2015 Minnesota Maternal and Child
Health Assessment
MATERNAL AND CHILD HEALTH SECTION
August 2015
Development of the Minnesota Maternal and Child Health Assessment was facilitated by the Maternal
and Child Health Assessment Leadership Team and the Minnesota Department of Health (MDH).
For more information, contact:
MATERNAL AND CHILD HEALTH SECTION
PO Box 64882, St. Paul, MN 55164-0882
651-201-3760
[email protected]
http://www.health.state.mn.us/divs/cfh/program/mch/
The information in the assessment were provided by the Maternal and Child Health Assessment
Leadership Team, community members, and staff from the Community and Family Health
Division at the Minnesota Department of Health. We offer our sincere gratitude for the
commitment of time and expertise provided by each contributing individual and organization.
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Executive Summary
Every five years the Minnesota Department of Health is asked to complete a comprehensive assessment
of the health needs of children, mothers, and families in Minnesota, in order to fulfill a requirement of
the Title V Block Grant. The purpose of this assessment was to review and determine the top health
needs for the following populations in Minnesota:
• Pregnant Women, Mothers and Infants;
• Children and Adolescents; and
• Children and Youth with Special Health Needs (CYSHN)
The goals for the health assessment process were to:
1. Determine Minnesota’s priority health needs for the maternal and child health (MCH) and
CYSHN populations; delineate a response to each; and make recommendations.
2. Create a highly engaging assessment process, setting a solid direction for maternal and child
health activities.
3. Engage stakeholders and MDH staff in a timely and useful manner.
4. Create deliverables that meet the needs of the stakeholders.
Health disparities and health equity were core threads that ran throughout the needs assessment
process. Using a health equity lens, assuring that community voices were included throughout the
process, using a “health in all policies” approach and assuring that populations experiencing the greatest
health needs had a voice in the solutions were the framework used to guide the process.
The intention of the findings from the health assessment is to inform, share ideas, and drive the work of
community members, policy makers, public health professionals, and others working towards improving
maternal and child health in Minnesota.
Maternal & Child Health Assessment Leadership Team
A health assessment Leadership Team was established in August 2014 to provide high-level guidance to
this process. It included 40 stakeholders from the public and private sectors, state and local
government, tribal governments, advisory groups, citizens and family members. A list of the members
can be found at the end of this summary. The team established the framework to be used for the needs
assessment process, developed the goals and objectives, provided input on the development of the list
of potential priorities and the inquiry survey process, reviewed outcomes of the stakeholder survey, and
advised on the selection of priorities.
Methodology
The methodology used in the needs assessment included a planning stage, data gathering, data analysis,
stakeholder input, and priority selection. Existing reports and needs assessments from state, local public
health, community organizations and others were used to identify current MCH and CYSHN priority
health needs in Minnesota. Additionally, an 11-question stakeholder inquiry survey was developed to
further assess the health needs of the MCH and CYSHN populations. Using the survey, inquiry sessions
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were conducted throughout the state to gather qualitative data. The purpose of the inquiry
survey/sessions was to qualitatively assess the strengths and needs of the MCH and CYSHN populations
in Minnesota.
The qualitative data from the inquiry survey was paired with quantitative sources, such as the National
Survey for Children’s Health (NSCH), National Survey for Children with Special Health Care Needs (NSCSHCN), Pregnancy Risk Assessment Monitoring System (PRAMS), Minnesota Student Survey, and
others, to gather a comprehensive picture of the general health status of the populations within the six
MCH domains. After review of the health status of the MCH populations, the final priority health needs
were selected.
Findings: MCH Priorities
The assessment culminated in the selection of nine health priorities, highlighting the top health needs
for Minnesota’s MCH and CYSHN populations. With input from stakeholders, priority sheets were
developed for each of the nine priorities, including the following information: data points, possible
strategies to address the issues, and examples of evidence-based/promising practices. The priority
sheets are available on the Maternal and Child Health Assessment webpage. Provided below is a short
summary of the nine priorities.
2015 Maternal and Child Health Needs Assessment Priorities with Recommendations
Priority: Improve Adolescent Health
Supporting Minnesota's youth and young adults as they connect with their communities; optimize
their mental, social, sexual, and physical health; and transition into healthy adults.
Focus: Transition to adulthood; preventative health care; community connectedness and
engagement.
Recommendations:
• Increase access to programs and services that promote transition to adulthood for
adolescents and Children and Youth with Special Health Needs.
• Increase adolescents’ usage of preventive health care (physical, mental, sexual health) by
training providers on how to best serve adolescents and educating adolescents on the
importance of preventive care.
• Involve youth in decision making and program planning.
• Create targeted outreach for youth of color and LGBTQ youth to promote physical, mental,
sexual and social health and use of preventive care.
• Build community capacity to engage and support young people to be connected to
community, school, and caring adults.
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2015 Maternal and Child Health Needs Assessment Priorities with Recommendations
Priority: Ensure Basic Needs
Promoting better public health for all Minnesotans by addressing the social factors that affect health.
Focus: Housing stability; food security; K-12 Education; quality early childhood education and
child care; transportation.
Recommendations:
• Develop policies that help people build capacity while they are in need of or utilizing services.
• Provide greater support and ease for individuals and families in need of services through
navigators and streamlining of applications.
• Increase access to financial security through policies to support higher wages and access to
paid leave.
Priority: Build Community Connectedness
Building stable communities that support stable families and individuals throughout Minnesota;
through this addressing and preventing community and population level trauma.
Focus: Building protective factors through individuals connecting to their communities;
communities are involved in plans that serve them; healing from historic or collective trauma.
Recommendations:
• Create or identify measures to assess level of community connectedness.
