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Sunday, July 14, 2002



Birth defects prevention
program gets boost with
marriage fee hike


By Helen Altonn
haltonn@starbulletin.com

Couples marrying in Hawaii after Sept. 1 will be contributing to healthier babies nationwide through a $10 increase in the license fee, to $60 from $50.

Funds raised from the increase will go toward collecting information to help prevent birth defects in Hawaii and, indirectly, around the country, said Ruth Merz, administrator of the state Health Department's birth defects program.

For example, she noted the national campaign to encourage women of childbearing age to take folic acid to prevent neural tube defects.

"You can't make progress in any kind of medical or public health field until you have enough data to make a difference that is statistically significant," Merz said.

Gov. Ben Cayetano signed a bill into law earlier this month authorizing the license fee increase, but it will not take effect for two months, allowing time to change the applications and inform the public and those involved.

Merz and her staff of two, Amy Yamamoto and A. Michelle Weaver, twice have earned an A grade for their tracking and prevention programs.

"We're one of the top four (in the country)," she said.

Hawaii's program stands out because it is statewide, while many are not, and it tracks all birth defects.

And unlike many states, Merz said, "We actually go out into records and extract information" rather than wait for nurses to send it in.

Each year, 800 to 1,000 of all Hawaii newborns, or about 20 percent, are diagnosed with a moderate to severe birth defect, Merz said.

The birth defects program, which costs about $250,000 annually, pays for itself if it can save 0.8 babies a year and spare parents the anguish of having a sick child, Merz said.

Birth defects can occur even though a pregnant woman does everything right, but some are completely preventable, Merz said. Fetal alcohol syndrome is one example, she said.

"Seventy percent of birth defects can be prevented by enough folic acid in the diet at the right time," Merz said.

After operating 14 years with patchwork funding from the Centers for Disease Control, private organizations and foundations, she said the license fee money "will be so tremendous," allowing her to direct private grants to special projects.

For example, the program collected data that disproved reports of a cluster of children born in Waipahu's Village Park with a higher rate of birth defects because of possible contamination of the land from agricultural pesticides.

Besides reassuring the community, the findings averted what could have been a multimillion-dollar lawsuit against the state, Merz said, noting that lawyers were calling her from California.

The program also participated in a study of birth defects among children of Gulf War veterans because of concern about possible exposure to toxic agents.

Hawaii was a pilot site for the project, conducted by the Naval Health Research Center in San Diego, and one of six states involved in a Phase II study of births.

Merz said the birth defects program functions "like an early warning system that something needs to be taken care of."

"We're not beholden to anybody to make results come out the way they want them to come out," she said.

The program is located in the old Central Pacific Bank Building, Room 208, 76 N. King St.



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