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    Frequently Asked Questions

    Center for Chronic Disease Prevention

    Chronic Disease Prevention Division

    How does Maryland use its Preventive Health and Health Services Block Grant dollars?

    The State of Maryland uses its Preventive Health and Health Services (PHHS) Block Grant by providing funds to the 24 jurisdictions to focus on the following priority areas: chronic disease prevention, oral health, injury prevention, and sexual assault prevention and victim services.  More information is available on the .  The PHHS Block Grant also funds the Maryland Heart Disease and Stroke Program.  The goal of this Program is to reduce morbidity, mortality, and health disparities associated with heart disease and stroke in Maryland.

    Office of Oral Health (OOH)

    What does the Office of Oral Health do?

    The mission of the OOH is to improve the oral health of all residents in Maryland.  This is accomplished by working with other state agencies, local health departments, schools, community agencies, and private dentists to address disease prevention, oral injuries, and oral cancer, as well as Maryland’s special population groups.

    Where can I find public dental services?

    The OOH publishes an Oral Health Resource Guide that lists by county and population affordable and appropriate dental care services in Maryland and the immediate surrounding regions.  Only those programs or public facilities which provide income-sensitive or otherwise special dental services are listed in this directory.

    Do you publish oral health brochures?  If so, how can I get some?

    The OOH publishes a multitude of fact sheets and brochures on brushing and flossing, oral health and diabetes, good oral health habits, and many more.  See our Fact Sheets and Brochures page for more.

    If I need assistance who do I call?

    The OOH staff is happy to provide assistance.  Please call 410-767-7899 for further assistance.

    What is oral cancer?  What are the risk factors associated with oral cancer?

    Oral cancer is cancer that occurs in the mouth and on the lips.  Patients with oral cancer very often are also users of tobacco and consumers of alcohol.  Vitamin deficiency and ultraviolet light are also associated.  Additionally, oral cancer is twice as common in men as women.

    What are the signs and symptoms of oral cancer?

    Many of the signs and symptoms may be caused by less serious problems.  However, it is important to see a medical doctor or dentist if any of these conditions persist for more than two weeks:

    • A sore in the mouth that does not heal (most common symptom)
    • A lump or thickening in the cheek
    • A white or red patch on the gums, tongue, tonsil, or lining of the mouth
    • A sore throat or a feeling that something is caught in the throat
    • Difficulty chewing or swallowing
    • Difficulty moving the jaw or tongue
    • Numbness of the tongue or other area of the mouth
    • Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
    • Loosening of the teeth or pain around the teeth or jaw
    • Voice changes
    • A lump or mass in the neck
    • Weight loss

    How can I prevent oral cancer?

    Tobacco and alcohol use are the greatest risk factors for developing oral cancers.  Never start smoking or chewing tobacco.  Quitting tobacco and alcohol use significantly lowers your risk of developing these cancers, even after years of use.  Additionally, if at all possible, avoid exposure to ultraviolet radiation, especially during the middle of the day.  Wear a wide-brimmed hat and use lip balm with SPF 15 or greater.  Eating a healthy diet and consuming vitamin supplements (especially Vitamin A) also helps to reduce your risk of developing oral cancer.  Finally, be sure to receive an oral cancer screening regularly.  Adults between the ages of 18 and 39 should have an oral cancer exam every three years.  Adults 40 years and older should have an oral cancer exam every year.

    Genetics and Children with Special Health Care Needs

    I just had a baby and would like to know how I get the results of my baby’s newborn screening blood tests?

    In most cases, you will not be personally notified if the test results are normal.  Your doctor or clinic will receive the report.  Parents are usually notified if there is a problem.  Ask about the tests results when you bring your baby to the doctor or clinic for a regular checkup. 

      You can also call the office at 410-767-6736 for more information.

    If a baby's results are not readily available, you can call the newborn screening laboratory at 410-767-6099 and leave a message to send a duplicate report.  You will need:

    • The baby’s name as it was in the hospital,
    • The mother’s full name,
    • The baby’s date of birth,
    • The hospital in which the baby was born,
    • Your name and relation to the baby,
    • The name of the baby’s doctor and the name of the practice or doctor’s office,
    • The doctor’s office phone number and fax number, and
    • Your phone number.

    HIPAA and State confidentiality laws require that we send the report to the baby’s doctor.  If there is an emergency, you can call the newborn screening follow-up program at
    410-767-6736, explain the situation, and one of the follow-up doctors will help you at any hour of the day or night.

    How can I find resources for my child with special health care needs?

