Healthy mothers, healthy babies

UTSA researcher explores birth weight disparities

by Vincent T. Davis

P. Johnelle Sparks has dedicated her career to answering unexplained questions about maternal and child health. Since joining UTSA in 2006 as an assistant professor in the Department of Demography and Organization Studies, she has concentrated on health inequalities among racial and ethnic groups.

It’s an interest that was ignited when she was just a teen growing up in Little Rock, Ark. There, her school’s high teen pregnancy rate prompted questions about the norms and behaviors that contribute to teen pregnancy. As a student at the University of Arkansas, she used her teenaged experience as a springboard to explore infant mortality rates. And her Ph.D. dissertation at Pennsylvania State University looked at low birth rates in different rural settings.

“What my discipline is good at is showing patterns across populations,” Sparks says. “As a rural sociologist and demographer, I draw on different perspectives to examine how social structures work and how people operate within them. The whole point of my research is to help people who may not know how to help themselves.”

Today, she has had several articles featured in publications, including some of the premier peer-reviewed journals in her field, Social Science and Medicine and Maternal and Child Health Journal.

Her published work is based on national studies and large representative samples, but she feels there is also value in studying things locally and knowing the context of a place.

Groundbreaking work

In her study published in Social Science and Medicine, “One Size Does Not Fit All: An Examination of Low Birth Weight Disparities Among a Diverse Set of Racial/Ethnic Groups,” Sparks explored behaviors of mothers from several different racial groups and their influence on low birth weights.

The groups she looked at included non-Hispanic white, non-Hispanic black, U.S. born Mexican-origin Hispanic, foreign-born Mexican-origin Hispanic, other Hispanic, Native American and Asian mothers.

Her research showed Hispanic mothers are most likely to have babies with healthier birth weights, followed by non-Hispanic white mothers. Non- Hispanic black mothers are the most likely to have low birth weight infants. This finding is a paradox, Sparks wrote, because the two minority groups have similar socioeconomic profiles.

One explanation could be better health behaviors and practices for Hispanics during pregnancy, including lower rates of smoking and drinking alcohol, she says.

In another study, Sparks investigates the impact of the Special Supplement Nutrition Program for Women, Infants, and Children (WIC) on childhood morbidity. Funded by the Institute for Research on Poverty at the University of Wisconsin, as part of a grant from the United States Department of Agriculture Research Innovation and Development Grants in Economics, the study examines how WIC can serve as a mediating mechanism to decrease disparities in early childhood health outcomes for lowincome children by reducing the impact of food insecurity in these homes. Publications from this grant are forthcoming in the Journal of Human Lactation and the Journal of Children and Poverty.

When comparing families who use WIC and those who are eligible for the program but do not use it, Sparks’ research showed maternal WIC usage protected against low birth weight and poor childhood health.

But child WIC usage, which differs by race and ethnicity, showed very little difference in health outcomes between those who participate versus those that are eligible to use the program but don’t.

She says there is a good health referral system through WIC, which helps women who use these services know where to go for assistance if their children are having health problems.

“I think different people use different mechanisms to deal with child health and resources,” Sparks says. “I’m not saying there’s a direct link between race/ethnicity and how people access resources, but there are different coping mechanisms across groups and how they use social support and other types of networks to deal with child health problems.”

Sparks’ research also showed foreign-born Mexican-origin Hispanic women use WIC at the highest rates and initiate and continue breastfeeding at the highest rates.

Filling the Gaps

“A health goal for the nation is to reduce infant and child mortality and to increase healthy deliveries, and research and medical professionals are working to those goals,” Sparks says. “The U.S. is doing much better on these health indicators than we were several decades ago. But there are certain racial/ethnic and low income groups that need more attention if gaps in these outcomes are to be eliminated.”

Sparks says she’s been thinking about the influx of Hispanic populations to rural areas and how this pattern of settlement is changing the face of what many rural areas look like.

But if rural areas are most familiar with serving a single type of client, most often non-Hispanic whites, and people in social service and health offices are having this new mix of clients, Sparks says the question that needs to be studied is how can these services best address the needs of a new set of clients.

Sparks says most programs and policies, particularly social services, have to be dynamic in order to meet the needs of the population groups they serve.

“We have to inform the people making policy decisions about how population groups are using services to better their health,” Sparks says. “And many of these conversations should be focused on the changing composition of the population.”

That’s something she stresses to future demographers. Her students say Sparks’ knowledge is in the forefront of her field, and she encourages them to pursue their own research publication interests.

“Beyond the classroom, Dr. Sparks maintains a focus on both furthering her own research and exploring the research of others so that her knowledge base remains current, topical and even cutting edge,” says Mary Bollinger, a May 2010 Ph.D. recipient and former graduate student of Sparks’.

“It is wonderful to share my educational journey with Dr. Sparks because her passion for demography and teaching, her dedication to her students, and her overall commitment to excellence in scholarship inspire me.”

And her work has far-reaching implications, says Lloyd Potter, professor and interim chair of the Department of Demography and Organization Studies. It has the potential to identify risk factors for low birth weight infants in specific sub-populations that could lead to developing prevention efforts in San Antonio and beyond.

“Her work clearly illustrates the caliber of scientist we have at UTSA and the university’s capacity to contribute to addressing significant health and social issues in our community and in the state,” Potter says. “Dr. Sparks and her research have had a tangible influence on the educational experience of the diverse group of graduate students in UTSA’s Ph.D. program in applied demography.”