Submit to IJERPH Review for IJERPH Propose a Special Issue

Journal Menu

Journal Browser

Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Published Papers

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Children's Health".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 49590

Share This Special Issue

Special Issue Editors

Dr. Maeve Wallace

E-Mail Website
Guest Editor

Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112, USA
Interests: maternal and child health; health equity; social determinants

Dr. Rachel Hardeman

E-Mail Website
Guest Editor

Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware St SE, MMC 729 Mayo, Minneapolis, MN 55455, USA
Interests: maternal and child health; sexual and reproductive health; health equity; structural racism; population health; medical education

Dr. Whitney Rice

E-Mail Website
Assistant Guest Editor

Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road, GCR 538, Atlanta, GA 30322, USA
Interests: HIV/AIDS prevention; health policy; maternal and child health; health services research; reproductive health; women’s health

Ms. Brigette Davis

E-Mail Website
Assistant Guest Editor

Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
Interests: structural determinants of health inequities; racism; trauma; community health and resilience; maternal and child health

Dr. Dara Mendez

E-Mail Website
Assistant Guest Editor

Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, 30 DeSoto Street, 5130 Parran Hall Pittsburgh, Pittsburgh, PA 15261, USA
Interests: pregnancy; birth; women's health

Special Issue Information

Dear Colleagues,

The health of women and children reflects the health of a nation. Yet, in countries across the globe—including the US—reproduction represents a potentially dangerous experience: maternal and infant mortality rates remain unacceptably high, maternal morbidity and other adverse maternal and child health outcomes continue to occur. The persistence of these health challenges, despite increased health care spending, improved access to care, and decades of public health and clinical research, suggests the need to explore more deeply rooted fundamental causes. These are features of the places where women are born, live, work, and play; the policies that shape those places as protective or harmful to health; and the very structure and functioning of a society that dictates the distribution of power and resources across the population.

Moreover, the persistence of vast inequities in maternal and child health outcomes reflects an ongoing failure to confront the reality of life in a stratified society, one where governance, policy, cultural, and societal norms and values are fundamentally shaped by structural racism, class, and gender oppression. Research is needed in order to illuminate how maternal and child population health inequities are a reflection of these conditions and how best to eliminate them.

This Special Issue seeks manuscripts that identify social, structural, and/or policy determinants of maternal and child health and health inequities. We welcome the submission of manuscripts that explore how maternal and child health outcomes and inequities are part of and inseparable from the contexts in which they occur. We encourage work that moves beyond documenting associations towards demonstrations of how policy can remediate harmful contexts to advance health equity. We especially welcome interdisciplinary work, mixed methodologies, and research that identifies interventions aiming to dismantle the systems that perpetuate racial, socioeconomic, geographic, and other health inequities in maternal and child health.

Dr. Maeve Wallace
Dr. Rachel Hardeman
Dr. Whitney Rice
Dr. Dara Mendez
Ms. Brigette Davis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

maternal and child health
health equity
social determinants of health
health policy
maternal mortality
infant mortality

Published Papers (12 papers)

Download All Papers

Research

10 pages, 339 KiB

Open AccessArticle

Associations between Adverse Childhood Experiences and Sexual Risk among Postpartum Women

by Jordan L. Thomas, Jessica B. Lewis, Jeannette R. Ickovics and Shayna D. Cunningham

Int. J. Environ. Res. Public Health 2021, 18(7), 3848; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073848 - 06 Apr 2021

