Infant Mortality and Racism in the United States

Significant health disparities exist in the United States with regard to infant mortality, a sensitive indicator of a nation’s health. The US has one of the highest infant mortality rates among OECD countries at nearly 6 infant deaths for every 1,000 live births. The rate for Black Americans (11.11 per 1,000) is more than double the rate for White Americans (5.06 per 1,000). Black American women are at higher risk of experiencing risk factors for infant mortality including preterm birth, low birthweight, and prenatal stress. The experience of racism from childhood through adulthood (personal experiences, vicarious experiences, and institutionalized structural racism) is likely a significant contributor to the disparity in infant mortality. This paper reviews the evidence for this and examines racism as a public heath issue.Faculty Sponsor: Disa Lubker Cornis

Infant Mortality and Racism in the United States

Significant health disparities exist in the United States with regard to infant mortality, a sensitive indicator of a nation’s health. The US has one of the highest infant mortality rates among OECD countries at nearly 6 infant deaths for every 1,000 live births. The rate for Black Americans (11.11 per 1,000) is more than double the rate for White Americans (5.06 per 1,000). Black American women are at higher risk of experiencing risk factors for infant mortality including preterm birth, low birthweight, and prenatal stress. The experience of racism from childhood through adulthood (personal experiences, vicarious experiences, and institutionalized structural racism) is likely a significant contributor to the disparity in infant mortality. This paper reviews the evidence for this and examines racism as a public heath issue

Barriers to Breastfeeding among Rural Women in the United States

Breastfeeding is well-established as a beneficial practice for both infants and mothers; substantial evidence from a wide variety of international settings supports the positive impacts of breastfeeding. However, a significant proportion of U.S. infants are not fed according to this standard. While poor breastfeeding rates can be found in all parts of the United States, the problem is particularly prevalent among mothers living in rural environments where health outcomes are consistently worse than national averages. Significant differences have been found between urban and rural women in many breastfeeding behavioral outcomes, including consistently lower rates reported among rural populations. The problem is considered so significant that the Centers for Disease Control and Prevention (CDC) specifically recommend rural mothers as one of the priority groups that should be targeted with breastfeeding promotion programs. It is important to consider what health education strategies have been used to successfully improve breastfeeding outcomes and how they might be incorporated into programming specific to rural populations. The most successful approaches are those that also incorporate participant interaction and an emphasis on building maternal confidence. Health educators should also make efforts to adapt existing prenatal and breastfeeding education programs to include elements that are known to improve breastfeeding outcomes. In addition to program implementation efforts, there are also numerous ways in which health educators can advocate for changes that would promote breastfeeding in rural areas. While there are many potential advocacy topics, some are more pertinent to the needs of rural populations than others. This commentary expands on these issues from an epidemiological and socio-cultural perspective and addresses possible health promotion and health education strategies that could work to reduce this important health disparity

Mother-To-Mother: Evaluation of The Sustainability of A Peer Model to Communicate Nutrition Messages in Mozambique

Background: Over the past twenty-five years, Africa had experienced the smallest relative decrease of child undernutrition in any world region. Many aid organizations were redirecting efforts and resources to supporting community - based initiatives such as Community Health Work (CHW).Aim / Objectives: While peer models showed short term hope, there was limited long-term evidence. The study expounded upon an evaluation on a health promotion program using the Care Group Model. The objective of this research was to examine the sustainability of health gains associated with the use of CHWs via a Care Group Model as a health promotion strategy in the USAIDfunded Child Survival Program in Mozambique five years after the program ended.Methodology: The program was implemented from 2005 to 2010 in Sofala Province, Mozambique. The present study extended the 2010 evaluation through additional data collection in 2015 with 506 participants in th study. Data analysis was done using SPSS and Anthro for behavioral andAnthropometric data entries respectively. Frequencies, Chi-square, Cross - tabulations, and measures of central tendency (i.e., mean) were calculated using SPSS. Initial evaluation of the program, consisted of baseline and endline questionnaires of knowledge, practices, and coverage (KPC questionnaires) this was conducted in February 2006 and June 2010, respectively. This second endline study was conducted in July 2015Results: The data collected showed that, statistically, significant program gains were sustained in 10 out of the 13 indicators during the follow-up  period from 2010 to 2015. Non reverted to their 2005 level nor below. The total number of direct beneficiaries in the Manga district at the end of the project in 2010 was 7,200 women. The original Care Group Model program was implemented from 2005 to 2010 by Food for the Hungry / Mozambique (FH/M) in Sofala Province.Conclusion: Without any external financial support or training, Care Group Volunteers remained important sources of information for community  residents and program impact largely sustainable. Key words: Child malnutrition, evaluation, Care Group Model, sustainabilit

