Graduate School of Nursing, University of Massachusetts Medical School, Worcester, MA, USA.
Department of Medicine, Division of Preventive and Behavioral Medicine University of Massachusetts Medical School , Worcester, MA, USA.
J Racial Ethn Health Disparities. 2018 Dec;5(6):1180-1191. doi: 10.1007/s40615-018-0465-2. Epub 2018 Feb 12.
Breastfeeding rates are lower for black women in the USA compared with other groups. Breastfeeding and lactation are sensitive time points in the life course, centering breastfeeding as a health equity issue. In the USA, experiences of racism have been linked to poor health outcomes but racism relative to breastfeeding has not been extensively investigated.
This study aims to investigate the association between experiences of racism, neighborhood segregation, and nativity with breastfeeding initiation and duration.
This is a prospective secondary analysis of the Black Women's Health Study, based on data collected from 1995 through 2005. Daily and institutional (job, housing, police) racism, nativity, and neighborhood segregation in relation to breastfeeding were examined. Odds ratios and 95% confidence intervals were calculated using binomial logistic regression for the initiation outcomes (N = 2705) and multinomial logistic regression for the duration outcomes (N = 2172).
Racism in the job setting was associated with lower odds of breastfeeding duration at 3-5 months. Racism with the police was associated with higher odds of breastfeeding initiation and duration at 3-5 and 6 months. Being born in the USA or having a parent born in the USA predicted lower odds of breastfeeding initiation and duration. Living in a segregated neighborhood (primarily black residents) as a child was associated with decreased breastfeeding initiation and duration relative to growing up in a predominantly white neighborhood.
Experiences of institutionalized racism influenced breastfeeding initiation and duration. Structural-level interventions are critical to close the gap of racial inequity in breastfeeding rates in the USA.
与其他群体相比，美国黑人女性的母乳喂养率较低。母乳喂养和哺乳期是生命历程中的敏感时期，将母乳喂养作为一个公平问题的中心。在美国，经历种族主义与健康结果不佳有关，但相对于母乳喂养，种族主义尚未得到广泛研究。
本研究旨在调查种族主义经历、邻里隔离和出生地与母乳喂养开始和持续时间的关系。
这是对黑人妇女健康研究的前瞻性二次分析，基于 1995 年至 2005 年期间收集的数据。研究了与母乳喂养相关的日常和机构（工作、住房、警察）种族主义、出生地和邻里隔离。使用二项逻辑回归计算起始结果（N=2705）的比值比和 95%置信区间，使用多项逻辑回归计算持续时间结果（N=2172）。
工作场所的种族主义与 3-5 个月母乳喂养持续时间的几率较低有关。与警察的种族主义与 3-5 个月和 6 个月母乳喂养的起始和持续时间的几率较高有关。出生于美国或父母出生于美国，预测母乳喂养的起始和持续时间的几率较低。作为孩子生活在隔离的社区（主要是黑人居民）与在以白人为主的社区中长大相比，母乳喂养的起始和持续时间减少。
制度化的种族主义经历影响了母乳喂养的开始和持续时间。结构性干预措施对于缩小美国母乳喂养率种族不平等的差距至关重要。
