May/June 2012


May/June 2012

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Life Course Perspective

By Stephanie Birch, RNC, MPH, MS, FNP

The life course perspective provides a working framework for maternal child health (MCH) programs to address health equity issues and implement interventions addressing the social determinants of health in an integrated fashion across the life span. This approach has begun to influence how MCH programs across the nation address health disparity issues using the latest research in public health and social science literature recognizing the impact that the social, economic and physical environments have on individual and community health over the life span. [more]


Looking Across the Life Course

By Mike R. Fraser, PhD CAE

Over the past several years, there has been a great deal of attention on the life course perspective in maternal and child health. Certainly from a theoretical level the perspective makes a great deal of sense: those things that influence our health as children certainly have an impact on our health as adults. One only need watch the first installment of the new HBO series The Weight of the Nation for an excellent example of how being overweight in childhood leads to future health problems as those kids grow to adulthood (diabetes, hypertension, etc). Clearly,
working across the life course and understanding the
social, as well as the behavioral, factors that impact health is a core part of maternal and child health practice. [more]


AMCHP Assessment of State Life Course Resources and Tools

By Kate Howe, MPH
Program Manager, Child Health, AMCHP

As state Title V programs are increasingly integrating the concepts of the Life Course Perspective into MCH work, the AMCHP Emerging Issues Committee (EIC) conducted an assessment of the resources and tools that states have developed to get this accomplished. The goal of the assessment was to help foster the sharing and development of ideas to support the application of life course into Title V programs. [more]


Website Launch: AMCHP State Life Course Resource Center

By Melody Cherny
Program Associate, Children with Special Health Care Needs, AMCHP

In response to a growing interest in the life course approach in MCH, and to further promote its adoption and integration within state Title V programs, AMCHP has launched a virtual State Life Course Resource Center. This website provides various tools and materials, best practices and research targeted specifically to the state level. The website also includes links to other key resources, but is designed to provide a central location for state Title V resources on the life course. [more]


LCRN -- A Profound New Way to Understand Health

By Neal Halfon, MD, MPH and Ericka Tullis, MPP
Life Course Research Network

In October 2010, the UCLA Center for Healthier Children, Families and Communities was awarded a threeyear grant from the Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau (MCHB) to develop the MCH Life Course Research Network (LCRN). This project represents an exciting and unique opportunity to improve our understanding of how health develops over the life span. [more]


Implications of the Life Course Perspective on State
Title V CYSHCN Programs and All CYSHCN

Eileen Forlenza
Director, Family Leadership Initiative
AMCHP Board Member
Title V Colorado

As we pulled off the highway, we made our way down a picturesque country road that welcomed us with trees with outstretched arms. It was almost as if we were getting a preemptive hug, a sense that perhaps we should prepare ourselves for a dose of emotion. I was going on a site visit to a long-term residential group home for adults with autism or other profound intellectual deficits and I was going in with my eyes wide open. I was far from my Colorado home, visiting an east coast state known for its history of excellence and dedication to children with special health care needs. My daughter Holly turned 23 this week wedging yet another year between childhood and adulthood. One more year in her unique life living with complex health care needs. [more]

Jessica Foster MD, MPH
CYSHCN Director, Medical Director, Bureau for Children with Medical Handicaps and Early Intervention Services, Ohio Department of Health

Title V CYSHCN programs support children facing a variety of challenges as they grow into healthy, active, independent and productive adults. Evidence suggests disparity exists in health care quality, home environment, and neighborhood and school environments for CYSHCN compared with non-CYSHCN. Life Course emphasizes impact of social determinants of health across the life span in attaining health equity for our children. Access to social and economic opportunities and a child's experience growing up in their home, school and community significantly impact long-term health, development and well-being. [more]

Holly Williams, RN, MS
Director, Bureau of Children with Special Health Care Needs, Utah Department of Health

The life course perspective will bring new opportunities to collaborate with our primary care and prevention partners in Utah and around the country, especially as science and medical advances allow children with disabilities to live longer. The life course perspective is an impetus to look beyond the service itself. Here is one example of what Utah is doing: The Children with Special Health Care Needs (CSHCN) Neonatal Follow-up Program, that sees young children who were born at 1250 grams or less, is partnering with the University of Utah (U of U) Department of Obstetrics to assist mothers in understanding their potential risk for a subsequent preterm birth. [more]


The Life Course Metrics Project

As MCH programs begin to develop programming guided by a life course framework, measures are needed to determine the success of their approaches. Currently, there are no standardized metrics for the life course approach. In response to this emerging issue, AMCHP launched a new project designed to identify and promote a set of indicators that can be used to measure progress using the life course approach to improve maternal and child health. [more]


By Josiah Barber
Student, Portland State University

Prior to my involvement with maternal child health programs in Oregon, my home state, I had never heard of life course theory. When I learned about the life course theory, though, it made perfect sense, and I can see threads of it appearing in my social work education. After spending some time working with youth with disabilities, I believe life course is a call to professionals to look beyond the medical model and diagnosis. Seek to understand what is happening in other aspects a young person's life. [more]



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What tips or tools do you have for state health agencies looking to implement life course?


