The purpose of this toolkit is to offer healthcare providers resources to improve their counseling and interactions with individuals they serve.
“The first funeral of a baby I ever attended was for the infant boy of a patient whose first son I delivered a couple of years earlier. One day, for some extraordinary reason, the elder son was placed to sleep in the same crib as his baby twin siblings. At some point he rolled over and suffocated one of the twins. He was there at the funeral – in his tiny little suit holding his mother’s hand. It broke my heart. Honestly, I do not remember having ever discussed safe sleep with this patient…I always wonder whether it might have made a difference if I had.”
Safe sleep for infants is an important health issue.
Sleep-related deaths are a leading cause of infant mortality and the leading cause of death for infants 1 month to 1 year of age. Most of these deaths occur two to four months after birth. Nationally, African-American infants are twice as likely as white infants to suffer a sleep-related death.
What you say and do makes a difference.
Studies indicate that parents who have been counseled by health care professionals about safe sleep are more likely to place infants on their backs for sleep. Similarly, if patients have seen their infant placed to sleep on his or her stomach by a health care provider, they are more likely to adopt this dangerous practice at home.
Most infants who die in their sleep are found in unsafe sleep environments. These environments include bed sharing with an adult or sibling, sleeping on an adult bed, a couch, or other unsafe surface, and sleeping on the stomach.
Safe sleep campaigns have been associated with a decrease in SIDS deaths in countries that have implemented coordinated, far-reaching campaigns. Nationally, the Back-to-Sleep campaigns in the U.S. are credited with a 42% reduction in SIDS between 1992 and 1998.
The number of sleep-related deaths (in Baltimore City) has dropped and remained at lower levels since the 2010 launch of the SLEEP SAFE campaign, a coordinated effort of mass media advertising, community mobilization, and provider counseling.
The obesity epidemic in the U.S. is a call to action for every healthcare worker dedicated to preventing disease in the 21st century. Among adults under the age of 70, obesity is second only to tobacco in the number of deaths it causes each year. We have a particular interest in the promotion of healthy bodies and lifestyles among reproductive age women.
Much of the information presented in this toolkit was drawn from national organizations dedicated to improving the lives of people affected by obesity. The Rudd Center for Food Policy and Obesity seeks to improve the world’s diet, prevent obesity, and reduce weight stigma by establishing creative connections between science and public policy, developing targeted research, encouraging frank dialogue among key constituents, and expressing a dedicated commitment to real change. A comprehensive toolkit for providers, including information on improving provider-patient interactions, can be found at biastoolkit.uconnruddcenter.org.
The Obesity Action Coalition is a nearly 50,000 member-strong national non-profit organization dedicated to giving a voice to individuals affected by the disease of obesity and helping them along their journey toward better health through education, advocacy and support. It works to raise awareness and improve access to the prevention and treatment of obesity, provide evidence-based education on obesity and its treatments, fight to eliminate weight bias and discrimination, and offer a community of support for the individual affected. Visit www.obesityaction.org for resources and information on how to join.
Teen Pregnancy Prevention
Preventing teen pregnancy is a top priority of the Healthy Babies Initiative (BHB). Though it has decreased since 2000, the teen birth rate remains extremely high. In 2010, the teen birth rate was 53.3 births per 1000 women ages 15-19 compared to the national rate of 34.3. While the birth rate among certain racial and ethnic groups have also decreased significantly, dramatic disparities between groups continue to persist: 25.9 among Whites, 55.4 among African Americans, and 79.6 among Hispanics (2012 Baltimore City data).
Teen pregnancy is associated with serious social problems including poverty (especially child poverty), child abuse and neglect, father-absence, low birth weight, school dropout, and unemployment. Nationally, only 38% of teens who become pregnant before turning 18 will graduate from high school, and pregnant teens are twice as likely to skip prenatal care in the first trimester. In 2010 taxpayers spent $9.4 billion on publicly financed medical care for women who experienced an unintended pregnancy. Most of the costs of teen childbearing are associated with negative consequences for the children of teen mothers, including increased costs for health care, foster care, incarceration, and lost tax revenue. (Data accessed from the nationalcampaign.org, June 2014).
The Teen Pregnancy Prevention Initiative has the goal of reducing teen births by 20% by 2015. The initiative is implementing a multi-pronged approach: 1) increasing access to evidence-based, sexual health education and information; 2) improving access to youth-friendly quality services for teens, especially in the delivery of long-acting reversible contraceptives and 3) creating greater demand for these services through an ongoing youth-led campaign, Know What U Want: U Choose.