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Giving every child a fair shot: Public health leader Michael Lu discusses federal initiatives at Childx conference

26539046226_fe53991526_bOne highlight of yesterday's Childx conference: an inspiring keynote address by Michael Lu, MD, associate administrator of maternal and child health of the Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services.

Lu oversees about 100 programs that affect the lives of 50 million of the nation's women, children and families. His opening was sobering:

It troubles me deeply that so many kids and families in this country are doing so poorly. We're the richest nation yet in the world, yet we consistently rank near the bottom among developed countries on most measures of maternal and child health.

But his agency is working hard to change that. Lu described several of the successes the HRSA has achieved since he took the helm four years ago, but he didn't gloss over the major, remaining challenges:

  • The Healthy Start program, which aims to lower infant mortality, has reduced the rate of infant mortality in 100 high-risk communities across the country from 9 per 1,000 births to 4.67 per 1,000 births, Lu said. (The national average is 6 per 1,000 births, meaning the U.S. ranks 44th in the world for infant mortality.) "We've still got work to do, but we've really positioned Healthy Start to move the needle on infant mortality," Lu said.
  • California provides a success story for lowering maternal mortality: the state's maternal mortality tracked with the rest of the country until 2006, when a large public-health effort was launched to reduce these deaths. By 2012, the program had produced a 64 percent reduction in maternal deaths. Stanford and the California Maternal Quality Care Collaborative (based at Stanofrd) have played a leading role in developing the tools that have produced this change, such as better toolkits and simulation protocols for dealing with emergencies like obstetric hemorrhage. "If we can replicate this success across the country, we can go from number 46 in the world to the best 10," Lu noted.
  • The agency has a new goal of preventing 100,000 child deaths and hospitalizations due to preventable injuries.
  • They also aim to bridge the "word gap" for poor children. By age 3, children growing up in poor households have heard 30 million fewer words, on average, than children in non-poor households, Lu said. "You're not going to get a fair shot in life if you start preschool 30 million words behind," he said. "We want to come up with low-cost, technology-based solutions to help motivate parent-child interactions. Technology is not the whole solution but it could definitely play a role."

In conclusion, Lu challenged conference attendees to think about health equity:

Innovations [in health] can widen disparities if you have differential access to them. We want to give every child and family a fair shot at reaching their fullest potential. This resonates with core American values about rights and liberties that are deeply embedded in the American dream.

The conference continues today.

Previously: New preeclampsia toolkit will help prevent maternal deaths, Pediatric health expert Alan Guttmacher outlines key issues facing children's health today and Study finds gaps in referring California's tiniest babies to follow-up care
Photo by Saul Bromberger

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