Paula Eurek
Administrator Lifespan Health Services Unit, Division of Public
Health, NE Department of Health and Human Services, Lincoln, NE

To effectively implement a life course approach, the MCH practitioner must develop an understanding of the theory within the broader public health community and build working relationships with other disciplines that have a stake in improving population outcomes -- such as behavioral health, child welfare and education. This requires that the MCH community find common ground and tools that make the approach relevant. [more]


Alicia Lincoln
PRAMS/TOTS Projects Manager

Julie Dillard
Public Health Social Work Coordinator

Change can be intimidating and overwhelming. Below are
some steps Oklahoma used to help ease the transition into
using life course approach in maternal and child health.

First, start by educating your staff about life course. [more]


By Brent Ewig, MHS
Director, Public Policy& Government Affairs, AMCHP

It recently occurred to me that I have now spent almost the exact number of years working in health policy in our nation's capital that I did in the state I grew up in (Hello Wisconsin!). This realization caused some soul searching moments, including a) how did I get so old so fast, b) have I become cynical, jaded and disillusioned, c) do I know any more about health policy and politics now than I did in 1994, and d) what happened to the hair I used to have and is my bald spot growing?

Especially today, the temptation to become discouraged is
strong. Budget pressures seem more intense than ever, the
divisiveness and uncertainty over the fate of health reform
is potentially paralyzing, and new threats to critical program
spring up faster than the dandelions in my yard. [more]


New MCH Leaders

See a list of new MCH Leaders. [more]

AMCHP welcomes new staff. [more]


New Women's Health Prevention Brief
AMCHP and CityMatCH have released a Women's Health Prevention Brief that highlights the importance of addressing the built environment in order to improve maternal health and birth outcomes. This brief is the last in a series of issue briefs highlighting the priority areas (injury and chronic disease, health disparities, reproductive and maternal health, and healthy lifestyles) identified in the AMCHP/CityMatCH Women's Preventive Health Framework. Previous briefs have focused on Women's Mental Health and Women’s Health Equity. [more]

Need Assistance Publishing Your Findings? MCHIRC Can Help!
State and local MCH agencies have a wealth of information but you often struggle to find it published because MCH agencies and their staff have limited time to publish scientific articles. MCHB, recognizing that MCH agencies needed help in getting this information disseminated, joined with CDC to develop the MCH Information Resource Center (MCHIRC). [more]

AMCHP/CDC Webinar on the RHAD Toolkit
AMCHP and CDC will host a national webinar, "Emergency Preparedness and MCH: A Guide to the Reproductive Health Assessment After Disaster (RHAD) Toolkit" on Jun. 28 from 3-4 p.m. EDT. This webinar includes a description on the importance of post-disaster reproductive health assessments and the rationale for the creation of the RHAD Toolkit; highlights one state's experience trying to capture post-disaster reproductive health data for their MCH program; and reviews the successes, challenges and lessons learned from piloting the toolkit. [more]

AAP/MCHB Time Out for Genetics Webinar Series
The Genetics in Primary Care Institute -- a cooperative agreement between the American Academy of Pediatrics (AAP) and MCHB -- is now offering Time Out for Genetics, a free educational webinar series. The objective of this 10-part webinar series is to increase awareness and education regarding the provision of genetic medicine in primary care practice. It is designed for primary care clinicians, pediatricians, pediatric sub-specialists, family physicians, nurse practitioners, genetic counselors, geneticists and other stakeholders. [more]

RWJF Seeking Nominations for the Young Leader Awards
The Robert Wood Johnson Foundation (RWJF) will honor up to 10 leaders age 40 and under who offer great promise for leading the way to improved health and health care for all Americans with The Young Leader Awards. The Foundation will make up to 10 awards of $40,000 each to outstanding young leaders. Winners will be publicly announced at a RWJF conference to be held in Princeton, New Jersey, on Oct. 25-26. [more]


Learn more about the information gathered from the AMCHP Assessment of State Life Course Resources and Tools here.


View and download resources about the life course perspecive here.

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