scholarly journals P10 Realist review linking political exposures to child and maternal health outcomes

Author(s):  
Maxwell Barnish ◽  
Si Ying Tan ◽  
Araz Taeihagh ◽  
Michelle Tørnes ◽  
Rebecca Nelson-Horne ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maxwell S. Barnish ◽  
Si Ying Tan ◽  
Araz Taeihagh ◽  
Michelle Tørnes ◽  
Rebecca V. H. Nelson-Horne ◽  
...  

Abstract Background Conceptual and theoretical links between politics and public health are longstanding. Internationally comparative systematic review evidence has shown links between four key political exposures – the welfare state, political tradition, democracy and globalisation – on population health outcomes. However, the pathways through which these influences may operate have not been systematically appraised. Therefore, focusing on child and maternal health outcomes, we present a realist re-analysis of the dataset from a recent systematic review. Methods The database from a recent systematic review on the political determinants of health was used as the data source for this realist review. Included studies from the systematic review were re-evaluated and those relating to child and/or maternal health outcomes were included in the realist synthesis. Initial programme theories were generated through realist engagement with the prior systematic review. These programme theories were adjudicated and refined through detailed engagement with the evidence base using a realist re-synthesis involving two independent reviewers. The revised theories that best corresponded to the evidence base formed the final programme theories. Results Out of the 176 included studies from the systematic review, a total of 67 included child and/or maternal health outcomes and were included in the realist re-analysis. Sixty-three of these studies were ecological and data were collected between 1950 and 2014. Six initial programme theories were generated. Following theory adjudication, three theories in revised form were supported and formed the final programme theories. These related to a more generous welfare state leading to better child and maternal health especially in developed countries through progressive social welfare policies, left-of-centre political tradition leading to lower child mortality and low birth weight especially in developed countries through greater focus on welfare measures, and increased globalisation leading to greater child and infant mortality and youth smoking rates in LMECs through greater influence of multinational corporations and neoliberal trade organisations. Conclusion We present a realist re-analysis of a large systematically identified body of evidence on how four key political exposures – the welfare state, democracy, political tradition and globalisation – relate to child and maternal health outcomes. Three final programme theories were supported.


Author(s):  
Jason Reece

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.


2018 ◽  
Vol 15 (1) ◽  
Author(s):  
Mishel Unar‐Munguía ◽  
Dalia Stern ◽  
Monica Arantxa Colchero ◽  
Teresita González de Cosío

2018 ◽  
Vol 19 (6) ◽  
pp. 209-224 ◽  
Author(s):  
Risa M. Hoffman ◽  
Konstantia Nadia Angelidou ◽  
Sean S. Brummel ◽  
Friday Saidi ◽  
Avy Violari ◽  
...  

2020 ◽  
Vol 135 (5) ◽  
pp. 658-667 ◽  
Author(s):  
Nadia N. Abuelezam ◽  
Adolfo G. Cuevas ◽  
Sandro Galea ◽  
Summer Sherburne Hawkins

Objectives The health profile of Arab American mothers and infants may differ from that of non–Arab American mothers and infants in the United States as a result of social stigma experienced in the historical and current sociopolitical climate. The objective of our study was to compare maternal health behaviors, maternal health outcomes, and infant health outcomes of Arab American mothers and non-Hispanic white mothers in Massachusetts and to assess the role of nativity as an effect modifier. Methods Using data from Massachusetts birth certificates (2012-2016), we conducted adjusted logistic and linear regression models for maternal health behaviors, maternal health outcomes, and infant health outcomes. We used Arab ethnicity as the exposure of interest and nativity as an effect modifier. Results Arab American mothers had higher odds than non-Hispanic white mothers of initiating breastfeeding (adjusted odds ratio [aOR] = 2.61; 95% CI, 2.39-2.86), giving birth to small-for-gestational-age infants (aOR = 1.28; 95% CI, 1.18-1.39), and having gestational diabetes (aOR = 1.31; 95% CI, 1.20-1.44). Among Arab American mothers, non–US-born mothers had higher odds than US-born mothers of having gestational diabetes (aOR = 1.80; 95% CI, 1.33-2.44) and lower odds of initiating prenatal care in the first trimester (aOR = 0.41; 95% CI, 0.33-0.50). In linear regression models, infants born to non–US-born Arab American mothers weighed 42.1 g (95% CI, −75.8 to −8.4 g) less than infants born to US-born Arab American mothers. Conclusion Although Arab American mothers engage in positive health behaviors, non–US-born mothers had poorer maternal health outcomes and access to prenatal care than US-born mothers, suggesting the need for targeted interventions for non–US-born Arab American mothers.


Author(s):  
Nataraj Kuntagod ◽  
Sanjay Podder ◽  
Satya Sai Srinivas Abbabathula ◽  
Sumantra Mukherjee ◽  
Abhishek Gautam

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