Abstract
In recent years, maternal and child health professionals have been seeking approaches to integrating the Life Course Perspective and social determinants of health into their work. In this article, we describe how community input, staff feedback, and evidence from the field that the connection between wealth and health should be addressed compelled the Contra Costa Family, Maternal and Child Health (FMCH) Programs Life Course Initiative to launch Building Economic Security Today (BEST). BEST utilizes innovative strategies to reduce inequities in health outcomes for low-income Contra Costa families by improving their financial security and stability. FMCH Programs’ Women, Infants, and Children Program (WIC) conducted BEST financial education classes, and its Medically Vulnerable Infant Program (MVIP) instituted BEST financial assessments during public health nurse home visits. Educational and referral resources were also developed and distributed to all clients. The classes at WIC increased clients’ awareness of financial issues and confidence that they could improve their financial situations. WIC clients and staff also gained knowledge about financial resources in the community. MVIP’s financial assessments offered clients a new and needed perspective on their financial situations, as well as support around the financial and psychological stresses of caring for a child with special health care needs. BEST offered FMCH Programs staff opportunities to engage in non-traditional, cross-sector partnerships, and gain new knowledge and skills to address a pressing social determinant of health. We learned the value of flexible timelines, maintaining a long view for creating change, and challenging the traditional paradigm of maternal and child health.
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References
Lu, M. C., & Halfon, N. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7, 13–30.
Pies, C., Parthasarathy, P., Kotelchuck, M., & Lu, M. (2009). Making a paradigm shift in maternal and child health: A report on the national MCH Life Course Meeting. Martinez (CA): Contra Costa Health Services.
Fine, A., Kotelchuck, M., Adess, N., & Pies, C. (2009). Policy brief—A new agenda for MCH policy and programs: Integrating a Life Course Perspective. Martinez (CA): Contra Costa Health Services.
Kotelchuck, M., & Fine, A. (2010). Rethinking MCH: The life course model as an organizing framework. Rockville (MD): U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau.
Lu, M. C., Kotelchuck, M., Hogan, V., Jones, L., Wright, K., & Halfon, N. (2010). Closing the black-white gap in birth outcomes: A life-course approach. Ethnicity and Disease, 20(1 Suppl 2), S62–S76.
Wilkinson, R., & Marmot, M. (Eds.). (2003). Social determinants of health: The Solid Facts (2nd ed.). World Health Organization Regional Office for Europe: Copenhagen (Denmark).
Marmot, M. (2007). Achieving health equity: From root causes to fair outcomes. Lancet, 370, 1153–1163.
Braveman, P., & Egerter, S. (2008). Overcoming obstacles to health: Report from the Robert Wood Johnson Foundation to the Commission to Build a Healthier America. Princeton (NJ): Robert Wood Johnson Foundation.
Adler, N. E., Stewart, J., Cohen, S., Cullen, M., Diez Roux, A., Dow, W., et al. (2007). Reaching for a healthier life: Facts on socioeconomic status and health in the U.S. San Francisco: The John D. and Catherine T. MacArthur Foundation Research Network on Socioeconomic Status and Health.
Adler, N. E., & Newman, K. (2002). Socioeconomic disparities in health: Pathways and policies. Health Affairs, 21, 60–76.
National Center for Health Statistics. (2012). Health, United States, 2011: With special feature on socioeconomic status and health. Hyattsville (MD): Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.
Smith, J. P. (1999). Healthy bodies and thick wallets: The dual relation between health and economic status. Journal of Economic Perspective, 13, 145–166.
Bauman, L. J., Silver, E. J., & Stein, R. E. K. (2006). Cumulative social disadvantage and child health. Pediatrics, 117, 1321–1328.
Brooks-Gunn, J., & Duncan, G. J. (1997). The effects of poverty on children. Future of Children, 7(2), 55–71.
Braveman, P., & Egerter, S. (2008). Early childhood experiences: Laying the foundation for health across a lifetime. Princeton (NJ): Robert Wood Johnson Foundation.
Jackson, A. P., Brooks-Gunn, J., Huang, C. C., & Glassman, M. (2000). Single mothers in low-wage jobs: Financial strain, parenting, and preschoolers’ outcomes. Child Development, 71, 1409–1423.
Evans, G. W., Brooks-Gunn, J., & Klebanov, P. K. (2011). Stressing out the poor: Chronic physiological stress and the income-achievement gap. Community Investments, 23(2), 22–27.
Cohen, S., Janicki-Deverts, D., Chen, E., & Matthews, K. (2010). Childhood socioeconomic status and adult health. Annals of the New York Academy of Sciences, 1186, 37–55.
Braveman, P., & Barclay, C. (2009). Health disparities beginning in childhood: A life-course perspective. Pediatrics, 124(Suppl 3), S163–S175.
