DHMIC 8th Annual Summit

4/17/13

David A. Paul, MD

Chair, Delaware Healthy Mother and Infant Consortium

Professor of Pediatrics, Thomas Jefferson University

Attending Neonatologist Christiana Hospital, Kent General Hospital

Welcome

www.healthywomende.com

Annual Review of Data and Progress

Delaware Infant Mortality

2000-2004 2004-2008 2005-2009 2006-20100

1

2

3

4

5

6

7

8

9

109.3

8.4 8.3 8

6.9 6.7 6.6 6.5

Delaware USA

Dea

ths/

1000

live

bir

ths

13.5% Reduction in Delaware Infant Mortality !

Delaware Infant Mortality by County2005-2009 vs 2006-2010

Wilmington NCC Sussex Kent

13.8

9

7.2 7.1

14.1

7.77 6.5

2005-2009 2006-2010

Dea

ths/

1000

live

bir

ths

Delaware Infant Mortality 2006-2010

Black Non-Hispanic White Non-Hispanic Hispanic0

2

4

6

8

10

12

14

1614.1

5.4

7.4

Dea

ths/

1000

live

bir

ths

Disparity ratio 2.6

Delaware Infant MortalityTemporal Trends in Disparity

New Castle -little change over time– 2002-06: Black NH IMR 16– 2006-10: Black NH IMR 15.8

Kent Count 40% reduction in Black IMR 2006-10 compared to 2001-05

Sussex County 34% reduction in Black IMR compared to 2001-2005

Health Equity Awards 2013 Announced at lunch session

Leading Causes of Infant DeathDelaware 2006-2010

Delaware1. Prematurity2. Birth Defects 3. SIDS

Distribution of Deaths/Births by BWDelaware 2006-2010

Deaths Births

Leading Causes of Infant Death By RaceDelaware 2006-2010

White1. Birth Defects2. Prematurity3. SIDS

Black 1. Prematurity2. SIDS3. Maternal Complications

Hispanic1. Birth Defects2. Prematurity3. Cord Complications

Source: CDC CPONDER, PONDER systems

White, NH

Black, NH

Hispanic

Other, NH

Overall

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0

21

36.6

29.7

25.8

26.2

79

63.4

70.3

74.2

73.8

Indicator of Sleep on Back by Race/EthnicityDelaware PRAMS 2010 Survey

YesNo

Percent

White, NH

Black, NH

Hispanic

Other, NH

Overall

0 10 20 30 40 50 60 70 80 90 100

86.3

70.9

82.5

74.4

81.3

13.7

29.1

17.5

25.6

18.7

Indicator of Co-sleeping by Race/EthnicityDelaware PRAMS 2010 Survey

YesNo

Percent

Source: CDC CPONDER, PONDER systems

Delaware Safe Sleep Campaign

Safe Sleep InitiativeChristiana NICU 2012

1= February, 201259= August, 2012

Safe Sleep InitiativeChristiana NICU 2012

1= February, 201259= August, 2012

Premature Births in Delaware

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 201011

11.5

12

12.5

13

13.5

14

14.5

11.811.6

11.912.1

12.312.5

12.712.8

12.7

12.312.2

12

12.912.7

12.8

13.613.7

13.1

14

13.7

14.3

12.9

12.5

12.8

USADelaware

Pre

mat

ure

Bir

th R

ate

Other Fun Facts Most popular names 2010

– Michael, William, Anthony– Isabella, Sophia, Ava

19.4% births Tuesday, 8.9% September Declining fertility rate DE and US 2006-2010 DE Teen birth rate below US

average: All Races, Black, White Birth to single mothers

– 47% (7th highest, US mean 40.8%) Cesarean Births

– 33.9% (19th highest, US mean 32.8%)

DHMIC Next 5 Years

Reduce Disparities Safe sleeping campaign Breast feeding Mental health Life course approach Community health workers