Kotch s Maternal and Child Health Problems Programs and Policy in Public Health 4th Edition by Russell S Kirby, Sarah Verbiest ISBN 9781284200256 1284200256

CHAPTER 1 Rights, Justice, and Equity

Introduction

Moral and Ethical Bases for Ensuring Equity by Addressing Health Disparities

Children’s Rights

Health Disparities and Health Inequities

Racial/Ethnic Disparities

From Minority Health to Health Disparities

The Impact and Legacy of the Heckler Report

Demographic Changes

Roots of Inequity: Social Determinants of Health

Connecting the Past to the Present

Case Example 1: The Social Security Act

Case Example 2: Redlining and Restrictive Covenants

Case Example 3: The GI Bill

Layers of Inequities

Religious Identity

Queer Identity

Transgender Parenting

Immigrant Populations

Paid Leave

Intersectionality

Better Frames for Addressing Disparities: Moving Toward Health Equity

Strategies for MCH Policy and Programs

Strategy 1: Decolonize Funding and Research

Strategy 2: Propose Policies and Legislation to Close Equity Gaps

Strategy 3: Prioritize Learnings from Communities Experiencing Burden of Inequities

Strategy 4: Adopt an Antiracist Stance as an Organization

Strategy 5: Employ Respectful Maternity Care

Strategy 6: Improve Data Collection and Analyses Processes

Strategy 7: Provide Visionary Leadership

Summary and Charge for the Future

Discussion Questions

References

CHAPTER 2 A Life Course Perspective on Maternal and Child Health and Health Inequities

Introduction

Fundamental Concepts in Life Course Theory

The Five Defining Principles of Life Course Theory

1. The Principle of Life Span Development

2. The Principle of Human Agency

3. The Principle of Timing

4. The Principle of Linked Lives

5. The Principle of Historical Time and Place

Three Key Concepts in Life Course Theory: Trajectories, Transitions, and Turning Points

Fundamental Concepts in Life Course Epidemiology

Applications of Life Course Theory and Epidemiology to MCH

Historical Applications to MCH

Contemporary Applications to MCH

1. Preconception Health and Well-Being

2. The Life Course Impact of Adverse Childhood Experiences

3. Fetal Origins of Adult Disease

Implications of a Life Course Perspective on MCH Policy and Practice

Implications for the Timing of Strategies to Improve MCH Outcomes

Implications for the Types and Targets of Strategies to Improve MCH Outcomes

Barriers to the Policy and Practice Changes Derived from a Life Course Perspective

Conclusion

Summary of Key Points

Discussion Questions

Additional Resources

Acknowledgments

References

CHAPTER 3 Families and Health

Introduction

American Family Composition Over Time

Immigrant and Refugee Families

Family Separation and Historic Trauma

Grandparent-Led Families

Marriage, Divorce, and Remarriage and Single Parenthood

Extended Families and Cohabiting Parents

Fathers

Family Median Income

Factors That Influence Family Health

Parents in the Workforce

Child Care

Poverty as an Indicator of Health Outcomes in Families

Race, Ethnicity, Immigration, and Poverty

Poverty and Its Effect on Family Well-Being

Structural Patriarchy and Racism

Policies and Community Context That Impact Family Health

Conclusion

Discussion Questions

Additional Resources

References

CHAPTER 4 An Overview of Maternal and Child Health History: A Political Determinants of Health Perspective

Introduction

MCH History Milestones

The 19th Century: A “Pre-MCH” Era

20th-Century Attention to MCH Issues

Title V of the Social Security Act of 1935

The 1960s: A Time of Significant Growth for MCH Programs

Changes to Foundational MCH Policies

Equity in MCH History

Advancing Health Equity: Past, Present, and Future

Defining Health Equity

Cultivating Health Equity

The Political Determinants of Health

Political Determinants of Maternal Mortality: Illustrations

An Example from Florida

Jessica’s Story: A Case Study

Conclusion

Discussion Questions

Additional Resources

References

CHAPTER 5 Women’s Health

Introduction

The Complex History of Women’s Health in the U.S.

