National Preparedness Month: Response Begins in Our Communities September is National Preparedness Month, an opportunity to renew our commitment to strengthen the ability of individuals and the Cincinnati community to respond and rebound from traumatic, tragic and unpredictable events. The anniversaries of Sept. 11 and Hurricane Katrina remind us of the devastating impacts of a disaster and the importance of community responses. Communities across the nation, includingCincinnati, must be able to withstand adversity such as an influenza pandemic, a natural disaster or a terrorist attack. Local preparedness is critical as Cincinnati emergency response agencies can quickly mobilize a response to event, while it may take 48 hours or more for federal resources to arrive. As the Cincinnati Health Department, we are responsible for planning for, responding to and mitigating public health emergencies—natural and human made—through our Center for Public Health Preparedness. The Center, led by Steven Englender, MD., MPH fulfills this role, in part, through grants, including the Cities Readiness Initiative (CRI) and the Public Health Emergency Preparedness (PHEP). The CRI is a federally-funded effort to prepare US cities and metropolitan areas to respond effectively to a large-scale bioterrorist event by dispensing antibiotics to entire identified population within 48 hours. PHEP provides funding to enable public health departments to have the capacity and capability to effectively respond to the public health consequences of terrorist threats, infectious disease outbreaks, natural disasters, and biological, chemical, nuclear, and radiological emergencies. Cincinnati’s challenge is this: We must be ready to respond quickly and efficiently to any emergency, minimize suffering, injury and death, and tend to the greater vulnerability of children, the elderly, the physically compromised and those who live in poverty. Our commitment will not end after immediate danger of an emergency is over. Our goals will be to rapidly restore Cincinnati to a state of self-sufficiency, health and social functioning. Look no further than last year for an example. I want to thank the hundreds of staff and volunteers who responded to the 2009 H1N1 pandemic. This campaign resulted in the Cincinnati Health Department providing more than 50,000 vaccinations at hundreds of schools, senior centers, recreation centers and community events throughout the City. While the Cincinnati Health Department and other emergency preparedness organizations make plans for a disaster, individuals have critical roles to play as well. Are you ready to help yourself, your family and your business in an emergency? Remember to 1. Get a Kit 2. Make a Plan 3. Stay Informed. After you’ve assembled an emergency supply kit, made your emergency plans and understand what to do during specific emergencies, you will be able to act when a disaster strikes. Find out information about emergency kits and plans at www.ready.gov Are you able to assist in this community preparedness effort? Are you a member of the local Tristate Medical Reserve Corps Unit (TMRC) or other volunteer organization? Physicians, nurses, pharmacists, dentists, veterinarians, interpreters, chaplains, office workers, legal advisors and others will be needed in an emergency and are a key component of a quick and effective emergency response. Information about how to join is available at http://www.swoph.org/tmrc.htm. We can honor the victims of past disasters by becoming ready and resilient individuals, families and communities.
Increasing Access to Affordable Primary Care through Health Centers
With the recent passage of healthcare reform, a focus throughout the country has been on increasing people’s access to affordable primary health care. Many of these new patients will find quality care at community health centers. Community health centers now serve 20 million people in America in 7,500 communities, including Cincinnati Health Department (CHD) Health Centers that serve more than 35,000 patients annually at six primary care and two dental sites. There are also 6 private non profit health centers located in Hamilton County providing healthcare services.
A key provision of the recently passed Patient Protection and Affordable Care Act expands the national network of community health centers and provides people with more health care homes, leading to better quality care at lower costs. In Ohio, by 2015, this will translate to doubling the number of patients that will be seen at Ohio’s community health centers to more than one million patients.
This new opportunity for expanding primary care through health centers was celebrated during National Health Center Week 2010, focusing on “Turning Vision into Reality.” This theme reflects the enormous task and opportunity before health centers, as we work to increase healthcare access. Enactment of health reform placed immense trust and confidence in community health centers, and it is up to us to define the future of preventive and primary healthcare and demonstrate how it should be delivered with quality, innovation and excellence.
By increasing access to primary and preventive healthcare at local health centers, hospital emergency rooms are able to focus on saving lives and reducing wait times, which translates to lightening the cost load for consumer’s taxpayers and governments.
