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Commentary: From Cradle to Maternity Ward

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A new report  by the Duke University Foundation for Child Development is quite sobering. For the past 33 years, researchers supported by a philanthropic grant have measured the overall quality of life and well being of families (including youth and children). There are seven core domains that include economic wellbeing, safe/risky behavior, social relationships, emotional/spiritual wellbeing, community engagement, educational attainment, and health. Family wellbeing has been on the decline since 2007 with the quality of life and well-being for children and youth declining since 2009 and projected to worsen throughout 2010. Children under the age of 18 comprise the largest group of people living in poverty. This cuts across geography, racial/ethnic differences and socioeconomic status. When children are challenged economically because of current fiscal conditions like rates of unemployment and the recession, every ethnic child is  also potentially at risk. The report states that "low income African-American and Latino children are more vulnerable to economic fluctuations. Health is worsening because of rising obesity in children. Communities are more fragmented because of local budget cuts. High employment rates for African-American (40%) and Latino (30%) youth ages 16-19 contribute to "detached youth". Detached youth are at increased risk for less safe and more risky behavior. Emotional and spiritual well-being is at lower rates as evidenced by less attendance at churches or places of worship. For many black youth, their challenges begin at birth. Black women have the highest rates of pre-term birth and low birthweight infants. Underlying factors proposed include access to care, lower rates of prenatal care , and the physiological effects of racism and chronic stress, a list that could go on. Now there's one more contributing factor. Obesity. Black women have the highest rates of overweight and obesity (Office of Minority Health). In fact, four out of every five black women falls into that category. Obese moms, according to a recent article in the New York Times, are contributing to very high c/section rates and "leading to more birth defects and deaths for mothers and babies". Babies that are born to obese moms are nearly three times as likely to die within the first month of birth. Obese women are also twice as likely to have a stillbirth.  Medical complications like high blood pressure, diabetes, strokes, and complications to anesthesia are more common in obese women. Economic costs are also higher. One New York Hospital reports that the costs of caring for obese women with complications and their infants more than ten times higher. Premature infants may be at risk for longer term complications and require more medical care throughout their lifetime. Not an incidental finding when considering days missed at school for doctor's appointments or a chronic illness. Obesity ( a body-mass index of 30 or above) in black women is largely preventable. Lifestyle factors related to exercise frequency (optimally 3-4 times a week for at least 45 minutes),  healthy diet and nutrition habits including leafy vegetables and low fat intake, good sleep balance and effective coping strategies for stress are key. Clearly, economic resources including consistent employment, access to health insurance and safe and supportive neighborhoods build in physical and mental benefits. As the well-being of our kids continues to decline, Moms need to step up. Get your body and baby ready by practicing healthy eating and physical fitness habits BEFORE you get pregnant. Why place you and your unborn infant at more of a disadvantage? Getting fit and losing weight is not about looking good. Black women have the choice and opportunity to flip the script by providing a proud legacy of health, quality of life and well-being for our future generations. For more "Real Talk" stories by Dr. Janet Taylor, click here.
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