Disparities in Breastfeeding Initiation Among African American and Black Immigrant WIC Recipients in the District of Columbia, 2007-2019

Amira A. Roess, Amira A. Roess is with the College of Health and Human Services, George Mason University, Fairfax, VA. Rebecca C. Robert is with the Conway School of Nursing, Catholic University of America, Washington, DC. Doris Kuehn, Emily Woody, Swathi Vinjamuri, and Paulette Thompson are with the District of Columbia Department of Health, District of Columbia Women Infant Child State Agency, Washington, DC. Nwanneamaka Ume is with the Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC. Brianna Ericson is with the Department of Epidemiology, Milken Institute School of Public Health.
Rebecca C. Robert, Amira A. Roess is with the College of Health and Human Services, George Mason University, Fairfax, VA. Rebecca C. Robert is with the Conway School of Nursing, Catholic University of America, Washington, DC. Doris Kuehn, Emily Woody, Swathi Vinjamuri, and Paulette Thompson are with the District of Columbia Department of Health, District of Columbia Women Infant Child State Agency, Washington, DC. Nwanneamaka Ume is with the Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC. Brianna Ericson is with the Department of Epidemiology, Milken Institute School of Public Health.
Doris Kuehn, Amira A. Roess is with the College of Health and Human Services, George Mason University, Fairfax, VA. Rebecca C. Robert is with the Conway School of Nursing, Catholic University of America, Washington, DC. Doris Kuehn, Emily Woody, Swathi Vinjamuri, and Paulette Thompson are with the District of Columbia Department of Health, District of Columbia Women Infant Child State Agency, Washington, DC. Nwanneamaka Ume is with the Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC. Brianna Ericson is with the Department of Epidemiology, Milken Institute School of Public Health.
Nwanneamaka Ume, Amira A. Roess is with the College of Health and Human Services, George Mason University, Fairfax, VA. Rebecca C. Robert is with the Conway School of Nursing, Catholic University of America, Washington, DC. Doris Kuehn, Emily Woody, Swathi Vinjamuri, and Paulette Thompson are with the District of Columbia Department of Health, District of Columbia Women Infant Child State Agency, Washington, DC. Nwanneamaka Ume is with the Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC. Brianna Ericson is with the Department of Epidemiology, Milken Institute School of Public Health.
Brianna Ericson, Amira A. Roess is with the College of Health and Human Services, George Mason University, Fairfax, VA. Rebecca C. Robert is with the Conway School of Nursing, Catholic University of America, Washington, DC. Doris Kuehn, Emily Woody, Swathi Vinjamuri, and Paulette Thompson are with the District of Columbia Department of Health, District of Columbia Women Infant Child State Agency, Washington, DC. Nwanneamaka Ume is with the Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC. Brianna Ericson is with the Department of Epidemiology, Milken Institute School of Public Health.
Emily Woody, Amira A. Roess is with the College of Health and Human Services, George Mason University, Fairfax, VA. Rebecca C. Robert is with the Conway School of Nursing, Catholic University of America, Washington, DC. Doris Kuehn, Emily Woody, Swathi Vinjamuri, and Paulette Thompson are with the District of Columbia Department of Health, District of Columbia Women Infant Child State Agency, Washington, DC. Nwanneamaka Ume is with the Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC. Brianna Ericson is with the Department of Epidemiology, Milken Institute School of Public Health.
Swathi Vinjamuri, Amira A. Roess is with the College of Health and Human Services, George Mason University, Fairfax, VA. Rebecca C. Robert is with the Conway School of Nursing, Catholic University of America, Washington, DC. Doris Kuehn, Emily Woody, Swathi Vinjamuri, and Paulette Thompson are with the District of Columbia Department of Health, District of Columbia Women Infant Child State Agency, Washington, DC. Nwanneamaka Ume is with the Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC. Brianna Ericson is with the Department of Epidemiology, Milken Institute School of Public Health.
Paulette Thompson, Amira A. Roess is with the College of Health and Human Services, George Mason University, Fairfax, VA. Rebecca C. Robert is with the Conway School of Nursing, Catholic University of America, Washington, DC. Doris Kuehn, Emily Woody, Swathi Vinjamuri, and Paulette Thompson are with the District of Columbia Department of Health, District of Columbia Women Infant Child State Agency, Washington, DC. Nwanneamaka Ume is with the Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC. Brianna Ericson is with the Department of Epidemiology, Milken Institute School of Public Health.

Document Type

Journal Article

Publication Date

4-1-2022

Journal

American journal of public health

Volume

112

Issue

4

DOI

10.2105/AJPH.2021.306652

Abstract

To estimate differences in breastfeeding initiation (BFI) rates between African Americans and Black immigrants enrolled in the District of Columbia Special Supplemental Nutrition Program for Women, Infants and Children (WIC) between 2007 and 2019. We used data collected as part of routine WIC program activities for first-time mothers (n = 38 142). Using multivariable logistic regression models, we identified determinants of BFI for African Americans, Black immigrants, non-Hispanic Whites, and Hispanics. To assess the trend in BFI over time, we calculated the average of the annual percentage changes. Compared with African Americans, Black immigrants had a 2.7-fold higher prevalence and Hispanics had a 5.8-fold higher prevalence of BFI. The average of the annual percentage changes was 0.85 for Hispanics, 3.44 for Black immigrants, 4.40 for Non-Hispanic Whites, and 4.40 for African Americans. African Americans had the only statistically significant change ( < .05). Disparities in BFI persisted over the study period, with African Americans demonstrating the lowest rates each year. Significant differences exist in BFI between Black immigrants and African Americans. Combining African Americans and Black immigrants masks important differences, overestimates rates among African Americans, and may lead to missed opportunities for targeting interventions and policies to improve breastfeeding. (. 2022;112(4):671-674. https://doi.org/10.2105/AJPH.2021.306652).

Department

Global Health

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