Cited by 3 | Viewed by 2866

Abstract

Epidemiological evidence suggests that exposure to adverse childhood experiences (ACEs) is associated with sexual risk, especially during adolescence, and with maternal and child health outcomes for women of reproductive age. However, no work has examined how ACE exposure relates to sexual risk for women during the postpartum period. In a convenience sample of 460 postpartum women, we used linear and logistic regression to investigate associations between ACE exposure (measured using the Adverse Childhood Experiences Scale) and five sexual risk outcomes of importance to maternal health: contraceptive use, efficacy of contraceptive method elected, condom use, rapid repeat pregnancy, and incidence of sexually transmitted infections (STIs). On average, women in the sample were 25.55 years of age (standard deviation = 5.56); most identified as Black (60.4%), White (18%), or Latina (14.8%). Approximately 40% were exposed to adversity prior to age 18, with the modal number of experiences among those exposed as 1. Women exposed to ACEs were significantly less likely to use contraception; more likely to elect less-efficacious contraceptive methods; and used condoms less frequently (p = 0.041 to 0.008). ACE exposure was not associated with rapid repeat pregnancy or STI acquisition, p > 0.10. Screening for ACEs during pregnancy may be informative to target interventions to reduce risky sexual behavior during the postpartum period. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

16 pages, 1075 KiB

Open AccessArticle

Sociodemographic and Service Use Characteristics of Abortion Fund Cases from Six States in the U.S. Southeast

by Whitney S. Rice, Katie Labgold, Quita Tinsley Peterson, Megan Higdon and Oriaku Njoku

Int. J. Environ. Res. Public Health 2021, 18(7), 3813; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073813 - 06 Apr 2021

Cited by 17 | Viewed by 6225

Abstract

Abortion funds are key actors in mitigating barriers to abortion access, particularly in contexts where state-level abortion access restrictions are concentrated. Using 2017–2019 case management data from a regional abortion fund in the southeastern U.S., we described the sociodemographic and service use characteristics of cases overall (n = 9585) and stratified by state of residence (Alabama, Florida, Georgia, Mississippi, South Carolina, and Tennessee). Overall, cases represented people seeking abortion fund assistance who predominately identified as non-Hispanic Black (81%), 18–34 years of age (84%), publicly or uninsured (87%), having completed a high school degree or some college (70%), having one or more children (77%), and as Christian (58%). Most cases involved an in-state clinic (81%), clinic travel distance under 50 miles (63%), surgical abortion (66%), and pregnancy under 13 weeks’ gestation (73%), with variation across states. The median abortion fund contribution pledge was $75 (interquartile range (IQR): 60–100), supplementing median caller contributions of $200 (IQR: 40–300). These data provide a unique snapshot of a population navigating disproportionate, intersecting barriers to abortion access, and abortion fund capacity for social care and science. Findings can inform abortion fund development, data quality improvement efforts, as well as reproductive health, rights and justice advocacy, policy, and research. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

► Show Figures

Figure 1

15 pages, 478 KiB

Open AccessArticle

Female Genital Mutilation/Cutting among Somali Women in the U.S. State of Arizona: Evidence of Treatment Access, Health Service Use and Care Experiences

by Georgia Michlig, Nicole Warren, Merry Berhe and Crista Johnson-Agbakwu

Int. J. Environ. Res. Public Health 2021, 18(7), 3733; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073733 - 02 Apr 2021

Cited by 12 | Viewed by 3422

Abstract

Background. Female genital mutilation/cutting (FGM/C) is associated with adverse sexual, reproductive and psychological sequelae. The aim of this study was to quantitatively explore factors related to satisfaction with FGM/C-related care in the US focusing on access to care, health service utilization, and women’s experiences. Methods. A community-based survey of 879 Ethnic Somali and Somali Bantu women using snowball sampling was conducted in Arizona. Bivariate, multivariable and ordered logistics analyses assessed the relationship between the aforementioned factors measured along six dimensions: non-discrimination, physical, economic, informational, health system accessibility and individual-level health service use factors. Findings. Most participants possessed FGM/C (77.4%), namely Type III (40.2%). FGM/C related health service use was low (14.3%). Perceived discrimination was associated with reduced satisfaction in care (OR = 0.22; CI 0.13–0.37). For FGM/C-specific variables, only recollection of adverse physical or psychological events at the time of circumcision predicted service use (OR = 3.09; CI 1.67–5.68). Somali Bantu (OR = 0.10; CI 0.02–0.44) and highly acculturated women (OR = 0.39; CI 0.17–0.86) had lower odds of service use. Conclusions. Achieving respectful care and outreach to women affected by FGM/C has contextual complexity. However, the clinical implications and insights provided may have broader impacts on advancing health equity for FGM/C-affected women. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

