Posts Tagged ‘WIC’

Encouraging WIC Outcome Measures

February 4th, 2014

There’s increasing evidence that whether a person will have a healthy weight as an adult is influenced by nutrition and physical activity in the first 5 years of life.  In fact, a new study this week in the New England Journal of Medicine suggests that overweight 5-year-olds are 4 x more likely to become obese later in life. 

That makes our Women Infant and Children program a critical leverage point in turning the tide on obesity.  WIC focuses on the nutritional and overall health of families with kids aged 0-5.  Back in 2009 we moved to a healthier food package, and we’ve ramped up our nutrition assessment and education activities with evidence based practices.  This week we got some encouraging performance measures in from WIC suggesting that our efforts are paying off.     

Our initiatives have resulted in a decrease in overweight 2-5 year old WIC participants from 14% in 2011 to 13.3% in 2013.   Likewise, obese WIC participants 2-5 years old decreased from 13.2% in 2011 to 12.4% in 2013.  The percent of WIC moms who breastfed at least 6 months also increased from 25.7% in 2011 to 27.1% in 2013.  Congratulations and keep up the good work.

Reviewing Child Fatalities Provides Critical Information

November 15th, 2013

One of the ways we create good public health interventions is by studying outcomes.  This week, the 20th Annual Child Fatality Review report came out- which examines all 854 deaths of children under the age of 18 in 2012.  The Report reviews the circumstances of each child’s death, determines preventability and makes recommendations to save children’s lives moving forward. 

Although the number of deaths this year is up from last year, Arizona has had a 26% decline in child deaths over the last 8 years.  The decrease we’ve seen over the years in AZ can be partially attributed to many of the initiatives recommend by the Annual Child Fatality Review Reports.  This year’s report makes recommendations to families, law enforcement, health care providers, social service agencies, and the communities in which children live.  

One area we’re going to focus on is the sleeping environment.  Fifty one children died in unsafe sleeping environments.  Every child under one should have his or her own sleeping space and always be put to sleep on his or her back.  Ideally that space can be in the parents’ room to make it easier to breastfeed.  The idea of co-sleeping has been around for many years, but it’s not a good idea until a child is able to easily move on its own.  We have a safe sleep task force starting working on this right now.  Our home visiting and WIC folks also help to spread the word about safe sleep to new parents and families.

Another area we’re going to focus on is reducing prematurity – almost 25% of the children who died last year were born too early.  We’ve had success in reducing the number of babies born early by working with partners across the state and parents – and we’ll continue fighting that with our preconception health campaigns, the March of Dimes programs and our home visiting program. 

Here’s a fact sheet and a document of community recommendations that everyone can use to help keep our children safe.

Outreach in Border Region Enhances WIC Enrollment

October 10th, 2013

The Arizona WIC Program is airing outreach ads in border counties, to ensure WIC clients know about the availability of WIC services in their communities.  Several local WIC agencies in the border region are undertaking special actions to promote WIC along with making healthy eating and active living the easy choice in their communities. 

The Mariposa WIC Program is a key partner in the Harvesting Well-being Initiative. The idea is to build a local food system in Santa Cruz County so that everyone has access to healthy food. The Mariposa WIC Program has been integral to the development of the Nogales Mercado, a new Farmers’ Market that just celebrated its six month anniversary. 

The Cochise County Health Department is working with the Naco Wellness Initiative, a non-profit organization working with both US and  Mexican professionals, volunteers, and community members. Their mission is to model health and wellness with people living in the rural and very poor communities near Naco in Arizona and Sonora. The Cochise County WIC Program is specifically working to refer obstetrical patients who are Arizona residents and may qualify for WIC services.

Childhood Obesity: Turning the Tide?

