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Embracing a Life Course Framework for Maternal, Child, and Adolescent Health Program Operations

Embracing a Life Course Framework for Maternal, Child, and Adolescent Health Program Operations. Cynthia A. Harding, M.P.H. Los Angeles County Department of Public Health Maternal, Child and Adolescent Health Programs. From preconception health to life course trajectory

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Embracing a Life Course Framework for Maternal, Child, and Adolescent Health Program Operations

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  1. Embracing a Life Course Framework for Maternal, Child, and Adolescent Health Program Operations Cynthia A. Harding, M.P.H. Los Angeles County Department of Public Health Maternal, Child and Adolescent Health Programs

  2. From preconception health to life course trajectory Mapping programs and services to the life course Putting a life course framework into practice Today’s Presentation

  3. Infant Mortality Refocuses MCAH Programs Infant Death Rate by Race/Ethnicity Antelope Valley vs. Los Angeles County, 1996-2005 Preconception Health Health Disparities

  4. Barriers to Favorable Birth Outcomes and Health Trajectories • No health insurance • Poverty • Depression • Low educational attainment • Racism • Perceiving a neighborhood as unsafe

  5. LAC MCAH Programs Change Life Course Health Trajectories Poverty Racism Poor Education Uninsured Depression Obesity and Associated Chronic Conditions Physical Inactivity Asthma Poor Diet Adverse Maternal & Child Outcomes Maternal Nutrition Bottle Feeding Lead Exposure NFP CPSP ALC Preconception - Interconception CLPPP Child Obesity Prevention Adapted from Lu MC, Halfon N. Racial and ethnic disparities in birth outcomes: a life-course perspective. Maternal and Child Health Journal 2003; 7:13-30.

  6. Depression Screening • Nurse Family Partnership • Mental health assessment, referrals to resources and services • Comprehensive Perinatal Services Program • Two-hour provider trainings on perinatal depression and PHQ9 screening tool

  7. Neighborhood Revitalization • Gang prevention • Family resource centers • Federal funding initiatives

  8. MCAH Nutrition for a Good Life Poor Maternal – Child Outcomes Sedentary Asthma Poor Diet Obesity Related Conditions Bottle Feeding Lead Exposure NFP CPSP HWWALC Obesity Prevention, CLPPP Breastfeeding Support Asthma Coalition Health Before-Between-After Pregnancy Infancy Childhood Puberty Pregnancy Adulthood Life Course Health Trajectory

  9. Childhood Lead Poisoning Prevention Program~Healthy Homes Assessment

  10. The Partnership to Eliminate Disparities in Infant Mortality (PEDIM) • PEDIM a joint project of CityMatCH, the Association of Maternal and Child Health Programs and the National Healthy Start Association • Action Learning Collaborative (ALC) an 18 month program of PEDIM • W.K. Kellogg Foundation Funded

  11. Overcoming staff perceptions that life course framing is either “nothing new” or more work Risk of giving up control or losing identify when partnering with others Staff and resource shortages Challenges

  12. Key Points: A Life Course Framework for MCAH Program Operations • Data to identify gaps at crucial periods in the life trajectory for intervention • Educate staff on life course model • New partnerships to connect MCH programs with community efforts to improve physical and social environment • Focus on promoting health before and between pregnancies

  13. Los Angeles County Department of Public Health Maternal, Child, and Adolescent Health Programs Cynthia A. Harding, M.P.H. Director charding@ph.lacounty.gov

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