Maternal and Child Health Library
MCH Alert: Focus on Infant Mortality is developed by the Maternal
and Child Health Library in collaboration with the National Sudden
and Unexpected Infant/Child and Pregnancy Loss Resource Center at
Georgetown University. This
and past issues are available online
at http://www.mchlibrary.info/alert/archives.html
and http://www.sidscenter.org/alert/archives.html.
September 3, 2010
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Special Notice: The Health Resources and Services Administration's
Maternal and Child Health Bureau (MCHB) is putting together a
supplement for submission to the Maternal and Child Health Journal
devoted to national, regional, and state-level analyses of the 2007
National Survey of Children’s Health (NSCH). Individuals interested in
contributing to the proposed supplement may contact Dr. Michael Kogan (mkogan@hrsa.gov), Dr. Reem Ghandour (rghandour@hrsa.gov), or Dr.
Ashley Schempf (aschempf@hrsa.gov).
The title, authorship, and brief (one page or less) outline are due by September 10, 2010. Data analysis
results are welcome but not required at this time.
Submissions will be evaluated based on contributions to the literature,
soundness of proposed methods, and level of analysis (national,
regional, or state). Proposals that examine time trends and their
determinants between the 2003 NSCH and the 2007 NSCH are welcome.
Authors will be contacted within 2 weeks if their topic has been
selected, and a schedule for completing the manuscripts will be
determined.
Assistance is available to individuals working in state or local
maternal and child health departments who, if chosen, would like help
preparing a manuscript on state-level data from the data set. Contact
Dr. Michael Kogan (mkogan@hrsa.gov).
The 2007 NSCH is sponsored by MCHB and is the second such survey to
examine the physical and emotional health of infants, children, and
adolescents from birth to age 17. Special emphasis is placed on factors
that may relate to infants’, children's, and adolescents’ well-being,
including medical homes, family interactions, parental health, school
and after-school experiences, and safe neighborhoods. The survey
includes data for 91,642 infants, children, and adolescents (about
1,700 per state). The data is available at http://www.nschdata.org/Content/Default.aspx
or http://www.cdc.gov/nchs/slaits/nsch.htm
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1. National Campaigns Offer New Resources to Raise
Community Awareness of Infant Mortality
2. Webcast Highlights Healthy Start and Early Head Start
Collaboration (Multimedia Featured Resource)
3. Paper Addresses the Role of the Healthy Start Model in
Health Reform
4. Study Explores Health and Safety Practices in Child
Care Centers in Pennsylvania
5. Authors Analyze African Americans' Awareness of Racial
Disparities in Infant Mortality Rates and Related Risk Factors
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1. NATIONAL CAMPAIGNS OFFER NEW RESOURCES TO RAISE COMMUNITY
AWARENESS OF INFANT MORTALITY
The National Healthy Start Association's infant mortality awareness
campaign has produced a new toolkit to help Healthy Start projects and
others promote awareness during National Infant Mortality Month
(September 2010) and throughout the year. The 2010 toolkit, Celebrate
Day 366 . . . every baby deserves a chance, contains ideas and tips for
advocacy, fundraising activities and events, media relations, and
marketing. Sample letters, press releases, proclamations, and public
service announcements are also provided. The toolkit is available at http://healthystartassoc.org/2010NIMAM_ToolKit.pdf.
The Office of Minority Health's 2010 campaign features a poster with
the tagline, A Healthy Baby Begins with Two: Minority Fathers Fight
Infant Mortality. The poster is available at http://minorityhealth.hhs.gov/Assets/pdf/Checked/1/AHealthyBabyBeginswithTwo.pdf.
Additional resources are available at http://minorityhealth.hhs.gov/templates/content.aspx?ID=6890&lvl=2&lvlID=117.
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2. WEBCAST HIGHLIGHTS HEALTHY START AND EARLY HEAD START COLLABORATION
(MULTIMEDIA FEATURED RESOURCE)
The Rewards of Collaboration -- Healthy Start and Early Head Start in
Action provides an overview of the Healthy Start (HS) and Early Head
Start (EHS) programs, the goals of their respective national
organizations, and the benefits of HS-EHS project collaborations as
experienced in selected communities. The August 17, 2010, Webcast,
which was sponsored by the Health Resources and Services
Administration's Maternal and Child Heath Bureau and the Administration
for Children and Families' Office of Head Start, highlighted project
collaboration in Las Cruces, NM, Baton Rouge, LA, and Des Moines, IA.
