Department of Family Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Clin Ther. 2022 Feb;44(2):186-192. doi: 10.1016/j.clinthera.2021.11.010. Epub 2021 Dec 12.
Despite overall improvement in breastfeeding in the past 3 decades in the United States, significant and alarming social disparities persist. Adverse social determinants of health are increasingly recognized as root causes of social disparities in health outcomes, including breastfeeding initiation and continuation. We provide an overview of the evidence and mechanisms by which social determinants of health, including education, employment, food, neighborhood, and housing contribute to ongoing social disparities in breastfeeding in the United States, including current research gaps. We also review the intersection of social determinants of health with income, racism, and theory of planned behavior, a commonly used decision-making framework for breastfeeding promotion. Future interventions to address social determinants of breastfeeding should occur at the policy, community, organization, and individual levels.
尽管美国在过去 30 年中整体母乳喂养率有所提高，但仍存在显著且令人震惊的社会差异。人们越来越认识到，健康的不利社会决定因素是导致包括母乳喂养开始和持续在内的健康结果存在社会差异的根本原因。我们概述了健康的社会决定因素（包括教育、就业、食品、邻里和住房）如何导致美国母乳喂养持续存在社会差异的证据和机制，包括当前的研究差距。我们还回顾了健康的社会决定因素与收入、种族主义和计划行为理论的交叉点，后者是用于促进母乳喂养的常用决策框架。未来解决母乳喂养社会决定因素的干预措施应在政策、社区、组织和个人层面上进行。
