Maternal and Child Health
Section Newsletter
Fall 2006

A MESSAGE FROM THE MCH SECTION CHAIR

Dear Colleagues:

As I sit here reflecting on the past two years as your chair, it is hard to separate out all the activities we’ve done and the things we have accomplished. First of all, I want to acknowledge your elected Leadership, the Section and Governing Councilors who respond quickly to issues and participate actively in decision making and program planning.  I want to give special thanks to our Section Secretary Deborah Allen, without whom I could not have done this job. She is organized, energetic, and gave freely of her time.

Joseph Telfair, our Governing Council Whip, Jane Pearson, who so expertly guided our student fellows, Clare Feinson, who pestered me for my newsletter greetings and got me moving, Jonathan Kotch, a past chair who remains a stalwart participant and consultant, Kay Johnson, another past chair who continues to provide leadership and expertise, Ben Gitterman, our Action Board representative, and Carol Nelson, our intrepid program chair, who wrestles with our choices for meeting times and sessions with good humor.

The committee structure is strong, and each year we have submitted at least one resolution or policy paper.  The collaboration with the leadership before submission to the Association has made our Governing Council support stronger. We have also had some active, interesting, and exciting business meetings!  Our paper submissions are up, and our presentations at the Annual Meeting are diverse. Thanks to the members in the Annual Meeting host cities for organizing such fun Saturday night dinners! I am looking forward to this year.

We are known throughout the Association as the Section with the model student fellowship program. With the leadership of the secretary-elect and the committee putting together the student paper session, we have a continuing stream of well-qualified, committed students in our Section actively learning the process of APHA participation.  We have been greatly assisted in this effort by the Kellogg Foundation for several years, and most recently by the Colgate Foundation and the MCH education program. Many of our Section members participate in the MCH education program as faculty.

MCH is represented at the Association leadership level by two Executive Board members. The incoming president of the Association, Deborah Klein-Walker, served as the chair of the MCH Section some time ago and set our Section on a trajectory of change much like she influenced the Executive Board and will guide the Association. We are truly excited to have our membership so involved in the whole Association. And why not? We all know that maternal and child health issues cross every sub-section of public health!

I am grateful to my mentors, especially Linda Randolph, whom I assisted when she was Section chair. I am thrilled that another mentor, Ruth Watson Lubic, midwife extraordinare and visionary community activist for mothers and children, is the recipient this year of the Martha May Elliot Award.

All in all, it has been a great experience and I know I leave Barb Levin, the incoming Chair-Elect, a strong group to work with.

Don’t worry, I have two more years on the Intersectional Council, so you will be seeing me!

Jan Weingrad Smith, CNM, MS, MPH
Chair MCH Section 2002 -2006

OVERVIEW OF MCH EVENTS IN BOSTON

DINNER


With help from staff in the MCH Department at the Boston University SPH, Debbie Allen is organizing dinner for Saturday night, at a seafood place. 


SECTION MEETINGS



As usual, our big meetings will be a Business Meeting on Sunday night and a Leadership Meeting on Monday morning. 


MARTHA MAY ELIOT EVENTS



Tuesday's big event will, of course, be the MME luncheon, which will include presentation of the MME and Young Professional Awards and recognition of student fellows and student paper awardees. The MME forum following the luncheon, reflecting discussions at last year's Business Meeting and follow-up work since then, will be on MCH implications of the war in Iraq. We have a wonderful set of invited speakers, including an Iraqi-American pediatrician, a leader of military families and an expert on health effects of exposure to spent uranium on U.S. and Iraqi MCH populations.

MCH SESSION TO MEET THE CANDIDATES

Your Governing Councilors strongly encourage you to a meeting specifically designed to give you a chance to meet the candidates for APHA Association-level offices. This is your chance to ask questions and promote our section's agenda. 


MCH "Meet the Candidates" Session:  Sunday, Nov. 5, 2:00 p.m. to 3:30 p.m. -- check the final schedule for the room.  Sponsored by MCH Section Governing Councilors 


SEE YOU IN NOVEMBER!