The Webcast archive is available at http://webcast.hrsa.gov/Postevents/archivedWebcastDetailNewInterface.asp?aeid=528
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3. PAPER ADDRESSES THE ROLE OF THE HEALTHY START MODEL IN HEALTH REFORM
Federal Healthy Start Initiative: A National Network for Effective Home
Visitation and Family Support documents evidence of the effectiveness
of the federal Healthy Start Initiative in building high-quality,
comprehensive early childhood systems for pregnant women, parents,
caregivers, and infants and children from birth to age 8 and its role
in health reform. The paper, published by the National Healthy Start
Association, begins with a brief history of the federal Healthy Start
initiative and an overview of its network and core services. Additional
topics include key attributes of the federal Healthy Start home
visitation model, evaluative evidence of program outcomes, and
implications for health reform. A map of Healthy Start locations and
the logic model for national evaluation are included. The paper is
available at http://healthystartassoc.org/NHSA_WhitePaper.pdf
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4. STUDY EXPLORES HEALTH AND SAFETY PRACTICES IN CHILD CARE CENTERS IN
PENNSYLVANIA
"Our data shows significant deficiencies in the health and safety
practices and policies of child care centers," state the authors of an
article published in The Open Pediatric Medicine Journal. Although the
rate of injury in child care centers (CCCs) is lower than in children's
homes, preventable injuries occur in CCCs. Since 1989, needs
assessments and interventions to improve health and safety in
Pennsylvania's early education and child care programs have been
undertaken by a health- and safety-promotion program of the state
chapter of the American Academy of Pediatrics, the Early Childhood
Education Linkage System (ECELS). The article describes an assessment
of the health and safety practices of a convenience sample of CCCs
served by ECELS.
ECELS staff sent an insert in the statewide newsletter inviting CCCs in
the Philadelphia, York, and Pittsburgh areas to participate in the
study. Additionally, regional child care leaders and community nurses
from the Pennsylvania Department of Health helped recruit centers.
ECELS staff contacted interested program directors by telephone to
explain the project and enroll willing centers (only those that were
regulated and certified to operate as CCCs were eligible to
participate). Designated ECELS staff interviewed each CCC director by
telephone about site demographics and safety policies. A trained
evaluator reviewed documented policies and observed behaviors on-site.
The on-site assessment included direct observation of hand washing
among staff and children, infant sleep position, playground equipment
safety, and presence and adequacy of safety policies and plans for the
care of children with special health care needs. The analyses assessed
urban and suburban differences in center practices and policies. The
study also explored the relationship between sites and demographics on
various on-site practice outcomes.
Centers were categorized based on their metro status (urban, suburban,
rural), profit designation (for profit, not for profit), and source of
funding (state funded, parent funded). Although 310 CCCs were initially
interested in participating from across the state of Pennsylvania, a
convenience sample comprising 134 sites was chosen based on the
feasibility of conducting the evaluations within a geographic area and
on the number of sites that evaluators could visit in each area.
The authors found that
- Eighty-eight (77 percent) of adults and 100 (92 percent) of
children washed their hands after preparing or consuming food; 78 (83
percent) of adults and 103 (95 percent) of children washed their hands
after diapering or toileting.
- Of 205 observations at 134 sites, staff placed 67 percent of
infants on their backs for sleep.
- For the 32 sites with indoor equipment, safe surfacing under and
around the equipment was observed at 10 (21 percent) of sites. For the
107 sites that had outdoor equipment, safe surfacing was observed under
and around the equipment at 52 (57 percent) of sites.
- Overall, suburban, non-profit, parent-funded centers performed
better than urban, for-profit, state-funded centers -- except for sleep
positioning. Urban child care providers were more likely to place
infants on their backs for sleep, compared with suburban providers (85
percent vs. 64 percent). At for-profit sites, infants were more likely
to be placed on their backs for sleep, compared with not-for-profit
sites (87 percent vs. 65 percent). There was no difference noted when
comparing state-funded vs. parent-funded sites.
"The data shows significant hazards and risky practices may be
commonplace in regulated early education and child care programs,"
conclude the authors. A growing body of evidence demonstrates that
improving staff training, drafting policies, and obtaining input from
skilled health professionals may promote safer and healthier CCCs.
