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: Ensure Basic Needs
Promoting better public health for all Minnesotans by addressing the social factors that affect health.
Focus areas:
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Housing stability
Food security
K-12 Education
Quality early childhood education and child care
Transportation
The Maternal Child and Health Assessment Leadership Team identified these specific action recommendations to
improve access to basic needs for Minnesotans:
1. Develop policies that help people build capacity while they are in need of or utilizing services.
2. Provide greater support and ease for individuals and families in need of services through navigators and
streamlining of applications.
3. Increase access to financial security through policies to support higher wages and access to paid leave.
In this priority area, much could be done to ensure basic needs through:
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Greater use of a “Health In All Policies” approach – considering how all policies affect an individuals or family’s
ability to provide for their basic needs.
Increasing access to basic needs through education, culturally-specific services, relationship building and greater
disclosure of available services.
Increasing access to and use of family home visiting – promote preventive health, early identification of concerns,
connect families to resources and services.
Using community “navigators,” specialized resource staff who work within a specific community to connect
families and individuals to resources.
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Housing stability
Objective: Reduce the number of individuals and families experiencing homelessness in Minnesota.
Housing instability can significantly impact a family’s ability to support their children’s health needs. In 2012, 15% of
homeless parents reported that at least one of their homeless children had a chronic or severe physical health problem.
Chart 1: Age distribution of persons experiencing homeless on a single night in October 2012
Source: Wilder Research 2012 Survey of Homelessness.
According to a study in 2012 on homelessness in Minnesota, an estimated 40,000 Minnesotans experience homelessness
at least once over the course of a full year* this includes an estimated:
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16,900 adults age 22 or older
3,900 young adults ages 18-21 on their own
5,100 minor youth (ages 17 or younger) on their own
13,900 children with their homeless parents
*This estimate does not include homeless persons living on American Indian reservations in the state. It also does not
include school-age children with parents who stay in temporary, doubled-up arrangements that are defined as “homeless”
under the McKinney-Vento Act as it applies to educational services.
Race/ethnicity of homeless adults and youth compared to overall Minnesota population
Race/Ethnicity
% of
HOMELESS
adults
% of all
Minnesota
adults
% of
unaccompanied
HOMELESS
youth age 21 and
under
% of all
Minnesota
Black/African American
American Indian
Asian American
Hispanic (any race)
White/Caucasian
Other/Mixed race
38
10
1
7
42
8
5
1
4
4
86
3
40
13
2
10
33
12
7
2
6
7
76
6
Source: Adapted from Wilder Research 2012 Survey of Homelessness
Measurements/outcomes for housing stability:
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Proportion of all households that spend more than 30% of income on housing.
Percentage of families with young children who have affordable housing.
Number of children qualifying as Homeless or Highly Mobile (federal designation).
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Examples of strategies and practices to support housing stability:
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Support financial stability through policies to support higher wages and paid family leave.
Promote and support a variety of safe and stable housing options.
Create healthy and affordable housing opportunities.
Support transitional housing for families.
Better promote home buyer/homeowner education, counseling, and support among all communities.
Housing First – modify homeless programs to initially focus on rehousing families, then to provide the support
families need to stay housed.
Transitional housing programs – provide rent assistance and supportive services to help stabilize families and
individuals.
Food security and access
Objective: Eliminate very low food security among children.
Chart 2: Percent of MN households with food insecurity by years
Source: US Department of Agriculture, State Fact Sheets: Minnesota, 2005-2013.
Chart 3: Percent of SNAP-Eligible families with children by race/ethnicity, 2011-2013
Source: MN Department of Human Services, Supplemental Nutrition Assistance Program Annual Reports.
Measurements/outcomes to support food access:
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Percent of students who had to skip meals in the last 30 days because their family did not have enough money to
buy food.
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Examples of strategies and practices to support food access:
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Strengthen charitable food distribution networks.
Promote use of Women, Infant and Children Program (WIC) Supplemental Nutrition Assistance Program
(SNAP).
Increased minimum wage.
Early Childhood to 12th Grade Education
Objectives:
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Decrease racial disparities in Minnesota’s high school graduation rates.
Increase graduation rates for Children and Youth with Special Health Needs.
During the 2011-2012 school year, 56.3% of students with an Individualized Education Program graduated from high
school in four years with a regular diploma. An estimated 15.7% of CYSHN ages 5 to 17 have health conditions that often
hinder school attendance. (Source: National Survey of Children With Special Health Care Needs, 2009-2010.)
