Moderator:
CAPT Wanda D. Barfield, MD, MPHActing Team Leader and Senior Scientist
Maternal and Child Health Epidemiology Program
Applied Sciences Branch/Division of Reproductive Health
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion

Speakers

Vijaya K. Hogan, MPH, DrPH Director of Curriculum on Health Disparities and Clinical
Associate Professor in the Department of Maternal Health and Child Health
at the University of North Carolina, Chapel Hill

Camara Jones, MD, PhD, MPH
Research Director on Social Determinants of Health and Equity
Division of Adult and Community Health,
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion

James Collins, MD, MPH
Neonatologist - Children's Memorial Hospital in Chicago
Associate Professor of Pediatrics
Northwestern University, Feinberg School of Medicine

Introduction
Although the U.S. infant mortality rate dramatically decreased during the 1900s among black and white infants, the racial disparity actually increased. Racial disparities in maternal and child health have been looming in U.S. public health despite various adjustments for age, education, and socio-economic status. The measurement of racism or racial bias in health resources, health care access, and care, as well as its burden on the health of individuals and communities over generations is an important aspect of understanding the persistent disparities in maternal, infant, and child health morbidity and mortality. Current public health research, policies, and intervention strategies are not sufficient to close the gap. In an effort to stimulate MCH field, this session will bring in leading national experts to present the challenges of measuring and eliminating racism and racial disparities in maternal and child health. Dr. Hogan will present the current challenges in addressing racial disparities with current approaches and the need for a new paradigm. Dr. Jones will present constructs and innovative approaches to measuring racism in health through survey data, contextual data and other data sources and will describe the challenges to measuring and addressing racism in health. Dr. Collins will present the constructs and innovative approaches to measuring racism and racial disparity in infant mortality and will describe the challenges to measuring and addressing the disparity.

Learning Objectives
- To identify the need for a paradigm shift in racism and disparities measurement, research, and interventions.
- To review innovative examples of the use of data to measure racism through survey data, linked data, and contextual data.
- To describe the challenges of measuring racism and the impact on racial disparities research and interventions.
- To compare conventional and innovative approaches to reducing racial disparities in MCH.
- To value the necessity for change in MCH epidemiologic practice and research.

Speakers

Captain Judith Thierry, DO, MPH, MCH Coordinator
Indian Health Services, Rockville, Maryland

Stacy A. Bohlen, Executive DirectorMember of the Sault Ste. Marie Tribe of Chippewa Indians
National Indian Health Board, Washington, DC

Sharon T. Smith, Tribal Health Liaison
White Earth Enrollee, Ojibwe
Office of Minority & Multicultural Health
Minnesota Department of Health

Alexis Avery, MPH, PhD, Epidemiologist/Acting Manager
Maternal and Child Health Epidemiology Program
New Mexico Department of Health/Family Health Bureau

Thalia Wood, MPH, CLC, Children's Health Unit Manager
Section of Women's, Children's, and Family Health
Alaska Department of Health and Social Services

Introduction
Substantial improvements have been made in the area of American Indian/Alaskan Native (AI/AN) maternal and child health over the past few decades but disparities continue to exist. Health outcomes differ by region, by rural versus urban residence, and by tribal affiliation. Federally recognized tribes reside in the majority of states with AI/AN populations widely distributed throughout the United States.

This plenary is designed to assist states in their efforts to improve MCH outcomes through enhanced partnerships with tribes. Attendees will learn about the complex system of Indian health care currently in place, the responsibilities of states, and about the work of the Indian Health Service, the National Tribal Health Board and the Urban Indian Health Programs. To assist with current Title V MCH Needs Assessment efforts, resources available to state and local governments will be highlighted. Finally, three diverse states ( Alaska, Minnesota and New Mexico) will discuss their successful partnerships to address identified health disparities.

While this session focuses on health disparities associated with the AI/AN population, techniques shared will benefit all who work to address health disparities in vulnerable populations.

