- The ARC - California Edition -

The Centers for Disease Control and Prevention

Within the federal government, there is an organizational function which is assigned the duty of reducing the incidence of mental retardation and other developmental disabilities. Most of these prevention efforts have been assigned to the Centers for Disease Control and Prevention. The CDC has the mission of preventing unnecessary disease, disability and premature death.

One of these official Centers within the CDC is almost totally involved with the casual factors related to the mission of the Arc. This center is known as the Center for Environmental Health and Injury Control. It has the established mission to prevent injury, to prevent birth defects and developmental disabilities, and to eliminate or control environmental hazards. 

The prevention of birth defects and developmental disabilities is the subject of this day as the higher priority interest of the Arc is - the prevention of Birth Defects and Developmental Disabilities.

DEVELOPMENTAL DISABILITIES
Developmental disabilities are a diverse group of physical, cognitive, psychological, sensory, and speech impairments that begin anytime during development up to 18 years of age. About 17% of U.S. children under 18 years of age have a developmental disability. In most instances, the cause of the disability is not known.

That is why it is important to understand what factors increase the chance that a child will have a developmental disability and what can be done to prevent the condition.

Approximately 2% of school-aged children in the U.S. have a serious developmental disability, such as mental retardation or cerebral palsy, and need special education services or supportive care.

State and federal education departments spend about $36 billion each year on special education programs for individuals with developmental disabilities who are 3-21 years old.

BIRTH DEFECTS
Birth defects are the leading cause of infant mortality in the United States, accounting for more than 20% of all infant deaths. About 120,000 U.S. babies are born each year with a birth defect, and 8,000 of these babies die during their first year of life. In addition, birth defects are the fifth-leading cause of years of potential life lost and contribute substantially to childhood morbidity and long-term disability. 

Because the causes of about 70% of all birth defects are unknown, the public continues to be anxious about whether environmental pollutants cause birth defects, developmental disabilities, or other adverse reproductive outcomes. The public also has many questions about whether various occupational hazards, dietary factors, medications, and personal behaviors cause or contribute to birth defects.   

(Source: Centers for Disease Control; Division of Birth Defects, Child Development, and Disability and Health; Developmental Disabilities Branch)

Folic Acid National Education Campaign — Folic acid is a B-vitamin that can be found in some enriched foods and vitamin pills.  If women have enough of it in their bodies before pregnancy, this vitamin can decrease the risk for birth defects of the baby's brain or spine.

For many women, an easy way to be sure you're getting enough folic acid is to take a vitamin with folic acid in it. Research funded by he CDC clearly indicates that all women who could possibly become pregnant should consume 400 micrograms of folic acid every day. They predict that this could prevent up to 70% of some types of serious birth defects. 

But to do this, women need folic acid BEFORE they get pregnant. That is why the CDC recommends that a woman should always get enough folic acid each day even if that woman is not thinking about a baby any time soon. Folic acid has been added to some foods, such as enriched breads, pastas, rice, and cereals.  

The challenge of the CDC education campaign is to carry this message to the general public and to the professionals of our country. 

Birth Defects Surveillance — During 1998, NCEH awarded some cooperative agreements to 18 states to address major problems that hinder the surveillance of birth defects and the use of data for prevention and intervention programs. These problems include variability in the effectiveness of state surveillance programs, lack of effective program support by states, and collected data not being used for planning, prevention, and evaluation. 

The states received funding for three categories of activities: to initiate new surveillance programs where none now exist; to support new programs; and to improve existing surveillance programs.

State Services — In 1996, Congress directed CDC to establish Centers of Excellence for Birth Defects Prevention Research. In 1996, the CDC awarded its first cooperative agreement to organizations in California and Iowa. They have since granted similar awards to organizations in Arkansas, Massachusetts, New Jersey, New York, and Texas. 

The centers established in these states will expand and improve existing surveillance by integrating prenatal diagnoses into surveillance activities. They will also develop, implement, and evaluate local studies in the following categories: the effectiveness of various methods for the primary prevention of birth defects, the teratogenicity of various drugs, the environmental causes of birth defects, and the genetic factors that make people susceptible to environmental causes of birth defects, the behavioral causes of birth defects, and the costs of birth defects. 

National Birth Defects Prevention Study — The largest activity for the seven Centers of Excellence will be their participation in the National Birth Defects Prevention Study, a case-control study of infants born with major congenital anomalies. The study involves an interview with the mother of study infants and the collection of biological specimens from the infants and their mothers and fathers. 

The CDC Birth Defects and Pediatric Genetics Branch will provide oversight to this risk-factor study and will pool the data to make it available to all collaborating researchers.