Transcript Understanding and Interpreting your Needs Assessment Data

Insert Local
MCAH/Health
Department Logo
Author(s)
Date
1. Provide a brief overview of the Title V Maternal
and Child Health Program
2. Discuss the Title V 5-year Needs Assessment
Requirement
3. Review community composition and local
context related to health and well-being
4. Present local data highlights, including bright
spots, areas for improvement and data of
interest
5. Provide a summary list of areas for improvement
 Enacted in 1935 as a part of the Social Security Act,
the Title V Maternal and Child Health (MCH)
Program is a Federal-State partnership.
 The Federal Title V Maternal and Child Health
Program has provided a foundation for ensuring the
health of the Nation’s mothers, women, children, and
youth, including children and youth with special
health care needs, and their families.
 Title V converted to a Block Grant Program in 1981.
1. Assure access to quality care, especially for those
with low-incomes or limited access to care
2. Reduce infant mortality
3. Provide and ensure access to comprehensive
prenatal and postnatal care, especially for lowincome and at-risk pregnant women
4. Increase the number of children receiving health
assessments and follow-up diagnostic and
treatment services
4
5. Provide and ensure access to preventive and
child care services as well as rehabilitative
services for certain children
6. Implement family-centered, community-based
systems of coordinated care for children with
special healthcare needs
7. Provide toll-free hotlines and assistance in
applying for services to pregnant women with
infants and children who are eligible for Title XIX
(Medicaid – known as Medi-Cal in CA).
Source: http://mchb.hrsa.gov/programs/titlevgrants/
5
State Title V programs: required to conduct a statewide,
comprehensive Needs Assessment every five years
California: decentralized the statewide needs assessment
process and each local health jurisdiction conducts a needs
assessment of their population of women and children
Key Goals 1. Build local health jurisdiction needs assessment capacity
2. Obtain extensive stakeholder input at the local level
3. Identify “needs” and issues that would be missed by only
analyzing state-level information
4. Focus local MCAH efforts by having each jurisdiction identify
priority areas they will focus on during the next 5 years
6
County
Total Population
Total Population African American
Total Population American
Indian/Alaska Native
Total Population Asian/Pacific
Islander
Total Population Hispanic
Total Population White
Total Live Births
State
37,570,307
2,195,986
163,262
4,994,232
14,277,952
14,995,619
501,994
Source: California Department of Finance Population Estimates, 2011
7
Socio-Ecological Models
Lifecourse Model
Health Happens where we
LIVE
LEARN
WORK
and PLAY
10
County
Poverty rate for people age 18 to 64 (0-200% FPL)
Source: Small Area Health Insurance Estimates (SAHIE), 2009-2011
Poverty rate for children age 0 to 64 (0-200% FPL)
Source: Small Area Health Insurance Estimates (SAHIE), 2009-2011
Children in foster care per 1,000 children age 0 to 17
Source: California Child Welfare Indicators Project, UCB, 2009-2011
% of Single mothers living in poverty (0-100% FPL)
Source: American Community Survey 1-Year Estimates, 2012
Unemployment rate
Source: State of California Employment Development Department., 2009-2011
% of Children receiving free or reduced price meals at school
Source: As cited on kidsdata.org, California Dept. of Education, Free/Reduced Price
Meals Program & CalWORKS Data Files, 2012
High school dropout rate in grades 9-12
Source: California Dept. of Education, California Basic Educational Data System
(CBEDS), 2009-2011
Number of days with ozone above regulatory standards
Source: Centers for Disease Control and Prevention, National Environmental Public
Health Tracking Network (Jul. 2013), 2011
State
33.8
45.4
6.7
39.4
12.3
57.5
14.7
16
11
 Bright spots - where we are doing significantly
better than the State, have met Healthy People
(HP) 2020 goals, or have improved over time
 Areas for improvement – where we are doing
significantly worse than the State, have gotten
worse over time, or are not meeting HP 2020
goals
 Additional data of interest – indicators that are
of particular concern or interest even though
comparisons with the State or previous points in
time might not be possible
12
Bright spots –

Our % of Uninsured children1 ages 0 to 18 is lower than the
state rate {or the 2000-2002 rate} (insert local rate vs. State
rate or rate from before)

Our % of Uninsured women1 ages 18 to 64 is lower than the
state rate {or the 2000-2002 rate} (insert local rate vs. State
rate or rate from before)
Areas for improvement –

Significantly fewer women are accessing prenatal care in their
first trimester2 than in 2000-2002 (insert current local rate vs.
previous local rate)

