Ruth Lubic Receives Martha May Eliot Award

Long-time Section member Ruth Lubic, founder and chair of the Family Health and Birth Center (FHBC), in Washington, D.C., received the prestigious Martha May Eliot Award from the Association during the Annual Meeting in Boston in 2006. 

In her acceptance speech, Ruth spoke about the improvements the FHBC has made since it was established, shortly after she received a prestigious MacArthur Fellowship in 1993.  Ruth came to D.C. because the city has the worst outcomes in the country, a situation that had long been on her professional conscience.  Making midwife services accessible to the women served by the FHBC has made a substantial difference -- from 2003 to 2005, the rate for Cesarean sections decreased by 47.2 percent, preterm birth went down 36.6 percent, and low birthweight dropped by 52 percent in the population served by the birthing center.  

Ruth attributes these remarkable reductions to the relationships established with the women and families by the midwifery staff, which empowers the women to take charge of their own health, and research backs up this claim.  A report from the World Health Organization in February 2006 entitled What is the Evidence on Effectiveness of Empowerment to Improve Health? concludes that “...empowerment is a viable public health strategy.”   In addition, in a recent study by Healy, Malone, and Sullivan, reported in Obstetrics and Gynecology 107 (3) pp. 625-631, entitled Early Access to Prenatal Care: Implications for Racial Disparity in Perinatal Mortality, the authors conclude that “prenatal care...remains insufficient in its present form for minority women.  Therefore, increasing early access to current prenatal care systems in the effort to minimize racial and ethnic disparities...is insufficient.” (emphasis added) 

Ruth also pointed out that the improvements implemented by FHBC are not possible to achieve in the 10-minute prenatal visit mandated by most managed care organizations.  “Certainly the mental health of expectant mothers cannot be addressed unless sufficient time to establish respectful, empowering relationships is allotted,” she said.  “Childbearing is not merely a physical event.  It is one with social, emotional, spiritual, and even political ramifications within families . . . and is treated as such by our nurse-midwives and pediatric nurse practitioners.”

She then went on to speak about the cost savings that have been realized due to the efforts of FHBC.  In 2005, the FHBC rate of cesarean sections was 13 percent, compared to 29 percent for D.C. as a whole.  If FHBC’s rate had also been 29 percent, an additional 24 births at FHBC would have been cesarean sections, at an estimated cost of $13,458 apiece, for a total of $322,992.  Instead, these events were normal births, at a cost of $1,600 each, for a total cost savings of $284,592. 

The savings from a reduction in preterm births was even greater.  In 2005, the rate of preterm birth among FHBC families was 7 percent, but in its most recent final data, the District as a whole had a rate of 14.2 percent.  The Institute of Medicine report, Preterm Birth: Causes, Consequences, and Prevention (in press), estimates that the annual economic burden on our society of each preterm birth is about $51,600.  By cutting the D.C. preterm birth rate in half, FHBC saved D.C. an estimated $567,600.  Added to the estimated savings from cesarean section, FHBC saved the District an estimated total of $852,192.  This is the equivalent of 66 percent of the total operating budget for FHSC, including a liability insurance premium of $175,000.  Yet in 2005, because of the reimbursement rules in place, FHBC was paid only 55 percent of the true cost of each medical visit and almost lost its liability insurance.

Ruth’s advocacy extends beyond the borders of D.C. to 42 birth centers in 19 states, all of which serve medically under-served populations.  “Thank you again for honoring me,” she said.  “In doing so you honor my professional colleagues as well, and you also give me the opportunity to share our work in addressing a national disgrace, the disparities among and between American families.  We look forward to the support of APHA once again in our advocacy program.”

APHA Student Assembly Alumini Database

In addition to providing resources to students, including scholarships, conferences, job postings, potential employers, and fellowships/internships, the APHA Student Assembly (SA) Opportunities Committee has also revamped the Alumni Database, which allows the  SA to keep track of their past members and provides current and potential students information about possible careers in the public health field.

To use the Alumni Database, students can visit the SA Web site, www.aphastudents.org, and click on the Opportunities Committee page.  Here students can look at jobs currently held by public health professionals in the field, to gain a better understanding of the wide variety of career paths available to them. Alumni range from recent graduates working in fellowships or entry-level positions to seasoned health professionals with well-established research agendas.

The SA Opportunities Committee co-chairs are working to increase participation of SA alumni in the Alumni Database. Anyone who at one time was a member of the Student Assembly (previously entitled Public Health Student Caucus) can visit the Web site, complete the form at www.aphastudents.org/phso_alumni_db.php and return it to jlcremeens@aol.com. With APHA-SA alumni support, the Alumni Database can become a wonderful resource for the next generation of public health students. We hope you will consider taking a few moments to add your information to the database.