The 18th and 19th Centuries

The 20th Century

The Early 21st Century

Women’s Health over the Life Course

Life Expectancy and Leading Causes of Death

Heart Disease

Cancer

Obesity and Cardiovascular Disease Risk in Women

Obesity

Cardiovascular Disease Risk

Adverse Pregnancy Outcomes: Implications for Women’s Cardiovascular Health

Health Concerns of Adolescents and Young Adults

Health Disparities: The Salience of Both Gender and Race

Unique Health Needs of Women

Sexually Transmitted Infections

Mental Health and Substance Use

Human Sex Trafficking and Sex Work

Violence Against Women

Women’s Health Care in the U.S.

The Health Care “System”

General Medical Care

Reproductive Health Care

Preventive Health Care

Financing Women’s Health Care

Data Sources for Women’s Health

Innovations in Health Care

Conclusion

Additional Resources

Discussion Questions

References

CHAPTER 6 Family Planning and Maternal and Child Health

Introduction

Reproductive Justice

Background

Family Planning and Public Health: A Complicated History

Structural Violence and Barriers to Health Equity

Pregnancy Planning and Unintended Pregnancy

Fertility in the U.S.

An Introduction to Unintended Pregnancy

Unintended Pregnancy in the U.S.

Barriers to Pregnancy Planning

Practice Considerations

Birth Control Methods

Definitions

Overview of Birth Control Use

Birth Control Options

Choice of Birth Control Method

Contraceptive Counseling

Special Considerations for Contraception

Gender and Contraception

Gaps in Scientific Evidence

Contraceptive Access

Abortion

What Is Abortion?

Abortion Trends in the U.S.

Types of Abortion in the U.S.

Medication Abortion

Aspiration Abortion

Other Methods

Long-Term Health and Safety

Future Fertility and Pregnancy Outcomes

Breast Cancer Risk

Mental Health

Barriers to Abortion Access

Infertility

Infertility as a Public Health Issue

Prevention

Infertility Treatment

Insurance Coverage for Infertility Treatment

Health Inequities and Infertility

Family Planning Policy: Current Issues and Debates

Title X

Medicaid

Affordable Care Act

Abortion Policy

Federal Level

State Level

Rise in Religious Health Care

Conclusion

Discussion Questions

Additional Resources

References

CHAPTER 7 The Reproductive and Perinatal Health of Women, Pregnant Persons, and Infants

Introduction

Key Reproductive and Perinatal Outcomes: Definitions, Point Estimates, and Trends

Low Birth Weight: Being Born Small, Being Born Early

Fetal Growth

Gestational Age

Fetal Death

Infant Death

Perinatal Mortality

Birth Defects

Maternal Morbidity and Mortality

Programs, Services, Policies, and Systemic Change to Improve the Health of Women, Pregnant Persons, and Infants

Strategies for Improving Women’s Health Prior to and Between Pregnancies

Reproductive Care

Preconception/Interconception/Well-Woman Care

Strategies for Improving Women’s and Infants’ Health During Pregnancy and Labor and Delivery

Access to, Utilization, and the Content of Quality Prenatal Care

Measurement of Prenatal Care

Barriers to Prenatal Care and Disparities in Prenatal Care Utilization

Content and Quality of Prenatal Care

Strategies/Approaches to Improving the Delivery of Prenatal Care

Maternal Health Care Providers, Childbirth Experiences, and Outcomes

Strategies for Improving Women’s and Infant’s Health After Delivery and During the Postpartum Period

Strategies to Protect and Promote the Health of the Infant After Delivery

Strategies to Protect and Promote the Health of the Pregnant Person/Woman After Delivery

Providing Supports for Women/Persons and Families at the Individual and System Levels Across the Prenatal and Postpartum Periods

Emerging Issues and Approaches in Reproductive and Perinatal Health

Substance Use During Pregnancy and Postpartum

Protecting Women’s/Pregnant Persons and Infants’ Health During Disasters and Emergencies

Justice-Involved Women

A Focus on Fathers

Centering Women’s/Pregnant Persons, Voices in the Struggle for Reproductive Justice

