MCH Alert

National Center for Education in Maternal and Child Health

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January 23, 2004

1. MCH Library Releases New Edition of Health Insurance and Access to Care Knowledge Path

2. Report Discusses Strategies to Improve Health in Persons with Primary Immunodeficiency Diseases

3. AAP Publishes Policy Statement on Soft Drinks in Schools

4. Working Paper Examines Effect of Maternal Leave on Maternal Health

5. Authors Compare BMI and Overweight in Adolescents in 15 Countries



The new edition of the Child and Adolescent Health Insurance and Access to Care knowledge path is an electronic guide on recent, high-quality resources and information tools, many with an emphasis on families with low incomes and the State Children's Health Insurance Program. Produced by the MCH Library, the knowledge path includes information on (and links to) Web sites and electronic publications, journal articles, databases, and electronic newsletters. It is intended for use by health professionals, program administrators, educators, researchers, and parents who are interested in tracking timely information on this topic. The knowledge path is available at

MCH Library knowledge paths on other maternal and child health topics are available at The MCH Library welcomes feedback on the usefulness and value of these knowledge paths. A feedback form is available at



Applying Public Health Strategies to Primary Immunodeficiency Diseases: A Potential Approach to Genetic Disorders presents a framework for future action to improve health outcomes among persons with primary immunodeficiency (PI) diseases and other genetic disorders. As part of efforts to highlight the emerging role of human genomics in the practice of public health in the United States, the Centers for Disease Control and Prevention, in collaboration with research, academic, clinical, and foundation partners, evaluated public health strategies that can be used to close the gap between gene discoveries and clinical practice. The report presents recommendations for action for four components of the public health framework as they relate to PI diseases, including public health assessment, population-based interventions (e.g., newborn screening), evaluation of screening and diagnostic tools, and communication. The report is intended for use by policymakers and health professionals in evaluating methods to increase recognition of PI diseases and other genetic disorders. It is available at or



"School officials and parents need to become well informed about the health implications of vended drinks in school before making a decision about student access to them," state the authors of an American Academy of Pediatrics (AAP) policy statement published in the January 2004 issue of Pediatrics. The authors note that decisions about which foods will be sold in schools is often made by school-district business officers alone rather than with input from local health professionals. The policy statement is intended to inform pediatricians and other health professionals, parents, superintendents, and school board members about nutritional concerns related to soft drink consumption in schools. The policy statement presents background and information and provides recommendations.

The authors cite the following health problems associated with high intake of sweetened drinks: (1) overweight or obesity attributable to additional calories in the diet; (2) displacement of milk consumption, resulting in calcium deficiency with an attendant risk of osteoporosis and fractures; and (3) dental caries and potential enamel erosion.

To safeguard against health problems as a result of overconsumption, AAP recommends that

AAP also recommends that

The authors state that "using optimal nutrition standards to create a model district-wide school nutrition policy . . . is not yet a routine practice in most states." They conclude that "the discussion engendered by the creation of such a policy would be an important first step in establishing an ideal nutrition environment for students."

American Academy of Pediatrics, Committee on School Health. 2004. Soft drinks in schools. Pediatrics 113(1):152-154.



"In sum, the findings suggest that longer maternal leave after childbirth may have lasting benefits for maternal mental health," state the authors of a working paper published by the National Bureau of Economic Research. The paper investigates how the length of maternal leave affects maternal health in a sample of mothers who returned to work after childbirth.

The study sample was drawn from the National Maternal and Infant Health Survey of 1988 and included 1,762 women ages 18 and older who returned to work within 6 months after the birth of their child. The authors examined the impact of the timing of returning to work on two aspects of maternal health: mental health as measured by a widely used screening tool for depression, and overall health as measured by whether the mother had at least three outpatient visits for any health problems during the 6 months after childbirth.

The authors found that

The authors conclude that "these findings contribute to the growing literature on maternal leave policy, which primarily focuses on the benefits of leave for infant health and development, by demonstrating that longer maternal leave also may have benefits for the health of mothers."

Chatterji P, Markowitz S. 2004. Does the length of maternity leave affect maternal health? Working Paper 10206. Cambridge, MA: National Bureau of Economic Research. Available at or



"The first main finding was the strong contrast between countries, with the highest prevalence of BMI [body mass index] at or above the 85th and 95th percentiles (overweight) being seen in the United States and the lowest in Lithuania," write the authors of an article published in the January 2004 issue of Archives of Pediatric and Adolescent Medicine. The authors suggest that since overweight and obesity -- considered a major public health threat -- have increased globally among children, adolescents, and adults, it is important to monitor overweight in adolescence. The aims of this article are to (1) determine and compare country-specific BMI at or above the 85th and 95th percentiles based on self-reported pooled data from adolescents across 15 countries and (2) estimate the prevalence of BMI at or above the 85th percentile and 95th percentile (overweight) in adolescents across countries. The authors established reference standards (BMIs at or above the 85th percentile and the 95th percentile for boys and girls ages 13.5 and 15.5). Any BMIs higher than these reference standards were considered "increased."

The analysis is based on nationally representative, cross-sectional 1997-1998 school-year surveys of 29,242 adolescents (ages 13-15) in Europe, Israel, and the United States.

The authors found that

The authors conclude that "since most obese adolescents remain obese as adults, this age group is a very important group to reach through preventive programs addressing issues of diet and sedentary lifestyles."

Lissau I, Overpeck MD, Ruan J, et al. 2004. Body mass index and overweight in adolescents in 13 European countries, Israel, and the United States. Archives of Pediatric and Adolescent Medicine 158(1):27-33.


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MCH Alert © 2003 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
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