Maternal and Child Health Assessment 2015
In 2015, the Minnesota Department of Health conducted a Maternal and Child Health Needs Assessment for the state of
Minnesota. Under the direction of a community leadership team, this assessment identified nine priorities for improving
the health of mothers, children, adolescents, pregnant women, infants, and children and youth with special health needs.
Working with stakeholders from across Minnesota, the leadership team identified specific areas of focus for each priority,
along with possible measurements, strategies, practices, and action recommendations. We understand that there are some
overlap among the nine priority areas; to avoid duplication, most areas of focus are only identified once, even though they
could be under multiple priorities. (For example, prenatal care is important for both Preventive Health Care and Healthy
Babies, but it is only listed under Healthy and Planned Pregnancy.)
These priority sheets were created to provide data and ideas for community members, policy makers, public health
professionals, and others working towards improving maternal and child health in Minnesota.
Priority: Promote Nurturing and Stable Families
Growing healthy Minnesota families through prevention of family violence and adverse childhood experiences and
promotion of positive parent-child attachment, including addressing historical, collective and family trauma.
Developing resources (e.g. child care, respite care) to promote supportive services for all families, especially for
children with special health needs.
Focus areas:
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Preventing Adverse Childhood Experiences
Promoting healthy parent-child attachment
Building family stability – done through access to Basic Needs – look at Basic Needs Priority Sheet
The Maternal Child and Health Assessment Leadership Team identified these specific action recommendations to
support nurturing and stable families in Minnesota:
1. Improve understanding of Adverse Childhood Experiences through greater community outreach and engagement.
2. Promote community partnerships between providers, public health and families to address family stability and
understanding of cultural differences and increase access to services to support stability.
3. Increase access for families with children and youth with special health needs to childcare services and respite care.
Preventing Adverse Childhood Experiences (ACEs)
Objectives:
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Increase awareness of ACEs, their impact on health and well-being, and Minnesotans’ capacity to act. Enhance
the capacity of communities to prevent and respond to ACEs.
Continue to collect Minnesota-specific data on the relationship among ACEs, health outcomes, and resilience.
Reduce nonfatal child maltreatment.
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Chart 1: Percent of Adults Reporting ACEs by Category, 2011
Source: Adverse Childhood Experiences in MN, Minnesota Department of Health.
According to the Minnesota Student Survey in 2010, students of color and American Indian students are more likely to
report experiencing physical and sexual abuse.
Chart 2: Percent of students who have ever been hit hard or often by an adult in the household, 2010
20%
20%
18%
18% 18%
17%
16%
15% 15%
14%
10%
12% 13%
9%
7%
Grade 6
African American
Grade 9
American Indian
Grade 12
Asian
Hispanic
White
Source: Minnesota Student Survey, 2010.
Children and youth with special health care needs are at increased risk for experiencing family violence.
Chart 3: Percent of Minnesota youth who have been victims of family violence, by health status
Source: Minnesota Student Survey, 2010.
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In Minnesota, 25,839 children were the subject of accepted child maltreatment reports, assessed by county and tribal
agencies in 2012. More than 18,000 reports involving more than 25,000 children received a Family Assessment Response,
which secures children’s safety while supporting families. Of those children, 30% were identified in need of, or offered,
voluntary supportive services. (Minnesota Department of Human Services, Child Safety and Permanency Fact Sheet.)
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Approximately 43 percent of all children in maltreatment reports were age 5 or younger; 22 percent were under
the age of 3; and 9 percent were under the age of 1.
171 children were abused and neglected in locally monitored, state-licensed facilities, such as family foster care or
home child care.
52 children suffered life-threatening injuries and 8children died from maltreatment.
American Indian and African-American children had the highest rates of contact with the child protection system,
being 6 times more likely to be reported as abused or neglected.
Measurements/outcomes:
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Percentage of infants and toddlers experiencing domestic violence.
Percentage of youth who have been victims of family violence.
Examples of strategies and practices:
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Provide screening, assessment for children (i.e. child psychotherapy in age 0-5) and include parents.
Include father’s role and participation in strategies.
Include mental health/chemical dependency issues in discussions related to family health.
Train providers and educators on how to approach all families from trauma-informed perspective.
Partner with the MN Department of Health and Human Services, primary care and health plans to promote
adverse childhood experiences screening at well child checkups.
Implement Nurse Family Partnership, a type of family home visiting.
Increase access to and usage of Trauma-Focused Cognitive Behavioral Therapy, a model of psychotherapy that
effectively combines trauma-sensitive interventions with cognitive behavioral therapy. It is designed to address
the needs of children with Post Traumatic Stress Disorder (PTSD) or other significant behavioral problems related
to traumatic life experiences.
