Examining the Role of Interpersonal Violence in Racial Disparities in Breastfeeding in North Dakota (ND PRAMS 2017–2019)

MichaeLynn Kanichy (Makah), Lexie Schmidt, RaeAnn Anderson, Grace Njau, Amy Stiffarm (Aaniiih), Matthew Schmidt, Anastasia Stepanov and Andrew Williams ()
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MichaeLynn Kanichy (Makah): Public Health Program, Department of Population Health, School of Medicine & Health Sciences, The University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
Lexie Schmidt: Public Health Program, Department of Population Health, School of Medicine & Health Sciences, The University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
RaeAnn Anderson: Department of Psychology, University of North Dakota, 501 North Columbia Road Stop 8380, Grand Forks, ND 58202, USA
Grace Njau: North Dakota Department of Health & Human Services, 600 East Boulevard Ave, Department 325, Bismarck, ND 58505, USA
Amy Stiffarm (Aaniiih): Department of Indigenous Health, School of Medicine & Health Sciences, University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
Matthew Schmidt: North Dakota Department of Health & Human Services, 600 East Boulevard Ave, Department 325, Bismarck, ND 58505, USA
Anastasia Stepanov: North Dakota Department of Health & Human Services, 600 East Boulevard Ave, Department 325, Bismarck, ND 58505, USA
Andrew Williams: Public Health Program, Department of Population Health, School of Medicine & Health Sciences, The University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA

IJERPH, 2023, vol. 20, issue 8, 1-14

Abstract: Background. The 2019 overall breastfeeding initiation rate in the US was 84.1%, yet only 76.6% of American Indian (AI) women initiated breastfeeding. In North Dakota (ND), AI women have greater exposure to interpersonal violence than other racial/ethnic groups. Stress associated with interpersonal violence may interfere with processes important to breastfeeding. We explored whether interpersonal violence partially explains racial/ethnic disparities in breastfeeding in ND. Methods. Data for 2161 women were drawn from the 2017–2019 ND Pregnancy Risk Assessment Monitoring System. Breastfeeding questions in PRAMS have been tested among diverse populations. Breastfeeding initiation was self-report to “Did you ever breastfeed or pump breast milk to feed your new baby, even for a short period?” (yes/no). Breastfeeding duration (2 months; 6 months) was self-reported how many weeks or months of breastmilk feeding. Interpersonal violence for both 12 months before and during pregnancy based on self-report (yes/no) of violence from a husband/partner, family member, someone else, or ex-husband/partner. An “Any violence” variable was created if participants reported “yes” to any violence. Logistic regression models estimated crude and adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for breastfeeding outcomes among AI and Other Race women compared to White women. Sequential models were adjusted for interpersonal violence (husband/partner, family member, someone else, ex-husband/partner, or any). Results. AI women had 45% reduced odds of initiating breastfeeding (OR: 0.55, 95% CI: 0.36, 0.82) compared to white women. Including interpersonal violence during pregnancy did not change results. Similar patterns were observed for all breastfeeding outcomes and all interpersonal violence exposures. Discussion. Interpersonal violence does not explain the disparity in breastfeeding in ND. Considering cultural ties to the tradition of breastfeeding and the role of colonization may provide a better understanding of breastfeeding among AI populations.

Keywords: breastfeeding; breastfeeding initiation; breastfeeding duration; American Indian; racial disparities; interpersonal violence; violence; indigenous; pregnancy risk assessment monitoring system; North Dakota (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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