Allen A. Herman, MD, PhD

Dance carefully with a Hippopotamus – You onlyStop when it Stops

How do you eat anElephant?

Activities or practices by the male partner and the couple anticipating birth that ideally lead to an optimal pregnancy outcome. Those activities take place during the the preconception and perinatal periods

Infant Mortality Rate (per 1000)

IMR

Ra

nk

50

40

30

20

10

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

● ●

●●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●

●●

Alabama

Alaska

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

DC

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

NebraskaNevada

NHNJ

NM

NY

NC

ND

Ohio

Oklahoma

Oregon

Pennsylvania

RI

SC

SD

Tennessee

Texas

Utah

Vermont

Virginia

Washington

WV

Wisconsin

Wyoming

5 6 7 8 9 10 11 12 13 14

Infant Mortality Rates

Year

Mo

rta

lity R

ate

pe

r 1

,00

0 (

Lo

g b

ase

10

)

5

10

20

40

60

80100

140 ●●

●●●●●●

●●●●●

● ●●●●●● ●●●

●●●●●● ●●●●●●●●● ●●●●

●●●●● ●●●● ●

●●● ●●●●●

●●●● ●●●●●●●●● ●●

●●●●●●● ●●●● ●●●●●

●●● ●●●

● ●●●● ●

●●●● ●●●●●●●

● ●●●●●●●

●● ●●●●●●●●● ●●●● ●●●●● ●●●● ●●●● ●●●●●●●●● ●●●●●●●

●● ●●●●●●●●● ●●●● ●●●● ●

●●●

●●●● ●

●●●●●●●●

●●●●●●●● ●●

●●●●●●● ●

●●●●●●●● ●●●● ●●●●● ●●●● ●●●● ●

●●●●●●●● ●●●●●●

●●● ●●●●●●●●● ●●●● ●●●● ●

1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010

Neonatal Mortality Rates

Year

Mo

rta

lity R

ate

pe

r 1

,00

0 (

Lo

g b

ase

10

)

5

10

20

40

60

80100

●

●●●●

●● ●●●● ●●●●●● ●●

●●●● ●●●

●● ●●●●●●●● ●●●●● ●●●●●●●●● ●●●● ●

●●● ●●●●

● ●●●●●●●● ●●●●●●●●● ●●●●● ●●●● ●●●●

●

●●● ●●●● ●●●● ●●●●●●●●●●●●● ●●●

●● ●●●●●●●● ●●●●● ●●●●●●●●● ●●●● ●●●● ●●

●●●

●●●●●●●● ●●●

●●●●●● ●●●●● ●●●● ●●●● ●

●●●●●●● ●●●●

●●●●●●●●●●●●● ●●●●● ●●

●●●●●● ●●●●● ●●●●●●●●● ●●●● ●●●●

●●

●●● ●

●●●●●●● ●●

●●●●●●● ●●●●● ●●●● ●●●● ●

1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010

Postneonatal Mortality Rates

Year

Mo

rta

lity R

ate

pe

r 1

,00

0 (

Lo

g b

ase

10

)

5

10

20

40

60

80100 ●

●

●●

●●●

●●●

●●●●

●●

●●

●●

●●●●●

●●●

●

●● ●●

●●●

●●●● ●●●●

●●●●●●

●●●

●●●●

●●●●●●●●● ●●●●●●●●● ●●●●●●●●● ●●●● ●●●●●

●●●

●

●●

● ●●

●● ●

●●●

●●

●●●

●●●●

●●●

●●●●

●● ●●●●●●

●●● ●●●● ●●●●●●

●●●

●●●●●●

●●●●●●● ●●●●●●●●●●

●●

●●●●●● ●●●● ●●●● ●

●

●●

●●

●● ●

●●●

●●●

●●

●●●●●●

●● ●●

●●●

●

●●● ●●

●●●●●●● ●●●● ●●●●

●●●

●● ●●●● ●●●●●●●●● ●●●●●●

●●● ●

●

●●●

●●●● ●●●●

●●●

1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010

Fetal Mortality Rates

Year

Mo

rta

lity R

ate

pe

r 1

,00

0 (

Lo

g b

ase

10

)

