KANSAS INFANT MORTALITY Dennis Cooley MD, FAAP September 2, 2010.
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Transcript of KANSAS INFANT MORTALITY Dennis Cooley MD, FAAP September 2, 2010.
KANSAS INFANT KANSAS INFANT MORTALITYMORTALITYDennis Cooley MD, FAAPDennis Cooley MD, FAAP
September 2, 2010September 2, 2010
Infant Mortality Quiz Infant Mortality Quiz #1#1
Who has the worst Infant Mortality rate? Who has the worst Infant Mortality rate? (2005)(2005) CubaCuba SingaporeSingapore KansasKansas PolandPoland
Infant Mortality Quiz Infant Mortality Quiz #1#1
Infant Mortality RatesInfant Mortality Rates(2005)(2005)
Singapore- 2.1Singapore- 2.1
Cuba- 6.2Cuba- 6.2
Poland- 6.4Poland- 6.4
Kansas-7.4Kansas-7.4
Countries that have better IMRs Countries that have better IMRs than KSthan KS
Cuba, Faroe Islands, Isle of Man, Italy, New Cuba, Faroe Islands, Isle of Man, Italy, New Zealand, Taiwan, San Marino, Greece, Monaco, Zealand, Taiwan, San Marino, Greece, Monaco, Ireland, Jersey, United Kingdom, Gibraltar, Ireland, Jersey, United Kingdom, Gibraltar, Portugal, Netherlands, European Union, Portugal, Netherlands, European Union, Luxembourg, Canada, Guernsey, Luxembourg, Canada, Guernsey, Liechtenstein, Australia, Belgium, Austria, Liechtenstein, Australia, Belgium, Austria, Denmark, Slovenia, Macau, Spain, Denmark, Slovenia, Macau, Spain, Switzerland, Germany, Andorra, Czech Switzerland, Germany, Andorra, Czech Republic, Malta, Norway, Finland, France, Republic, Malta, Norway, Finland, France, Iceland, Hong Kong, Japan, Sweden, Iceland, Hong Kong, Japan, Sweden, Singapore, Estonia, Cayman Islands, Slovakia, Singapore, Estonia, Cayman Islands, Slovakia, Poland, Serbia, Cyprus, Lithuania, Croatia ……Poland, Serbia, Cyprus, Lithuania, Croatia ……
Central Intelligence Agency, The World Factbook, 2009
Infant Mortality Quiz Infant Mortality Quiz #2#2
List the states in order of highest African List the states in order of highest African American Infant mortality ratesAmerican Infant mortality rates MichiganMichigan KansasKansas MississippiMississippi District of ColumbiaDistrict of Columbia
Infant Mortality Quiz Infant Mortality Quiz #2#2
Michigan-18.3Michigan-18.3
Kansas-17.6Kansas-17.6
Mississippi-17.2Mississippi-17.2
DC-17DC-17
Kansas Ranks 47Kansas Ranks 47thth among States for Black among States for Black Infant Mortality Rate Infant Mortality Rate
States:States: Black IMR 05Black IMR 05 Rank:Rank:
Delaware 18.9 50
Michigan 18.3 49
Wisconsin 17.7 48
Kansas 17.6 47
Mississippi 17.2 46
DC* 17
Indiana 17 45
Ohio 16.9 44
North Carolina 16.4 43
Illinois 16.4 43
Colorado 16.3 41
USA 13.7
Source: National Center for VS, CDC, 2006
IMR trendsIMR trendsKS and U.S.A, 1992-2006KS and U.S.A, 1992-2006
African American and White Infant African American and White Infant Mortality Rates & Ratio, KS Births: Mortality Rates & Ratio, KS Births:
1998-20071998-2007
1.4 2.1 1.93.1 2.5 2.5 2.4 2.7 2.8 2.9
2.1
0
5
10
15
20
25
Rat
es a
nd
Rat
io
White NH
Black NH
Ratio
Infant deaths by cause of Infant deaths by cause of deathdeath
KS, 2007KS, 2007
Births and Deaths by Gestational Age, Births and Deaths by Gestational Age, KS 20005-2008 AverageKS 20005-2008 Average
All RacesAll Races
Pre-term = 9%Pre-term = 9% Pre-term=62%Pre-term=62%
Source: KDHE
Premature babies: <10% of births, BUT >60% of deaths!
How old are babies when How old are babies when they die?they die?
Neonatal deaths (= Neonatal deaths (= <28 days old) are <28 days old) are more common than more common than post-neonatal deaths post-neonatal deaths in all races and in all races and ethnicitiesethnicities
This distinction is This distinction is less important todayless important today LBW and prematurity LBW and prematurity
more important than more important than the age of the baby the age of the baby
SummarySummary KS IMR is higher than in most other statesKS IMR is higher than in most other states
Rates are higher in KS than U.S. for all race and Rates are higher in KS than U.S. for all race and ethnic groupsethnic groups
Wide disparities by race and ethnicityWide disparities by race and ethnicity Causes of infant deaths mimic those in Causes of infant deaths mimic those in
other states:other states: Prematurity and LBW are key factorPrematurity and LBW are key factor
Kansas Infant Kansas Infant Mortality PanelMortality Panel
Spring 2009 KDHE approached the GCHACSpring 2009 KDHE approached the GCHAC
GCHAC agreed to take the chargeGCHAC agreed to take the charge
Set up a wide group of experts to look at Set up a wide group of experts to look at the problemthe problem
June 3, 2009 first meetingJune 3, 2009 first meeting
Goal of PanelGoal of Panel
Develop recommendations to improve IMR Develop recommendations to improve IMR in the statein the state
Meet over the next yearMeet over the next year
Preliminary recommendations by December Preliminary recommendations by December 20092009
First 6 monthsFirst 6 months
Gather Information Gather Information
RecommendationsRecommendations
PrioritizePrioritize
RecommendationsRecommendations
Completed by end of DecemberCompleted by end of December
18 separate recommendations divided 4 18 separate recommendations divided 4 groupsgroups
Sent to the Secretary of KDHESent to the Secretary of KDHE
Now What?Now What?
SuccessesSuccesses
Legislative success on data collectionLegislative success on data collection
Met with CDRB Met with CDRB
Continued to obtain info on successful Continued to obtain info on successful programsprograms
Public media eventPublic media event
Met with Kansas SIDS Network Met with Kansas SIDS Network
Medicaid 1115 waiverMedicaid 1115 waiver
SuccessesSuccesses
Supported the state in its development of a Supported the state in its development of a Genetics Plan Genetics Plan
Successful passage of tobacco legislationSuccessful passage of tobacco legislation
Developing a statewide collaborative for Developing a statewide collaborative for quality improvement at perinatal institutions quality improvement at perinatal institutions
Exploring expanding our current Health Start Exploring expanding our current Health Start and FIMR community programs in KC and and FIMR community programs in KC and WichitaWichita
What Next?What Next?
Another yearAnother year
Support of KDHE the Panel will continue for Support of KDHE the Panel will continue for at least another yearat least another year
Goal to implement as many of our Goal to implement as many of our recommendations as possiblerecommendations as possible
Continue to gather information on best Continue to gather information on best practicespractices
ChallengesChallenges
Lack of fundingLack of funding
Public awarenessPublic awareness
Best practices- what works and will it work Best practices- what works and will it work herehere
Keeping up interest among the PanelKeeping up interest among the Panel
Final ThoughtsFinal Thoughts