National Center for Education in Maternal and Child Health

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May 16, 2003

1. Number of Black Children in Extreme Poverty Reaches Record High, Analysis Finds

2. Issue Brief Looks at Impact of Women's Multiple Roles on Health and Economic Well-Being

3. Web Site Launched to Help Parents Promote Their Children's Mental Health

4. Policy Statement Highlights Pediatricians' Role in Improving Children's Oral Health

5. Study Examines Risk Factors for Sudden Infant Death Syndrome

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1. NUMBER OF BLACK CHILDREN IN EXTREME POVERTY REACHES RECORD HIGH, ANALYSIS FINDS

Technical Report: Trends in the Data on Extreme Black Child Poverty presents an analysis of poverty data from the U.S. Census Bureau's Current Population Survey. The Children's Defense Fund tabulated data during the period 1991-2002 and analyzed trends in extreme poverty among black children. The report presents the results of this analysis and also explores technical issues that could affect the statistics. The report is available at http://www.childrensdefense.org/pdf/extreme_poverty.pdf.

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2. ISSUE BRIEF LOOKS AT IMPACT OF WOMEN'S MULTIPLE ROLES ON HEALTH AND ECONOMIC WELL-BEING

Women, Work and Family Health: A Balancing Act examines women's role in family health care decision-making and coordination, the effect of that involvement for women who work, and women's caregiving responsibilities. This issue brief is based on data from the 2001 Kaiser Women's Health Survey, a nationally representative sample of nearly 4,000 women ages 18 through 64. The brief presents information, in both text and graphic formats, on women's role in coordinating care for their children, balancing work and family responsibilities, characteristics and health concerns of female caregivers, and access-to-care barriers. It is intended for use by policymakers, researchers, health professionals, and others interested in women's health policy. The brief is available at http://www.kff.org/content/2003/3336/Balancing_Act_Issue_Brief.pdf.

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3. WEB SITE LAUNCHED TO HELP PARENTS PROMOTE THEIR CHILDREN'S MENTAL HEALTH

A Family Guide to Keeping Youth Mentally Healthy and Drug Free is a public education Web site developed to support the efforts of parents and other caring adults to promote mental health and prevent the use of alcohol, tobacco, and illegal drugs among 7- to 18-year-olds. Developed by the Substance Abuse and Mental Health Administration (SAMHSA), the Web site presents information on talking with children and adolescents, getting involved, setting rules, being a role model, teaching children and adolescents to choose friends wisely, and monitoring children's and adolescents' activities. The site also includes a mental health dictionary, drug facts, links for children and adolescents, and other resources. It is available at http://www.family.samhsa.gov.

Readers: More information on mental health in children and adolescents is available on the Bright Futures Web site at http://www.brightfutures.org/mentalhealth/index.html.

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4. POLICY STATEMENT HIGHLIGHTS PEDIATRICIANS' ROLE IN IMPROVING CHILDREN'S ORAL HEALTH

"Pediatricians and pediatric health care professionals should develop the knowledge base to perform oral health risk assessments on all patients beginning at 6 months of age," according to an American Academy of Pediatrics (AAP) policy statement published in the May 2003 issue of Pediatrics. The policy statement is intended to raise pediatricians' and other pediatric health professionals' awareness of the risk factors for early childhood caries (ECC) and of the importance of making appropriate decisions about intervention and referral timing.

The AAP Section on Pediatric Dentistry compiled information on basic preventive strategies, oral health risk assessment, groups at risk for dental caries, establishing the dental home (an accessible, continuous, comprehensive source of care), anticipatory guidance, and parent and child education.

Recommendations include the following:

• All health professionals who serve mothers and infants should integrate into their practices parent and caregiver education on effective methods for preventing ECC.
• Information about the infectious and transmissible nature of the bacteria that causes ECC and about oral health risk assessment methods, anticipatory guidance, and early intervention should be included in the curriculum of all pediatric medical residency programs and postgraduate continuing medical education programs.
• Every child should begin to receive oral health risk assessments, conducted by a pediatrician or another qualified pediatric health professional, by age 6 months.
• Pediatricians, family practitioners, and pediatric nurse practitioners and physician assistants should be trained to perform oral health risk assessments on all children beginning by age 6 months to identify known risk factors for ECC.
• Between age 6 months and age 12 months, infants identified as being at significant risk for dental caries or as being in one of the risk groups should be entered into an aggressive anticipatory guidance and intervention program provided by a dentist.
• Pediatricians should support the concept of identifying a dental home as ideal for all children during infancy or early childhood.

