Making the Connection between MCH and Injury Prevention
How many members of the MCH community attended the recent conference of the State and Territorial Injury Prevention Directors Association in Oklahoma City? I wish I could say I was one of many, but in fact there were only a few of us present. During the meeting I was struck by how many sessions were MCH-related and how much of injury prevention involves interventions for mothers, children, and families. Most of the conference participants were state injury program directors that were not situated within the maternal and child health sections of their agencies. The participants I talked with noted that while they understood the link between state injury prevention programs and state maternal and child health programs, it was hard to make the connection because their programs were in separate divisions with separate funding. At the meeting it became clear to me that we have some work to do to enhance collaboration between MCH and injury prevention programs!
MCH and injury prevention program collaboration is more than just a good thing to do. It is absolutely vital to addressing one of the leading causes of death for children. Over 20,000 children between the ages of 0 and 19 die of injuries annually in the U.S. Unintentional and intentional injuries account for more deaths than all other causes combined. The Maternal and Child Health Bureau’s Strategic Plan: FY 2003–FY 2007 recognizes that safety from injury and violence is an essential part of health when it describes the Bureau’s mission to “improve the physical and mental health, safety, and well-being of the maternal and child health (MCH) population, which includes all of the nation’s women, infants, children, adolescents, and their families, including fathers and children with special health care needs.” As many of you know, two of the Title V National Performance Measures specifically concern injuries: the rate of deaths to children age 14 and younger caused by motor vehicle crashes and the rate of suicide deaths among youths age 15 through 19.
Perhaps no other issue represents the disconnection between science and policy than our national approach to injury prevention. The U.S. spends billions of dollars every year to provide health insurance to children – in part to treat injuries – while last year the entire budget of the CDC’s National Center for Injury Prevention and Control was only $134 million. At this level the CDC is only able to fund 30 states for basic injury prevention programs. Anecdotally, AMCHP is hearing about cuts to MCH-specific injury prevention programs in states due to reductions in federal funding for MCH. There are few better illustrations of where our public policy favors treatment over prevention. We know that public health efforts to prevent injuries have been highly successful and deserve to be celebrated. Injuries to children are down 45 percent over the past 20 years, and the CDC estimates that 240,000 lives were saved between 1966 and 1990 because of improved motor vehicle and highway design, increased use of safety belts and motorcycle helmets, and enforcement of laws regarding drinking and driving and speeding. Similar results are possible with other types of injuries. The current funding environment puts maintaining these successes and doing even better in the future at risk.
Injury, specifically violence, has a profound effect on the health of pregnant and postpartum women. Homicide is a leading cause of death in pregnant and postpartum women in the United States. Addressing and preventing violence against women of reproductive age improves women’s overall health as well as that of their children, and their families.
Injury prevention is an issue for MCH programs. Families who need lead screening, immunization services, and oral health and nutrition education also need free or low-cost child safety seats, bicycle helmets, and domestic violence prevention services. MCH programs are well positioned to add injury and violence prevention components to existing programs. Some examples include:
- Providing mothers with car seats through WIC clinics
- Teaching home safety and offering safety devices as part of home visits
- Implementing bullying prevention programs as part of school health programs
- Providing teens with guidance on safe driving practices at school-based health centers
- Addressing intimate partner violence prevention at teen parenting programs
AMCHP is committed to working with partners such as the Children’s Safety Network, who partnered with us to produce this issue of Pulse, and the State and Territorial Injury Prevention Directors Association to reduce injury among MCH populations. Making the connection between state injury prevention programs and state MCH programs is a vital piece of moving our national agenda forward. With your help, we can reduce the number of injuries to our nation’s mothers, children, and families.