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Volume 5, No. 4, April 2007
From Your Colleagues
Gordon Belcourt, Montana Wyoming Tribal Leaders
Project Safe Neighborhoods
Application deadline dates have changed: PSN applications for FY 2007 are due by 8:00 p.m. e.t. on April 5, 2007 and Anti-Gang Initiative applications for FY 2007 are due by 8:00 p.m. e.t. on April 12, 2007 http://www.ojp.usdoj.gov/BJA/grant/psn.html
Recent changes affecting maternal mortality data
In the National Vital Statistics System (NVSS), maternal deaths increased with the introduction of the ICD [International Classification of Disorders]-10 and when the separate pregnancy status question switched from being supplemental information available from some state certificates to an item expected to be included on all state certificates.
In 1915, the maternal mortality rate was 607.9 deaths per 100,000 live births for the birth registration area. In 2003, the maternal mortality rate was 12.1 deaths per 100,000 live births in the United States. Despite this tremendous overall improvement, maternal mortality continues to be a significant public health issue and commands an enormous amount of attention. One of the consequences of this intense scrutiny is that enhanced surveillance efforts have been developed to actively identify deaths of women near the time of pregnancy. Death certificates are a common tool for researchers interested in this topic and serve several roles; for example, the source of National Vital Statistics System (NVSS) maternal mortality data and one of the sources used in pregnancy mortality surveillance efforts to identify cases.
Following the rules and regulations of the ICD, the NVSS has provided maternal death counts since 1900 and maternal mortality rates since 1915. It remains a valuable source of information on trends and is characterized by universal coverage and consistent data collection. However, the NVSS does not identify as many events as active surveillance
The authors found that
* Maternal mortality fluctuates from year to year but was 12.1 deaths per 100,000 live births in 2003.
* The implementation of the ICD-10 in 1999 resulted in about a 13% increase in the number of deaths identified as maternal deaths between
1998 and 1999.
* The rate increased again between 2002 and 2003 after a separate pregnancy question became a standard item on the U.S. Standard Certificate of Death.
The authors conclude that "because most states have yet to adopt the standard format of the separate pregnancy question, it is likely that maternal and late maternal death rates in all states will continue to be subject to increases because of the adoption of questions rather than actual increases in maternal mortality."
Hoyert DL. 2007. Maternal mortality and related concepts. Vital Health Statistics 3(33). http://www.cdc.gov/nchs/data/series/sr_03/sr03_033.pdf
What is known about the outcomes of school health programs?
Includes some key questions excerpted below AND links to CDC Healthy People 2010 Chapter 7 – education goals.
KEY QUESTIONS
■ What is known about the outcomes of school health programs? Is there a link between school health programs and better child health or academic performance? How do the different staffing patterns affect the quality and service capacity of school health programs?
■ What is the role of K-12 school systems in protecting the health of children and delivering health care? Are schools an adjunct or core part of the health care safety net for children?
■ What are some challenges to administering school health programs? How can local, state, and federal agencies coordinate oversight and revenue streams to more effectively improve children’s health and academic success?
■ What is the appropriate federal role in addressing the multiple factors influencing child health and academic success? What are the current federal streams from the Departments of Agriculture, Education, and Health and Human Services? To what extent should Medicaid be used to fund school health services? To what extent are these funding streams coordinated with one another, or might they be coordinated better?
■ Does the government have a responsibility to set national health standards for schools, and by extension, to fund health programs that support public health needs and academic performance benchmarks?
W.D.C. SBHC policy meeting announcement http://www.nhpf.org/announcements/FS_SchoolHealth_03-09-07.pdf
THE LINK to the 2010 healthy People Chapter 7 community and Education objectives
A MUST OPEN AND SCROLL AND READ DOCUMENT THAT WILL HELP FRAME WHAT YOU ARE ALREADY DOING, provide measures for future grants.
http://www.health.gov/healthypeople/document/html/volume1/07ed.htm#_Toc490550856
Stephen W. Heath, Albuquerque
When Things Go Wrong: Responding to Adverse Events
A Consensus Statement of the Harvard Hospitals. Burlington, Massachusetts: Massachusetts Coalition for the Prevention of Medical Errors. This consensus paper of the Harvard-affiliated hospitals proposes a full disclosure when adverse events or medical errors occur, including an apology to the patient. The paper represents the collaborative effort of a group of clinicians, risk managers, and patients participating from several Harvard teaching hospitals and the Risk Management Foundation.
