March of Dimes

For the unaffiliated Canadian charitable organizations, see Ontario March of Dimes and March of Dimes Canada.

March Of Dimes
Formation	January 3, 1938
Headquarters	White Plains, New York, U.S.
President	Jennifer L. Howse
Website	marchofdimes.com

The March of Dimes Foundation is a United States nonprofit organization that works to improve the health of mothers and babies.^[1]

Organization

The March of Dimes is a not-for-profit organization with 501(c)(3) tax-exempt status. The mission of the March of Dimes is to improve the health of babies by preventing birth defects, premature birth and infant mortality.^[2] The foundation is headquartered in White Plains, NY and has 51 chapters across the U.S., including the District of Columbia and Puerto Rico. The March of Dimes provides mothers, pregnant women and women of childbearing age with educational resources on baby health, pregnancy, preconception and new motherhood, as well as supplying information and support to families affected by prematurity, birth defects, or other infant health problems.^[3]

Name

The organization began as the National Foundation for Infantile Paralysis. The name "March of Dimes"—coined in the late 1930s by vaudeville star Eddie Cantor as a play on the contemporary newsreel series "The March of Time"—was originally used for the foundation's annual fundraising event and gradually became synonymous with that of the organization.^[4] It was officially adopted as the organization’s name in 1976, when it became known as the March of Dimes Birth Defects Foundation. In 2007, the name became the March of Dimes Foundation.^[5]

History

March of Dimes poster ca. late 1950s

Anti-polio efforts

The group was founded by President Franklin D. Roosevelt on January 3, 1938, as a response to U.S. epidemics of polio, a condition which can leave people crippled. Roosevelt was himself diagnosed with polio in 1921, and it left him unable to move his legs. The foundation was an alliance between scientists and volunteers, with volunteers raising money to support research and education efforts.^[5] Basil O’Connor, an attorney and a close associate of President Roosevelt, helped establish the foundation. He became its president in 1938, a position he held for more than three decades. His first task was to create a network of local chapters that could raise money and deliver aid—more than 3,100 county chapters were established during his tenure.^[5] In the years between 1938 and the approval of the Salk vaccine in 1955, the foundation spent $233 million on polio patient care, leading to more than 80 percent of polio patients in the U.S. receiving significant^{[clarification needed]} foundation aid.^{[6][verification needed]}

Change of mission

With its original goal of eliminating polio accomplished, the March of Dimes faced a choice: to either disband or dedicate its resources to a new mission. Basil O’Connor, president of the March of Dimes at the time, directed his staff to identify strengths and weaknesses of the organization and reformulate its mission.^[5] In 1958, the NFIP shortened its name to the National Foundation (NF) and launched its "Expanded Program" against birth defects, arthritis, and virus diseases, seeking to become a "flexible force" in the field of public health. In the mid-60s, the organization focused its efforts on the prevention of birth defects and infant mortality, which became its mission thereafter.^{[citation needed]} At this time the cause of birth defects was unknown; only the effects were visible. In 1976, the organization changed its name to the March of Dimes Birth Defects Foundation.^[5] In 2005, reducing the toll of premature birth was added as a mission objective.

Initiatives after polio

Rubella

Rubella, also called German measles, is associated with a disorder called congenital rubella syndrome, which can cause miscarriages and birth defects such as deafness, blindness and mental retardation.^[7] Vaccination is an effective preventive measure. On behalf of the March of Dimes, Virginia Apgar testified to the United States Senate in 1969 about the importance of federal funding of a rubella immunization program,^[8] and the organization funded^{[clarification needed]} a vaccine, which was licensed in the early 1970s.^[9] In 2006, a statement published in Birth Defects Research Part A credited the "remarkable success of the immunization program to eliminate rubella is due to joint efforts by the Centers for Disease Control and Prevention, various state and local health departments, the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, and the March of Dimes".^[10]

