Reductions in local health departments’ spending on maternal and child health programs are strongly related to increased rates of low-birth-weight babies, according to a University of Washington-led study.

“Low-birth-weight infants are extremely costly to our healthcare system and to families and, even more important, have negative long-term effects on these babies – even well into adulthood,” said Betty Bekemeier, the study’s lead author and an associate professor in the UW School of Nursing.

WIC-Bekemeier

"Our study really underscores the value of local health department services around maternal and child health," said researcher Betty Bekemeier.

picture of Betty Bekemeier

The study was published May 6 in the American Journal of Preventative Medicine. It is the first multi-state study to explore the impact of budget cuts to maternal child health services over time and to demonstrate a relationship between spending and health outcomes.

Bekemeier and research colleagues explored 11 years of data from 102 county health departments across Washington and Florida. Their findings indicate that local health department spending overall can positively affect infant mortality, as well.

Lower-income populations are typical users of local health departments’ programs. Maternal and child health consultations are prevention-focused, highlighting family planning and education as well as screenings and other services available to mothers, children and pregnant women.

Decisions about funding such programs often are made outside of the agency and with little or no awareness of the impact these programs have. Local health departments often lack the infrastructure to collect and analyze data that could inform such decisions.

WIC-birthweight chart

Bekemeier et al / Am J Prev Med 2014;46(6):569–577

(Click to enlarge.) Changes in low birth weight and infant mortality rates by 3-year smoothed averages

chart of low birth weight and infant mortality rates by 3-year smoothed averages

“Communities have a harder time seeing prevention as valuable and supporting these upfront costs,” said Dr. Astrid Newell, community health manager at the Whatcom County Health Department. “We need this type of data and evidence for decision-making and to assure healthy communities,” she said.

While local health departments do not often provide prenatal care directly, Bekemeier thinks that community programs are integral to healthy pregnancies.

“Our study really underscores the value of local health department services around maternal and child health, particularly in needy communities. These findings come at a time when those same services have been in jeopardy,” she said.

Bekemeier thinks this is a first step to helping funding sources understand the impact of program cuts and the need for consistent tracking methods for health department data and services.

She and her research colleagues recently received funding to help develop standardized data collection among local and state public health systems in several states.