Adler, N. E., & Rehkopf, D. H. (2008). U.S. disparities in health: Descriptions, causes, and mechanisms. Annual Review of Public Health, 29, 235–252.
Center on the Developing Child at Harvard University. (2010). The foundations of lifelong health are built in early childhood. Cambridge (MA): Center on the Developing Child at Harvard University.
Webb, B. C. (2012). Moving upstream: Policy strategies to address social, economic, and environmental conditions that shape health inequities. Washington (DC): Joint Center for Political and Economic Studies, Health Policy Institute.
Baughman, R. (2012). The effects of state EITC expansion on children’s health. Durham (NH): Carsey Institute, University of New Hampshire.
Children’s HealthWatch. (2011). Too many hurdles: Barriers to receiving SNAP put children’s health at risk. Boston: Boston Medical Center.
Children’s HealthWatch. (2011). Boost to SNAP benefits protected young children’s health. Boston: Boston Medical Center.
Children’s HealthWatch. (2011). LIHEAP stabilizes family housing and protects children’s health. Boston: Boston Medical Center.
Barber, S. L., & Gertler, P. J. (2008). The impact of Mexico’s conditional cash transfer programme, Oportunidades, on birthweight. Tropical Medicine & International Health, 13, 1405–1414.
Fernald, L. C. H., Gertler, P. J., & Neufeld, L. M. (2008). Role of cash in conditional cash transfer programme for child health, growth, and development: An analysis of Mexico’s Oportunidades. Lancet, 371, 828–837.
Fernald, L. C. H., Gertler, P. J., & Neufeld, L. M. (2009). 10-year effect of Oportunidades, Mexico’s conditional cash transfer programme, on child growth, cognition, language, and behaviour: A longitudinal follow-up study. Lancet, 374, 1997–2005.
Pies, C., Parthasarathy, P., & Posner, S. F. (2012). Integrating the Life Course Perspective into a local maternal and child health program. Maternal and Child Health Journal, 16, 649–655.
Wang, C. C., & Pies, C. A. (2004). Family, maternal, and child health through photovoice. Maternal and Child Health Journal, 8, 95–102.
Pies, C. A., & Parthasarathy, P. (2007). Photovoice: Giving local health departments a new perspective on community health issues. Martinez (CA): Contra Costa Health Services, Public Health Division.
Unnatural Causes [Internet]. San Francisco: California Newsreel; c2012 [cited 2012 April 29]. Available from: http://www.unnaturalcauses.org/.
Robert Wood Johnson Foundation. (2008). Overcoming obstacles to health. Princeton (NJ): The Foundation.
WIC Program database, Contra Costa Health Services. Retrieved November 2011.
Ritchie, L. D., Whaley, S. E., Spector, P., Gomez, J., & Crawford, P. B. (2010). Favorable impact of nutrition education on California WIC families. Journal of Nutrition Education and Behavior, 42, S2–S10.
Ashton, M. (2008). Public health nurses as social mediators navigating discourses with new mothers. Nursing Inquiry, 15, 280–288.
Mistry, R. S., Benner, A. D., Tan, C. S., & Kim, S. Y. (2009). Family economic stress and academic well-being among Chinese-American youth: The influence of adolescents’ perception of economic strain. Journal of Family Psychology, 23, 279–290.
O’Neill, B., Sorhaindo, B., Prawitz, A., Kim, J., & Garman, E. T. (2006). Financial distress: Definition, effects and measurements. Consumer Interest Annual, 52, 489–496.
Woods, N. F., Mitchell, E. S., Percival, D. B., & Smith-DiJulio, K. (2009). Is the menopause transition stressful? Observations of perceived stress from Seattle midlife women’s health study. Menopause, 16, 190–197.
Acknowledgments
The authors want to thank the following individuals for their significant contributions to and critical review of this article: Debbie Casanova, MPH; Chuck McKetney, PhD, MPH; Mary Jane Kiefer, RD; Beverly Clark, RD; Raz Moghbel, RD; Bette Lucey, RN, BSN; Linda Black, RN, BSN; Alicia Grand, RN, BSN; Nayeli Zavala, RN, BSN; Kristina Kutter, MPH; Lauren Leimbach, MBA; Kayley Harrington, MSW, MPH; and Wendel Brunner, MD, PhD. Funding for BEST and the writing of this article was provided by Contra Costa Health Services; California Department of Public Health, Maternal, Child and Adolescent Health Program; The San Francisco Foundation; East Bay Community Foundation; Kaiser Permanente Diablo Area; Kaiser Permanente East Bay; and Y & H Soda Foundation.
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Parthasarathy, P., Dailey, D.E., Young, ME.D. et al. Building Economic Security Today: Making the Health–Wealth Connection in Contra Costa County’s Maternal and Child Health Programs. Matern Child Health J 18, 396–404 (2014). https://doi.org/10.1007/s10995-013-1309-7
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DOI: https://doi.org/10.1007/s10995-013-1309-7