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Public Health Matters for Women and Families:
A National Maternal and Child Health Perspective
Brittany Argotsinger, MPH, PHPS FellowOffice for State, Tribal, Local and Territorial Support
Centers for Disease Control and Prevention
PHAP/PHPS Summer SeminarJune 1, 2015
Centers for Disease Control and Prevention
Office for State, Tribal, Local and Territorial Support
AMCHP supports state maternal and child health programs and provides national leadership on issues affecting women and children.
Title V Maternal and Child Health (MCH) Services Block Grant
What is the MCH Services Block Grant? A federal-state partnership The only Federal program that focuses solely on improving the
health of all mothers and children Support for core public health functions
A Brief History
19121921
1935 1981 2015
$ $$
$$
Transformation of the Block Grant (2015)
Direct Services
Enabling Services
Public Health Services and Systems for MCH Populations
Source: Guidance and Forms for the Title V Application/Annual Report, HRSA, 2015
Population Health Domains:1) Women’s & Maternal Health2) Infant Health3) Child Health4) Adolescent Health5) Children and Youth with Special
Health Care Needs6) Cross-cutting/Life Course
The “M” in MCH10.0 deaths per 100,000 live births(1990, all races)
Source: Pregnancy Mortality Surveillance System. August 11, 2014. Trends in pregnancy-related mortality in the United States: 1987–2010 [Table]. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Retrieved at: http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html.
The “M” in MCH10.0 deaths per 100,000 live births(1990, all races)
17.8 deaths per 100,000 live births(2011, all races)
Source: Pregnancy Mortality Surveillance System. August 11, 2014. Trends in pregnancy-related mortality in the United States: 1987–2010 [Table]. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Retrieved at: http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html.
The “M” in MCH10.0 deaths per 100,000 live births(1990, all races)
17.8 deaths per 100,000 live births(2011, all races)
Source: Pregnancy Mortality Surveillance System. August 11, 2014. Trends in pregnancy-related mortality in the United States: 1987–2010 [Table]. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Retrieved at: http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html.
52,000 severe maternal morbidities each year
The “M” in MCH12.5 deaths per 100,000 live births(non-Hispanic white)
Source: Pregnancy Mortality Surveillance System. August 11, 2014. Trends in pregnancy-related mortality in the United States: 1987–2010 [Table]. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Retrieved at: http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html.
The “M” in MCH12.5 deaths per 100,000 live births(non-Hispanic white)
Source: Pregnancy Mortality Surveillance System. August 11, 2014. Trends in pregnancy-related mortality in the United States: 1987–2010 [Table]. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Retrieved at: http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html.
42.8 deaths per 100,000 live births(African American)
Aim: Strengthen state maternal mortality surveillance systems and enhance states’ ability to translate data into policies and programs that improve maternal health.
• Key Components:
AMCHP Every Mother Initiative
Two 15-month Action Learning Collaboratives (ALCs)
State sub-awards to implement translation projects
Beta-testing of the CDC Maternal Mortality Review Data System
Tools and resources for state MCH programs
Health for Every Mother• A menu of strategies mined
from 35+ consensus reports
• An assessment tool to facilitate dialogue on comprehensive initiatives
• Examples from 30+ states to foster effective practice and innovation
• A wealth of national implementation resources
TITLE V
Methods• Environmental scan of
consensus documents and state maternal mortality review (MMR) reports
• Analysis for key themes
• State examples solicited through regional networks
• Vetting of resources
• Input from state and national expert reviewers
Core Elements of a Comprehensive Initiative
Maternal Data Systems
Value of Investments
Healthy Living
Access to Care
High Quality Health Care for Women
Readiness for Adverse Events
Core Elements of a Comprehensive Initiative
Maternal Data Systems
Value of Investments
Healthy Living
Access to Care
High Quality Health Care for Women
Readiness for Adverse Events
Infr
astr
uctu
re
Action Elements & Related Strategies • Social Determinants of Health• Physical and Policy Environment• Health Promotion Efforts
• Comprehensive Health Coverage• Availability and Acceptability of Services
• High Quality Well Woman Care• High Quality Routine Maternity Care• Coordination Across the Care Continuum
• Clinical Recognition and Response to Adverse Obstetric Events
The Health Impact Pyramid
Tier 2: Change the Context for Health
Tiers 3-4: Protective, Long-Lasting and Clinical Interventions
Tier 5: Education and Counseling
Tier 1: Address Socioeconomic Factors In
crea
sing
pop
ulati
on h
ealth
impa
ct
3 4 5 6
Adapted from: Frieden TR. 2010. A framework for public health action: The health impact pyramid. Am J Public Health; 100(4): 590-595.
Assessment and Planning Tools
Communications
• Launch in conjunction with National Women’s Health Week
• Direct outreach to members; partner newsletters and calls; conference presentations; social media (#EveryMother)
• Help us promote this important resource!
Download the resource today:http://bit.ly/HealthforEveryMother
For more information, please contact CDC’s Office for State, Tribal, Local and Territorial Support
4770 Buford Highway NE, Mailstop E-70, Atlanta, GA 30341Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: http://www.cdc.gov/stltpublichealth
The findings and conclusions in this presentation are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Questions?
Brittany Argotsinger, [email protected]
Centers for Disease Control and Prevention
Office for State, Tribal, Local and Territorial Support