Feature: GPS for Maternal and Child Health

GPS for Maternal and Child Health: Using State-Level Data to Improve Systems of Care for Children
By Michael D. Kogan, PhD, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services

In the not too distant past, many maternal and child health (MCH) programs were designed without data to guide them or they did not collect data during the program to evaluate their effectiveness.  In a way, it’s like driving a car blind-folded; while it may be thrilling at first, there’s a good chance that you will not wind up at your final destination.

At the beginning of the 21st century, many states did not have data on either the health status or health care experiences of children in their states, often because they lacked the resources to collect the data. To rectify this situation, the Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration began an ambitious program to conduct nationally- and state-representative surveys every two years, alternating a survey on children with special health care needs (CSHCN), with a survey on the overall children’s population.  The purposes were to provide data to help states respond to MCHB’s Title V Block Grant performance measures, and to be used as a tool for improving systems of care and outcomes for children.

Beginning with the 2001 National Survey of CSHCN and followed by the 2003 National Survey of Children’s Health, the MCHB has now conducted four of these surveys.  The information from the 2007 National Survey of Children’s Health should be available in early 2009.  The information from the 2005-2006 National Survey of CSHCN recently became available. This survey, with 40,000 CSHCN and at least 750 CSCHN in each state, illustrates the importance of being able to conduct state-specific analyses.  The chart book on this survey, available at http://mchb.hrsa.gov/cshcn05/ shows, for example, that the percent of CSHCN who received coordinated, ongoing, comprehensive care in a medical home ranged from 39 – 57 percent across states, or the percent of CSHCN who had unmet needs for health services ranged from 10-23 percent.  Moreover, since this is the second National Survey of CSHCN, changes over time periods can also be viewed when the measures are comparable.  For example, from 2001 to 2005-2006, there was a dramatic change in how CSHCN are insured: in 2001, 21.7% of CSHCN were covered only by public insurance; by 2005-2006, that had increased to 28%. 

It is not enough to simply conduct the surveys.  Otherwise, the data would just sit there, collecting dust like a bad wedding gift (the Elvis Presley-shaped wine holder that my Great Aunt Selma gave me comes to mind).  The data needs to be available and accessible in a form that even the most number-phobic individual can access.  So the MCHB established the Data Resource Center, where anyone can simply type in a query and information for your state will be provided almost instantaneously.  The website is http://www.childhealthdata.org.

Think of these surveys as GPS devices for your state MCH programs; they can help guide you to use your resources most efficiently to develop systems of care to improve children’s health.  Hopefully, the days of driving blind-folded are now in the past.