SAMPLE POLICY PROPOSALS PROPOSAL FOR ACCESS TO NONTRADITIONAL, HIGHER-PAYING JOBS FOR CALIFORNIA WOMEN A proposal for state budget and administrative change to prioritize getting California women in the welfare-to-work ranks out of low-income, dead-end jobs by providing them with access to non-traditional jobs that can result in higher-paying, self-sufficient wages. The goal is to stop the poverty cycle and state dependency that results from current state policies. In 2005, the average wage for a CalWORKs recipient was $7.23 an hour. Most of the CalWORKs recipients are the sole supporters of their families. According to statistics from Alameda County, a single mother in Oakland with one child must make at least $18 an hour in order to support herself and her child, and this figure increases incrementally with more children. There is great potential for women in the employment ranks of construction, biotech, metal industry (machining), satellite/cable installation, and other non-traditional fields. Although women are not prohibited from participating in training programs for these careers, it is apparent they are not actively recruited for these programs. Many of these training programs report a typical ratio of only four women trainees out of a total of 100 participants. These numbers are staggering, because for the few women participants, these training programs are often a lonely and discouraging place to be. The barriers of entry for women into non-traditional careers must be identified and resolved. Construction Careers provide a great potential for CalWORKs and other low-income women: Women currently comprise less than 3% of construction workers nationally and less than 5% in California. Paradoxically, the booming construction industry is experiencing a nationwide shortage of skilled workers, and this urgent workforce challenge may soon become a crisis in California. The Department of Labor estimates that the construction industry nationwide will require 240,000 new workers each year for the next five years – yet only 150,000 new workers are expected to enter the trades yearly, creating a continual workforce shortage. For every four people who leave the trades, the apprenticeship programs now supply only one new person to replace them. A woman can expect to earn 20-30% more in a construction career than in a traditionally female occupation. Entry-level jobs in the trades, which often only require a GED and a driver’s license, start at $12 to $18 an hour. After completing a three to five-year union apprenticeship that includes free classroom and paid on-the-job training, journey-level workers can make a minimum of $22 an hour, and often as much as $40 an hour or more, depending on their trade. These careers also offer excellent family health and pension benefits, as well as career pathways beyond working with tools. The recently passed infrastructure and transportation bond measures, representing $50 billion worth of taxpayer funding for California projects, are estimated to require 144,000 new construction workers over the next 10 years. As by far the lowest demographic percentage in the skilled trades, women represent the greatest untapped resource to meet this critical workforce shortage. Proposed Solution In order to access these lucrative jobs, women need to be recruited, trained and supported to enter and succeed in the various training programs that lead to success in these non-traditional careers. A dynamic statewide media /outreach campaign to promote these careers to California’s low-income women can be developed through funds from the Dept. of Social Services and/or the Employment Training Panel, and/or through the legislative budget process. Through partnerships with state agencies (such as the DSS, ETP, Division of Apprent. Standards, CA Apprenticeship Council, Dept. of Education, Community Colleges, etc.) and other community stakeholders (such as employer/contractor associations, building trades councils, community-based organizations, etc.), model programs can be developed that will significantly increase the numbers of low-income California women who participate and succeed in non-traditional career paths and training preparation programs. For more information contact: Inez Gonzalez – National Hispanic Media Coalition, (213) 534-3026, firstname.lastname@example.org Annie Marie King Meredith – North Richmond Empowerment