Joseph Telfair, MCH Governing Council Whip

MCH TEACHERS HOLD FREE BREAKFAST IN BOSTON

The Association of Teachers of Maternal and Child Health cordially invites you to breakfast!

Come meet & mingle with MCH faculty and other MCH students for a free breakfast in Boston!   All MCH students and faculty (not only ATMCH members) are invited.

Sunday, November 5, 2006, 8:00 a.m. to 9:30 a.m.

Boston Marriott Copley Place, see final program for the room.

If you are interested in joining us, please RSVP by Oct. 23, 2006 to Ms. Kalpana Ramiah at kramiah@asph.org.

For more information about ATMCH, see our Web site at http://www.atmch.org.

BREASTFEEDING COMMITTEE

The MCH Breastfeeding and Infant Nutrition Committee will meet Sunday, Nov. 5, from 10:00 a.m. to 11:30 a.m.  It is listed as session 221.0, which will assist you in finding the room at the Convention Center. Everyone interested in breastfeeding and infant nutrition is encouraged to attend – grab a cup of coffee and a breakfast roll and come join us.  The agenda will include developing an updated policy statement to put forward in light of the new WHO recommendations on breastfeeding and infant nutrition. There will also be discussion of the national “Ban the Bags” campaign and other issues of interest to the group. The Breastfeeding Committee has three oral sessions and three poster sessions this year – great job, everyone, on getting abstracts submitted!! For one session, we have invited Miriam Labbok, MD, MPH, IBCLC, FACBM to present a featured presentation entitled “Breastfeeding in 2006: More Important than Ever,” on Wednesday from 2:30 p.m. to 4:00 p.m. Miriam is director of the new Center for Infant and Young Child Feeding and Care at the UNC Chapel Hill School of Public Health. We hope to see many of you at all of the sessions! For more information contact Laura Duckett ducke001@umn.edu or Mary Rose Tully mrwtully@bellsouth.net, co-chairs.

IMPROVING PREGNANCY OUTCOMES COMMITTEE


Greetings from the Improving Pregnancy Outcomes Committee! 


 


Come join us at the APHA 2006 ANNUAL MEETING in Boston.  The theme for this meeting is "Public Health and Human Rights."  As you will see below, the Improving Pregnancy Outcomes Committee will play a highly visible role at this year’s meetings.


 



  1. Improving Pregnancy Outcomes (IPO) Committee Meeting:

Sunday, Nov. 5, 2006: 10:00 a.m. to 11:30 a.m., Session # 222.0


Please join us for our annual meeting to be held at the APHA Annual Meeting in Boston (See the program for the exact location).  We will set our priorities and goals for the coming year and plan sessions for 2007; we welcome your input.  You do not have to be a member of our committee to attend the meeting; however, the IPO committee always welcomes new members! (Please note: It is listed as a business meeting, but it is our yearly planning meeting).



  1. IPO Position Paper to be reviewed by the APHA Governing Council


  • The position paper, “Reducing Racial/Ethnic and Socioeconomic Disparities in Preterm and Low Birthweight Births”, was endorsed by our section at the MCH Mid-year leadership meeting and is now being put forward by the Joint Policy Committee to the Governing Council for approval at the 2006 APHA Annual Meeting. 
  • The revised version of the proposal is posted online at: http://www.apha.org/private/2006_proposed_policies/2006_policies.htm to be viewed by APHA members.
  • Please attend the public hearings to provide support for our proposal.  Public hearings are scheduled for Sunday, Nov. 5, from 3:30 p.m. to 6:00 p.m. at the Annual Meeting.
  • We are grateful to the many authors and our MCH committee leadership and members for their support and help in getting the position paper submitted and revised. The co-chairs of this committee as well as our MCH Fellow from last year, Janine Lewis, devoted countless hours in the final revisions of this document. We wish to especially acknowledge the efforts of our MCH Fellow: Thank you, Janine!


