Medicine and Health Sciences Commons^™

Community Health Workers, Stress Reduction, And Racial Equity In Infant Vitality, Justin Rex

ICS Fellow Lectures

How can communities help mothers reduce stress during pregnancy and provide the social supports that contribute to infant vitality? This talk presented findings from an evaluation of the Northwest Ohio Pathways HUB program, a nationally recognized best practice program model that pairs at-risk mothers with community health workers (CHWs) who connect mothers to services that reduce pregnancy risks. The talk included stories from mothers and CHWs about the challenges and stresses they face as well as data from interviews and surveys that quantify the impact CHWs have for reducing mothers' stress and providing supports that help mothers and their children …

Assessment Of Knowledge And Attitudes Toward Determinants Of Infant Mortality In Head Start Teachers, Teacher Aides, Caregivers, And Family Support Workers, Susan Mayfield-Johnson Phd, Mches, Danielle Fastring Phd, Stephanie T. Mcleod Mph

Journal of Public Health in the Deep South

IMR (11.9 infant deaths per 1,000 live births) almost twice the rate observed in (6.2 infant deaths per 1,000 live births). Objectives. The purpose of this project was to assess Head Start teachers’, teacher aides’, caregivers’, and family support workers’ perceptions, knowledge, attitudes, values and beliefs on topics (nutrition, exercise, breastfeeding, safe sleep, smoking, stress, postpartum depression, and mental health) related to infant mortality prevention in a Mississippi Gulf Coast Head Start consortium. Methods. A 47-item questionnaire was developed that focused on areas associated with primary prevention of infant mortality. Results. Participants (n=82) ages were 25 to 44 years of …

Births In The Mountain West, 2016-2020, Corryn Richardson, Hira Ahmed, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines state-level data on births and health indicators from the National Center for Health Statistics (NCHS), a government health statistics unit of the Center for Disease Control and Prevention (CDC). This fact sheet presents data related to births in the Mountain West states of Arizona, Colorado, New Mexico, Nevada, and Utah.

Neonate, Infant, And Child Mortality In North Africa And Middle East By Cause: An Analysis For The Global Burden Of Disease Study 2019, Sadaf G. Sepanlou, Hossein Rezaei Aliabadi, Reza Malekzadeh, Ali. A. Asadi-Pooya

Global Health Articles

Background: During the past three decades, neonate, infant, and child mortality declined in North Africa and Middle East. However, there is substantial heterogeneity in mortality rates across countries.

Methods: This study is part of the Global Burden of Diseases study (GBD) 2019. We report the number as well as mortality rates for neonates, infants, and children by cause across 21 countries in the region since 1990.

Results: Between 1990 and 2019, the neonate mortality rate in the region declined from 31.9 (29.8, 34.0) to 12.2 (11.1, 13.3) per 1000 live births. Respective figures for under 5 mortality rates (U5MRs) were …

Impact Of Coalition Building To Promote Maternal Infant Health Equity In The District Of Columbia, Maryland, And Virginia, Sydney J. Turner

Capstone Experience

The health of women and babies is critical to creating a healthy world. Stratified data shows the overwhelming rates at which Blacks are affected more than Whites. Literature has shown that leveraging partnerships and community engagement are critical components of decision-making and can positively impact the health of communities. Through a direct observational study, the Community Coalition Action Theory was used to analyze the current structure of the March of Dimes Maternal Infant Healthy Equity Coalition. The study aimed to identify strengths and gaps and subsequently provide recommendations to advance the coalition work and promote maternal and infant health equity …

When Keeping It Real Is Required: Challenging The Pandemic Of Racism In Lactation Land, Tameka Jackson-Dyer

Journal of Health Disparities Research and Practice

Human milk is the optimal source of nutrition for infants, but few are able to provide their milk to their babies for the minimum twelve months recommended by health experts. This is especially true for Black women. Due to structural racism embedded in medical care, implicit bias of healthcare providers and generational traumas that began during American chattel slavery, Black women are less likely than every other ethnic group to initiate breastfeeding. Those that do are often sabotaged by unsupportive systems and lack of access to clinically-skilled, culturally respectful lactation consultants. Calling out the racism that exists in Lactation Land …

