III.E.2.b.iii.a. MCH Epidemiology Workforce

Title V program places a strong emphasis on improving data capacity and infrastructure to support MCH programs. Since 2010, Title V has dedicated one of its 10 state priorities to improving data capacity and infrastructure. The 2020 Title V Needs Assessment demonstrated substantial growth in this area, but also affirmed the need for continued emphasis on strengthening the MCH epidemiology workforce in Illinois. As a result, Illinois chose to continue a state MCH priority centered on data for 2021-2025.This priority demonstrates the ongoing commitment of the Title V to ensuring evidence-based practice and data-driven decision-making.

During 2021, Title V hired two new FTE epidemiologists to expand the epidemiology capacity. This filled a vacancy that was open for over one year and created a new second position. This brings the permanent state positions in epidemiology to three FTEs.

Over the course of 2021, the core Title V MCH epidemiology team included:

• CDC MCH Epidemiology Program Field assignee, funded through an interagency agreement between CDC, HRSA, and IDPH, with partial funding from the Illinois Title V program (80%) and CDC (20%). Amanda Bennett, PhD, MPH, has held this position since December 2014. Dr. Bennett received her MPH and PhD in maternal and child health epidemiology from the University of Illinois at Chicago. Prior to this role, Dr. Bennett was a CSTE Applied Epidemiology Fellow in Illinois and a research specialist at the University of Illinois at Chicago. Dr. Bennett serves as the senior MCH epidemiologist for the Illinois team and leads the strategic planning for improving state MCH data capacity and infrastructure. She provides scientific leadership, advises on evidence-based practices, supervises the scientific work of state epidemiology staff, and mentors fellows/interns during temporary positions at IDPH.

• Maternal Morbidity and Mortality analyst, funded 100% through the CDC Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE-MM) grant. Cara Bergo, PhD, MPH, started this position in February 2020. Dr. Bergo received her PhD in maternal and child health epidemiology from the University of Illinois at Chicago and her MPH in epidemiology from Emory University. Prior to this role, Dr. Bergo was a CSTE Applied Epidemiology Fellow in Louisiana and an epidemiologist at the Louisiana Department of Public Health. Dr. Bergo serves as the project director for the ERASE-MM grant and oversees the implementation of maternal mortality review in Illinois.

• Maternal and Infant Health Epidemiologist, funded by Title V. This position was vacant from February 2020 until May 2021. Ashley Horne, MSPH, started this position in May 2021. Ms. Horne received her MSPH in epidemiology from Emory University. Prior to this role, Ms. Horne was a CSTE Applied Epidemiology Fellow in Illinois and a research specialist at the University of Illinois at Chicago. Ms. Horne provides epidemiologic support to the Title V program for the women’s/maternal health and infant/perinatal health population domains, including surveillance, needs assessment, program evaluation, data linkage, and analysis for the Title V annual report measures.

• Child and Adolescent Health Epidemiologist, funded by Title V and State System Development Initiative (SSDI) funds. This was a new position created in 2021. Julia Howland, MPH, started this position in May 2021. Ms. Howland received her MPH in maternal and child health from the University of Illinois at Chicago. Prior to this role, Ms. Howland was a CSTE Applied Epidemiology Fellow in Illinois and an epidemiologist with the IDPH Division of Patient Safety and Quality. She is currently in the process of completing her PhD dissertation in maternal and child health epidemiology at the University of Illinois at Chicago and expects to finish in 2022. Ms. Howland provides epidemiologic support to the Title V program for the child health and adolescent health population domains, including surveillance, needs assessment, program evaluation, data linkage, and analysis for the Title V annual report measures. She also serves as SSDI project director.

In addition to these core staff members positions, the MCH epidemiology team also included three full-time short-term positions that were added through partnerships with external organizations.

