Maternal Health Needs and Resources in a Changing Community

1. Maternal Health Needs and Resources in a Changing Community Monterey County Health Department, Salinas, California

2. DUI Project Team • Krista Hanni, Research Analyst, Presenter • Dr. Linda Velasquez, Health Officer • Dr. Alicia Paris-Pombo, Epidemiologist • Susan McNelley, Perinatal Services Coordinator • Darryl Tyler, GIS Analyst, Information Technology • Robbie Gonzales Dow, Perinatal Outreach Coordinator • Joyce Brown, Head of Public Health Nursing • Linda McGlone, Injury Prevention • Judy Garrison, Program Director, Cancer Detection Programs Monterey County Health Department - DUI Project

3. Monterey County Salinas • 3,322 mi2 • 417,185 people • 126 persons/mi2 • Largest city: Salinas – 151,030 Monterey County Health Department - DUI Project

4. 1990 to 2000: Growth in Median Household Income Monterey County Health Department - DUI Project

5. Latinos: A Growing “Minority” • 72,000 not citizens out of 181,000 Latinos in county Monterey County Health Department - DUI Project

6. County Latino Profile Compared to Whites in 2000, Latinos: • Younger • Lower household income • Larger household size • Households more overcrowded • Less likely to own house • Less education Monterey County Health Department - DUI Project

7. County Health Profile 2002 • Monterey County saw improvements for most of 36 indicators over past ten years • Met HP 2010 objective for 6 indicators • Better than California for 24 indicators • Disparity in health within county? Monterey County Health Department - DUI Project

8. Socioeconomic Disparities and Health • Socioeconomic disparities shown to affect health outcome • Poverty one of the better geographic indicators of health • Mother’s use of services correlated with childrens’ health Monterey County Health Department - DUI Project

9. Objective Identify ‘hot spots’ for maternal health indicator within Monterey County in relation to services Monterey County Health Department - DUI Project

10. Identification • Area-based Socioeconomic Measure • % in Poverty • Maternal Health Indicators • Births by payment method • Birth weight • Entry to prenatal care • Teen births • Born in Mexico • Services • Hospitals • Clinics Monterey County Health Department - DUI Project

11. How we did it • GIS – Geographic Information Service • Focus on Salinas for today’s presentation • 1990 and 2000 census data by census tract • 1998 and 2002 county birth data with addresses • Use address to map out birth locations Monterey County Health Department - DUI Project

12. Where People Live in Salinas Monterey County Health Department - DUI Project

13. % in Poverty in 1990 by Census Tract Monterey County Health Department - DUI Project

14. % in Poverty in 2000 by Census Tract Monterey County Health Department - DUI Project

15. Maternal Health Indicators * Percent of teen births Monterey County Health Department - DUI Project

16. Hot Spots • Density – 1000 x 1000 ft sq grabs data within square mile • Square is color coded to indicate range low middle high • Deeper red areas are our hot spots Monterey County Health Department - DUI Project

17. MediCal & No Insurance Births in 2002 Monterey County Health Department - DUI Project

18. Low Birth Weight Births in 2002 Monterey County Health Department - DUI Project

19. Late Entry to Care Births in 2002 Monterey County Health Department - DUI Project

20. Teen (15-17 Years Old) Births in 2002 Monterey County Health Department - DUI Project

21. Change Hot Spots Negative Little Change Positive • Extremes are most (+) or (–) difference between 1998 and 2002 Monterey County Health Department - DUI Project

22. Medi-Cal & No Insurance Change in Births 1998 to 2002 Monterey County Health Department - DUI Project

23. Low Birth Weight Change in Births 1998 to 2002 Monterey County Health Department - DUI Project

24. Late Entry to Prenatal Care Change in Births 1998 to 2002 Monterey County Health Department - DUI Project

25. Teen (15-17 Years Old) Change in Births 1998 to 2002 Monterey County Health Department - DUI Project

26. Mexican Born Teen (15-17 Years Old) Change in Births 1998 to 2002 Monterey County Health Department - DUI Project

27. Medi-Cal Births and Hospitals Monterey County Health Department - DUI Project

28. Medi-Cal OB Providers & Clinics in 2002 Monterey County Health Department - DUI Project

29. Summary • Hot spot: East Salinas • Hospitals located fine, but concern about closure of hospital with most Medi-Cal deliveries • Identified area of need for obstetric providers and clinics accepting Medi-Cal Monterey County Health Department - DUI Project

30. Accomplishments • Identified meaningful indicators • Spatially represented birth data • Beginning to develop similar projects for children, injury, and cancer Monterey County Health Department - DUI Project

31. Lessons Learned • Difficult to match data to community resources • Watch for database error • Teamwork is essential for useful final result • Include community partners Monterey County Health Department - DUI Project

32. Thanks CityMatCH-DUI!We are learning from you. Monterey County Health Department - DUI Project