by Team GHEP | Jul 13, 2019 | News
A new study by the Editors of the International Journal of Maternal and Child Health and AIDS (IJMA) shows the first known long-term data on the consequences of maternal opioid use on physical health and developmental outcomes of children using 20 years of clinical data. The study shows that children exposed to opioids in the womb are more likely to face short-term and long-term physical and mental difficulties as they grow up.
The study published in JAMA Network OPEN by Dr. Romuladus Azuine, IJMA Editor-in-Chief and Dr. Gopal Singh, IJMA Editor, showed that for babies, exposure to opioids in the womb was associated with higher risks of fetal growth restriction and preterm birth.
According to the study, among preschool-aged children, opioid exposure was associated with increased risks of lack of expected physiological development and conduct disorder/emotional disturbance. For school-aged children, opioid exposure was associated with a higher risk of attention-deficit/hyperactivity disorder (ADHD).
The U.S. Government is making concerted efforts to identify risk factors and improve prevention strategies to reduce health effects of opioids. In fact, reducing opioid epidemic is a key policy of the Trump administration with billions of dollars budgeted to address the public health problem hitting the country.
Using decades of data from the Boston Birth Cohort, one of the longest existing cohorts in the U.S., Drs. Azuine, Singh, and colleagues found that 454 of the 8509 babies (5.3%) were exposed to opioids in the womb. There was an upward trend in Neonatal Abstinence Syndrome (NAS) over the last 15 years, ranging from a low of 12.1 per 1,000 hospital births in 2003 to a high of 32 per 1,000 births in 2016.
“We have in our hands an epidemic that bears dire risks and consequences for babies, mothers, and future generations. Regardless of who we are: program planners, policy makers, or community leaders, these findings give us enough information to act. The time to act and stop the opioid epidemic is now,” said Dr. Azuine.
LINKS AND MEDIA COVERAGE:
Azuine RE, Ji Y, Chang H, et al. Prenatal Risk Factors and Perinatal and Postnatal Outcomes Associated With Maternal Opioid Exposure in an Urban, Low-Income, Multiethnic US Population. JAMA Netw Open. Published online June 28, 20192(6):e196405. doi:10.1001/jamanetworkopen.2019.6405
Brogly S. Maternal and Child Health After Prenatal Opioid Exposure. JAMA Netw Open. Published online June 28, 20192(6):e196428. doi:10.1001/jamanetworkopen.2019.6428
Birth, Child Outcomes Associated With Moms Using Opioids During Pregnancy, JAMA Network Open, June 28, 2019.
‘Flawed’ study shows possible lasting effects from drug exposure in the womb, Boston Globe, June 28, 2019.
Opioid exposure leads to poor perinatal and postnatal outcomes, MDEdge, July 10, 2019.
Prenatal opioid exposure could bring long-term harm to kids, MedicalExpress, June 28, 2019.
Significant health risks associated with opioid use during pregnancy, The Evidence Base, July 2, 2019.
International Journal of Maternal and Child Health and AIDS (IJMA).
by Team GHEP | Jun 1, 2019 | News
Large inequalities in US infant mortality by race and socioeconomic status have persisted for over a century, despite the massive decline in mortality over time, according to a major new study published in the International Journal of MCH and AIDS (IJMA).
The study entitled “Infant Mortality in the United States, 1915-2007: Large Social Inequalities Have Persisted for Over a Century,” is the first comprehensive attempt to empirically examine infant mortality disparities in the US by race/ethnicity, socioeconomic status, geographic area, and cause of death by using more than 100 years of vital statistics data.
The following are some of the key findings from the study:
- The US ranks 31st in the infant mortality rate when compared to 36 other industrialized nations. The 2015 data show a 3-to-4 times higher infant mortality rate in the US compared to Hong Kong, Singapore, and Finland and a 31-to-51% higher rate compared to Canada and England & Wales.