► Show Figures

Figure 1

21 pages, 1169 KiB

Open AccessArticle

USDA Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Vendor Criteria: An Examination of US Administrative Agency Variations

by Matthew J. Landry, Kim Phan, Jared T. McGuirt, Alek Ostrander, Lilian Ademu, Mia Seibold, Kathleen McCallops, Tara Tracy, Sheila E. Fleischhacker and Allison Karpyn

Int. J. Environ. Res. Public Health 2021, 18(7), 3545; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073545 - 29 Mar 2021

Cited by 4 | Viewed by 4895

Abstract

The food retail environment has been directly linked to disparities in dietary behaviors and may in part explain racial and ethnic disparities in pregnancy-related deaths. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), administered by the United States Department of Agriculture, is associated with improved healthy food and beverage access due to its requirement for minimum stock of healthy foods and beverages in WIC-eligible stores. The selection and authorization criteria used to authorize WIC vendors varies widely from state to state with little known about the specific variations. This paper reviews and summarizes the differences across 16 of these criteria enacted by 89 WIC administrative agencies: the 50 states, the District of Columbia, five US Territories, and 33 Indian Tribal Organizations. Vendor selection and authorization criteria varied across WIC agencies without any consistent pattern. The wide variations in criteria and policies raise questions about the rational for inconsistency. Some of these variations, in combination, may result in reduced access to WIC-approved foods and beverages by WIC participants. For example, minimum square footage and/or number of cash register criteria may limit vendors to larger retail operations that are not typically located in high-risk, under-resourced communities where WIC vendors are most needed. Results highlight an opportunity to convene WIC stakeholders to review variations, their rationale, and implications thereof especially as this process could result in improved policies to ensure and improve healthy food and beverage access by WIC participants. More work remains to better understand the value of state WIC vendor authorization authority, particularly in states that have provided stronger monitoring requirements. This work might also examine if and how streamlining WIC vendor criteria (or at least certain components of them) across regional areas or across the country could provide an opportunity to advance interstate commerce and promote an equitable supply of food across the food system, while ensuring the protection for local, community-oriented WIC vendors. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

► Show Figures

Figure 1

17 pages, 633 KiB

Open AccessArticle

“Something Was Attacking Them and Their Reproductive Organs”: Environmental Reproductive Justice in an Indigenous Tribe in the United States Gulf Coast

by Jessica L. Liddell and Sarah G. Kington

Int. J. Environ. Res. Public Health 2021, 18(2), 666; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18020666 - 14 Jan 2021

Cited by 32 | Viewed by 5141

Abstract

Environmental reproductive justice is increasingly being utilized as a framework for exploring how environmental exploitation and pollution contribute to reproductive health and reproductive injustices. However, little research explores how settler colonialism and historical oppression contribute to the physical transformation of land, and how this undermines tribal members’ health. Even less research explores the intersection of environmental justice and reproductive justice among Indigenous groups, especially in the Gulf South, who are especially vulnerable to environmental justice issues due to climate change, land loss, and oil company exploitation, and for tribes that are non-federally recognized. A qualitative description research methodology was used to conduct 31 life-history interviews with women from a Gulf Coast Indigenous tribe. Findings of this study reveal that central components of reproductive justice, including the ability to have children and the ability to raise children in safe and healthy environments, are undermined by environmental justice issues in the community. Among concerns raised by women were high rates of chronic healthcare issues among community members, and issues with infertility. Recognizing Indigenous sovereignty is central to addressing these environmental reproductive justice issues. This research is unique in exploring the topic of environmental reproductive justice among a state-recognized Gulf Coast tribe. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

► Show Figures

Figure 1

21 pages, 422 KiB

Open AccessArticle

A Comparison of Weight-Related Behaviors of Hispanic Mothers and Children by Acculturation Level

by Colleen L. Delaney, Kim Spaccarotella, Virginia Quick and Carol Byrd-Bredbenner

Int. J. Environ. Res. Public Health 2021, 18(2), 503; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18020503 - 09 Jan 2021

