Maternal and Child Health Library

This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.

July 2, 2009

************************************************************

Special Notice: MCH Alert will not be published for the next 2 weeks. The next issue is scheduled for July 24, 2009.

While MCH Alert takes a break, please take a few moments to respond to the 2009 MCH Alert Reader Feedback Form at
https://www.surveymonkey.com/s.aspx?sm=16ZJG5kXZgVQC_2bHc_2bxFH6A_3d_3d

************************************************************

1. PAPER SUMMARIZES STATE STRATEGIES AND POLICY OPTIONS FOR ADVANCING MEDICAL HOMES

Building Medical Homes in State Medicaid and CHIP Programs provides information for policymakers to use to improve Medicaid and CHIP beneficiaries' access to high performing medical homes (defined as an enhanced model of primary care in which care teams attend to the multi-faceted needs of patients and provide whole person, comprehensive and coordinated patient-centered care). The paper was published by the National Academy for State Health Policy in coordination with the Patient Centered Primary Care Collaborative and with the support of the Commonwealth Fund. Topics include 1) complementary activity in the private sector and at the federal level that may make this an opportune time for states' efforts in this area, 2) the amount and scope of recent state activity, and 3) five strategies states are using to advance medical homes and the options they have for implementing those strategies. The paper is available at http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2009/Jun/Building%20Medical%20Homes%20in%20State%20Medicaid%20and%20CHIP%20Programs/medicalhomesfinal_revised.pdf.

• Rates of motor vehicle accident (MVA) mortality, homicide, and suicide have changed little since the late 1990s.
• Trends in reproductive health indicators have been encouraging since the early 1990s. However, some of these trends, including rates of being sexually experienced, first sex before age 13, and condom use appear to have plateaued since 2004 to 2005.
• There are continuing disparities in almost all indicators of health; blacks continue to have the highest homicide rates, and American Indians-Alaskan Natives have the highest suicide and MVA death rates.
• There is a worsening of nearly all indicators among young adults.
• Adolescents and young adults continue to face barriers in access to care.
• Young adults, especially those who rely on public programs, face greater challenges in the transition from adolescence.
• National monitoring data are limited in several respects.

• The prevalence of high risk for depression (CES-D 16 or higher) was 32.4 percent in the U.S. study sample and 36.8 percent in the Mexico study sample; the prevalence of very high risk for depression (CES-D 24 or higher) was 15.7 percent and 23.9 percent of each sample, respectively.
• There were no group differences in mean levels of depressive symptoms. Similarly, there were no group differences in the proportion of women meeting either the high risk or very high-risk CES-D scores. There were also no group differences in history of suicidal thoughts.
• In the U.S. sample, the most important predictor of high risk for depression was having more years of education. For very high-risk depression status, second trimester, as compared to first, and history of suicidal thoughts were significant predictors.
• In the Mexican sample, history of suicidal thoughts predicted risk for depression. In this group, cohabitating, as compared to being married, and multiparity (i.e., mother of more than one child) predicted very high risk for depression.