Sudden infant death and social justice: A syndemics approach

Sudden unexpected infant death (SUID) and sudden infant death syndrome (SIDS) prevention has focused on modifying individual behavioural risk factors, especially bedsharing. Yet these deaths are most common among poor and marginalized people in wealthy countries, including U.S. Blacks, American Indians/Alaskan Natives, New Zealand Māori, Australian Aborigines, indigenous Canadians, and low‐income British people. The United States now has the world's highest prevalence of SUID/SIDS, where even Whites' SIDS prevalence now approaches that of the Māori. Using public databases and the literature, we examine SUID/SIDS prevalence and the following risk factors in selected world populations: maternal smoking, preterm birth, alcohol use, poor prenatal care, sleep position, bedsharing, and formula feeding. Our findings suggest that risk factors cluster in high‐prevalence populations, many are linked to poverty and discrimination and have independent effects on perinatal outcomes. Moreover, populations with the world's lowest rates of SUID/SIDS have low income‐inequality or high relative wealth, yet have high to moderate rates of bedsharing. Employing syndemics theory, we suggest that disproportionately high prevalence of SUID/SIDS is primarily the result of socially driven, co‐occurring epidemics that may act synergistically to amplify risk. SUID must be examined through the lens of structural inequity and the legacy of historical trauma. Emphasis on bedsharing may divert attention from risk reduction from structural interventions, breastfeeding, prenatal care, and tobacco cessation. Medical organizations play an important role in advocating for policies that address the root causes of infant mortality via poverty and discrimination interventions, tobacco control, and culturally appropriate support to families

Gender mainstreaming within local planning authorities

This paper discusses the extent to which EU-derived gender mainstreaming (GM) requirements are being adopted with reference to Royal Town Planning Institute research on the situation in UK local planning authorities (LPAs). Firstly, the problem of a lack of gender perspective on planning policy is summarised. Barriers to progress are explained and the role of enablers is identified. International and European factors that resulted in GM becoming an integral component of the UK planning system are explained. The second part of the paper outlines the current extent of GM in LPAs. Although generic equalities policy is widespread, it is primarily concerned with personnel matters and there is little understanding of the impact of gender considerations on planning policy. At best there is an assumption that only policies related to women's traditional roles are affected. At worst some LPAs do not consider gender to be of any relevance to the planning process, particularly in departments where there is little social awareness and a technical and quantitative approach predominates. The methodological steps required to achieve GM that need to be applied to the planning process are summarised. Little will change unless central government gives high-level guidance on mainstreaming, and resource allocation and awareness training is increased. Cultural change is needed within the profession to enable planners to take gender seriously