All of those service providers get some support from the City. You are not powerless. We are not powerless to do that. We also ask again that the state act on the insurance crisis and develop appropriate consumer patient focus responses, in addition to extending Medicaid. The second issue we want to talk about for a minute is the danger of working in hazardous environments. Many of the women who work in that area work in small business outside of the reach of the Family Medical Leave Act, outside of all other 179 9/17/02 - PUBLIC HEALTH - RES. 010675 health and safety reaches. They're working in small businesses. We urge you to recognize that inhaling smoke is very dangerous, whether you're smoking or you're working in a smoke environment. It's bad. It's bad for your baby. Therefore, we urge you to support City Council's legislation that has been introduced before to prohibit smoking in the workplaces of the City. And, actually, I have to say that it doesn't make it -- it doesn't make it easier to make exemptions where you know women work in those areas. So there's a lot of problems with excluding some areas like restaurants because that's whose waitressing most of the time. It's most of those women. The difficulty of securing appropriate physical and mental health treatment during the workday has got to be addressed. My colleagues mentioned the fact that the welfare reform, used in quotation marks, does require people to go to work. And as a result most of them do not have the ability to go to secure treatment, whether it's for their depression, for their hypertension or just prenatal care. They can't go during nine-to-five hours. And there's not a lot of other options for them. So we 180 9/17/02 - PUBLIC HEALTH - RES. 010675 have got to figure out ways that this City and this City Council can do something about that. I think that we could. We would urge you to pull together the Chamber of Commerce Small Business Task Force, some citizen activists, some health professionals, and work together on how, indeed, the City could develop a model program to assure that women can go and take care of their medical and their children's health needs during the workday at the same time. Of course, as we have to also urge that you keep track of insisting that any health care provider make room for an hours after work and on Saturdays so that people can go visit and get their health care needs taken care of. There are not enough health clinics, centers, prenatal care or mental health programs in many sections of the City. And that is absolutely true in the section we are talking about. The City should expand it's services to meet the needs of the people in the Northwest, to encourage its private partners to do so and, actually, there are other areas as well, but clearly in the sections of the Northwest we're talking about. Next, many pregnant women do not know 181 9/17/02 - PUBLIC HEALTH - RES. 010675 that they and their infants are eligible for health insurance and the importance of prenatal care. It still exists, that non-information. The City, in collaboration with the private sector and the state, should develop a major public education program about the importance of seeking prenatal care. And actually, as well, the important of breast-feeding. Lastly, many women are not prepared for the difficult, important task of parenthood. Confusion leads to complications. When Councilwoman Tasco and I were first pregnant we were supposed -- we thought you were supposed to put your babies down on their belly. Then we found years later that 15 that wasn't true. Well, luckily our babies were okay, but --
Well, it's true. They were just very different things. This City can be safer. The City and state should develop programs that assures all babies have home visits, not just the few that -- those that meet the David Olds model, which is a wonderful program. And we should have it all over and not have it be like a lot of programs. 182 9/17/02 - PUBLIC HEALTH - RES. 010675 If you're outside of the boundaries, you don't get it. One of the reasons I would posit that West Oak Lane and Cedarbrook and Ogontz have such bad figures right now is that they were never bad enough. They were triaged out right away. And so we turn around and we look and we have to pay for the consequences. But we're not paying. Babies are and families are. We should be doing much better than that. So I think we can reduce SIDS by home visiting, and really building that kind of relationship up with home visiting. And make the state and the City come together and say, we're going to visit every baby, every newborn, and we're going to follow up where necessary. Second, we can deal much better with how healthy women are during their pregnancy if they, in fact, are reached out to, if they are informed, and if there's a place they can go to get the care and it's open when they need it. And they've got to be able to do that not just when they're pregnant. They've also got to be able to do that -- if we're going to have healthy babies, the moms have to be healthy. What research says is before they get pregnant. That doesn't mean we have to plan that 183 9/17/02 - PUBLIC HEALTH - RES. 010675 I'm going to get pregnant in two years and, therefore, I'll be healthy. It means they've got to be healthy anyway. And I think that, in that, we've got to deal with the states, Medicaid extension and we've got to really deal with there being adequate clinics. There's no health care clinic really that's set up to deal with the population in the area you're talking about. We can do better than that if we open our eyes to it. And I want to also say that I think we need to have hearings on this every year. We are not constantly alert to issues in public health that can save babies, that can save children. And only when you have a public calling together do people say, oh, wow, yeah, it didn't do so well. We can do better than that. And at least 224 babies this year should tell us that we ought to. Thank you.
