Newborn Nest, or Baby in a Box

November 18, 2016

CHW LogoThere are a number of striking features of the American healthcare system compared with those of other developed countries: the huge percentage of our GDP that goes to health (currently at 17.5%); the enormous gap between our spending and health outcomes (i.e., the apparent lack of value); and the tremendous health disparities in this country compared with others.  We have recognized these disparities as a particular problem in Milwaukee, and one of our strategic priorities is to address those disparities in our community.

One area we are addressing is safe sleep.  In Wisconsin, an average of one baby dies each week in an unsafe sleep environment, and while these tragic deaths are spread across the state, they disproportionately affect the underserved.  Children’s Health Alliance of Wisconsin has a safe sleep program that includes a variety of media, hospital, and community-based educational efforts. The ABCs recommendations for safe sleep from the American Academy of Pediatrics include:

  • Sleeping alone
  • Sleeping on the back
  • Sleeping in a crib
  • Non-smoking environment

For disadvantaged families, availability of cribs can be a barrier.  So one intriguing element of the CHAW program is the Newborn Nest.  It is essentially a cardboard box for the baby to sleep in.  For real.

Now, lest you think the idea of a baby in a box is crazy, it’s actually based on an extremely successful program from Finland.  Basically, all new mothers in Finland receive a maternity package.  Unlike in the US, where kits may be given out by hospitals but vary widely, it’s the same for all Finnish moms.  The kit comes in a box and includes breast feeding information, along with bodysuits, a sleeping bag, outdoor gear, diapers, bathing products for the baby, as well as bedding and a small mattress – the mattress is designed to go into the box, which serves as a crib!   And the culture is such that everyone uses it.  Mothers have a choice between the kit and a 140 euro cash grant; 95% choose the kit.

This baby box therefore not only provides a safe sleep environment, it levels the playing field.  Imagine how things might be different if all babies in the Milwaukee area, whether they live in Lindsay Heights or Whitefish Bay, napped in the same type of box.  Of course, that would require a cultural change that could be even harder to achieve than income redistribution.  The Finns note that part of the appeal of the maternity kit is the fact that it symbolizes equality.  But when it comes to children, there is a strain of American culture that supports that: for example, the traditional commitment to universal public education dating back to the first years of the Republic.

Our health disparities are a daunting problem.  Could the answer lie in a box?


Letter to My Nieces on the Election of President Trump

November 10, 2016

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I’ve been thinking about you two a lot recently, especially when I saw the election results.  It’s probably always challenging to be an almost 11 year old girl, but especially now.  Living in Florida, you’ve certainly seen a lot that was said during this election campaign, no matter how hard your mom might have tried to shield you from it.  And a lot of what was said was ugly, on all sides.  Now, this isn’t about Mr. Trump per se, and I don’t want to talk about what kind of president he might be (you also certainly know that there are many widely varying opinions about that, including within our own family).  I want to talk about what I think this election means for girls and women.

When your mother and I were growing up, it was the era of “women’s liberation.”  Since the early days of this country, there have been laws oppressing women: keeping them from voting, owning property, and in general participating fully in society.  By the 1960s and 70s, many of those legal barriers were gone.  But it was still generally assumed that women were simply not as qualified as men.  (We were lucky to have a mother – your Nana –  that defied those stereotypes.)   And just because women were no longer legally second-class citizens didn’t mean they were treated the same.  Liberty is not the same as freedom; attitudes can hold people back as effectively as laws.  So many women, and many men, worked to change those attitudes.  They also worked to enact laws to counteract the discrimination that came from those attitudes.  For example, even though many people thought sports were only for boys, Title IX meant that schools couldn’t only invest in boys’ sports – they had to provide equal opportunities for girls.  And gradually, things got better.  Not perfect – women still earned less than men, were less likely to be leaders in government and business, and frequently judged by different and stricter standards – but better.  Or so I thought.

A few things became clear during the past year or so.  First, when a woman (Hillary Clinton) and a man (Donald Trump) try to do the same thing, they are still judged very differently.  In particular, Americans still have a very “masculine” view of leadership and strength.  People can be strong in many, many ways.  (Just look at your grandmother.)  But it seems when we are electing a leader, we focus only on the kinds of strength – being pushy, brash, in-your-face – that are traditionally associated with boys and men.  It’s another one of those attitudes that is holding women back.  And I’m not sure that’s actually the right kind of strength for a leader.  Look at Vladimir Putin versus Angela Merkel – I’d take Merkel any day.

What’s more disturbing is that not only is the attitude that women are not as qualified as men still quite common, but so is the attitude that women aren’t as good as men, not worth as much.  That they are in many ways simply objects for men.  During the recent campaign we heard people say things about women that I didn’t think many people actually thought, much less said out loud, much less did.  And worse, we heard so many stories from women who said yes, they had heard it and seen it and experienced it.  The leers, the comments, the put-downs, the touches.  As a man I have never had to put up with what all the women I know say has happened to them.  And as a man I am ashamed for those other men.

Now, very few people actually said this sexual harassment was a good thing (though shockingly some did), and I know that most people who voted for Mr. Trump don’t believe it’s good.  Some people dismissed it as “just talk.”  Others said that’s just what guys do.  And many said yes, it’s bad, but we’re going to ignore it because nobody is perfect, and there are more important issues like security or the economy that we agree with him on.  It’s true no one is perfect – certainly Ms. Clinton isn’t – and we have to view people as a whole package of traits, some admirable and some not.  But there are some things that you can’t ignore: sexual harassment and assault is one of them.  You can’t minimize it, or trivialize it, or excuse it, or rationalize it because at least the trains are running on time.  By doing that, it sends the message that it’s only a little bad.

Which is why I was thinking of you on election night.  Obviously, if Ms. Clinton had won, that would have been a strong positive message for girls and women.  I worry that the message in Mr. Trump’s election is that mistreating , demeaning, and even abusing women is not so bad.  In fact, it may even be good – after all, it shows the kind of strength you need to lead.  Which means things are worse for women than I thought, and that makes me sorry and scared for you.

So know a few things.  First, degrading women is not OK.  It’s wrong.  Always.  Period.

Second, everyone has inherent worth and dignity.  Everyone deserves to be respected.  Don’t ever let anyone deny you that.  Be strong.

Third, it’s not something that all guys do or talk about.  I don’t, your cousins don’t, and most men don’t.  Sexism and misogyny are not carried on the Y chromosome.  They are learned, and they can be unlearned (or better, prevented).

I’m not going to send you this yet.  I wanted to get it off my chest, but I’m going to save this until I think you’re ready.  My sincere hope is that when I send it to you in 10 years or so, things will be better.  That no one will assume what you can and can’t do because you’re a girl.  That you’ll be treated fairly and with respect.  That you won’t have to deal with a demeaning boyfriend, or a creepy boss or colleague.  That no guy will brush up against you or press up against you or grab you.  That you won’t ever be a victim of “date” rape.  I hope that board rooms and legislatures and other halls of power will look like America, and not like an NHL hockey team.  I hope all those things.  But hope is not a plan.  So also know that you have people – women and men, like your aunt and your cousins and me –  who are going to fight like hell to make it so.

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