Collaborative, (510) 374-7113, email@example.com Jenny Whyte - Marjaree Mason Center, (559) 487-1316, firstname.lastname@example.org Beth Youhn – Tradeswomen Inc., (510) 891-8773 ext 313, email@example.com Family Communication Challenge Grant Program Concept Statement (Draft 12-7-05) Problem Statement: In California, certain communities and populations experience reproductive and sexual health disparities as evidenced by key indicators, including disproportionately high rates of teen pregnancies and STIs, lack of access to health services and information, and poverty. The lack of family communication about sexuality has been identified as a specific need to address such disparities. Goal: To promote broader access to comprehensive reproductive and sexual health care and information for teens and their families through the model of family communication. Proposed program outcomes: o Increased family communication about sexuality in communities with the greatest need o Increased teens’ utilization of reproductive health services, including: Protection against unplanned pregnancies and STIs Timely access to prenatal care and abortion services o Increase information and awareness for teens and their families about the availability of existing confidential health care services in their communities Proposed program concept: o Create competitive grant program to fund targeted community outreach and education models that: o promote teens’ overall health and well-being; o provide families with resources and tools for promoting family communication about sexuality; o provide information to teens and families about existing reproductive and sexual health issues and/or services o target California communities with the greatest need as defined o meet organizational criteria as defined Strategic Opportunities: Opportunity to continue momentum with allies who became active supporters of the Campaign for Teen Safety/No on 73 to organize around this issue. Opportunity for legislators to champion reproductive health access in a proactive manner that provides positive solutions. Opportunity to develop broader coalitions of communities that favor more education about sexual and reproductive health. Legislative Proposal to: Increase Breastfeeding Rates in California Introduction In a time when overwhelming research shows that human milk is vastly superior to any sort of manufactured human milk substitute, reaping great health and economic benefits for breastfeeding families, the health care system, and society in general,i,ii breastfeeding is no longer seen as just an individual choice, but rather as a public health challenge that deserves promotion to create supportive systems and environments for mothers to breastfeed. The national goals as set by Healthy People 2010 are for 75% of women to initiate breastfeeding, for 50% to still be breastfeeding at 6 months, and 25% by 12 months.iii Billions of healthcare dollars would be saved if more infants were exclusively breastfed and breastfed for a longer duration of time.iv The United States Breastfeeding Committee (USBC) estimates that $2 billion per year are spent by families on infant formula and that $3.6 – 7 billion dollars could be saved each year in preventable conditions if breastfeeding rates were increased to the recommended levels. Breastfeeding is one of the most important contributors to infant health. When babies are fed with formula rather than breastmilk, they are more likely to be ill more often and more seriously. The health consequences of not breastfeeding for infants are higher rates of gastrointestinal,v,vi,vii respiratory,viii,ix,x and ear infections.xi,xii,xiii Researchers have also connected a host of serious, chronic diseases and conditions—SIDS,xiv diabetes, obesity,xvxvi childhood cancers,xvii asthma and other allergic conditionsxviii,xixand lowered IQxx,xxi—to infants’ consumption of formula. These studies are especially significant because they demonstrate that not only initiation of breastfeeding, but exclusivity and duration of breastfeeding matter. There are negative health consequences to not breastfeeding for the mother also. Mothers who formula feed their babies experience more postpartum bleeding and delayed uterine involution,xxii later return or no return to pre-pregnancy weight,xxiii and increased risk of ovarian cancerxxiv, endometrial cancerxxv, premenopausal breast cancerxxvi