American Academy of Pediatrics. 2003. Oral health risk assessment timing and establishment of the dental home. Pediatrics 11(5):1113-1116.

Readers: For more information on oral health, see Bright Futures in Practice: Oral Health at http://www.brightfutures.org/oralhealth/about.html, and the Maternal and Child Oral Health Resource Center at http://www.mchoralhealth.org, including the Oral Health and Children and Adolescents knowledge path at http://www.mchlibrary.info/KnowledgePaths/kp_oralhealth.html.

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5. STUDY EXAMINES RISK FACTORS FOR SUDDEN INFANT DEATH SYNDROME

"[Parents] should receive instruction that emphasizes supine sleeping, firm bedding, not using pillows, and not sharing a bed with other children or sleeping with another person on a sofa," state the authors of an article published in the May 2003 issue of Pediatrics. The authors of this article point out that, despite the success of interventions that resulted in a decline of prone sleeping and sudden infant death syndrome (SIDS) rates among all racial/ethnic groups, the black-to-white ratio for SIDS still exceeds 2.0. This article presents a comprehensive picture of SIDS risk in a primarily black urban population, giving particular attention to hazards in the sleep environment.

The study included 260 Chicago-based infants whose death between 1993 and 1996 was determined to have been caused by SIDS. Each SIDS infant was matched with a control infant.

The authors found that

• The racial/ethnic composition of both the SIDS group and the control group was 75.0% black, 13.1% Hispanic white, and 11.9% non-Hispanic white.
• Being placed in the prone position at last sleep was associated with having more than twice the risk of SIDS, compared with being placed in the non-prone position.
• A soft sleep surface was associated with more than five times the risk of SIDS, and pillow use was associated with more than three times the risk, as was covering of the head or face with bedding.
• Decreased risk of SIDS was found with pacifier use during last sleep and with breastfeeding for any length of time ever or currently.
• Infant bed sharing with one or more people, and especially infant bed sharing with people other than the parents, was associated with an increased risk of SIDS.
• In the final multivariate model, factors that remained significant independent risk factors were not using a pacifier, soft sleep surface, maternal smoking during pregnancy, prone sleeping position, pillow use, and bed sharing in combinations other than the parents alone.

The authors conclude that "risk factors particularly pertinent to black[s], as demonstrated in this study, must be addressed to reach the national goal of eliminating the racial disparity in SIDS."

Hauck FR, Herman SM, Donovan M, et al. 2003. Sleep environment and the risk of sudden infant death syndrome in an urban population: The Chicago Infant Mortality Study. Pediatrics 3(5 Suppl.):1207-1214.

Readers: This article appears in the May 2003 Supplement to Pediatrics entitled, Maternal Influences on Child Health: Preconception, Prenatal, and Early Childhood. Topics of other articles in this supplement include birth defects and maternal multivitamin use, birth defects and maternal obesity, fetal alcohol syndrome, fertility treatments and birth defects, and attention deficit hyperactivity disorder. The articles are available at www.pediatrics.org/current.shtml.

For more information, see the MCH Library knowledge path, Racial and Ethnic Disparities in Health, at http://www.mchlibrary.info/KnowledgePaths/kp_race.html.

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MCH Alert © 2003 by National Center for Education in Maternal and Child Health and Georgetown University. MCH Alert is produced by MCH Library Services at the National Center for Education in Maternal and Child Health under its cooperative agreement (6U02 MC 00001) with the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. The Maternal and Child Health Bureau reserves a royalty-free, nonexclusive, and irrevocable right to use the work for federal purposes and to authorize others to use the work for federal purposes.

Permission is given to forward MCH Alert to individual colleagues. For all other uses, requests for permission to duplicate and use all or part of the information contained in this publication should be sent to MCH Alert Editor, National Center for Education in Maternal and Child Health, at mchalert@ncemch.org.

The editors welcome your submissions, suggestions, and questions. Please contact us at the address below.

EDITORS: Jolene Bertness, Tracy Lopez

COPYEDITOR: Ruth Barzel

National Center for Education in Maternal and Child Health
Georgetown University
Mailing address: Box 571272, Washington, DC 20057-1272
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