Integrating the Built and Social Environment into Health Assessments for Maternal and Child Health: Creating a Planning-Friendly Index

Abstract

Environmental and community context earliest in the life course have a profound effect on life-long health outcomes. Yet, standard needs assessments for maternal and child health (MCH) programs often overlook the full range of influences affecting health in-utero and early childhood. To address this, we developed a methodology for assessing community risk in MCH based on six domains integrating 66 indicators across community, environment, socioeconomic indicators, and MCH outcomes. We pilot this methodology in Pennsylvania, and share examples of how local governments, planners, and public health officials across the geographic spectrum can integrate this data into community planning for improved maternal and child health.

Healthy Places for Children: The Critical Role of Engagement, Common Vision, and Collaboration

“…What makes a healthy community for children? Public health looks beyond the individual and pays attention to the social determinants of health, and the physical and social environment of the community where people live, work, and play [6][7][8][9]. UNICEF describes a child-friendly city as a place which offers a safe environment, access to essential services, and the inclusion and participation of children [1].…”

“…Public health often uses a human ecology approach [5,10,11] to show the nested nature of individual health in family, community, and policy systems. This approach has been used to structure community level studies of public health as it relates to early childhood [6,12,13] and family wellbeing [14][15][16], and to design comprehensive models for community action and policy engagement [6,7,10,11]. A human ecological model of public health looks at multiple layers: the community built environment, community level services, public engagement, collaboration among health related agencies, and geographic differences across place [17].…”

The mental health of women and climate change: Direct neuropsychiatric impacts and associated psychological concerns

“…In the limited number of studies of children with intellectual and mental disorders, elevated distress in caregivers, particularly mothers, was most predicted by the presence of autistic spectrum disorder, conduct disorder, oppositional defiance disorder, and other psychopathology 67 . With the elevated risk conferred by air pollution on both several of these maternal disorders and several of these childhood disorders, there is a mutually reinforcing deterioration of the ability of the mother and child to cope together driven by air pollution and other climate effects, often within the adverse socioenvironmental circumstances in which the poorest quality air environments are found 68 . Fortunately, family, multifamily, and group interventions that include psychoeducation, skills training, emotional regulation strategies, play, and mind–body exercises may improve outcomes 69 and are adaptable to the kinds of community‐level novel interventions to improve mental health that the scale of climate change may demand.…”