Graduation status of MN students four years after entering 9th grade, 2008-2009
Non-Hispanic
Black
American
Indian
Asian
Hispanic
Non-Hispanic
White
Graduated
44%
41.3%
68%
45.2%
82.4%
Dropped Out
10.9%
19.3%
5.7%
16.9%
3.7%
Continuing in
School
33.1%
26.9%
17.4%
24.6%
9.9%
Unknown
12.1%
12.6%
8.9%
13.3%
4.1%
Total
100%
100%
100%
100%
100%
Source: Minnesota Department of Education, Data Center
Measurements/outcomes for education:
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Percentage of students graduating high school four years after entering 9th grade.
Percentage of students with an Individualized Education Program graduating from high school four years after
entering 9th grade.
Examples of strategies and practices to support education:
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Support families in accessing early intervention and support services through early and continuous screening and
referral.
Support stable housing to improve stable schools for children and adolescents.
Mentoring programs – match K-12 students with caring adults to provide additional support.
Individualized education plans.
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Quality early childhood education and child care
Objective: Infants and toddlers reach critical developmental benchmarks.
In 2009-2010, 27.9% of CYSHN receiving special education received early intervention services before they were 3 years
old. (National Survey of Children With Special Health Care Needs, 2009-2010.)
Chart 4: Percent of three and four year olds not attending preschool by race, 2010-2012
Source: U.S. Census Bureau, 2012 American Community Survey
Chart 5: Percent of kindergarteners reaching 75% standard by selected sub-categories, 2012*
Source: Minnesota Department of Education, Minnesota School Readiness 2012 Study: Developmental Assessment at Kindergarten
Entrance. *The 75% standard is defined as the percent reaching at least 75% of the possible points on the checklist, a predictor of
grade 3 MCAs. FPL= federal poverty level.
Measurements/outcomes to support quality, accessible early childhood education:
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Children ages 0-3 with disabilities who improve their acquisition and use of knowledge and skills.
Children demonstrating proficiency in three domains (language and literacy, mathematical thinking and personal
and social development) at kindergarten entrance.
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Infants and toddlers with high needs participating in early learning and development programs that are in the top
tiers of the tiered quality rating and improvement system.
Examples of strategies and practices to support quality, accessible early childhood education:
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Provide ongoing training and support to child care providers.
Increase access to child care assistance by expanding eligibility requirements.
Implement universal pre-kindergarten education.
Rating systems for quality child care, designed to help families in making child care choices.
“Follow Along,” local public health led programs to support universal screening and increased identification of
children with special health needs.
Early intervention services for children with delays in development or social-emotional areas, provided free to all
families.
Transportation
Objective: Increase access to basic needs (education, health, employment) through accessible and affordable public
transportation.
In Greater Minnesota, six urban systems, 41 rural systems and 13 small urban systems provide some level of transit
service in most of the state. In 2009, four counties had no public transit service at all and eight counties had service only
in certain cities within the county. (Transportation in Minnesota: A Roadmap to 2040. Minnesota Transportation Alliance,
September 2011.)
Minnesota CYSHN who had difficulties or delays getting needed services because they weren’t available locally
Percent of Minnesota Children and Youth with Special Health Needs…..
Percent
…who had difficulties or delays getting needed services because they weren’t available
locally.
10.3%
… with functional limitations who had difficulties or delays getting needed services because
they weren’t available locally.
15.2%
… with emotional, developmental or behavioral issues who had difficulties or delays getting
needed services because they weren’t available locally.
18.7%
Source: National Survey of Children With Special Health Care Needs, 2009-2010
Measurements/outcomes to support transportation:
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Increase access to transportation for health care visits for public health plan participants outside the Twin Cities
area, including mental health.
Examples of strategies and practices for transportation:
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Ensure all regions within the state have transit services that allow people to participate fully in their communities.
Provide transportation to medical appointments for clients of both Medicaid and fee for service health plans.
Promote guidance for policies and specific improvements to rural transportation systems.
Organize local communities to identify and promote changes to urban transportation systems, based on
collaborations between transit professionals and community organizations.
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Ensure Basic Needs was or is an identified priority, focus, or goal of all of these reports, plans, and
organizations:
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Maternal and Child Health Assessment Inquiry Feedback – MDH
2010 Title V National Performance Measure
Adolescent Health Action Plan
Advancing Health Equity Report - MDH
CDC Healthy People 2020
Children’s Defense Fund – MN
Community Health Boards – MN
MN Children & Youth With Special Health Needs Strategic Plan 2013-2018
Prenatal to Three Plan
Rural Health Advisory Committee
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/ .
On the data charts above, all races are non-Hispanic ethnicity.
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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