National experts are calling for more integrated approaches such as the life course perspective to reduce health disparities and achieve greater health equity. The translation and application of the life course perspective is therefore of great interest to public health planners, policy makers and funders to promote community-wide improvements in maternal and child health. However, few organizations have applied the life course perspective in designing strategic funding initiatives. For over three decades, Wisconsin has observed persistent racial disparities in birth outcomes. This complex public health issue led to the development of the Lifecourse Initiative for Health Families, a regional multi-million dollar funding initiative created and supported by the Wisconsin Partnership Program of the University of Wisconsin School of Medicine and Public Health (Created by the UW SMPH from an endowment following the conversion of Blue Cross Blue Shield United of Wisconsin, the Partnership Program makes investments in research, education, and public health and prevention initiatives that improve health and reduce health disparities in the state.). Over a 2-year period, the program funded four collaboratives to adopt a life course perspective and develop strategic plans for improving African American birth outcomes. The Twelve-point plan to close the black–white gap in birth outcomes provided the framework for the planning process. Despite the conceptual challenges, the life course perspective was embraced by the collaboratives, challenged community assumptions on the root causes of poor birth outcomes and provided a unifying funding construct for organizing and planning complementary individual-level interventions with social and physical environmental change strategies. These integrated and complimentary approaches provide a long-term opportunity to address the persistent racial birth outcome disparity in Wisconsin.
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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.
Wisconsin Health Facts: Racial and Ethnic Disparities in Infant Mortality, Wisconsin Department of Health Services, Division of Public Health (January 2010). Available at: http://www.dhs.wisconsin.gov/healthybirths/pdf/infanthealthfactsheet.pdf.
Mathews, T. J., & MacDorman, M. F. (2011). Infant mortality statistics from the 2007 period linked birth/infant death data set. National vital statistics reports, vol 59 no 6. Hyattsville, MD: National Center for Health Statistics. Available at: http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_06.pdf.
Wisconsin Department of Health Services, Division of Public Health, Bureau of Health Information and Policy. Wisconsin Interactive Statistics on Health (WISH) data query system, http://dhs.wisconsin.gov/wish/, Infant Mortality Module. Accessed Aug 2012.
U.S. Census Bureau: State and County QuickFacts. Data derived from Population Estimates, American Community Survey, Census of Population and Housing, State and County Housing Unit Estimates, County Business Patterns, Nonemployer Statistics, Economic Census, Survey of Business Owners, Building Permits, Consolidated Federal Funds Report. Accessed Aug 2012.
U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC. Available at http://www.healthypeople.gov/2020, Accessed May 2012.
Byrd, D. R., & Katcher, M. L. (2007). Infant mortality: Explaining black/white disparities in Wisconsin. Maternal and Child Health Journal, 4, 319–326. Epub 2007 Feb 14.
Fine, A., & Kotelchuck, M. (2009). Policy brief: A new agenda for MCH policy and programs: Integrating a life course perspective. Available at: http://cchealth.org/groups/lifecourse/pdf/2009_10_policy_brief.pdf.
Institute of Medicine of the National Academies. (2006). Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: The National Academies Press.
Tuan, W. J., & Hatfield, P. (2007). Possible factors illuminating increased disparities in neonatal mortality in Wisconsin from 1991–2005. Wisconsin Medical Journal, 106(3), 130–136.
Kvale, K. M., & Mascola, M. A. (2004). Trends in maternal and child health outcomes: where does Wisconsin rank in the national context. Wisconsin Medical Journal, 103(5), 42–47.
Wisconsin Department of Health Services, Division of Public Health. (2008). A framework for action to eliminate racial and ethnic disparities in birth outcomes Wisconsin, 2008–2011. Available at: http://www.dhs.wisconsin.gov/healthybirths/pdf/framework20082011.pdf.
City of Milwaukee Health Department [Internet]. (2007). Infant Mortality and Disparity Fact Sheet. Available at: http://www.milwaukee.gov/ImageLibrary/Groups/healthAuthors/MCH/PDFs/InfantMortality/2007_inf_mort_and_disp_fact_sheet.pdf.
Aronson, R. A. (2008). White paper for wisconsin partnership program special funding initiative, elimination of racial and ethnic disparities in birth outcomes in Wisconsin. Available at: http://www.med.wisc.edu/files/smph/docs/community_public_health/partnership/targeted_initiative/partnership_elimination_of_disparities.pdf.
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 Supplemental): S2:62–76.
Unnatural Causes [Internet]. San Francisco: California Newsreel; c2008 [cited 2010 May 26]. Available at: http://www.unnaturcauses.org/.
Robert Wood Johnson Foundation. (2010). A new way to talk about the social determinants of health: Health starts where we live, learn, work and play. Available at http://www.rwjf.org/vulnerablepopulations/product.jsp?id=66428.
The authors also want to thank the following individuals for their suggestions, and critical review of this article: Eileen Smith MS, Mary Jo Knobloch MPH, CHES, Ann McCall MSSW. Funding for the writing of this article was provided by the Wisconsin Partnership Program of the UW School of Medicine and Public Health. The authors would also like to thank the members of the Oversight and Advisory Committee and Steering Committee, and the four Lifecourse collaboratives in Beloit, Kenosha, Milwaukee and Racine for their leadership in applying life course and social determinants principles.
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Frey, C.A., Farrell, P.M., Cotton, Q.D. et al. Wisconsin’s Lifecourse Initiative for Healthy Families: Application of the Maternal and Child Health Life Course Perspective Through a Regional Funding Initiative. Matern Child Health J 18, 413–422 (2014). https://doi.org/10.1007/s10995-013-1271-4