All Cincinnati residents can receive care at the Health Department, even without health insurance. CHD patients have access to a range of primary and preventive care services—Pediatrics, Internal Medicine, Obstetrics and Gynecology, Nursing Services, Pharmacy, Laboratory Testing, Immunizations, WIC Nutritional Services, and Dental Services. We also operate a school based health center at Oyler School in Price Hill. These services allow people in Cincinnati, who may have no other access to healthcare to receive regular care that is both coordinated and targeted to meet specific health care needs, contributing to the health and wellness of all Cincinnati citizenry.
National Health Center Week 2010, was August 8-14. The Elm Street Health Center, one of the Health Department’s sites, celebrated by giving out school supplies to our school-age patients and their parents. For more information on the Cincinnati Health Department or our health centers, visit: www.cincinnati-oh.gov.
What Does Federal Health Reform mean for Cincinnati?
The 2010 national healthcare reform is the most sweeping change to the American healthcare system since the introduction of Medicare in 1965 and aims to succeed in two major areas: increasing access to insurance for millions of Americans and containing healthcare costs.
After a long and often contentious debate, President Obama signed the two healthcare acts, the Patient Protection and Affordable Care Act and Health Care and Education Affordability Reconciliation Act, into law on March 23, affecting millions of Americans. Here are some highlights.
In the long run this will save the taxpayers millions of dollars by better management and prevention of chronic conditions, such as diabetes or coronary disease, that often land people in emergency rooms—the most expensive setting to provide treatment. For Cincinnati, this means in 2014 an estimated 40,000 more Cincinnatians will be insured, including roughly 16,000 current Cincinnati Health Department (CHD) patients. Our primary care centers are at full capacity and on pace to conduct 115,000 patient visits in 2010 (113,500 in 2009). If implemented as planned, Health Reform means millions of additional dollars coming to the CHD enabling us to expand services and improve the health of our citizenry.
What does this reform mean for you? The Affordable Care Act does not force people to change insurance providers. Individuals satisfied with their insurance can keep their current plans and stay with a plan even if they switch jobs because of increased insurance portability.
However, under the new law insurance companies can no longer place lifetime limits on coverage or drop coverage for those with certain pre-existing illnesses or conditions. Beginning in September 2010, children under age 19 with pre-existing conditions cannot be denied coverage, and this is extended to adults in 2014. Another immediate aspect of healthcare reform is coverage for young adults who will be able to stay on their parents’ plans until age 26.
In order to increase the number of insured Americans, Medicaid benefits will be extended to those making below 133 percent of the Federal Poverty Level ($29,327 income for a family of four). Financial assistance will be available for those making 133 to 400 percent of the Federal Poverty Level (up to $88,000 income for a family of four). Tax penalties will exist for non-coverage for individuals and employers with more than 50 employees.
The prescription drug “doughnut hole” for Medicare patients will be closed. Medicare covers prescription costs below $3,000 and offers assistance over $6,000. This year, $250 rebate checks will be mailed to affected Medicare recipients.The doughnut hole will continue to be phased out and eliminated completely by 2020.
In efforts to decrease the number of preventable conditions, Medicare and Medicaid will cover preventive services. Health Reform will also offer funding for research on health disparities, epidemiology, lab capacity grants and funding for mid-career training to increase the public health workforce.
With legislation of this magnitude and scope, many details regarding implementation have not yet been fully determined and will continue to be finalized over the coming months. This legislation is good news for the City and the citizens we serve and presents an exciting time for the healthcare providers. The CHD will continue to follow the implementation of the legislation in order to maximize opportunities to improve the health and wellness of Cincinnatians.
Cincinnati Health Department’s WIC program recognized nationally for decreasing infant mortality
The Cincinnati Health Department (CHD) has received national recognition for its success in research determining the effectiveness of its WIC program in reducing the infant mortality rate (IMR), especially among the African American population in Hamilton County.
An article published in the April edition of the American Journal of Public Health (AJPH)titled, “The Impact of Prenatal WIC Participation on Infant Mortality and Racial Disparities,” features results from a CHD study that concludes our commitment to supporting programs that provide services to improve the health of mothers and infants are successful in reducing infant deaths. We’re proud to say that this is the first time in the department’s history it has had a peer reviewed paper published in the AJPH.
The research shows the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) for low-income individuals reduces the disparity between African American and White infant mortality rates. The CHD administers WIC, a national program for all of Hamilton County. WIC served 22,000 women and children in 17 different locations throughout the city and county in 2008.
