Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
2.7
2.0
Journals
Children
Special Issues
Social Determinants of Disparities in Maternal and Infant Health Outcomes
share announcement

Social Determinants of Disparities in Maternal and Infant Health Outcomes

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Nursing".

Deadline for manuscript submissions: closed (5 July 2022) | Viewed by 46334

Special Issue Editor

Dr. Rada K Dagher

E-Mail Website
Guest Editor
NIH National Institute on Minority Health & Health Disparities (NIMHD) Division of Scientific Programs BETHESDA, MD, USA
Interests: Health Disparities; Maternal and Child Health; Perinatal Depression; Mental Health; Occupational Health; Health Services Research and Policy

Special Issue Information

Dear Colleagues,

There are large disparities in maternal and infant health in the United States (U.S.) but the reasons underlying these disparities are understudied and interventions to address these disparities remain limited. For example, African American (AA), American Indian, and Alaska Native (AI/AN) women are two to three times more likely to die from pregnancy-related causes than non-Hispanic white women. Similarly, AAs and AI/AIs have two to three times the infant mortality rate as non-Hispanic whites. Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health and quality-of-life outcomes and risks. Studying how different population groups (e.g., racial/ethnic minorities, socioeconomically disadvantaged, rural underserved residents) experience these conditions (e.g., social, economic, and physical) in various environments and settings (e.g., school, church, workplace, and neighborhood) and the impact of these experiences on disparities in maternal and infant health outcomes would help us gain a better understanding of the underlying reasons for these disparities and potential interventions to reduce and eventually eliminate them.

The purpose of this special issue is to stimulate urgently needed research on social determinants of disparities in maternal and infant morbidity and mortality by race/ethnicity, socioeconomic status, and other social identities (e.g., sexual and gender minority status, rural residence). We welcome original research studies (e.g., observational, quasi-experimental, randomized controlled trials, mixed methods) and meta-analyses. It is encouraged that the focus of the research be to either investigate understudied social determinants of maternal and/or infant health that could explain disparities in maternal and/or infant morbidity and mortality (for e.g., the role of work policies/benefits, working conditions, and occupational status has been understudied) or to evaluate interventions to reduce and/or eliminate these disparities.

I look forward to receiving your contributions.

Dr. Rada K Dagher
Guest Editor

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. Children 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 2400 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

  • Health Disparities;
  • Maternal Morbidity and Mortality;
  • Infant Morbidity and Mortality;
  • Social Determinants of Health;
  • Etiological research;
  • Intervention research

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue polices can be found here.

Published Papers (8 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review

13 pages, 1265 KiB  
Article
The Association between NICU Admission and Mental Health Diagnoses among Commercially Insured Postpartum Women in the US, 2010–2018
by Dana C. Beck, Karen M. Tabb, Anca Tilea, Stephanie V. Hall, Ashlee Vance, Stephen W. Patrick, Amy Schroeder and Kara Zivin
Children 2022, 9(10), 1550; https://doi.org/10.3390/children9101550 - 13 Oct 2022
Cited by 4 | Viewed by 2906
Abstract
Maternal mental health (MH) conditions represent a leading cause of preventable maternal death in the US. Neonatal Intensive Care Unit (NICU) hospitalization influences MH symptoms among postpartum women, but a paucity of research uses national samples to explore this relationship. Using national administrative [...] Read more.
Maternal mental health (MH) conditions represent a leading cause of preventable maternal death in the US. Neonatal Intensive Care Unit (NICU) hospitalization influences MH symptoms among postpartum women, but a paucity of research uses national samples to explore this relationship. Using national administrative data, we examined the rates of MH diagnoses of anxiety and/or depression among those with and without an infant admitted to a NICU between 2010 and 2018. Using generalized estimating equation models, we explored the relationship between NICU admission and MH diagnoses of anxiety and/or depression, secondarily examining the association of NICU length of stay and race/ethnicity with MH diagnoses of anxiety and/or depression post NICU admission. Women whose infants became hospitalized in the NICU for <2 weeks had 19% higher odds of maternal MH diagnoses (aOR: 1.19, 95% CI: 1.14%–1.24%) and those whose infants became hospitalized for >2 weeks had 37% higher odds of maternal MH diagnoses (aOR: 1.37 95% CI: 1.128%–1.47%) compared to those whose infants did not have a NICU hospitalization. In adjusted analyses, compared to white women, all other race/ethnicities had significantly lower odds of receiving a maternal MH condition diagnosis [Black (aOR = 0.76, 0.73–0.08), Hispanic (aOR = 0.69, 0.67–0.72), and Asian (aOR: 0.32, 0.30–0.34)], despite higher rates of NICU hospitalization. These findings suggest a need to target the NICU to improve maternal MH screening, services, and support while acknowledging the influence of social determinants, including race and ethnicity, on health outcomes. Full article
(This article belongs to the Special Issue Social Determinants of Disparities in Maternal and Infant Health Outcomes)
►▼ Show Figures