• Increase involvement of community members in the plans and activities that serve their
communities.
• Build capacity of communities to deliver services within their communities.
Priority: Support Healthy and Planned Pregnancy
Laying the ground work for healthy women and babies in Minnesota by increasing access to and use
of preconception and interconception health care, early prenatal care, access to affordable
contraception, and preventing adolescent pregnancy.
Focus: Planned pregnancy; preconception and interconception health; early access to prenatal
care; accessible and affordable contraception; adolescent pregnancy prevention.
Recommendations:
• Increase awareness, access, and use of long acting reversible contraceptives among women
of reproductive age at risk of unintended pregnancy.
• Increase access to culturally responsive, early prenatal care and reduce barriers to prenatal
care access.
• Advocate for and increase use of evidence-based comprehensive sexuality education in
school based settings.
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2015 Maternal and Child Health Needs Assessment Priorities with Recommendations
Priority: Increase Health of All Babies
Getting Minnesota's children off to a strong and healthy start: babies sleeping safe, receiving
preventative care complete with screening and breastfeeding support.
Focus: Infant mortality; healthy weight; safe sleep; newborn screening; breastfeeding.
Recommendations:
• Develop and increase access to culturally responsive coordinated health care for all women
during preconception, pregnancy and post-partum periods.
• Promote and support breastfeeding through family home visiting and WIC programs across
the state of Minnesota, including the development of policies that promote breastfeeding in
various settings (e.g. workplace, educational institutions, health care centers).
• Increase awareness of current policies and efforts in place to address the needs and concerns
of families' with chemically dependent individuals.
• Create partnerships to address concerns related to keeping families together (e.g. fears
related to mandated reporting at clinical visits).
• Reduce infant mortality rate and racial and ethnic disparities in infant death rates.
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: Preventing Adverse Childhood Experiences; promoting healthy parent-child attachment;
access to adequate family paid leave
Recommendations:
• Increase access to childcare and respite care for all families, especially those with children
and youth with special health needs.
• Improve understanding of Adverse Childhood Experiences through greater community
outreach and engagement.
• 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.
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Priorities with Recommendations
Priority: Promote Positive Mental Health
Creating Minnesota communities where every person can realize his or her own potential, cope with
the normal stresses of life, work productively and fruitfully, and make a contribution to her or his
community. Building communities where people are connected and have the power to achieve
community-specific, culturally-focused, actions to build resilience and change the social and economic
conditions that enable trauma and health inequity.
Focus: Available, culturally appropriate, and quality mental health services for individuals and
within family relationships (mother/baby, multigenerational); build community capacity to
address mental health and well-being; address historical, generational trauma and promote
resilience; integrate behavioral health with primary care; postpartum depression prevention and
treatment; suicide prevention; bullying prevention.
Recommendations:
• Create more opportunities for community dialogue, capacity building, and engagement in
decision making regarding mental health.
• Develop measures for "culturally appropriate care" to increase understanding of accessibility
and address problems.
• Increase access to mental health education, preventive care and treatment for youth,
including building the capacity of specific approaches for youth of color and who identify as
LGBTQ.
• Increase screening and community awareness of the benefits of screening child
development, mental health, social and emotional health, behavioral health, and maternal
health.
• Build capacity to provide mental health services (prevention and treatment) throughout the
state through integrative behavioral health and professionals maximizing their licensure
capability.
Priority: Promote Preventive Health Care
Promoting community health and keeping all women and children healthy through access to prenatal
care, well woman and child visits, screenings, immunizations, and preventative oral health care.
Focus: Immunizations; well checkups; oral health; screening and follow up.
Recommendations:
• Improve access to preventive health care in rural Minnesota and tribal areas by
increasing access to transportation and quality providers in shortage areas.
• Establish more integrated care sites, inclusive of services such as, but is not limited to:
dental, physical, behavioral and mental health care.
• Expand providers’ prescription capability to include alternatives such as cooking and
physical activity classes.
• Promote routine well-woman visits to support the mental and physical health needs of
women.
• Increase developmental screening during well-child visits and appropriate follow-up to
support the developmental, social-emotional and physical health needs of children.
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Priorities with Recommendations
Priority: Ensure Adequate and Accessible Care
Ensuring all Minnesotans have access to adequate coordinated, timely, culturally appropriate and
effective health care; including oral care.
Focus: Culturally responsive care; medical homes and health care homes; affordable and timely
care; adequate insurance coverage.
Recommendations:
• Improve access to preventive health care in rural Minnesota by increasing access to
transportation and quality providers in shortage areas.
• Establish more integrated care sites that accepts public plan coverage and are inclusive of
services such as, but not limited to: dental, physical, behavioral and mental health care.
• Increase access to and use of medical homes for children and youth with special health
needs (CYSHN) and promote a comprehensive, coordinated, and integrated system of
services and supports for CYSHN and their families.
• Ensure adequate health insurance coverage for maternal and child populations.
• Expand providers’ prescription capability to include alternatives such as cooking and
physical activity classes.
Although Minnesota consistently ranks in the top ten for overall health according to America’s Health
Rankings, and ranked 5th in 2014 for overall child well-being by the Annie E. Casey Foundation, these
rankings do not tell the whole story. For many populations, the opportunity to be healthy is not
available leading to significant and persistent disparities in health outcomes such as: MN's African
American and American Indian babies die at twice the rate of White babies and women of color were
two to three times more likely and American Indian women seven times more likely to receive
inadequate or no prenatal care.
We hope that findings from this assessment will help guide the work of community members, policy
makers, public health professionals, and others in working towards improving the health of children,
mothers, and families in Minnesota.
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