WIC helps improve the nutritional status of women, infants and children. It provides nutritious food, including milk, grains, fruits, vegetables and eggs. In addition women enrolled in WIC participate in nutritional counseling to help them create and maintain a healthy diet.
The program also offers health service referrals, which help women find and utilize health care services that can contribute to a healthier pregnancy and birth outcomes, a lower chance of preterm deliveries and a reduction in the risk for infant mortality. Without WIC, mothers often do not know where to find health services crucial to a healthy delivery and first year of life.
The AJPH article published in April 2010 compares those mothers enrolled in WIC with those who did not participate from 2005 through 2008. The study found that WIC is successful in greatly minimizing the disparity of IMR rates between African Americans and Whites as shown below:
Infant Mortality Rates per 1000 live births, 2005-08
Non-WIC Comparison group
This is encouraging because it affirms the important role the CHD is playing in reducing IMR. For example, for women who received prenatal and postnatal Health Department services, and obstetric services through our collaboration with University Hospital, the IMR was 5.3 and 7.1 respectively for 2006 and 2007. Our findings show that if the non-WIC mothers had the same infant death rate as our WIC mothers, 38 infant deaths would have been prevented.
Certainly, more work must be done in order to reduce Hamilton County’s IMR of 13.3 below the 2003-05 national average of 6.8 per 1000 live births. Given the stellar outcomes, WIC and other CHD maternal and infant vitality programs, will continue to be utilized to reduce the IMR. Through outreach and education we will reach a greater number of women stressing the importance of preconceptual health as well as expectant mothers about healthy food, nutritional counseling and other interventions that decrease the IMR.
The Health Department will continue to use research and data to implement and enhance those programs providing solutions to problems negatively effecting the health of our citizens. For example we will further examine other results from the study which found prenatal smoking may counteract the benefits of the WIC program—especially among White women. This is another example of using data to drive performance based decision making, offering the CHD an opportunity to improve our maternal and infant vitality efforts that promote health equity and improves community well being for all.
MANAGING CHRONIC DISEASE THROUGH HEALTHY LIFESTYLES January 2010 Each New Year promises to eat healthier, exercise more or quit smoking top many of our lists’. The results of these efforts, including weight loss and increased physical fitness, are especially important because they can often prevent or reduce chronic disease and lead to a higher quality of living. Chronic disease is any disease that has long-lasting or recurrent effects that can cause serious health problems and they account for seven out of 10 deaths in the United States (US). The most common chronic diseases we see at the Cincinnati Health Department (CHD) are asthma and attention deficient hyperactivity disorder in children and high blood pressure, diabetes, high cholesterol and obesity in adults. Chronic diseases, such as obesity—a major problem in the US—can lead to other chronic diseases, including diabetes, respiratory illnesses and high blood pressure. Also, 7 of the 10 leading causes of death are driven by chronic diseases. If not deadly they often inhibit everyday life. In fact in the US, about 25 percent of those with chronic conditions have daily limitations, according the Center for Disease Control and Prevention (CDC). Many chronic diseases and their effects can be prevented or delayed by developing and maintaining a healthy diet and an exercise plan. Eating well does not always require giving up your favorites but may mean experimenting to make healthier meals. For example, substituting lower calorie ingredients—non-fat milk instead of whole milk, or using less high fat foods such as butter, and preparing food in a healthier way—like grilling instead of frying. Simply becoming aware of serving sizes on packages also helps us lose weight because often we are not aware we are eating more than we should. As a general rule consider dividing your plate in to four quarters. Half of the plate should be fruits or vegetables—not including corn or potatoes (which are high in starch), one quarter protein and the last quarter should be a starch—rice, noodles or potatoes. Examine your beverage choices because they are often a source of hidden calories. Soda contains concentrated sugar products and no other nutritional value. Fruit juices may appear to be a healthy option, but make sure they do not contain a lot of artificial sugars and syrups. Instead, drink lots of water, natural juices and make sure your diet contains the appropriate amount of milk for your age. Staying active, is the other crucial component of a healthier lifestyle. Children and teenagers should participate in 60 minutes of physical activity daily, according to the CDC. For adults they recommend 150 minutes of moderate physical activity such as walking, biking, or my favorite, jogging per week. Lastly, get some sleep. A successful wellness plan must include 8 hours of sleep—plus it’s free! Before beginning a new exercise schedule, or with questions about your diet, you should contact your doctor. If you don’t have a doctor call us. At the CHD we offer resources for Cincinnati residents that promote healthy lifestyles. For example our health centers provide services that can help prevent and manage chronic diseases and our doctors and nurses can recommend an exercise schedule. Our registered dieticians can help create a healthy eating plan. At our Elm Street Health Center, we implemented a Diabetes Collaborative that assists our diabetes patients by establishing a healthy diet, addressing and treating side effects and improving their overall quality of life. For more information about our health centers or the services we provide, visit http://www.cincinnati-oh.gov or call 513-357-7200. Stay well Cincinnati!
