From the CEO

Going for Gold

By Michael R. Fraser, PhD, CAE

I loved watching the Summer Olympics this year. "The thrill of victory and the agony of defeat" were definitely present and it was great fun to see so many records broken and medals won. Country against country, athlete against athlete, the whole spectacle of the Olympics was very cool. Throughout my viewing, however, was a twinge in the back of my mind: something just didn’t feel right. When I finally focused on what was bothering me I realized that I was making comparisons to health status between countries and there was a contradiction between how great our athletes were doing in their events in London and how poor our population health was back at home. I often say that the United States would not even qualify for most Olympic events if we used health status as one of our criterion. The only gold medal we would win would be for having the highest expenditures on health than any other country in the world. Not sure we want that medal to be our claim to Olympic glory.

Infant mortality is one of the problems that keeps us from getting bronze, silver and gold medals in MCH. The complex issue of improving birth outcomes is a major focus of state MCH programs and has recently received a great deal of national attention with several exciting ongoing initiatives. Reducing infant mortality is a key goal of these programs, and AMCHP along with its members are playing a major part. This issue of Pulse focuses on many of those initiatives that have a starring role for Title V. Here is an overview of some national work that AMCHP is participating in with key partners:

The COIN initiative: With the support of the Maternal and Child Health Bureau (MCHB), HHS Regions IV and VI have been working as state teams and as regions to address infant mortality and prematurity. Using a Collaborative Improvement and Innovation Network (COIN) methodology, state Title V programs and partners are developing action plans and strategies to improve MCH outcomes in their states. This work is expanding, with MCHB looking to involve other regions as resources allow.

ASTHO President’s Challenge: Last year, Dr. David Lakey, Health Commissioner in Texas and the president of ASTHO, challenged states to reduce prematurity rates nationwide by 8 percent by 2014. The "Healthy Babies" Challenge has picked up a great deal of support and almost all states have signed on to the ASTHO challenge. Using resources from many partners, including the March of Dimes, states are bringing together their activities and focusing on prematurity prevention in both policies and programs.

Secretary’s Initiative on Infant Mortality: HHS Secretary Sebelius recently announced that infant mortality was a priority area for the administration and will work with states to address this challenge in the coming months. The Secretary’s Advisory Committee on Infant Mortality will be working on ways to develop this initiative and align it with other efforts nationwide.

Healthy Babies are Worth the Wait: The March of Dimes has been working with state partners to move its Healthy Babies are Worth the Wait campaign forward. AMCHP, a supporter of this work, is looking to connect activities in the states to amplify its impact and align it with current state efforts nationwide.

Strong Start: The Centers for Medicare and Medicaid Services (CMS) released its "Strong Start" funding opportunity, testing innovative models to improve pregnancy outcomes specifically by reducing significant complications and long-term health problems for expectant mothers and newborns. This demonstration project aims to identify evidence-based programs that could be replicated in the future should they show significant savings and improved outcomes.

These are only five of the national initiatives that we are tracking – and there are several more, including work by the National Governors Association and the work of provider groups, such as the American College of Obstetricians and Gynecologists. MCH programs have a piece to play in all of this and many of you have state initiatives that have been ongoing and tie directly to these national efforts. This is a critical time for MCH programs to coordinate efforts and share learning with each other. AMCHP wants to support that sharing and learning as your national partner, resource and advocate. One of the best examples of what states are doing is our newly released Infant Mortality Compendium on efforts to address improving birth outcomes and reducing infant mortality. Tools like the AMCHP Compendium, which you will learn more about later in this issue, demonstrate the practical steps and programmatic initiatives that state MCH programs can use to make a difference on this important issue.

Getting to gold in the MCH Olympics is a tall order for the United States, but we can do it. Efforts like the ones above and the long history of state Title V programs show that we can make a difference. If you are seeking more information on any of these programs or have ideas you would like to share, please contact us. In time, we will get get our medal – but only with all of us pulling together!