happy children, mother and child, and expecting mother and father

Highlighting Diversity and Health Equity

Division Highlights

DMCHWD prepares and empowers MCH leaders from diverse communities to promote health equity and wellness, and reduce disparities in health and health care. This month, DMCHWD highlights several of the ways that our programs support diversity and health equity.

Trainee and Faculty Diversity Data

DMCHWD Training Programs U.S. Population Long-Term Trainees Faculty and Staff
# of Long-Term Trainees or Faculty/Staff - 2150 2006
Underrepresented Race 21.4% 24.7% 15.3%
Underrepresented Ethnic Group (Hispanic or Latino) 16.3% 8.8% 6.2%

graph showing diversity of programs, key trends are listed above

Key Trends:

  • In Fiscal Year 2015, the percentage of long-term trainees from an underrepresented racial group (24.7%) was higher than the percentage of the US population from an underrepresented racial group (21.4% - 2010 US Census).
  • The percentage of faculty and staff from an underrepresented racial group (15.3%) has increased by 2.3% from Fiscal Year 2014 (13%).
  • The percentage of faculty and staff from an underrepresented ethnic group (6.2%) has increased by 1.1% from Fiscal Year 2014 (5.1%)

Source of DMCHWD diversity data.
Source of U.S. population data from the 2010 Census

Program Highlights

2017 Diversity and Health Equity Peer Learning Collaborative

The Division of MCH Workforce Development launched the 2017 Diversity and Health Equity Peer Learning Collaborative for MCH Training Programs interested in:

  • Improving training program or institution’s practices around diversity or health equity
  • Revamping existing practices related to training on cultural and linguistic competence
  • Using new resources, tools, and best practices related to diversity, cultural and linguistic competence and health equity initiatives

The collaborative, which took place from January – October 2017, has facilitated sharing and use of information, and has highlighted successes, challenges, and solutions to more effectively address diversity and health equity within MCH Training Programs. Each team identified a project to address through the Learning Collaborative. Through participation in interactive monthly webinars and technical assistance sessions with the National Center for Cultural Competence and the Altarum Institute, the teams have been able to advance the goals of their projects and implement practice and policy changes. Webinar topics include implicit bias in the clinical setting and learning environment; culturally responsive patient-centered care; best practices to increase health workforce diversity; effective marketing strategies to recruit and retain diverse trainees; and getting faculty buy-in for health equity and implicit bias training.

The following teams were selected for participation in the collaborative:

  • Missouri LEND/Saint Louis University SPH
  • Riley Child Development Center LEND (Indiana)
  • New Hampshire - Maine LEND
  • Tulane CoE
  • Univ. Minnesota MCH Training Programs (LEND, LEAH, CoE, Nutrition)
  • Univ. Wisconsin MCH Training Programs (LEND, PPC, and Pipeline)
  • Univ. Alabama at Birmingham MCH Network

Top team accomplishments include: 

  • Engaging with university administration to share the results of a faculty survey on the culture and environment on campus when teaching about health equity
  • Connecting faculty and trainees to implicit bias trainings and resources on campus
  • Developing a trainee-led MCH mentoring program for high school students
  • Convening an inter-university team to work on an MCH cultural competence plan and identifying resources for inclusion in the plan
  • Setting up a clinical preceptorship and research mentorship program with a HRSA-funded pipeline program (Bureau of Health Workforce’s Health Professions Academy)
  • Developing a “Let’s Stay Connected” form and process that creates an on-going and intentional communications pathway for underrepresented students transitioning from undergraduate to graduate MCH Training Programs
In the upcoming months, MCHB will develop two documents. First, a 1-2 page document that will provide an overview of the Collaborative, identify the teams with a brief description of each project, and describe key collaborative activities and accomplishments. Second, a more in-depth analysis of the Collaborative, focusing on three case studies. In each case study, readers will learn more about the selected team, the need for their identified project, the solutions the team discovered to address barriers and challenges, and the impact of their key collaborative activities and accomplishments.