    In Maryland, there are many State and local resources available to your child with special health care needs.  Please visit the Office for Genetics and Children with Special Health Care Needs/Specialty Care and Regional Resources Development’s website at  for information regarding:  Care Coordination, Outreach Specialty Clinics, Children’s Medical Services, Health Care Transition, Linking Children and Youth with Special Health Care Needs and their Families to Services, Medical Home, The Parents’ Place of Maryland, and much more.

    For additional information, please call the Office for Genetics and Children with Special Health Care Needs Children’s Resource Line at 1– 800-638 -8864 where knowledgeable staff can assist you.

    Why does my baby need to have a hearing test? 

    Hearing loss is the number one birth defect in the United States.  One to three babies per 1000 will be born with a permanent hearing loss.  It is important to find hearing loss as early as possible because babies start learning how to use sound as soon as they are born.  Therefore, early identification and early intervention are the keys to successful communication development.  We know that if intervention starts by six months of age, children with hearing loss have the greatest chance of developing normal language and communication skills.  This is why it is so important to have newborn's hearing screened and follow up testing initiated as soon as possible.

    For additional information, please call the Infant Hearing Program at 410-767-5803 or
    1-800-633-1316 TTY 866-635-4410.  

    Office of Health Policy and Planning

    What areas in Maryland are considered rural?

    The Maryland State Office of Rural Health uses two definitions to classify Maryland’s jurisdictions as rural: the State definition in the Annotated Code of Maryland, and the federal Office of Rural Health Policy definition.  Those jurisdictions that are mandated by Maryland’s Annotated Code to have representatives on the Rural Maryland Council are considered rural in the State.  These include 18 of the 24 jurisdictions in Maryland:

    In addition, the Rural Assistance Center provides the “Am I Rural?” tool (http://www.raconline.org/funding/rural.php) on its website.  The tool allows users to enter an address and determine if a certain area is rural according to various definitions and funding classifications.

    Where can I find funding for my rural health project?

    The following resources for researching grant funding are available.  In addition, please contact the State Office of Rural Health if you would like any assistance researching grant opportunities and/or preparing proposals/applications for funding.

    1. For information on federal grant funding, visit www.grants.gov.  Grants.gov is a federal government website where all federal funding opportunities are posted.  Users can sign up for email grant alerts to be notified as funding opportunities are posted.
    2. Rural Assistance Center online, http://www.raconline.org/funding/.  RAC’s funding website provides an up-to-date list of grant opportunities and allows users to search for opportunities by subject area and state.
    3. Foundation Center, http://foundationcenter.org/.  The Foundation Center, located in Washington, DC, provides online funding search tools and free on-site classes in grant research, writing, and management.
    4. Maryland Governor’s Grants Office, http://grants.maryland.gov/Pages/grantshome.aspx, provides information and resources for a wide range of public and private sources.
    Center for Health Promotion, Education and Tobacco Use Prevention

    Maryland Kids in Safety Seats Program (KISS) - FAQs

    How long should my baby sit rear-facing?

    According to the American Academy of Pediatrics (AAP), babies should ride rear-facing to the maximum weight or height of the rear-facing convertible seat for the best protection.  Look in your car seat owner’s manual or labels on the seat for this information.  When your baby outgrows the infant-only seat, move him/her to a rear-facing convertible seat, which will allow you to keep the baby backwards for a longer period of time.  Minimum recommendations for forward-facing usage are one year old* and 20 pounds.  In addition, medically fragile children should ride rear-facing as long as possible.  Click here for a copy of AAP’s policy statement pertaining to the transportation of children.
    *Babies born pre-maturely must continue to ride backwards for a minimum of one year from their full-term due date and a minimum of 20 pounds.

    Where can I get my car seat installed?

    Maryland has a network of volunteers and agencies that provide car seat inspections for the public.  These sites, called Permanent Fitting Stations, are run by appointment only and availability varies by organization.  KISS asks that you call the Helpline directly at
    800-370-SEAT (800-370-7328) to be matched with a site nearest you based on your need.  However, it is very important to realize that these are inspection sites, not installation sites.  So, once your appointment is made, we suggest that you:

    • Pre-install the car seat(s), if at all possible.  The point of this service is education, not installation.  The technician is there to double check and correct your work, if necessary.
    • Please read and bring your owner’s manuals, prior to the appointment, for both the car seat and vehicle.  This will ensure a quicker and more comprehensive education process.
    • Ask questions if you do not understand something.  This is your child and car seat - you need to know how to re-install your car seat prior to leaving the appointment.  Get into the vehicle, if possible and work with the technician.

    The goal is to the learn how to do it yourself (you can do it!) so that if the car seat is taken out of the car for some reason, you do not have to wait for another appointment to re-install your seat.

    When is my child ready to sit in the car without a booster seat?