Crisis Nurseries provide short-term, immediate shelter for children or a family in need. Shelters often provide
enrichment activities and developmentally appropriate, nurturing care. Many also provide smooth transitions into
other supports for the family, such as home visitor programs.
Parent, child, and family education classes that enhance parent/child relationships through coaching and modeling
of positive behavior guidance, problem solving, and effective family communication.
Promoting healthy parent-child attachment
Objectives:
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Address intergenerational trauma utilizing a holistic family approach.
Increase breastfeeding initiation and duration.
Increase percent of infants with “secure” attachment, as defined by the National Institute of Health.
Increase the percent of children and youth who feel they can talk with their parents about problems they are
having.
Measurements/outcomes:
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Participation rates in Early Childhood Family Education and other parent education and support models.
Percent of infants who are ever breastfed and percent of infants breastfed exclusively through 6 months.
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Chart 4: Percent of 9th grade students communicating with parents about problems, 2013
Source: Minnesota Student Survey, 1992-2013 Trends.
Chart 5: Minnesota WIC breastfeeding initiation by race/ethnicity
Source: Minnesota WIC data system, accessed April 2015.
Examples of strategies and practices:
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Expand opportunities for parenting education.
Assure that workers in all sectors have paid sick leave to attend to their own health and the health of their
families.
Promote postpartum depression screening for all women.
Promote intergenerational transmission of healthy cultural practices such as breastfeeding.
Provide incentives for milestones and early education.
Provide tools and services for early identification of children’s mental health status.
Promote breastfeeding-friendly policies across the state.
Increase community engagement to better understand the communities’ needs for raising healthy children.
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Early Childhood and Family Education (ECFE), based on the idea that the family provides a child's first and most
significant learning environment and parents are a child's first and most important teachers. ECFE works to
strengthen families and enhance the ability of all parents and other family members to provide the best possible
environment for their child's learning and growth. ECFE also has a home visiting program to reach families
experiencing multiple stresses.
Women, Infant and Children Program’s support of breastfeeding and use of Peer Counselors to support women
with culturally specific approaches and supports.
Access to adequate sick and family paid leave
Objective: Increase access to adequate sick and family paid leave for all Minnesota families.
Impact of CSHCN Health Conditions on Employment
Percent reporting family
Race/Ethnicity
members did not cut back
hours/stop working
Hispanic
White, non-Hispanic
Black, non-Hispanic
Other, non-Hispanic
All CSHCN Families
Percent reporting family
members did cut back
hours/stop working
51.2%
80.1%
62.5%
77.2%
76.4%
48.8%
19.9%
37.5%
22.8%
23.6%
National Survey of Children and Youth with Special Health Care Needs, 2009/2010
Measurements/outcomes:
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Percent of Minnesotans with access to sick and/or paid leave.
Examples of Strategies and Practices:
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Improve the uniformity of terms and concepts used in data gathering, more data are needed at the state level
regarding eligibility and use of paid sick leave and family leave. (Gault, Barbara, Hartmann, Heidi, Hegewisch,
Ariane, Milli, Jessica, and Lindsey Reichlin. 2014. Paid parental leave in the United States: What the data tell us
about access, usage, and economic and health benefits. Institute for Women’s Policy Research. Prepared for the
U.S. Department of Labor).
Eliminate gaps in current laws on paid sick and family leave.
Promoting nurturing and stable families was identified as a priority, in part, because it was an identified
priority, focus, or goal of all of these reports, plans, and organizations:
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ACEs in Minnesota Executive Summary – MN Department of Human Services
MCH Assessment Inquiry Feedback - MDH
2010 Title V National Performance Measure
2010 Title V State Performance Measure
2015 Title V National Performance Measure
Adolescent Health Action Plan – MDH
Advancing Health Equity Report - MDH
CDC Healthy People 2020
Children’s Defense Fund – MN
Community Health Boards - MN
Eliminating Health Disparities Initiative - MDH
Healthy MN 2020: Statewide Health Improvement Framework
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Hospital Community Health Needs Assessments - MN
Injury and Violence Prevention – MDH
MN Children & Youth With Special Health Needs Strategic Plan 2013-2018
MN Council of Health Plans
MN Statewide Health Assessment 2012
Prenatal to Three Plan - MN
Rural Health Advisory Committee - MDH
Women, Infant and Children -MN
For more information about the 2015 Maternal and Child Health Assessment, or about the Title V Block Grant, please
visit the Minnesota Department of Health webpage at http://www.health.state.mn.us/divs/cfh/na/ .
PO Box 64882, St. Paul, MN 55164-0882
651-201-3760
[email protected]
http://www.health.state.mn.us/divs/cfh/na/MCHNeedsAssessment.html\
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