Bernard Jonathan Y, Cohen Emmanuel, Kramer Michael S
Inserm, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Developmental Origins of Health and Disease (ORCHAD) Team, Villejuif, France.
Paris Descartes University, France.
BMJ Glob Health. 2016 Dec 6;1(4):e000151. doi: 10.1136/bmjgh-2016-000151. eCollection 2016.
Breast feeding initiation rates remain below 80% in some Western countries. Many individual-level determinants are known; however, less is known regarding cultural and societal determinants, such as religion, that could explain population-level variations. We examined the correlations of the proportions of Catholics and Protestants with the breast feeding initiation rates across and within Western countries.
Using publicly available data, we carried out an ecological study comparing the proportions of Catholics and Protestants with the rates of breast feeding initiation. We correlated data at the country level, and additionally explored within-country data in five Western countries: France (Departments), Ireland (counties), the UK (countries), Canada (provinces) and the USA (states). Our analyses accounted for human development index, gross domestic product and population density.
We observed a negative correlation (r=-0.30) between the proportion of Catholics and the rate of breast feeding initiation in Western countries. This correlation was consistent when using within-country data in France (r=-0.27), Ireland (r=-0.23), the UK (r=-0.79) and Canada (r=-0.62). In the USA, the positive correlation (r=0.26) between a state's proportion of Catholics and its breast feeding initiation rate was confounded by race, education and socioeconomic status (SES). After controlling for education and SES, the state proportion of non-Hispanic white Catholics was negatively correlated (r=-0.29) with the rate of breast feeding initiation.
In this ecological study, we found consistent negative correlations between Catholicism and breast feeding initiation rates. Qualitative and quantitative studies at the individual level are needed to confirm and explain our findings. Our results suggest that women living in a country or region where Catholicism has historically dominated are less likely to initiate breast feeding, and that breast feeding promotion policies should be adapted to better fit populations' cultural and religious norms.
在一些西方国家，母乳喂养启动率仍低于80%。许多个体层面的决定因素已为人所知；然而，对于文化和社会层面的决定因素，如宗教，了解较少，而这些因素可能解释了人群层面的差异。我们研究了天主教徒和新教徒的比例与西方国家整体及内部母乳喂养启动率之间的相关性。
利用公开数据，我们开展了一项生态研究，比较天主教徒和新教徒的比例与母乳喂养启动率。我们对国家层面的数据进行了相关性分析，并额外探究了五个西方国家内部的数据：法国（省）、爱尔兰（郡）、英国（国家）、加拿大（省）和美国（州）。我们的分析考虑了人类发展指数、国内生产总值和人口密度。
我们发现西方国家中天主教徒比例与母乳喂养启动率之间存在负相关（r = -0.30）。在法国（r = -0.27）、爱尔兰（r = -0.23）、英国（r = -0.79）和加拿大（r = -0.62）使用国内数据时，这种相关性是一致的。在美国，一个州天主教徒比例与其母乳喂养启动率之间的正相关（r = 0.26）受到种族、教育和社会经济地位（SES）的混淆。在控制了教育和SES之后，非西班牙裔白人天主教徒在该州的比例与母乳喂养启动率呈负相关（r = -0.29）。
在这项生态研究中，我们发现天主教与母乳喂养启动率之间存在一致的负相关。需要在个体层面进行定性和定量研究来证实和解释我们的发现。我们的结果表明，生活在天主教历史上占主导地位的国家或地区的女性进行母乳喂养的可能性较小，并且母乳喂养促进政策应加以调整，以更好地符合人群的文化和宗教规范。
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