The Global Network Socioeconomic Status Index As A Predictor Of Stillbirths, Perinatal Mortality, And Neonatal Mortality In Rural Communities In Low And Lower Middle Income Country Sites Of The Global Network For Women's And Children's Health Research, Archana B Patel, Carla M Bann, Cherryl S Kolhe, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Lester Figueroa, Nancy F Krebs, Fabian Esamai, Sherri Bucher, Sarah Saleem, Robert L Goldenberg, Elwyn Chomba, Waldemar A Carlo, Shivaprasad Goudar, Richard J Derman, Marion Koso-Thomas, Elizabeth M Mcclure, Patricia L Hibberd

Global Health Articles

BACKGROUND: Globally, socioeconomic status (SES) is an important health determinant across a range of health conditions and diseases. However, measuring SES within low- and middle-income countries (LMICs) can be particularly challenging given the variation and diversity of LMIC populations.

OBJECTIVE: The current study investigates whether maternal SES as assessed by the newly developed Global Network-SES Index is associated with pregnancy outcomes (stillbirths, perinatal mortality, and neonatal mortality) in six LMICs: Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan, and Zambia.

METHODS: The analysis included data from 87,923 women enrolled in the Maternal and Newborn Health Registry of the NICHD-funded …

Midwifery Care's Potential To Improve Birth Outcomes And Experiences For Black Women And Infants, Neville Wintergerst-Burch

Undergraduate Theses

Black women and infants experience higher morbidity and mortality rates compared to white women and infants in the United States. Forces of systemic racism and poverty often lead to inadequate access to prenatal care for Black women, and care received is often compromised by implicit bias or barriers related to insurance coverage, impersonal provider-patient relationships, and poor healthcare literacy. Despite the rich history of Black Granny midwives in the United States, most Black women began using physicians for obstetric care in the 20th and 21st centuries. This integrative review explores how improving access to midwifery care for Black women could …

Risk Factors Of Infant Mortality Among Sub-Saharan Immigrants In The United States, Roland Lankah

Walden Dissertations and Doctoral Studies

While prepregnancy body mass index (BMI), gestational weight gain (GWG), and birthplace have been suggested to play a key role in predicting infant mortality outcomes, they have not been thoroughly investigated across all races/ethnicities. The purpose of this study was to examine the associations between prepregnancy BMI, GWG, birthplace as independent variables, and infant mortality as the outcome variable within the United States Sub-Saharan African Immigrants (SSAI). A quantitative cross-sectional study design grounded in the biopsychosocial model was used. Data were extracted from the 2017-2018 natality-linked birth/infant death file from the Centers for Disease Control and Prevention Wonder Database. It …

Factors Affecting The Rates Of Childhood Poverty In Tennessee, Aleeya F. Shareef

Scholarship in Medicine - All Papers

Objective: The goal of this investigation is to analyze data to determine the factors that influence childhood poverty in Tennessee. Specifically, I am examining how child poverty has changed over the past years, as well as determining its associations with residential segregation (Black/white), food insecurity, teen births, low birthweights, child and infant mortalities, drug overdose deaths, access to healthy foods, premature deaths, and uninsured children. Data was used from the County Health Rankings website. Their data has been collected from surveys. Paired t-tests, unpaired t-tests, Pearson correlations, and stepwise linear regressions were performed. Results indicated that Tennessee has had decreased …

Accelerating The Provision Of Safe Water Supply In Urban And Rural Areas Of Indonesia, Sumengen Sutomo, Salord Sagala, Bebi Sutomo, Sri Winarti, Gelant Sanjaya

Kesmas

Over the past 100 years, the provision of a safe water supply to drink in Indonesia has been slowly progressed with low coverage. The majority of the population does not have access to safe water. Morbidity and mortality of water-related diseases, including diarrhea, are very high. The provision of safe water is not a technological issue but good water management that comprises content, institutional, and communication layer. This paper provided information for strategic and operational decisions to accelerate the provision of safe water services in urban and rural areas. Benchmarking good water management with the characteristics of the water supply …

Perinatal Periods Of Risk: Examination Of Data Quality & Inclusion Criteria, New Unbiased Reference Groups, And A Nationwide County-Level Analysis, Carol S. Gilbert

Theses & Dissertations

Records of births, infant deaths, and fetal deaths are compiled by the US Vital Records System and used to monitor population health and guide health policy. The Perinatal Periods of Risk Approach (PPOR) relies on vital records data to address fetal and infant mortality in US cities. It uses reference groups to estimate preventable mortality by risk period. To avoid biased analyses due to poor data quality for small and early infant and fetal deaths, an expert committee recommended that PPOR analyses exclude fetal deaths delivered at gestational age (GA) <24 >weeks, and infant deaths and live births with birthweights (BW) …

Community Health Assessment: Kalamazoo, Kathleen Bolter, Jim Robey, Gerrit Anderson

Reports

No abstract provided.