Conclusion

Summary of Key Points

Recommendations

Discussion Questions

Additional Resources

References

CHAPTER 8 Toddlers and Preschool-Age Children

Introduction

The Toddler/Preschool-Age Child

Demographics

Health and Well-Being

Overall Health Status of Toddlers and Preschoolers

General Health Status

Well-Child Visits

Vaccinations

Physical Health

Obesity

Allergies

Oral Health

Mental Health/Socioemotional Development

Developmental Delay and Disability

Injuries

Toxic Stress

Drivers of Health Status

Families

Childcare

Health Insurance

Poverty

Emerging Issues

Bullying

Screen Time

Sleep

Conclusion

Discussion Questions

Additional Resources

References

CHAPTER 9 School-Age Children

Introduction

Family Structure

Impact of Family Structure on Children

Special Populations of Children

Children Who Live in Poverty

Children Who Experience Abuse and Neglect

Children Who Are in Immigrant and Migrant Families

Children with Adverse Experiences

Children with Autism and Neurodiversity

School-Related Issues

School Readiness and Transition into Kindergarten

Physical Health and Motor Development

Social and Emotional Learning

Approaches to Learning

Language and Cognitive Development

Community Roles

Learning Differences

Bullying

Behavioral Challenges

School Shootings/Gun Violence Prevention

Key Health and Mental Health Issues

Vaccines

Overweight/Obesity

Body Image/Eating Disorders

Attention-Deficit/Hyperactivity Disorder

Anxiety and Mood Issues

Emerging and Important Considerations

Electronic Devices and Social Media

Vaping

Transgender and Gender-Diverse Youth

Sexuality, Sexual Exploration, and Sexual Orientation

Conclusion

Discussion Questions

Additional Resources

References

CHAPTER 10 Adolescent Health

Introduction

Historical Changes In Views of Adolescence

Demographics of Adolescence

What Is Adolescence Today?

Who Are Adolescents?

Adolescent Health Status

Data Sources for Adolescent Health

What Influences Adolescent Health?

Primary Contributors to Adolescent Mortality and Morbidity

Mortality

Violence

Substance Use

Sexuality, Contraception, Fertility, and Sexually Transmitted Infections

Mental Health and Suicide

Obesity, Nutrition, and Physical Activity

Chronic Conditions and Disabilities

A Developmental Systems Perspective on Adolescence

Puberty and Biological Development

Cognitive Development and Decision Making

Impulsivity, Sensation-Seeking, and Risk-Taking During Adolescence

The Neurologic Basis of Changes in Adolescent Decision Making

Social Development

Environmental and Contextual Influences on Adolescent Health and Development

Schools

Neighborhood and Community

Legal Systems

Media and Technology

Improving Adolescent Health

Education

Neighborhoods

Health Care

Legal Systems

Agencies and Public Health Programs Focused on Adolescents

Maternal and Child Health Bureau (MCHB)

Division of Adolescent and School Health (DASH)

