Studying the Impact of Prenatal WIC Participation on Infant Mortality
Grand Canyon University
Introduction to Nursing Research
August 15, 2014
Studying the Impact of Prenatal WIC Participation on Infant Mortality Infant Mortality is a barometer of a community or nation’s health. Globally the poor have higher infant mortality rates (IMR) than those with greater resources. In the United States, there are many programs designed to bridge the gap between the poor and rich, and reduce infant mortality in those with less access to resources. Women, Infants, and Children (WIC) is one such program and has had substantial impact on IMR in the poor in the US. The study performed by Khanani, Elam, Hearn, Jones & Maseru, “The Impact of Prenatal WIC Participation on Infant Mortality and Racial Disparities”, examined the value of WIC as a public health intervention which sought to improve birth outcomes and reduce racial disparities.
In 2011 24,000 infants died in the United States. (CDC, 2012). The rate of death for non-Hispanic Black infants was twice the rate of non-Hispanic White infants. There were five leading causes of infant death identified by the CDC, which were: 1. Born with serious birth defects
2. Born too small and too early
3. Victims of Sudden Infant Death Syndrome (SIDS)
4. Affected by maternal complications of pregnancy
5. Victims of injury
Healthy People 2020 has used the baseline from 2006 of 6.7 infant deaths per 1,000 live births which occurred in the first year of life as the basis for their goal of 6.0 deaths per 1,000 births by the year 2020. (Healthy People 2020, 2010). To reach these goals there must be emphasis on bridging disparities. “Social determinants of health (economic status, race, ect.) lead to health disparities and inequities on health status across the life course of individuals.” (Fraser, 2012, p.772). Women, Infants, and Children (WIC) was started in 1972 as a supplemental nutritional program. The services of the program included supplemental food, health services, and nutrition counseling for low income pregnant women, breastfeeding and non breastfeeding mothers as well as infants and children who are at risk for nutrition. . (Khanani, Elam, Hearn, Jones, & Maseru, 2010). More than 9.17 million women and children participated in WIC, in the Fiscal year 2010. (USDA, 2014). WIC offers a range of resources that may affect birth outcomes, including immunization screenings, breastfeeding promotion, and referrals for prenatal care, pediatric care and social services. The study performed by Khanani et al. used a retrospective cohort design. Files were obtained which contained prenatal WIC participation for women that lived in Hamilton County, Ohio from 2005-2007. Mothers were counted separately who had more than 1 pregnancy in the study period. 18,091 women enrolled in WIC in the prenatal period, their infant outcomes were linked with infant birth and death records. Information such as gestational age, race/ethnicity, and mother’s behavioral risk factors were used. Mothers with multiple gestations were excluded. The data collected on participants in WIC was compared to the data of women who did not participate in WIC in the same county, which were 14,585 births. A Visual Basic program (Microsoft Corporation, WA) was used to match the data in both categories. The subjects were not approached directly and their data was utilized in a confidential unbiased format. There are glaring differences in the levels of health experienced by the poor and wealthy, as well as between racial divides. It is ethically sound to explore these issues when attempting to find solutions to such problems as well as directing future funding and program development. This study meets the standards of ethical research, and has continued validity as solutions to high IMRs are explored. After analyzing all the data it was found that 94 deaths were matched with the pre-natal...
References: Centers for Disease Control (2012). Infant Mortality. Retrieved from http://www.cdc.gov/reproductivehealth/maternalinfanthealth.
Fraser, M. (2013). Bringing it All Together: Effective Maternal and Child Health Practice as a Means to Improve Public Health. Maternal & Child Health Journal,17(5), 767-775. doi:10.1007/s10995-012-1064-1.
Healthy People 2020.gov (2010). Healthy People 2020: Maternal, Infant, and Child Health. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020.
Khanani, I., Elam, J., Hearn, R., Jones, C., & Maseru, N. (2010). The Impact of Prenatal WIC Participation on Infant Mortality and Racial Disparities. American Journal Of Public Health, 100(S1), S204-S209.
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