African American women have lower rates of first trimester2
prenatal care than White women (insert AA rate vs. White
Source: 1Small Area Health Insurance Estimates (SAHIE), 2009rate)
2011, 2California Center for Health Statistics, Vital Statistics, Births
Statistical Master File, 2009-2011
13
Bright Spot: Children and Women
without Health Insurance
22.1%
15.5%
County
State
9.3%
6.4%
Uninsured children
ages 0 to 18
Uninsured women
ages 18 to 64
Source: Small Area Health Insurance Estimates (SAHIE), 2009-2011
14
Data of interest: Children and women who
visited a doctor in the last year
91.1%
89.4%
86.5%
85.9%
County
State
Childen 0 - 17
Women 18 and over
Source: CHIS (California Health Interview Survey), 2011-2012
15
Areas for improvement -
 Births within 24 months of a previous
pregnancy1 per 100 females age 15 to 44
delivering a live birth (County = 24.2 vs.
CA = 21.0)
 Substance use diagnoses2 per 1,000
hospitalizations of pregnant females age
15 to 44 (County = 69.8 vs. CA = 13.8)
Sources: 1California Center for Health Statistics, Vital Statistics, Births Statistical
Master File, 2009-2011; 2Office of Statewide Health Planning and Development
(OSHPD). Hospital discharge data, 2009-2011
16
Area for improvement: Smoking during
1st or 3rd Trimester of Pregnancy
28.3%
8.1%
County+
State
Smoking during the 1st or 3rd trimester
per 100 females with live births
+ Regional Data
Source: MIHA (Maternal Infant Health Assessment Survey), 2011
17
Data of interest -
 Rate of Domestic Violence1 per 100,000
population in higher than state rate (County =
674 vs. State = 439)
 Rate of mood disorder hospitalizations2 per
100,000 female population age 15 to 44 in
2009-2011 is higher than state rate (County=
1,763 vs. State = 1,030), and higher than it
was in 2000-2002 (County = 1,602)
Sources: 1California State Department of Justice, Office of the Attorney General, Domestic
Violence-Related Calls for Assistance, 2009-2011; 2Office of Statewide Health Planning and
Development (OSHPD). Hospital discharge data, 2009-2011
18
Bright spots -
 Rate of live births weighing less than
2,500 grams at birth is lower than the
state (County = 6.0% vs. CA = 6.8%)
 HP 2020 Objectives achieved for:
 Low birth weight (6.0%)
 Very low birth weight (1.0%)
 Premature births - less than 37 weeks (8.2%)
Source: California Center for Health Statistics, Vital Statistics,
Births Statistical Master File, 2009-2011
19
Bright spot -
 Exclusive in-hospital breastfeeding – better
than the state (County = 85.6% vs. CA =
62.6%)
Source: California Department of Public Health,
Center for Family Health,
Genetic Disease Screening Program,
Newborn Screening Data, 2012
20
Data of interest: Overweight and obesity
among students and women
54.5%
34.1%
Public school students in
grades 5, 7, 9, & 11
Females age 15 to 44
Source (Students): Babey, S. H., et al. (2011). A patchwork of progress: Changes in
overweight and obesity among California 5th-, 7th-, and 9th-graders, 2005-2010.
Source (Women): CHIS (California Health Interview Survey), 2011-2012
21
Bright Spot Teen births
 Births per 1,000 females age 15 to 17 in
2009-2011 are lower than the State (County
= 13.5 vs. CA = 16.8), HP2020 Objective
achieved
 Births declined from 19.9 per 1,000 females
age 15 to 17 in 2000-2002 to 13.5 in 20092011
Source: California Center for Health Statistics, Vital Statistics,
Births Statistical Master File, 2009-2011
22
Areas for improvement -
 Births within 24 months of a previous
birth per 100 females under 20 years old
delivering a live birth
 Increased from 51.2% in 2000-2002 to 67.0%
in 2009-2011
 Significant increasing trend for White females
under 20 to giving birth within 24 months of a
previously giving birth
Source: California Center for Health Statistics, Vital Statistics,
Births Statistical Master File, 2009-2011
23
Areas for improvement -
 Substance abuse hospitalizations per
100,000 population age 15 to 24 higher than
State rate (County = 1055 vs. CA = 638.9)
Data of interest -
 Mental health hospitalizations per 100,000
population age 15 to 24 higher than state
rate (County = 1,734 vs. CA = 1,282)
Source: Office of Statewide Health Planning and Development
(OSHPD). Hospital discharge data, 2009-2011
24
Area for Improvement: Death Rates
129.8
69.0
70.30
County
State
41.70
Deaths per 100,000
Deaths per 100,000
population age 15 to 19 population age 20 to 24
Source: Death Statistical Master files, 2009-2011
25
•
Accessing prenatal care in their first trimester
•
Births within 24 months of a previous birth per 100 females age 15 to
44 delivering a live birth
•
Births within 24 months of a previous birth per 100 females under 20
years old delivering a live birth
•
Substance use diagnoses per 1,000 hospitalizations of pregnant
females age 15 to 44
•
Smoking during 1st or 3rd Trimester of Pregnancy
•
Overweight and obesity among public school students
•
Overweight and obesity among females ages 15-44
•
Substance abuse hospitalizations per 100,000 population age 15 to 24
•
Deaths per 100,000 population age 15 to 19
•
Deaths per 100,000 population age 20 to 24
•
Accessing prenatal care in their first trimester
•
Births within 24 months of a previous birth per 100 females age 15 to
44 delivering a live birth
•
Births within 24 months of a previous birth per 100 females under 20
years old delivering a live birth
•
Substance use diagnoses per 1,000 hospitalizations of pregnant
females age 15 to 44
•
Smoking during 1st or 3rd Trimester of Pregnancy
•
Overweight and obesity among public school students
•
Overweight and obesity among females ages 15-44
•
Substance abuse hospitalizations per 100,000 population age 15 to 24
•
Deaths per 100,000 population age 15 to 19
•
Deaths per 100,000 population age 20 to 24