Cited by 4 | Viewed by 2925

Abstract

Hispanic mothers and children in the United States experience a high prevalence of obesity, which may be affected by maternal acculturation level. Little is known about the association of acculturation on weight-related behaviors. This study describes differences in weight-related behaviors by acculturation level of Hispanic mothers residing in the U.S. and compares them to behaviors of White mothers. Acculturation level was determined using personal acculturation and acculturation environment variables. Cluster analysis of acculturation variables identified three groups of Hispanic mothers: low personal and environmental acculturation (n = 46), high personal and low environmental acculturation (n = 65), and high personal and environmental acculturation (n = 38). Results indicate that, compared to White mothers (n = 340), the least acculturated cluster of Hispanic mothers tended to model physical activity less often and the most acculturated exerted more pressure on children to eat. Mothers in the least acculturated cluster tended to rate children’s health status lower, indicate that children had greater fruit juice and less milk intakes, have more meals in locations associated with less healthy meals, and have the least space and supports for physical activity. Findings highlight relationships between maternal acculturation level and weight-related behaviors and suggest strategies for helping acculturating Hispanic mothers create healthier lifestyles and home environments. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

15 pages, 372 KiB

Open AccessArticle

Adverse Childhood Experiences on Reproductive Plans and Adolescent Pregnancy in the Gulf Resilience on Women’s Health Cohort

by Megan Flaviano and Emily W. Harville

Int. J. Environ. Res. Public Health 2021, 18(1), 165; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010165 - 28 Dec 2020

Cited by 10 | Viewed by 2916

Abstract

We investigated if adverse childhood experiences (ACEs) and ACE sub-types were associated with increased odds of planning to have children and adolescent pregnancy. The Gulf Resilience on Women’s Health (GROWH) is a diverse cohort of reproductive-age women living in southeastern Louisiana during the 2010 Deepwater Horizon oil spill. In our sample of 1482 women, we used multinomial logistic regression to model odds ratios of wanting future children and assessed effect measure modification by educational attainment. We also estimated odds ratios of adolescent pregnancy with binomial logistic regression. Exposure to ACEs increased odds of wanting future children across all ACE sub-types. Among women with lower educational attainment, three or more ACEs (overall, childhood, and adolescence) had over two times the odds of wanting future children. History of ACE and the various sub-types, except for emotional abuse, were associated with increased risk of adolescent pregnancy. ACEs may be linked to adolescent pregnancy and reproductive plans, and variations by educational status highlighted social discrepancies and importance of social context in evaluation and intervention. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

12 pages, 2000 KiB

Open AccessEditor’s ChoiceArticle

Severe Housing Insecurity during Pregnancy: Association with Adverse Birth and Infant Outcomes

by Kathryn M. Leifheit, Gabriel L. Schwartz, Craig E. Pollack, Kathryn J. Edin, Maureen M. Black, Jacky M. Jennings and Keri N. Althoff

Int. J. Environ. Res. Public Health 2020, 17(22), 8659; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228659 - 21 Nov 2020

Cited by 32 | Viewed by 7013

Abstract

Introduction: Housing insecurity is increasingly commonplace among disadvantaged women and children. We measured the individual- and population-level impact of severe housing insecurity during pregnancy on adverse birth and infant outcomes. Methods: We analyzed data from 3428 mother–infant dyads enrolled in the Fragile Families and Child Wellbeing Study, a prospective cohort study representing births in 20 large U.S. cities from 1998 to 2000. Severe housing insecurity was defined as threatened eviction or homelessness during pregnancy. Outcomes included low birth weight and/or preterm birth, admission to a neonatal intensive care unit (NICU) or stepdown facility, extended hospitalization after delivery, and infant health and temperament. We estimated exposure–outcome associations with risk ratios adjusted for pre-pregnancy maternal sociodemographic and heath factors and calculated a population attributable fraction (PAF) of outcomes attributable to severe housing insecurity. Results: We found statistically significant associations between severe housing insecurity during pregnancy and low birth weight and/or preterm birth (risk ratio (RR] 1.73, 95% confidence interval (CI) 1.28, 2.32), NICU or stepdown stay (RR 1.64, CI 1.17, 2.31), and extended hospitalization (RR 1.66, CI 1.28, 2.16). Associations between housing insecurity and infant fair or poor health (RR 2.62, CI 0.91, 7.48) and poor temperament (RR 1.52, CI 0.98, 2.34) were not statistically significant. PAF estimates ranged from 0.9–2.7%, suggesting that up to three percent of adverse birth and infant outcomes could be avoided by eliminating severe housing insecurity among low-income, pregnant women in US cities. Conclusions: Results suggest that housing insecurity during pregnancy shapes neonatal and infant health in disadvantaged urban families. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

