Toney-Noland Caroline, Cohen Ronald S, Joe Lenae, Kan Peiyi, Lee Henry C
School of Nursing, Oregon Health and Sciences University, Portland, Oregon, USA.
School of Medicine, Department of Pediatrics Stanford University, Palo Alto, California, USA.
Breastfeed Med. 2024 Dec;19(12):964-968. doi: 10.1089/bfm.2024.0199. Epub 2024 Oct 28.
Donor human milk (DHM) can provide many benefits to neonates. This study examines access to DHM and how structural barriers may exacerbate inequities. The median test and analysis of variance test were used to compare the distribution of maternal race/ethnicity and insurance status variables with DHM access for California neonatal intensive care units (NICUs) in 2021. Across 124 NICUs, those serving a higher percentage of white families were more likely to have access to DHM ( = 0.04). NICUs with a higher percentage of Hispanic families were less likely to have access to DHM ( = 0.03). Hospitals that had higher proportions of uninsured patients were also less likely to have access to DHM ( = 0.015). Inequities in DHM access and use among NICU infants begin at the structural level. Policies that reduce barriers to DHM access may reduce health inequities for Hispanic and uninsured families.
捐赠人乳（DHM）可为新生儿带来诸多益处。本研究考察了获取DHM的情况以及结构性障碍可能如何加剧不平等。采用中位数检验和方差分析检验，比较了2021年加利福尼亚新生儿重症监护病房（NICU）中产妇种族/族裔和保险状况变量的分布与获取DHM的情况。在124个NICU中，为白人家庭服务比例较高的机构更有可能获取DHM（P = 0.04）。西班牙裔家庭比例较高的NICU获取DHM的可能性较小（P = 0.03）。 uninsured患者比例较高的医院获取DHM的可能性也较小（P = 0.015）。NICU婴儿在获取和使用DHM方面的不平等始于结构层面。减少获取DHM障碍的政策可能会减少西班牙裔和无保险家庭的健康不平等。 （注：原文中“uninsured”未翻译，可能是原文有误，推测应为“无保险的”）
