Breastfeeding and Incarceration: An Analysis of California County Jails' Written Breast Milk Feeding Policies.

Between 1980 and 2019, the number of incarcerated women rose by more than 700%. Rising imprisonment of women corresponds with an increase in incarcerated lactating people. In 2018, California signed Assembly Bill (AB) 2507, requiring county jails to develop and implement a breast milk feeding policy for incarcerated women who wish to express their breast milk. We conducted a cross-sectional, descriptive study to determine if California's 58 counties created policies compliant with AB2507. Additionally, policies were analyzed for inclusion of evidence-based breastfeeding and lactation management practices and given a letter grade for their performance. Public records act requests were sent to all California counties, requesting their breast milk feeding policies. Of the 55 counties that responded, 51 had policies. Twenty-eight (51%) counties were in full compliance and 27 (49%) counties lacked compliance. No counties received letter grade A and 48 (87%) counties received letter grade C or below. Results reveal a discrepancy between legally compliant policies and evidence-based practices. The California county jail management needs increased surveillance to ensure policies are in full compliance and reflect best practices. Further research is required to investigate the actual implementation of compliant written breastfeeding policies.

Master of Public Health in Health Equity and Criminal Justice: Student and Alumni Feedback on the Development of a New Master of Public Health Concentration.

Purpose: To describe Master of Public Health (MPH) student and alumni interest in a new Health Equity and Criminal Justice (HECJ) concentration, highlight their personal experiences with mass incarceration, and summarize their input on developing the concentration. Methods: From July to October 2017 current MPH students and alumni at Touro University California (Vallejo, CA) were electronically surveyed. Results: The 152 respondents included those who had focused exclusively on public health, and those who concurrently obtained clinical degrees in osteopathic medicine, pharmacy, or physician assistant studies. Approximately 90% of the current and former students surveyed believed HECJ to be an integral part of public health, and one in three respondents described being personally impacted by incarceration. More than half (64%) were interested in the HECJ concentration, and 81% of those respondents were interested in completing their field study internship at a correctional facility. Conclusion: The HECJ concentration will fill an educational gap and may provide a pedagogical model for training a future generation of public health professionals to mitigate the health impacts of the U.S. mass incarceration epidemic.

Developing a Health Equity and Criminal Justice Concentration for a Master of Public Health (MPH) Program: Results From a Needs Assessment Among Community Partners and Potential Employers.

The United States has experienced a 4-fold increase in jail and prison populations over the last 40 years, disproportionately burdening African American and Hispanic/Latinx communities. Mass incarceration threatens the health of individuals, families, and communities, and requires a public health response. The Master of Public Health (MPH) Program at Touro University California (TUC) trains students to become skillful, socially-conscious public health professionals. We are developing a concentration focused on the public health impacts of incarceration. Along with the core public health curriculum, students of this new "Health Equity and Criminal Justice (HECJ)" concentration will receive training in criminal justice, reentry, reintegration, recidivism, restorative justice, structural racism, and social and community impacts of incarceration. Our study gauges interest in an HECJ concentration in our local community, including potential employers. We surveyed a cross-section of community partners including public health departments, other governmental agencies, California correctional facilities, county jails, community groups, health clinics, and hospitals. A majority (89%) of respondents consider mass incarceration a public health problem and 86% believe specialized training would make graduates employable by criminal justice related organizations. The HECJ track will fill a gap in the field and train a future generation of public health professionals to address the epidemic of mass incarceration.

Growing a Best Babies Zone: Lessons Learned from the Pilot Phase of a Multi-Sector, Place-Based Initiative to Reduce Infant Mortality.

PURPOSE: Infant mortality reduction in the U.S. has been addressed predominantly through clinical approaches. While these efforts have reduced the infant mortality rate overall, they have not reduced disparities between different racial/socioeconomic groups. To address the interrelated social, economic and environmental factors contributing to infant mortality, a place-based approach is needed to complement existing initiatives and clinical practices. DESCRIPTION: Best Babies Zone (BBZ) is an early attempt to put life course theory into practice, taking a place-based approach to reducing infant mortality by aligning resources, building community leadership, and transforming educational opportunities, economic development, and community systems in concentrated neighborhoods. BBZ is currently in three neighborhoods: Price Hill (Cincinnati, OH), Hollygrove (New Orleans, LA), and Castlemont (Oakland, CA). Assessment In its first 4 years, each BBZ crafted resident-driven strategies for decreasing the root causes of toxic stress and poor birth outcomes. To address resident priorities, BBZ sites experimented with tools from other fields (like design thinking and health impact assessment), and emphasized existing MCH strategies like leadership development. Early challenges, including shifting from traditional MCH interventions and addressing health equity, point to areas of growth in implementing this approach in the maternal and child health field. CONCLUSION: BBZ aims to elevate local voice and mobilize multiple sectors in order to address the social determinants of infant mortality, and other initiatives working to improve MCH outcomes can learn from the successes and challenges of the first 4 years of BBZ in order to bring life course theory into practice.

Mexico's Seguro Popular Appears To Have Helped Reduce The Risk Of Preterm Delivery Among Women With Low Education.

Beginning in 2001 Mexico established Seguro Popular, a health insurance scheme aimed at providing coverage to its large population of uninsured people. While recent studies have evaluated the health benefits of Seguro Popular, evidence on perinatal health outcomes is lacking. We conducted a population-based study using Mexican birth certificate data for 2010 to assess the relationship between enrollment in Seguro Popular and preterm delivery among first-time mothers with singleton births in Mexico. Seguro Popular enrollees with no formal education had a far greater reduction in risk of preterm delivery, while enrollees with any formal education experienced only slight reduction in risk, after maternal age, marital status, education level, mode of delivery, and trimester in which prenatal care was initiated were controlled for. Seguro Popular appears to facilitate access to health services among mothers with low levels of education, reducing their risk for preterm delivery. Providing broad-scale health insurance coverage may help improve perinatal health outcomes in this vulnerable population.