embracing a life course framework for maternal, child ... · todaytoday s’s presentation...
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Embracing a Life Course gFramework for Maternal, Child,
d Ad l H l h Pand Adolescent Health Program OperationsOperations
Cynthia A. Harding, M.P.H.
Los Angeles County Department of Public HealthMaternal, Child and Adolescent Health Programs
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Today’s PresentationToday s Presentation
From preconception health to life course trajectory
Mapping programs and services to the life coursecourse
Putting a life course framework into practice
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Infant Mortality Refocuses yMCAH Programs
I f t D th R t b R /Eth i itInfant Death Rate by Race/EthnicityAntelope Valley vs. Los Angeles County,
1996-2005
PreconceptionPreconception Health
Health Disparitiesp
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Barriers to Favorable Birth Outcomes and Health Trajectories No health insurance Povertyy Depression Lo ed cational attainment Low educational attainment Racism Perceiving a neighborhood as unsafe
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LAC MCAH Programs ChangeLife Course Health TrajectoriesLife Course Health Trajectories
DepressionPoor EducationPoverty Racism
Uninsured
Ob i d
Physical InactivityAsthma
Poor Diet
Obesity and Associated Chronic
Conditions Adverse Maternal & Child Outcomes
Maternal NutritionBottle FeedingLead Exposure
NFPCPSPALC
CLPPPChild Obesity Prevention
Preconception - Interconception
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.
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Depression Screening
Nurse Family Partnership
p g
Mental health assessment, referrals to resources and services
Comprehensive Perinatal Services ProgramT h id i i i l Two-hour provider trainings on perinataldepression and PHQ9 screening tool
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Neighborhood Revitalizationg
♥ Gang prevention
♥ Family resource centers
d l f di i i i i♥ Federal funding initiatives
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MCAH Nutrition for a Good Life
Poor Maternal –
SedentaryAsthma
Poor Maternal Child Outcomes
ObesityRelated Conditions
Bottle FeedingLead Exposure
Poor DietRelated Conditions
B tf di
NFPCPSPHWWALC
ObesityPrevention A th
Infancy Childhood Puberty Adulthood
BreastfeedingSupport
Pregnancy
Prevention,CLPPP
AsthmaCoalition
Health Before-Between-After Pregnancy
8
Life Course Health Trajectory
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Childhood Lead
PoisoningPoisoning Prevention PProgram
~~Healthy HomesHomes
Assessment
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The Partnership to Eliminate Disparities in Infant Mortality (PEDIM)
PEDIM a joint project of CityMatCH the Association PEDIM a joint project of CityMatCH, the Association of Maternal and Child Health Programs and the National Healthy Start Associationy
Action Learning Collaborative (ALC) an 18 month program of PEDIMprogram of PEDIM
W.K. Kellogg Foundation Funded
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Challengesg
Overcoming staff perceptions that lifeOvercoming staff perceptions that life course framing is either “nothing new” or more worko e wo
Risk of giving up control or losing identify h i i h hwhen partnering with others
Staff and resource shortagesStaff and resource shortages
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Key Points: A Life Course Framework for MCAH Program Operations
D t t id tif t i l i d i Data to identify gaps at crucial periods in the life trajectory for intervention
Educate staff on life course model
New partnerships to connect MCH p pprograms with community efforts to improve physical and social environment
Focus on promoting health before and between pregnanciesp g
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L A l C tLos Angeles CountyDepartment of Public HealthMaternal, Child, and Adolescent Health ProgramsHealth Programs
Cynthia A. Harding, M.P.H. [email protected]