► Show Figures

Figure 1

14 pages, 683 KiB

Open AccessArticle

Unmet Healthcare Needs of Children in Vulnerable Families in South Korea: Finding from the Community Child Center Child Panel Survey

by Suyon Baek, Eun-Hi Choi and Jungeun Lee

Int. J. Environ. Res. Public Health 2020, 17(21), 8241; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218241 - 07 Nov 2020

Cited by 2 | Viewed by 2442

Abstract

Presented in this paper is a study that examined the status of unmet healthcare needs of children in vulnerable families and identified factors affecting such unmet needs. The Community Child Center (CCC) Child Panel Survey data in Korea were used. A multiple stepwise logistic regression analysis was performed to examine factors influencing unmet healthcare needs of children. Influencing factors comprised predisposing, enabling, and need factors based on the Andersen Behavioral Model of Health Services Utilization. A total of 340 sixth-graders from vulnerable families participated, and 96 (28.2%) children had unmet healthcare needs. Factors included absence of an after-school caregiver (OR = 1.95, 95% CI [1.16, 3.27]), perceived physical symptoms (OR = 1.33, 95% CI [1.02, 1.73]), parental indifference (OR = 1.33, 95% CI [1.002, 1.77]), duration of daily stay at CCCs (OR = 1.32, 95% CI [1.01, 1.71]), and satisfaction with CCC teachers (OR = 0.65, 95% CI [0.49, 0.85]). The relationship with parents and CCC teachers had the strongest influence on unmet healthcare needs of children. In order to reduce the unmet healthcare needs of children in vulnerable families, existing support structures should be expanded to offer financial and administrative support for children’s parents and CCC teachers. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

► Show Figures

Figure 1

15 pages, 911 KiB

Open AccessArticle

Racial Differences in the Biochemical Effects of Stress in Pregnancy

by Paris Ekeke, Dara D. Mendez, Toby D. Yanowitz and Janet M. Catov

Int. J. Environ. Res. Public Health 2020, 17(19), 6941; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17196941 - 23 Sep 2020

Cited by 14 | Viewed by 2766

Abstract

Prenatal stress has been linked to preterm birth via inflammatory dysregulation. We conducted a cross-sectional study on female participants who delivered live, singleton infants at University of Pittsburgh Medical Center Magee Women’s Hospital. Participants (n = 200) were stratified by cumulative risk scores using a combination of individual factors (maternal education, diabetes, hypertension, smoking, relationship status, obesity, depression) and neighborhood deprivation scores. We hypothesized that inflammatory cytokines levels differ by risk group and race. Multiplex analyses of IL-6, IL-8, IL-10, IL-13 and TNF-alpha were run. We found that Black birthing people had more risk factors for chronic stress and had lower levels of IL-6 compared to White birthing people. When stratified by risk group and race, low-risk Black birthing people had lower levels of IL-6 compared to low-risk White birthing people, and high-risk Black birthing people had lower levels of IL-8 compared to high-risk White birthing people. Higher area deprivation scores were associated with lower IL-6 levels. Our results suggest that the relationship between chronic stress and inflammatory cytokines is modified by race. We theorize that Black birthing people encounter repetitive stress due to racism and social disadvantage which may result in stress pathway desensitization and a blunted cytokine response to future stressors. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

