Krieger et al.
What were some of the laws stipulated by Jim Crow that would impact infant health? Name at least 3 that were used by the study to define Jim Crow States.
Segregation of...
Schools
Hospital and healthcare facilities
Pauper Homes (Gov. Run facilities for housing and and support)
Penal institutions
Employment
Transportation
Marriage
Voting
Public accommodation
Name two indicators used to assess structural racism in Wallace et al.
Imprisonment rate, median household income, juvenile custody rate, unemployment rate, educational states, rate of residents in a managerial position.
What are the three causal pathways discussed in Beck et al.
Increased Risk, Lower quality care, socioeconomic disadvantages
How would Jones (author of “Levels of Racism”) categorize the various contexts of inequities described in the articles?
Open-ended!
True or False:
White infant populations experienced the same infant mortality rates in both JC and non-JC states.
False - White infant death rates in fully specified models were consistent to 1.1 - 1.2 times higher in Jim Crow vs non-Jim Crow states.
What contextual predictor showed the strongest association for both black and white infant mortality rates?
Median household income
Name (and describe) one of the three theories we have already learned that is associated with increased risk of preterm birth in black infants.
SDH (Fundamental causes of disease), weathering hypothesis, allostatic load, epigenetics, levels of racism, fetal origins hypothesis.
How can the cliff analogy be used to describe the different gaps in care described by these articles, as well as the solutions presented?
Open ended!
Fill in the blanks:
A unique ____ during the mid-____ provided critical evidence for the _____ affect of the state policy change on the inequity of infant health.
A unique convergence during the mid-1960’s provided critical evidence for the positive effect of the state policy change on the inequity of infant health.
True or False:
Greater racial inequity increased white infant mortality rates.
False - “Greater racial inequity did not increase white infant mortality rates nor did whites experience a health benefit (reduced infant mortality rates) relative to their increasingly advantaged status” (144).
Name two characteristics found in hospitals with higher proportions of VLBW infants.
Higher rates of Infection, Discharge without breast milk, Nurse understaffing, Worse practice environments for nurses, Higher patient to nurse ratio, Higher “missed care”.
What do you suppose are some of the intergenerational/systemic impacts of the experiences faced by Black mothers/infants from the conditions given by the authors?
Open-ended!
What observation provided justification for the conclusion that Black infant death was attributable to racial discrimination and not just income?
Inclusion of random-state cohort affect and county-level income suggested that the trends seen in black infant death occurred outside of income level variants (especially during the 1960s which underwent the war on poverty).
Fill in the blank:
“For every ____ (ICR) increase in states’ median household income, the black infant mortality rate decreased by ____” (142).
“For every $12,641 (ICR) increase in states’ median household income, the black infant mortality rate decreased by 17%” (142).
What are the two strategies NICUs are using to improve infant health outcomes?
High value care + optimized transitions/discharges as patients and families leave the NICU
What did the authors find would be the impact of internal migration patterns had they been a limiting factor to study findings?
The Great Migration (1900-70s) in which millions of African Americans moved away from the South (JC to non-JC) would have increased the effect of Jim Crow (ie. we would have seen a greater concentration of black infant deaths in JC states).
What findings underscored the importance of measuring state economic instability, in addition to national economic instability, association with race specific infant mortality rates?
Unemployment,
(Race-specific infant mortality rates were not significantly associated with total population unemployment, but they were associated with state unemployment rates.)
Describe a possible clinical-community partnership that can be implemented to target infant health disparities.
Open ended!