  1. IPO Podium and Poster Sessions, (Boston, 2006)

We will have two IPO podium and two poster sessions. 




·         Monday, Nov. 6, 2006


      8:30 a.m. to 10:00 a.m.


      Session # 3048.0


      Global Perspectives: Macro-Level Screening and Surveillance To Improve Pregnancy Outcomes (Oral)



 


·          Tuesday, Nov. 6, 2006


      2:30 p.m. to 3:30 p.m.


      Session #4177.0


      The Right to Positive Pregnancy Outcomes: Barriers to Care and Other Issues (Poster)


 


·          Wednesday, Nov. 7, 2006


      8:30 p.m. to 9:30 p.m.


      Session #5019.0


      Improving Pregnancy Outcomes (Poster)


 


·          Wednesday, Nov. 7, 2006


      12:30 p.m. to 2:00 p.m.


      Session #5122.0


      Disparities in Pregnancy Outcomes and Access To Care: A Human Rights Issue (Oral)



The Improving Pregnancy Outcomes Committee is an active committee in the Maternal and Child Health Section.   We welcome your participation and input.  If you would like to become a member, please e-mail one of the committee co-chairs. 

With Warmest Regards from your co-chairs,

Judith Katzburg                                                                                   
jkatzbur@ucla.edu                                                                               


 


Tyan Parker-Dominguez
tyanpark@usc.edu


 

INNOVATIONS IN MATERNITY HEALTH SERVICES COMMITTEE

The Innovations in Maternity Health Service Committee is using this year’s APHA Annual Meeting to begin a campaign to improve United States policy on access to maternity services for all women.   The Committee has planned several sessions to focus on these issues, and will use business sessions to organize this advocacy effort.  The APHA Annual Meeting is essential to the lifeblood of this organization.  Not only does the meeting provide a large amount of the revenue for the group; but it is the place individuals go to get recharged to meet their various professional responsibilities. 

The four sessions sponsored by the committee this year at the Annual Meeting include the following:  


 




  • Developing Local and National Policies to Assure Access to Comprehensive Maternity Care:  Monday, Nov. 6, 10:30 a.m. to 12:00 p.m., Session #3131.0 -- An oral session that explores evidence-based issues in maternity services.


  • Options for Childbirth:  A Fundamental Woman’s Right:  Monday, Nov. 6, 4:30 p.m. to 6:00 p.m., Session #3412.0 -- Another oral session on evidence-based issues.


  • Innovations in Maternity Health Services -- Policy and Financing:  Tuesday, Nov. 7, 4:30 p.m. to 5:30 p.m., Session #4272.0 -- A poster session.


  • Women’s Choices in Childbirth -- Access to Care:  Tuesday, Nov. 8, 2:30 p.m. to 4:00 p.m., Session #5178.0.  -- This final oral scientific session includes Hencie Goen, author of  An Intelligent Woman’s Guide to Childbirth, and other speakers. 

The focus of these panels is:  What do pregnant women want and need?  How do they make their decisions?  Where do they get their information about birth options?  How can health professionals facilitate their patients getting evidence-based information to improve decision making, is our goal.  We want to stress “partnering” of practitioner and patient.

The Committee meeting will follow the Monday afternoon seminar.  The baseline for the advocacy program will be set at that time.  We are looking for increased participation and new members, since both of the present co-chairs have other section responsibilities within APHA for the next two years.

The mission of the Innovations in Maternity Health Services Committee is to raise the “hard” questions in childbirth:  Why do maternity care providers do what they do? Is it necessary? Is it mother- and child-friendly?  Does it help have better outcomes?  The continued growth of technology has caused loss of control by childbearing families of their birth options.  The focus  is on alternatives to traditional obstetrics, including midwives, birth centers, and home birth.  The present crisis in malpractice is forcing us to look at the even bigger picture:  WHO IS GOING TO CATCH THE BABIES?  The almost five-fold increase in malpractice is closing birth centers and forcing both low-risk and high-risk providers to reevaluate what they are doing.   There is a need to establish a national conversation on this vital issue. At this time, the Committee feels that the underlying structure of maternal health care delivery should be evaluated.

