scholarly journals A Prematurity Collaborative Birth Equity Consensus Statement for Mothers and Babies

2020 ◽  
Vol 24 (10) ◽  
pp. 1231-1237
Author(s):  
Fleda Mask Jackson ◽  
Kweli Rashied-Henry ◽  
Paula Braveman ◽  
Tyan Parker Dominguez ◽  
Diana Ramos ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Maternal Health ◽  
Racial Disparities ◽  
Health Equity ◽  
Social Determinants ◽  
Consensus Statement ◽  
Core Values ◽  
Call To Action ◽  
The Core ◽  
March Of Dimes

Abstract Introduction In 2016, March of Dimes (MOD) launched its Prematurity Collaborative to engage a broad cross section of national experts to address persistent and widening racial disparities in preterm birth by achieving equity and demonstrated improvements in preterm birth. African-American and Native American women continue to have disproportionate rates of preterm birth and maternal death. As part of the Collaborative, MOD created the Health Equity Workgroup whose task was the creation of a scientific consensus statement articulating core values and a call to action to achieve equity in preterm birth utilizing health equity and social determinants of health frameworks. Methods Health Equity Workgroup members engaged in-person and virtually to discuss key determinant contributors and resolutions for disparate maternal and birth outcomes. Workgroup members then drafted the Birth Equity Consensus Statement that contained value statements and a call to action. The birth equity consensus statement was presented at professional conferences to seek broader support. This article highlights the background and context towards arriving at the core values and call to action, which are the two major components of the consensus statement and presents the core values and call to action themselves. Results The result was the creation of a birth equity consensus statement that highlights risks and protections of social determinants based on the prevailing science, and identifies promising solutions for reducing preterm birth and eliminating racial disparities. Conclusion The birth equity consensus statement provides a mandate, guiding the work of March of Dimes and the broader MCH community, for equity-based research, practice, and policy advocacy at local, state, and federal levels. Significance This field report adds to the current knowledge base on racial and ethnic disparities in birth and maternal health outcomes. Research has documented the science behind eliminating health disparities. Scientists and practitioners should continue to explore in practice how the social determinants of birth and maternal health, which manifest historically and contemporarily, can be addressed.

scholarly journals Explaining the Black-White Disparity in Preterm Birth: A Consensus Statement From a Multi-Disciplinary Scientific Work Group Convened by the March of Dimes

2021 ◽  
Vol 3 ◽  
Author(s):  
Paula Braveman ◽  
Tyan Parker Dominguez ◽  
Wylie Burke ◽  
Siobhan M. Dolan ◽  
David K. Stevenson ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Black Women ◽  
Socioeconomic Factors ◽  
Racial Disparities ◽  
White Women ◽  
Work Group ◽  
Scientific Work ◽  
Systemic Racism ◽  
March Of Dimes ◽  
Disease Risks

In 2017–2019, the March of Dimes convened a workgroup with biomedical, clinical, and epidemiologic expertise to review knowledge of the causes of the persistent Black-White disparity in preterm birth (PTB). Multiple databases were searched to identify hypothesized causes examined in peer-reviewed literature, 33 hypothesized causes were reviewed for whether they plausibly affect PTB and either occur more/less frequently and/or have a larger/smaller effect size among Black women vs. White women. While definitive proof is lacking for most potential causes, most are biologically plausible. No single downstream or midstream factor explains the disparity or its social patterning, however, many likely play limited roles, e.g., while genetic factors likely contribute to PTB, they explain at most a small fraction of the disparity. Research links most hypothesized midstream causes, including socioeconomic factors and stress, with the disparity through their influence on the hypothesized downstream factors. Socioeconomic factors alone cannot explain the disparity's social patterning. Chronic stress could affect PTB through neuroendocrine and immune mechanisms leading to inflammation and immune dysfunction, stress could alter a woman's microbiota, immune response to infection, chronic disease risks, and behaviors, and trigger epigenetic changes influencing PTB risk. As an upstream factor, racism in multiple forms has repeatedly been linked with the plausible midstream/downstream factors, including socioeconomic disadvantage, stress, and toxic exposures. Racism is the only factor identified that directly or indirectly could explain the racial disparities in the plausible midstream/downstream causes and the observed social patterning. Historical and contemporary systemic racism can explain the racial disparities in socioeconomic opportunities that differentially expose African Americans to lifelong financial stress and associated health-harming conditions. Segregation places Black women in stressful surroundings and exposes them to environmental hazards. Race-based discriminatory treatment is a pervasive stressor for Black women of all socioeconomic levels, considering both incidents and the constant vigilance needed to prepare oneself for potential incidents. Racism is a highly plausible, major upstream contributor to the Black-White disparity in PTB through multiple pathways and biological mechanisms. While much is unknown, existing knowledge and core values (equity, justice) support addressing racism in efforts to eliminate the racial disparity in PTB.

scholarly journals A Systematic Policy Review of Black Maternal Health-Related Policies Proposed Federally and in Massachusetts: 2010–2020

2021 ◽  
Vol 9 ◽  
Author(s):  
Keri Carvalho ◽  
Anna Kheyfets ◽  
Pegah Maleki ◽  
Brenna Miller ◽  
Siwaar Abouhala ◽  
...  
Keyword(s):  
Data Analysis ◽  
Black Women ◽  
Maternal Health ◽  
Racial Disparities ◽  
Health Equity ◽  
White Women ◽  
Positive Impact ◽  
State Level ◽  
Unintended Effects ◽  
National Policies

