Early this year, the Centers for Disease Control and Prevention (CDC) announced the release of 2018 data from the Pregnancy Risk Assessment Monitoring System (PRAMS). Developed in 1987, the system aims to support efforts to reduce infant morbidity and mortality by providing data that are not available through other sources. PRAMS data are useful in identifying groups of women and infants that are in high risk categories for negative health outcomes. PRAMS reports on approximately 83 percent of U.S. births. Public health officials and researchers use these data to help improve the wellness of women, infants, and their families.
In 2018, prior to the COVID-19 pandemic, the uninsured population in the U.S. was approximately 30 million, representing roughly 5 percent of children and 13 percent of adults ages 19 through 64. Higher uninsured rates fell disproportionately on communities of color, including American Indian/Alaskan Native, Black, and Hispanic populations. The persistent lack of insurance coverage affects all populations including women, children, and families. Further exasperating this issue is the pandemic. The Commonwealth Fund recently estimated that nearly 7.7 million individuals, including women of reproductive age, lost employer-sponsored insurance as of June 2020 due to the COVID-19 pandemic. With touchpoints throughout the community and partnerships with state and local service agencies, MCH programs are well positioned to actively promote, support, and educate the public about the open enrollment season.
Community-led programs and organizations that focus on addressing the social drivers of health through a racial and health justice lens are collaborating with marginalized families and leverage the voices and expertise of these community members to achieve health equity. Funded by the Health Resources and Services Administration, the Healthy Start Initiative is a community-driven program with nearly 30 years of experience in improving perinatal health and racial disparities among marginalized communities across the nation.
Meeting the Substance Use and Mental Health Needs of Maternal and Child Health (MCH) Populations during COVID-19: Local and State Health Department Solutions
Stay-at-home orders, social distancing protocols, and concerns about overall well-being have increased levels of anxiety and depression for many people during the COVID-19 pandemic. Protocols such as virtual prenatal appointments, limited in-person contact with home visitors and support people during birth, and physical distancing and isolation measures have resulted in escalating concerns about mental health issues, particularly for pregnant and postpartum people.
We are living in an era of where safety net systems are increasingly strained and state health budgets are saddled with competing priorities. No one entity or sector can keep up with the demands to increase patient access to care and make health care more affordable. A coordinated approach between state health agencies and nonprofit organizations can serve as a model to achieve both goals successfully. The importance of state fiscal responsibility runs parallel with increased patient access. State governments must explore every avenue to balance cost-savings priorities and improve health outcomes. In its partnership with Title V entities for more than 20 years, Patients Services, Inc. (PSI), a national 501 (c)(3) nonprofit, has bridged that gap.
Using the National Standards as a Framework for Partnering with Others to Improve Outcomes for CYSHCN
Title V Children and Youth with Special Health Care Needs (CYSHCN) Programs address challenges that are often complex in an ever-changing landscape. Title V CYSHCN agencies are critical partners, and often they are leaders of multisector collaborations aimed to eliminate siloes and advance common goals. The National Standards for Systems of Care for CYSHCN is a helpful framework to bring together nontraditional (such as community-based organizations, community health workers) and traditional partnerships (such as family-led organizations, health systems) to collaborate to improve systems of care for CYSHCN and their families.