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  • The second hypothesis relates to infants

    2018-11-05

    The second DBM 1285 dihydrochloride relates to infants’ iron stores at birth, which form infants’ primary source of iron for the first months of life. Iron status of mothers during pregnancy is a key determinant of infant iron stores at birth (Allen, 2000). In our ENSIN sample we find that infants (6–12 month olds) whose mothers had taken iron supplements for 4 or more months of pregnancy had a mean haemoglobin concentration 3.10g/L higher than those whose mothers had not. This is consistent with inadequate iron statuses of pregnant mothers being a key cause of early childhood anaemia in Colombia. A related potential factor is early clamping of the umbilical cord which is an important determinant of low iron stores in infants (McDonald, Middleton, Dowswell, & Morris, 2013). While we do not have access to reliable information on timing of cord clamping in Colombia this may be important in analysing early childhood anaemia in Colombia.
    Conclusions
    Acknowledgements
    This study was funded by the Economic and Social Research Council (Grant RES-062-23-1548), Inter-American Development Bank, World Bank, and International Growth Center. Data analysis was supported by the Grand Challenges Canada Grant 0072-03. In addition, researchers’ time was partly funded by the European Research Council Advanced Grant no. 249612 and by the ESRC Professorial Fellowship ES/K01070011. The sponsors of the study approved the study design but had no role in data collection, data analysis, data interpretation, writing of the paper or the decision to submit it for publication.
    Introduction What are the population health implications of having cognitive, emotional, and physiological “bandwidth” taken up by the lived experiences of stereotype, stigma, and inequity that are especially common among members of non-dominant social identity groups? Bandwidth can be commandeered by acute, interpersonal incidents such as that described in the poem, occasions for subjective distress. Bandwidth can also be hostage to subtle or pervasive features of the social, psychological and physical environmental “surround” (Turner, 2013), subliminal reminders in our everyday rounds of the degree to which our social identity group is – or isn’t — valued by society. We argue US social inequalities in health remain entrenched, in part, because of inequalities across social identity groups in the frequency, pervasiveness, objective severity, and subjective significance of such cues to social identity and one’s societal value or acceptance. We choose this emphasis because the role of the “surround” in maintaining and perpetuating health inequity is under-theorized relative to other social determinants of population health including more overt racism and micro-aggression, yet, it informs the nature and frequency of more recognized social determinants of health, constraining potential progress in eliminating them. As we review and synthesize, an emergent body of social epidemiologic scholarship points to the promise of considering the surround, and also increasingly reveals the limits of focusing on the role of conventional socioeconomic indicators, such as income and education, alone (Pearson, 2008). Moreover, as with other broad contextual contributors to health inequity, such as sociopolitical context, the surround might, at first blush, be thought of as too amorphous, large or enmeshed to be a feasible intervention site to produce short or medium term change. We argue in contrast, that through applying what we call “Jedi Public Health” principles, the surround is not only an essential target of intervention, but an eminently practical and tractable one (Geronimus, 2013). While it is premature to offer an exhaustive JPH policy or intervention plan, we offer examples for straightforward, low-tech, and evidence-based interventions that help diffuse the ideological and psychosocial landmines that promote health inequity in everyday life. Most importantly, we call for an expansion and, in some ways, a re-orienting of efforts to eliminate population health inequity.