Surveillance for Disparities in Maternal Health-Related Behaviors--Selected States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2000-2001

Phares, Tanya M.; Morrow, Brian; Lansky, Amy; Barfield, Wanda D.; Prince, Cheryl B.; Marchi, Kristen; Braveman, Paula; Williams, Letitia; Kinniburgh, Brooke

doi:10.1037/e307152005-001

Cited by 69 publications

(59 citation statements)

References 32 publications

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“…9 Most studies of maternal smoking focus on individual-level correlates, finding higher rates among women who are unmarried, US born, or who are of low socioeconomic status (SES). [9][10][11][12] A small, newly emerging body of research has begun to examine the contribution of neighborhood attributes to smoking patterns. [13][14][15][16][17][18][19] Results of these studies suggest contextual factors-including neighborhood socioeconomic disadvantage-play a role in smoking behavior over and above the role of individual-level attributes.…”

Section: Introductionmentioning

confidence: 99%

Associations Between Residential Segregation and Smoking During Pregnancy Among Urban African-American Women

et al. 2007

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Approximately 10% of African-American women smoke during pregnancy compared to 16% of White women. While relatively low, the prevalence of smoking during pregnancy among African-American women exceeds the Healthy People 2010 goal of 1%. In the current study, we address gaps in extant research by focusing on associations between racial/ethnic residential segregation and smoking during pregnancy among urban African-American women. We linked measures of segregation to birth certificates and data from the 2000 census in a sample of US-born AfricanAmerican women (n=403,842) living in 216 large US Metropolitan Statistical Areas (MSAs). Logistic regression models with standard errors adjusted for multiple individual observations within MSAs were used to examine associations between segregation and smoking during pregnancy and to control for important sociodemographic confounders. In all models, a u-shaped relationship was observed. Both low segregation and high segregation were associated with higher odds of smoking during pregnancy when compared to moderate segregation. We speculate that low segregation reflects a contagion process, whereby salutary minority group norms are weakened by exposure to the more harmful behavioral norms of the majority population. High segregation may reflect structural attributes associated with smoking such as less stringent tobacco control policies, exposure to urban stressors, targeted marketing of tobacco products, or limited access to treatment for tobacco dependence. A better understanding of both deleterious and protective contextual influences on smoking during pregnancy could help to inform interventions designed to meet Healthy People 2010 target goals.

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Section: Introductionmentioning

confidence: 99%

Associations Between Residential Segregation and Smoking During Pregnancy Among Urban African-American Women

et al. 2007

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“…In national datasets, WIC participants with college educations breastfeed significantly more often and at higher rates 15,22 ; however, consistent with Pregnancy Risk Assessment Monitoring Survey data for Hawaii, 6 education was not a significant factor in this sample. The age and parity (60% of the primiparous women were in the 21-29 age category) distributions mirrored national and state data trends.…”

Section: Characteristics Of the Samplementioning

confidence: 73%

“…According to the 2002 Pregnancy Risk Assessment Monitoring Survey data for Hawaii (N = 6251), the highest prevalence rates were found in Caucasian women (91.0%), Asian women (92.1%), and, unlike other Hawaiian breastfeeding surveys, Filipino women (918%). 6 Socioeconomic differences within the state sample were not a significant factor in the duration of breastfeeding. This finding is incongruent with the findings of other researchers who have reported decreased breastfeeding rates in national and state samples among lower socioeconomic status populations.…”

Section: Introductionmentioning

confidence: 99%

“…2,25 Nationally, EBF rates have been increasing in the general population 6 and among WIC participants. 15 26 and the enhanced efforts of WIC to promote breastfeeding.…”