Graphical abstract

13 pages, 306 KiB  
Article
Inequities in Availability of Evidence-Based Birth Supports to Improve Perinatal Health for Socially Vulnerable Rural Residents
by Bridget Basile Ibrahim, Julia D. Interrante, Alyssa H. Fritz, Mariana S. Tuttle and Katy Backes Kozhimannil
Children 2022, 9(7), 1077; https://doi.org/10.3390/children9071077 - 19 Jul 2022
Cited by 9 | Viewed by 6056
Abstract
Rural residents in the United States (US) have disproportionately high rates of maternal and infant mortality. Rural residents who are Black, Indigenous, and People of Color (BIPOC) face multiple social risk factors and have some of the worst maternal and infant health outcomes [...] Read more.
Rural residents in the United States (US) have disproportionately high rates of maternal and infant mortality. Rural residents who are Black, Indigenous, and People of Color (BIPOC) face multiple social risk factors and have some of the worst maternal and infant health outcomes in the U.S. The purpose of this study was to determine the rural availability of evidence-based supports and services that promote maternal and infant health. We developed and conducted a national survey of a sample of rural hospitals. We determined for each responding hospital the county-level scores on the 2018 CDC Social Vulnerability Index (SVI). The sample’s (n = 93) median SVI score [IQR] was 0.55 [0.25–0.88]; for majority-BIPOC counties (n = 29) the median SVI score was 0.93 [0.88–0.98] compared with 0.38 [0.19–0.64] for majority-White counties (n = 64). Among counties where responding hospitals were located, 86.2% located in majority-BIPOC counties ranked in the most socially vulnerable quartile of counties nationally (SVI ≥ 0.75), compared with 14.1% of majority-White counties. In analyses adjusted for geography and hospital size, certified lactation support (aOR 0.36, 95% CI 0.13–0.97), midwifery care (aOR 0.35, 95% CI 0.12–0.99), doula support (aOR 0.30, 95% CI 0.11–0.84), postpartum support groups (aOR 0.25, 95% CI 0.09–0.68), and childbirth education classes (aOR 0.08, 95% CI 0.01–0.69) were significantly less available in the most vulnerable counties compared with less vulnerable counties. Residents in the most socially vulnerable rural counties, many of whom are BIPOC and thus at higher risk for poor birth outcomes, are significantly less likely to have access to evidence-based supports for maternal and infant health. Full article
(This article belongs to the Special Issue Social Determinants of Disparities in Maternal and Infant Health Outcomes)
9 pages, 268 KiB  
Article
The Impact of Natural Disasters on Maternal Health: Hurricanes Irma and María in Puerto Rico
by Irene Lafarga Previdi, Michael Welton, Jazmín Díaz Rivera, Deborah J. Watkins, Zulmarie Díaz, Héctor R. Torres, Chrystal Galán, Natacha I. Guilloty, Luis D. Agosto, José F. Cordero, Akram Alshawabkeh and Carmen M. Vélez Vega
Children 2022, 9(7), 940; https://doi.org/10.3390/children9070940 - 23 Jun 2022
Cited by 9 | Viewed by 3912
Abstract
The PROTECT research Center funded by the NIH’s National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program was launched in 2010 to explore the impact of exposure to pollutants on the high rate of premature births in Puerto Rico. In September 2017, [...] Read more.
The PROTECT research Center funded by the NIH’s National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program was launched in 2010 to explore the impact of exposure to pollutants on the high rate of premature births in Puerto Rico. In September 2017, Hurricanes Irma and María devastated the archipelago, which caused: collapse of the electrical system, collapse of the communication system, limited access to clean water, food, gas, and health services, destruction of public (e.g., hospitals) and private property (e.g., houses) and more than 4500 deaths. Pregnant and postpartum individuals are especially vulnerable to natural disasters. They face difficulty obtaining adequate pre- and post-natal care, are exposed to increased risk of miscarriage, premature delivery, and giving birth to low birth weight babies during and after disasters and are also more likely to suffer physical and mental health problems compared to the general population during and after disasters. A face-to-face questionnaire was administered to