Background: U.S. maternal and infant mortality rates constitute an important public health problem, because these rates surpass those in developed countries and are characterized by stark disparities for racial/ethnic minorities, rural residents, and individuals with less privileged socioeconomic status due to social determinants of health (SDoH). Methods: A critical review of the maternal and infant mortality literature was performed to determine multilevel SDoH factors leading to mortality disparities with a life course lens. Results: Black mothers and infants fared the worst in terms of mortality rates, likely due to the accumulation of SDoH experienced as a result of structural racism across the life course. Upstream SDoH are important contributors to disparities in maternal and infant mortality. More research is needed on the effectiveness of continuous quality improvement initiatives for the maternal–infant dyad, and expanding programs such as paid maternity leave, quality, stable and affordable housing, and social safety-nets (Medicaid, CHIP, WIC), in reducing maternal and infant mortality. Finally, it is important to address research gaps in individual, interpersonal, community, and societal factors, because they affect maternal and infant mortality and related disparities. Conclusion: Key SDoH at multiple levels affect maternal and infant health. These SDoH shape and perpetuate disparities across the lifespan and are implicated in maternal and infant mortality disparities.

This cross-sectional study uses data from the 2017 National Survey of Children’s Health to assess whether social challenges increase with higher medical conditi

Objective: This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate a promotora -led community health program designed for Latinas ages 50 and older that sought to improve physical activity, nutrition, and stress management. Method: A mixed-methods evaluation approach was administered at participant and organizational levels with a focus on the efficacy, adoption, implementation, and maintenance components of the RE-AIM theoretical model. Results: The program was shown to be effective at improving participants’ eating behaviors, increasing their physical activity levels, and lowering their depressive symptoms. Promotoras felt motivated and sufficiently prepared to deliver the program. Some implementation challenges were reported. More child care opportunities and an increased focus on mental well-being were suggested. Discussion: The promotora delivery model has promise for program sustainability with both promotoras and participants alike expressing interest in leading future programs.

Despite the burgeoning U.S. Latino population and their increased risk of chronic disease, little emphasis had been placed on developing culturally sensitive lifestyle interventions in this area. This article examines older Latinas’ sociocultural context relative to health with the goal of developing a culturally sensitive health behavior intervention. Photo-elicitation indicated two emerging themes that influenced lifestyle choices: family caregiving and religion. Researchers partnered with a faith-based organization to develop and implement a 6-month lifestyle intervention for Latinas ages 50 and older: Abuelas en Acción (AEA). At completion, interviews were conducted to understand women’s experiences and the influence AEA had on their lifestyles and health. Findings suggest that religious content empowered and deeply affected women; however, the intergenerational content presented significant challenges for instruction, retention, and implementation. We discuss findings in relation to the health intervention literature and provide suggestions for future interventions drawing on religion, family, and health behavior change.

Background: Maternal mental illness is a significant public health problem during the perinatal period and beyond. Little is known about how social determinants of health (SDOH) affect maternal mental health. Materials and Methods: We used cross-sectional data from the 2016 to 2017 National Survey of Children's Health with 19,127 mothers of a nationally representative sample of U.S. children aged 0–5. We estimated the prevalence of poor reported mental health (reported as “fair”/“poor”) among mothers with children aged 0–5 by SDOH. Multivariable logistic regression was used to examine factors associated with poor maternal mental health. Results: Approximately 4.5% of mothers with children aged 0–5 reported having poor mental health in 2016–2017. Postadjustment and mothers' poor mental health were significantly associated with age (adjusted odds ratio [AOR]: 18–20 years: 2.77, 95% confidence interval [CI]: 1.35–5.67; 21–24 years AOR: 2.14, 95% CI: 1.22–3.73, and 30–34 years AOR: 1.97, 95% CI: 1.13–3.43), U.S.-born status (AOR: 2.31, 95% CI: 1.48–3.63), poor physical health (AOR: 8.69, 95% CI: 5.81–13.02), having a child with a special health care need (AOR: 1.65, 95% CI: 1.03–2.64), experiencing food insecurity (afford enough food, yet, unhealthy [AOR: 2.74, 95% CI: 1.59–4.70] and sometimes/often not afford enough food [AOR: 3.20, 95% CI: 1.76–5.84]), and low social capital (AOR: 1.97, 95% CI: 1.04–3.73). Conclusion: Mothers with children aged 0–5 who had poor physical health and experienced food insecurity were at the greatest risk for poor mental health. Integrated perinatal and behavioral health models, screening, and referrals may help identify and treat mothers experiencing these issues.