In August, Michael Fraser, PhD, joined the Association of Maternal and Child Health Programs (AMCHP) as the chief executive officer.  AMCHP is the national organization representing state public health leaders and others working to improve the health and well-being of women, children, youth and families, including those with special health care needs.

Q:  How did you get involved in maternal and child health? That is a really interesting question.  My background is in sociology – my dissertation research was on social support networks for people living with HIV/AIDS.  I never “formally” studied MCH, and in fact my first public health job was a research synthesis project looking at HIV/AIDS prevention strategies.  A good friend from college went to UNC and concentrated in MCH, and eventually she helped me land my second “public health” job at NACCHO, where I worked on a study of public health infrastructure.  I remember calling her up and asking “what the heck does EPSDT stand for?” because I was too embarrassed to ask a colleague sitting next door!  As I got to know more about state and local public health departments,  I realized that MCH was at the core of public health, and MCH issues are some of the most pressing and critical concerns of our day.  I also realized that working in MCH can have a profound impact on improving the health of communities. 

Q: What is one of the most rewarding accomplishments from your career?  I think the most rewarding thing that I’ve experienced to date is watching the people that have worked with me grow as leaders and public health professionals.  I guess another accomplishment is finally getting my 87-year-old grandmother to understand what I do, which to her is “helping the people that keep moms and kids healthy and out of the hospital.”  Listen, if we can’t even get our own families to understand what we do, what chance do we have getting policy-makers, stakeholders and other key decision-makers to work with us and support us?

Q: What do you see as the challenges facing MCH today?  What keeps me going in the face of all our challenges is the importance of our shared vision - healthy families, healthy moms, healthy babies - and the incredible resources we have in this country for giving everyone a chance to succeed and live a healthy life.   All of us in MCH share this goal: I have yet to meet one person that says we should give up despite all the challenges we face.   The challenge isn’t sharing a goal – the challenge is in our strategies and tactics.  We have to get the diverse partners who have a stake in our work to figure out what each of us can do to realize our shared goal and work together to achieve it.  This is tough because we are divided.  We have to overcome this fragmentation of our work, move beyond our “silos” and realize how important we all are in reaching our shared goal.  It takes looking up from our holes, holding hands, and saying yes, we are all invested in getting to the same place.  That’s hard to do when we think the only issue in the world is the issue closest to us. 

Q:  How can we take them on?  We all know “partnering” is important, but what does that really mean?  Can we trust each other to truly create change in our communities, in our states and in our nation?  Can we begin to tell stories that convince the public that what we do is as important as our schools, fire departments and police departments?   There is so much potential to gain support for public health, especially MCH.  But we have to do it in partnership, and realize that we’ll never do it alone – we have to get communities behind us, policy-makers behind us, and people who disagree and may not be like us, behind us.   That means addressing our issues politically and programmatically, with both urgency and patience, and adopting what I call a “rigorous flexibility.”  We also have to change the mindset that if we all just had health insurance, we’d be healthy.  The social determinants of health go well beyond going to see a doctor.  We have to take on the social conditions that contribute to disease, and make these as important as clinical practice and health care, if we are going to be successful.  That may not be a mind shift for those of us who have been in this enterprise for a while, but believe me, it is a huge mind shift for people who don’t do public health for a living. 

Q:  What is your vision for the future of MCH?   Five billion dollars for Title V.  OK, just kidding, but that would be great.  Look, public health means creating the conditions through which all people can be healthy.  MCH is core to that vision – healthy children, healthy families, living in healthy communities.  My vision is a society in which we give everyone a chance to thrive and to contribute to making the world a better place.  Our MCH activities are essential to making that happen.   We are all part of that vision.