Community Health Assessment: Van Buren County, Kathleen Bolter, Jim Robey, Gerrit Anderson

Reports

No abstract provided.

A Public Health Approach For Deciding Policy On Infant Feeding And Mother-Infant Contact In The Context Of Covid-19, Nigel Rollins, Nicole Minckas, Fyezah Jehan, Rakesh Lodha, Daniel Raiten, Claire Thorne, Philippe Van De Perre, Mija Ververs, Neff Walker, Rajiv Bahl

Department of Paediatrics and Child Health

The COVID-19 pandemic has raised concern about the possibility and effects of mother-infant transmission of SARS-CoV-2 through breastfeeding and close contact. The insufficient available evidence has resulted in differing recommendations by health professional associations and national health authorities. We present an approach for deciding public health policy on infant feeding and mother-infant contact in the context of COVID-19, or for future emerging viruses, that balances the risks that are associated with viral infection against child survival, lifelong health, and development, and also maternal health. Using the Lives Saved Tool, we used available data to show how different public health approaches …

Fetal/Infant Mortality: Understanding Race And Ethnicity, Birthing Location, And Prenatal Care, Chelsea Collum

Walden Dissertations and Doctoral Studies

This study addressed whether race and ethnicity, birthing location, the month the mother begins prenatal care, and pregnancy risk level impact fetal/infant mortality. Infant mortality is a gauge by which the efficacy of the healthcare system and the overall health of the country is measured. The United States falls behind most other developed countries in terms of infant mortality rates. The ecological perspective was used as the theoretical framework. The study design was a cross-sectional cohort design using a sample of births and infant deaths from U.S. Vital Statistics data. Binomial logistic regression analyses were carried out to calculate odds …

Racial Disparities Among Black Women In Maternal Health: A Literature Review, Tatiyana Rich

Honors Undergraduate Theses

African American women are at a higher risk of experiencing maternal health complications than women of other races. Determining the factors that contribute to the severity of their maternal health complications can help bring awareness and exposure to the disparities among black women in maternal health. The purpose of this study was to explore the various elements that contribute to the high pregnancy mortality ratio and infant mortality ratio in black women and black infants. The secondary purpose was to determine the relationship between stereotypes about African American women as healthcare consumers and the disproportionate percentage of black women experiencing …

Black Midwifery In The United States: Past, Present, And Future, Alicia Suarez

Sociology & Anthropology Faculty publications

While sociologists have long explored health and illness, much of it has been androcentric and White-centered. Scholars began to focus more on women’s health including pregnancy and birth in the 1970s yet have historically largely ignored Black women’s birth experiences. Midwifery in the United States was once the standard practice for prenatal care and birth. However, the vast majority of births have been medicalized and now occur in hospital settings. In this review, I will highlight the role of race in the historical shifts in the provision of care to Black pregnant and birthing women, the marginalization of Black midwives …

Non-Adherence To Who Recommendations Regarding Infant Feeding Practices Results In Dilemma Of Malnourishment: A Community-Based Prospective Cohort Study Conducted In Karachi, Pakistan, Muhammad Osama, Anosh Aslam Khan, Sohaib Hasan Syed, Osama Mohiuddin, Ammar Hassan, Syeda Ramsha Zaidi, Neelofar Sami

Community Health Sciences

Background: The prevalence of chronic malnutrition and its associated morbid outcomes has been a significant cause of health loss globally, affecting millions of children hampering their mental, physical, social, and immune system development. World Health Organization's (WHO) recommendations presenting infant feeding guidelines have largely controlled this burden. However, developing countries including Pakistan have failed to promote these guidelines and still succumb to a huge burden of morbidity and mortality secondary to malnourishment among infants.
Methodology: Our study is a prospective cohort including 300 infants without predisposing congenital anomaly, followed from 6 months to 18 months of age. The primary outcome …

