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How Childhood Experiences Shape Our Nation's Health

Mar 12, 2015, 3:36 PM, Posted by Kristin Schubert

New findings strongly suggest that Americans are ready for new approaches to address early childhood trauma and stress. To do that in a big way, we need more than science—we need a movement.

I remember when I first learned about research showing that what happens to a person as a child impacts their health later in life. It was 2007, and I was pregnant with my first child. My boss and mentor, Jim Marks, brought the Adverse Childhood Experience’s (ACE) study to my attention. The Centers for Disease Control and Kaiser Permanente had surveyed 17,000 Kaiser members about their childhood experiences and compared the answers to those members’ medical records.

The ACE researchers found that the more trauma and stress you experienced as a child, the more likely you were to have cancer, heart disease, and diabetes as an adult. The more likely you were to suffer from chronic depression, be addicted to drugs and alcohol, or attempt suicide. And the more likely you were to drop out of school, be incarcerated, or chronically unemployed.

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Go Back to Basics, Go Back to Schools

Jan 23, 2015, 9:00 AM, Posted by Katherine Vickery

Erin Maughan
Health Care in 2015 logo

If we want to create a Culture of Health in America, a 2015 priority must be to focus on ways to break down the barriers that separate us and keep us from being as effective and efficient as possible. Currently, health care systems, education, housing, and public health work in siloes; they are funded in siloes, and workers are trained in siloes. Yet, people’s concerns and lives are not siloed and a community health culture/system cannot be either.  One of the places to begin coordinated cultural change is in schools.

Schools are a smart choice to target because nearly 98 percent of school-age children, in their formative years, attend school and schools provide access to families and neighborhood communities. The Department of Education’s Full-Service Community Schools Program and Whole School, Whole Child, Whole Community Initiative reminds us that, in order for children to be educated, they need to be healthy and there must be a connection between school and community.

There are many school health initiatives in place, such as healthy food choices, physical fitness, healthy policies, school health services, community support, and after-school programs. The potential is there—but so are the siloes. But when schools are appropriately staffed with school nurses, the nurses help break down the siloes; that is because school nurses are extensions of health care, education, and public health and thus can provide or coordinate efforts to ensure a holistic, resource efficient, healthy school community.

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Every Child Counts: Stopping Infant Loss

Nov 13, 2014, 3:08 PM, Posted by Sheree Crute

mother with son on her lap

“Matthew was born big and healthy, just under eight pounds,” Carol Jordan says.

That’s why it was such a shock to her to lose him on an otherwise average Sunday afternoon.

“We had just gotten home from church. My daughter Taylor and my other son Jacob settled in with their video games,” Carol recalls. “I breastfed Matthew and lay him down on his back in his bassinet. He was 3 and ½ months old. About 30 minutes later, I went to check on him. He was on his stomach and he was not breathing.”

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Babies are Dying in Rochester at Twice the National Average. Why?

Nov 7, 2014, 11:13 AM, Posted by Maria Hinojosa

America by the Numbers series on Infant Mortality Photo by: Paul de Lumen.

Rochester, N.Y., is the birthplace of Xerox, Bausch & Lomb, and Kodak, and home to two top-ranked research institutions, the University of Rochester and Rochester Institute of Technology. Nevertheless, babies die in this upstate New York city at a rate two times higher than the national average, and Rochester’s children of color are three times more likely than white infants to die before their first birthday. Why?

To come up with some answers, Futuro visited Rochester as part of its America by the Numbers series, made in partnership with Boston public TV station WGBH (check your local PBS and World Channel listings to see the series). We went knowing that the U.S. as a whole ranks 56th in the world for infant mortality, by far the lowest of any industrialized nation, despite the fact that we spend more on health care per capita than any other country, and the largest portion goes towards pregnancy and childbirth. This makes Rochester’s statistics even more tragic—an outlier in an outlier.

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Bringing Brain Science to the Front Lines of Care

Nov 4, 2014, 5:34 PM, Posted by Jane Isaacs Lowe, Martha Davis

070702.tt.RWJF.Davis.00685

The brain is an exquisitely sensitive organ—so sensitive that, as recent advances in brain science show us, children who are exposed to violence, abuse, or extreme poverty can suffer the aftereffects well into adulthood. They are more likely to develop cancer or heart disease as they age, for example.

But how to translate these findings into practices and policies that can strengthen families and children? How do caregivers help traumatized children and their families cope with adversity? How can the science be applied to what teachers, doctors, social workers, and others on the front lines do every day? And how should the science affect whole systems, so that every person, at every level, can do their part to help children and families thrive?

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Special Delivery: March of Dimes Honors Arizona State Health Director for Work on Improving Turnaround Times on Newborn Screening

Oct 2, 2014, 1:23 PM

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In the Media: TV Show Zooms in on Birthplace of Midwifery in America

Sep 9, 2014, 9:00 AM

This is part of the September 2014 issue of Sharing Nursing’s Knowledge.

Nurse-midwifery took a turn in the media spotlight last month during a television talk show in Kentucky, the “birthplace” of midwifery and family nursing practice in America.

In a half-hour segment on Kentucky Educational Television, TV host Renee Shaw interviewed officials from Frontier Nursing University, the longest continuously operating and largest midwifery program in the country. The university will mark its 75th anniversary in October.

