TY - JOUR
T1 - A Spatial Analysis of Breastfeeding and Breastfeeding Support in the United States
T2 - The Leaders and Laggards Landscape
AU - Grubesic, Tony H.
AU - Durbin, Kelly M.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Background: To better track progress in achieving the Healthy People 2020 goals, the Centers for Disease Control and Prevention (CDC) publishes an annual Breastfeeding Report Card (BRC) that represents a compilation of data on breastfeeding practices in all states. With data drawn from the CDC National Immunization Survey, the BRC provides an especially valuable source of information about geographic trends in breastfeeding and related support activities. Research aim: This study aimed to identify important geographic trends in both breastfeeding practices and support structures in the United States, highlighting their spatial disparities. Methods: Exploratory spatial data analysis, including local indicators of spatial association, is combined with spatial regression models to highlight geographic variations in breastfeeding practices and support. Results: Geographic variation in both breastfeeding practices and allied support exists within the United States. Geographic hot spots of breastfeeding are found in the western and northeastern sections of the United States, and cool spots are located primarily in the Southeast. Regression results suggested that unemployment and demographic diversity are negatively associated with breastfeeding rates, whereas higher education and the presence of International Board Certified Lactation Consultants® (IBCLCs®) are positively connected to persistent breastfeeding practices. Further, although the availability of professional support (IBCLC) strengthened nationwide between 2011 and 2016, the availability of mother-to-mother support (La Leche League) softened. Conclusion: Although breastfeeding initiation rates continue to increase in the United States, rates of exclusive breastfeeding at 3 and 6 months remain low, displaying significant geographic variation. The ability to pinpoint lagging regions can help to efficiently allocate additional breastfeeding support resources and interventions.
AB - Background: To better track progress in achieving the Healthy People 2020 goals, the Centers for Disease Control and Prevention (CDC) publishes an annual Breastfeeding Report Card (BRC) that represents a compilation of data on breastfeeding practices in all states. With data drawn from the CDC National Immunization Survey, the BRC provides an especially valuable source of information about geographic trends in breastfeeding and related support activities. Research aim: This study aimed to identify important geographic trends in both breastfeeding practices and support structures in the United States, highlighting their spatial disparities. Methods: Exploratory spatial data analysis, including local indicators of spatial association, is combined with spatial regression models to highlight geographic variations in breastfeeding practices and support. Results: Geographic variation in both breastfeeding practices and allied support exists within the United States. Geographic hot spots of breastfeeding are found in the western and northeastern sections of the United States, and cool spots are located primarily in the Southeast. Regression results suggested that unemployment and demographic diversity are negatively associated with breastfeeding rates, whereas higher education and the presence of International Board Certified Lactation Consultants® (IBCLCs®) are positively connected to persistent breastfeeding practices. Further, although the availability of professional support (IBCLC) strengthened nationwide between 2011 and 2016, the availability of mother-to-mother support (La Leche League) softened. Conclusion: Although breastfeeding initiation rates continue to increase in the United States, rates of exclusive breastfeeding at 3 and 6 months remain low, displaying significant geographic variation. The ability to pinpoint lagging regions can help to efficiently allocate additional breastfeeding support resources and interventions.
KW - La Leche League International
KW - breastfeeding
KW - breastfeeding rates
KW - breastfeeding support
KW - lactation counseling
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U2 - 10.1177/0890334419856615
DO - 10.1177/0890334419856615
M3 - Article
C2 - 31206311
AN - SCOPUS:85067871021
SN - 0890-3344
VL - 35
SP - 790
EP - 800
JO - Journal of Human Lactation
JF - Journal of Human Lactation
IS - 4
ER -