Maternal and child health journal
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Matern Child Health J · Apr 2014
Sex-specific effects of fetal exposure to the 1959-1961 Chinese famine on risk of adult hypertension.
Previous research is inconsistent about the effects of prenatal famine exposure on risk of adult hypertension. Follow-up of persons exposed to the 1959-1961 Chinese famine, the largest in human history, provides an opportunity to examine the long-term impact of prenatal famine exposure on adult cardiovascular disease (CVD). We investigated the effects of fetal-infant exposure to the famine on risk of hypertension in adulthood. ⋯ No statistically significant increases in mean BP or hypertension were seen among men. Exposure to famine during the fetal-infant period or early childhood has deleterious effects on adult health, but the effects may be greater for women. Gender-specific intervention strategies for CVD may be warranted for populations exposed to under-nutrition during critical time periods of fetal development.
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Matern Child Health J · Feb 2014
Wisconsin's Lifecourse Initiative for Healthy Families: application of the maternal and child health life course perspective through a regional funding initiative.
National experts are calling for more integrated approaches such as the life course perspective to reduce health disparities and achieve greater health equity. The translation and application of the life course perspective is therefore of great interest to public health planners, policy makers and funders to promote community-wide improvements in maternal and child health. However, few organizations have applied the life course perspective in designing strategic funding initiatives. ⋯ The Twelve-point plan to close the black-white gap in birth outcomes provided the framework for the planning process. Despite the conceptual challenges, the life course perspective was embraced by the collaboratives, challenged community assumptions on the root causes of poor birth outcomes and provided a unifying funding construct for organizing and planning complementary individual-level interventions with social and physical environmental change strategies. These integrated and complimentary approaches provide a long-term opportunity to address the persistent racial birth outcome disparity in Wisconsin.
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Matern Child Health J · Jan 2014
Symptoms associated with pregnancy complications along the Thai-Burma border: the role of conflict violence and intimate partner violence.
To assess the association between lifetime violence victimization and self-reported symptoms associated with pregnancy complications among women living in refugee camps along the Thai-Burma border. Cross-sectional survey of partnered women aged 15-49 years living in three refugee camps who reported a pregnancy that resulted in a live birth within the past 2 years with complete data (n = 337). Variables included the lifetime prevalence of any violence victimization, conflict victimization, intimate partner violence (IPV) victimization, self-reported symptoms of pregnancy complications, and demographic covariates. ⋯ However, lifetime IPV victimization was not associated with symptoms, after accounting for conflict victimization (aOR: 1.8; 95 % CI 0.4-9.0). Conflict victimization was strongly linked with heightened risk of self-reported symptoms associated with pregnancy complications among women in refugee camps along the Thai-Burma border. Future research and programs should consider the long-term impacts of conflict victimization in relation to maternal health to better meet the needs of refugee women.
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Matern Child Health J · Jan 2014
Effect of an integrated care system on utilization for CSHCN in Florida.
In 2006, Florida began a pilot program under a federal Medicaid waiver to reform its Medicaid program in Broward and Duval counties. The Children's Medical Services Network, a subcontracted health care delivery system for Florida's children with special health care needs (CSHCN) enrolled in public insurance programs, participated in Medicaid reform through an Integrated Care System (ICS) for its enrollees. The ICS constitutes a significant departure from the subcontracted fee-for-service system used to deliver care to CSHCN in the non-reform counties, and limited information exists about its impact. ⋯ Results suggest that managed care under the ICS has impacted utilization, most significantly for inpatient care. The ICS presents a viable model of managed care for CSHCN that could result in cost savings. Results should be interpreted with care because the full effects of the ICS implementation may take more time to materialize.
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Matern Child Health J · Jan 2014
Formative research to examine collaboration between special supplemental nutrition program for woman, infants, and children and head start programs.
Both the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Head Start/Early Head Start (HS/EHS) Programs serve low-income women and children at high risk for health disparities, yet they do not have a formal state-level partnership in Connecticut. Both programs serve children up to age five, yet children's participation in the WIC Program declines sharply after 2 years of age, limiting the potential benefits of cross-program participation. The goal of this study is to examine current and prospective collaboration efforts among the WIC and HS/EHS Programs in Connecticut and identify barriers to collaboration. ⋯ Staff from both programs strongly expressed interest in a cross-program collaboration (73 % of HS staff and 86 % of WIC staff). This research serves as a framework for how a state-level collaboration could be established in Connecticut, to enable these two programs to work together more efficiently and effectively for the benefit of mothers and children. Results can provide other State WIC Programs with a blueprint for collaborating with HS/EHS.