Nurse midwives and nurse practitioners “really want to make their community a better place, and they know from working in the system that, as nurses, they can do that,” said Julie Marfell, DNP, APRN, FAANP, dean of nursing at Frontier Nursing University.

Midwifery got its official start in America thanks to Mary Breckenridge, a nurse from a prominent political family who was born in the 1880s. After the deaths of her first husband and both of her children, Breckinridge decided to devote her life to improving health and health care. In 1925, she founded the Frontier Nursing Service in Hyden, Ky., a remote and unserved part of the country, so she could bring British midwifery practices to the United States. The Frontier Nursing Service later added the nation’s first schools of midwifery and family nurse practice.

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To Build a Culture of Health, There Is No Place Like Home

Aug 11, 2014, 3:36 PM, Posted by Kristin Schubert

mother with child speaking with a care coordinator

A century ago, it was normal for a doctor to make a house call to tend to a patient in need. By the time I was a child growing up in New Jersey in the 1970s and 80s, the practice had become virtually obsolete.

The case for bringing health care back into the home is becoming more compelling every day. One place where we see the potential to make a big impact is with new parents and newborns.

Last month, JAMA Pediatrics published new research from on the effects of nurse-home visits on maternal and child health. The randomized, clinical trial followed a group of low-income, primarily African American mothers and children living in disadvantaged, urban neighborhoods of Memphis over a 19-year period. Specifically, they wanted to see whether home visits conducted by the Nurse-Family Partnership before and after a birth influenced whether the mothers and children died prematurely.

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Public Health Campaign of the Month: A Public Health Reason to Post a Selfie

Jul 24, 2014, 2:34 PM

NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to info@newpublichealth.org.

The March of Dimes has launched a PSA “selfie” campaign to remind women that if a pregnancy is healthy then it’s best to aim for at least 39 completed weeks of gestation before scheduling a delivery. The campaign features photos of women well into their pregnancies—bellies out to there and all with broad smiles.

According to the March of Dimes, important development of the brain, lungs and other organs occurs during the last weeks of pregnancy. The organization, along with state and local health departments, has increased its attention on the issue in the last few years.

“Every week of pregnancy is crucial to a newborn’s health,” said March of Dimes President Jennifer L. Howse, MD. “We believe that using ‘selfie’ photos will help reach today’s mothers-to-be, so they understand that healthy babies are worth the wait.”

The campaign photos all come (with permission) from women who have downloaded a free March of Dimes app, Cinemama, which lets expecting moms take and store selfies to give them a photo record of their pregnancies. Television stations across the country are giving free air time to broadcast the PSA.

>>Bonus Link: Read more on NewPublicHealth about maternal and infant health.

This commentary originally appeared on the RWJF New Public Health blog.

Faces of Public Health: James Perrin, MD, American Academy of Pediatrics

Jun 20, 2014, 2:30 PM

file James M. Perrin, MD

Earlier this week the American Academy of Pediatrics (AAP) hosted a daylong Symposium on Child Health, Resilience & Toxic Stress in Washington, D.C. that brought together federal government officials, national thought leaders and medical professionals to discuss the emerging science of toxic stress.

According to the AAP, science shows that adversity experienced in childhood has long-lasting physical and emotional effects that have come be known as "toxic stress.” Toxic stress can occur when a child experiences chronic adversity without access to stable, supportive relationships with caring adults. These adverse childhood experiences can include physical and emotional abuse; neglect; exposure to violence; food insecurity; and economic hardship. An AAP 2011 policy statement found that toxic stress can affect a child's brain development and lead to the presence of many adult diseases, including heart disease, cancer, chronic lung disease and liver disease.

“[Currently], there are more randomized trials for leukemia than for effects of stress on children,” said James S. Marks, MD, MPH, senior vice president of the Robert Wood Johnson Foundation, at the symposium. “This is about more than our children—it’s about our future as a people and a society, and the earlier you invest in children the better the return to society and to those children and families.”

During the symposium, the AAP announced the formation of the Center on Healthy, Resilient Children to launch in the next year or so, which will be a national effort coordinated by the AAP and many partners to support healthy brain development and prevent toxic stress. In addition to prevention efforts to keep children healthy, the Center will focus on ways to help pediatricians and others identify children who have experienced adversity and toxic stress and ensure they have access to appropriate interventions and supports.

"Pediatricians envision a world in which every child has every opportunity to become a healthy, successful adult," said James M. Perrin, MD, president of the AAP. "Achieving this will require strong, sustained investments in the health of the whole child, brain and body. It will require building upon our existing work and forging new partnerships across sectors and fields of expertise.”

NewPublicHealth spoke with Perrin following the symposium

NewPublicHealth: How familiar are pediatricians with the evidence surrounding the burden and response to toxic stress in children and families?

James Perrin: I think there is increasing awareness of toxic stress in pediatric practice, not only in community practice, but in our specialty practices, too. I think people are recognizing how critically important toxic stress is to the developing child and developing brain. And the increasing science in this area has been incredibly helpful for us to understand the potential permanent effects of toxic stress. But we also want to focus on positive ways to affect brain development. Reading to children, for example, affects brain development and brain growth in positive ways. 

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