    The “Gold Star” standard for determining when a child is ready to be graduated out of the booster seat is called the 5-Step Test.  While viewing the child sitting buckled up on the vehicle seat, ask yourself these five questions:

    • Can the child sit all the way back against the vehicle seat?
    • Do the child’s knees bend naturally over the edge of the seat?
    • Does the shoulder belt cross the center of the upper chest?
    • Does the lap belt sit low and snug across the hipbone, touching the thighs?
    • Can the child sit like this for the entire trip?

    If you answered “NO” to any of these questions, your child should remain in a booster.  If your child will be riding in more than one vehicle, it is important to ensure that they take the 5-Step Test for each car.  All vehicles are not made the same; in one car a child may not need a booster, yet in another car he may need a booster.

    While the National Highway Traffic Safety Administration (NHTSA) says that children can use adult seat belts once they reach 4’9”, not all children are built the same.  Some children may benefit from continued use of the booster seat even after reaching this height guideline.  This is why the 5-Step Test is the best guideline.

    Click here to view a list of booster seat resources.
    Click here to view the Partners for Child Passenger Safety report on the importance of booster seat safety.
    Click here to view the National Highway Traffic Safety Administration, “Improving the Safety of Older Children: A Progress Report on Reducing Death and Injuries Among 4-8 Year Old Child Passengers.”

    Injury Prevention

    How do I find Maryland data about injuries and violent deaths?

    Annual Reports related to injuries and violent deaths can be found on our reports and statistics page.

    Are injuries really a public health problem?

    Yes.  Injuries are the leading cause of death in Maryland for those between the ages of 1 and 44, and injury related hospitalization charges cost over $360.7 million in 2003.  In the United States, annual loss of productivity due to injuries cost $242.7 billion.  More importantly, injuries are preventable and the same methods used to prevent infectious and chronic diseases can be applied to injury prevention.

    Tobacco Use Prevention - FAQs

    What is the Clean Indoor Air Act of 2007?

    Maryland’s Clean Indoor Air Act of 2007 was signed into law on May 17, 2007.  The purpose of the Act is to preserve and improve the health, comfort, and environment of the people of Maryland by limiting exposure to environmental tobacco smoke.

    What does the Clean Indoor Air Act of 2007 do, and whom does it affect?

    The Act has several provisions.  It defines the types of business and establishments that are covered and are not covered.  The Act states that beginning on February 1, 2008, a person may not smoke in:

      • An indoor area open to the public;
      • An indoor place in which meetings are open to the public in accordance with Title 10, Subtitle 5 of the State Government Article;
      • A government-owned or government-operated means of mass transportation including buses, vans, trains, taxicabs, and limousines; or
      • An indoor place of employment.

    Where can I get help to quit smoking?

    Maryland’s Tobacco Quitline, 1-800-QUIT-NOW (1-800-784-8669), provides free services for smokers, including a professional “quit coach” who can give you quitting techniques, help you make a personal quit plan, and offer ongoing telephone support.  Free nicotine replacement therapy (patches and gum) is also available now while supplies last.  The Quitline can even refer you to other cessation resources in your community.  For more information, call your local health department or visit the Quitline’s Web site at www.smokingstopshere.com.

    Maternal and Child Health

    What are the laws related to breastfeeding in Maryland?

     Mothers have the right to breastfeed wherever they go with their baby. No particular legislation should be needed to protect the right of mothers’ to breastfeed in public. However, legislation has been enacted in nearly one-half of the states in the U.S. (including Maryland) in order to clarify the right, and provide remedy for mothers told to stop breastfeeding in public. In 2003, Maryland passed legislation regarding breastfeeding in public.

    Maryland Code: Health- General: Title 20. Miscellaneous Health Provisions: Subtitle 8. Breastfeeding: 20-801

    The law states that:

    A mother may breast-feed her child in any public or private location in which the mother and child are authorized to be
    A person may not restrict or limit the right of a mother to breast-feed her child.
    In regards to breastfeeding support, Maryland was the first state to provide an exemption from sales tax for breastfeeding accessories, that may be used by breastfeeding mothers (Maryland Code: Tax General: Title 11. Sales and use tax: Subtitle 2. Exemptions: 11-211). Exempt items include breast pumps, breast pump hook-up kits, breast shells, nursing shields, Supplemental Nursing System (SNS), feeding tubes, breast milk storage bags, finger feeders, and purified lanolin.

    What are Fetal Alcohol Spectrum Disorders (FASD)?

      Fetal alcohol syndrome (FAS) is a set of physical and mental birth defects that can result when a woman drinks alcohol during her pregnancy. When a pregnant woman drinks alcohol, such as beer, wine, or mixed drinks, so does her baby. Alcohol passes through the placenta right into the developing baby. The baby may suffer lifelong damage as a result.

