MCH Alert


National Center for Education in Maternal and Child Health

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September 3, 2004

1. Maternal and Child Health Bureau to Sponsor Series of Webcasts for MCH Community
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 Provision
5. Authors Compare Access to and Use of Preventive Health Services by Hispanic Women

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1.MATERNAL AND CHILD HEALTH BUREAU TO SPONSOR SERIES OF WEBCASTS FOR MCH COMMUNITY

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 http://www.mchcom.com. 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 http://www.mchcom.com.

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2. NATIONAL INSTITUTES OF HEALTH FINALIZES OBESITY RESEARCH AGENDA

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 http://obesityresearch.nih.gov/About/strategic-plan.htm.

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3. NEW CHILD HEALTH SURVEY TO PROVIDE NATIONAL AND STATE DATA

"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 article.

Purpose
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 8(3):183-188.

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.

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4. ANALYSIS EXAMINES THE IMPACT OF CHANGING URBAN GEOGRAPHY AND SERVICE PROVISION

"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 areas.

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 areas.

* 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 http://www.brookings.edu/metro/pubs/20040816_allard.htm or http://www.brookings.edu/metro/pubs/20040816_allard.pdf.

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5. AUTHORS COMPARE ACCESS TO AND USE OF PREVENTIVE HEALTH SERVICES BY HISPANIC WOMEN

"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 13(6):654-661.

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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 mchalert@ncemch.org.

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

EDITORS: Jolene Bertness, Tracy Lopez
COPYEDITOR: Ruth Barzel

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 20007-2292
Phone: (202) 784-9770
Fax: (202) 784-9777
E-mail: mchalert@ncemch.org
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