The health and well-being of our infants and children are affected by the health, nutrition and behaviors of their mothers during pregnancy and early childhood.
To ensure the health of a child, however, is no small
feat - prenatal care and post-partum support care are crucial.

But imagine young pregnant women with low education levels, low employment rates and high rates of untreated mental health issues who lack the skills and support necessary to get the care they need. Imagine women living in rural communities where access to care and support is a constant challenge.

And for the women living in the small urban centers and rural communities of central New York, rates of poverty, teen pregnancy, obesity and smoking are higher than in other communities.

So it’s no surprise that all of this results in high-risk pregnancies, low birth weights and in some cases, even infant death.

As part of the Health Foundation for Western and Central New York’s (formerly Community Health Foundation of Western and Central New York) vision to ensure that every young child is healthy and ready to succeed in school, the Foundation is launching a new phase in its efforts to improve maternal and child health in Central New York.

This project focuses on improving the health and health care of children up to age one and women of child bearing age living in poverty in central New York, with a strong emphasis on areas with high risk of poor maternal and child health outcomes – “hot spot” neighborhoods.

To accomplish this goal, the Foundation is implementing three strategies:

 
Expansion of midwifery – Support the development and growth of midwifery services for low income women in the central New York region. 
 
MCH systems improvement – The Foundation announced a funding opportunity to support improvements to current maternal and child health services in five high-risk "hot spot" communities in central New York in March 2012.  
 

Facilitated coordination – Provide professional facilitation and technical assistance to health and human service providers in Oneida County to support coordination of services for young children and families.

Project Background 

In 2009, the Foundation commissioned Chapin Hall at the University of Chicago, a nationally-known research and policy center focused on issues affecting the well-being of children, families and their communities, to conduct an environmental scan of the Central New York region to identify needs, gaps and strengths in the existing maternal child health system.

The report, “Improving Services for Pregnant Women and Children 0-1 in Central New York State,” provides an overview of the existing service infrastructure by county, and includes interviews with key staff at a variety of community-based organizations that provide maternal and child health services. 

Key findings from the report include the following strengths:

•  Adequate service capacity throughout the region
•  A comprehensive array of high quality services available
•  Strong cooperation and collaboration between service providers

•    A lack of services available to women after they give birth
•    A lack of standardized at-risk birth assessment procedures
•    No collectively understood and implemented accountability system in the region

The report also detailed why pregnant women and mothers with infants may have difficulty accessing services and why service providers may not be operating at full capacity, including limitations that providers face in reaching underserved populations such as refugees and migrant workers, transportation issues and state and local policies that limit services provided in the region.

As a follow-up, Chapin Hall analyzed maternal/child health data at the zip code level in a second report, “Improving Services for Pregnant Women and Children 0-1 in Central New York State: Profiling High Risk Communities.”  This report provides zip code level analysis of the following maternal and child health outcomes: teen pregnancy, teen births, prenatal care status, low birth weight and infant mortality.

From these data, the Foundation selected the following five geographic areas, or “hot spots”, in which to concentrate its efforts: 

County	Zip Codes	Poverty Rate	Births (2007-2009)
1. Oneida (Utica)	13502	14%	2,884
	13501	22%
2. Oneida (Rome/Blossvale/Taberg)	13440	10%	1,248
	13308	8%
	13471	5%
3. Onondaga (Syracuse)	13208	17%	17,099
	13203	19%
	13204	32%
	13202	47%
	13207	17%
	13205	23%
	13206	13%
	13210	24%
4. Herkimer (Little Falls and Cold Brook)	13365	9%	365
	13324	17%
5. Oswego (Richland/Altmar/Williamstown/ Pulaski)	13144	18%	430
	13302	12%
	13493	11%
	13142	10%

For more information about the outcomes and risk factors analyzed to identify these “hot spots,” click here.

In late 2010, interviews were conducted with women in these “hot spots” to gather further insights regarding the experience of being pregnant and parenting in these communities, and to assess any relevant community norms regarding prenatal and perinatal care. 

Themes that emerged from the interviews included:

·         High rates of teen pregnancy and having pregnancies and births spaced closely together.

·         Low employment rates, with available jobs having poor working conditions

·         Sustained feelings of isolation, depression and anxiety

·         The women expressed a need for benefit programs, such as Medicaid and WIC, as well as education and support regarding pregnancy and parenting

To read the full report, "Maternal and Child Health in Upstate New York: A Qualitative Study," please click here.

By capitalizing on what the Foundation has learned from the data collection and analysis phases of the Maternal and Child Health project, we aim to improve the health of young children and families in poverty living in central New York.