HJBR May/Jun 2023

PUBLIC HEALTH AND MEDICINE 26 MAY / JUN 2023 I  HEALTHCARE JOURNAL OF BATON ROUGE doing social needs screenings in commu- nities that have lower incomes and link- ing these community members to services — intervening early with trusted members with community resources. Focusing on a few other CDC programs, SET-NET or Surveillance for Emerging Threats to Mothers and Babies was started during Zika. I think Zika was one of those many diseases that really caught us all by surprise because as we kept learning more and more about it, there were so many more things we didn’t learn like being sexually transmitted, having congenital defects, all these things. It was a very complex dis- ease. So, we set up this network to moni- tor throughout pregnancy and then early childhood. But when we did this, we realized there were some areas of the country that certainly were experiencing more of this. So, we included field staff in those areas to help collect the data but also educate the com- munity about risks, how to protect yourself, and what to look for. And I don’t know if it’s that I’m an ER doc or in public health, but I think in both, you learn to be versatile. And so, when COVID hit, we were able to use this system to do the same thing to monitor exposures. We looked at COVID during pregnancy and were able to use this to inform clinical changes — things like if a mom had COVID 14 days prior to delivery, they were less likely to have the infant room-in with them and then had breastfeeding difficulties. They needed lactation services. Thinking about that early on to address it. We also saw that if you had COVID in your second or third trimester, you were about four times more likely to have a preterm delivery than those with a mild infection. Really, really stress- ing the importance of COVID vaccination in pregnancy, which was one of the under- vaccinated populations that we were seeing. Just last week, we released our new dashboard on maternal mortality. One of the things we’re trying to do is much more provisional data so that it’s more timely. Unfortunately, we’re seeing that disparities are still occurring, and maternal mortality is still a significant issue in the U.S. About 700 moms die a year in the U.S. We are work- ing with state teams, called “perinatal qual- ity collaboratives,” in about 39 states now — working with nurses, physicians, health- care systems — to identify how you can have more quality care and each group identi- fies different initiatives that they can focus on. One example in New England was they looked at both opioid use disorder and also breastfeeding and they found that they were able to increase counseling by 20% as well as naloxone use and distribution by about 25% in these groups. And then the “Hear Her” campaign, for me, was pretty personal. I lost one of my staff a few years ago. She was a brilliant, up-and-coming African American PhD — a scientist that worked for me. She died a few weeks after giving birth, and she fit all of those warning signs. She’d been to the hospital, she’d been back, she was having complications. And when you look at the data, race is what’s driving a lot of this. You separate socioeconomics ... Shalon, was well-educated. She had a good social sup- port system, but she died. So, we’re trying to do more of these Hear Her campaigns to, when you have these warning signs, get clinicians to really listen and for women to feel empowered to say, “I’m having these symptoms.”We need muchmore awareness of what’s going on because, again, mater- nal mortality for our country is a stagger- ing number of deaths that we should be preventing. And, I promise there’s happy stuff at the end; I don’t want to appear unoptimistic about all of this. Climate and health is one of those things Image 2 More Information: CDC Vital Signs: Adverse Childhood Experiences (ACEs). https://www.cdc.gov/vitalsigns/aces/index.html