Turning the Ship: Making the Shift to a Life-Course Framework

• Published in: Maternal and child health journal Vol. 18; no. 2; pp. 423 - 430
• Main Authors: Rohan, Angela M., Onheiber, Patrice M., Hale, Linda J., Kruse, Terry L., Jones, Millie J., Gillespie, Katie H., Lathen, Lorraine S., Katcher, Murray L.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-02-2014; Springer; Springer Nature B.V
• Subjects: African Americans; African Americans - statistics & numerical data; Analysis; Babies; Children & youth; Childrens health; Chronic illnesses; Community; Community Networks - organization & administration; Community Networks - standards; Community Networks - trends; Cultural differences; Economic aspects; Family Health - ethnology; Family Health - trends; Female; Focus Groups; Gynecology; Health care; Health disparities; Health Plan Implementation - methods; Health Plan Implementation - organization & administration; Health promotion; Health services; Health Status Disparities; Hispanic Americans; Humans; Infant; Infant mortality; Infant Mortality - ethnology; Infant Mortality - trends; Infant Welfare - ethnology; Infant Welfare - trends; Life course theory; Local communities; Maternal & child health; Maternal and Child Health; Maternal Health Services - organization & administration; Maternal Health Services - standards; Maternal Health Services - trends; Medicine; Medicine & Public Health; Pediatrics; Population Economics; Preconception Care - organization & administration; Preconception Care - standards; Preconception Care - trends; Pregnancy; Pregnancy Outcome - ethnology; Public awareness; Public Health; Social aspects; Social Marketing; Social skills in children; Sociology; Wisconsin - epidemiology; Womens health; Wisconsin; United States; United States > US; Disparities; Title V; Life-course; Implementation
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-013-1225-x

Turning a ship requires small but steady and deliberate efforts over time. During the past 9 years, Wisconsin’s Maternal and Child Health (MCH) Program has begun to utilize the life-course perspective as its framework for guiding efforts around women’s health, early childhood systems, children and youth with special health care needs, chronic disease integration, and elimination of racial and ethnic disparities in birth outcomes. In collaboration with many state and national partners, Wisconsin’s MCH Program has integrated the life-course perspective into efforts that include the following: increasing professional and public awareness of the framework; creating focus groups and social marketing campaigns in communities most affected by health disparities; expanding preconception and women’s health initiatives; integrating 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. Wisconsin’s implementation of the life-course perspective has not been without challenges, but opportunities have also been identified along the journey. Initial efforts focused on training and supporting partners in their understanding and application of the life-course framework, and a train-the-trainer model was discovered to be key to achieving these goals. We took care to engage special populations and their advocates and to work closely with local communities. We hope that the lessons we have learned in this process will provide guidance for others as they work to incorporate life course into their MCH work. The life-course perspective has helped us to inform partners, policy makers, and funders of the need for a new approach in addressing racial and ethnic disparities in health.