Thank you very much. We really appreciate your comments and your recommendations. I do agree with Karen and you too, Shelly, because what we fail to do, what government fails to do, is to look at the change in the trends. Well, you know, 1990 census said, this is what the neighborhood looked like. And if you go up and you 184 9/17/02 - PUBLIC HEALTH - RES. 010675 drive through the neighborhood, you see it doesn't look like the neighborhood in 1970 or '75 or '80. Or even though you have -- you talk about white flight. You talk about middle-class black flight. Because when we moved to that area, it was predominantly upper, middle-class working people. A lot of them did have health care because they worked for the schools. They were doctors. And I can name some very important people who lived right around my neighborhood who have now gone on. And that's okay because people's income increase and they move. And, of course, people followed in their footsteps. They may not have the same level of income that they had. And so instead of the bureaucrats saying, well, we have to follow the federal guidelines, we have to deal with the census information that exists today. And, you know, the demographics of the neighborhood has changed. And so, I was like a voice in the wilderness because, as you said, we weren't that bad. We didn't meet the numbers, but we knew that the problems existed. And we don't have a lot of community-based organizations in that community because they just have not evolved. You have to 185 9/17/02 - PUBLIC HEALTH - RES. 010675 know that neighborhood. But there are organizations that we might be able to encourage to come into the community if we find a facility for them to operate out of. So there are a lot of things that I've -- thoughts in my head that sort of -- that have come to me about what we can do to provide outreach up there in that community. Not re-inventing the wheel, but hopefully using the existing resources that are available just to expand in that area and to work to get those resources for them to operate in that community. So, we are going to be very active in trying to bring those resources to that area. And, of course, I do agree with Dr. Robinson, education is extremely important. And there is hope now. Today what we will do with this, the results of this hearing, we will develop a report and then we'll develop an action plan. And certainly we'll be back to you about that action plan because it will probably involve you in whatever we do. And we have some preconceived notions about what we want to do, but we haven't come to a conclusion on that yet. It will evolve as a result of the testimonies today. And I think we got some very, very good information. 186 9/17/02 - PUBLIC HEALTH - RES. 010675 I think now we have enough statistics. We have enough documentation. What we need to do is figure out what is the action plan and how we get it moving. And so, I'm encouraged by the Health Commissioner. I'm encouraged that he's brought on staff to work in this problematic area. We will be meeting with them very soon. And, again, I don't want anyone to feel that I begrudge any community for having received funds or are working with the City on programs in their neighborhood. My role is to advocate and secure something for my district. And so what we have to do is look at how we restructure the way we fund programs and how do we just find a better way of doing business. And so we appreciate everyone who has come. Councilwoman, do you have any comments or you have questions?
Is there anyone else here to testify on this resolution? We will not adjourn. We will recess to the call of the Chair because it leaves the record open. And we 187 9/17/02 - PUBLIC HEALTH - RES. 010675 will call our Health Commissioner back definitely this time next year, but you never what happens between now and then in terms of what action or information we may need to call this committee back and we can do that with adequate notice. Joanne.
I know a number of us will be upset if we don't get on the record the connection with oral health and pregnancy.
And that there are very important new research findings there. And also, looking at the oral health status, particularly of adolescent girls, is another area that we really have to look at in addressing this issue.
That is that there are a lot of rumors right now because the City is facing perhaps a financial crunch of critical programs being lessened. This City government -- and I've been advocating, as you know, for a long time -- has never seriously, never, ever, ever seriously 188 9/17/02 - PUBLIC HEALTH - RES. 010675 invested in maternal and child health. And the idea that there are rumors now that we may be facing a pulling back of the few home visiting programs that do exist, we ask you to exercise a lot of guardianship over those programs because we don't want to wake up one day when it's too late, we could have done some -- made some noise had we known. Thank you.
I'd just like to say that my child is much older than 22, but I remember when I first went to -- and I didn't know anything about having a baby -- but I went to the University of Penn clinic. And they had a mother's club. And the mother's club we went once -- every time we went for a visit, we went to the mother's club. And we made clothes for our babies. And at the mother's club they talked to us about what it meant to have a baby, what was going to happen to you. So you got a lot of information. And certainly you see on television, everybody says, well, my water's going to break right away. And mine leaked, but I wouldn't have known it had I not gone to the mother's club. So that kind of information is very important. Then after my son 189 9/17/02 - PUBLIC HEALTH - RES. 010675 was born I had a visiting nurse. She came to help me. And it was just a nice experience because having a child is just very traumatic anyway. It's an experience unto itself. But having those supportive services are very important. And someone said earlier all of those social services, all those programs, are no longer in existence. That would make it exciting for a young girl to want to go and have her baby, if she had access to a mother's club or that kind of thing, which was fun. You met other women and you had dialogue. But we still have a lot to do, a long ways to go and it's not over yet. And hopefully we can create some noise that we can make a difference. Again, I want to thank all of you for contending. Those people who came who did not testify, but listened, we appreciate your presence. Thank you very much. I'd like to thank Ross Associates, Bill 21 Miller, and Janet Parrish who provided the technical -- and Heidi Gold -- I'm sorry, Heidi -- for providing the technical assistance to this committee on this whole issue. And they will be working with us to prepare the report and whatever future 190 9/17/02 - PUBLIC HEALTH - RES. 010675 activity we are involved in. We will work with them. Thank you very much. (Council recessed at 2:40 p.m.) - - - 191 C E R T I F I C A T I O N I HEREBY CERTIFY that the foregoing proceedings of the Council of the City of Philadelphia of Public Health and Human Services, were reported fully and accurately by me, and that this is a correct transcript of the same. RE: COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES ___________________________ Lisa C. Bradley, RPR and Notary Public