Population Disparities in Breastfeeding in the United States

Harvard School Of Public Health, Boston MA

Investigators

Abstract

[unreadable] DESCRIPTION (provided by applicant): The purpose of this project is to document and describe the extent to which breastfeeding rates, as well as social disparities in breastfeeding, vary across the United States, and to examine whether certain state-level policy factors and social conditions are associated with these rates and disparities. This project addresses the CDC's Health Protection Goal, "Healthy People in Every Stage of Life: Infants and Toddlers, ages 0-3: Start Strong" and specifically, starter objective #2: "Promote social and physical environments that support the health, safety, and development of infants and toddlers;" and starter objective #3: "Promote optimal development among infants and toddlers." Furthermore, the project supports Healthy People 2010 objective 16-19, to increase the proportion of mothers who breastfeed their babies, and the overarching goal of eliminating health disparities. The project involves three overarching aims: 1) To describe the extent to which rates of breastfeeding vary across the United States, controlling for population composition, and to describe the extent to which social disparities in breastfeeding rates (by race and social class) are variable across the states; 2) To identify whether differences in state-level Temporary Aid to Needy Families (TANF) policy are associated with disparate breastfeeding rates by family income; and 3) To identify associations of state-level measures of the "status of women" with state breastfeeding rates, and to identify whether state-level disparities in the women's status by race are associated with state-level racial disparities in breastfeeding rates. For all three analyses, multi-level logistic regression analyses modeling the probability of breastfeeding and the probability of breastfeeding at 6-months, will be conducted using data from the National Survey of Children's Health of 2003, (NSCH). NSCH data will be linked to state-level variables, including TANF policy and "status of women" composite measures obtained from the Institute for Women's Policy Research. The results of this study will help to fill critical gaps in knowledge around factors potentially driving long- standing, and to date, unexplained population disparities in breastfeeding. Examining the effects of state-level conditions provides an opportunity to identify determinants of breastfeeding disparities which may be modified by changes in policy. This project addresses Healthy People 2010 objective 16-19, to increase the proportion of mothers who breastfeed their babies, and the goal of eliminating health disparities, and also aligns with the CDC's new health protection goal, "Healthy People in Every Stage of Life: Start Strong." The study will be informative around policy and social conditions affecting breastfeeding disparities in the United States. [unreadable] [unreadable] [unreadable] [unreadable]