"There is a surprising degree of overlap between the kinds of questions a psychiatrist asks and those asked by a chaplain."
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Whether chugged amid the forests of Mazatlan or the frenzy of Manhattan, a can of beer is a can of beer. It follows that populations with high maternal drinking levels should be burdened with unusually numerous disabled infants. This does seem to be the case – up to a point. Certainly, communities that promote religious or moral abstention from alcohol consumption tend to have much lower prevalence rates of fetal alcohol syndrome. And those demographic groups whose social or cultural activities are centered on drinking are subject to greater prevalence. The two demographic factors most commonly associated with a disproportionate number of FAS cases are lower socioeconomic status and membership in certain ethnic groups.However, the correlation between socioeconomic and racial factors and FAS cannot be explained entirely by the alcohol poisoning to the fetus that results from greater alcohol use among the populations in question. One important cause is not so much what members of these groups do ingest, but rather what they do not. Few would consider alcohol a diet-friendly beverage. Devoid of almost all nutrients, vitamins, and minerals, it has an extremely high caloric density. As a result, women who drink regularly often receive much of their daily caloric need from the habit, at the expense of foods that would otherwise provide nutrition crucial to fetal development. Since lower socioeconomic status correlates with alcoholism, it therefore also correlates with the malnutrition that alcoholism brings.
Low socioeconomic status is also associated with a plethora of factors not directly related to alcohol use, all of which can have a deleterious effect on a fetus. The most notable of these include an increased likelihood of nicotine and other drug use, a greater risk of physical abuse, an amplified exposure to pollutants and toxins, significantly worse medical care, and the daily psychological stresses of poverty.
Certain ethnic groups show a disproportionate number of fetal alcohol syndrome cases. Spanning across two years and four states (Alaska, Arizona, Colorado, and New York), a recent extensive CDC-backed research initiative by the Fetal Alcohol Syndrome Surveillance Network (FASSN) reported the highest rates to be among Alaska Native and American Indian, as well as black, populations. Race and socioeconomic status are so closely linked, however, that the latter no doubt has a considerable influence in pairing cases to cultures. Even seemingly ethnic variables such as drinking practices for festival rites and ceremonies may be shaped by economic deprivation.
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