lead to Baby-Friendly designation, and decrease racial disparities in breastfeeding. METHODS: Hospitals in Mississippi, Louisiana, Tennessee, and Texas were enrolled into the Communities and Hospitals Advancing Maternity Practices initiative from 2014 to 2017 and received an intensive quality improvement and technical assistance intervention to improve compliance with the Ten Steps. Community partners and statewide organizations provided parallel support. Hospitals submitted monthly aggregate data stratified by race on breastfeeding, skin-to-skin care, and rooming in practices. RESULTS: The disparity in breastfeeding initiation between African American and white infants decreased by 9.6 percentage points (95% confidence interval 1.6-19.5) over the course of 31 months. Breastfeeding initiation increased from 66% to 75% for all races combined, and exclusivity increased from 34% to 39%. Initiation and exclusive breastfeeding among African American infants increased from 46% to 63% (P , .05) and from 19% to 31% (P , .05), respectively. Skin-to-skin care after cesarean delivery was significantly associated with increased breastfeeding initiation and exclusivity in all races; rooming in was significantly associated with increased exclusive breastfeeding in African American infants only. CONCLUSIONS: Increased compliance with the Ten Steps was associated with a decrease in racial disparities in breastfeeding.

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Neighborhood Disadvantage and Neighborhood Affluence: Associations with Breastfeeding Practices in Urban Areas

Cited by 25 publications

References 27 publications

A Spatial Analysis of Breastfeeding and Breastfeeding Support in the United States: The Leaders and Laggards Landscape

A Spatial Analysis of Breastfeeding and Breastfeeding Support in the United States: The Leaders and Laggards Landscape

Impact of breastfeeding interventions among United States minority women on breastfeeding outcomes: a systematic review

Addressing Racial Inequities in Breastfeeding in the Southern United States

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