Section: Ebf Patternmentioning

confidence: 99%

“…Some interpretation of who might be underserved may be projected from the maternal characteristics and breastfeeding rates collected in existing national and state databases; however, it is not a The breastfeeding initiation rate in Hawaii (89.6%) is higher than the national average (70%) and exceeds the 2010 Healthy People (2000) goals (≥75%). 2,6 Researchers have found that breastfeeding initiation for women of Hawaiian ancestry (64.0%) is well below state and national rates. 7 Healthy People 20108 sets a goal of 50% of mothers continuing to breastfeed at least 6 months; however, national rates (33%) are well below this target.…”

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Breastfeeding Patterns in a Community of Native Hawaiian Mothers Participating in WIC

Dodgson

Codier

Kaiwi³

et al. 2007

Family &Amp; Community Health

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Although Hawaii has high breastfeeding initiation rates (89%), Native Hawaiian WIC* participants have much lower initiation (64%) rates. Little is known about why these disparities occur. The study's aim was to describe the breastfeeding patterns of Hawaiian/part-Hawaiian women enrolled in the WIC who had initiated breastfeeding. Retrospective descriptive data (N = 200) were gathered from WIC records. Descriptive and parametric statistics with univariate and multivariate analysis of breastfeeding patterns were completed. Mothers exclusively breastfeeding at initiation weaned significantly later and were significantly more likely to breastfeed for 6 months than were mothers who partially breastfed. Practice and policy implications of these findings are discussed. Keywordsbreastfeeding; Native Hawaiian; Women; Infants and Children Supplemental Nutrition Program INCREASING breastfeeding initiation, exclusivity, and duration rates is a priority preventive health behavior and also a national public health goal. 1 The many infant health benefits of breastfeeding (eg, reduction in respiratory, gastrointestinal, and allergic conditions, childhood cancers, type I and type II diabetes later in life) are dose dependent; thus, infants exclusively breastfed for longer periods of time receive greater benefits. 2 Because of these increased benefits, the American Academy of Pediatrics 2 has recommended exclusive breastfeeding for the first 6 months and continued breastfeeding with the introduction of solid foods during the second 6 months of life. Improving children's health both in infency and in later life is possible by increasing the dose (exclusivity and duration) of breast milk during the first 6 months of life. Receiving appropriate and timely breastfeeding services has been shown to improve exclusivity and duration. 1 "Ensuring that breastfeeding mothers have access to comprehensive, up-to-date, and culturally tailored lactation services provided by trained physicians, nurses, lactation consultants and dietitians" (p19) is one of the recommendations made within the DHHS Blueprint for Action on Breastfeeding ,1 the document setting the national agenda concerning breastfeeding. Some interpretation of who might be underserved may be projected from the maternal characteristics and breastfeeding rates collected in existing national and state databases; however, it is not a The breastfeeding initiation rate in Hawaii (89.6%) is higher than the national average (70%) and exceeds the 2010 Healthy People (2000) goals (≥75%). 2,6 Researchers have found that breastfeeding initiation for women of Hawaiian ancestry (64.0%) is well below state and national rates. 7 Healthy People 20108 sets a goal of 50% of mothers continuing to breastfeed at least 6 months; however, national rates (33%) are well below this target. 2 In Hawaii again this rate is higher than national rates, except for Native Hawaiian and other Pacific Islander women. Many factors may influence the decreased rates (eg, increased teen pregnancies, higher rates o...

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Neighborhood Disadvantage, Race and Ethnicity, and Postpartum Depression

