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IMPORTANCE Large racial/ethnic disparities in breastfeeding are associated with adverse health outcomes. OBJECTIVES To examine breastfeeding trends by race/ethnicity from 2009 to 2015 and changes in breastfeeding gaps comparing racial/ethnic subgroups with white infants from 2009-2010 to 2014-2015. DESIGN, SETTING, AND PARTICIPANTS This study used data from 167 842 infants from the National Immunization Survey-Child (NIS-Child), a random-digit-dialed telephone survey among a complex, stratified, multistage probability sample of US households with children aged 19 to 35 months at the time of the survey. This study analyzed data collected from

All racial/ethnic groups are non-Hispanic unless otherwise noted. † California does not report breastfeeding initiation data to NVSS. Michigan uses nonstandard wording for the breastfeeding initiation item on the birth certificate,which prevents comparison of data to other states.

Breast cancer is the most commonly diagnosed cancer and a leading cause of death from cancer among U.S. women. Studies have suggested that breastfeeding reduces breast cancer risk among parous women, and there is mounting evidence that this association may differ by subtype such that breastfeeding may be more protective of some invasive breast cancer types. The purpose of this review is to discuss breast cancer disparities in the context of breastfeeding and the implications for black mothers. Black women in the U.S. have lower rates of breastfeeding and nearly twice the rates of triple-negative breast cancer (an aggressive subtype) compared with white women. In addition to individual challenges to breastfeeding, black women may also differentially face contextual barriers such as a lack of social and cultural acceptance in their communities, inadequate support from the healthcare community, and unsupportive work environments. More work is needed to improve the social factors and policies that influence breastfeeding rates at a population level. Such efforts should give special consideration to the needs of black mothers to adequately address disparities in breastfeeding among this group and possibly help reduce breast cancer risk. Interventions such as peer counseling, hospital policy changes, breastfeeding-specific clinic appointments, group prenatal education, and enhanced breastfeeding programs have been shown to be effective in communities of color. A comprehensive approach that integrates interventions across multiple levels and settings may be most successful in helping mothers reach their breastfeeding goals and reducing disparities in breastfeeding and potentially breast cancer incidence.

Cervical cancer incidence and mortality have declined in the U.S. over the past 50 years because of broad screening efforts; however, some states continue to bear a greater burden due to under-screened and -treated populations. The purpose of this study was to utilize the socio-ecological model to examine barriers to cervical cancer screening and treatment in Florida. A qualitative semi-structured interview guide was used to conduct telephone interviews with 21 purposively sampled health care professionals from 13 high-risk counties. Interviews were transcribed and coded using themes identified a priori based on levels of the socio-ecological model. Investigators identified barriers to cervical cancer screening and treatment in Florida across four levels: (1) regulations and funding issues at the policy level are inconsistent between federal, state and local levels; (2) community level barriers range from cultural differences and fear of deportation, to transportation issues; (3) institutional level barriers complicate the administration of screening and treatment services; and (4) individual beliefs, behaviors, and stressors due to poverty hinder women's ability to access services. Many of our findings are consistent with previous studies that identified constraints to screening and treatment of cervical cancer, such as poverty and lack of access to care. This study adds to the literature by examining barriers from the viewpoint of service providers and program coordinators, and through the utilization of the socio-ecological model to provide a comprehensive framework for identifying and understanding these challenges.

Inadequate support for addressing early breastfeeding challenges is compounded by a lack of collaboration among various healthcare providers and the family. Findings provide insight into the professional management issues of early breastfeeding problems faced by lactation consultants. Team-based, interprofessional approaches to breastfeeding support for mothers and their families are needed; improving interdisciplinary collaboration could lead to better integration of lactation consultants who are educated and experienced in providing lactation support and management of breastfeeding problems.

Knowledge about the purpose of the Pap smear remains low. Findings underscore the significant need for clear and consistent messages among high-risk women regarding the prevention of cervical cancer and other reproductive health conditions.