Laws Restricting Access To Abortion Services And Infant Mortality Risk In The United States, Roman Pabayo, Amy Ehntholt, Daniel M. Cook, Megan Reynolds, Peter Muennig, Sze Yan Liu

Department of Public Health Scholarship and Creative Works

Objectives: Since the US Supreme Court′s 1973 Roe v. Wade decision legalizing abortion, states have enacted laws restricting access to abortion services. Previous studies suggest that restricting access to abortion is a risk factor for adverse maternal and infant health. The objective of this investigation is to study the relationship between the type and the number of state-level restrictive abortion laws and infant mortality risk. Methods: We used data on 11,972,629 infants and mothers from the US Cohort Linked Birth/Infant Death Data Files 2008–2010. State-level abortion laws included Medicaid funding restrictions, mandatory parental involvement, mandatory counseling, mandatory waiting period, and …

Substantial And Sustained Reduction In Under-5 Mortality, Diarrhea, And Pneumonia In Oshikhandass, Pakistan: Evidence From Two Longitudinal Cohort Studies 15 Years Apart, C L. Hansen, B J J. Mccormick, Iqbal Azam Syed, K Ahmed, J M. Baker, E Hussain, A Jahan, A F. Jamison, N Samji, Oshikhandass Diarrhea And Pneumonia Project, Anita K. M. Zaidi, Ahmed Jan

Community Health Sciences

Background: Oshikhandass is a rural village in northern Pakistan where a 1989-1991 verbal autopsy study showed that diarrhea and pneumonia were the top causes of under-5 mortality. Intensive surveillance, active community health education and child health interventions were delivered in 1989-1996; here we assess improvements in under-5 mortality, diarrhea, and pneumonia over this period and 15 years later.
Methods: Two prospective open-cohort studies in Oshikhandass from 1989 to 1996 (Study 1) and 2011-2014 (Study 2) enrolled all children under age 60 months. Study staff trained using WHO guidelines, conducted weekly household surveillance and promoted knowledge on causes and management of …

The Influence Of Education On Health: An Empirical Assessment Of Oecd Countries For The Period 1995–2015, Viju Raghupathi, Wullianallur Raghupathi

Publications and Research

Background: A clear understanding of the macro-level contexts in which education impacts health is integral to improving national health administration and policy. In this research, we use a visual analytic approach to explore the association between education and health over a 20-year period for countries around the world.

Method: Using empirical data from the OECD and the World Bank for 26 OECD countries for the years 1995–2015, we identify patterns/associations between education and health indicators. By incorporating pre- and post- educational attainment indicators, we highlight the dual role of education as both a driver of opportunity as well as of …

Infant Death Rates Between Different Medical Attendants, Zenab Saeed

Scholarship in Medicine - All Papers

The function of midwives in the context of maternal health is important, especially when understanding the role of midwives in a global context compared to in the United States. Globally, midwives have served as historically important members in the process of childbirth, but their role has experienced changes in response to increased medicalization over the years, especially in the United States.1 Based of their use and effectiveness in a global context, literature suggests that it may be beneficial for both the healthcare system, mothers, and infants to expand the role of midwives in the United States.2 The purpose of this …

Factors Influencing Infant Death Due To Respiratory Syncytial Virus, Michelle Adamczyk

Scholarship in Medicine - All Papers

Objective: Determine what factors are associated with increased mortality in infants <1 year old due to respiratory syncytial virus. Methods: Using publicly accessible infant mortality data from CDC Wonder, I used z-scores to compare infant death rates due to RSV between different groups including levels of prematurity, birth weight, and race. Results: When compared by race, mortality rates were highest for infants with mothers who are American Indian or Alaska Natives, followed by infants with Black mothers, and lowest for infants with White or Asian mothers. Infants born with lower weight at birth had higher mortality rates by RSV than infants with higher birth weights. Infants born prematurely, especially at <28 weeks gestation had higher RSV mortality rates. When compared by geographic region, RSV mortality rates were highest in the Southern U.S.. Sorting by mother’s age, infants born to younger mothers, especially mothers <20 years old had higher mortality rates due to RSV. These findings align with previous research focusing on RSV mortality and overall trends in epidemiological factors influencing infant mortality.