- During 1915-2017, the infant mortality rate declined dramatically overall and for black and white infants. However, racial disparities in mortality increased through 2000 due to a slower decline in mortality for black infants. In 2017, black infants had a 122% higher risk of infant mortality than white infants.
- Detailed comparisons show an approximately five-fold difference in infant mortality among ethnic groups, with rates ranging from a low of 2.3 infant deaths per 1,000 live births for Chinese infants to a high of 8.5 for American Indian/Alaska Natives and 11.2 for black infants.
- Infant mortality from major causes of death such as perinatal conditions, birth defects, sudden infant death syndrome, respiratory distress syndrome, and pneumonia and influenza showed a downward trend during the past 5 decades. However, infant mortality from prematurity/low birthweight and unintentional injury has increased in recent years.
- Educational disparities in infant mortality widened between 1986 and 2016. In 2016, mothers with less than a high school education experienced 2.4, 1.9, and 3.7 times higher risk of infant, neonatal, and post-neonatal mortality than those with a college degree.
- Geographic disparities were marked and widened across regions and states during 1969-2016, with states in the Southeast region having higher infant mortality rates than those in New England and Pacific regions.
According to the authors, improvements in living conditions, advances in neonatal medicine and infant healthcare, reductions in smoking during pregnancy, and increased access to and use of prenatal care were responsible for decreases in infant mortality rates over the past several decades.
However, they argue that increases in mortality from prematurity and low birthweight, widening socioeconomic disparities, and a continuing gap in access to high-quality neonatal and infant health care have stalled the progress made in reducing infant mortality.
“Large and increasing social disparities in infant mortality, particularly in recent decades, are a major factor contributing to the worsening international standing of the United States,” said Dr. Singh, adding that “these disparities pose a significant barrier to further improvements in population health.”
About IJMA: The International Journal of Maternal and Child Health and AIDS (IJMA) is a multidisciplinary, peer-reviewed, global health, open access journal that publishes original research articles, review articles, methodology articles, field studies or field reports, policy papers, and commentaries in all areas of maternal and child health (MCH) and human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS).
Study Contact: For additional information, please contact the study’s lead author, Dr. Gopal Singh of the Health Resources and Services Administration, US Department of Health and Human Services (email: [email protected]).
by Team GHEP | May 9, 2018 | News
National Nurses Week begins each year on May 6 and ends on May 12, Florence Nightingale’s birthday. These permanent dates enhance planning and position National Nurses Week as an established recognition event. As of 1998, May 8 was designated National Student Nurses Day, to be celebrated annually. And as of 2003, National School Nurse Day is celebrated on the Wednesday within National Nurses Week each year.
The nursing profession has been supported and promoted by the American Nurses Association (ANA) since 1896. Each of ANA’s state and territorial nurses associations promotes the nursing profession at the state and regional levels. Each conducts celebrations on these dates to recognize the contributions that nurses and nursing make to the community.
The ANA supports and encourages National Nurses Week recognition programs through the state and district nurses associations, other speciality nursing organizations, educational facilities, and independent health care companies and institutions.
FLORENCE NIGHTINGALE PLEDGE
This modified “Hippocratic Oath” was composed in 1893 by Mrs. Lystra E. Gretter and a Committee for the Farrand Training School for Nurses in Detroit, MI. It was called the Florence Nightingale Pledge as a token of esteem for the founder of modern nursing.
Follow this link to celebrate with the Nurses at this National Nurses Week
American Nurses Association Inc.
by Editor | Mar 4, 2018 | News
Social Inequalities in health are marked and, in fact, have widened over time for a number of health indicators in the United States, most notably in life expectancy, infant mortality, cancer and cardiovascular mortality, and HIV/AIDS, according a new study published in the International Journal of MCH and AIDS (IJMA).
The study entitled “Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016” which was published in the latest issue of the journal examines many important health inequality trends by social determinants such as race/ethnicity, education, income, poverty, area deprivation, unemployment, housing, rural-urban residence, and geographic location.
