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 Health919.707.5515Sarah.Mccracken@dhhs.nc.gov