• CDC COVID-19 epidemiology field assignee, funded 100% by CDC. This position was requested by IDPH to assist with COVID-19 surveillance for pregnant persons and children. Sonal Goyal, PharmD, MPH, was assigned by CDC and served in this role during July 2020-September 2021. Dr. Goyal received her PharmD from the University of Illinois at Chicago, and her MPH in epidemiology from the University of California – Berkeley. She was formerly a CDC Epidemic Intelligence Service Officer at CDC Headquarters (Atlanta) during 2018-2020. Dr. Goyal provided subject matter expertise related to COVID-19 among pregnant persons. She led the implementation of surveillance for COVID-19 among pregnant persons through several systems, including implementing innovative sentinel surveillance system in labor and delivery units and the CDC’s Surveillance for Emerging Threats among Mothers and Newborns Network (SET-NET) for COVID-19 in pregnancy.

• CSTE Applied Epidemiology Fellow in maternal and child health, funded 100% by CSTE. Bria Oden, MPH, has held this position August 2020-April 2022. Ms. Oden received her MPH in epidemiology from Kent State University. Her main projects included: youth suicide analyses, evaluating the utility of syndromic surveillance data for pregnant persons, analyzing data on infants with neonatal abstinence syndrome, investigating details related to maternal deaths caused by homicide. Ms. Oden completed her fellowship in April 2022 and took an MCH epidemiologist position with the Ohio Department of Public Health. Dr. Bennett serves as the primary mentor for this fellowship position.

• CSTE Applied Epidemiology Fellow in maternal mortality, funded 100% by CSTE. Jelena Debelnogich, MPH, has held this position since August 2021. Ms. Debelnogich received her MPH in epidemiology from Kent State University. Her main projects so far have included: analyzing PRAMS data on health insurance stability and the association with perinatal health care utilization, planning use of community-level data for the next state maternal mortality report, assisting with chart abstraction for the SET-NET COVID-19 project, and supporting the IDPH COVID-19 data intelligence team. Dr. Bergo serves as the primary mentor and Dr. Bennett serves as the secondary mentor for this fellowship position.

While the Illinois MCH epidemiology team grew substantially over the last two years, adding new staff members and fellows during the season of remote work during 2020-2021 has been challenging for building team cohesion, supporting staff needs, and developing the workforce. In-person conferences, which usually provide ample opportunities for professional development and trainings, were either canceled or moved online (which could be challenging for engagement and depth of learning). The Title V epidemiology team began monthly meetings in mid-2021 to provide opportunities for peer sharing, collaboration, coordination of work, and technical support. In late 2022, the team will complete assessments to consider the skills and expertise represented among staff members and to identify potential areas of growth and learning that would further grow Title V’s epidemiology capacity. Training opportunities will continue to be offered to Title V staff members as they are available and feasible.

The Title V program also increases internal MCH epidemiology capacity by hosting and mentoring students seeking internships in maternal and child and/or epidemiology. During 2021, Title V hosted five MPH students for internships. These students completed projects on a wide variety of topics, including child mental health, breastfeeding, prenatal smoking, maternal morbidity, and maternal mortality. They significantly contributed to the work of the health department through both quantitative and qualitative data analyses, and they developed four formal data reports, one conference abstract, and one fact sheet.

Title V has a strong history of collaboration with the Center of Excellence in Maternal and Child Health (CoE-MCH) at the University of Illinois at Chicago School of Public Health (UIC-SPH). Since the mid-2000s, Title V programs has developed formal agreements to receive technical assistance and epidemiologic consultation from the CoE-MCH. Through such agreements, Title V substantially increases epidemiology capacity by expanding the number and types of projects that are undertaken for public health surveillance, needs assessment, program evaluation, and applied research. The current intergovernmental agreement between IDPH and CoE-MCH covers calendar years 2021-2022 and supports time for three faculty members, one staff member, and two graduate student assistants. During 2021, Title V directed the CoE-MCH to focus on two main projects: developing an evaluation plan to monitor impact of Illinois Medicaid’s 12-month postpartum extension and developing analytic plans for data on COVID-19 during pregnancy in Illinois. Data analysis for these projects began in early 2022.