We design and conduct innovative interdisciplinary research in order to generate evidence-based recommendations for community advocates, policymakers, and public health practitioners interested in improving population health.
Structural and Policy Level
Reproductive rights afford women the ability to decide the number, timing, and spacing of children, access to the information and resources needed to exercise voluntary choice, and the right to the highest attainable standard of health. Restrictions on women’s reproductive rights have the potential to shape women’s socioeconomic trajectories across their life course, with implications for population health. Ongoing research at MAC involves the impact of reproductive rights policies on maternal and child health outcomes across US states. We seek to identify policies that individually and collectively influence women’s risk for adverse birth outcomes, infant, and maternal mortality. This line of research is imperative to the passage of more evidence-based and less ideologically driven policy to protect the health of all women and children in this country.
MAC is a proud partner of Louisiana Families First, a statewide coalition of medical experts, businesses, families, and advocacy organizations who recognize the benefits paid leave will provide for Louisiana families, including improving infant and maternal health outcomes and supporting our growing aging population. Our research on the maternal and child health benefits of paid family leave and other workplace policies including reasonable accommodations for pregnant women and workplace breastfeeding support laws help to inform advocacy efforts that seek to facilitate the passage of state and federal legislation that guarantees all families have a chance to thrive.
Community Level
The Healthy Neighborhoods Project (HNP) is a collaborative effort between five organizations: Tulane University (Schools of Public Health and Tropical Medicine and Architecture), the Tulane Mary Amelia Women's Center, the Institute of Women and Ethnic Studies (IWES), Columbia University, the City of New Orleans, and the Center for Employment Opportunities. HNP is aimed at testing a population level, community approach to better health, safety and well-being, particularly for youth and family violence. Results will be aimed at developing scalable models that can be used in other cities and an overall goal of making all neighborhoods in New Orleans vibrant and thriving places to live. This work is supported in part by the Robert Wood Johnson Foundation (76131) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (R01HD095609).
Interpersonal and Individual Levels
Evidence on pregnancy/birth and cardiovascular health outcomes among birthing people in same-sex relationships remains limited primarily due to the lack of population-level data with measures of sexual orientation, sexual identity, or same-sex relationships. Marriage equality has established birth certificates as a promising new source of population-based data on births to same-sex parents. Some state vital records, including the state of Louisiana, now specify the sex of both parents on the child’s birth certificate. This research project, led by Dr. Vilda, involves secondary analysis of Louisiana birth certificate data from 2016 to 2022. The purpose of this research is two-fold: first, to investigate disparities in pregnancy/birth outcomes and cardiovascular health during pregnancy among birthing people in the same-sex relationships compared to their counterparts in the different-sex relationships; and second, to examine whether these associations were modified by race/ethnicity and the use of assisted reproductive technologies (ART). This study aims to contribute to the scant evidence on perinatal health outcomes among same-sex vs. different-sex families and advance our understanding of reproductive health disparities which must be documented to better inform public health interventions.
Dr. Vilda’s BIRCWH project examines the impact of fertility treatment on cardiovascular complications during pregnancy, childbirth and the postpartum period while also accounting for preexisting health conditions and fertility treatment type. The key research question guiding this study is as follows: is fertility treatment associated with increased risk for cardiovascular complications during pregnancy, childbirth, and the first months of postpartum, and is it moderated by fertility treatment types (invasive vs. non-invasive)? This project involves collaborations with Woman’s Hospital in Baton Rouge, LA and the REACHnet program at the Louisiana Public Health Institute (LPHI). A recent study “The risk of perinatal and cardiometabolic complications in pregnancies conceived by medically assisted reproduction” has been published at the Journal of Assisted Reproduction and Genetics.
MAC faculty are proud to be part of the Weaving Healthy Families project led by Tulane School of Social Work faculty member Dr. Catherine McKinley. This program seeks to promote family resilience and healthy living skills while preventing substance abuse and violence among Native American families. This work is supported by National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under Award Numbers R01AA028201 and 3R01AA028201-01S1.
Dr. Katherine Theall is one of a team of Principal Investigators at the Comprehensive Alcohol Research Center (CARC), housed within the Louisiana State University’s Health Sciences Center. The scientific focus of the CARC is to conduct cutting-edge basic research on alcohol and HIV that can be translated into effective community-based interventions. CARC includes the ALIVE New Orleans Alcohol Use in HIV (NOAH) study, a dynamic longitudinal cohort of adults (18+ years) living with HIV in and around the New Orleans metro area. Data from this cohort will be used to develop a better understanding of the mechanism linking early life adversity and chronic psychosocial stress to HIV clinical outcomes and the potentially harmful role of maladaptive coping behaviors including alcohol use. This research is particularly aimed at sex and gender differences in stress exposures and clinical outcomes. Findings from this line of research will inform disease management and prevention efforts, providing critical information for targeted structural, individual-level, and multilevel interventions. This work is supported in part by the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health (P60AA009803).