CHD BACKS CDC’S RECOMENDATION ON H1N1 VACCINE SAFETY; ENCOURAGES IMMUNIZATION December 2009 The Cincinnati Health Department (CHD) is one of the primary distributors of the H1N1 vaccine in Cincinnati and we are working diligently to immunize as many people as quickly as possible. Our Primary Health Care Centers are open Monday through Thursday evenings from now until Dec. 17 for high priority (Tier One) individuals: http://cincinnati-oh.gov/health/downloads/health_word38140.doc As of Nov. 30th, we have vaccinated over 27,000 people in more than 100 sessions throughout the City. Vaccine is the best defense we have against the flu. The CHD agrees with the Centers for Disease Control and Prevention (CDC) and strongly encourages you and your family members to be protected by receiving the H1N1 and seasonal flu vaccines. All forms of the H1N1 vaccine are being produced with the identical process used successfully for years for seasonal flu. There are a lot of rumors, half truths and conspiracy theories circulating about H1N1 vaccine safety. Our recommendation comes after reviewing the CDC recommendations and analyzing data on the tested vaccine, which says the vaccine is as safe as a seasonal flu vaccine and is the “best way to prevent influenza infection and its complications.” We take our role to keep Cincinnati safe seriously. Thus, the CDC, US Food and Drug Administration (FDA), state and local health departments, including the CHD, will continue to monitor the vaccine to ensure its safety by continually reviewing data about the vaccine and investigating claims about vaccine safety. As of Nov. 30, we have not had any reported cases of serious side effects or safety concerns from the vaccine. The vaccine comes in two forms, a nasal spray and a shot. The nasal spray, is a weakened form of the live virus, and the shot contains inactivated virus. You cannot get the flu from taking the mist or the shot form of the vaccine. Eggs are used to produce the vaccine so those who are allergic to eggs may experience an allergic reaction to the flu vaccines and should consult with a medical professional before receiving the vaccine. Mild side effects of the nasal mist can include runny nose, headache, sore throat and cough in adults. For children, side effects may include runny nose, wheezing headache, vomiting, muscle aches and fever. There are some mild side effects for the shot form of the vaccine including soreness, redness, or swelling where the shot was given, low-grade fever, aches and nausea. The effects of the Flu, if contracted, are far more serious and unpleasant. Some parents have expressed concern over whether thimerosal, a mercury-based preservative that has been used for decades to prevent vaccines against microbial contamination. The CDC, the Advisory Committee on Immunization Practices (ACIP), and the Institute of Medicine have all reviewed numerous studies on Thimerosal and have found no medical complications related to the preservative. Another safety concern is Guillain-Barré syndrome (GBS), a rare disorder—usually, though not always, found in adults where a person’s immune system damages nerve cells. Several studies on the subject have indicated that there is no relationship between vaccine and the disease. In the US About 3,000 to 6,000 people a year develop GBS, whether or not they are vaccinated. The vaccine, which has been tested and shown to be safe, is the best way to prevent H1N1. Furthermore, the Federal Trade Commission and the Food and Drug Administration warn people to be wary when purchasing and using products including pills, air filtration devices and cleaning agents that claim to prevent, treat or cure the H1N1 virus. If you still have questions about vaccine safety, priority groups or vaccine availability give us a call at 513-357-7499 or visit www.cincinnati-oh.gov (click on H1N1 Flu Info in top right corner).
WIC PROVIDES WOMEN, INFANTS AND CHILDREN WITH NEW, HEALTHIER FOOD OPTIONS TO PROMOTE HEALTY LIFESTYLES
A healthy diet is one of the most effective tools in preventative health care. Encouraging healthy eating habits from an early age helps promote healthy life styles, reduces obesity and lessens the risks for disease and chronic health problems including heart disease and type two diabetes.