► Show Figures

Graphical abstract

12 pages, 542 KiB

Open AccessArticle

Association of Summer Heat Waves and the Probability of Preterm Birth in Minnesota: An Exploration of the Intersection of Race and Education

by M. Luke Smith and Rachel R. Hardeman

Int. J. Environ. Res. Public Health 2020, 17(17), 6391; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176391 - 02 Sep 2020

Cited by 18 | Viewed by 3993

Abstract

Preterm birth (PTB) is common and has negative impacts on infant health. While some maternal risk factors have been identified, including age under 20 or over 40, substance abuse, low BMI, and racism, less is known about the impact of environmental exposures like high heat. We combined 154,157 records of live births occurring in Minnesota between 2009 and 2015 with hourly weather records collected from the Minneapolis–St. Paul airport. We tested if maternal heat wave exposure (a seven-day period with a mean daily high temp of 37 °C) immediately prior to birth leads to a higher risk of preterm birth. Additional covariates included maternal age, race/ethnicity, educational status, and residence in the seven-county Minneapolis–St. Paul metro area. Pregnant women exposed to a seven-day heat wave of 37 °C or higher experienced a higher relative risk of PTB compared to women who did not experience a heat wave (1.14 risk ratio (RR), 1.0–1.3 95% confidence interval (CI)). The result is robust to controls for a woman’s age, race/ethnicity, educational attainment, place of residence, and year of the birth. Children born to Black women with college degrees who are exposed to heat waves experience a higher relative risk of PTB compared to White women with college degrees in a heat wave (2.97 RR, 1.5–6.1 95% CI). Summer heat waves are associated with higher risk of PTB in late-term pregnancies in Minnesota. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

► Show Figures

Figure 1

21 pages, 385 KiB

Open AccessArticle

Cultural Influences on Complementary Feeding Beliefs amongst New Chinese Immigrant Mothers in England: A Mixed Methods Study

by Xiaoning Zhang, Diana Margot Rosenthal, Lorna Benton and Monica Lakhanpaul

Int. J. Environ. Res. Public Health 2020, 17(15), 5468; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17155468 - 29 Jul 2020

Cited by 7 | Viewed by 3144

Abstract

Adequate nutrition during infancy and early childhood is essential for ensuring the growth, health, and development of children so that they can reach their full potential. There is a current void of data on infant and young child feeding practices (IYCF) in ethnic minority communities in the UK; specifically, it is difficult to find accurate Chinese IYCF data in the UK because survey data often includes Chinese in the category of ‘Chinese or other ethnic group’, further contributing to health inequalities. This mixed methods study aimed to explore the cultural influences on IYCF beliefs among new Chinese immigrant mothers. A total of 31 mothers of infants aged 6–23 months were recruited from informal community organizations. All 31 mothers were born in Mainland China, the mean length of their stay after immigrating to the UK was 10 years (range = 1–21 years), and their mean age was 29 ± 3.40 years. When using the Infant Feeding Style Questionnaire (IFSQ) to investigate IYCF beliefs, the highest score was obtained for responsive attention, with a value of 4.28 ± 0.92, indicating that parents were very attentive to child hunger and satiety cues; lower scores were obtained for indulgence soothing (1.82 ± 1.01), indulgence coaxing (2.11 ± 1.18), indulgence pampering (1.90 ± 0.95), and pressuring to soothe (1.92 ± 0.86), indicating lesser maternal indulgence and pressuring/controlling beliefs. A sub-sample (n = 14) participated in semi-structured interviews in order to understand the balancing sources of information and cultural preferences, the influence of traditional Chinese medicine, and language difficulties in accessing health services. The mothers reported barriers of IYCF beliefs and the introduction of solid foods earlier than the NHS guidelines. This study can promote optimal IYCF in Chinese immigrants and show health services the need to reconcile differences between the perceptions of British and Chinese health beliefs. Full article

(This article belongs to the Special Issue Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities)

Journal Menu

Journal Browser

Social, Structural, and Policy Determinants of Maternal and Child Health and Health Inequities

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Published Papers (12 papers)

Research

Further Information

Guidelines

MDPI Initiatives

Follow MDPI