Reducing Childhood Mortality

A new recommendation from the American Public Health Association (APHA) could save children across the globe, thanks in part to the work of a School of Public Health doctoral student.

Kathryn Mishkin, a DrPH candidate in the Health Policy, Management, and Behavior department, worked with a diverse, international six-person team to develop a policy for the American Public Health Association (APHA) - a not-for-profit widely regarded as the only public health organization that influences federal policy in the United States. The new policy, aimed at curbing childhood diarrhea, was adopted by APHA’s Governing Council at the 2018 Annual Meeting in San Diego and was officially released this January.

Mishkin conducted this work in conjunction with her work as a 2017-2018 national Maternal and Child Health (MCH) Student Fellow with the MCH Section of APHA. Upon commencing the Fellowship, she joined the international MCH committee of the MCH Section and the Global Maternal and Child Health Network (GMCHN), a joint effort between the MCH and International Health Sections of APHA.

Mishkin and colleagues from the GMCHN wrote the policy intended to reduce child mortality rates by increasing access to oral rehydrating and zinc treatments in order to reduce diarrhea, which according to the Centers for Disease Control & Prevention (CDC), kills 2,195 children every day – “more than AIDS, malaria, and measles combined.”

“Experts worldwide agree that deaths caused by diarrhea are preventable, so it’s astonishing that so many children are still dying from it,” said Mishkin. “It’s also widely known that oral rehydration salts and zinc treatments, which are affordable and can be administered at home, can serve as an effective treatment option that requires minimal care directly from health care providers.”

The policy calls on federal officials to appoint an individual referred to as the “Children’s Champion” to coordinate U.S. activities to reduce diarrhea-related mortality and serve as a global voice for children’s health. It also encourages global health programs in the U.S. to improve the supply of oral rehydration salts and zinc treatments, train providers in treatment guidelines, and increase public-private partnerships to scale up oral rehydration salts and zinc treatment by 30% within three years.

When APHA publishes a policy, leaders take notice, said Mishkin.

“APHA has connections to many different sectors and a lot of influence on medical communication, public health communication, and social work communication. When they push a policy out, other organizations such as the UN use them to strategically tackle issues.”

Mishkin represented the team by presenting the statement at the APHA Public Hearings in November 2018, and afterwards the team received word that it will be adopted by APHA.

As a current Co-Chair of the GMCHN and the international MCH committee and a Senior MCH Fellow, Mishkin is now leading the development of an APHA policy on advocating for investment in maternal mental health, a topic on which she has experience through previous work experiences at the CDC and the New York State Department of Health, among other organizations.

“While APHA has policies that touch upon the importance of maternal mental health, currently, no policies exist that focus in-depth on the topic," Mishkin said. "Many organizations including the World Health Organization are increasingly recognizing the importance of mental health and maternal mental health in particular. Women’s health matters because women matter.”