For the last 30 years the Cincinnati Health Department’s (CHD) Women Infant and Children (WIC) Program, a Special Supplemental Nutrition Program, has been serving income-eligible (up to 185 percent of the poverty level) pregnant, postpartum and breastfeeding women, infants and children up to 5 years old who meet nutritional or health risks.
CHD runs the WIC program which serves all of Hamilton County. We assist approximately 22,000 clients at 16 offices. There is a WIC office in the five CHD health centers. The scope of the program attests to our commitment to reach as many clients as possible to provide them with quality preventative care.
In order to enhance the program, Cincinnati WIC is now providing, new healthier food options for women and children. These food options will increase WIC’s ability to prevent nutrition-related health problems for its clients.
The new food changes follow the Dietary Guidelines for Americans and focus on foods lower in fat and higher in fiber. The WIC food packages supplement diets with foods that are more culturally diverse, commonly consumed and rich in 5 target nutrients known to be lacking in the diets of the WIC population—Vitamins A and C, Calcium, Iron and Protein. This will help WIC clients maintain healthy weights, decrease risks of certain diseases and increase breastfeeding rates.
Some of the new food offerings include 2 percent, 1 percent or skim milk. Previously, all clients could choose whole milk, but now WIC is promoting lower fat milk choices. Only children from 12-24 months of age will receive whole milk (higher fat).
Furthermore, WIC encourages mothers to breast-feed children since breastfeeding is critical in protecting children from health issues, including sudden infant death syndrome (SIDS), diabetes, GI infections (diarrhea) and lower respiratory infections. WIC provides education and classes, along with other resources to increase breast-feeding numbers.
Clients can also receive whole grain breads, cereals and tortillas; vouchers for fresh, canned or frozen fruits and vegetables, brown rice, baby foods and infant cereal. Other healthy food options such as tofu and soymilk will soon be available. Mothers can also use their voucher at Farmer’s Market venues.
WIC provides clients with nutrition information and education. To establish a lasting habit of healthy diets, WIC offers nutrition education to help clients understand healthy food choices and develop long-term healthy diets.
These healthy food choices and maternal health education are paying of in improved infant vitality. Infant deaths are less for Cincinnati WIC enrollees and for African American babies the death rate was twice as low when compared to African American babies not enrolled in WIC.
WIC also offers other services to improve clients’ health, specifically through community partnerships with CHD programs and outside organizations in a wide spectrum of areas. Some of these partnerships include CHD’s Childhood Lead Poisoning Prevention Program, immunization screening, smoking intervention, the Farmer’s Market Nutrition Program, and offers referrals to health and human service programs.
Help us spread the word about this critically important program which impacts so many lives. For more information about the WIC program please call 513-821-7012 or visit http://www.cincinnati-oh.gov/health/pages/-14133-/ .
When emergencies arise, many people are left unprepared without a plan or the necessary supplies. Did you have food and flashlights easily accessible when the windstorm of 2008 knocked out your power? As flu season approaches are you prepared for the possible effects of the ongoing H1N1 pandemic?
The storm and H1N1 highlight why preparedness is essential to ensure a healthy and safe Cincinnati. Preparedness must come from public entities and governments, businesses and individuals. During September’s National Preparedness Month, the Cincinnati Health Department (CHD) is highlighting our role in emergency preparation and response and educating and encouraging Cincinnatians to be ready for emergencies.
The CHD’s Center for Public Health Preparedness, led by Dr. Steven Englender, is dedicated to planning, responding to and mitigating public health emergencies. These include natural disasters like pandemics, flooding, tornados, storms, and human made disasters such as chemical releases, terrorist attacks and the like. Our Department’s response is critical to ensuring Cincinnati residents have the proper resources to ensure health and safety during a public health emergency. The Center utilizes local, state and federal resources to enhance Cincinnati’s level of readiness.
The Center also ensures Cincinnati’s preparedness through the Cities Readiness Initiative (CRI). The CRI is a federally funded effort to prepare major US cities and metropolitan areas to effectively respond to a large-scale bioterrorist event by dispensing antibiotics to their entire identified population within 48 hours of the decision to do so.
In order for Cincinnati to maintain the CRI designation, it must meet certain requirements. For example in July, the Center for Public Health Preparedness conducted a full-scale Points of Dispensing (POD) exercise, a simulated activation of a mass medication plan that may be needed as a result of a biological terrorist attack. CHD’s performance in these exercises exemplifies CHD’s high-level of readiness to respond quickly and efficiently to an actual emergency.