Maternal and neonatal care

In 1976, the March of Dimes published a report titled Toward Improving the Outcome of Pregnancy (TIOP), and in 1993 they published Toward Improving the Outcome of Pregnancy: The 90s and Beyond (TIOP II).^[11] TIOP "stratified maternal and neonatal care into 3 levels of complexity and recommended referral of high-risk patients to centers with the personnel and resources needed for their degree of risk and severity of illness."^[11] TIOP was published when "resources for the most complex care were relatively scarce and concentrated in academic medical centers."^[11] TIOP II updated care complexity designations from levels I, II and III to basic, specialty and subspecialty, and the criteria were expanded.^[11] In 2001, the March of Dimes introduced a family support program for those with babies in a neonatal intensive care unit (NICU).^[12] The program seeks to educate NICU staff to communicate effectively with patients' families.^[13][14] The March of Dimes hosted the Symposium on Quality Improvement to Prevent Prematurity in October 2009.^[15][16][17] In December 2010, the March of Dimes released TIOP III, subtitled Enhancing Perinatal Health Through Quality, Safety, and Performance Initiatives.

Fetal alcohol syndrome

Fetal alcohol syndrome (FAS) is categorized as a group of birth defects ranging from mental retardation to various growth and behavioral problems.^[18] The March of Dimes has provided grant funding for FAS research,^{[citation needed]} and they supported the National Council on Alcoholism in its push for legislation to bring public attention to the dangers of alcohol use by pregnant women.^{[verification needed]} This led to a 1989 law mandating a warning label about the risk of birth defects that alcoholic beverages still carry today.^{[19][verification needed]}

Folic acid

The March of Dimes has campaigned for public education on folic acid,^[20] a vitamin which can prevent spina bifida if mothers have enough of it in their body. The March of Dimes has funded polls on folic acid from The Gallup Organization.^[21] Analysis of some of the results, said that women aged 18–24 years had the least awareness regarding folic acid consumption or knowledge about when it should be taken.^[22] On the issue, the organization partnered with the Grain Foods Foundation, an industry group, in public education efforts.^[23][24]

Prematurity campaign

Awareness about preterm birth, which is associated with a variety of negative health outcomes, is an organizational goal. According to an editorial in the May 2004 issue of the Journal of the National Medical Association, the original goals of the campaign were to raise awareness of the problem from 35 percent to at least 60 percent and to decrease the rate of premature births by at least 15 percent (from 11.9 percent to 10.1 percent).^[25] In 2008, the Prematurity Campaign was extended by the Board of Trustees until 2020, and global targets were set for prematurity prevention.^[26] In 2008, the March of Dimes started its annual Premature Birth Report Card, which grades the nation and each individual state on preterm birth rates.^[27]

Newborn screening

March of Dimes states on its website that it supports mandated newborn screening of all babies in all states in the U.S. for at least 30 life-threatening conditions for which effective treatment and reliable testing is available to prevent catastrophic consequences to the child.^[28][29]

In 2003, the March of Dimes began releasing an annual, state-by-state report card on each state’s adoption of expanded newborn screening recommended by the American College of Medical Genetics. March of Dimes president Jennifer L. Howse, Ph.D. has stated that this program is intended to inform parents of the tests available in their state, enabling those with affected babies to pursue early treatment.^[30]

According to a presentation at the 2005 annual meeting of the American Public Health Association, individual, state-based March of Dimes chapters work with governors, state legislators, health departments, health professionals, and parents to improve state newborn screening programs and to make comprehensive newborn screening programs available to every newborn throughout the country.^[31]

In 2005, only 38 percent of infants were born in states that required screening for 21 or more of 29 core conditions recommended by the American College of Medical Genetics; but by 2009, all 50 states and the District of Columbia required screening for 21 or more of these treatable disorders.^[32]

SCHIP reauthorization

The March of Dimes has lobbied the United States' Congress to support the continuation of the State Children's Health Insurance Program (SCHIP) in 2007 and 2009. SCHIP is a program provides health insurance to 11 million low-income children and pregnant women. March of Dimes partnered with the American Academy of Pediatrics (AAP) and the National Association of Children's Hospitals (NACH) on the issue.^[33][34][35]

Global Report on Birth Defects

The March of Dimes published their Global Report on Birth Defects in 2006, which estimated birth defects' global burden.^[36]