Group photo of the 2017 Diversity and Health Equity Peer Learning Collaborative

2017 Diversity and Health Equity Peer Learning Collaborative

logo for the Healthy Tomorrows Partnership for Children Program

Supporting Diversity and Reducing Health Disparities

In 2016, the American Academy of Pediatrics (AAP) joined forces with Altarum Institute to collect and share information from Healthy Tomorrows Partnership for Children Program (HTPCP) grantees about their efforts to integrate diversity and cultural and linguistic competence, and to reduce health disparities in their projects. The Altarum Institute conducted a focus group session with six HTPCP grantees to hear firsthand how they are effectively integrating cultural and linguistic competence into project values, policies, structures and practices, and how they address disparities and inequities through public health and clinical practice. HTPCP and Healthy Tomorrows Resource Center staff reviewed progress reports submitted to MCHB and conducted follow-up calls with selected grantees to gather additional information on their strategies for addressing diverse populations and reducing health disparities. Among the themes identified during the review process were the need for staff training, cultural and linguistic competence plans, community advisory boards, organizational policies and procedures, family navigators, and community health workers. The AAP launched the Diversity and Health Equity Tip Sheets with an article in the May/June 2017 issue of AMCHP Pulse  Exit Disclaimer on emerging issues.


Grantee Highlights

Healthy Tomorrows Grantee: Access Community Health Network (ACCESS)

logo for ACCESS Community Health NetworkSummary of Grant Project
In a community on the South Side of Chicago, which consisted primarily of low income African-American residents, grew an overwhelming need to provide quality, affordable health care. The few places that did provide care did not tailor their services to meet the specific needs of this population. There was a lack of routine screenings to identify future health complications, and other health barriers, like transportation and financial stability, were not addressed. These barriers prevented residents from obtaining the health care support and services they needed. Due to the lack of access to primary and preventative health care, children in this community were also at high risk for developing long-term mental and physical health issues.

With the help of a Healthy Tomorrows grant, Access Community Health Network (ACCESS) opened the ACCESS at Gary Comer Youth Center in 2010 to ensure students and other community residents received culturally appropriate mental and primary health care. The convenience of having a health center onsite at the youth center was a great benefit for the community. Medical compliance increased to 98% in the high school and early dismissal rates fell sharply.

ACCESS’ commitment continued after the Healthy Tomorrows grant period ended in 2014 and continues even today with the health center seeing more than 700 patients a year on average. Although barriers to health are still a significant issue facing this population, the staff members at ACCESS at Gary Comer Youth Center remain committed to supporting their community and addressing the health disparities residents still face, day in and day out. 

Example of How ACCESS Helps
Randall was just 17 years old when he was displaced from his home in Iowa and moved to Chicago to live with his 24-year-old sister, Daria, who is blind in one eye. Already afflicted with her own health complications, Daria now had the added responsibility of caring for Randall. Randall came to her without health insurance nor enough clothing to keep warm during the harsh Chicago winters. Additionally, they lacked the basic funds for adequate food and transportation.

Randall’s high school contacted the staff at ACCESS at Gary Comer Youth Center, which was a resource available in part due to the Healthy Tomorrows grant. First, the ACCESS staff helped Randall and Daria sign up for health insurance. Then, they ensured Randall was up-to-date on all the required immunizations. Daria and Randall are now insured and know that the ACCESS school-based health center is always there to help them and provide support.

By placing this health center right in a school-based community in need,  more underserved children and young adults on the South Side of Chicago now have better access to health care.

ACCESS Community Health Network

photo of hand pointing at water testing strip

Members of the Leaders in Maternal and Child Health student group

MCH Catalyst Training Program Takes Step into the Great Indoors

The Florida International University (FIU) MCH Public Health Catalyst training program is in Miami, a “majority-minority” city of over 2.3 million, with the highest proportion of foreign-born persons of any US major metropolitan area.  FIU students mirror the amazing diversity of Miami, with Latino/as from throughout Latin America, African-Americans, and Caribbean young people making up most of the student body. In 2015, the Catalyst grant awarded to FIU’s Stempel College of Public Health and Social Work supported a unique program to support MPH students as MCH Scholar Consultants, who would help guide all aspects of course preparation and adaptation, and educational activities such as MCH Grand Rounds. The Grand Rounds bring together professionals from multiple disciplines from the community, including the health department, and expose our students to the diversity of professional opportunity in Miami MCH practice.  The student group, Leaders in Maternal and Child Health, now boasts over 85 members, and frequently joins with the Stempel Public Health Association on community-based service events.

