Chester County Medicine Winter 2019 - 24

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Reducing Barriers in Accessing
Maternal and Child Healthcare

Improving Perinatal Birth Outcomes for
Vulnerable Women and Children
BY CATHERINE BINZ AND EMMA GARNER

I

n Chester County, heart disease is reported as the number one
major cause of death, while diabetes is the sixth leading cause
of death (Chester County Health Profile, 2016). Not only
does Pennsylvania have the 25th highest adult obesity rate
in the nation, but its adult obesity rate has made a steady incline
in the past two decades, raising to 30.3% from 20.3% in 2000
and from 13.7% in 1990 (The State of Obesity: Better Policies for a
Healthier America, 2017).
While cardiovascular disease, diabetes, and obesity have
obvious physical health impacts, they also greatly affected Chester
County citizens financially. For example, those living with
diabetes have average medical expenses that are approximately 2.3
times higher than those who are not affected by the disease. In
Pennsylvania, medical expenses for diagnosed and undiagnosed
diabetes, pre-diabetes, and gestational diabetes were estimated
at a sum of $10.2 billion in 2012 (The Burden of Diabetes in
Pennsylvania, ADA 2015).
These numbers create an even larger burden on those who are
already financially vulnerable and affected by chronic disease. By
preventing heart disease and diabetes, there could be a reduction
in health care costs, contributions to a healthier economy, and
an overall improvement to the quality of life in Chester County.
Because obesity is a multi-factorial condition, if addressed early
and properly it could lead to reduced risk of developing unhealthy
lifestyles that contribute to heart disease and other chronic
conditions.
At Maternal and Child Health Consortium (MCHC), a
nonprofit organization in Chester County that aims to reduce
barriers in accessing maternal and child healthcare and improve
perinatal birth outcomes for vulnerable women and children,
chronic disease prevention, including diabetes and heart disease
prevention education, is provided to pregnant and parenting
women and their partners, children and their family members,
and to community members to improve their long-term health
outcomes. MCHC's recent strategic planning helped them to
understand the link between social determinants of health and
diabetes can lead to the identification of nontraditional strategies
by using nontraditional partners and identifying opportunities for

24 CHESTER COUNT Y Medicine | WINTER 2019

improving or preventing negative health outcomes in communities
affected by the inequitable conditions that create them.
In early 2017, MCHC developed their bilingual Diabetes
and Heart Disease Prevention education program integrated into
their home-visiting Healthy Start and Family Center programs,
leveraging the current structure and Community Health Worker
(CHW) approach. The program is delivered by MCHC's trained,
culturally competent and bilingual CHWs during home visits in
a one-on-one setting with participant mothers and their partners
and children. Group workshops are also offered to participants'
extended family members, friends, and community partners and
providers as well as members of the community. The goal of the
program is to increase low income mothers' and their children
and families' awareness on self-management of diabetes and
heart disease risk factors. For one MCHC participant, a stay at
home Latino mother, her daily routine of cooking meals for her
family, getting her daughters, aged 4 and 7, ready for school,
cleaning the house, and caring for her newborn made healthy
meal preparation a challenge, in addition to not always having the
means to afford healthy food options. She often chose prepared
foods for convenience to help her manage her busy days. She had
been enrolled in MCHC's Healthy Start home visiting program
while she was pregnant with her third child. During her health
assessment, she shared that her husband had been diagnosed with
high cholesterol a few years ago, but they really did not understand
what having a high cholesterol level meant or what chronic
diseases it could cause and were guilty of poor diet and lack of
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Chester County Medicine Winter 2019

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