Gates Pledges $1.5b for Maternal & Child Health

The Bill & Melinda Gates Foundation has pledged $1.5 billion over 5 years to improve systems that will reduce maternal and newborn deaths and illness in the developing world. The announcement came yesterday during the Women Deliver conference.

I heard the story first on NPR  - you can access their brief interview with Melinda Gates here. But this story peppers papers from the Wall Street Journal to USA Today and has now made headlines on Politico and the Kaiser Family Foundation websites. Melinda Gates wrote her own article, 'A New Vision for the Health of Women & Children' in the Huffington Post.

The Gates Foundation sees this clearly as an area that requires public-private partnerships. In other words, they recognize that in the case of maternal & child health private organizations and nonprofits cannot have meaningful, sustainable change without the support of local and national governments.

Improving consistent access to contraceptives to prevent unwanted pregnancy clearly appears to be a major focus of the Foundation's efforts.

This investment is great news for the field of maternal and child health -- and will hopefully raise these issues to greater prominence both here in the US and abroad. In addition to raising awareness, effective use of $1.5 billion ought to have considerable impact on the health of women and children - and I hope to see and read about these improvements.

Task Force Releases Report on Childhood Obesity

To rollback childhood obesity in one generation.

Ambitious goal - to get the prevalence of childhood obesity down to 5% by 2030. No society has ever succeeded in undertaking such an enormous task - one that is complicated by deeply ingrained norms around diet and exercise, a well-financed commercial industry (not only fast/junk food, but also when it comes to diet and weight loss), and a general distrust of government-led initiatives.

The White House Task Force on Childhood Obesity released its report (commissioned by President Obama on February 9, 2010) and it combines the best evidence for tackling weight gain among our nation's kids.

It quickly lays out the facts: our children are fatter than ever and it is impacting their health.

Caution: Camel Orbs are NOT Kid Friendly

Photo from the HSPH website

Candy or tobacco? Do you think your child could tell the difference?

Harvard School of Public Health professor, Gregory Connolly, recently published an article in Pediatrics on the dangers of this Camel Orbs, a dissolvable nicotine tablet, widely available in the US.

(Click here for the news release)

Note: I looked up the Colbert Report segment that references Camel Orbs and embedded it below. I think Stephen Colbert is hilarious. Thanks, Kelsey for your comments!

 

The Colbert Report	Mon - Thurs 11:30pm / 10:30c
Cheating Death - Tobacco Mints, Breast Milk & Hallucinogens
www.colbertnation.com
Colbert Report Full Episodes Political Humor Fox News

Breastfeeding Saves Money, Saves Lives

Most parents enter labor expecting to breastfeed. Many are confronted with numerous challenges (some from the start, others as they go back to work) to continue breastfeeding throughout infancy.

A CNN news report highlights the challenges and public health importance of promoting and supporting new mothers in breastfeeding their baby throughout the first 6 months of their child's life.

This challenge makes me wonder how much of the problem is one of

• Biology - Moms physically aren't able to breastfeed their kids.
• Education - Moms don't know to breastfeed - exclusively - until their child reaches 6 months.
• Awareness - Moms don't know about the benefits/risk of breastfeeding - or not - on their child's health.
• Social - Relationships (partners, family members) and social norms interfere with moms' decision or ability to breastfeed.
• Structural/Political - Policies and structural factors like break time at work inhibit moms from being able to breastfeed or pump throughout the day.

As a quick aside: the new health care reform law makes it mandatory for employers to provide breaks to female workers who are lactating (i.e. breastfeeding). I expect that will begin to address some of the structural barriers mentioned above!

Let's Move! ...to Prevent Childhood Obesity

It's no surprise that childhood obesity is drawing more public attention than ever before. Evidence is growing on the ill-effects and complicated origins of childhood obesity, making inaction impossible both for public health programs and politicians.

We can prevent childhood obesity. And that's precisely what the White House initiative, Let's Move!, intends to do.

