healthy north carolina 2020 objective: maternal and infant health a state public health perspective
TRANSCRIPT
Healthy North Carolina 2020 Objective:Maternal and Infant Health
A State Public Health Perspective
Maternal and Infant Health 2020 Objectives
1. Reduce the infant mortality disparity (Key Performance Indicator)
2. Reduce the infant mortality rate
3. Reduce the percent of women smoking during pregnancy
Reduce the infant mortality rate
The infant mortality rate is the number of infant deaths per 1,000 live births. Infant death is defined as the death of an infant before his or her first birthday.
Reduce the infant mortality rate
The leading causes of infant death include congenital abnormalities, pre-term/low birth weight, Sudden Infant Death Syndrome (SIDS), problems related to complications of pregnancy, and respiratory distress syndrome.
Importance of Infant Mortality in North Carolina
IM is an issue of great magnitude In 2008, 68% of all child deaths in NC
were infant deaths.IM is a good “proxy measure” for a
community’s public health as IM has many causes with origins ranging from medical to socio-economic factors.
Importance of Infant Mortality in North Carolina
IM is not just about deaths Infants who survive are our future school
children.i.e. only 15.2% of low birth weight babies
graduated from high school by age 19, compared to almost 60% of their normal birth weight siblings
Infants who survive are prone to chronic disease.
-
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
20.0
1988 1991 1994 1997 2000 2003 2006 2009
Total
White
Minority
Infant Mortality RateNorth Carolina, 1988-2009
7.9
Reduce the infant mortality disparity
Defined as gap between the infant death rate for whites and African Americans (the largest disparity between two groups in North Carolina) expressed as a ratio.
Reduce the infant mortality disparity
This ratio expresses the number of times greater the African American infant mortality rate is in proportion to the white infant mortality rate.
Reduce the infant mortality disparity
NC Black/White Infant Mortality Disparity Rate
2.2
2.3
2.4
2.5
2.6
2.7
2.8
2000 2001 2002 2003 2004 2005 2006 2007 2008
Reduce the infant mortality disparity
NC Black/White Infant Mortality Disparity Rate
2.2
2.3
2.4
2.5
2.6
2.7
2.8
2000 2001 2002 2003 2004 2005 2006 2007 2008
~ 2.7 in 2009
http://www.schs.state.nc.us/SCHS/pdf/MinRptCard_WEB_062210.pdf
Reduce the percent of women smoking during pregnancy
Smoking during pregnancy can have a negative impact on the health of infants and children by increasing the risk of complications during pregnancy, premature delivery, and low birth weight.
Reduce the percent of women smoking during pregnancy
Percent of NC women who smoked during pregnancy Source: NC Vital Records
0
5
10
15
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
NC Public Health Efforts to Reduce Infant Mortality
Improve infant health careImprove maternity careIncrease planned pregnanciesImprove women’s health
NC Public Health Efforts to Reduce Infant Mortality
Improve infant health careImprove maternity careIncrease planned pregnanciesImprove women’s health
Planned Pregnancies Have Better Outcomes
44% NC pregnancies not planned [PRAMS 2006-08] By race African Americans
(64%), Latinas (40%) and Whites (38%)
Associated with late PNC, poor birth spacing, abuse/neglect
Healthy Women More Likely to Have Healthy Babies
IM and disparities related to mother’s health including- socioeconomic status chronic stress chronic disease and infection smoking, and nutrition age
Life-Course Approach
12 point plan to reduce Black-White Disparities
Described in article entitled Closing the Black-White Gap in Birth Outcomes: A Life-Course Approach in Ethnicity & Disease, Volume 20, Winter 2010 by authors Michael Lu, et.al.
12-Point Plan
1. Provide interconception care to women with prior adverse pregnancy outcomes
2. Increase access to preconception care to African American women
3. Improve the quality of prenatal care
4. Expand healthcare access over the life course
12-Point Plan, continued
5. Strengthen father involvement in African American families
6. Enhance coordination and integration of family support services
7. Create reproductive social capital in African American communities
8. Invest in community building and urban renewal
12-Point Plan, continued
9. Close the education gap
10. Reduce poverty among African American families
11. Support working mothers and families
12. Undo racism
12-Point Plan
1. Provide interconception care to women with prior adverse pregnancy outcomes
2. Increase access to preconception care to African American women
3. Improve the quality of prenatal care
4. Expand healthcare access over the life course
Preconception Health
TO BE RELEASED SOON – Check the SCHS website (http://www.schs.state.nc.us/SCHS/)
Tracking Preconception Health
New Web site at the State Center for Health Statistics http://www.schs.state.nc.us/SCHS/data/preconception.html
Indicators developed by a 7 state working group which included NC
Further Questions or Comments
Sarah McCracken CobbSSDI Project CoordinatorWomen’s and Children’s HealthNC Division of Public [email protected]