Transcript Healthy North Carolina 2020 Objective: Maternal and Infant

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.
Infant Mortality Rate
North Carolina, 1988-2009
20.0
18.0
16.0
14.0
12.0
7.9
10.0
Total
White
Minority
8.0
6.0
4.0
2.0
1988
1991
1994
1997
2000
2003
2006
2009
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
2.8
2.7
2.6
2.5
2.4
2.3
2.2
2000
2001
2002
2003
2004
2005
2006
2007
2008
Reduce the infant mortality
disparity
NC Black/White Infant Mortality Disparity Rate
2.8
~ 2.7 in 2009
2.7
2.6
2.5
2.4
2.3
2.2
2000
2001
2002
2003
2004
2005
2006
2007
2008
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
15
10
5
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
NC Public Health Efforts to
Reduce Infant Mortality
Improve infant health care
Improve maternity care
Increase planned pregnancies
Improve women’s health
NC Public Health Efforts to
Reduce Infant Mortality
Improve infant health care
Improve maternity care
Increase planned pregnancies
Improve 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
 chronic
status
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 Cobb
SSDI Project Coordinator
Women’s and Children’s Health
NC Division of Public Health
919.707.5515
[email protected]