Looking forward to seeing you in Boston!

Barb Levin  (BarbL11@aol.com)    


Carol Nelson (cpmcnel@usit.net) 


Cecilia Wachdorf

FOLIC ACID AWARENESS WEEK COMING UP IN JANUARY 2007

The 2007 Folic Acid Awareness Week Campaign, which engaged partners in 46 states in 2006, is in its third year.  The focus for 2007 is on action, with great new tools to make it easier to share the folic acid awareness message.  The resources include downloadable brochures, educational outreach activities, and new E-Cards.  In addition, free consumer materials can be ordered through the Web site.  Spanish and English brochures, bookmarks, and new stickers are available.  These tools present an easy way for physicians and health care educators, who use electronic communication tools, to share the message faster with more of the women who need it most. 

The National Council on Folic Acid (NCFA) asks for a personal commitment from anyone who interacts with women of child-bearing age, especially health care providers.  Through NCFA, a health care provider can obtain free materials for distribution, as well as wear and share the new stickers with their patients.  Wearing the stickers themselves and providing them during patient visits presents a great opportunity to share the message that every woman of child-bearing age needs to hear.   Learning about the importance of folic acid from their health care provider increases the probability of women taking action to get 400 micrograms of folic acid every day.

Folic acid is a B-Vitamin necessary for proper cell growth.  The U.S. Public Health Service recommends that all women of childbearing age consume 400 micrograms of folic acid by taking a multivitamin daily and by eating fortified grains and a variety of foods as part of a healthy diet.  Following this recommendation helps prevent pregnancies affected by neural tube birth defects (NTD), serious birth defects of the brain and spine. 

Spina Bifida, the most common NTD, is the leading cause of childhood paralysis, and presents lifelong challenges for affected families.  Research has shown that if adequate amounts of folic acid are consumed before pregnancy, up to 70 percent of neural tube defects can be prevented.  Research also indicates that Latina women in the United States have up to three times the risk of delivering babies with neural tube defects as non-Latina Whites (“Folic Acid and Birth Defects Prevention:  Focus Group, Research with Women at Risk,” Centers for Disease Control and Prevention, July 1998).  In addition to preventing a NTD, folic acid also reduces the risk of other birth defects, such as cleft lip, cleft palate, and heart defects.  It may reduce the risk of cardiovascular disease and colon, breast, and cervical cancer.  It may even help prevent Alzheimer’s disease.  Yet, 65 percent of women are still not getting enough folic acid.

In 1998, the Food and Drug Administration required the addition of folic acid to enriched breads, cereals, flours, pastas, rice, and other grain products in order to increase the amount of synthetic folic acid in the diet of the general population.  Though it is possible to obtain the recommended dosage of folic acid through unfortified foods, it is difficult.  The human body actually absorbs the synthetic form of folic acid better than the natural form of folic acid, called “folate.”  The easiest way to be sure to get the recommended daily amount of folic acid is to take a multivitamin every day.

For more information about folic acid and National Folic Acid Awareness Week, visit the National Council on Folic Acid at http://www.folicacidinfo.org.

NEW HEALTH LITERACY RESOURCES ONLINE

An exciting new resource is available for public health professionals: The Quick Guide to Health Literacy. The Quick Guide is produced by the U.S. Office of Disease Prevention and Health Promotion and is written for health professionals at the national, state, and local levels. It contains:




  • A basic overview of key health literacy concepts.
  • Techniques for improving health literacy throughcommunication, navigation, knowledge-building, and advocacy.
  • Examples of health literacy best practices.
  • Suggestions for addressing health literacy in your organization.