The following are some of the key findings of the study:
- Life expectancy of Americans increased from 69.7 years in 1950 to 78.8 years in 2015. However, disparities have persisted. In 2015, life expectancy was highest for Asian/Pacific Islanders (87.7 years) and lowest for African Americans (75.7 years).
- There are wide disparities in US life expectancy – a gap of more than 17 years in life expectancy between African American men (72.3 years) and Asian/Pacific Islander women (89.7 years).
- Life expectancy is lower in rural areas of the United States. Rural-urban disparities in life expectancy have widened over the past 25 years. Life expectancy ranges from 74.5 years for men in rural areas to 82.4 years for women in large metropolitan areas.
- During the past eight decades, infant mortality rates have decreased greatly for all groups. However, racial disparities have widened over time. In 2015, the mortality rate for African American infants was 11.4 per 1,000 live births, 2.3 times higher than the rate of 4.9 for white infants.
- Infant mortality is two times greater in the poorest communities of the US compared to the most-affluent communities.
- Men with less than a high school education and those below the poverty level have 2.6 times higher lung cancer mortality than their more educated and affluent counterparts.
- Men and women with less than a high school education have, respectively, 42% and 120% higher colorectal cancer mortality risks than those with a college degree.
- Women with less than a high school education and below the poverty level have 6.3 and 4.0 times higher cervical cancer mortality than women with the highest education and income levels, respectively.
- Men and women with low education and incomes have 46-76% higher CVD mortality than their counterparts with high education and income levels. Women in transport occupations have 2.6 times higher mortality risks than those in executive and managerial occupations.
For further information, please contact IJMA at: [email protected]
by Editor | Jul 1, 2017 | News
Washington, DC — About 61 percent of people with Nigerian ancestry age 25 and older had a bachelor’s degree or higher — more than twice the U.S. rate of 28.5 percent, according to a recent U.S. Census Bureau report on Characteristics of Selected Sub-Saharan African and Caribbean Ancestry Groups in the United States: 2008-2012.
This new report from the 2008-2012 American Community Survey covers the population who reported Sub-Saharan African ancestry — Ethiopian and Nigerian — and Caribbean (West Indian) ancestry — Haitian, Jamaican, and Trinidadian and Tobagonian. These ancestry groups were selected due to their relatively small populations and being under researched compared to their counterparts. About 2.5 million people in the United States identified as one of these ancestry groups, or around 0.8 percent of the total U.S. population. This represents an increase of about 2.1 million, or around 469 percent, since the 1980 Census.
“Acquiring a college or other advanced degree was a major factor for many people of Nigerian ancestry coming to the United States, so it is not surprising that twice as many had a bachelor’s degree or higher compared to all people and the other selected ancestry groups,” said Dr. Stella Ogunwole, a demographer in the Population Division.
The report also found the rate of labor force participation was 71 percent or higher for all of the selected groups compared to the U.S. rate of 64.7 percent. Thirty-six percent of the civilian employed population age 16 and older in the United States worked in management, business, science and arts occupations, but the Nigerians — the most educated group — had the largest share in this type of occupation at 52 percent.
“Each of these ancestries carved a different immigration path to the United States: many sought technical training, advanced education, political asylum and better opportunities with the thriving labor market,” added Ogunwole.
Ethiopians were the fastest growing among these ancestry groups — growing from 1980 to 2008-2012 by around 2,400 percent, and Haitians had the largest numeric change over the same period, with an increase of about 777,000 (862 percent).
“The New York and Miami metro areas in particular had large concentrations of people of Jamaican or Haitian ancestry,” said Darryl Cohen, a geographer in the Population Division.
These findings came from the 2008-2012 American Community Survey. The report also used decennial censuses back to 1980 to compare changes in population for given ancestry groups, since ancestry was first measured in the 1980 Census. The findings from the report include the geographic distribution of the population in these ancestry groups, as well as various demographic and socio-economic characteristics, such as age and sex, household type, nativity, educational attainment, labor force participation, occupation, earnings, poverty and homeownership.