PROTECT participants who were pregnant during hurricanes Irma or Maria or who became pregnant shortly after in order to identify hurricane-related sources of stress and other adverse effects. This paper is based on the answers to the open-ended question at the end of the questionnaire where participants were asked to share their experiences during and after the hurricanes. Among the 375 participants who completed the survey, 76 answers to the open-ended question were considered due to data saturation. The answers to the open-ended question were transcribed into a document in order to facilitate the coding process. The transcribed text was analyzed first to identify emerging categories and then coded to identify common themes as well as divergence among participants. The following themes were identified: pregnancy and birth challenges, lack of access to basic services, housing conditions, stressful working conditions, concerns about health, concerns about their children, and positive or protective aspects. The results indicate how the disruption in access to basic services has a unique impact on the physical and mental health of pregnant and post-partum women in an emergency situation. These findings point to the potential benefit of developing specific protocols designed for emergency preparedness aimed at this population, which can inform healthcare providers and community organizations in case of future events. Full article
(This article belongs to the Special Issue Social Determinants of Disparities in Maternal and Infant Health Outcomes)
14 pages, 394 KiB  
Article
Models and Interventions to Promote and Support Engagement of First Nations Women with Maternal and Child Health Services: An Integrative Literature Review
by Catherine Austin, Danny Hills and Mary Cruickshank
Children 2022, 9(5), 636; https://doi.org/10.3390/children9050636 - 28 Apr 2022
Viewed by 3645
Abstract
Background: Studies show that participation in maternal and child health (MCH) services improves health outcomes for First Nations families. However, accessing MCH services can be associated with fear, anxiety, and low attendance at subsequent appointments. Objective: To identify the existing knowledge of models/interventions [...] Read more.
Background: Studies show that participation in maternal and child health (MCH) services improves health outcomes for First Nations families. However, accessing MCH services can be associated with fear, anxiety, and low attendance at subsequent appointments. Objective: To identify the existing knowledge of models/interventions that support engagement of First Nations women with MCH services in the child’s first five years. Methods: An integrative review was undertaken of full-text, peer-reviewed journal articles and grey literature, which were analysed to identify barriers and enabling factors that influenced the engagement of First Nations families with MCH services. Results: Enabling factors that influenced the engagement with MCH services included service models/interventions that are timely and appropriate, and effective integrated community-based services that are flexible, holistic, culturally strong, and encourage earlier identification of risk and further assessment, intervention, referral, and support from the antenatal period to the child’s fifth birthday. Barriers to engagement included inefficient communication, lack of understanding, cultural differences between the client and the provider, poor continuity of care, limited flexibility of service delivery to meet individual needs, and a health care model that does not recognise the importance of the social determinants of health and wellbeing. Discussion: Timely, effective, holistic engagement with First Nations women during their child’s first 2000 days, which respects their culture and facilitates genuine partnerships built on co-design and shared decision making with the indigenous community, needs to be an essential part of the MCH service model if health care providers seek to practice within First Nations communities. Conclusion: Improving engagement with MCH services is important for First Nations families, nursing practice, and public health. Full article
(This article belongs to the Special Issue Social Determinants of Disparities in Maternal and Infant Health Outcomes)
►▼ Show Figures