Enhancing Academic Integrity and Facing Academic Dishonesty Afternoon Plenary Session & Wrap-Up

A core classroom value for many college and university instructors is academic integrity and honesty. Instructors often employ a range of strategies to strengthen academic integrity and limit academic dishonesty in their individual courses. By bringing together panelists from a variety of disciplines and professional experiences, who teach a range of courses in diverse formats, levels, and sizes, this panel aims to generate a discussion about how to support a culture of academic integrity. We will address these issues based on how we think about academic integrity and dishonesty, our discipline or course specific concerns, our physical and institutional environments, and our experiences with students and other members of our communities. Ultimately, it is worth noting that cultivating academic integrity within each individual classroom is but one dimension of strengthening and sustaining a broader culture of integrity in the academic communities of which we are a part. In keeping with the spirit of strengthening a broader culture of integrity, this session will include opportunity for discussion and synthesis with the audience

Ethics without Borders: Translating the Ethical Standards to an International Setting

Despite increased interest in research-based health promotion in international settings, the application of ethical principles in health promotion research in these settings is not often discussed. The gap in progress may stem from a limited understanding of how to translate or apply ethical principles in health promotion among poor nations. In addition, there is a limitation in experience in applying ethics in health promotion research (2). There is a substantial literature base related to bioethics, the practical ethics of medicine and biotechnology, but the application of ethics to health promotion and education research is more limited (3). Although advancing empirical knowledge and public health is the intended end of health promotion research, the means by which that end is met are also very important. Many nations in developing countries have been struggling with how to apply codes of ethics in health promotion practice. Those who have developed codes of ethics to guide the responsible act of research often lack capacity to reinforce these codes. Mozambique is one such country that is left to the integrity of researchers. The country has distinctive challenges in conducting health promotion research, namely to fulfill moral duties of justice and respect in the face of poverty, lack of resources and the potential for exploitation. The purpose of this paper is to present one example of how ethical guidelines for U.S. research were translated for use in health promotion research conducted in Mozambique. Using the framework of an evaluation of the cascading health promotion model, this presentation will describe the ways in which principles of the Belmont Report, informed consent, and the Code of Ethics for Health Educators were applied to this international research study. In addition, recommendations and “lessons learned” will be provided for students and faculty seeking to conduct future research in international settings when clear ethical guidelines are missing. References: 1. Kerridge I, Lowe M, Stewart C. Ethics and Law for the Health Professions. 3rd ed. Annandale, NSW: The Federation Press; 2009. 2. Skolnik R. Global Health 101: Essential of Public Health. 2nd ed. Burlington, MA: Jones & Bartlett Learning; 2012. 3. Sindall C. Does health promotion need a code of ethics? Health Promote Int. 2002; 17:201-3

Rural School Food Service Director Perceptions on Voluntary School Meal Reforms

This mixed-method study examined rural U.S. food service directors' perceptions of and experiences with voluntary school meal programs, which have the potential to improve school nutrition but have not been widely adopted in rural areas of the United States. Little is known about how rural food service directors perceive these programs. Interview and survey instruments examined how rural food service directors characterize barriers and facilitators to participation in voluntary school meal programs like farm-to-school and school garden programs. Rural school food service directors participated in a semistructured telephone interview (n=67) and an online survey (n=57). We defined rural school districts by the most rural locale codes (as categorized by the National Center for Education Statistics) in a midsized Midwestern state. Quantitative data were analyzed using descriptive statistics. We analyzed qualitative responses using thematic coding. The qualitative analysis revealed that directors had little experience with these programs and perceived these programs to be very challenging to implement. Issues common to rural school districts were a very small staff, lack of concrete knowledge about how these programs work, and lack of access to local producers and chefs. These findings underscore the need to consider the unique situation of rural schools when promoting voluntary school meals reform programs. We make recommendations about adopting and adapting these voluntary programs to better fit the reality of rural areas