If you are new to health literacy, the Quick Guide will give you the information you need to become an effective advocate for improved health literacy. If you are already familiar with the topic, you will find user-friendly, action-oriented materials that can be easily referenced, reproduced, and shared with colleagues.

The Quick Guide to Health Literacy and other tools for improving health literacy can be found at http://www.health.gov/communication/literacy. If you would like to request a hard copy of this resource, or if you have any questions, please contact Stacy Robison at (240) 453-8271 or at stacy.robison@hhs.gov.

DEPLETED URANIUM IN IRAQ -- THE RISK NO ONE TALKS ABOUT

Oncologists in Basra are seeing two new phenomena among cancer patients in their city.  The first is multiple primary cancers in single patients -- leukemia and stomach cancer in one person, separate primary cancers in each kidney of another unfortunate patient.  The second is clustering of cancers in families, with over 58 families affected, including one family with nine cancer patients. 


In a speech in Japan, Dr. Jawad Al-Ali, director of the oncology center at the largest hospital in Basra, told the audience that these unprecedented occurrences of cancer are caused by the use of depleted uranium (DU) for bombs and bullets in Iraq -- an estimated 1,700 pounds of it so far at the time of Dr. Al-Ali's speech. 


"Children in particular are susceptible to DU poisoning," Dr. Al-Ali added. "They have a much higher absorption rate as their blood is being used to build and nourish their bones and they have a lot of soft tissues. Bone cancer and leukemia used to be diseases affecting them the most. However, cancer of the lymph system, which can develop anywhere on the body and has rarely been seen before the age of 12, is now also common."


For the full story, see the Chicago Tribune article by Robert Koehler at:


http://commonwonders.com/archives/col352.htm.

NEW KNOWLEDGE PATH EDITION: PHYSICAL ACTIVITY AND CHILDREN AND ADOLESCENTS


The MCH Library has released a new knowledge path about physical activity and children and adolescents. This electronic resource guide offers a selection of current resources that analyze data, describe public health campaigns and other promotion programs, and report on research aimed at identifying promising strategies for improving physical activity levels within families, schools, and communities. The knowledge path also provides resources that describe the consequences of sedentary behavior.


The knowledge path for health professionals, policy-makers, educators, coaches, and families is available at: http://www.mchlibrary.info/KnowledgePaths/kp_phys_activity.html .


Knowledge paths on other maternal and child health topics are available at:  http://mchlibrary.info/KnowledgePaths/index.html.

ROUNDUP OF RECENT HEADLINES ON MCH ISSUES

For the full story of these headlines, click on the link that follows the headline.