Onyewuenyi,

Peterman,

Zaritsky

et al. 2023

JAMA Netw Open

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ImportancePostpartum depression (PPD) is a debilitating condition with higher rates among Black individuals. Increasingly, neighborhood disadvantage is being recognized as a contributor to poor health and may be associated with adverse postpartum mental health; however, associations between neighborhood disadvantage, race and ethnicity, and PPD have not been examined.ObjectiveTo investigate the association between neighborhood disadvantage and PPD and evaluate the extent to which these associations may differ by race and ethnicity.Design, Setting, and ParticipantsThis population-based cross-sectional study included 122 995 postpartum Kaiser Permanente Northern California members 15 years or older with a live birth between October 7, 2012, and May 31, 2017, and an address in the electronic health record. Analyses were conducted from June 1, 2022, through June 30, 2023.ExposuresNeighborhood disadvantage defined using quartiles of the Neighborhood Deprivation Index (NDI), a validated census-based socioeconomic status measure; self-reported race and ethnicity ascertained from Kaiser Permanente Northern California electronic health records.Main Outcomes and MeasuresMultivariable Poisson regression was conducted to assess associations between neighborhood disadvantage, race and ethnicity, and a diagnosis of PPD.ResultsOf 122 995 included postpartum individuals, 17 554 (14.3%) were younger than 25 years, 29 933 (24.3%) were Asian, 8125 (6.6%) were Black, 31 968 (26.0%) were Hispanic, 47 527 (38.6%) were White, 5442 (4.4%) were of other race and ethnicity, and 15 436 (12.6%) had PPD. Higher neighborhood disadvantage and race and ethnicity were associated with PPD after covariate adjustment. Compared with White individuals, Black individuals were more likely to have PPD (adjusted relative risk [ARR], 1.30; 95% CI, 1.24-1.37), whereas Asian (ARR, 0.48; 95% CI, 0.46-0.50), and Hispanic (ARR, 0.92; 95% CI, 0.89-0.96) individuals and those identified as having other race and ethnicity (ARR, 95% CI, 0.90; 0.85-0.98) were less likely to have PPD. Associations between NDI and PPD differed by race and ethnicity (likelihood ratio test for interaction, χ212 = 41.36; P &lt; .001). Among Black individuals, the risk of PPD was the greatest overall and increased with neighborhood disadvantage in a dose-response manner (quartile [Q] 2 ARR, 1.39 [95% CI, 1.13-1.71]; Q3 ARR, 1.50 [95% CI, 1.23-1.83]; Q4 ARR, 1.60 [95% CI, 1.32-1.93]; Cochrane-Armitage test for trend, P &lt; .001). Neighborhood disadvantage was associated with PPD among Asian (Q2 ARR, 1.17 [95% CI, 1.04-1.31]; Q3 ARR, 1.20 [95% CI, 1.06-1.35]) and White (Q3 ARR, 1.14 [95% CI, 1.07-1.21]; Q4 ARR, 1.17 [95% CI, 1.09-1.26]) individuals and those of other race and ethnicity (Q3 ARR, 1.34 [95% CI, 1.09-1.63]; Q4 ARR, 1.28 [95% CI, 1.03-1.58]), but the magnitude of risk was lower. Neighborhood disadvantage was not associated with PPD among Hispanic individuals (eg, Q2 ARR, 1.04 [95% CI, 0.94-1.14]; Q3 ARR, 1.00 [95% CI, 0.91-1.10]; Q4 ARR, 0.98 [95% CI, 0.90-1.08]).Conclusions and RelevanceIn this cross-sectional study of postpartum individuals, residing in more disadvantaged neighborhoods was associated with PPD, except among Hispanic individuals. Neighborhood disadvantage may be associated with racial and ethnic differences in postpartum mental health. Geographic targeting of mental health interventions may decrease postpartum mental health inequities.

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Surveillance for Disparities in Maternal Health-Related Behaviors--Selected States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2000-2001

Abstract: depar depar depar depar department of health and human ser tment of health and human ser tment of health and human ser tment of health and human ser tment of health and human services vices vices vices vices

Cited by 69 publications

References 32 publications

Associations Between Residential Segregation and Smoking During Pregnancy Among Urban African-American Women

Associations Between Residential Segregation and Smoking During Pregnancy Among Urban African-American Women

Breastfeeding Patterns in a Community of Native Hawaiian Mothers Participating in WIC

Neighborhood Disadvantage, Race and Ethnicity, and Postpartum Depression

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