August 15th, 2013

We finally got some better news from the childhood obesity public health front this week.  Tuesday’s CDC Morbidity and Mortality Weekly Report found that childhood obesity rates are stabilizing or decreasing slightly across the country.  In fact, 19 states had a significant downward trend in obesity prevalence among low-income preschoolers.  There was no change in Arizona- but that’s better than going up.  The study looked at kids between 2 and 4 years old that participate in WIC, Early and Periodic Screening, Diagnosis and Treatment program, and the Maternal and Child Health programs between 2008–2011 and found a downward trend in obesity- for the first time that I can remember in my career. 

Where do we go from here?  Basically, we need to continue to press ahead and implement evidence-based best practices – as turning the tide on childhood obesity will be a long term effort.  Here are a few AZ specific examples: 

  • We’ll continue to work with many county health departments on the implementation of the Health in Arizona Policy Initiative.  This initiative focuses on school health, worksite wellness, healthy community design, procurement of healthy foods (like having healthy alternatives in vending machines), preventive clinical care, and inclusion of children with special health care needs.
  • The CDC recently awarded us a new public health prevention grant.  Like the Health in Arizona Policy Initiative, the goal is to make healthy living easier by supporting healthy environments in workplaces, schools, early childhood education/child care, and in the community.  Arizona was one of 32 states to be awarded enhanced funding; in total, ADHS will receive $2M per year for five years.   Activities are expected to begin rolling out by October. 
  • State and local partners can continue to help communities to conduct needs assessments, Health Impact Assessments, action plans, and initiatives aimed at increasing healthy eating and active living by using tools like the Arizona Health in Policy and Practice Resources and the Urban Land Institute’s Community Plan, both of which help local officials to focus on a holistic approach to land use planning, zoning, transportation, economic development, real estate development and finance. 
  • We’ll continue to support School Health Advisory Councils which help schools to identify and incorporate best practices for obesity prevention including standards that promote healthy eating and physical activity, like focusing on serving fruits and vegetables, limiting sugary beverages, and providing more opportunities for physical activity, and reducing screen time- like our nationally-recognized Empower program does. 
  • Our public health system will continue to assist local businesses, communities, and local elected by educating them about the importance of and tools to provide opportunities for physical activity, healthy food availability, and improving access to safe, free drinking water in public places.  Maryvale on the Move is a good example of this kind of approach. 
  • We can also continue to help community groups improve access to local play spaces & increase opportunities for physical activity by helping decision-makers to provide easier access to safe recreational facilities by passing laws like ARS 33-1551   which addresses liability concerns of schools when opening outdoor facilities to the public outside of the school day- making it easier for schools to open playgrounds to the public so children have more places to play and be physically active.

New WIC Website

April 1st, 2013

We’re happy to unveil the new Arizona WIC Program website, which has been redesigned with a fresh new look that is more user friendly. Last year the WIC webpage had more than 76,000 unique visitors with nearly 350,000 page views- making it one of our most popular sites.  The redesigned site includes a Find a Clinic feature, a newly released WIC Needs Assessment, and an easy way to report complaints, abuse or fraud. 

The Arizona WIC Program provides nutrition education and breastfeeding support services, supplemental nutritious foods, and referrals to health and social services for low income pregnant, breastfeeding, and postpartum women, infants and children under 5.  WIC currently serves approximately 64% of the potentially eligible population in Arizona and reaches more than 330,000 women, infants, and kids each year. Special thanks to Jennifer Tweedy, Jesse Lewis, Rose Halberg, Karen Sell and lots of folks from our Bureau of Nutrition and ­Physical Activity who worked to redesign the site.

Sequestration and Our Mission

March 12th, 2013

No doubt the word “ Sequestration” is front and center in your vocabulary these days.  This is just a quick note to forecast how it might impact our mission.  For starters… the main impacts from federal sequestration (i.e. the federal budget reduction for some programs) will be related to the services that we provide and the planning that we do related to our federal cooperative agreements and grants.  The primary agencies that award us funding are within HHS (CMS, HRSA, CDC, SAMHSA) and USDA (WIC).  Not all federal programs are subject to the federal budget reduction that will go into effect shortly. 