    FAS is characterized by brain damage, facial deformities, and growth deficits. Heart, liver, and kidney defects also are common, as well as vision and hearing problems. Individuals with FAS have difficulties with learning, attention, memory, and problem solving.

    Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include physical, mental, behavioral, and/or learning disabilities with possible lifelong implications. The term FASD is not intended for use as a clinical diagnosis.
    FASD covers other terms such as:

    Fetal alcohol syndrome (FAS) - the only diagnosis given by doctors.
    Alcohol-related neurodevelopmental disorder (ARND) - reserved for individuals with functional or cognitive impairments linked to prenatal alcohol exposure, including decreased head size at birth, structural brain abnormalities, and a pattern of behavioral and mental abnormalities
    Alcohol-related birth defects (ARBD) - describes the physical defects linked to prenatal alcohol exposure, including heart, skeletal, kidney, ear, and eye malformations
    Fetal alcohol effects (FAE) - a term that has been popularly used to describe alcohol-exposed individuals whose condition does not meet the full criteria for an FAS diagnosis
    Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe a broad range of effects associated with alcohol use during pregnancy. The spectrum can include physical effects as well as effects on the brain that may result in problems with learning, emotions and behavior.

    When a pregnant woman drinks, so does her baby.
    The baby's growth can be altered and slowed.
    The baby may suffer lifelong damage.
    Pregnant women who drink do not intentionally harm their unborn babies. In most cases, they simply do not know about FASD or fully understand the risks. They may have been given incorrect information about alcohol and pregnancy from family, friends or health care providers. In some cases, women have a serious problem with alcohol and they need professional help to stop drinking. Others do not even realize they are pregnant when the drinking occurs.

    How can I find Maryland data about pregnancy and postpartum health?

    Maryland surveys between 2,000-2,500 new mothers annually under a cooperative agreement with the Centers for Disease Control and Prevention (CDC) called Pregnancy Risk Assessment Monitoring System (PRAMS).  Annual reports and program briefs can be found at www.marylandprams.org/.

     What services are available through the Maryland State Family Planning Program?

    The Maryland State Family Planning Program provides a wide range of highly effective family planning   methods and related preventive health services for clients of reproductive age. Clinical services for women include physical examination, breast and cervical cancer screening, Sexually Transmitted Infection screening, diagnosis and treatment, assessment of minor gynecological problems, and pregnancy testing with options counseling.  Clinical services for men include a reproductive health examination and Sexually Transmitted Infection screening, diagnosis, and treatment.  Clinics offer a choice of contraceptive methods, including birth control pills, patches, rings, implants, injections, intrauterine devices, condoms, spermicides, natural family planning,  emergency contraception, and abstinence. Referral for sterilization, infertility services and primary care services are also available.  Every client receives extensive counseling and education on reproductive health issues and lifestyle management.  All services are confidential.

    Are Maryland State Family Planning Program services free?

    Clients are assessed a fee for services using a sliding fee scale based on reported income, with many  individuals eligible for no- or low-cost services. Clients with incomes at or below 100% of the Federal Poverty Level are not charged. No one is denied services due to an inability to pay.  Insurance and medical assistance programs may be billed for services, and voluntary donations may be accepted. Charges to confidential teens are based on the teen’s income and ability to pay.

    Website: http://fha.md.gov/mch/fp_home.aspx

    What is the rationale for requiring reporting of blood lead levels at school entry, particularly as it relates to testing of 5-6 year olds?

    Testing of older children who are at-risk and have not been tested at the appropriate time is benefitial since intervention is not totally dependent on children's age, particularly as it relates to prevention of ongoing exposure.  The requirement encourages the testing of children at the appropriate time rather than waiting until children are ready to enter school. This is particularly important for high risk populations where testing rates are still not optimal.  National standards all recommend testing 3-6 years olds who are at-risk and have not previously been tested.  Maryland is not alone in a requirement to report blood lead testing status at time of school entry.    Also, there is increasing evidence regarding the impact of lead levels less than 10mg/dl on cognitive and behavioral function.  Due to this evidence, it is possible that the CDC will lower the blood lead level of concern  (currently 10mg/dl) This will increase the number of older children whose levels exceed the cutoff and require intervention.

    What is the current asthma prevalence for adults in Maryland?  For  children?

    The current prevalence for adults reporting that they have asthma is 8.9% (2006 data).  For children, it is 9.2%.Statewide, about 13.3% of Maryland adults and 13.1% of children have a history of asthma.  An estimated 356,000 adults and 113,000 children currently have asthma.  (2005-2006 combined estimates)

    Website : http://fha.md.gov/mch/asthma.aspx