Learning Objectives

1. Identify key MCH health disparities experienced by the AIAN population both in rural and urban areas of the United States.
2. Understand the complex system of care in place to address the health needs of the AIAN population, including the Indian Health Service, Tribal Health Boards and Urban Indian Health Programs.
3. Describe resources available to states and local health departments with regard to AIAN health data analysis, including the Tribal Epidemiology Centers with MCH epidemiology expertise.
4. Discuss how vital records in New Mexico have been modified to identify tribal affiliations, allowing for specialized reports and queries addressing health risks and outcomes.
5. Understand how a partnership between the State of Minnesota and the Great Lakes Tribal Epidemiology Center addresses disparities in infant and maternal mortality through an infant death review project.
6. Describe newborn metabolic disorders more commonly found in Alaska Native populations and ways to work with families to avoid untoward sequelae.
7. Discuss how the newborn hearing program has worked with the Alaska Native Health System to assure all newborns are screened for hearing by one month of age and achieve further diagnostic testing by three months of age.

Moderator:
Nan Streeter, MS, RN Director
AMCHP Board President
Maternal and Child Health Bureau,
Utah Department of Health

Speakers

Katherine J Bradley, PhD, RN
Administrator/Title V Director
Office of Family Health
Department of Human Services, Oregon  

Ken D Rosenberg, MD
MCH Epidemiologist
Office of Family Health
Department of Human Services, Oregon

Alethia Carr
Acting MCH Director
Michigan Department of Community Health

Sheryl Lowe, RN, MA
Director of Health Policy and Social Mission
Blue Cross/Blue Shield of Michigan

Giannina Donatoni
MCH Analyst
L A County - Public Health Department
Maternal, Child, and Adolescent Health Programs

Cindy Harding, MPH
L A County - DPH-MCAH Programs Director
Preconception Care Council of California  

Introduction
This session will highlight specific efforts of state and local MCH public health agencies that use data results to drive their health programs and policies. The presenters will discuss the challenges and benefits of translating data into programs and policy. They will also highlight how federal, state and local policy makers collaborate in sharing data to improve the health outcomes of the MCH populations. Each presentation will focus on addressing how data was collected, analyzed and translated to develop state MCH policy initiatives, including state legislation as passed in Oregon to support breastfeeding mothers as they return to work; Michigan's Blueprint for Preventing Unintended Pregnancy, and Los Angeles County's community stakeholder effort with focus on preconception health promotion.

Moderator:
Juan Acuña, M.D., MSc
Associate Professor of Obstetrics and Gynecology
Director of the Information and Data Coordinating Center
Florida International University College of Medicine

Speakers
Joe Leigh Simpson, MD
Executive Associate Dean of Academic Affairs,
Florida International University College of Medicine

Carol Hogue, PhD, MPH
Terry Professor of Maternal and Child Health
Professor MCH Epidemiology
Emory University Rollins School of Public Health

Charles W Duke, MD, MPH
Medical Officer, Birth Defects
Centers for Disease Control and Prevention, NCBDDD

Introduction
Although the U.S. infant mortality rate dramatically decreased during the 1900s in all populations, it is unclear that stillbirths (>19 weeks' gestation) and fetal deaths (<20 weeks' gestation) have experienced the same downward trend.  Current data suggest that the fetal death rate remains very much stable, but the data available are of varying quality, and analysis is complex. Missing and incomplete information on cause of death greatly limit our ability to understand causality and the potential opportunities for prevention. Since stillbirths are at least half of all fetal and infant deaths up to one year of age and comprise the vast majority of perinatal deaths, it is critically important to establish accurate population-based information about this emerging biological, clinical, and public health problem. The presentations in this plenary will explore fetal death biology, issues with current data and information, and future opportunities. Dr. Acuña will introduce the topic and present background on the subject. Dr. Simpson will describe the biology and most common causal paths underlying the death of a fetus.  Dr. Hogue will present analytical challenges using current data and how the Stillbirth Collaborative Research Network study supported by NIH/NICHD might help improve the understanding of fetal death and stillbirth as a public health problem. Dr Duke will present the current initiative on fetal death-stillbirth at the CDC and how it might impact surveillance for fetal deaths and stillbirths.