Teen Pregnancy Prevention Programs

Future Directions

Key Points

Discussion Questions

Additional Resources

References

CHAPTER 11 Children and Youth with Special Health Care Needs

Introduction

National Survey of Children with Special Health Care Needs

Social Determinants of Health

Minoritized CYSHCN

Evolution of Public Policy for CYSHCN

Unique Needs of CYSHCN and Their Families

Life Course Approach to CYSHCN

Mental Health

Health Care Financing for CYSHCN

Medicaid and CHIP

Family-Centered Programs and Strategies to Improve Outcomes

Medical Home/Family-Centered Care

Parents as Partners in Health Care

Family-to-Family Support During the Diagnostic Odyssey

Care Coordination

Educational Supports

Transition Planning for CYSHCN

Conclusion

Discussion Questions

Additional Resources

References

CHAPTER 12 Environmental Health

Introduction

Structural Racism Determines Environmental Exposures and Health Outcomes

Inequities in Health Outcomes

Structural Racism

Inequities in Environmental Exposures

The Environmental Justice Movement

Role of the MCH Professional

Environmental Exposures Across the Life Span

The Chemical, Biological, and Physical Environment Influences Health

Global Climate Change

Epidemics of Environmental Illness

Major Chemical Agents of Concern for Health

Tobacco and Nicotine

Outdoor Air Pollutants

Carbon Monoxide

Lead

Mercury

Arsenic

Pesticides

Persistent Organic Pollutants

Phthalates

Major Biological Agents of Concern for Health

Molds and Mycotoxins

Trichothecene Mycotoxins

Major Physical Agents of Concern for Health

Radiation

Prevention

Primordial Prevention

Regulation of Environmental Chemicals

Case Studies

Lessons from the Case Studies of Environmental Regulation

Role of the MCH Professional

Primary Prevention

Secondary Prevention

Tertiary Prevention

Research

Collaboration with National and International Organizations

Conclusion

Discussion Questions

Additional Resources

Acknowledgments

References

CHAPTER 13 Maternal, Child, and Family Nutrition

Introduction

Malnutrition in the U.S.

