Maternal and Child Health Journal

, Volume 18, Issue 2, pp 423–430 | Cite as

Turning the Ship: Making the Shift to a Life-Course Framework

  • Angela M. Rohan
  • Patrice M. Onheiber
  • Linda J. Hale
  • Terry L. Kruse
  • Millie J. Jones
  • Katie H. Gillespie
  • Lorraine S. Lathen
  • Murray L. Katcher
Article

Abstract

Turning a ship requires small but steady and deliberate efforts over time. During the past 9 years, Wisconsin’s Maternal and Child Health (MCH) Program has begun to utilize the life-course perspective as its framework for guiding efforts around women’s health, early childhood systems, children and youth with special health care needs, chronic disease integration, and elimination of racial and ethnic disparities in birth outcomes. In collaboration with many state and national partners, Wisconsin’s MCH Program has integrated the life-course perspective into efforts that include the following: increasing professional and public awareness of the framework; creating focus groups and social marketing campaigns in communities most affected by health disparities; expanding preconception and women’s health initiatives; integrating with traditionally “non-MCH” programs such as chronic disease programs; and shifting Title V resources from provision of individual services to assurance of effective early childhood systems. Wisconsin’s implementation of the life-course perspective has not been without challenges, but opportunities have also been identified along the journey. Initial efforts focused on training and supporting partners in their understanding and application of the life-course framework, and a train-the-trainer model was discovered to be key to achieving these goals. We took care to engage special populations and their advocates and to work closely with local communities. We hope that the lessons we have learned in this process will provide guidance for others as they work to incorporate life course into their MCH work. The life-course perspective has helped us to inform partners, policy makers, and funders of the need for a new approach in addressing racial and ethnic disparities in health.

Keywords

Life-course Disparities Title V Implementation 

Notes

Acknowledgments

Support for the work described here was provided, in part, by the Health Resources and Services Administration’s First Time Motherhood/New Parents Initiative; Title V Maternal and Child Health Block Grant; and the Wisconsin Tobacco Prevention and Control Program and Minority Health Program mini-grant. We acknowledge the valuable contributions of countless individuals and organizations not listed here to the projects and efforts described within this paper.