Figure 1

20 pages, 299 KiB  
Article
Family Stressors and Resources as Social Determinants of Health among Caregivers and Young Children
by Natalie Slopen, Benjamin Le Cook, Justin Winston Morgan, Michael William Flores, Camila Mateo, Cynthia Garcia Coll, Dolores Acevedo Garcia, Naomi Priest, Elaine Wethington, Esther Lee, Margo Moyer, Nathaniel M. Tran, Sandra Krumholz and David R. Williams
Children 2022, 9(4), 452; https://doi.org/10.3390/children9040452 - 23 Mar 2022
Cited by 3 | Viewed by 3697
Abstract
Life course-informed theories of development suggest it is important to integrate information about positive and negative aspects of the social environment into studies of child and parental wellbeing, including both stressors that compromise health and resources that promote well-being. We recruited a sample [...] Read more.
Life course-informed theories of development suggest it is important to integrate information about positive and negative aspects of the social environment into studies of child and parental wellbeing, including both stressors that compromise health and resources that promote well-being. We recruited a sample of 169 pairs of caregivers and young children (birth to 5 years) from a community health clinic and administered survey questions to assess stressors and resources. We constructed inventories of stressors and resources and examined the relationships between these inventories and caregivers’ depressive symptoms, anxiety symptoms, and sleep problems, and young children’s medical diagnoses derived from electronic health records. Cumulative stressors and resources displayed bivariate and adjusted associations with caregivers’ depressive symptoms, anxiety symptoms, and sleep problems. For depressive and anxiety symptoms, these associations were evident in models that included stressors and resources together. Caregivers with high stressors and low resources displayed the highest levels of depressive and anxiety symptoms and sleep problems. In terms of children’s health outcomes, only modest trends were evident for developmental/mental health outcomes, but not other diagnostic categories. Future studies are needed to examine stressors and resources together in larger samples and in relation to prospectively assessed measures of child well-being. Full article
(This article belongs to the Special Issue Social Determinants of Disparities in Maternal and Infant Health Outcomes)

