Public health scholars and community leaders gather to highlight 20 years of the Chiles Center’s statewide contributions to the health of mothers, children and families
As they celebrated the last 20 years of successes, staff and friends of the Lawton and Rhea Chiles Center for Healthy Mothers and Babies looked toward a future of building upon the Chiles family legacy to make an even bigger difference in the lives of women, children and families.
Officials from the university, USF College of Public Health, and the community, joined by members of the Chiles family, gathered Feb. 23 for a special tribute to Rhea Chiles, wife of the late Florida Gov. Lawton Chiles. Rhea Chiles passed away Nov. 8 at age 84 at her home in Anna Maria Island, Fla.
Rhea Chiles shared her husband’s advocacy for public health issues related to reducing high rates of infant mortality and prematurity, leading to the founding of the USF College of Public Health’s Lawton and Rhea Chiles Center for Healthy Mothers and Babies in 1996. The center gained a permanent freestanding building on the USF Tampa campus in 2001. This year marks the 20th anniversary of the research, program and policy institute, which has attracted more than $88 million in grants and garnered the respect of maternal and child health experts across the U.S. and abroad.
USF System President Judy Genshaft joined College of Public Health and community leaders in the Feb. 23 special tribute to Rhea Chiles that also celebrated the history and future of the USF College of Public Health’s Lawton and Rhea Chiles Center for Healthy Mothers and Babies.
“Lawton and Rhea Chiles were visionaries who made a difference in the lives of Floridians. Their great legacy was grounded in knowing that thriving communities begin with healthy mothers and babies,” said USF System President Judy Genshaft. “They understood that the best way to secure the future was by investing in children. At USF, we share that commitment and pledge to act upon it for decades to come.”
In their remarks, Chiles Center Founding Director Charles Mahan, MD, dean and professor emeritus of the College of Public health, and current Chiles Center Director William Sappenfield, MD, MPH, professor and chair of the Department of Community and Family Health, bridged the rich history of the center with plans for its future. They were joined by several other speakers from Chiles Center’s past and present.
The tribute to their mother was attended by, from left: Tandy Chiles, Rhea Chiles and Ed Chiles.
Remembering the Past
Dr. Mahan, an OB-GYN, spoke about the bond he forged with then U.S. Sen. Lawton Chiles and wife Rhea in the early 1980s when the senator served as chair of the landmark National Commission to Prevent Infant Mortality and they attended public hearings together.
When Chiles was elected Florida governor in 1991, he asked Dr. Mahan to remain as state health officer on loan from the medical school at the University of Florida. Gov. Chiles and Dr. Mahan began work on a concept for statewide center to promote and protect the health of pregnant women and infants. The Chiles Center’s originally intended location was the University of Florida, the governor’s alma mater, Dr. Mahan said, but that was before the state established its first college of public health at USF and several years later Dr. Mahan was appointed as dean.
Dr. Charles Mahan, dean emeritus of the College of Public Health and founding director of the Chiles Center, spoke about the center’s history.
“The Chiles’ idea was that the center would be a think tank, a way to come up with new programs to help Florida and the United States move up in the world in terms of our mother and baby outcomes,” Dr. Mahan said.
“Rhea and Lawton Chiles worked as a team. I don’t believe I’ve ever seen a couple in public life who were so totally linked together in their thinking… and that was so often seen in their deep, honest interest in mothers and children.”
That deep-seated interest had a personal component. One of Lawton and Rhea Chiles’ grandchildren was born prematurely and spent time in a neonatal intensive care unit at Shands Hospital. But, rather than pushing for more funding to expand NICU treatment, the Chiles focused their efforts on prevention and early intervention to advance prenatal and perinatal care.
By informing policy and working with community partners to improve maternal and child health outcomes, the Chiles Center played a lead role in helping the state substantially cut its infant mortality rates. This work was helped immensely, Dr. Mahan said, by Rhea Chiles advocacy for a hallmark feature of state’s bipartisan Healthy Start legislation enacted in 1991 – the establishment across Florida of public-private coalitions empowered to prioritize community needs and act on behalf of families. No other state has such coalitions, which continue to thrive today, he added.
Betty Castor, who served as president of USF when the Chiles Center was founded, speaks with Steve Freedman, PhD, adjunct professor in the USF College of Public Health.
Building upon a legacy of success
Among the Chiles Center’s accomplishments over the years:
- Provides technical assistance to Healthy Start Coalitions so that they can more meaningfully use maternal and child health data.
- Expanded prenatal care and outreach childbirth education to low-income pregnant women.
- Began the Central Hillsborough Healthy Start, which later transitioned from its university-based Chiles Center location to become a successful freestanding community organization serving the needs of East Tampa. The program grew from a $2 million grant to a diversified non-profit organization, known as REACHUP, Inc., with about $15 million in funding.
- Led a national Friendly Access program, partnering with the Disney Institute, to train health department clinic staff to be more customer-service oriented in providing care.
- Florida Covering Kids and Families, working with collaborators across the state, surpassed the federal goal for Florida in enrolling people for health care coverage in the federal health insurance marketplaces.
- Founded and directs the Florida Perinatal Quality Collaborative (FPQC), which provides leadership and consultation to public and private partners across Florida, often joining perinatal quality collaboratives in other states, to launch health care quality improvement initiatives.