and osteoporosis.xxvii,xxviii Additionally, formula feeding is not environmentally sound. It burdens our landfills and requires fossil fuels for its manufacturing and preparation. It also increases the pollutants created from by- products during the manufacture of plastic bottles and containers for the storage and delivery of infant formula. Despite this evidence, too few California women exclusively breastfeed their babies in the first six months of life, as recommended by the American Academy of Pediatrics, let alone in the early postpartum period.xxix Based on the most recent data from the California Department of Health Services, 42 percent of California mothers are exclusively breastfeeding their babies at the time of hospital discharge. Another 40 percent of California mothers are breastfeeding combined with infant formula supplements at the time of hospital discharge, already compromising breastfeeding efforts and leading to early cessation of breastfeeding. So why aren’t more California mothers exclusively breastfeeding their babies in the early postpartum period? While demographic factors have an influence on breastfeeding rates, hospital policies and practices also have a powerful influence on a mother’s attitude toward breastfeeding as well as her perception about her ability to breastfeed.xxx,xxxi Studies have shown that supportive breastfeeding practices in the hospital, such as early initiation of breastfeeding, early breastfeeding guidance, allowing mothers and infants to remain together, and avoiding formula supplementation significantly increase breastfeeding duration rates.xxxii,xxxiii,xxxiv Existing Law Several laws have been enacted in California to protect a woman’s right to breastfeed. In 1997, Assembly Bill 157 added Section 43.3 to the Civil Code, which specifies that, notwithstanding any other provision of law, a mother may breastfeed her child in any location, public or private, except the private home or residence of another, where the mother and child are authorized to be present. In 2000, Assembly Bill 1814 enacted a law that exempts breastfeeding mothers from jury duty, and requires the State to take steps to eliminate the need for the mother to appear in court to make this request. In 2001, Assembly Bill 1025 added sections 1030, 1031, 1032 and 1033 to the labor code which mandates that employers accommodate breastfeeding mothers when they return to work by providing a reasonable amount of break time to accommodate an employee desiring to express breastmilk for her infant child and to make reasonable efforts to provide the employee with the use of a room or other location, other than a toilet stall, in close proximity to the employee’s work area, for the employee to express milk in private. In addition, existing law requires all general acute care hospitals, as defined in subdivision (a) of Section 1250, and all special hospitals providing maternity care, as defined in subdivision (f) 1250, shall make available a breastfeeding consultant or alternatively, provide information to the mother on where to receive breastfeeding information. While the intent of this law was for women to receive the support they need in the early postpartum period, the reality is that in most cases the law is not being implemented since there are no provisions for enforcement. Instead, women encounter multiple barriers during this vulnerable time, including lack of adequate assistance from hospital staff and messages and free samples of formula, which can undermine their efforts to breastfeed. Proposal To address this issue, we are proposing breastfeeding legislation that would: 1) restrict formula marketing and the distribution of free formula samples within hospital maternity units; and 2) recommend that all licensed nurses working within a maternity unit of a hospital receive a minimum of 18-hours of training on basic lactation management and/or demonstrate a specified level of competency; and While women experience many barriers to successful breastfeeding, the proposed legislation would address three of the most egregious ones and those that occur during the most vulnerable time. The early postpartum period is critical to the successful establishment of lactation, making what occurs in this short window extremely important. While a breastfeeding woman can always switch to formula feeding very easily, the decision to bottle- feed