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Their Fears for Their Newborn's Future

Mark A. Schuster, MD, PhD; Neal Halfon, MD, MPH; David L. Wood, MD, MPH

Arch Pediatr Adolesc Med. 1998;152:264-268.

Objective  To determine what African American mothers in a low-income community fear for their newborn's future.

Design  An interview survey was conducted with mothers of recently born infants randomly sampled from birth certificate records in the spring of 1994 in 10 postal codes in the Compton Health District in south central Los Angeles, Calif, with high concentrations of low-income African American children. Among 522 eligible mothers, 419 (80%) were interviewed. Children were an average of 17.7 days old at the time of the interview.

Main Outcome Measure  The open-ended survey item, "What is your biggest fear for [child's name] growing up?" Mothers were prompted to give more than 1 answer. Responses were classified into 16 categories.

Results  Thirty-nine percent of the mothers reported a fear of gangs, violence, or both. The largest other response categories included disease, illness, and health problems (17%); drugs and alcohol (15%); growing up in the local environment (10%); and society and the world in general (6%). Fifty percent of the mothers of boys reported a fear of gangs, violence, or both compared with 28% of the mothers of girls (P<.001).

Conclusions  More than half the fears are in the medical and public health domains. Some involve traditional health concerns (eg, disease), while others are problems that the health professions have been addressing more recently (eg, violence). The American Academy of Pediatrics has recommended counseling families about violence prevention and the prevention of firearm injuries. While this study shows that many mothers are concerned about these subjects, we need a greater understanding of what role physicians can play in helping their patients (and their patients' families) address violence in their lives.

From RAND, Santa Monica, Calif (Drs Schuster, Halfon, and Wood); the Department of Pediatrics, School of Medicine (Drs Schuster and Halfon), and the School of Public Health (Dr Halfon), University of California, Los Angeles; and Shriners Hospitals for Children, Tampa, Fla (Dr Wood).

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