OB/GYN CCC Editorial comment:
Another reason to attend the National Indian Women’s Health and MCH Conference
As the Program is rather extensive, if you didn’t have enough reasons already, Stephen Heath will present on the nuances of systematic error and its effect on Risk Management in Indian Health. The Conference will be in Albuquerque, NM August 15- 17, 2007. The theme of the meeting is “Improve the System: Improve the Outcome” so it will explore how we can all work together to raise the AI/AN health status to the highest possible status. The meeting is only every 3 years, so you and a team from your facility should try your best to attend.
National Indian Women’s Health and MCH Conference
http://www.ihs.gov/MedicalPrograms/MCH/F/CN01.cfm#Aug07
Scott Giberson, HQE
HHS National HIV/AIDS Mobilization Campaign
As hoped, AI/AN HIV/AIDS activities and initiatives are gaining momentum – just in time for our National Native Awareness Day. Our IHS HIV/AIDS Program is working with HHS’s National Mobilization Campaign to help promote awareness of HIV/AIDS and knowledge of status across the US in disproportionately impacted populations (This includes African American, Latino, AI/AI, IDU, incarcerated individuals, etc). Each region has an HHS Regional HIV Resource Consultant to assist with the Department’s National Mobilization Campaign. Collaborating with the HHS National Mobilization Campaign will in-turn continue to improve communication, build capacity, develop linkages and advocate for getting our communities screened. The National Mobilization Campaign will be ongoing through most of 2008 and will focus on knowledge of status –also a principal goal of the IHS HIV/AIDS Program… More information on HHS's National Mobilization Campaign will be forthcoming.
The below message is regional in nature (representing HHS Region VIII), however it is a good example of the HHS Regional HIV Resource Consultant (Ms Lisa Cohen) reaching out to those community members, leaders and advocates that would like to be involved or communicate the HIV awareness message and screening initiative. It is an opportunity for I/T/U communities to tap into potential resources, materials, points of contact and coordination efforts. I will be working with other HHS regional coordinators over the period of this initiative to make sure that the IHS HIV program is involved and helping to promote this within our communities. Please pass this message and the email below along to those appropriate contacts. Scott.Giberson@ihs.gov
National IHS HIV/AIDS Consultant
Office of Clinical and Preventive Services
Rhonda Johnson, Anchorage
The Disparities Solution Center: Disparities Leadership Program
To address the need for leaders with expertise in addressing racial/ethnic disparities in health care, The Disparities Solutions Center will sponsor a Disparities Leadership Program in 2007. The Disparities Leadership Program (DLP) is a yearlong executive education program designed for leaders from hospitals, health plans and other health care who wish to implement practical strategies to eliminate racial and ethnic disparities in health care, particularly through quality improvement.
The DLP will focus on lessons learned and expertise gained from the development and evolution of programs currently in place at Massachusetts General Hospital, as well as at several leading health plans across the country. The program centers around a formal skills curriculum, disparities project development, technical assistance, and group learning/dissemination. Co-sponsors of this program include the National Committee for Quality Assurance (NCQA) and Joint Commission Resources, Inc., an affiliate of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
For more information, please contact The Disparities Solutions Center at (617) 724-7658 or disparitiessolutions@parters.org or http://www.massgeneral.org/disparitiessolutions/DLP.html
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OB/GYN
Dr. Neil Murphy is the Obstetrics and Gynecology Chief Clinical Consultant (OB/GYN C.C.C.). Dr. Murphy is very interested in establishing a dialogue and/or networking with anyone involved in women's health or maternal child health, especially as it applies to Native or indigenous peoples around the world. Please don't hesitate to contact him by e-mail or phone at 907-729-3154.