is very hard to reverse even after only a few days. Rationale for restricting formula marketing: Women need to feel confident in their ability to adequately nourish their babies. Exposure to formula marketing and free samples of formula has been shown to undermine a woman’s confidence, especially if she is encountering difficulties in establishing lactation. The use of supplements has the negative effect of decreasing a woman’s milk supply and further interfering with adequate latch on and can thus lead to greater supplementation and early weaning from the breast. Restricting formula marketing during the early postpartum period allows women to make a more informed decision about feeding, based on personal preference and available resources. Given what has been proven about the health risks of not breastfeeding, marketing formula to women during the vulnerable postpartum period, is unethical from a public health standpoint and akin, if not worse than, schools selling soda and junk food to impressionable youth. The two groups are particularly vulnerable to the products being offered and often taken in by the highly sophisticated marketing tactics. Yet health care professionals are colluding with industry by accepting materials, incentives and financial assistance (discharge packs, free supplies, lunches, sponsorship of in-services and conferences, upgrades and construction of maternity facilities, etc.) from formula companies. Instead of formula samples and messages, health care institutions should provide women with unbiased, medically accurate breastfeeding support and information. Rationale for recommend training of nurses: Women need and should have the right to receive medically accurate, evidence-based information about lactation from health care providers. Adequate assistance and support during the critical postpartum period from nurses who possess accurate, up-to-date information and skills in basic lactation management is essential to helping women breastfeed. During the early postpartum period, nurses are often the most influential and trusted sources of information about infant feeding. Yet, many do not possess the knowledge or skills to adequately provide the support needed to help women to initiate lactation. Nurses who have not been trained in breastfeeding management cannot be expected to give mothers effective guidance and provide skilled counseling. Lactation management is often omitted from curricula in basic training of nurses and is currently not a required part of on the job training. i Breastfeeding Promotion Committee Report to the California Department of Health Service Primary Care and Family Health. Breastfeeding: Investing in California’s Future. 1996. ii U.S. Department of Health and Human Services. HHS Blueprint for Action on Breastfeeding, Washington, D.C. U.S. Department of Health and Human Services, Office of Women’s Health, 2000. iii U.S. Department of Health and Human Services. Healthy People 2010: Conference Edition – Volumes I and II. Washington, DC: U.S. Department of Health and Human Services, Public Health Service, Office of the Assistant Secretary for Health, January 2000, pp. 2, 47,-48. iv United States Department of Agriculture, “The Economic Benefits of Breastfeeding: A Review and Analysis,” Food Assistance and Nutrition Research Report No. 13 (2001). v A.S. Goldman, “Modulation of the Gastrointestinal Tract of Infants by Human Milk, Interfaces and Interactions: An Evolutionary Perspective,” Journal of Nutrition 130 (2000): 426S-431S. vi L.K. Pickering and A.L. Morrow, “Factors in Human Milk that Protect Against Diarrheal Disease,” Infection 2 (1993): 355-357. vii Amal K. Mitra and Fauziah Rabbani, “The Importance of Breastfeeding in Minimizing Mortality and Morbidity >From Diarrhoeal Diseases: The Bangladesh Perspective,” Journal of Diarrhoeal Diseases Research 13 (1995): 1-7. viii A.L. Wright, C.J. Holberg, F.D. Martinez, W.J. Morgan, and L.M. Taussig, “Breast Feeding and Lower Respiratory Tract Illness in the First Year of Life,” British Medical Journal 299 (1989): 946-949. ix Y.Chen, “Synergistic Effect of Passive Smoking and Artifical Feeding on Hospitalization for Respiratory Illness in Early Childhood,” Chest 95 (1989): 1004-1007 x A.L. Wright, C.J. Holberg, L.M. Taussig, and F.D. Martinez, “Relationship of Infant Feeding to Recurrent Wheezing at age 6 Years,” Archives of Pedicatric and