- Established the Annual Chiles Center Lecture, which draws leading physicians and research scientists in maternal and child health care or policy from the U.S. and Central and South American to exchange ideas..
This year marks the 20th anniversary of the Chiles Center, which has attracted more than $88 million in grants and garnered the respect of maternal and child health experts across the U.S. and abroad.
Transitioning to a New Paradigm
Looking toward the future, the Chiles Center and its community partners have begun to broaden their approaches to maternal and child health. Rather than try to address all the needs of women during pregnancy, Dr. Sappenfield said, the center has begun to focus more holistically on women to more positively affect the health trajectory of their children’s lives.
“We’ve now discovered that our (greatest) impact on a pregnancy is not only with the mother, but it may even start with the mother’s mother,” Dr. Sappenfield said.
“It’s the mother’s health care and preventive practices that tend to define what happens to the entire family,” he said. “So, we need to address the overall health of women across their life course, especially in the early years, because if we have healthy women we have healthy children and families – which all adds to the health of the community.”
Dr. William Sappenfield, chair of the Department of Community and Family Health and current director of the Chiles Center, spoke about plans for broadening the center’s maternal and child health agenda.
Through the FPQC, directed by Dr. Sappenfield, the Chiles Center also analyzes big data to better understand health issues, to determine which programs work. and to guide evidence-based health policy that drives prevention and quality improvement.
Dr. Sappenfield pointed to one of the FPQC’s first successes: This March of Dimes-supported, multistate pilot project radically reduced rates of early elective deliveries – inductions of labor and Cesarean sections without a medical reason before 39 weeks of gestation that can cause low-birth weight babies with serious complications. Florida has now caught up with most other states. Recently launched FPQC initiatives target ways to reduce hypertension (high blood pressure) during pregnancy and maternal hemorrhaging during delivery – both leading causes of pregnancy-related illnesses and deaths in Florida.
Future goals also include evaluating Florida’s expanded home visiting program led by the Florida Association of Healthy Start Coalitions to help better identify and intervene early in mental health and family violence issues, Dr. Sappenfield said. “The return on investment for home visits is huge – as much as $24 for every $1 invested in some programs. That’s not just in improved health, but in helping keep kids in school and out of prisons.”
Dr. Mahan shows off the tie given to him by Lawton Chiles.
Inspired By a Lasting Legacy
Several members of the Chiles family, including son Ed and daughters Tandy and Rhea, attended the tribute to their mother Rhea Chiles.
Reflecting on the event, Ed Chiles said his mother understood that “top-down solutions” to problems as complex as infant mortality and prematurity did not work. Grassroots efforts beginning at the community level were required to effectively address the needs underserved groups, like, for example, home visits by doulas who live in the same neighborhoods as the high-risk pregnant women they visit, he said.
“Both Mom and Dad realized if you did not start at the beginning, especially with mothers and children, then you were never going to be able to fix problems down the line, or you would have a lot more difficulty doing that.”
Ed Chiles recalled that his father and mother never wanted a building named after them, but they agreed because it represented a cause that was so important to them.
“It was such a privilege to be here and get reacquainted with the work being done at the Lawton and Rhea Chiles Center for Healthy Mothers and Babies. What an incredible legacy,” he said.
“The idea that this center has spawned a group of public health experts… and now the young students coming after them, who are making life-changing differences in the lives of mothers, children and families — that is powerful.”
Sound bites from the other speakers:
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“We owe a great debt to Rhea Chiles. For over 20 years in the Chiles Center, and over 30 years in the College of Public Health, there have been countless students and scholars working together and growing into passionate professionals who can carry on the work that was her dream.”
Donna Petersen, ScD, dean of the USF College of Public Health
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“When we do this kind of applied, time-sensitive work, we often don’t have a chance to stop and think about the breadth of what’s being done. Listening to the whole story – Charlie Mahan providing the history, and all of the speakers talking about what we do – was one of those opportunities to see how everything is connected.”
Ellen Daley, PhD, professor and co-director, Center for Transdisciplinary Research on Women’s Health
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“We engaged communities with nontraditional providers… training women from neighborhoods with the highest rates of infant mortality to be doulas so they could provide support before, during and after pregnancies… We have data now to show these things work.”
Dee Jeffers, MPH, RN, former program director, Chiles Center
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“Since the establishment of the Florida Perinatal Quality Collaborative, we have more obstetricians and pediatricians talking to one another… We’re looking at the best evidence and starting to turn them into products that will change practice.”
John Curran, MD, associate vice president, USF Health, and co-director of the Chiles Center-based FPQC
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“We’ve made significant advances in children’s health care in the last 20 years… but looking ahead we need to help build systems of care that will enable parents of developmentally delayed children to obtain a broader range of care, so that we enable every child to achieve their highest potential.”
Russell Kirby, PhD, USF Distinguished Professor and Marrell Endowed Chair in Community and Family Health
Ed Chiles takes a photo of some of the memorabilia in the Chiles Center commemorating the work of his parents Lawton and Rhea Chiles.
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To listen to WUSF Florida Matters show on the Rhea Chiles tribute and Chiles Center legacy, click here.
Video by Sandra C. Roa and photos by Eric Younghans, USF Health Communications & Marketing