For example, the behavioral health services that we provide via Medicaid are largely exempt from the reductions… but most of our cooperative agreements and federal grants are subject to the reductions. We receive a total of about $255M in federal funds that look like they’ll be subject to reductions for the remainder of this federal fiscal year.  WIC is the biggest chunk, at about $161M (or 63% of our total grant funds affected). 

How we manage these reductions will vary depending on how much flexibility the parent federal agency gives us.  As we make these decisions, we’ll consider grant variables…  like how much of the award we’ve spent so far this fiscal year and whether the grant is mainly service dollars or strategic planning etc.  For some programs we may be able to identify under-performing areas of the grant or agreement and focus our adjustments there.  

For example: Karen Sell’s WIC team has done a fair amount of planning already to mitigate the immediate and even mid-term impact…  like changing the food package starting July 1 (adopting less expensive brands) and identifying some current unspent funds.  We won’t need to put WIC applicants on a waiting list for at least a month…  but depending on how things go, we may need to start a list later in the year. 

I’ve asked the executive management team to work with each of the programs that look like they’ll be affected and start the planning process for making the reductions- focusing on identifying ways that we can make reductions that will minimize impacts in the field (like the way WIC will be moving to less expensive food brands).  Anyway…  stay tuned.  Things at the federal level look like they’re still in flux.  The more nimble and creative we are the better off our mission will be.

Our Most Popular ADHS Website

February 14th, 2013

Guess which one of our ADHS Websites consistently has the most hits.  Our influenza pages during flu season?  Medical marijuana during our rulemaking?  Questions about WIC eligibility?  Nope.  It’s our Genealogy website.  The site has had more than 5,100,000 queries in the last 2 years.

Our Vital Records team has been keeping data on birth and death certificates since 1855.  A few years ago, our easy to use Genealogy website was put together so folks can do research on their family history.   The data on the site includes AZ births before 1938 and deaths before 1963.  The public records statute says that birth certificates need to be at least 75 years old and death certificates 50 years ago in order to be loaded on the site.  The information was extracted from photo reproductions of the original certificates by volunteers from the Mesa Regional Family History Center.

We don’t have a budget top maintain the site… but we recently put up a feature so that folks can donate funds to the ADHS Public Genealogy Website for future enhancements.

Informed Consent Website Up & Running

November 26th, 2012

Last legislative session the Governor signed HB 2036- which amends state law regarding abortions. Some parts of the law are pending legal challenges, but the parts requiring us to develop a website were unaffected- and our new informed consent site just went up.  The website lists agencies and services that are available to assist women throughout their pregnancy, including information about adoption.  The information is listed to make it easy for women to find local resources.  Many of our public health programs are listed, like WIC, breastfeeding support, and home visiting programs.  The website also includes information describing fetal development and info describing various abortion methods and medical risks associated with the procedures. 

It’s important that providers are aware of the website because the law requires AZ health care providers to give a woman considering an abortion the opportunity to review the information. A “Potential Resources Submission Form” is posted in case agencies are interested in listing additional resources on the site.

The Road to Lifelong Health Begins with Breastfeeding

August 6th, 2012

The first week of August is World Breastfeeding Week and it has been for 20 years.  This year’s theme is The Road to Lifelong Health Begins with Breastfeeding.  Those long-term benefits apply to both mothers and babies.   When babies are fed human milk, they are more likely to avoid obesity, less likely to die from SIDS, and have a lower risk of many diseases including several cancers and type 2 diabetes.  Mothers get immediate and long-term benefits from breastfeeding, including a lower risk of breast and ovarian cancer and a lower risk of postpartum depression.