Adolescent Medicine 149 (1995): 758-763. xi Nancy F. Sheard, “Breast-Feeding Protects Against Otitis Media,” Nutrition Reviews 51 (1993): 275-277. xii B. Duncan, J. Ey, C.J. Holberg, A.L. Wright, F.D. Martinez, and L.M. Taussig, “Exclusive Breast-Feeding for at Least 4 Months Protects Against Otitis Media,” Pediatrics 91 (1993): 867-872. xiii G. Aniansson, “A Prospective Cohort Study on Breast-Feeding and Otitis Media in Swedish Infants,” Pediatric Infectious Disease Journal 13 (1994): 183-187. xiv B. Alm, G. Wennergren, S.G. Norvenius, et al., “Breast Feeding and the Sudden Infant Death Syndrome in Scandinavia, 1992-95,” Archives of Disease in Childhood 86 (2002): 400-402. H.C. Gerstein, “Cow’s Milk Exposure and Type 1 Diabetes Mellitus: A critical overview of the clinical literature,” Diabetes Care 17 (1994): 13-19. H.M. Dosch and D.J. Becker, “Infant Feeding and Autoimmune Diabetes,” Adv Exp Med Biol 503 (2002): 133-140. xv Rüdiger von Kries, Berthold Koletzko, Thorsten Sauerwald, et al., “Breast Feeding and Obesity: Cross Sectional study,” British Medical Journal 319 (1999): 147-150. xvi Matthew W. Gillman, Sheryl L. Rifas-Shiman, Carlos A. Camargo Jr., et al., “Risk of Overweight Among Adolescents Who Were Breastfed as Infants,” Journal of the American Medical Association 285 (2001): 2461-2467. xvii A. Bener, S. Denic, and S. Galadari, “Longer Breast-Feeding and Protection Against Childhood Leukaemia and Lymphomas,” European Journal of Cancer 37 (2001): 234-238. xviii W.H. Oddy, P.G. Holt, P.D. Sly, et al., “Association Between Breastfeeding and Asthma in 6 Year Old Children: Findings of a Prospective Birth Cohort Study,” British Medical Journal 319 (1999): 815-819. xix S. Dell, “Breastfeeding and Asthma in Young Children: Findings from a Population-Based Study,” Archives of Pediatrics & Adolescent Medicine 155 (2001): 1261-1265. xx Erik Lykke Mortensen, Kim Fleischer Michaelson, Stephanie A. Sanders, and June Machover Reinisch, “The Association Between Duration of Breastfeeding and Adult Intelligence,” Journal of the American Medical Association 287 (2002): 2365-2371. xxi A. Lucas, R. Morley, T.J. Cole, G. Lister, and C. Lession-Payne, “Breast Milk and Subsequent Intelligence Quotient in Children Born Preterm,” Lancet 339 (1992): 261-264. xxii M.J. Heinig and K.G. Dewey, “Health advantages of breastfeeding for mothers: a critical review” Nutr Res Rev 10 (1997): 35-36. M.H. Labbock, “Effects of breastfeeding on the mother,” Pediatr Clin North America 48 (2001): 143-158. xxiii M.J. Heinig and K.G. Dewey, “Health advantages of breastfeeding for mothers: a critical review” Nutr Res Rev 10 (1997): 35-36. xxiv Ibid xxv B. Petterson et al, “Menstruation span – a time limited risk factor for endometrial carcinoma” Acta Obstst Gyneocol Scand 65 (1986): 247-255. xxvi T. Zheng, L. Duan, Y. Liu, et al., “Lactation Reduces Breast Cancer Risk in Shandong Province, China,” American Journal of Epidemiology 152 (2000): 1129-1135. xxvii L.J. Melton et al, “Influence of Breastfeeding and other Reproductive Factors on Bone Mass Later in Life,” Osteoporos Int. 22 (1993): 684-691. xxviii R.G. Cumming and R.J. Klineberg, “Breastfeeding and other Reproductive Factors and the Risk of Hip Fractures in Elderly Women,” Int J Epidemiol 22 (1993): 684-691. xxix American Academy of Pediatrics. Policy Statement: Breastfeeding and the Use of Human Milk (RE9729). Pedicatrics 1997; 100(6): 1035-1039. xxx U.S. Department of Health Services. “Baby-Friendly Hospital Initiative Improves Breastfeeding Initiation Rates in U.S. Hospital Setting.” Best Practice Initative. U.S. Department of Health Services, Public Health Service, Office of the Assistant Secretary for Health, August 2002. xxxi Barbara L. Philipp, Anne Merewood, Lisa W. Miller, Neetu Chawla, Melissa M. Murphy-Smith, Jenifer S. Gomes, Sabrina Cimo, and John T. Cook. “Baby-Friendly Hospital Initiative Improves Breastfeeding Inititation Rates in a US Hospital Setting. Pediatrics 108 (2001): 677-681. xxxii D.A. Frank et al, “Commerical Discharge Packs and Breastfeeding Counseling: Effects on Infant-Feeding Practices in a Randomized Trial,” Pediatrics 80 (1987): 845-854. xxxiii C.I. Dungy et al “The Effects of Discharge Samples on Duration of Breastfeeding,” Pediatrics 90 (1992): 233- 237. xxxiv G. Hayden et al, “Providing free samples of baby items to newly delivered patients,” Clinical Pediatrics 26 (1987): 111-115.