Beginning in Fall 2017, the Leaders in Maternal and Child Health are undertaking their next challenge: Great Indoors. Great Indoors is a community-based participatory research project in Liberty City public housing, a historically African American community with some of the most troubling MCH indicators in the county. As part of this project, Catalyst trainees seek to assess the impact on quality of life and health of mothers and children before and after innovative integrated pest management, improved conditions in the apartments and health promotion strategies to support smoking cessation are implemented.

MCH Pipeline – Baylor and Texas Southern University’s MCH STARS Program Has Its First Undergraduate Manuscript Published!

Texas Southern University (TSU) and Baylor College of Medicine (BCM) offer a joint one-year undergraduate fellowship program leading to the award of an undergraduate certificate in Maternal and Child Health (MCH). The MCH Student Training for Academic Readiness and Success (STARS) program recruits economically and educationally disadvantaged students, including students from racially and ethnically diverse groups. The program developed and implemented an effective and enriching MCH research mentoring program that meets the learning and skill development needs of the students as they navigate through the pipeline program and consider future career options in MCH-related fields. To date, four manuscripts have been submitted for review by the first cohort of 28 MCH undergraduate students. The first manuscript was recently published in the American Journal of Infection Control.

Article: Hospital length of stay and cost burden of HIV, tuberculosis, and HIV-tuberculosis coinfection among pregnant women in the United States Exit Disclaimer

MCH Nutrition Grantees – Diversity Learning Collaborative (DLC)

In December 2014, a Diversity Learning Collaborative (DLC) for the MCH Nutrition Grantees was established.

Accomplishments of the DLC include:

  • Creation of a Diversity Recruitment and Retention Toolkit, which was disseminated to all grantees.
  • Establishment of a peer-mentoring network, which led to the establishment of subgroups of funded trainees working on policy-related projects and meeting quarterly via web-based conference calls.
  • Creation of a Cultural and Linguistic Competence Online Learning Module, which is in the final phase of revision based on feedback received by all training programs.

Trainee Highlights

Denise Prehay: Lifting My Voice

A LEND Self-Advocate Trainee Reflects on MLK Day

"An injustice anywhere is a threat to justice everywhere." Dr. Martin Luther King, Jr.

Five years ago while I was shopping, the store manager stopped and asked me where I had gotten the item under my sweater. It was my purse, yet, I was mistaken for a shoplifter. When I spoke up, the store attendant noticed my physical disability, cerebral palsy, which affects my speech, and assumed I lacked intelligence. She was condescending and couldn't understand what I was saying. The police were called. It was a double-whammy: I was discriminated against for being a person of color and for having a disability.

I thought that moving from Jamaica, my country of birth, to the "Land of Opportunity" would mean the end of the barriers I had faced growing up. However, in America, it turned out to be no different. When I started my final semester of junior high, I was surprised to find all my classes had been changed to Special Education. After that, I learned nothing useful in my high school years. The only thing that I learned was how not to get pregnant.

Even though my Voc Rehab counselor discouraged me from pursuing a college education, I achieved my educational goals, including a Master's in Social Work. After landing my dream job at Parent-to-Parent I noticed how families were often challenged in knowing how to help their child. I felt it would give hope to parents if they saw more people with disabilities as professionals in the workplace.

As Martin Luther King Jr. Day approaches, I reflect on the parallels between our lives. We have both dealt with adversities and injustices, and, as far back as I can remember, I have always spoken up for my right to be heard. Like Dr. King, many did not want to hear a person of color speak for justice and equal rights. I, too, have my voice; but, growing up, people didn't listen. Just because I have trouble speaking doesn't mean I don't have anything to say. Being inspired by Dr. Martin Luther King, Jr., led me to become a fierce advocate for people with developmental disabilities. ​

Dr. King and the Civil Rights Movement have taught us in the Disability Rights Movement to continue to advocate. As a self-advocate trainee at the University of Miami's Mailman Center for Child Development's LEND program, I am tackling a project dear to my heart which focuses on Disability Awareness month in the school system, and working to mandate the inclusion of Disability History/Civil Rights history into Florida's public-school curriculum.