Neighborhoods and the places people spend time are important to health behaviors and can affect daily experiences such as mood, stress, and coping. For those with HIV, this can have an impact on medication adherence and care engagement which, in turn, can impact viral suppression. The NOLA GEM project explores these daily experiences, and the sex and gender differences in these experiences, to develop a mobile application to address stress and promote healthy behavior for HIV+ individuals who have experienced violence. The app builds on an existing evidence-based trauma intervention by adapting Living in the Face of Trauma (LIFT) and adding location-based “in-the-moment” intervention strategies that are vitally needed to reach people, quite literally, where they are. This work is supported by the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health (R34AA028961-01)
Cross-cutting
Faculty within MAC are thrilled to be part of the new Southern Center for Maternal Health Equity co-lead by the Tulane School of Public Health and Tropical Medicine, Ochsner Health, and long-time MAC community partner RH Impact (formerly NBEC). It is one of 10 new centers across the US funded by the NIH’s Implementing a Maternal Health and Pregnancy Outcomes Vision for Everyone (IMPROVE) initiative. The Southern Center for Maternal Health Equity received a 7-year grant to reduce the disproportionately high and disparate rates of maternal morbidity and mortality in Louisiana and the Gulf South through innovative research, training, and community-centered strategies. The establishment of this Center will bring together maternal health experts across a variety of areas—including medicine, public health, healthcare systems, community organizations, and public policy—to work as a team to address the multifaceted multilevel risk factors that create disparities in maternal health outcomes.
Through analysis of local, state, and nationwide data, we aim to raise awareness of homicide as a leading cause of death during pregnancy and postpartum. While homicide mortality rates consistently exceed mortality rates due to common obstetric causes of death, it receives less attention by public health and clinical efforts to reduce maternal mortality. Our research suggests that improved violence screening and prevention services during prenatal care may reduce maternal death. It also highlights the role of state policy in shaping trends and inequities in homicide of pregnant and postpartum women. For example, state policies that prohibit possession of firearms by perpetrators of domestic violence may reduce pregnancy-associated homicide, while state polices that restrict access to abortion may place people at greater risk of fatal violence.
MAC is proud to collaborate with the Newcomb Institute at Tulane University on work to advance our shared goal of partnering with the New Orleans community to promote women's equality through a series of reports on the health of women and girls in Louisiana. Read the 2021 report here.
Completed Work
Healthy Beginnings was a system of care implemented in early care and education settings in New Orleans, Louisiana. This unique, community-based model was a partnership between the Mary Amelia Center, Educare New Orleans, and Daughters of Charity. This program integrated early childhood education and child health services in a coordinated approach for young children in their families with a vision to support children’s continuing health and development as they prepare to become successful learners throughout life. This system of care provided young children and their families with access to health care by connecting them to health insurance coverage, medical and dental homes, and other specialty care as needed.
In collaboration with colleagues from the Institute of Women and Ethnic Studies, researchers at MAC represented the New Orleans team for the National Collaborative for Health Equity’s Building Capacity of Public Health to Advance Equity (BCPHAE) initiative. A W.K. Kellogg Foundation sponsored project, BCPHAE aimed to identify opportunities and strategies that health departments can employ to advance racial, social, and health equity. We conducted a series of key informant interviews with local public health officials and their community partners and reviewed documentation of existing programs within and external to the New Orleans Health Department. Our goal is the identification of barriers, needs, and opportunities facing the Health Department in their work towards becoming a catalyst for health equity. See our publication in Health Equity and this report by the National Collaborative for Health Equity to learn more about findings and recommendations.
MAC proudly partnered with the National Birth Equity Collaborative to conduct research and advocacy on the unacceptably high infant and maternal mortality rates experienced by Black women and families in the US. We examined these deaths in context, exploring aspects of the neighborhoods, communities, and societies in which women live that influence the likelihood they will experience an infant loss or be at risk of death during pregnancy and postpartum. Our ultimate goal was the identification of factors that are amenable to community or policy-based interventions to improve population health and promote racial health equity. This work was supported in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (R01HD092653).
