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MCHB Perspective on Local MCH: CityMatCH 2008

Sept. 2008. 2. . The Importance of Local Government. Sept. 2008. 3. . Web hits for:Local Government: 74,200,000State Government: 14,400,000Federal Government: 60,800,000. Sept. 2008. 4. . The Importance of Local Data. Sept. 2008. 5. . Widening Disparities in Infant, Neonatal, and Postneonatal Mortality Among Major US Metropolitan Cities, 1985-2002GK Singh, PhD; MD Kogan, PhD; RA Hummer, PhD; PC van Dyck, MD, MPH; M Badura; K Hench.

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MCHB Perspective on Local MCH: CityMatCH 2008

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    1. MCHB Perspective on Local MCH: CityMatCH 2008 US Department of Health and Human Services Health Resources And Services Administration Maternal And Child Health Bureau Michael D. Kogan, PhD Director, Office of Data and Program Development for Peter C. van Dyck, MD, MPH Associate Administrator for Maternal and Child Health Health Resources and Services Administration

    2. Sept. 2008 2 The Importance of Local Government

    3. Sept. 2008 3 Web hits for: Local Government: 74,200,000 State Government: 14,400,000 Federal Government: 60,800,000

    4. Sept. 2008 4 The Importance of Local Data

    5. Sept. 2008 5 Widening Disparities in Infant, Neonatal, and Postneonatal Mortality Among Major US Metropolitan Cities, 1985-2002 GK Singh, PhD; MD Kogan, PhD; RA Hummer, PhD; PC van Dyck, MD, MPH; M Badura; K Hench

    6. Sept. 2008 6 Considerable disparities in infant mortality exist across major US cities, with the rate in 1999-2002 varying from a low of 4.2 per 1000 live births in San Francisco to a high of 15.5 for Birmingham, AL. When broken down by race, the infant mortality rate in 1999-2002 varied from a low of 2.9 for white infants in San Francisco to 18.8 for black infants in Pittsburgh.

    7. Sept. 2008 7 The infant mortality rate for most cities declined by =30%, but not for a number of cities. However, overall disparities in infant, neonatal, and postneonatal mortality widened between 1985 and 2002, especially postneonatal mortality.

    8. Sept. 2008 8

    9. Sept. 2008 9

    10. Sept. 2008 10 The Importance of Neighborhood Data

    11. Sept. 2008 11 5 year project examined racial disparities in preterm birth across neighborhoods in Maryland, Michigan, and North Carolina, and Philadelphia. Examined neighborhood-level factors such as employment, housing, and residential stability. Developed a neighborhood deprivation index.

    12. Sept. 2008 12 Across all sites, non-Hispanic white women were 57% more likely to deliver preterm in neighborhoods with the most deprivation (compared to non-Hispanic white women in the least deprived areas). Across all sites, non-Hispanic African-American women were 15% more likely to deliver preterm in neighborhoods with the most deprivation (compared to non-Hispanic African-American women in the least deprived areas).

    13. Sept. 2008 13 Can Interventions Help?

    14. Sept. 2008 14 Healthy Start Program and Feto-Infant Morbidity Outcomes: Evaluation of Program Effectiveness HM Salihu, AK Mbah, D Jeffers, AP Alio, L Berry

    15. Sept. 2008 15 Measured impact of Hillsborough, Florida Healthy Start program on low birth weight and preterm birth. Pregnant women in Healthy Start offered initial screening and assessment, health education, care coordination and utilization. Healthy Start women who received assessment and/or care coordination compared to Healthy Start women who had none of the above or just initial contact.

    16. Sept. 2008 16 The Hillsborough Healthy Start program reduced the level of low birth weight and preterm delivery by 30% among service recipients as compared to non-recipients. The higher the recipients’ initial risk score, the greater the benefit of program services.

    17. Sept. 2008 17 MCH Bureau

    18. Sept. 2008 18 The Community-Based Doula Program MCHB was allotted $1.4 million to launch the Community-Based Doula Initiative. Purpose: to provide first time motherhood demonstration programs to urban and rural communities to support community-based Doulas. Projects identify and train indigenous community workers to mentor pregnant women during the months of pregnancy, birth and at least twelve weeks post-partum, (optimally one year post-partum).

    19. Sept. 2008 19 The Community-Based Doula Program Up to 6 awards made to urban and rural community-based organizations to support community-based Doula activities. Rural portions will focus on the best ways of delivering supportive services, including delivery outside the hospital setting both before and after the birth of the child. Priority given to applications which emphasized breastfeeding initiation and retention.