The theme for AUCD's last conference was "Lift Your Voice," which really resonated with me. Today, like Dr. Martin Luther King, Jr., before me, I am lifting my voice, not only for myself, but for others. It's true what my parents always told me, now more than ever: "Denise, you may not speak well, yet you always speak up." I encourage you to do the same.

See the original article on the AUCD website. Exit Disclaimer

Kathryn Mishkin and Wayne Lawrence selected as 2017-18 APHA Fellows

photo of Kathryn Mishkin and Wayne LawrenceSUNY - Albany Catalyst Trainees Kathryn Mishkin and Wayne Lawrence have been selected as 2017-18 fellows for the American Public Health Association’s (APHA) maternal and child health (MCH) section. SUNY-Albany SPH Interim Dean Laura Schweitzer said that the duo will benefit greatly from the guidance and training provided by their fellowships. “These opportunities are structured to provide significant work experience, and fellows often assume responsibilities to become fully immersed in their field,” she said. “We are so pleased that two of our students were selected for this prestigious honor and wish Kate and Wayne the best as they embark on this journey.” Read the full article here Exit Disclaimer

Trainee Ambassador GroupYuka Asada “Time With TAG”

I’ve had the privilege of serving on the Maternal and Child Health Bureau (MCHB) Trainee Ambassador Group (TAG) for the first two years of the initiative. I learned about the TAG as I was graduating from the doctoral program in Maternal and Child Health (MCH) Center of Excellence (CoE) program in the School of Public Health, University of Illinois at Chicago (UIC). During my doctoral studies in the MCH CoE, I benefitted from comprehensive coursework, leadership trainings, and mentorship from MCH staff and faculty. Since I was beginning a post-doctoral program not directly connected to MCH, the TAG was an excellent way to remain connected to the field of MCH. I have greatly appreciated the opportunity to continue my work in school nutrition and wellness policy implementation with the USDA-funded National Wellness Policy Study while continuing to network and learn about the various activities within MCH.

During my time with TAG, I’ve had the opportunity to attend the Making Lifelong Connections (MLC) meeting in 2017. At MLC, I appreciated the opportunities to meet and learn about the wide range of colleagues’ work in the field. In addition to networking, we had the opportunity to hear from distinguished MCH professionals and to discuss our future goals and aspirations as MCH leaders. I also served as the MLC Liaison for the TAG, where I learned about the planning processes for a very well executed professional meeting.

As I complete my time with the TAG, I am proud of the recently launched initiative (MCH Connects). MCH Connects offers a space for MCH professionals seeking mentors and mentees to connect online. Mentorship has advanced my professional career for the last 15 years and I am pleased to be able to offer mentorship opportunities to others in the field. I look forward to being a mentor on MCH Connects and to seeing initiatives developed by future TAG cohorts!

Trainee Ambassador GroupMichelle Gin

I’ve been honored to serve on the Maternal and Child Health Bureau (MCHB) Trainee Ambassador Group (TAG) for its first two years. My journey began in my final year of graduate studies earning my MPH in Maternal and Child Health from the University of Minnesota School of Public Health while I was also an Interdisciplinary Fellow of the Leadership Education in Adolescent Health (LEAH) program in the University of Minnesota Medical School. That year, I learned of the Making Lifelong Connection (MLC) Annual Meeting and was provided the opportunity to attend as a current MCHB trainee. I was thrilled to meet fellow trainees from:

  • Leadership Education in Adolescent Health (LEAH),
  • Leadership Education in Neurodevelopmental and Related Disabilities (LEND),
  • MCH Nutrition,
  • MCH Pipeline,
  • Pediatric Pulmonary Centers (PPC),
  • Developmental-Behavioral Pediatrics (DBP),
  • Centers of Excellence in MCH (CoE), and
  • MCH Catalyst.