Hunger, Undernutrition, and Food Insecurity

Prevalence

Recent Trends and Current State of Food Insecurity

Impact on Growth, Development, and Health

Overnutrition

Public Health Nutrition Guidelines

2020 Dietary Guidelines for Population Health

Nutrition Recommendations for MCH Populations

Maternal Nutrition

Weight Gain During Pregnancy

Nutrition During Pregnancy

Nutrition During Lactation

Breastfeeding

Baby-Friendly Hospital Initiative

Barriers to Breastfeeding

Donor Human Milk

Complementary Feeding

Recommendations and Adherence

Dietary Guidelines for Children Younger Than 2 Years

Feeding Styles and Approaches

Child Nutrition

Public Health Nutrition Programs

Supplemental Nutrition Assistance Program

Special Supplemental Nutrition Program for Women, Infants, and Children

School Nutrition Programs

Conclusion and Recommendations

Discussion Questions

Additional Resources

References

CHAPTER 14 Women, Children, and Family Oral Health

Introduction

Theoretical Perspectives on Oral Health of Women, Children, and Families

Life Course Perspective

The Social-Ecological Model

Maternal–Child Oral Health

Preconception and Pregnancy

Childhood and Adolescence

Population-Based Strategies

Barriers to Oral Health Care

Moving Forward: Future Directions for MCH Oral Health

Conclusion

Discussion Questions

Additional Resources

References

CHAPTER 15 Child and Family Mental Health

Introduction

Mental Illness Is Very Common

Prevalence of Mental Health Conditions in Children

Treatment Gap: Most Youth with Psychiatric Disorders Are Untreated

Child and Adolescent Mental Health: Disparities in Treatment Access and Quality

Untreated Trauma Leads to Negative Social and Health Outcomes

Child Mental Health Policy Through A Public Policy Lens

Women’s Mental Health: Priorities and Challenges

Family-Centered Care

Using Science to Inform Child and Family Mental Health Policy

Accountable Care and Health Care Reform

Integrated Care: Outcomes and Opportunities

Policies in Action: Monitoring Outcomes

Discussion Questions

Additional Resources

References

CHAPTER 16 Global Maternal and Child Health

Introduction

Defining Global Health

Demographic, Epidemiologic, Nutritional, and Obstetric Transitions

Persistent Inequalities and Disparities

International Organizations

Sustainable Development Goals

Measuring Maternal and Child Health

Health Indicators

Data Sources

Measurements

Maternal Mortality

Blood Loss

Birth Weight and Gestational Age

Child Growth

Rapid Diagnostic Tests

Prenatal Clinics: Sentinel Community HIV/AIDS Monitoring

Evaluating MCH Interventions

An Evidence-Based Approach

Implementation Trials

Global Collaborations

Conclusion

Discussion Questions

Additional Resources

References

CHAPTER 17 Research Methods

Introduction

Current MCH Research Priorities

Translating Key MCH Concepts into Measurable Constructs

Assessing Maternal, Women’s, and Child Health at the Population Level

Evaluating the Effects of Policies on the Health of Children and Families

Health Equity

International Issues

Fundamental Concepts of Science and Research

Ethics and Scientific Integrity

Measurement, Order, and Classification

Validity and Reliability of Measurement

Causality, Association, and Chance

Building Blocks of Research

Theories, Hypotheses, and Operational Definitions

Conceptual Models and Hypotheses

Directed Acyclic Graphs

Research Approaches

Quantitative Studies

Qualitative Studies

Mixed-Methods Studies

Study Design

Nonexperimental Designs

Experimental Designs

Health Services Research and Evaluation

Multilevel Models

Data for Research

Types and Sources

Data Visualization and Communication Tools

Geographic Information Systems

Dissemination and Implementation of Research

Conclusion

Discussion Questions

Additional Resources

References

CHAPTER 18 Assessment and Program Planning

Introduction

Overview of Key Program Planning Components

Understanding the Broader Context

Literature Review

Reviewing the Program and Policy Landscape

Reviewing the Secondary Data

Community Assessment

Purpose

Partners

Process

Connecting Needs Assessment to Program Design

Program Design

Models for Program Design

Intervention Development and Implementation

Implementation Science

Evaluation and Continuous Quality Improvement

Summary

Discussion Questions

Additional Resources

References

CHAPTER 19 Program Monitoring and Evaluation

Introduction

Context for the Practice of MCH Monitoring and Evaluation

Questions That Can Be Answered by M&E

Public Health Approach to M&E Steps 1–4

Public Health Approach to M&E Steps 5–6

Public Health Approach to M&E Step 7

Public Health Approach to M&E Step 8

Indicators and Their Use in M&E

Data Sources for Monitoring and Evaluation

Quantitative Data

Qualitative Data

Specific Data Sources

Health Systems Data

Population-Based Surveys

Study Designs for Evaluating MCH Program Success

Randomized Experiments

Quasi-experimental Designs

Non-experimental Designs

Choosing and Implementing an Evaluation Design

The Importance of Engaging Stakeholders

Monitoring and Evaluation Guidelines

Conclusion

Discussion Questions

Additional Resources

References

Appendix A Useful Resources for Program Monitoring and Evaluation

Online Resources for MCH Evaluation

General Monitoring and Evaluation Online Resources

Textbooks

Participatory and Empowerment Focused

Sampling Resources

Appendix B MCH HRSA Grant Application Workplan Example

Appendix C Generic Evaluation MCH Training Report Outline

Appendix D Example of SDOH Public Health Program Logic Model

Appendix E Theory of Change MCH Program

CHAPTER 20 Medicaid and CHIP Coverage for Women and Children: Politics and Policy

Introduction

Medicaid and Medicare

From Medicare to Medicaid: Medicaid Policy for Pregnant Women and Children, 1965–1976

From CHAP to CHIP: Medicaid Policy for Pregnant Women and Children, 1977–1997

Medicaid Policy and Program Change in the 1990s

Medicaid-CHIP Coverage for Children with Special Health Care Needs and Disabilities

Medicaid and the Affordable Care Act Era

The Impact and Legacies of Medicaid Policy Change

Structural Changes

Social Learning and Block Grants

The Legacies of CHIP

Medicaid’s Comprehensive Child Health Benefit: Epsdt

The Uniquely Child-Focused and Preventive Purposes of EPSDT

The Origins of EPSDT in the War on Poverty

The Ongoing Failure to Implement EPSDT

The Role of Medicaid and CHIP in Health Coverage for Children

Trends in Public and Private Health Coverage for the MCH Population

Medicaid as a Program to Advance Equity

Conclusion and Opportunities Ahead

Discussion Questions

Acknowledgments

References

CHAPTER 21 Advocacy and Policy Development

Introduction

Levels of Advocacy

Why Is Advocacy Important in Maternal and Child Health?

Who Are Advocates?

Where Are Advocacy Efforts Directed?

How Is Advocacy Conducted?

How Does Advocacy Relate to the Policy Development Process?

Conclusion

Discussion Questions

Additional Resources

References

CHAPTER 22 Leadership in Maternal and Child Health

Introduction

The MCH Leadership Challenge

What’s Happening Now?

What Must Be Different?

A Focus on Antiracism and Equity

A Broader Perspective on Partnership

Community Engagement

Nontraditional Partners

Workforce

Characteristics of New Leaders

Visionary

Humble

Strategic

Reflective of Those Whom They Serve/Culturally Competent

Willing to Create a Culture of Learning

Willing to Make It Personal: Alignment of Purpose, Passion, and Position

Ready to Challenge the Status Quo

What Should the New World Order Look Like?

Discussion Questions

Additional Resources

References

Index