    20. Sept. 2008 20

    21. Sept. 2008 21

    22. Sept. 2008 22 The Community-Based Doula Program An additional award made to an organization with expertise in replicating community-based Doula programs, to offer outreach, training, technical assistance and evaluation services to the Doula grantees in order to maximize project effectiveness and quality care across all projects.

    23. Sept. 2008 23 Breastfeeding Worksite Support Includes: Resource kit: The Business Case for Breastfeeding Full kits and individual components available from MCHB at: www askhrsa.com or 1-888-ASK HRSA Training and TA

    24. Sept. 2008 24 First-Time Motherhood/ New Parent Initiative Purpose: Develop, implement, evaluate and disseminate novel social-marketing approaches that: Concurrently increase awareness of existing preconception/interconception, prenatal care, and parenting services/programs, and Address the relationship between such services, health/birth outcomes, and a healthy first year of life. 

    25. Sept. 2008 25 First-Time Motherhood/ New Parent Initiative The target populations are those disproportionately affected by adverse pregnancy outcomes in their community including racial/ethnic minorities.  Organizations should also outreach to providers who service these populations.  

    26. Sept. 2008 26 First-Time Motherhood/ New Parent Initiative Services promoted through the public awareness campaign should augment programs that have already been implemented by States to encourage a healthy first year of life and promote educational and social support services for expectant mothers/new parents.  Public awareness campaigns could be Statewide or countywide. 

    27. Sept. 2008 27 First-Time Motherhood/ New Parent Initiative MCHB was allocated approximately $4.8 million for this activity. 13 awards were given.

    28. Sept. 2008 28 Combating Autism Act 2006 Background & Purpose 1 in 150 children diagnosed with Autism Spectrum Disorder Need to know more & need more services Purpose of Combating Autism Act 2006 to improve upon previous activities by: Expanding research, increasing awareness and integrating health, education and disability programs.

    29. Sept. 2008 29 HRSA’s Combating Autism Act Initiative (CAAI) Funding Summary: $37 Million $34 Million (after rescission) _______________________________ $20 Million LEND/Developmental Behavioral Pediatrics (DBP) Training (SPRANS) $ 6 Million LEND Expansion $ 6 Million Autism Intervention Research (AIR) Networks - Network on Physical Health (AIR-P) - Network on Behavioral, Mental Health (AIR-B) $ 2+Million Information/Education/Tool Dissemination (State Demonstration Grants, DBP, evaluation, etc.)

    30. Sept. 2008 30 State Autism Demonstration Grants 6 State Autism Demonstration Grants. To improve State and local infrastructure for serving individuals with Autism Spectrum Disorders and other developmental disabilities. Grantees will implement existing state plans to improve services.

    31. Sept. 2008 31 Data Initiatives

    32. Sept. 2008 32 National Survey of Children with Special Health Care Needs, 2005-2006 Measures and Tracks Prevalence of CSHCN Nationally By State Describes Demographic Characteristics Other Measures Include Functional Limitations Health Care Access Needs and Satisfaction with Care Burden and Impact on Family

    33. Sept. 2008 33 Prevalence of CSHCN: State Variation

    34. Sept. 2008 34 CSHCN in a Medical Home

    35. Sept. 2008 35 Impact on Parent’s Employment

    36. Sept. 2008 36 Reduce/Stop Work Because of Child’s Care and =>10 Hours Providing Care

    37. Sept. 2008 37 Health Insurance Coverage We can go back to one pie chart for 2006 and discuss differences in text if that is preferable.We can go back to one pie chart for 2006 and discuss differences in text if that is preferable.

    38. Sept. 2008 38 National Survey of Children’s Health, 2007 Purpose: To produce national and State-based estimates on the health and well-being of children, their families, and their communities Sample: Independent random-digit-dial samples for all 50 States and the District of Columbia (DC) of over 90,000 children

    39. Sept. 2008 39 NSCH Topic Areas Insurance coverage consistency and adequacy Medical home Child care arrangements Reading for pleasure Television watching Home alone (6-11) Working for pay (12-17) Volunteering (12-17) Weekly attendance at religious services School enrollment and engagement Participation in activities outside of school Repeating a grade Parents’ health status Parenting aggravation Smoking in the household Neighborhood amenities, condition, and social support Child’s safety in neighborhood and at school