Our commitment to a prepared Cincinnati extends beyond the readiness of the CHD to respond to emergencies. It is also our goal to educate the public of the importance of personal preparedness. Citizens can be ready for emergencies by following three steps:
Get a Kit. During emergencies, stores may be closed and water may be shut off, leaving people with no access to essentials. Every residence should have a kit which includes basic necessities, one gallon of water per person per day, for three days; at least a three-day supply of non-perishable food; battery-powered or hand crank radio and a NOAA Weather Radio; flashlight; a first aid kit and necessary medications.
Make an emergency plan. This plan can help people to stay in contact if they are separated during an emergency. An emergency plan should contain actions people should take in an emergency, a designated meeting place and an out of town emergency contact.
Stay informed. Know how to respond to different manmade and natural emergencies that could happen in Cincinnati.
More information about how to best keep your business or family prepared visit www.ready.gov.
Cincinnati let’s do our part to keep ourselves and our families healthy, safe and prepared.
A few years ago, when registered nurse Liz Dewar's client asked her to be a bridesmaid in her wedding, Dewar had to laugh. “This is a girl who used to ditch my phone calls when we first met,” says Dewar, smiling and shaking her head.
The teenager, just a few weeks pregnant for the first time, met Dewar after a friend told her she needed help. Her friend referred her to the Nurse-Family Partnership program (NFP), a nurse-led, healthcare program for at-risk first-time moms provided by the Cincinnati Health Department for over 10 years.
“We were off to a rocky start,” says Dewar. But the nurse persisted and met the teenager for lunch three times to answer questions and tell her what the program could offer – parenting and healthcare, goals coaching, and, most importantly, someone a new, unsure mom could trust. The teenager was reluctant, at first, but she graduated from the program after two years of home visits.
With an overall infant mortality rate two times higher than the national average and three times higher for African-Americans mothers, Nurse-Family Partnership is critically important to Cincinnati's health. According to the World Health Organization, rates of infant mortality directly correlate to the health of a community. And with infant mortality rates this high, Cincinnati doesn't just have the sniffles, it has pneumonia.
But by providing services to mothers and babies, the Nurse-Family Partnership model, under the Every Child Succeeds (ECS) funding umbrella, can impact these troubling statistics. NFP has been shown to be effective through three long-term randomized, controlled trials [Elmira 1977, Memphis 1988, Denver 1994].
The trials studied moms who participated in the program versus moms who didn't. The results showed that when compared to other first-time, at-risk moms, those who are enrolled in the NFP have healthier pregnancies, fewer premature births and fewer low birth-weight babies. They also have higher rates of employment and improved economic self-sufficiency. The infants had fewer childhood injuries and significant improvements in childhood readiness, language cognition and behavioral regulation.
The strength of this evidence has been enough to garner attention from President Obama who has proposed federal funding for home visitation programs. Beginning prenatally, our Cincinnati Health Department (CHD) staff of three nurses and two supervisors serve over 100 first-time mothers and their children in Cincinnati and Hamilton County and make over 1,500 home visits a year.
These efforts contribute to the CHD’s Infant Vitality effort which includes an Infant Mortality rate of 7.1 for CHD clients which is in line with the national average of 6.7. NFP is part of a comprehensive Infant Vitality Initiative at the CHD which includes Every Child Succeeds, Healthy Start, Women Infant Child the Fetal and Infant Mortality Review and Quality Improvement efforts in our OB/GYN centers.
Dewar's client now has two sons. She never misses their doctor's visits. They are up to date on shots. She takes them to baseball and soccer practice. After completing a nursing assistant program, she left her job working at a fast food restaurant and now works in a doctor's office. “She changed from being flighty to being a responsible mom,” says Dewar. “She went from being self-absorbed to putting her children's needs first.”
“I have come across many young ladies who in the beginning of the program had no sense of direction, but because they want more for their baby they return to school, get degrees and decent jobs," says Doris Nelson-Frierson, the program's supervisor.
The program is voluntary and can last from pregnancy to the child’s second birthday. “Few changes are immediate, but we are in it for the long haul, and the difference made lasts a lifetime,” says Nelson-Frierson.
Dewar's client got married after the program ended, but still wanted Dewar as a bridesmaid. “She knew she could count on me,” Dewar says, chuckling. “But I told her, that's going to look pretty strange – I am old enough to be your mother!”
For more information about the Nurse Family Partnership Program please call the Cincinnati Health Department at 352-1423.