Other highlights from the report:
Age
The two Sub-Saharan African ancestry groups (Nigerian and Ethiopian) and those of Haitian ancestry each had a median age of about 30 years, younger than the other two Caribbean groups (Jamaican at 34.5 years, and Trinidadian and Tobagonian at 35.8 years).
Labor Force
Nationally about two-thirds (65 percent) of the population age 16 and older was in the labor force. People who reported Nigerian or Ethiopian ancestries had the highest participation rates (76 percent each) among all the selected ancestry groups.
At least 71 percent of people age 16 and older with Haitian, Jamaican, and Trinidadian and Tobagonian ancestries participated in the labor force.
Geography
The geographic distributions of these ancestry groups vary considerably, with those of Haitian, Jamaican, and Trinidadian and Tobagonian ancestries most concentrated in Florida and New York. The Ethiopian and Nigerian ancestry groups are more widely dispersed across the United States.
Language diversity
Even though English is the official language of Nigeria, less than half of the population reporting Nigerian ancestry spoke only English at home (43 percent).
Eighty percent of the U.S. population age 5 and older spoke only English at home. Among the selected ancestry groups, those with Trinidadian and Tobagonian (95.5 percent) and Jamaican (92.7 percent) ancestries were most likely to speak only English at home.
Foreign-Born Status
In 2012, 13 percent of people residing in the United States were foreign-born. By comparison, almost three-quarters of the population reporting Ethiopian ancestry (72 percent) were foreign-born, the highest among the selected ancestry groups.
Approximately six out of every 10 people among the other ancestry groups (Trinidadian and Tobagonian, Nigerian, Jamaican and Haitian ancestries) were foreign-born.
Homeownership
Those with Jamaican ancestry had the highest rate of homeownership among the five groups, at 53.7 percent; the national rate was 65.5 percent.
The American Community Survey is a nationwide survey designed to provide communities with reliable and timely demographic, social, economic and housing data for congressional districts, counties, places and other localities every year.
by Team GHEP | Nov 15, 2016 | News
The Maryland Environmental Health Network (MdEHN) seeks to fill the position of Director in early 2017.
MdEHN was formed 5 years ago through the support and vision of key funders, with guidance from a Steering Committee of issue experts, and under the leadership of Rebecca Ruggles. MdEHN functions under the auspices of the Association of Baltimore Area Grantmakers which serves as its fiscal agent.
MdEHN has three full-time staff: Rebecca Ruggles, Director; Allison Rich, Children’s Environmental Health Specialist, and Rebecca Rehr, Public Health Advocacy Coordinator.
Rebecca Ruggles will leave her role as founding director at the end of 2016 or in early 2017. The Director position is responsible for strategic planning, project oversight, partner and funder relations, grant-writing, and staff coordination.
We seek candidates who are able to support our strong staff and enable their work to continue, as guided by our strategic plan, vision, mission, and values. The new director will be a professional with knowledge of public health, advocacy, environmental health, and/or non-profit management. Passion for issues of environmental justice and equity in Maryland is central to our organization. The next director will also take MdEHN in new directions, forging new partnerships, and competing successfully for new funding streams.
The position can be structured to accommodate schedule preferences, including the possibility of working on a part-time basis and with flexibility for the work to be performed both on-site and remotely.
Applicants should send a confidential letter of inquiry to the email address below discussing the following:
- Your background or training in public health, environmental health, or related fields
- Your knowledge of the Maryland landscape (or a similar state)
- Your philosophy of leadership and team management
- Specific skills, contacts, or relevant knowledge that you can offer – particularly in
- Strategic Planning for small non-profits
- Funder Relations and Grant Writing
- Advocacy
- Why you would like to join MdEHN
Further Information
Rebecca Ruggles is available to talk by phone or email to discuss this opportunity informally.
Please review the organization website MdEHN.org and the summary below of our vision, mission, values, roles, and strategic priorities before contacting Rebecca to schedule a time to speak.