Review

Jump to: Research

16 pages, 340 KiB  
Review
The Role of Work as a Social Determinant of Health in Mother’s Own Milk Feeding Decisions for Preterm Infants: A State of the Science Review
by Tricia J. Johnson, Paula P. Meier, Daniel T. Robinson, Sumihiro Suzuki, Suhagi Kadakia, Andrew N. Garman and Aloka L. Patel
Children 2023, 10(3), 416; https://doi.org/10.3390/children10030416 - 21 Feb 2023
Cited by 1 | Viewed by 1975
Abstract
In the United States, 10% of infants are born preterm (PT; <37 weeks gestational age) each year and are at higher risk of complications compared to full term infants. The burden of PT birth is borne disproportionately by Black versus non-Black families, with [...] Read more.
In the United States, 10% of infants are born preterm (PT; <37 weeks gestational age) each year and are at higher risk of complications compared to full term infants. The burden of PT birth is borne disproportionately by Black versus non-Black families, with Black mothers significantly more likely to give birth to a PT infant. One proven strategy to improve short- and long-term health outcomes in PT infants is to feed mother’s own milk (MOM; breast milk from the mother). However, mothers must make decisions about work and MOM provision following PT birth, and more time spent in paid work may reduce time spent in unpaid activities, including MOM provision. Non-Black PT infants are substantially more likely than Black PT infants to receive MOM during the birth hospitalization, and this disparity is likely to be influenced by the complex decisions mothers of PT infants make about allocating their time between paid and unpaid work. Work is a social determinant of health that provides a source of income and health insurance coverage, and at the same time, has been shown to create disparities through poorer job quality, lower earnings, and more precarious employment in racial and ethnic minority populations. However, little is known about the relationship between work and disparities in MOM provision by mothers of PT infants. This State of the Science review synthesizes the literature on paid and unpaid work and MOM provision, including: (1) the complex decisions that mothers of PT infants make about returning to work, (2) racial and ethnic disparities in paid and unpaid workloads of mothers, and (3) the relationship between components of job quality and duration of MOM provision. Important gaps in the literature and opportunities for future research are summarized, including the generalizability of findings to other countries. Full article
(This article belongs to the Special Issue Social Determinants of Disparities in Maternal and Infant Health Outcomes)
21 pages, 381 KiB  
Review
A Critical Review on the Complex Interplay between Social Determinants of Health and Maternal and Infant Mortality
by Rada K. Dagher and Deborah E. Linares
Children 2022, 9(3), 394; https://doi.org/10.3390/children9030394 - 10 Mar 2022
Cited by 44 | Viewed by 19504
Abstract
Background: U.S. maternal and infant mortality rates constitute an important public health problem, because these rates surpass those in developed countries and are characterized by stark disparities for racial/ethnic minorities, rural residents, and individuals with less privileged socioeconomic status due to social determinants [...] Read more.
Background: U.S. maternal and infant mortality rates constitute an important public health problem, because these rates surpass those in developed countries and are characterized by stark disparities for racial/ethnic minorities, rural residents, and individuals with less privileged socioeconomic status due to social determinants of health (SDoH). Methods: A critical review of the maternal and infant mortality literature was performed to determine multilevel SDoH factors leading to mortality disparities with a life course lens. Results: Black mothers and infants fared the worst in terms of mortality rates, likely due to the accumulation of SDoH experienced as a result of structural racism across the life course. Upstream SDoH are important contributors to disparities in maternal and infant mortality. More research is needed on the effectiveness of continuous quality improvement initiatives for the maternal–infant dyad, and expanding programs such as paid maternity leave, quality, stable and affordable housing, and social safety-nets (Medicaid, CHIP, WIC), in reducing maternal and infant mortality. Finally, it is important to address research gaps in individual, interpersonal, community, and societal factors, because they affect maternal and infant mortality and related disparities. Conclusion: Key SDoH at multiple levels affect maternal and infant health. These SDoH shape and perpetuate disparities across the lifespan and are implicated in maternal and infant mortality disparities. Full article
(This article belongs to the Special Issue Social Determinants of Disparities in Maternal and Infant Health Outcomes)
8 pages, 1219 KiB  
Review
Can the Healthy Start Risk Screen Predict Perinatal Depressive Symptoms among High-Risk Women?
by Roneé Wilson, Adriana Campos, Mannat Sandhu, Sarah Sniffen, Rashida Jones, Hope Tackett, Estrellita Berry and Adetola Louis-Jacques
Children 2022, 9(2), 180; https://doi.org/10.3390/children9020180 - 1 Feb 2022
Cited by 2 | Viewed by 1994
Abstract
Objectives: Early detection of depression in at-risk populations is critical for ensuring better maternal and child health outcomes. This study assessed whether Healthy Start Prenatal Risk Screening (HSPRS) could predict depressive symptoms in women enrolled in a Healthy Start (HS) program in under-resourced, [...] Read more.
Objectives: Early detection of depression in at-risk populations is critical for ensuring better maternal and child health outcomes. This study assessed whether Healthy Start Prenatal Risk Screening (HSPRS) could predict depressive symptoms in women enrolled in a Healthy Start (HS) program in under-resourced, high-risk communities of Hillsborough County. Methods: Data from HS participants were included for those who were evaluated using the HSPRS and the Edinburgh Postnatal Depression Scale (EPDS). A correlation analysis determined if the HSPRS score was associated with a positive EPDS screen, and HSPRS questions related to the participants psychosocial environment were assessed individually to determine their predictive potential. The crude odds ratio (OR) and adjusted OR (controlling for sociodemographic covariates) were calculated for each question of interest. Results: A total of 736 women were included, with 122 (16.5%) scoring 14 or greater on the EPDS, indicating probable depression risk. There were significant differences between women at risk for depression compared to those not at risk regarding maternal age (p-value = 0.03) and marital status (p-value = 0.01). There were no significant differences in education, ethnicity, or race. The total HSPRS score had a weak yet significant correlation with the EPDS score (r = 0.14, p-value = 0.0001), and seven individual HSPRS questions were significantly associated with risk for perinatal depression. Conclusions for Practice: By focusing on responses to key HSPRS questions rather than the overall score, women may receive access to much needed services more quickly, thereby reducing the risk for poorer maternal and developmental outcomes. Significance: A young maternal age and single marital status have been identified as risk factors for perinatal depression. Additionally, women from racial/ethnic minority groups or low-income populations are more likely to experience depression. Thus, in communities where women exhibit many pre-identified risk factors for perinatal depression, the ability to quickly identify those at the highest risk is imperative. This work indicates that among medically and socially high-risk mothers enrolled in a HS program, the overall HSPRS score was not as predictive of perinatal depression as individual responses to key questions. Attention to these responses could result in women receiving much needed services quicker. Full article
(This article belongs to the Special Issue Social Determinants of Disparities in Maternal and Infant Health Outcomes)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-8
Back to TopTop