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Building Economic Security Today: Making the Health–Wealth Connection in Contra Costa County’s Maternal and Child Health Programs

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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

  1. 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.

    Article  PubMed  Google Scholar 

  2. 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.

    Google Scholar 

  3. 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.

    Google Scholar 

  4. 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.

    Google Scholar 

  5. 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.

    Google Scholar 

  6. Wilkinson, R., & Marmot, M. (Eds.). (2003). Social determinants of health: The Solid Facts (2nd ed.). World Health Organization Regional Office for Europe: Copenhagen (Denmark).

    Google Scholar 

  7. Marmot, M. (2007). Achieving health equity: From root causes to fair outcomes. Lancet, 370, 1153–1163.

    Article  PubMed  Google Scholar 

  8. 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.

    Google Scholar 

  9. 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.

  10. Adler, N. E., & Newman, K. (2002). Socioeconomic disparities in health: Pathways and policies. Health Affairs, 21, 60–76.

    Article  PubMed  Google Scholar 

  11. 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.

    Google Scholar 

  12. Smith, J. P. (1999). Healthy bodies and thick wallets: The dual relation between health and economic status. Journal of Economic Perspective, 13, 145–166.

    Google Scholar 

  13. Bauman, L. J., Silver, E. J., & Stein, R. E. K. (2006). Cumulative social disadvantage and child health. Pediatrics, 117, 1321–1328.

    Article  PubMed  Google Scholar 

  14. Brooks-Gunn, J., & Duncan, G. J. (1997). The effects of poverty on children. Future of Children, 7(2), 55–71.

    Article  CAS  PubMed  Google Scholar 

  15. Braveman, P., & Egerter, S. (2008). Early childhood experiences: Laying the foundation for health across a lifetime. Princeton (NJ): Robert Wood Johnson Foundation.

    Google Scholar 

  16. 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.

    Article  CAS  PubMed  Google Scholar 

  17. 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.

    Google Scholar 

  18. 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.

    Article  PubMed  Google Scholar 

  19. Braveman, P., & Barclay, C. (2009). Health disparities beginning in childhood: A life-course perspective. Pediatrics, 124(Suppl 3), S163–S175.

    Article  PubMed  Google Scholar 

  20. Adler, N. E., & Rehkopf, D. H. (2008). U.S. disparities in health: Descriptions, causes, and mechanisms. Annual Review of Public Health, 29, 235–252.

    Article  PubMed  Google Scholar 

  21. 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.

    Google Scholar 

  22. 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.

    Google Scholar 

  23. Baughman, R. (2012). The effects of state EITC expansion on children’s health. Durham (NH): Carsey Institute, University of New Hampshire.

    Google Scholar 

  24. Children’s HealthWatch. (2011). Too many hurdles: Barriers to receiving SNAP put children’s health at risk. Boston: Boston Medical Center.

    Google Scholar 

  25. Children’s HealthWatch. (2011). Boost to SNAP benefits protected young children’s health. Boston: Boston Medical Center.

    Google Scholar 

  26. Children’s HealthWatch. (2011). LIHEAP stabilizes family housing and protects children’s health. Boston: Boston Medical Center.

    Google Scholar 

  27. 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.

    Article  Google Scholar 

  28. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  29. 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.

    Article  PubMed  Google Scholar 

  30. 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.

    Article  PubMed  Google Scholar 

  31. Wang, C. C., & Pies, C. A. (2004). Family, maternal, and child health through photovoice. Maternal and Child Health Journal, 8, 95–102.

    Article  PubMed  Google Scholar 

  32. 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.

    Google Scholar 

  33. Unnatural Causes [Internet]. San Francisco: California Newsreel; c2012 [cited 2012 April 29]. Available from: http://www.unnaturalcauses.org/.

  34. Robert Wood Johnson Foundation. (2008). Overcoming obstacles to health. Princeton (NJ): The Foundation.

    Google Scholar 

  35. WIC Program database, Contra Costa Health Services. Retrieved November 2011.

  36. 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.

    Article  PubMed  Google Scholar 

  37. Ashton, M. (2008). Public health nurses as social mediators navigating discourses with new mothers. Nursing Inquiry, 15, 280–288.

    Article  Google Scholar 

  38. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  39. 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.

    Google Scholar 

  40. 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.

    Google Scholar 

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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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Correspondence to Padmini Parthasarathy.

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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

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