    40. Sept. 2008 40 Release of 2007 NSCH Data February or March 2009 Public use microdata files Extensive documentation Online data query system http://www.childhealthdata.org

    41. Sept. 2008 41

    42. Sept. 2008 42 What is the Data Resource Center? A website that delivers: Hands-on, user-friendly access to national, state and regional data from the 2001 and 2005-2006 NS-CSHCNs and the 2003 National Survey of Children’s Health (NSCH) Technical assistance by email/telephone and online materials, such as examples of data use by states and links to related websites Education -- thru e-updates, e-facts & in-person, telephone, and online workshops

    43. Sept. 2008 43 Other Programs

    44. Sept. 2008 44

    45. Sept. 2008 45

    46. Sept. 2008 46 The Early Childhood Comprehensive Systems Program (ECCS) A State-based system of collaborations and partnerships that support families and communities in their development of children that are healthy and ready to learn at school entry. The goal of the ECCS Program is to build collaborations and partnerships that support families and communities in developing healthy children who are ready to learn. This goal embraces the central role of families and local communities in the development of children that are healthy and ready to learn and also recognizes that sometimes the services and systems needed may not always be accessible. The goal of the ECCS Program is to build collaborations and partnerships that support families and communities in developing healthy children who are ready to learn. This goal embraces the central role of families and local communities in the development of children that are healthy and ready to learn and also recognizes that sometimes the services and systems needed may not always be accessible.

    47. Sept. 2008 47 The Early Childhood Comprehensive Systems Program (ECCS) State ECCS grants support “use of leadership and convening powers to foster the development of early childhood systems” Building ECCS requires intentional efforts to: Bridge the gaps left between programs to provide health, mental health, early learning, family support, etc. Support integrated, cross-systems development through partnerships Develop governance and structural mechanisms that are needed to sustain comprehensive systems ECCS has five program component areas: medical home, mental health, early care and education, parenting education, and family support. Why these five areas? Our decision was based upon data derived from a number of sources including the Institute of Medicines report “From Neurons to Neighborhoods” and the National Association for the Education of Young Children school readiness definition. ECCS has five program component areas: medical home, mental health, early care and education, parenting education, and family support. Why these five areas? Our decision was based upon data derived from a number of sources including the Institute of Medicines report “From Neurons to Neighborhoods” and the National Association for the Education of Young Children school readiness definition.

    48. Sept. 2008 48 The Early Childhood Comprehensive Systems Program To date, there have been two phases of ECCS. Phase I 2003 – 2004 Development of the State Plan Phase II 2005 – 2008 Implementation of the State Plan. To date, there have been two phases of ECCS. During Phase I , through their ECCS grant support, the State MCH program worked with partners from mental health, child care, and Head Start to develop a State-level plan for building a comprehensive system of services. An ECCS Plan focuses on the results the State wants to achieve; identifies partners and their contributions; reflects involvement of families and local communities; is based on a needs assessment /environmental scan; and, contains an evaluation plan and a core set of indicators of early childhood well-being. During Phase II , with additional support through their ECCS grant, State MCH programs and their partners built upon their work and relationships developed in Phase I and started to put into place the elements of their State Plan. During this phase, States also began to include additional partners into their ECCS activities, such as the Community Based Child Abuse Prevention Program and Early Intervention, Part C.To date, there have been two phases of ECCS. During Phase I , through their ECCS grant support, the State MCH program worked with partners from mental health, child care, and Head Start to develop a State-level plan for building a comprehensive system of services. An ECCS Plan focuses on the results the State wants to achieve; identifies partners and their contributions; reflects involvement of families and local communities; is based on a needs assessment /environmental scan; and, contains an evaluation plan and a core set of indicators of early childhood well-being. During Phase II , with additional support through their ECCS grant, State MCH programs and their partners built upon their work and relationships developed in Phase I and started to put into place the elements of their State Plan. During this phase, States also began to include additional partners into their ECCS activities, such as the Community Based Child Abuse Prevention Program and Early Intervention, Part C.

    49. Sept. 2008 49 The Early Childhood Comprehensive Systems Program (ECCS) There will be a third Phase of ECCS: 2009 – 2012 During this Phase III the implementation of the State Plan will intensify in scope and depth: Implementation activities to become focused on incorporating goals of partnering agencies Increased emphasis on community systems building efforts Call Joe Zogby at (301) 443-4393 or Dena Green at (301) 443-9768 for further information . .

    50. Sept. 2008 50 Local Maternal and Child Health

    51. Sept. 2008 51 Contact

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