This project documents the unique paths of MCH leaders in academe, focused on five key questions. The hope of this project is to preserve these experience and the wisdom from the field that each expert brings and also to inspire a new generation of MCH academics.
Marie C. McCormick is a pediatrician with a second doctorate in health services research. She was born in Massachusetts and attended Emmanuel College, Boston, from which she graduated Magna cum Laude in 1967. She then went to Johns Hopkins Medical School completing her MD in 1971. Following that she did a pediatric residency at Johns Hopkins Hospital while completing her doctoral work for a Doctor of Science in the Johns Hopkins School of Public Health (awarded in 1978). Her initial faculty appointment was at the University of Illinois in Chicago, but she returned quickly to Hopkins to join the Health Services Research Center there as the project director of the evaluation of the National Perinatal Regionalization Program funded by the Robert Wood Johnson Foundation (RWJF). In 1981, she moved to the University of Pennsylvania, Department of Pediatrics, and in 1987, she joined the faculty of the Department of Pediatrics at Harvard Medical School and, in 1991, she became Professor and Chair of the Department of Maternal and Child Health at the Harvard School of Public Health, and Professor of Pediatrics. She is currently the Sumner & Esther Feldberg Professor of Maternal & Child Health Emerita in the Department of Social and Behavioral Sciences at the Harvard T. H. Chan School of Public Health, and Senior Associate for Academic Affairs in the Department of Neonatology at the Beth Israel Deaconess Medical Center.
The evaluation of the RWJF program launched an investigative career in two interconnected areas of research: the outcomes of high-risk, especially premature, infants and evaluation of programs to improve perinatal outcomes. As part of the evaluation of the RWJF program, the one-year outcomes, data on about 10,000 children were obtained, at the beginning of the program and at midpoint. This large sample permitted examination of outcomes beyond the traditional ones of cerebral palsy and low IQs. The results were among the first to document the post-NICU use of health services, and to examine contextual factors affecting outcomes. The final results showed no increase in neurodevelopmental disability following sharp decreases in birth-weight specific mortality, addressing a criticism of the use of neonatal intensive care. In addition, the overall results contributed to the use of the proportion of infants weighing less than 1500 grams born in Level III hospitals as a marker of regionalization. In a follow-up effort, she reconstructed portions of this cohort plus that of a large multi-site trial involving very low birth weight infants at school age. In this study, she applied instrumentation designed to capture the elements of the WHO definition of health. In doing so, she was among the first to establish the risk of lower birth weights for a greater range of adverse outcomes like behavioral problems, as well as the health services and educational needs of these infants. An important element arising from this approach was the focus on the functional impact of perinatal events, not just diagnoses.
Besides the RWJF program, she also was a co-investigator of the evaluation of the original national Healthy Start Program. Her primary responsibility was the analysis of a survey of postpartum women in the target communities to estimate participation rates and access to services. The results clearly supported the role of Healthy Start in enhancing the use of case management. In addition, she also documented the use of Fetal and Infant Mortality Reviews in this program. On the theme of increasing access to services, she and a colleague evaluated a small program at Harlem Hospital using several techniques to encourage early use of prenatal care including community health workers to identify pregnant women and enroll them in care. The evaluation provided some of the first results on the productivity and cost of such an effort.
An effort that combined both streams of research was the Infant Health and Development Program (IHDP). This research examined the role of early educational intervention in improving the outcomes of premature, low birth weight infants in a multi-site trial. Phase I of the project included the provision of a combination of home-visiting and center based developmental services, with longitudinal follow-up until age 18 years. During this time, she had a variety of roles in the project from the Research Steering Committee in Phase I to site director in the follow-up to age 8 and overall principal investigator of the 18-year assessment. The results clearly supported a major influence on development (as measured by IQ) even for the tiniest infants, and a substantial advantage among heavier infants at 18.
In her role at the Harvard T. H. Chan School of Public Health, she has been the director of the Maternal and Child Training program, now Center of Excellence. In that role, she has expanded the program to be school-wide, attracting a diverse group of students.
She is the member of a number of professional organizations and the recipient of several awards and honors, including Martha May Eliot Forum Invited Speaker, American Public Health Association Meeting, November, 1988.
Of most significance is her several roles in the Academic Pediatric Association. She is currently the Senior Associate Editor of the Associations journal, and in that role initiated an annual report on health services use for children and youth in the United States. She was elected to membership in the Institute of Medicine, in 1997, and has served on 16 committees, chairing 5. Most notably, her efforts as chair of the Immunization Safety Review Committee earned her the David Rall Medal for exceptional service.
Click below to listen to Marie McCormick's story as she responds to five questions.