Oliver Davis
Fairbanks School of Public Health
PBHL-S337: Health Equity Final Project
Health and Society Issue Brief
PBHL-S337, Health Equity and Social Determinants of Health, has been selected as a course with engaged learning experiences to reflect back on. This section should be relatively short, just a quick introduction of this artifact and what class it was from. The bulk of this content is the artifact itself.
This course provides students with an ecological perspective on health, exploring how the systems in which people live work, learn, and play impact their health. The culminating assignment calls on students to demonstrate understanding of core concepts in the class regarding the connection between upstream social issues and population health and health equity. Students use credible evidence to describe a social issue they believe needs to be addressed, explain the connection between that social issue and population health, and then identify one evidence-based course of action that addresses the upstream social problem.
Working in a pair with another student is encouraged to build collaborative skills, though students may elect to prepare the brief on their own. The assignment is meant to hone students' communication skills for writing in a simple, clear, and straightforward way, aiming for an audience of people one might meet in community organizations or the general public.
The following work is from student Katie Mumaugh, a student in the Fairbanks School of Public Health at IU Indianapolis. Her work was shared from professor Tess Weathers with the permission of Katie. Her work was modified for web format, with the original included below in the PDF. This page includes an excerpt of her work, along with highlighted key findings and the PDF with a pull-out quote.
Health Equity and Social Determinants of Health
Diaper Insecurity and the Downstream Health Impacts
Key Findings
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Diapers are a substantial cost for parents and families in the first several years of their child's life.
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Governmental programs such as WIX and SNAP do not cover the purchase of diapers
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Low-income guardians, single mothers, and families of color are disproportionately affected by diaper need.
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Diaper insecurity is the number one hardship contributing to maternal depression.
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Exempting diapers from sales tax and offering monthly diaper stipends can help reduce diaper insecurity.
Diaper Insecurity as a Social Issue
Diapers are an essential part of caring for an infant. In the first month alone, an infant uses an average of 10-12 diapers per day. That totals up to about 325 diapers in the first four weeks of life, (Ryan, 2025). Furthermore, within the first year, a baby uses around 2,500-3,000 diapers, (Ryan, 2025). The total cost for diapers per year adds up to around $840, (Zauderer, 2025). As such, diapers are a considerable expense for parents and caregivers. Studies have shown that one out of every three mothers in the United States struggles with diaper insecurity, meaning they do not have adequate access to diapers for their child, (Institute for Research on Poverty, 2022). In interviews conducted with seventy low-income mothers, it was found that 79% reported sacrificing other necessities to buy diapers instead, (Randles, 2022).
Diapers are not getting any cheaper as time goes on. In fact, diaper costs have risen 22% since 2018, according to NielsenIQ, (Institute for Research on Poverty, 2022). During the Covid-19 pandemic, diaper costs rose alongside many other products, with their prices increasing 10%. Nevertheless, the federal minimum wage has not improved from $7.25 since 2009, (U.S. Department of Labor, n.d.).
There is a clear dissonance between the rising costs of all goods, especially diapers, and the minimum wage. Although there are social safety net programs in place for things like food, these programs do not cover personal hygiene products such as diapers, leaving the most vulnerable population left to struggle with the high cost of diapers alone.
Because of the high costs associated with diapers, low-income individuals and families are disproportionately affected by diaper insecurity. Furthermore, diapers are not covered by safety net social programs such as the Supplemental Nutrition Assistance Program (SNAP) or the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), (Randles, 2022). Black and Latina unmarried mothers are more likely to suffer from diaper insecurity, and single motherhood is a predictor of diaper need, (Randles, 2022). Children of color are more likely to belong to families who live in poverty, which leads to them being more likely to suffer from diaper scarcity, (Institute for Research on Poverty, 2022). Thirty percent of Native American children under 18 are living at or below the Federal Poverty Level (FPL), as well as thirty-one percent of Black children, (Institute for Research on Poverty, 2022).
Additionally, twenty-three percent of Hispanic children live at or below the FPL, (Institute for Research on Poverty, 2022). As demonstrated by these statistics, minority groups are disproportionately affected by diaper need due to the higher number of them living at or below the FPL. For reference, ten percent of White children in the United States live at or below the FPL, (Institute for Research on Poverty, 2022). Additionally, many childcare facilities require parents to provide a certain number of diapers per day. When parents or guardians do not have an adequate number of diapers to provide to childcare, it may lead to missed shifts at work. This can then lead to them losing their job, therefore jeopardizing their ability to participate in certain safety net programs, (Institute for Research on Poverty, 2022). As a result, a cycle perpetuates in which they cannot afford diapers, so they cannot go to work, leading to them being even less able to afford diapers
Diaper insecurity has been found to have a profound negative impact on the mental health of mothers. The Policy Center for Maternal Mental Health found that diaper need is the number one hardship contributing to maternal depression, even more so than food insecurity, (Britt, 2024).
What I learned
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