DHMIC 9 th Annual Summit
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DHMIC 9 th Annual Summit 4/9/13 David A. Paul, MD Chair, Delaware Healthy Mother and Infant Consortium Professor of Pediatrics, Thomas Jefferson University Interim Chair, Department of Pediatrics, Christiana Care Health System Attending Neonatologist, Kent General Hospital
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DHMIC 9 th Annual Summit. 4/9/13 David A. Paul, MD Chair, Delaware Healthy Mother and Infant Consortium Professor of Pediatrics, Thomas Jefferson University Interim Chair, Department of Pediatrics, Christiana Care Health System Attending Neonatologist, Kent General Hospital. Welcome. - PowerPoint PPT Presentation
Transcript of DHMIC 9 th Annual Summit
DHMIC 9th Annual Summit
4/9/13
David A. Paul, MD
Chair, Delaware Healthy Mother and Infant Consortium
Professor of Pediatrics, Thomas Jefferson University
Interim Chair, Department of Pediatrics, Christiana Care Health System
Attending Neonatologist, Kent General Hospital
Welcome@DEThrives
#DHMICsummit
www.healthywomende.com
Delaware Progress
13.5% drop in infant mortality since inception of DHMIC
10.5 % drop in premature birth rate
Delaware Progress 2013-2014
Beebe Medical Center Certified as Baby Friendly
Christiana Hospital Established Center for Women’s Emotional Wellness
DOSE Program Every Birth Hospital with 39 week
initiative
Delaware Challenges
Disparity ratio of 2.5 Root causes of disparity? How far can we go with medical model?
Income/Longevity GapNYT, March 16, 2014
Fairfax, VA Population 1 million Household income $107,000 Adult obesity 24% Unemployment 6.3% 1/8 adults smokes 6/10 adults with college degrees
McDowell, WV Population 22,000 Household income $ 22,900 Adult obesity 30% Unemployment 8.8% 1/3 adults smoke 1/18 adults with college degrees
Income/Longevity GapNYT, March 16, 2014
Fairfax, VA Male life expectancy 82 y Female life expectancy 85 y Similar to Sweden
McDowell, WV Male life expectancy 64 y Female life expectancy 75 y Similar to Iraq
Housing
4498 women in low income census tract 1994-1998 randomized to:– Vouchers/move to higher income tract and
counseling– Vouchers/move and counseling (no change in
census tract) Prevalence of BMI > 35, HgB A1C
>6.5% lower in group moving to higher income census tract
Ludwig, NEJM, 2011
Proportion of Delaware Children Living in Poverty
2005-2009 2006-2010 2007-2011 2008-201214
14.5
15
15.5
16
16.5
17
17.5
15.1
16.3
16.716.9
%
White
AfricanAmerican
Puberty Pregnancy0 5ys
The Racial Gap in Reproductive Potential: A Life-Course Perspective Lu and Halfon,MCHJ, 2003
Rep
rodu
ctiv
e Po
tent
ial
Risk Factors
Life Course
Protective Factors
DHMIC Next 5 Years
Reduce Disparities Safe sleeping campaign Breast feeding Mental health Life course approach Community health workers
