Healthy Babies Minnesota: A Q&A with State Health Officer Edward Ehlinger
Healthy Babies Minnesota is an umbrella of activities aimed at using prenatal and first-year initiatives to make Minnesotans healthier throughout their lives. NewPublicHealth spoke with Edward Ehlinger, MD, the state’s commissioner of health, about the program.
Today marks the start of the regional Infant Mortality Summit, kicking off a collaborative, multi-State initiative to improve infant health outcomes. NewPublicHealth will feature some innovative programs and initiatives to support healthy babies this week.
NewPublicHealth: What are key initiatives that make up Healthy Babies Minnesota?
Dr. Ehlinger: We have a lot of activities related to pregnancy, prenatal care, preconception care and early childhood care; and so we’re collaborating on all of those. We also have a Children’s Cabinet that’s focusing on early childhood growth and development. We’re also really focusing on adverse childhood experiences. We’re collecting information across the state on what’s happening to babies in the first year of life, adverse childhood experiences, to make sure that we prevent those or can intervene quickly. And we’re also really focusing on preconception care. Trying to make sure that women who are anticipating becoming pregnant will focus on all of the important issues—make sure their weight is normal, their blood sugars are under control, if necessary, that they’re not smoking, they’re not drinking.
NPH: And what is the next set of ideas for 2012?
Dr. Ehlinger: We formed a task force during the last legislative session and we’ve been really working on improving birth outcomes. The task force is looking for ways to help prevent low birth weight babies, and they’re going to be making a recommendation to the legislature shortly. We’ll be focusing a lot of our attention on those recommendations.
NPH: From your perspective, why is the first year of life so pivotal?
Dr. Ehlinger: The data show that if you don’t have a good start, you’re going to be in trouble for the rest of your life. The birth weight is certainly one of the big predictors of health in early childhood, and we really have good amount of data showing that if you experience adverse childhood experiencesin that first year of life, you’ll have major impacts down the road. So this is the point in time where you get the biggest bang for your buck for any interventions—for education, for health and for just general social well-being.
NPH: Many hospitals in Massachusetts and a few other states have announced recently that they will no longer allow elective cesareans before 39 weeks. Is that something that has come up as an issue in Minnesota as well?
Dr. Ehlinger: Yes, that’s certainly been part of the conversations, and I know that the data are showing that if you don’t allow elective C-sections before 39 weeks it lowers the rates of low birth weight births. Some of the hospitals and health plans have already implemented the change voluntarily, and we’ll see what the task force does in terms of making policy recommendations on the issue.
NPH: What are some of your other priority areas for the year in addition to the first year of life?
Dr. Ehlinger: We’re trying to expand the whole concept of primary care, to do community-oriented primary care as a way of integrating medical care, social services and public health services, recognizing that right now we have these cylinders of excellence. We’ve got the medical field providing great medical care and public health services providing their thing and social services doing their important work, but all pretty independently. As I looked around the world, the places that really have the best outcomes, both for children but also for adults, is where they integrate medicine, public health and social services.
NPH: What is an example of the concept in action?
Dr. Ehlinger: Well, I would hearken back to what we did with Title V from the Social Security Act, maternal and child health activities back in the 80s where we had the children and youth programs take a community-oriented approach, and they target areas of the city, not target populations.
They would look at housing issues and transportation issues and nutrition issues and child care issues and education issues in addition to the medical care issuesand they would have a team approach. They’d have the social workers and the nutritionists and the occupational therapists and the child development specialists, along with the pediatricians and nurses that worked as a team. They really showed that they could reduce infant mortality dramatically and improve birth weights and school readiness for everybody in that target area. So, we’re trying to recreate that through health care homes and the accountable care organizations—you need to take the community-oriented approach and be accountable to the community for outcomes.
In a nutshell, we’re trying to make sure that we have community outcomes and not just individual patient outcomes.