Heck Katherine E, Braveman Paula, Cubbin Catherine, Chávez Gilberto F, Kiely John L
National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
Public Health Rep. 2006 Jan-Feb;121(1):51-9. doi: 10.1177/003335490612100111.
Objectives. To examine multiple dimensions of socioeconomic status and breastfeeding among a large, random sample of ethnically diverse women.
This study used logistic regression analysis to examine the influence of a range of socioeconomic factors on the chances of ever breastfeeding among a stratified random sample of 10,519 women delivering live births in California for 1999 through 2001. Measures of socioeconomic status included family income as a percentage of the federal poverty level, maternal education, paternal education, maternal occupation, and paternal occupation.
Consistent with previous research, there was a marked socioeconomic gradient in breastfeeding. Women with higher family incomes, those who had or whose partners had higher education levels, and women who had or whose partners had professional or executive occupations were more likely than their counterparts to breastfeed. After adjustment for many potential confounders, maternal and paternal education remained positively associated with breastfeeding, while income and occupation were no longer significant. Compared with other racial or ethnic groups, foreign-born Latina women were the most likely to breastfeed.
The significant association of maternal and paternal education with breastfeeding, even after adjustment for income, occupation, and many other factors, suggests that social policies affecting educational attainment may be important factors in breastfeeding. Breastfeeding rates may be influenced by health education specifically or by more general levels of schooling among mothers and their partners. The continuing importance of racial/ethnic differences after adjustment for socioeconomic factors could reflect unmeasured socioeconomic effects, cultural differences, and/or policies in Latin American countries.
目的。在一个种族多样的大型随机抽样女性群体中，研究社会经济地位和母乳喂养的多个维度。
方法。本研究采用逻辑回归分析，在1999年至2001年于加利福尼亚州分娩活产的10519名女性的分层随机样本中，检验一系列社会经济因素对曾经进行母乳喂养几率的影响。社会经济地位的衡量指标包括家庭收入占联邦贫困线的百分比、母亲教育程度、父亲教育程度、母亲职业和父亲职业。
结果。与先前研究一致，母乳喂养存在明显的社会经济梯度。家庭收入较高、本人或其伴侣教育水平较高、本人或其伴侣从事专业或行政职业的女性比其他女性更有可能进行母乳喂养。在对许多潜在混杂因素进行调整后，母亲和父亲的教育程度与母乳喂养仍呈正相关，而收入和职业不再具有显著性。与其他种族或族裔群体相比，外国出生的拉丁裔女性最有可能进行母乳喂养。
结论。即使在对收入、职业和许多其他因素进行调整后，母亲和父亲的教育程度与母乳喂养之间仍存在显著关联，这表明影响教育程度的社会政策可能是母乳喂养的重要因素。母乳喂养率可能受到专门的健康教育或母亲及其伴侣更普遍的教育水平的影响。在对社会经济因素进行调整后，种族/族裔差异的持续重要性可能反映了未测量的社会经济影响、文化差异和/或拉丁美洲国家的政策。
