Maternal Child Health Newsletter 9/3/04

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Maternal Child Health Newsletter 9/3/04

Postby laura » Fri Sep 03, 2004 12:12 am

MCH Alert
Tomorrow's Policy Today

National Center for Education in Maternal and Child Health
Search past issues of the MCH Alert and other MCH Library resources at

September 3, 2004

1. Maternal and Child Health Bureau to Sponsor Series of Webcasts for MCH
2. National Institutes of Health Finalizes Obesity Research Agenda
3. New Child Health Survey to Provide National and State Data
4. Analysis Examines the Impact of Changing Urban Geography and Service
5. Authors Compare Access to and Use of Preventive Health Services by
Hispanic Women



The Maternal and Child Health Bureau will sponsor a series of Webcasts as
part of an ongoing effort to bring information on topics of interest and
importance to the maternal and child health (MCH) community. The series
will feature multiple presenters from federal, state, and local agencies
and will focus on experiences and recommendations for improving MCH
through state and local partnerships. The Webcasts will combine
video/audio broadcasting with PowerPoint slides, and participants will be
able to ask the presenters questions. The current series includes the
following Webcasts:

Wednesday, September 8, 2004
2:00-3:30 p.m. EST
MCHB/DRTE Navigating the New MCH Training Web Site with a Preview of the
MCHB All-Grantee Meeting Webcast

Thursday, September 9, 2004
2:00-3:00 p.m. EST
MCH/CSHCN Director Webcast

Wednesday, September 15, 2004
2:00-3:30 p.m. EST
MCHB Research Networks: PECARNS, PROS, and CARN

Participating in the Webcasts requires preregistration. Agendas and
registration information are available at Archived
versions of the Webcasts will be made available 1 week following the live
events. Archived Webcasts, as well as online MCH conferences and online
MCH training resources, are available at



The Strategic Plan for Obesity Research is a multi-dimensional research
agenda to enhance both the development of new research in areas of
greatest scientific opportunity and the coordination of obesity research
across the National Institutes of Health (NIH). The NIH Obesity Research
Task Force, created in spring 2003, developed the plan with input from
scientists, organizations advocating for patients and health
professionals, and members of the public. The plan calls for
interdisciplinary research teams to bridge the study of behavioral and
environmental causes of obesity with the study of genetic and biological
causes. The plan addresses the link between obesity and disease, special
populations at high risk for obesity, translating basic science into
clinical research and community intervention studies, and disseminating
results to the public and health professionals. The report is available at



"The National Survey of Children's Health is designed to fill important
gaps in our knowledge of children's health and well-being," state the
authors of an article published in the September 2004 issue of the
Maternal and Child Health Journal. In January 2003, the Maternal and Child
Health Bureau (MCHB) in partnership with the National Center for Health
Statistics (NCHS) launched a new telephone survey -- the National Survey
of Child Health (NSCH) -- to provide state and national data on children's
health and well-being, as well as information on their families and
neighborhoods. The plan and design of this survey are the focus of this

The primary purpose of the NSCH is to provide representative state and
national data on children that can be used to characterize their health
status, their families and communities, the types of services they need
and use, and the challenges they face in navigating the health care
system. The NSCH will provide baseline estimates for federal and state
Title V Maternal and Child Health performance measures, MCHB companion
objectives for Healthy People 2010, and data for each state's 5-year Title
V needs assessment.

Design and Procedures
The NSCH is conducted using the State and Local Area Integrated Telephone
Survey mechanism and is administered to a representative random sample of
households with children in each of the 50 states and the District of
Columbia. A parent or guardian answers questions about the child related
to (1) demographics and program participation (TANF, Medicaid/SCHIP, WIC,
food stamps, school-based breakfast and lunch programs, Head Start, and
Early Head Start), (2) physical and mental health status, (3) health
insurance coverage, (4) access to and utilization of services, and (5)
medical home.

Expected Uses
MCHB intends to use the survey for program planning and evaluation
purposes at the federal and state levels, including monitoring Title V
performance measures related to children. The data will be used by states
in their needs assessment activities and to measure progress toward
meeting Healthy People 2010 objectives.

The authors conclude that "[The NSCH] will provide an important source of
new state-level information."

van Dyck P, Kogan MD, Heppel D. 2004. The National Survey of Children's
Health: A new data resource. Maternal and Child Health Journal

Readers: This is the second state and national survey jointly completed by
MCHB and NCHS. It is designed to complement the 2001 National Survey of
Children with Special Health Care Needs by providing data on the health of
the general child population. Data collection began in January 2003 and
continued through April 2004. Summary reports and electronic data files
will be available to the public by early 2005.



