Examining the Relationship Between Sleep-Related Infant Deaths and Social Determinants of Health in Urban Communities

• Published in: Journal of racial and ethnic health disparities Vol. 9; no. 3; pp. 779 - 785
• Main Authors: Alston, Margaret, Thomas, David, Jambulingam, Malliga, Hunt, Ariel, Grover, Raneitra, Bronner, Leslie, Bronner, Yvonne
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2022; Springer Nature B.V
• Subjects: Academic achievement; African Americans; Babies; Births; Caregivers; Childbirth & labor; Community; Community support; Economic depression; Epidemiology; Fatalities; Health disparities; Households; Housing; Humans; Inequality; Infant; Infant Death; Infant mortality; Infants; Medicine; Medicine & Public Health; Middle class; Mortality; Neighborhoods; Poverty; Psychological functioning; Quality of Life Research; Race factors; Racial differences; Racial Groups; Racial inequality; Riots; Sleep; Social Determinants of Health; Social factors; Social Inequality; Social Structure; Unemployment; Urban areas; United States > US; Maryland; Baltimore Maryland; Infant; Safe sleep; Disparity; SRID; SDOH; Stress
• ISSN: 2197-3792; 2196-8837
• DOI: 10.1007/s40615-021-01016-5

In 2017, sleep-related infant deaths (SRID) accounted for about 3600 deaths in the USA. The SRID rate for African American infants (186. 41 per 100,000 live births) is more than twice that of Caucasian American infants (85. 43 per 100,000 live births) (Centers for Disease and Prevention, July 2020). Purpose The purpose of this article is to develop a case for considering the relationship between racial disparities in SRID and social determinants of health (SDOH) in impoverished communities. The later has been related to chronic stress impacting biological and psychological functioning. The authors advocate that undesirable SDOH be regarded when developing safe sleep strategies for at risk communities, since chronic stress can impact psychological and biologic functioning, possibly manifesting in inconsistent safe sleep practices by caregivers. Methods An adapted environmental scan (AES), using SRID and SDOH data from impoverished communities, was used to illustrate the comparison of SRID and SDOH in contrasting Baltimore neighborhoods. Results The AES revealed a match between disparities in SRID and SDOH (e.g., educational achievement, unemployment, poverty, poor housing, and violence). The comparison between the SDOH and SRID increases together for named impoverished neighborhoods, as compared to those with low SRID rates in Baltimore. Conclusion Rather than limit safe sleep interventions to crib and infant sleeper give-aways, for example, hazardous SDOH seen in impoverished communities should be addressed. We posit that these results will stimulate discussion for well-placed and financed programs, along with policies that focus on decreasing SRID by improving poor SDOH.