Injury-Related Infant Mortality In West Virginia, 2010-2014, Wilson A. Koech

Graduate Theses, Dissertations, and Problem Reports

Background and objective

Infant mortality in United States is high relative to other more developed nations. Therefore, there is a need to curb this trend, especially in states with high infant mortality rates. Hence, this research investigated and examined characteristics associated with injury-related infant death in West Virginia. The objective of this retrospective study was to 1) investigate maternal and infant characteristics associated with injury-related infant deaths in West Virginia, 2) examine the relationship between unintentional-injury-related infant death and rurality in West Virginia, holding other variables in the model constant, and 3) compare differences in the unintentional-injury related infant mortality …

Structural Racism And Odds For Infant Mortality Among Infants Born In The United States 2010, Roman Pabayo, Amy Ehntholt, Kara L. Davis, Sze Yan Liu, Peter Muening, Daniel Cook

Sze Yan Liu

Abstract

OBJECTIVES:

While ecological studies indicate that high levels of structural racism within US states are associated with elevated infant mortality rates, studies using individual-level data are needed. To determine whether indicators of structural racism are associated with the individual odds for infant mortality among white and black infants in the US.

METHODS:

We used data on 2,163,096 white and 590,081 black infants from the 2010 US Cohort Linked Birth/Infant Death Data Files. Structural racism indicators were ratios of relative proportions of blacks to whites for these domains: electoral (registered to vote and voted; state legislature representation), employment (civilian labor …

Structural Racism And Odds For Infant Mortality Among Infants Born In The United States 2010, Roman Pabayo, Amy Ehntholt, Kara L. Davis, Sze Yan Liu, Peter Muening, Daniel Cook

Department of Public Health Scholarship and Creative Works

Abstract

OBJECTIVES:

While ecological studies indicate that high levels of structural racism within US states are associated with elevated infant mortality rates, studies using individual-level data are needed. To determine whether indicators of structural racism are associated with the individual odds for infant mortality among white and black infants in the US.

METHODS:

We used data on 2,163,096 white and 590,081 black infants from the 2010 US Cohort Linked Birth/Infant Death Data Files. Structural racism indicators were ratios of relative proportions of blacks to whites for these domains: electoral (registered to vote and voted; state legislature representation), employment (civilian labor …

Evaluation Of Maternal Mortality In The United States Using A Socio-Ecological Model, Ashley Dang

Global Honors Theses

The United States has the most alarming rates of maternal mortality compared to other developed nations. An important factor to discuss with maternal issues and delivery is the racial disparities between African-American women and white women; the CDC states that pregnancy-related deaths for African-American women are three to four times higher than white women. Institutional racism and implicit bias are important factors when discussing African-American patients and healthcare providers in medicine. The focus of this thesis will examine current solutions to reduce maternal mortality in the United States through a Socio-Ecological Model, as well as discuss the racial disparities that …

Women’S Experiences With Prenatal Care: A Mixed-Methods Study Exploring The Influence Of The Social Determinants Of Health, Karen A. D'Angelo, Janelle K. Bryan, Brenda Kurz

Janelle K. Bryan

Background & Purpose: Racial and ethnic disparities pervade birth outcomes in the United States and the state of Connecticut. While Connecticut’s infant mortality rate is less than the national average, rates for the state’s Black/African American and Hispanic/Latino communities exceed it. This study explored how prenatal care in Connecticut may be enhanced to address these disparities.

Methods: In spring 2013, seven focus groups and two semi-structured interviews were conducted (n=47). Participants also self-administered brief surveys. Recruited by local service providers, participants were 18 or older, pregnant and/or in the first year post-partum at the time. Most self-identified as …

Early Neonatal Vitamin A Supplementation And Infant Mortality: An Individual Participant Data Meta-Analysis Of Randomised Controlled Trials, Rajiv Bahl, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Biannual vitamin A supplementation is a well-established survival tool for preschool children 6 months and older in vitamin A deficient populations but this schedule misses the opportunity to intervene on most young infant deaths. Randomised trials of neonatal vitamin A supplementation (NVAS) in the first few days of life to assess its impact on under 6-month mortality in low/middle-income countries have had varying results.
Methods: Investigators of 11 published randomised placebo-controlled NVAS trials (n=163 567 children) reanalysed their data according to an agreed plan and pooled the primary outcomes of mortality from supplementation through 6 and 12 months of …