Background: Black women in the United States experience maternal mortality three to four times more often than white women (1, 2). States vary in degree of disparity, partially due to programs and policies available to pregnant people. In Massachusetts, Black women were approximately twice as likely as white women to experience pregnancy-associated mortality, with a large percentage of these deaths reported to be preventable (3).Methods: Using Massachusetts as a state-level comparison to national policies, we searched the US Congress and Massachusetts legislative databases for maternal health policies from 2010 to 2020. We screened 1,421 national and 360 Massachusetts bills, following set inclusion/exclusion criteria. Data analysis included (1) assessment of bill characteristics, (2) thematic analysis, and a (3) quality appraisal following an adapted model of the analytical framework for evaluating public health policy proposed by the National Collaborating Centre for Healthy Public Policy. Additionally, our data analysis identified the level of racism (internalized, interpersonal or institutional) that each policy addressed.Results: From 2010 to 2020, 31 national and 16 state-level policies were proposed that address maternal health and racial disparities. The majority of policies addressed racism at the institutional level alone (National: N = 19, 61.3%, Massachusetts: N = 14, 87.5%). Two national and two Massachusetts-level policies became law, while two national policies passed only the House of Representatives. Our critical appraisal revealed that the majority of unintended effects would be neutral or positive, however, some potential negative unintended effects were identified. The appraisal also identified 54.8% (n = 17) of national policies and 68.8% (n = 11) of Massachusetts with positive impact on health equity.Conclusions: There has been an increase in policies proposed addressing racial disparities and health equity in maternal health over the last 10 years. Although half of national policies proposed showed positive impact on health equity, shedding light on the work the U.S. is doing on a federal level to confront the Black maternal health crisis, only two policies made it to law, only one of which addressed racial disparities directly and had a positive impact on health equity.

Citizenship, Community, and Ethics: Forrest Gump as a Moral Exemplary

Public Voices ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 82
Author(s):  
William D. Richardson ◽  
Ronald L. McNinch
Keyword(s):  
Public Administration ◽  
Common Sense ◽  
Democratic Republic ◽  
Core Values ◽  
Elected Officials ◽  
Political Climate ◽  
Ordinary Citizen ◽  
The Core ◽  
Timely Reminder ◽  
Ordinary Citizens

"Forrest Gump" bas been extraordinarily popular with the ordinary citizens and one of the reasons is self-evident: it presents a Jeffersonian confidence in the moral stalwartness of the yeoman citizenry that runs counter to some of the current approaches in ethics. The film celebrates a basic decency and a common sense that are accessible to all. No real or imagined superiority is required for one to partake. The film is not only popular but also populist in its assertion of the primacy of the ordinary citizen within this regime. In a political climate that now finds the tenure of elected officials uncertain and the legitimacy of public administration suspect, the visible portrayal of exemplary citizen virtues may serve as a timely reminder to all that, more so than any other regime, a democratic republic is ultimately and fundamentally dependent on the core values possessed by its citizenry.

scholarly journals Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lauren Dyer ◽  
Rachel Hardeman ◽  
Dovile Vilda ◽  
Katherine Theall ◽  
Maeve Wallace
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Black Women ◽  
Low Birth Weight ◽  
Racial Disparities ◽  
Population Health ◽  
Birth Outcomes ◽  
Mass Incarceration ◽  
Interquartile Range ◽  
Adverse Birth Outcomes

Abstract Background A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. Methods We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. Results There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. Conclusion Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.

Assessing baccalaureate nursing students’ knowledge and attitudes of social determinants of health after a health equity simulation

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Quyen Phan ◽  
Naomi Johnson ◽  
JoAnna Hillman ◽  
Daniel Geller ◽  
Laura P. Kimble ◽  
...  
Keyword(s):  
Nursing Students ◽  
Social Determinants Of Health ◽  
Health Equity ◽  
Social Determinants ◽  
Baccalaureate Nursing ◽  
Baccalaureate Nursing Students ◽  
Determinants Of Health ◽  
Marginalized Populations ◽  
Knowledge And Attitudes ◽  
The Impact

AbstractObjectiveFor nursing students, competency in population health management involves acquiring knowledge and forming attitudes about the impact of the social determinants of health (SDoH) on health equity. The purpose of this pilot study was to assess nursing students’ knowledge and attitudes about the SDoH and health equity following a focused simulation activity.MethodBaccalaureate nursing students (N=182) participated in a ninety-minute health equity simulation and a post-simulation debrief. Forty-four students (23%) completed a 19-item post-simulation survey.ResultsSixty-four percent of participants reported positive attitude change in working with marginalized populations caused by the SDoH, and 89% reported being knowledgeable about the role of the registered nurse in addressing health equity. Seventy-five percent reported enhanced knowledge of the SDoH through the health equity simulation.ConclusionUsing health equity simulation may be effective in enhancing students’ knowledge, as well as their attitudes in caring for the health of marginalized populations by addressing the SDoH.

scholarly journals Researching Change and Changing: Integrating Collaboration and Action Through Interiority

2021 ◽  
pp. 002188632110260
Author(s):  
Abraham B. (Rami) Shani ◽  
David Coghlan
Keyword(s):  
Organizational Change ◽  
Core Values ◽  
Actionable Knowledge ◽  
The Core ◽  
Integrative Process ◽  
Present Tense ◽  
Collaborative Ventures

In this essay, we are arguing that the field of organizational change and development is positioned to face the challenges of researching change and changing for the next decade and beyond. The core values in the field—that researching change and enacting changing are collaborative ventures undertaken in the present tense where the outcome is actionable knowledge, and that it serves the practical ends of organizations and generates the knowledge of how organizations change—are of utmost relevant for the emerging workplace and organizations. Through differentiated consciousness interiority challenges the polarizations that beset the field (between science and practice) and provides an integrative process focused on the operations of human knowing.

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