MODULE 4: EXERCISE July 22, 2015 Barbara Dennison, MD Director, - - PDF document

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July 22, 2015

Evidence‐Based Public Health: Supporting the New York State Prevention Agenda

MODULE 4: EXERCISE

Barbara Dennison, MD Director, Policy and Research Translation

Background

• Increasing breastfeeding is a public health goal.

– HP2020, CDC, WHO, APHA, NYS Prevention Agenda.

• Infants should be fed exclusively breast milk for the first 6

months of life to achieve optimal growth, development and health, ” with continuation through 12 months.

– WHO, DHHS, AAP, ACOG, AAFP, etc.

• Exclusive Breast Milk Feeding: defined as giving no
• ther food or drink – not even water – except breast milk.

– WHO, Joint Commission, NYSDOH, NYS/NYC Vital Records

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Breastfeeding Provides Health Benefits to Infants

Short Term Benefits

• 72%

Reduction in hospitalization from lower respiratory diseases in the first year of life

• 64%

Fewer episodes of gastroenteritis

• 50%

Reduction in otitis media

3

Source: US Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding, Washington, DC; 2011.

Long-Term Benefits of Breastfeeding to Children

• Lower total cholesterol levels
• Lower systolic and diastolic blood pressure
• Lower risk of type-2 diabetes
• Higher scores on intelligence tests

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World Health Organization, Long-Term Effects of Breastfeeding, Systematic Review, 2013

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Breastfeeding Provides Health Benefits to Women

Short Term Benefits

• Reduction in postpartum bleeding, anemia
• Faster return to pre-pregnancy weight
• Reduced risk of excess maternal weight gain

Long Term Benefits

• Reduced risk of breast cancer
• Reduced risk of ovarian cancer

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Source: US Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding, Washington, DC; 2011.

81.9 70.0 14.2 85.0 41.7 51.0* 10 20 30 40 50 60 70 80 90 100

Any BF Exclusive BF BF Supplemented

Percent HP 2020 NYS

*CDC Breastfeeding Report Card 2014: NIS shows that NYS has the highest % of breastfed infants receiving formula before 2 days of age in the U.S.

Breastfeeding Metrics - HP 2020 vs. NYS 2013

Source: NYSDOH, Birth Certificate, 2013

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Exclusive Breastfeeding Maternal Education, stratified by Race/Ethnicity, 2011

33.6% 17.7% 13.4% 40.0% 22.9% 43.8% 21.7% 17.9% 47.4% 27.0% 52.0% 28.4% 24.4% 52.8% 32.0% 55.8% 34.6% 35.8% 59.0% 37.8%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

White, non‐ Hispanic Black, non‐ Hispanic Asian/PI, non‐ Hispanic Am Indian, non‐Hispanic Hispanic

Race/ethnicity

< High School High School graduate or GED

Exclusive Breastfeeding by Maternal Education, stratified by Race/ethnicity and, 2011

33.6% 43.8% 52.0% 55.8% 17.7% 21.7% 28.4% 34.6% 13.4% 17.9% 24.4% 35.8% 40.0% 47.4% 52.8% 59.0% 22.90% 27.00% 32.00% 37.80%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

< High School HS grad/GED Some college College degree

White, nH Black, nH Asian/PI, nH Am Indian, nH Hispanic

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Exercise

• Small Groups with 5-6 Each
• A problem described by NY State Senator Nestle
• Form groups to work in teams
• Discuss and write-down, following worksheet guidance
• Background/epidemiologic issue
• Programmatic questions (intervention, evaluation, managerial,

policy)

• Avoid getting caught up in solutions and outcomes at

this point