Nadel FM, Aronson SS, Giardino AP, et al. 2010. Results of an
observational study of child care centers in Pennsylvania: Varying
approaches to health and safety. The Open Pediatric Medicine Journal
4(9):14-22. Available at (open access) http://www.bentham-open.org/pages/content.php?TOPEDJ/2010/00000004/00000001/14TOPEDJ.SGM
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5. AUTHORS ANALYZE AFRICAN AMERICANS' AWARENESS OF RACIAL DISPARITIES
IN INFANT MORTALITY RATES AND RELATED RISK FACTORS
"A significant proportion of African Americans remain unaware of the
increased risk of infant mortality in their communities and of key
preventive measures for SIDS [sudden infant death syndrome]," write the
authors of an article published in the August 2010 issue of the Journal
of Health Care for the Poor and Underserved. In the United States, the
infant mortality rate (IMR) for African Americans remains more than
twice that for whites; however, according to a nationally
representative survey, most African Americans are unaware of this
disparity. This lack of awareness can be a barrier to encouraging this
population to engage in efforts to improve its overall health. The
study described in this article is part of a project (which includes a
health communication strategy) to improve African-American infant
health outcomes in San Francisco (SF). The article reports the results
of a baseline survey conducted as part of the project and contributes
to the literature on awareness and disparities by (1) quantifying
current levels of awareness of the IMR disparity and related risk
factors among African-American residents of four targeted neighborhoods
and (2) identifying factors that are associated with awareness of these
disparities.
Four SF neighborhoods with the highest number of African-American
births were selected as sites for the study. Researchers conducted a
69-item telephone survey of the neighborhoods. Eligible participants
had to identify as African American, black, or a mixed race including
African American/black, live in a targeted zip code area, and be
between the ages of 18 and 64. The survey assessed awareness of
disparities in IMR, proper infant sleep position, importance of
prenatal care, and effects of alcohol and tobacco on a fetus. There
were 804 eligible participants who completed the survey.
The authors found that
- A majority (57.3%) of respondents had never heard that
African-American infants in SF are two to three times more likely to
die than white infants. Respondents who were over 40 were more likely
to report hearing about this disparity than those under 40, as were
respondents with more than a high school (HS) education compared with
those with an HS education or less.
- Almost 52 percent of respondents reported engaging in any type of
volunteering in the last 12 months. Respondents who knew about the
disparity were more likely to have volunteered than those who did not
know about it.
- Respondents who knew of a local organization working to improve
the health of African-American infants, participated in activities to
benefit the African-American community in the last year, and had a
sense or very strong sense of belonging from his/her neighborhood or
from a community group were also more likely to know about the
disparity.
- Regarding awareness of SIDS prevention, 69.4 percent of
respondents agreed that putting infants to sleep on their backs reduces
risk, 86.6 percent agreed that avoiding fluffy pillows reduces risk,
94.1 percent agreed that avoiding secondhand smoke reduces risk, and
94.5 percent agreed that getting good prenatal care reduces risk.
- Respondents who were aware of the importance of putting infants
to sleep on their backs were significantly more likely to have more
than an HS education, a sense of belonging or a very strong sense of
belonging from family and friends, and a sense of belonging or a very
strong sense of belonging to the African-American community.
The authors conclude that "the process [of addressing disparities] must
build social capital and cohesion through engaging communities in the
assessment and planning of health promotion campaigns and programs to
alert their communities to increased health risks, and to solicit their
input on underlying causes and the development of strategies for change
and workable interventions."
Oliva G, Rienks J, Smyly V. 2010. African American’s [sic] awareness of
disparities in infant mortality rates and sudden infant death syndrome
risks. Journal of Health Care for the Poor and Underserved
21(3):940-960. Abstract available at http://muse.jhu.edu/journals/hpu/summary/v021/21.3.oliva.html
Readers: More information is available from the following MCH Library
resources:
- Infant Mortality and Pregnancy Loss: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_infmort.html
- Racial and Ethnic Disparities in Health: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_race.html
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MCH Alert © 1998-2010 by National Center for Education in Maternal
and
Child Health and Georgetown University. MCH Alert: Focus on Infant
Mortality is produced by
Maternal and Child Health Library at the National Center for Education
in Maternal and Child Health at Georgetown University under its
cooperative agreements
(U02MC00001 and U48MC08717) with the Maternal and Child Health Bureau,
Health
Resources and Services Administration, U.S. Department of Health and
Human Services. The Maternal and Child Health Bureau reserves a
royalty-free, nonexclusive, and irrevocable right to use the work for
federal purposes and to authorize others to use the work for federal
purposes.
Permission is given to forward MCH Alert, in its entirety, to others.
For
all other uses, requests for permission to duplicate and use all or
part of the information contained in this publication should be sent to
mchalert@ncemch.org.
The editors welcome your submissions, suggestions, and questions.
Please contact us at the address below.
EDITOR/ADMINISTRATOR: Jolene Bertness, M.Ed.
CO-EDITOR: Tracy Lopez, M.S.L.S.
COPYEDITOR/WRITER: Ruth Barzel, M.A.
WRITER: Beth DeFrancis, M.L.S.
MCH Alert
Maternal and Child Health Library
National Center for Education in Maternal and Child Health
Georgetown University
Box 571272
Washington, DC 20057-1272
Phone: (202) 784-9770
Fax: (202) 784-9777
E-mail: mchalert@ncemch.org
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