At the time, I wasn’t aware of the many MCHB training programs. I had been in the depths of my research on adolescent sexual behaviors. Once meeting trainees focused on neurodevelopment and related disabilities and developmental-behavioral pediatrics, I wanted to learn more. MLC 2015 was an eye opening experience where I made lasting friendships. During MLC 2015, a MCHB representative presented a new initiative, TAG, to which I applied for because I wanted to be more connected with current and former MCHB trainees after I graduated and completed my fellowship in the coming months.

In the two years of serving in TAG, I have had the opportunity to plan MLC 2016, present at MLC 2016 and 2017, and help develop MCH Connects – a virtual mentorship program for MCHB trainees. Along the way, I have built professional relationships as well as friendships among fellow members and staff. I know that if I chose to relocate, I will have connections to help me find the resources to get me settled in the local public health community.

Now, as a former trainee of both LEAH and Center of Excellence in MCH, I wish to help navigate current trainees through the system of opportunities. I am a current mentor for the University of Minnesota School of Public Health for maternal and child health students. It is exciting when I am able to share my passion of adolescent health or environmental health with my mentee or direct them to a colleague I’ve met through TAG or MLC depending on their area of interest.
I would recommend serving on TAG if one is interested in:

  • interdisciplinary collaboration,
  • sharing opportunities with others, and
  • learning more about what it means to work at the federal level.

Heidi Jonson

My name is Heidi Jonson and I am currently completing the final semester of my Master of Public Health degree in Nutritional Epidemiology at the University of Minnesota. Additionally, I am finalizing my master's thesis at the Minnesota Department of Health, using data from the Minnesota Women, Infants, and Children (WIC) Program. My research objective is to determine the association between interpregnancy weight gain and subsequent child weight at ages 2-5. My major research interests are rooted in the “Life-Course Approach to Health." Specifically, I am interested in childhood obesity prevention at the federal policy level and intend to continue working within this area of research after graduation.

During Summer 2017, I had the opportunity to complete an impactful 10-week internship with the Division of Maternal and Child Health Workforce Development (DMCHWD) in Rockville, MD under the supervision of Madhavi Reddy, MSPH and Samantha Croffut, MPH, RD. I had a unique chance to work with the Division as they transitioned to meet the administration's new priorities in health—mental health, substance abuse, and childhood obesity. I was able to assist Meredith Morrissette, MPH in her research on childhood obesity prevention frameworks and guidelines, and present our findings at several nutrition-focused meetings with leaders across the Maternal and Child Health Bureau (MCHB).

In addition to childhood obesity work within the Bureau, I attended the National Academy of Sciences' Workshop on Strategies to Limit Sugar-Sweetened Beverage Consumption in Young Children and networked with fellow childhood obesity prevention researchers and policy experts. I also had the opportunity to attend the Autism CARES Meeting and the Meeting of the Interagency Autism Coordinating Committee where I learned about current research and advocacy for the Autism Community.   

Overall, I was able to apply my skills and knowledge from the academic setting to the innovative projects and proposals MCHB was putting forward. I really enjoyed my time at HRSA and was able to improve my communication and collaboration skills, and gain a unique insight into federal, state, and local maternal and child health programming and professional training. I am especially grateful for the world-class mentoring and support I received from the DMCHWD staff during my time at HRSA. I highly recommend this internship to students interested in pursuing careers in Maternal and Child Health!

Trainee Ambassador GroupNathan Fields “Time With TAG”

I came to the MCH Trainee Ambassador Group (TAG) as a student from Vanderbilt's UCEDD and LEND programs. I'm not a traditional TAG partner with a background in public health or medical experience, but am committed to partnering across disciplines to serve children and families who experience disability. From 2010-2015 I lived in China and there I became immersed in the complexities of disability, community development, power, and privilege. When our family of 3 learned we were growing with twins on the way, we moved back to the US. I applied to graduate schools and landed at Vanderbilt to get my Masters in Special Education, with a focus on children K-12th who have severe disabilities.

