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Title V Technical Assistance Meeting

 Women’s and Infant Health: Health Equity in 2016

By The AMCHP Women's and Infant Health Team
( Erin Bonzon, Andria Cornell, Megan Phillippi, and Christina Ratleff)

The Women's and Infant Health (WIH) program is committed to improving maternal and child health (MCH) programs and enhancing the delivery of MCH services at the national, state and local levels. The program goals are to improve the health of women and infants through increased capacity of Title V MCH programs and coordination between stakeholders. The WIH team collaborates with numerous partners to implement projects that span diverse topics such as home visiting, breastfeeding, infant mortality, health reform and health system redesign, maternal mortality, chronic disease, oral health, return on investment and preconception health. As we look back on our efforts from 2015 and gear up for an exciting 2016, we would like to highlight a few of our key projects. 

Looking Back on Health Equity

Nationally there has been growing interest in addressing the social factors which influence health, known as the social determinants of health. Federal initiatives such as Healthy People 2020 aim to 'create social and physical environments that promote good health for all' and not only ameliorate health disparities, but achieve health equity, defined as the 'attainment of the highest level of health for all people'. Given that the greatest factors shaping health occur outside of the health care system, AMCHP's WIH team spent 2015 exploring the role of Title V in advancing health equity.

With funding from the Robert Wood Johnson Foundation (RWJF), the Women's and Infant Health team launched the AMCHP Birth Outcomes Collaborative: Building a Culture of Quality to Demonstrate Value and Improve Equity in 2015. This project builds off the work and existing infrastructure of the CoIIN and continues to develop and disseminate evidence-based practices (EBPs) to reduce infant mortality, improve birth outcomes and facilitate continued progress toward health equity across states in regions IV/VI.

Health equity and disparity in maternal outcomes continued to be a focus for AMCHP's Every Mother Initiative in 2015. Through participation in AMCHP's Every Mother initiative, Florida, upon review of maternal death data learned  that non-Hispanic black women are significantly more likely to die from pregnancy complications compared to non-Hispanic white and Hispanic women. To act upon these findings, Florida partnered with REACHUP Inc, a community collaborator and federal Healthy Start site, to focus on an upstream intervention to improve the preconception health of women of childbearing age in their state. REACHUP is increasing the capacity of Preconception Peer Educators (PPE) within the state of Florida to work with and through community partners to increase preconception health knowledge, skills and confidence. The PPE program adapts the Office of Minority Health training focused on improving birth outcomes to be inclusive of women's and maternal health outcomes and deploys the new program at multiple sites, including Historically Black Colleges and Universities.

Looking Ahead on Health Equity

The Women's & Infant Health Team is looking forward to continued engagement with several initiatives focused on health equity in 2016. With generous support from RWJF, we will explore how states, and specifically Title V agencies, are addressing the social determinants of health in programs and policies. We will build upon roundtable dialogues at the 2016 AMCHP conference and identify action steps to guide states in applying a health equity lens in the design and development of Title V programs and initiatives.

AMCHP continues to serve as a key partner in the national infant mortality CoIIN and is the lead technical assistance organization for the SIDS/SUID/safe sleep and the social determinants of health (SDOH) learning networks within the CoIIN.  AMCHP will support state teams in assessing their current knowledge and capacity to address social determinants of health, and supports states to select strategies from the WHO Framework to focus on in the coming year to promote health.

AMCHP is a core partner on the Alliance for Innovation on Maternal Health (AIM). The overall goal of AIM is to prevent 1,000 maternal deaths and 100,000 cases of severe maternal morbidity nationally by 2018. AIM sets out to accomplish this by collaborating with states and hospital systems to implement maternity safety bundles across birth facilities in 8 states over 4 years. AMCHP has been invited to serve on a national expert workgroup for the development of the Reduction of Peripartum Racial Disparities patient safety bundle and consensus statement.

In 2016, AMCHP is looking forward to assisting states in supporting and implementing MCHB's strategic plan for addressing health equity and health disparities within the MCH population. AMCHP is pleased to learn more about the MCHB Health Equity Blueprint and the strategies within it to help MCHB achieve their vision of health equity and elimination of health disparities for the MCH population.