Teenage Pregnancy: A Cool Website

This semester I started working with a group of Harvard School of Public Health (HSPH) students on a student-run social media campaign. After some collaboration with the Center for Health Communication at HSPH we decided to pursue an online campaign that targets pregnant teenagers in the Boston area.

Why? Because teens who become pregnant are less likely to have a healthy pregnancy and less likely to see a doctor for prenatal care. Everything from diet, activity, stress, and support are critical to having a healthy pregnancy. A healthy pregnancy leads to a healthy birth, a health birth leads to a healthy infant, and a healthy infant leads to a healthy child. You get the idea...

More Children in the US Insured

Today President Obama signed a bill to expand health insurance coverage to more low-income children across the United States through the State Children's Health Insurance Program (or SCHIP for short). As the New York Times reports, seven times the House has voted on the bill since August 2007 and none of those times did the bill pass. The bill did not have the support of the former Bush administration.

Several major changes to SCHIP follow the passage of this bill:

1. States can opt to extend coverage to legal immigrant children without the 5-year delay (verification of citizenship status is necessary).
2. Dental coverage is mandated.
3. Equal coverage for both mental health and physical health issues ("mental health parity") is required.

A criticism of the bill is that low-income individuals will switch from private to public insurance as a result of this expansion -- putting unnecessary burden on the government and tax payer dollars. While this may happen in certain cases, there is absolutely a need to ensure access to health insurance for more children in the US. 

Current estimates are that nearly 9 million children remain uninsured (from a Kaiser Family Foundation report published last month). Insurance will likely help children get access to vaccinations, primary care services, dental care, and other disease care services that can improve their health into adolescence and adulthood. The next step is to make sure that eligible families are enrolled in the program so that these efforts reach the children who need them most.

Changes to WIC Nutrition Standards: Which State is Next?

Even if you have never received WIC assistance, you have most likely heard of the government program if you worked as a cashier in a grocery store. WIC is the name given to the government food program for low-income pregnant women and young mothers called the Special Supplemental Nutrition Program for Women, Infants, and Children. 

The program was created in 1974. It provides vouchers for foods considered to provide for the nutrition needs of nursing/pregnant women and their baby or infant under age 5.  For example, white bread, whole milk, and cheese are commonly bought WIC items. However, as nutrition science has evolved, those in the field of public health and policy realized that WIC was promoting many foods that were likely contributing to obesity and overweight. 

In 2005 the Institute of Medicine (IOM) and other agencies began writing reports on changes in dietary patterns among women using WIC, as well as changes in what is known to provide adequate nutritional benefits without creating other potential health problems  such as overweight, diabetes, digestive problems, etc. (As an aside, the recommendations of the IOM are in a book called WIC Food Packages that can be found here, but appallingly costs $36.  An 8-page brief report can be found in pdf, here.).

Numerous recommendations were given by the IOM committee including 

• increasing the vouchers for fresh fruits and vegetables
• reducing cheese vouchers from 4 lbs/month to 1 lb/month
• offering only whole grain breads, rice, and cereals to certain food packages
• allowing the purchase of jarred baby foods
• restricting the amount of juice that can be bought.
  

Nearly a full four years later (read January 2009), Delaware and New York have been among the first to adopt new WIC nutrition standards. New York, rather than using the IOM report standards, chose to adopt dietary guidelines set forth by the CDC. Among the changes for WIC recipients are ability to purchase whole grain breads and cereals, canned or dried beans, and jarred baby foods, as well as cash value checks for buying fresh fruits and vegetables. According to a Robert Wood Johnson Foundation announcement, WIC will begin changing its nutrition standards to align more closely with federal dietary recommendations in - RWJF says October 2010, but the Food and Nutrition Service website shows an implementation date of October 2009.

This is a great success for public health; it is a change that will affect millions of lives not just in the short term, but also in terms of long-term health outcomes. It is another example of persistence and hard work paying off. Now the question is -- how will States adopt the new standards? Will there be uniform change? And will there be regular evaluation and updating of nutrition standards, or will these last another 30-40 years?