White paper on prematurity

In 2009, the March of Dimes partnered with the Department of Reproductive Health and Research of the World Health Organization (RHR/WHO) to publish a white paper on the global and regional toll of preterm birth worldwide. This report, which was the first attempt to identify the global scope of premature births and related infant deaths, found that an estimated 13 million infants worldwide are born premature each year and more than one million of them die in their first month of life. Further, premature births account for 9.6 percent of total births and for 28 percent of newborn deaths. The highest rates of premature birth are in Africa, followed by North America (Canada and the United States combined).^[37]

March for Babies

Established in 1970, the March for Babies, previously called WalkAmerica,^[38] is the largest fundraiser of the year for the March of Dimes, as well as the oldest nationwide charitable walking event.^[39] In the decades since, many other organizations have used the "walk-athon" format to help raise money.^[40] Funds raised by the event support March of Dimes-sponsored research and other programs to prevent premature birth, birth defects and infant mortality.^[41]

According to the March of Dimes, March for Babies is held in more than 900 communities across the nation. Every year, 1 million people—including 20,000 company teams, family teams and national sponsors—participate in the event, which has raised more than $1.8 billion since 1970.^[42] The March of Dimes states that seventy-six cents of every dollar raised in March for Babies is spent on research and programs to help prevent premature birth, birth defects and infant mortality.^[43]

Sounds of Pertussis

Once rare in the United States, cases of pertussis (whooping cough) are appearing across the country with greater frequency.^{[citation needed]} To address this issue, the March of Dimes and Sanofi Pasteur launched a national education campaign in 2010 called "Sounds of Pertussis" to raise awareness about the seriousness of pertussis and the need for adult vaccination to prevent infecting babies.^{[44][dead link]} NASCAR driver Jeff Gordon is a national spokesperson for the campaign.^[45] The campaign recently sponsored a song-writing contest called Sound Off About Pertussis, which was won by Maria Bennett with her original song, "Give Pertussis a Whooping."^[46]

Healthy Babies are Worth the Wait

In 2007, the March of Dimes, the Johnson & Johnson Pediatric Institute, and the Kentucky Department for Public Health partnered with six Kentucky hospitals to launch “Healthy Babies Are Worth the Wait,” a health promotion and prematurity prevention initiative intended to reduce the rate of preventable preterm births in targeted areas of Kentucky.^[47][48] The primary goal of Healthy Babies Are Worth the Wait is a 15 percent reduction in the rate of singleton (one baby) preterm births in these targeted areas.^[49]

Perinatal Data Center

The March of Dimes Perinatal Data Center includes the PeriStats Web site, which provides free access to U.S., state, county, and city maternal and infant health data.^[50]

Notable staff

• Virginia Apgar, M.D., the creator of the Apgar Score, joined the March of Dimes in 1959 and eventually served as vice president for medical affairs^[51]

Controversy

Animal rights organizations have raised concerns about March of Dimes-funded medical research involving animals.^[52] The foundation states it supports the use of non-animal research alternatives wherever possible. March of Dimes grants for research involving animals are awarded only to studies that comply with the highest ethical standards to protect the health and welfare of animal subjects.^[53]

Criticism

The March of Dimes has been described as a bureaucracy that has taken on a life of its own through a classic example of a process called goal displacement. Faced with redundancy after Jonas Salk discovered the polio vaccine, it adopted a new mission, "fighting birth defects", which was recently changed to a vaguer goal of "breakthrough for babies", rather than disbanding.^[54][55]

Charity Navigator has given the organization a rating of one out of four stars based on its financial filings, meaning "Fails to meet industry standards and performs well below most charities in its Cause." It also note that the president Jennifer Howse was paid $633,132 in 2010.^[56]

References

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51. ^ "Bio of Doctor Virginia Apgar, Changing The Face of Medicine Website". http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_12.html. Retrieved November 11, 2010. 
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53. ^ "Research Involving Animals". March of Dimes. http://www.marchofdimes.com/professionals/691_14438.asp. Retrieved April 17, 2008. 
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External links

• Official website