While this may be breastfeeding awareness week – we promote breastfeeding all year long in Arizona.   ADHS provides resources to breastfeeding mothers such as a 24-hour Breastfeeding Hotline at 800-833-4642.  Each month, the hotline takes hundreds of calls from parents with questions about breastfeeding techniques, medications, going back to work, and more.  Other breastfeeding support includes Arizona Baby Steps to Breastfeeding Success – our partnership to promote breastfeeding-friendly maternity care practices.   ADHS also offers a certification for Breastfeeding-Friendly Childcare Centers.  Last, but not least, the Arizona WIC program is the largest breastfeeding support resource in the state, providing mothers and babies with access to skilled lactation help, breast pumps, and more. 

 

Arizona is not alone in recognizing that breastfeeding is one of the best preventative care measures.  Healthy People 2020 cites the need for increasing the rate of breastfeeding and improving breastfeeding support in hospitals. The group that Joint Commission recently made breastfeeding one of its core measures for maternity care hospitals.  Last year, the Surgeon General issued a Call to Action to Support Breastfeeding, which detailed ways for health providers to increase the level of support provided to new mothers.

The Push to Stop Preterm Births

July 2nd, 2012

On June 18, we held a news conference with the Arizona March of Dimes and the Arizona Perinatal Trust to officially launch a new campaign to reduce preventable preterm births.  We got great coverage this week, including a FOX News interview  that aired in several other cities across the country.  We’ve joined a national challenge issued by the President of the Association of State and Territorial Health Officials and pledged to set a goal of reducing premature births by 8% by 2014.  This would mean 800 more babies would make it to full term.

Why the focus on prematurity? Many babies die because they’re born too soon.  In 2010, almost 200 babies died due to prematurity, the leading cause of deaths for newborns.  Even babies born a few weeks early have high odds of learning disabilities, vision & hearing loss and cerebral palsy. The Healthy Babies are Worth the Wait  campaign stresses that if the pregnancy is healthy, it’s best to let labor begin on its own rather than scheduling an early delivery.

Until recently, it’s been an accepted practice for parents-to-be and doctors to schedule elective (non-medically necessary) inductions or c-sections just for the convenience of the parents’ schedule, or the doctor’s schedule, or because a date holds a special meaning for the family.  Because of the hard work of the Arizona Perinatal Trust (APT) promoting the March of Dimes 39-week Toolkit this practice may soon be a thing of the past.  90% of all APT-certified hospitals have already agreed to put a stop to allowing elective inductions and c-sections prior to 39 weeks.  This will go a long way to reducing preterm births, but there’s more that we can do.

In the past decade, mounting scientific evidence has concluded that if pregnancy outcomes are going to improve, it’s real important that women and men are as healthy as possible before conception.  We call this preconception health, and the concept is simple.   Healthy people are more likely to have healthy babies.  Prenatal care is important, but it’s not magic.   We can’t expect even the best prenatal care to undo the damage that may have been sustained through years of unhealthy behaviors and stressful environments.  It is not a substitute for being healthy, especially when about half of all pregnancies are unplanned.

Our interventions include implementing evidence-based practices to get moms to stop smoking, practice good oral health, improve physical activity and nutrition and behavioral health- all are part of our Preconception Health Strategic Plan and our Every Woman Arizona educational materials, grants to implement preconception health strategies, and home visitation programs that address many of the things that lead to prematurity.  Our WIC program and clinics also work with young moms in their reproductive years to improve their health.  Maintaining a healthy weight before pregnancy is really critical.  Women who are obese are at higher risk for infant death, premature births and several birth defects (brain, spinal and some heart defects) and babies born large for gestation. Obese mothers are at greater risk of experiencing gestational diabetes, high blood pressure etc.- associated with preterm births.

Most of us know what we need to do to be healthy, but sometimes we lack motivation to make those healthy choices for ourselves.  But the choices we make today are not just for ourselves – they are choices for our kids & the next generation.  Check out our new Healthy Babies webpage for more information about the campaign and view the new March of Dimes public service announcement.