"It is very possible that the safety net may not be well equipped to meet
the challenge of serving increasingly geographically dispersed needs,"
states the author of an August 2004 report published by the Brookings
Institution's Metropolitan Policy Program. Spatial proximity to service
providers is an important consideration for adequate access to
governmental and non-governmental service providers, and this may be
particularly true for families with low incomes. The report examines
neighborhood variation in access to social services in three metropolitan

Using publicly available guides, directories, and resources, the author
compiled a list of service providers that assisted families with low
incomes during 2000 and 2001 in Chicago, Los Angeles, and Washington, DC.
The cities were chosen because of their differing sizes, densities,
ethnic/racial compositions, and economic conditions, yet they all had
comparable poverty rates (i.e., about 22% of central city residents lived
below the federal poverty line). Providers were included in the Multi-City
Social Service Provider Database (MSSPD) if they offered services in at
least one of five program areas: substance abuse and mental health; food
assistance; job training; education; and non-food emergency assistance.
The author calculated the number of service providers for each program
area within a 1.5 mile radius of each residential census tract. The MSSPD
was then combined with tract-level demographic and economic data from the
1990 and 2000 censuses. The author examined how proximity to service
providers varied by tract racial composition, poverty rates, and patterns
of public assistance receipt.

The author found that

* On average, poor populations in central cities were geographically
closer to social service providers than poor populations in suburban

* While spatial access to social services providers was greatest in
central city areas, potential demand for services was also much greater in
central city areas than in suburban areas.

* The location of social service providers was not always well matched
with the changing demographics of cities.

* High-poverty central city tracts with large percentages of Hispanics
were geographically closest to service providers.

The author concludes that policymakers and service providers need to focus
more attention on "how spatial trends in employment, population, and
support services converge to shape demand and needs of low-income
populations in our metropolitan areas."

Allard SW. 2004. Access to social services: The changing urban geography
of poverty and service provision. Washington, DC: Brookings Institution.
Available at or



"The analyses presented here suggest that . . . underutilization [of
preventive services by Hispanic women] persisted in 2001," state the
authors of an article published in the July/August 2004 issue of the
Journal of Women's Health. During the 1990s, a 58% increase in the
Hispanic/Latino population, fueled by the century's largest immigration
wave and the highest fertility rate of any U.S. group, resulted in
Hispanics becoming the largest U.S. minority group. However, little data
exists on Hispanics' experience with health care and preventive health
services, particularly in the fastest-growing new destinations. The
article compares access to and use of women's preventive health services
by race and ethnicity in Atlanta, Georgia (the largest Hispanic new
destination) and Miami, Florida (the largest established Hispanic
community in the Southeast).

Data for the analysis were drawn from the population-based 2000 National
Health Interview Survey (NHIS; N=927) and from questionnaires completed by
Hispanic attendees as they registered for health screenings during health
fiestas held in 2001 in Atlanta and Miami (N=361). Proportions of
respondents who had ever used several preventive services were compared by
various characteristics.

>From the NHIS sample, the authors found that

* Non-Hispanic white and black women were more likely than Hispanic women
to report annual household income over $20,000, a routine source of
preventive care, or ever having had Pap cervical cancer screening or used
oral contraception.

* Hispanic women over age 50 were more likely to than non-Hispanic black
women but less likely than non-Hispanic white women in this age group to
report ever having had a mammogram.

* Compared to Hispanics in Miami, Hispanics in Atlanta were more likely to
be male and to speak only Spanish and less likely to have a usual source
of preventive care, to have at least 12 years of education, or to report
annual household income over $20,000.

>From the health fiesta questionnaire surveys, the authors found that

* Only 1.8% of Atlanta women, compared with 65.3% of Miami women, had
health insurance.

* Insured women were more likely than uninsured women to report ever
having had Pap cervical cancer screening and a mammogram but less likely
to report ever having received family planning services.

"Underutilization appeared to be strongly associated with possible
indicators of low access to preventive services such as low income and
uninsured status," the authors conclude. They add that "culturally
appropriate health fiestas may provide an acceptable alternative for
underserved Hispanic women to access preventive health services. Moreover,
they provide opportunities to participate in the health system and in
research, giving Hispanic women a voice in the planning of how their
health needs are met, particularly in the more underserved, marginalized
new destination communities."

Asamoa K, Rodriguez M, Gines V, et al. 2004. Use of preventive health
services by Hispanic/Latino women in two urban communities: Atlanta,
Georgia and Miami, Florida, 2000 and 2001. Journal of Women's Health


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MCH Alert © 2004 by National Center for Education in Maternal and Child
Health and Georgetown University. MCH Alert is produced by MCH Library
Services at the National Center for Education in Maternal and Child Health
under its cooperative agreement (6U02 MC 00001) with the Maternal and
Child Health Bureau, Health Resources and Services Administration, U.S.
Department of Health and Human Services. The Maternal and Child Health
Bureau reserves a royalty-free, nonexclusive, and irrevocable right to use
the work for federal purposes and to authorize others to use the work for
federal purposes.

Permission is given to forward MCH Alert to individual colleagues. For all
other uses, requests for permission to duplicate and use all or part of
the information contained in this publication should be sent to MCH Alert
Editor, National Center for Education in Maternal and Child Health, at

The editors welcome your submissions, suggestions, and questions. Please
contact us at the address below.

EDITORS: Jolene Bertness, Tracy Lopez

National Center for Education in Maternal and Child Health
Georgetown University
Mailing address: Box 571272, Washington, DC 20057-1272
Street address: 2115 Wisconsin Avenue, N.W., Suite 601, Washington, DC
Phone: (202) 784-9770
Fax: (202) 784-9777
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