Tarrant County's Infant Mortalit

Document Sample
Tarrant County's Infant Mortalit Powered By Docstoc
					 Local data overview
 PPOR findings
 Women’s Health Assessment
 Preconception health
                                                     U.S.        Texas        Tarrant County
                        9.0

                        8.5
Infant Mortality Rate




                        8.0

                        7.5

                        7.0

                        6.5

                        6.0

                        5.5

                        5.0
                              1995   1996   1997       1998    1999   2000   2001   2002     2003      2004     2005

                                                                      Year
        Rate = number of infant deaths per 1,000 live births


                                                                                 Source: Tarrant County Public Health, 2010
                              Harris          Dallas              Tarrant          Bexar                   Travis

                        9.0


                        8.0
Infant Mortality Rate




                        7.0


                        6.0


                        5.0


                        4.0


                        3.0
                               1997    1998     1999       2000     2001    2002      2003        2004        2005

                                                                    Year
    Rate = number of infant deaths per 1,000 live births


                                                                             Source: Tarrant County Public Health, 2010
                        10.0
                                 9.4

                                            8.1
                         8.0
                                                    7.4
Infant Mortality Rate




                                                             6.9          6.7

                         6.0                                                        5.7
                                                                                                 5.2          5.1


                         4.0



                         2.0



                         0.0
                               Arlington    Fort   Dallas   Houston    San        Austin       Laredo       El Paso
                                           Worth                      Antonio

                                                                   City
 Rate = number of infant deaths per 1,000 live births


                                                                                Source: Tarrant County Public Health, 2010
                                      Whites            Blacks          Hispanics          All Races
                        25.0



                        20.0
Infant Mortality Rate




                        15.0



                        10.0



                         5.0



                         0.0
                               1995   1996     1997     1998     1999   2000   2001    2002      2003     2004      2005

                                                                        Year
       Rate = number of infant deaths per 1,000 live births


                                                                                    Source: Tarrant County Public Health, 2010
Is it education?
Source: National Center for Health Statistics, 2002
                Infant Mortality Rates
by Maternal Education Level, Tarrant County 2002-2004

                        16


                        14                                                                                     Whites
                                                                                                               Blacks
                        12                                                                                     Hispanics
Infant Mortality Rate




                        10                                                                                     TC Infant
                                                                                                               Mortality Rate
                         8


                         6


                         4


                         2


                         0
                             < High School Diploma   High School Diploma   Some College/Degree

                                                       Education Level


                                                                                     Source: Tarrant County Public Health, 2010
                                       Infant Mortality Rates
                             by Maternal Age, Tarrant County 2002-2004

                        16


                        14                                                                    Whites
                                                                                              Blacks
                        12                                                                    Hispanics

                        10                                                                   TC Infant
Infant Mortality Rate




                                                                                             Mortality Rate
                        8


                        6


                        4


                        2


                        0
                                 ≤ 17           18-39             ≥ 40
                                        Maternal Age (in Years)


                                                                    Source: Tarrant County Public Health, 2010
•Developed by McCarthy & WHO
• Simple approach
• Strong conceptual basis
• Mobilizes communities
• Prioritizes prevention efforts




                         CityMatCH PPOR: http://www.citymatch.org/ppor_index.php
   Examines the four “Periods of Risk”:

    1.   Maternal Health / Prematurity
    2.   Maternal Care
    3.   Newborn Care
    4.   Infant Health

    for various population groups
   Identifies groups and periods of risk with the most
    deaths, highest rates
   Uses comparison groups to estimate “excess
    deaths” for these groups and periods of risk
FETO-INFANT MORTALITY RATES, ALL
RACIAL/ETHNIC GROUPS: 2001-2003



         Maternal Health/Prematurity
                     3.1

Maternal Care          Newborn Care                              Infant Health
     1.7                   1.4                                        1.7

          *Feto-infant mortality per 1,000 live births & fetal deaths
            Maternal Health/
             Prematurity



  VLBW births               mortality rate
                         among VLBW babies


                Interventions
Preconception                   Perinatal
    Health                        Care
To Summarize…

            Maternal Health/           PPOR-Phase I
             Prematurity



                VLBW births            PPOR-Phase II

                       Interventions


                Preconception
                    Health
•Targeted   women 18-44 in specific zip
codes
•Face-to-face survey assessed health
status, health behaviors, knowledge,
neighborhood and organizational
factors affecting their health
•405 respondents
18
                                   Healthy People 2010 Goal: 4.5




Source: The Annie E. Casey Foundation, State Level Data Online,
                Tarrant County Infant Mortality Task Force, 2005
Source: National Center for Health Statistics, BRFSS, Texas, 2004-2006, Females 18-44, National   ,
        Center for Health Statistics, NHANES, United States 2003-2006, Females 20-44
   Lack of fruits and vegetables
    › 88% eat less than five fruits and vegetables a day




   Lack of grocery stores in designated area
Source: CDC Health Date for All Ages (HDAA)http://209.217.72.34/HDAA/TableViewer/tableView.aspx?ReportId=161,
                                                               Texas, BFRSS , 2004-2006 US, NHIS, 2004-2006.
                                                                                             22
•   25% reported feeling down, depressed or
    hopeless every day, or nearly everyday
    over the past 2 weeks

•   8% of women experienced intimate
    partner violence in the past year
   Women are unhealthy, compromising their
    opportunity for healthy pregnancy

   Improving the health of women holds great
    promise in improving the health of babies

   Many opportunities to address and improve
    women’s health through prevention and promotion

   Everyone has an important role to play
•CDC   defines preconception health as “a
set of interventions that aim to identify and
modify biomedical, behavioral, and social
risks to a woman’s health or pregnancy
outcome through prevention and
management”
      Prevention and management of health
       risks and conditions
      Includes management of fertility,
       including contraception, in order to
       empower women to plan and prepare
       for pregnancies



Source: Kent H, Johnson K, Curtis M, Richardson Hood J, Atrash H. Proceedings of the Preconception Health and Health Care
Clinical, Public Health, and Consumer Workgroup Meetings. Atlanta, GA: CDC; 2006.
 Perinatal periods of risk analyses
  indicate that interventions should focus
  on African American women and on the
  maternal health/ prematurity period of
  risk
 Consistent with preconception health,
  including family planning and
  addressing health behaviors such as
  smoking and drug abuse
Paradigm Shift

From --
   Anticipation and Management
                    to
        Health Promotion and Prevention



From --
   Healthy Mothers, Healthy Babies
                      to
    Healthy Women Healthy Mothers Healthy Babies
Preconception Care - Goal

To promote the health of women of
reproductive age before
conception and thereby improve
pregnancy-related
outcomes …
A LIFE COURSE APPROACH
 Dr. Anita Kurian, Tarrant County Public
  Health
 Micky Moerbe, Tarrant County Public
  Health
 Amy Raines, Fort Worth Women’s Health
  Initiative
 Dr. Hani Atrash, CDC

				
DOCUMENT INFO