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

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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: OSTLTSfeedback@cdc.gov 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, MPHbargotsinger@amchp.org

Centers for Disease Control and Prevention

Office for State, Tribal, Local and Territorial Support