References

  1. 1.
    America’s Health Rankings ®2011 Edition ©2011 United Health Foundation. Available at http://www.americashealthrankings.org/SiteFiles/Reports/AHR%202011edition.pdf. Accessed October 02, 2012.
  2. 2.
    Ashford, K., Bartz, A., Cox, J., Fitch, A., Gandel, S., Hyatt, J., Kelley, R., & Knight, K., et al. (2007). Best places to live: Top 100. Available at http://money.cnn.com/galleries/2007/moneymag/0707/gallery.BPTL_top_100.moneymag/index.html. Accessed October 02, 2012.
  3. 3.
    Walkscore.com. Most bikeable cities. Available at http://www.walkscore.com/bike. Accessed October 02, 2012.
  4. 4.
    Aiming higher: Results from a state scorecard on health system performance. (2009). The Commonwealth Fund Commission on a High Performance Health System, October 2009. Available at http://www.commonwealthfund.org/Publications/Fund-Reports/2009/Oct/2009-State-Scorecard.aspx. Accessed October 02, 2012.
  5. 5.
    Booske, B. C., Roubal, A. M., Graupner, A. G., Bergum, A. H., Kindig, D. A., & Remington, P. L. (2010). Health of Wisconsin Report Card-2010. University of Wisconsin Population Health Institute, 2010. Available at http://uwphi.pophealth.wisc.edu/programs/match/healthiest-state/report-card/2010/reportCard.pdf. Accessed October 02, 2012.
  6. 6.
    Booske, B. C., Kempf, A. M., Athens, J. K., Kindig, D. A., & Remington, P. L. (2007). Health of Wisconsin Report Card. University of Wisconsin Population Health Institute, 2007. Available at http://uwphi.pophealth.wisc.edu/programs/match/healthiest-state/report-card/2007/reportCard.pdf#cover. Accessed October 02, 2012.
  7. 7.
    Wisconsin Department of Health Services. (2010). Healthy growth and development focus area profile, July 2010. Available at http://www.dhs.wisconsin.gov/hw2020/pdf/healthygrowth.pdf. Accessed October 02, 2012.
  8. 8.
    Wisconsin Department of Health Services. Health focus areas for Wisconsin women of reproductive age (18–44 years), updated August 2012. (Report in development).Google Scholar
  9. 9.
    Wisconsin Department of Health Services. Health and Disability in Wisconsin-Estimates from Three Population-based Surveys (draft working papers). Available at http://www.waisman.wisc.edu/healthdisparities/WorkingPaperJune2012.pdf. Accessed January 29, 2013.
  10. 10.
    Wisconsin Department of Health Services. (2010). Oral health focus area profile, July 2010. Available at http://www.dhs.wisconsin.gov/hw2020/pdf/oralhealth.pdf. Accessed October 02, 2012.
  11. 11.
    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.CrossRefGoogle Scholar
  12. 12.
    Kvale, K. M., Mascola, M. A., Glysch, R., Kirby, R. S., & Katcher, M. L. (2004). Trends in maternal and child health outcomes: Where does Wisconsin rank in the national context? WMJ, 103(5), 42–47.PubMedGoogle Scholar
  13. 13.
    Geronimus, A. T. (2001). Understanding and eliminating racial inequalities in women’s health in the United States: The role of the weathering conceptual framework. Journal of the American Medical Women’s Association, 56(4), 133–136.PubMedGoogle Scholar
  14. 14.
    Wisconsin’s framework for action to eliminate racial and ethnic disparities in birth outcomes, 2006 progress report. Available at http://www.dhs.wisconsin.gov/healthybirths/pdf/2006ffaprogressrpt.pdf. Accessed October 02, 2012.
  15. 15.
    Cruz, E., Guhleman, P., & Onheiber, P. M. (2008, November). Wisconsin healthy birth outcomes: Minority health program challenges and contributions. Journal of Public Health Management Practice (Suppl), S58–S64.Google Scholar
  16. 16.
    ABCs for healthy babies: A social marketing campaign for eliminating racial and ethnic disparities in birth outcomes in southeastern and southern Wisconsin. Final report on concept and message testing in Milwaukee, Beloit, Racine, Kenosha, and Madison/Dane County. Available at http://www.dhs.wisconsin.gov/healthybirths/pdf/abchbfinalreport200903.pdf. Accessed October 02, 2012.
  17. 17.
    Krieger, N., Smith, K., Naishadham, D., Hartman, C., & Barbeau, E. M. (2005). Experiences of discrimination: validity and reliability of a self-report measure for population health research on racism and health. Social Science and Medicine, 61, 1576–1596.PubMedCrossRefGoogle Scholar
  18. 18.
    Final report of the ABCs for healthy families project. Available at http://www.dhs.wisconsin.gov/healthybirths/pdf/abcshealthyfamiliesfinalreport.pdf. Accessed October 02, 2012.
  19. 19.
    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(Suppl 2), s2-62–s2-76).Google Scholar
  20. 20.
    U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. (2010, November). Rethinking MCH: The life course model as an organizing framework (concept paper).Google Scholar
  21. 21.
    Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and trauma and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14, 245–258.PubMedCrossRefGoogle Scholar
  22. 22.
    Schonkoff, J. P., & Phillips, D. A. (Eds.). (2000). From neurons to neighborhoods: The science of early childhood development. Committee on Integrating the Science of Early Childhood Development; National Research Council and Institute of Medicine.Google Scholar
  23. 23.
    MCH Leadership Competencies Workgroup. (Eds.). (2009, June). Maternal and child health leadership competencies, version 3.0. Available at http://devleadership.mchtraining.net/mchlc_docs/mch_leadership_comp_3-0.pdf. Accessed October 02, 2012.
  24. 24.
    Broussard, D. L., Sappenfield, W. B., Fussman, C., Kroelinger, C. D., & Grigorescu, V. (2011). Core State Preconception health indicators: A voluntary, multi-state selection process. Maternal and Child Health Journal, 15, 158–168.PubMedCrossRefGoogle Scholar
  25. 25.
    Unnatural causes: Is inequality making us sick? California Newsreel, 2008. Information at http://www.unnaturalcauses.org. Accessed October 02, 2012.

Copyright information

© Springer Science+Business Media New York (outside the USA)  2013

Authors and Affiliations

  • Angela M. Rohan
    • 1
  • Patrice M. Onheiber
    • 1
  • Linda J. Hale
    • 1
  • Terry L. Kruse
    • 1
  • Millie J. Jones
    • 1
  • Katie H. Gillespie
    • 1
  • Lorraine S. Lathen
    • 2
  • Murray L. Katcher
    • 1
  1. 1.Wisconsin Division of Public HealthDepartment of Health ServicesMadisonUSA
  2. 2.Jump at the Sun Consultants, LLCMequonUSA

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