Wisconsin’s Lifecourse Initiative for Healthy Families: Application of the Maternal and Child Health Life Course Perspective Through a Regional Funding Initiative

Abstract

National experts are calling for more integrated approaches such as the life course perspective to reduce health disparities and achieve greater health equity. The translation and application of the life course perspective is therefore of great interest to public health planners, policy makers and funders to promote community-wide improvements in maternal and child health. However, few organizations have applied the life course perspective in designing strategic funding initiatives. For over three decades, Wisconsin has observed persistent racial disparities in birth outcomes. This complex public health issue led to the development of the Lifecourse Initiative for Health Families, a regional multi-million dollar funding initiative created and supported by the Wisconsin Partnership Program of the University of Wisconsin School of Medicine and Public Health (Created by the UW SMPH from an endowment following the conversion of Blue Cross Blue Shield United of Wisconsin, the Partnership Program makes investments in research, education, and public health and prevention initiatives that improve health and reduce health disparities in the state.). Over a 2-year period, the program funded four collaboratives to adopt a life course perspective and develop strategic plans for improving African American birth outcomes. The Twelve-point plan to close the black-white gap in birth outcomes provided the framework for the planning process. Despite the conceptual challenges, the life course perspective was embraced by the collaboratives, challenged community assumptions on the root causes of poor birth outcomes and provided a unifying funding construct for organizing and planning complementary individual-level interventions with social and physical environmental change strategies. These integrated and complimentary approaches provide a long-term opportunity to address the persistent racial birth outcome disparity in Wisconsin.

Prepregnancy Obesity and Primary Cesareans among Otherwise Low‐Risk Mothers in 38 U.S. States in 2012

“…More importantly, recent systematic reviews and meta analyses suggest that reducing prepregnancy BMI could have a positive change to population‐based research. Campaigns to prevent maternal obesity can be extremely challenging but are necessary steps in mitigating the negative effects of obesity on maternal and infant health.…”

Enhancing Healthier Birth Outcomes by Creating Supportive Spaces for Pregnant African American Women Living in Milwaukee

“…The objective was to implement the intervention, evaluate its effectiveness, and document its usefulness to inform development of future interventions. The MBP is part of a larger strategic effort, the Life-course Initiative for Healthy Families, promoting sustainable evidence-based strategies to address persistent racial disparities in Wisconsin (Frey et al 2014). The MBP was operated out of a church-affiliated community center located in a Milwaukee zip code with some of the poorest birth outcomes.…”

Improving Maternal and Child Health Across the Life Course: Where Do We Go from Here?

“…• Data collection-What data should be collected about the pre-disease pathway-the early and long-term biological, behavioral, psychological and social precursors to a particular outcome [9]-that the intervention is designed to alter? What data is needed to establish the biological plausibility or economic returns of an intervention?…”

“…This issue of the MCH Journal highlights some of the most innovative applications of the life course theory in our field. Frey et al [9] describe the efforts of Wisconsin's MCH program to operationalize the life course theory that includes expansion of preconception and women's health initiatives, integration with traditionally ''non-MCH'' programs such as chronic disease programs, and shifting Title V resources from provision of individual services to assurance of effective early childhood systems. Shrimali et al [10] describe Alameda County Public Health Department's countywide multisector initiative to engage community partners in improving neighborhood conditions, which includes creating a shared vision statement and bill of rights that connects diverse stakeholders to common goals, launching a webbased learning community, and implementing innovative programs such as Food to Families that advance health equity from a life course perspective.…”