a special program of the National Emergency Medicine Association (NEMA)
Week: 568.6 Guest: Dr. Thurma McCann, spokeswoman, Div. of Health Start, Maternal & Child Health Bureau, DHHS Topic: 1-800-311-BABY & 1-800-504-7081 Producer/Host: Steve Girard
NEMA: If the U.S. government has a motherly side... it would have to be the Department of Health and Human Services. Personnel in its many branches watch for the ideas and concepts that will help us get along and be healthy. Don't know about you, but I like that in a government agency. We at The Heart of the Matter concentrate much of our effort on child health and family issues...and with that in mind, we're visiting with Dr. Thurma McCann of the Maternal and Child Health Bureau...to talk about the agency, and in particular, about the new 800-311-BABY telephone line, that links expectant mothers with every possible service they may need to give the child a good start... I would guess Healthy start would be more a propos.
McCANN: Well, the Division of Healthy Start is located in the Maternal and Child Health Bureau of Health Resources Services Administration, which is the area of the Department of Health and Human Services which manages the title 5 block grant, or other maternal and child programs that are funded through the states. In addition, we have the Healthy Start Initiative, which has been a demonstration program to determine what it is that communities can do to lower their infant mortality rate over a 5-year demonstration period. This initiative is in its sixth year now and a very important part of this initiative has been public education and information. We have had two other, public service campaigns which have spoken through different audiences, but this time our intention was to go out with a message that it's important for a pregnant woman to get early and continuous prenatal care... and we went into this effort with our partnership with the Ad Council, and we feel like we're reaching out to all women, to get this message out about getting into early and continuous prenatal care. The Healthy Start communities are located at 22 locations throughout the country, and they are working very hard to put together community driven approaches to reducing infant mortality, such as outreach and getting women handled through referrals and tracking mechanisms and case management. These ads will be played all over the country and the 800 number that you see written at the last screen will refer any caller to a localized maternal and child health information line. And the information line that is answered will be in that particular person's community... from wherever they've called. And we are expecting that anyone should get information about prenatal care and how important it is in their pregnancy. They also may be able to get referrals to other agencies where they can get further care. We're also very proud of the fact that we have an 800 number which is answered completely in Spanish and all the materials that are given out, or are sent out to the caller will be in Spanish as well, and all the referrals that will be made on that line will be to Spanish providers, or providers that are particularly, culturally competent with our Hispanic population.
NEMA: The Spanish speaking line is 1-800-504-7081. Over the last decade, the rate of infant mortality has dropped in the U.S., to its lowest level...ever. But you're mission with this new 800 line is to "reduce the nation's alarmingly high rate of infant mortality". So, I would assume we've done well...but there's more to do...?
McCANN: We're very proud of the fact that our infant mortality rate is going down and I'd love to take full credit for that through the Healthy Start Initiative and its efforts in the demonstration phase however, there're been many other programs across the country which have been implemented over the last 5 to 10 years which have made a major difference and an impact on reducing infant mortality. We know that we've made many technological advances in terms of neonatal ICU's, and surfactant...the substance that is given to infants prior to birth in order to achieve greater development of their lungs. We know that we've made a lot of advances in terms of saving babies and preventing them from being born too soon. But we're still having a problem with the disparity between black and white infant death. That disparity continues to show that black infants are dying at 2 to 3 times more than white infants in this country. So, whereas we're making large strides in saving babies, we still haven't figured out why we are unable to save black infants at the same rate that we're able to save white infants. Many of those issues have been taken on through the Healthy Start demonstration initiative, some of which we've been able to determine or recognize that issues such as outreach and economic development programs and community motivation makes a difference, but there are other issues such as stress and bacterial infections in the vaginal area that cause early delivery that we haven't quite been able to really work with yet. Many of the studies are just beginning to show an implication that some of these issues play a real role in contributing to our black infant death in this country.
NEMA: That's interesting...I recently talked with a Wilmington, Delaware organization called Reach, that has a community outreach van. It deals with the kinds of information, referrals and activities that help create better parents. The administrator said stress is a powerful element in inner city communities, and that people don't know neighbors as they did in the past...and therefore aren't apprised of the services of their community, their local clinic...and so it's not surprising to find they're not up on city or state resources for children's services....
McCANN: That's right. When the Healthy Start demonstration initiative was first put together in 1991, the first opportunity for these communities was to do a needs assessment and to put together a comprehensive plan of how they were going to reduce infant mortality over the 5 year period, and many of them brought together people who had never talked to one another before, to come together and discuss how they would make a community-wide effort to reduce infant mortality. As a result, we know that many of the programs have become more integrated, and are recognized by the community now as they have never been before.
NEMA: Now, one of the things that's been a real joy to report on the last couple of years is the SIDS death decrease, but I'm not quite sure of the connection between that particular statistic and getting better prenatal care.
McCANN: The Sudden Infant Death Syndrome actually has decreased and we think that part of the reason for that is our Back to Sleep campaign. That was the new recommendation from providers that all parents, when putting their infants down to sleep, should put them on their backs. You know our culture was such that we were putting babies on their side or their stomachs to sleep... and we found that the literature has found that there is a significant decrease in the number of Sudden Infant Death Syndrome deaths just as a result of changing the way the babies sleep. Early and continuous prenatal care can help us to determine if there are other kinds of problems that put a woman at risk during her pregnancy that can be taken care of. For example, a woman that has a chronic condition such as asthma, or diabetes, or seizure disorder would need to be treated very closely and watched during her pregnancy, and if not, then perhaps that infant would have difficulties and not be able to stay in-utero long enough. There are other issues, such as smoking, that we can address early on in pregnancy, and we're also very concerned about second-hand smoke in the home, and how that affects infants and how that may have some impact on Sudden Infant Death as well.
NEMA: I think that some people are daunted going to a line like this because they feel they don't know exactly what to say... they don't know what that voice is going to sound like on the other side of the line, and they may be afraid of people telling them that they're wrong in doing something. What are the kinds of things they call in for...or maybe some things they should ask when they call.
McCANN: Well, we've done some research on the 800 number within the various states, through our field offices and our state Maternal and Child Health directors. We've asked them to call the lines periodically and make sure that we have a friendly voice on the other end - a receptive, and understanding and caring voice on the other end. I would think a woman who sees the ad and that sparks an interest of "Gee, I wonder what this is all about,how can I get help for myself and my baby,so that I'm not putting my baby's life on the line"? ... and they pick up the number and the person would say, "Are you pregnant?, Do you need information"?... and you know you would respond in the positive and then be sent brochures or locations of the sites where providers are where you can get that care that you need and other kinds of information about important steps to take during your pregnancy to insure a healthy baby.
NEMA: 25% of women in our country still don't get prenatal care during the first three months of their pregnancy...the most crucial time in fetal development....and the resources to get help and information are there...accessible with just one phone call. 1-800-311-BABY...and for Spanish speaking mothers to be, 1-800-504-7081. Our thanks to Dr. Thurma McCann of the Maternal and Child Health Bureau and the Division of Healthy Start.
SPOT: 15 years in the prevention of heart disease, stroke and trauma - The National Emergency Medicine Association. This show is just part of what NEMA does. We send out millions of pieces of prevention information to people around the country, give grants to organizations in research, public information and emergency services, and have been instrumental in the creation and expansion of the Chest Pain Emergency Room movement. To play a role, call 800-332-6362.
NEMA: Thanks for joining us for today's program. If you have any comments or suggestions, contact this station. Or visit our home page at: www.NEMAhealth.org...for a look at transcripts of this or past programs, or to find out more about the National Emergency Medicine Association. I'm Steve Girard at The Heart of the Matter.