HJBR Jan/Feb 2022

HEALTHCARE JOURNAL OF BATON ROUGE  I  JAN / FEB 2022 55 Stewart T. Gordon, MD, FAAP Chief Medical Officer, Medical Affairs Louisiana Healthcare Connections Today, the absolute best way to help chil- dren — throughout the course of their life — is by helping their mothers, by focusing on pregnant women as well as women of child-bearing age. Pre-emptive targeting breaks with the pound of cure approach that steers resources to the sick but is a smarter investment because it increases lasting impact through more cost-effective interventions. n REFERENCES 1 Paul, Annie Murphy. Origins: How the Nine Months Before Birth Shape the Rest of Our Lives. New York: Free Press, 2011. 2 Almond, D. and Currie, J. “Killing Me Softly: The Fetal Origins Hypothesis.” National Center for Biotechnology Information. Summer 2011. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4140221/ 3 Katon, J.; Lewis, C.; Seervai, S.; Zephyrin, L. “Community-Based Models to Improve Maternal Health Outcomes and Promote Health Equity.” Commonwealth Fund, March 4, 2021. https:// www.commonwealthfund.org/publications/ issue-briefs/2021/mar/community-models-im- prove-maternal-outcomes-equity 4 Artiga, S.; Orgera, K.; Pham, O.; Ranji, U. “Ra- cial Disparities in Maternal and Infant Health: An Overview.” Kaiser Family Foundation. Nov. 2020. https://www.kff.org/report-section/racial-dispar- ities-in-maternal-and-infant-health-an-overview- issue-brief/ 5 “HHS Announces $350 Million to Strengthen Maternal and Child Health Across the Nation.” U.S. Department of Health and Human Services. Press release, Sept. 17, 2020. https://www.hhs . gov/about/news/2021/09/17/hhs-announc- es-350-million-to-strengthen-maternal-child- health-across-the-nation.html In September of 2021, the U.S. Depart- ment of Health and Human Services (HHS) announced nearly $350 million in awards to every state across the country for the support of safe pregnancies and healthy babies. Funding will expand home visiting services to families most in need, increase access to doulas, address health disparities in infant deaths and improve data report- ing on maternal mortality. Louisiana re- ceived $10,381,042 through the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program. MIECHV supports pregnant women and parents with young children who live in communities that face greater risks and barriers to achieving pos- itive maternal and child health outcomes. Families choose to participate in home visiting programs and partner with health, social service and child development pro- fessionals to set and achieve goals that im- prove their health and overall well-being. 5 The program seeks to: • Improve maternal and child health. • Prevent child abuse and neglect. • Reduce crime and domestic violence. • Increase family education level and earning potential. • Promote children’s development and readiness to participate in school. • Connect families to needed communi- ty resources and supports. THE SHORT-TERM — AND LONG-TERM — BENEFITS OF MATERNAL HEALTH With nearly 17.4 deaths for every 100,000 live births, and despite a profoundly higher investment in maternity care, the U.S. has one of the highest rates of maternal mortal- ity among high-income countries. Worse, risks for maternal mortality are dispropor- tionately higher among Black women, who have a pregnancy-related mortality ratio of more than double that of white women, re- gardless of their education level. 3 Among clinicians and policymakers, there is a concerted focus on reducing rates of disparities in preterm birth and low birthweight as well as on eliminating racial disparities. Recognition of maternal health disparities has prompted efforts from clin- ical groups and public health officials to better understand and address their biases, practice shared decision making, as well as listen to and act on the concerns of preg- nant and postpartum patients, particularly in urgent situations. In addition, a number of initiatives are underway through Medic- aid to improve maternal and infant health and reduce disparities given the substantial role the program plays in covering low-in- come children and pregnant women — par- ticularly, low-income children and preg- nant women of color. 4