As a TAG ambassador, I've developed a new set of lenses to see children and families. I'm digitally networking with partners who have perspectives that I need to hear. We have the privilege to work with children and mothers, many whose lives are marked by courage, and that requires our commitment to their flourishing. Resilience doesn't come easy for me. I oftentimes get overwhelmed by some of the hard realities I encounter with children and families, and in all honesty, have cried a lot in working with children who have lived through trauma. But leaning into professional partners has lightened my heavy load of feeling like I need to have the answers to questions I don't know.

I live in Nashville, TN in a zip code where 40% of my community lives in extreme poverty. Connecting with MCH through TAG has given me a heightened sense of my commitment to address racial disparities experienced in maternal and children health. I have partnered with Meharry Medical College on a grant through the CDC's REACH 2020 (Racial and Ethical Approaches to Community Health) initiative, which works to bring mobile markets of fresh produce into food desert communities here in North Nashville. I have also been able to use my training and experience in TAG to provide a weekly StoryTent to children at our local farmers markets each Saturday morning. Since we started the program in early June, over 375 children have come to read, earn book bucks, and use their bucks to purchase prizes or produce.

I am grateful that I have this opportunity to be developed through MCHB's TAG. Not only has it provided me with a team of professionals from around the country, it's opened my eyes to the value of collaborating to accomplish a practical goal: developing a mentor and mentee directory for connecting seasoned professionals to early career professionals. The potential of this sort of tool is incredible! This sort of tool will allow us to tap into the power of our professional networks, to advance them and use them to enrich our world. I also envision this tool as a golden opportunity to enhance the networks of professionals with mentees that are in places where they can glean guidance from those they find through the MCH Connects platform.

Trainee Ambassador GroupShelly Johnston “Time With TAG”

MCH Nutrition Leadership

In 2015, I became an MCH Nutrition Leadership Trainee at the University of Washington (UW). At the time, I was entering the second year of UW’s Graduate Coordinated Program in Dietetics (GCPD) – a program designed to equip future dietitians with the knowledge base to work both at the individual and systems levels. While the program highlighted many facets of nutrition, I was drawn to topics that served the MCH population. In particular, I was struck by the concept of the Life Course approach and the potential to impact health disparities early in life. This interest developed into a passion for breastfeeding and opportunities to empower breastfeeding families. With the encouragement of my MCH Traineeship advisor and GCPD peers, I took a deep dive into breastfeeding. I began to focus most assignments on topics surrounding lactation and completed my thesis on the drivers of breastfeeding policy adoption in Washington State Clinics. As an MCH Trainee, I continued to expand my understanding through participation in annual trainee conferences and collaborative discussions with fellow MCH Nutrition Trainees. Each of these actions, paired with my public health nutrition training, led me to value the impact of multilevel strategies upon breastfeeding and other aspects of MCH.

While my long-term goals to pursue higher education and research remained, I began to rethink my first step out of graduate school with a new appreciation for each level of the system. To influence breastfeeding at the policy level, I wanted to first experience breastfeeding at the individual level. With a new degree and credential in tow, I accepted a position as a Nutritionist-RD at a local community health center WIC program. I also joined the Maternal Child Health Bureau Traineeship Ambassador Group (TAG).

As a WIC Nutritionist-RD, I see the downstream effects of policies and the resilience of families. In particular, the topic of breastfeeding continues to stand out in my daily endeavors. I built a basic knowledge of breastfeeding through my training, yet I learn more each day from families who push beyond the aggressive marketing strategies, social stigmas, and lack of paid parental leave to provide the best start for their children. I am grateful for the opportunity to invest in future generations through these one-on-one interactions.

As a TAG Ambassador, I collaborate with peers who share a similar passion for the MCH population. Each of us brings a unique strength to the projects at hand and subsequently reinforce the value of interdisciplinary, multi-level strategies. The emphasis of the Maternal Child Health Bureau’s (MCHB) Division of MCH Workforce Development (DMCHWD) to build relationships and networks across professions has been a key driver in my professional experience and time with TAG. I look forward to maintaining and building additional connections with the MCH community.

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