5

10

20

40

60

80100

●●●● ●●

●●●●●●●●●●● ●●●

●● ●●●●

●●●● ●●●●● ●●●●●

●●●● ●●●● ●

●●●

●●●●●

●●●●●●●● ●●●●●●●●● ●●●●● ●●●●

●

●●●● ●●●●●●●●●●●●● ●●●●● ●●●●●●

●● ●●●●● ●●●●●●●●● ●●●● ●

●●●●

●●●● ●●●●●

●●● ●●●●●●●●● ●●●●● ●●●●

●● ●●

●

● ●●●●●●●●●●●●● ●●●●● ●●●●●●●● ●●●●● ●●●●●●●●● ●●

●● ●●●

●●●●●● ●●●●●●●● ●●

●●●●●●●●●●●● ●●●●

●

1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010

Race/Ethnicity

● African American

● All Races

● White

20121898 1905 1910 1915 1920 1925 1930 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

225%

0

25%

50%

75%

100%

125%

150%

175%

200%

Year

Rela

tive

Gap

in In

fant

Mor

talit

y be

twee

n A

fric

an A

mer

ican

and

Whi

tes

HHS Region IIIUnited States

141%

75%

50%

200%

IMR, per 1,000

0 to 2.5 per 1,000

to 5 per 1,000

to 7.5 per 1,000

to 10 per 1,000

to 12.5 per 1,000

to 15 per 1,000

to 50 per 1,000

US Infant Mortality Rates, per 1,000

that define the place where African American men live. Black men are more likely to live in urban settings with high levels of poverty; they are more likely to be incarcerated; and they are more likely to live in unstable family environments.

: African American men are more likely to be poorly educated, unemployed or be in low social status jobs, and have low incomes. They are also less likely to be homeowners and have any wealth.

• African American men have high rates of such as drug and alcohol abuse, poor diets and inadequate nutrition, and a lack of exercise.

• Black men are less likely to use and services and tend to use primary health services

inadequately and hospital-based healthcare inappropriately.

• A number of the social risk factors are chronic and inter-generational.

• The emergence of social risk in late adolescence and early adulthood is associated with a ‘disappearance’ of African American men from communities, and from health and social services.

• This ‘disappearance’ is also accompanied by the emergence of female-headed household where men play a transient and sometimes disruptive role in family formation.

Family formation healthcare exists along a continuum from family planning, through care before conception, prenatal care,

postnatal care, and early childcare.

: Human Sexuality and Family Formation, smoking, drug and alcohol abuse prevention, and nutrition and exercise.

: vaccination, family planning, the role of men in pre-conception and prenatal care, the prevention of chronic diseases such as diabetes, hypertension, and chronic renal and cardiovascular disease.

: The importance of having a primary care provider and regular wellness evaluations.

• Expand current efforts in, and support for, research on PIPO, especially in communities with marked disparities in health and healthcare

• Funding should be made available to develop a network of trans-disciplinary research centers of excellence in PIPO

• Funding should be made available for researchers to identify effective clinical and population-based strategies for enhancing PIPO

13

Paternal Involvement in Pregnancy Outcomes

American Journal of Men’s Health

CALL FOR PAPERS

Factors Influencing Paternal Involvement in Pregnancy

Outcomes: The P in MCH

GUEST EDITOR: Jermane Bond, Ph.D. Despite the fact that men are important to maternal and child health (MCH), men have not played a significant role in family planning, pregnancy, and childbirth nor have they had a place in reproductive health initiatives. A large body of research exists on a father’s influence on child health and development, but little is known regarding the role of the expectant father in pregnancy outcomes. Much of what we know and understand about fathers during pregnancy has stemmed from research on the mother. Investigators have documented that expectant fathers can be a strong source of support or stress during labor and delivery, but more research and literature is needed to better understand exactly what role the expectant father plays in pregnancy outcomes. Building on the best and promising recommendations set forth by the Commission on Paternal Involvement in Pregnancy Outcomes, the aim of this special issue is to advance an evidence-based body of literature on paternal involvement in pregnancy and family health by concentrating on eliminating barriers in research, policy and clinical practice to focus more on the involvement of the expectant father. This special issue will address three focus areas (research, policy and clinical practice) in paternal involvement in pregnancy and consist of approximately 8 manuscripts. Deadline for Paper Submission: November 15, 2013. http://jmh.sagepub.com