1. The Los Angeles County Preconception Health Collaborative Project
Cynthia A. Harding, MPH
Maternal, Child, and Adolescent Health Programs
Los Angeles County

2. Los Angeles, California
LAC a wonderfully diverse population of 10 million people
Over half comprised of racial/ethnic minorities
Over 200 languages spoken
69.8% of women age live in households with income below 300% of FPL (2005 LA Health Survey)
10% of women age in households with income below 300% of FPL have food insecurity with hunger (2005 LA Health Survey) 1 2

3. Selected Perinatal Health Statistics, 2004 Compared with HP 2010 Goals
Medi-Cal funds prenatal care for over half of LAC births.
Racial/ethnic and geographic disparities are continuing challenges.
Women with poor birth outcomes at risk of poor birth outcomes in future pregnancies.
LAC has one of higher teen birth rates compared to other California counties. 3

4. Selected Health Conditions and Behaviors Women 18 – 44 Years, 2005
Alcohol consumption,
(past month)
Depression/depressive disorder
Diabetes
High blood pressure
Obesity
Smoking
LAC1
48.9%
13.8%
3.0%
8.8%
17.1%
12.2%
CA2
53.6% -
2.3%
9.3%
17.9%
12.3%
Many health conditions associated with poor birth outcomes are preventable.
Among LAC women aged years old, 38.3% have difficulty getting medical care & 24.9% have no regular source of health care (2005 LA Health Survey).
Every dollar invested in preconception care for diabetes saves five dollars in medical costs (Carolina Reyes, no data source cited).
Data source: 2005 LA Health Survey.
12005 LA Health Survey
22005 California Health Interview Survey 4

5. Efforts to Improve Birth Outcomes Los Angeles County
2005 Perinatal Summit
Diverse stakeholders & leadership
Unified call to action
Recommendation to promote improved preconception health
LAC has connected leadership, committed stakeholders, sufficient resources, and political will to address preconception health.
1998 approval of CA Prop 10, the California Children and Families First Act. 50-cent surtax on cigarettes and tobacco product to improve early childhood development from prenatal  age five.
2001 First5 LA Healthy Births Initiative. $15 million to improve birth outcomes in LAC.
First5 LA selected LABBN to provide implement Healthy Births Initiative.
2004 First5 LA approved LABBN’s plan to implement Healthy Births Initiative. 5

6. Preconception Care Council of California
Sponsored by CA Dept. of Public Health & March of Dimes CA Chapter
Statewide forum for planning and decision-making for the integration, development and promotion of preconception care
Clearinghouse for Preconception efforts across the State

7. Public Health Department
Los Angeles County
Preconception Health Community Profile
Foundations Churches Schools LAC Dept
LAC Dept Parks & Recreation First5 LA Mental Health California Family Black Infant
Breastfeeding Health Councils Health Program Hospitals
Task Force of
Greater Los Asthma
Angeles Coalition
MCH
Access
Service PHFE-WIC
Planning
Areas
LA Best Physicians LAC
Health March of Healthy Babies Midwives Dept of Public
Plans Dimes Births Network Nurse Practitioners Social Services
Learning Community Clinics
LA Care Collaboratives Association
Los Angeles County
Public Health Department 6

8. Los Angeles Collaborative Core Members
California Family Health Council
LA Best Babies Network
LA County Public Health Department
March of Dimes
PHFE – WIC Program 7

9. Collaborative Activities
Baseline preconception health (PCH) data
Speakers’ Bureau presentation on PCH
Curriculum to integrate pre- & interconception health into family planning clinics
Interconception Care - Case Management of High Risk Women in PHFE – WIC
Improve communication among stakeholders
CDC Recommendation Collaborative Activity(ies)
Individual responsibility across lifespan LABBN will develop reproductive lifeplan toolkit. CFHC project.
Consumer awareness CFHC project, WIC project, communication among stakeholders.
Preventive visits Speakers’ Bureau to educate providers & public
Interventions for identified risks WIC project, CFHC project
Interconception care WIC project Monitor HEDIS postpartum visits via briefs NA
8. PH Programs and Strategies Speakers’ Bureau, briefs, communication
Research briefs, monitoring data via LAMB, LA Hope, vital records, LA Health Survey
Monitoring Improvements “ ” 8

10. Short-Range Project Goals
Preconception brief
Speakers’ Bureau presentation
Toolkit to plan reproductive life plan
Integrate pre- interconception care into Title X family planning programs
PHFE-WIC case management to high-risk mothers
PHFE-WIC CM to moms of preterm and low birthweight babies. 9

11. Long-Range Project Goals
Policy/advocacy
Increase postpartum visits
Improve content of risk reduction/health promotion at postpartum visit
Decrease: Unintended pregnancies
Prepregnancy obesity
Infant mortality
Low birthweight births
Policy/advocacy: interconception care financing, extend Medi-Cal financing 2 yrs postpartum, preconception care in CA health care reform debate. Monitor health data & indicators; use for programmatic & policy work. 10

12. Putting the Pieces Together
State
Partners
L. A. Public Health
CDC

13. Questions?
Partners
State
L.A. Public Health C D

14. Maternal, Child, and Adolescent Health Programs Los Angeles County
Cynthia A. Harding, MPH
Director
Maternal, Child, and Adolescent Health Programs
Los Angeles County 12