  • ASTHMA -- RESCUE INHALERS DON'T TRACK DOSAGE:  Rescue inhalers for asthmatics don't keep track of bronchodilator doses used or remaining, leaving some patients in the lurch when they need the drugs most.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3829
  • ASTHMA -- INHALED CORTICOSTEROIDS DON'T ALTER DEVELOPMENT OF DISEASE:  Inhaled corticosteroids do not alter the development of asthma in early childhood, although in some children they may relieve persistent or severe wheezing, according to two reports.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3269
  • AMENORRHEA AFTER SPINAL CORD INJURY DOES NOT HAMPER PREGNANCY:  Women who have transient amenorrhea for as long seven months following spinal cord injury can conceive, carry the fetus to term and nurse the infant following delivery, researchers have reported.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3181
  • AVOIDING MILK IN PREGNANCY LEADS TO LOWER WEIGHT BABIES:  Women who spurn milk during pregnancy to avoid gaining weight tend to have lighter babies, researchers have reported.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3158
  • STRESSED MOTHERS STILL NEED TO SUPPORT BABIES:  Just when it is highly difficult for a stressed mother to offer the most support, when a baby is wailing inconsolably, is when the infant needs loving attention the most-an approach said to pay dividends for later security.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3828
  • CHILDREN WITH MENTALLY ILL MOTHERS AT INCREASED RISK:  Children of mothers suffering from the triad of mental health problems, substance use, and domestic violence are at increased risk for emotional and behavioral problems as early as age three, according to researchers.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3206
  • VACCINE ADJUVANT MAY BOOST IMMUNE RESPONSE IN BABIES:  A novel adjuvant approach may allow newborns to be vaccinated against a range of pathogens, which could arm infants with immune responses as powerful as those seen in adults.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3164
  • RALOXIFENE REDUCES BREAST CANCER, INCREASES STROKES:  Even as Evista (raloxifene) reduced the risk of invasive breast cancer by 44 percent compared with placebo, it had a sharply increased relative risk of fatal strokes, according to a study of more than 10,000 postmenopausal women.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3716
  • AUTISM DIAGNOSES DELAYED BY PEDIATRICIANS:  Autism's full spectrum is not often on the radar screen of primary care pediatricians, and even when doctors are thinking autism a proper diagnosis may take a year or more.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3275
  • PLACENTAL SIGNS MAY SIGNAL AUTISM:  Preserved placentas from children later diagnosed with autism contained cellular abnormalities that could be the earliest signs of the condition.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3638
  • ACOG WANTS YOUNG ADOLESCENTS AS PATIENTS:  The American College of Obstetricians and Gynecologists is indulging in what pediatricians and family doctors might consider cradle-robbing. ACOG wants girls as young as 13 to get under the ob-gyn umbrella. http://www.medpagetoday.com/tbindex2.cfm?tbid=3267
  • INCREASE IN CAESAREAN RATES TIED TO OBESITY:  The ever increasing rates of cesarean births in the United States are now estimated at 29 percent of births, may have more to do with overweight and obese patients than doctors' tee times or patient requests.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3268
  • INFANT MORTALITY FALLS AGAIN AFTER SPIKE:  The US infant mortality rate, an important indicator of the nation's health, is back on the right track after rising slightly in 2002. http://www.medpagetoday.com/tbindex2.cfm?tbid=3260
  • TEEN VIRGINITY PLEDGES -- HALF RECANTED IN FIRST YEAR:  Virginity pledges by adolescents are recanted at a high rate within a year, according to a national survey of thousands of teens.  http://www.medpagetoday.com/tbindex2.cfm?tbid=3223

All articles in this section are from MedPage Today, providing real-time coverage of breaking medical news and the top stories in health and medicine.  Physicians may also receive Category 1 CME credit as part of MedPage Today's news coverage.  Sign up for the free Daily Headlines e-mail at http://www.medpagetoday.com/.

PLEASE JOIN US! MONDAY, NOVEMBER 6, 10:30 AM - 12 PM

Creating Leadership in the Community - Lessons Learned from the Maternal and Child Health Community Leadership Institute


During this session (3089.0) APHA's Maternal and Child Health Community Leadership Institute team members will describe lessons learned from their participation in this Institute. Topics of discussion include: health birth outcomes, preconceptional, intra-partum and postpartum care, creating leadership in the community and promoting peace and well-being. The Institute, funded by the Colgate Palmolive Company, was designed to build the capacity of participating teams to advance the Healthy People 2010 maternal and child health objectives.


For more information, visit http://apha.confex.com/apha/134am/techprogram/session_19048.htm

JOIN YOUR STATE AFFILIATE AT THE ANNUAL MEETING

While APHA is the national voice on public health, it cannot succeed without the complementary efforts of its state Affiliates. To help build infrastructure and strengthen local efforts, APHA will be implementing an exciting new initiative to promote Affiliate membership at this year's Annual Meeting. This new project includes a booth at the Exposition that gives meeting attendees an opportunity to join their local Affiliate on site electronically. To join your state public health association, please visit the Affiliate membership booth, numbers 942 and 1041 in the exhibit hall, located near “Everything APHA.” If you are interested in volunteering to help staff the booth, contact Katie Sheedy at (202) 777-2432 or kaitlin.sheedy@apha.org