To help rural America, policymakers must first understand it
America's future depends on the health of mothers and their kids
Each year, more than 22,000 infants die in this country - one about every 24 minutes - and the rate for black babies is more than two times greater than the rate for white babies. I became a pediatrician because I wanted to help babies and improve each of their chances at life.
I started that journey in July 2003 as a brand new intern in the middle of the neonatal intensive care unit at Vanderbilt University Medical Center, surrounded by the tiniest of babies attached to all sorts of tubes and machines.
I studied each baby's ventilator settings, fluid rates and medication dosages, preparing for the questions I'd get on daily rounds. What I wasn't expecting was the question an attending physician posed to me: "But Michael, why was this baby born prematurely?"
This wise teacher reminded me not to overlook the health of mothers. A mother's health, not only during her pregnancy but also before, can directly influence the outcomes of that pregnancy, including prematurity and low birth weight, which are two of the leading causes of death among infants in America. But it's not just babies who are dying.
The CDC recently noted that approximately 700 women die each year in America from pregnancy-related causes; black women are three times more likely than white women to die from pregnancy-related causes. These numbers have recently been on the rise in America.
As a pediatrician, I couldn't just pass off the health of a baby's mom to her obstetrician, internist, or family physician (the "adult docs"). I had a responsibility to keep today's young girls as healthy as possible so they would become healthy mothers. Giving girls and their future families the best shot at health today could help prevent both infant and maternal deaths down the line.
Fast forward 16 years and I'm continuing this work as I lead the Maternal and Child Health Bureau (MCHB) in the Health Resources and Services Administration within the Federal Government.
We partner with state public health agencies, academic institutions, community agencies and others in the federal government such as the Administration for Children and Families, the Centers for Disease Control and Prevention and the National Institutes of Health, on initiatives like evidence-based home visiting, maternal mortality review committees and safe sleep campaigns. These and other efforts across the administration aim to improve health outcomes for women before, during and after pregnancy.
MCHB's largest investment is the Title V Maternal and Child Health Block Grant Program, the oldest federal-state partnership. Combined with state investments, the MCH Block Grant promotes the access and quality of public health services for women and children in this country.
In 2017, Title V funds supported health care and public health services for 56 million people nationwide, including 86 percent of all pregnant women, 99 percent of infants and 55 percent of children, including children with special health-care needs, according to the Title V Information System state annual Block Grant reports.
Last year, our Maternal, Infant, and Early Childhood Home Visiting Program supported more than 150,000 parents and children, particularly those who are considered at-risk. Home visits provide these families with the necessary resources and skills to raise children who are physically, socially and emotionally healthy.
Through our Healthy Start program, we provide a wide range of services for women, children and families, including parenting and breastfeeding support, linkage to social services, case management, screening and counseling for tobacco and other drug use and child development education.
Colleagues across the administration have been investing in maternal and child health, too, from testing new models of treatment for women and babies suffering from the opioid crisis (the MOM model) to expanding access to Medicaid for new mothers. These and other programs have allowed us to make tremendous progress in helping mothers and reducing infant mortality.
As a pediatrician, I still want to save babies. And as we look at the high rates of maternal morbidity and mortality in this country, especially as we celebrate National Women's Health Week, I'm reminded again that we must also continue to focus on saving their mothers.
America's future depends on the health of mothers and their children. Not only do we want more babies to reach their first birthday, we want their mothers to be there to celebrate with them. Promoting health across a woman's life course gives us the best opportunity to do that.
Michael D. Warren M.D. M.P.H. is the associate administrator of the Maternal and Child Health Bureau of the Health Resources and Services Administration, part of the United States Department of Health and Human Services.