Discuss disparities related to ethnic and cultural groups relative to low-birth-weight infants and preterm births. Describe the impact of extremely low-birth-weight babies on family and society (short and long term, including economic considerations, ongoing care considerations, and comorbidities associated with prematurity). Discuss whether you feel that support services and systems in your community for preterm infants and their families adequately address their needs or not. Explain your answer. Respond to other learners’ posts in a manner that initiates or contributes to discussion.
Low birth weight and preterm births remain the most significant contributors of infant mortality and morbidity in the U.S. (Xiong, Pridjian, & Dickey, 2013). According to Sparks (2009), the percentage of preterm births varies greatly among different ethnic and racial groups. This often relates to the socioeconomic status of the parents, sociodemographic profile, or behaviors during pregnancy, all of which very among cultures “in a manner that might explain the racial/ethnic variation in preterm births” (Sparks, 2009, p. 1668). Sparks (2009) further states, “there is a need to better understand the existence and possible explanations” (p. 1667) for the racial and ethnic disparities because of the effect they have on early childhood outcomes such as poor health, development, and educational issues. One of the characteristics that likely leads to cultural disparities in preterm births relates to maternal health status before and during pregnancy (Sparks, 2009).
For example, research evidence suggests, “African American women are more likely than white women to experience a number of infections, including bacterial vaginosis and sexually transmitted infections” (Behrman & Butler, 2007, p. 132), which, according to Behrman & Butler (2007), may be a significant factor leading to cultural disparities. Proper diagnosis and treatment of these conditions may also vary among different cultural groups. Families caring for preterm infants face multiple challenges, which depend on the severity of the infant’s health condition. Furthermore, multiple studies show that the mother’s psychosocial well-being may also be affected, placing mothers at higher risk of experiencing postpartum depression (Behrman & Butler, 2007). In additional to the emotional impact, there is also a long-lasting financial impact that families may face. Behrman & Butler (2007) state that families of premature infants “continue to manage the effects of prematurity” (p. 390) well into adolescence. This not only impacts each parent individually but also the whole family unit, which leads to stress and possible dysfunction, as well as “parents’ difficulty in maintaining employment” (Behrman & Butler, 2007, p. 391).
Extremely low birth weight babies often spend months struggling to survive and require constant monitoring and ongoing care. The relative immature lung function of premature neonates makes them vulnerable to respiratory distress syndrome. Moreover, low birth weight babies born to mothers who smoke, drink alcohol, or use drugs are also at risk for developmental deficits. For example, fetal alcohol syndrome “is believed to be a leading cause of birth defects, including growth retardation, developmental delay, and impaired intellectual ability” (Taylor et al., 2011, p. 379). The impact of these disabilities, cerebral palsy, for example, may extend over a lifetime and require services beyond routine care, such as physical and occupational therapy, and special education arrangements. Caring for babies with long-term disabilities certainly takes an emotional and financial toll on families but it also adds to the societal costs. The Institute of Medicine estimates the cost of health care for preterm infants to be $26 billion each year, which “does not include subsequent lifelong costs of medical therapy and other needs” (Connors, 2008, p. 29).
Due to a wide range of health outcomes, “many resources are required to provide the necessary medical, neurodevelopmental, and educational support” (Behrman & Butler, 2007, p. 397) for the families of preterm born infants. Functional and health outcomes of premature infants, same as the preterm births etiologies, are multifactorial, and depend on the care provided, home environment, and available community resources (Behrman & Butler, 2007). For example, in NYC, multiple community resources are available that provide different types of interventions to help families care for premature infants. One such program is Healthy Start that provides support services, education, and training to women living in neighborhoods where the number of premature births is the highest. In an effort to reduce these inequalities, the staff reaches out to women through different community settings, including health care clinics and hair salons.
Through its collaboration with hospitals, community-based organizations, and agencies, Healthy Start Brooklyn also works to develop health care advocacy strategies and improved practices and services. Education and training programs include child development and developmental delays, family planning, and perinatal depression. The support services provided by this program adequately address the unique needs of the families with premature and low-birth infants. The overall success of such programs is in the engagement and outreach to the community. Central Brooklyn is considered to be a low-income area and some residents lack the necessary resources and support. This program identifies families in need and connects them to important health and social services.
