1 / 12

Infant Mortality

Infant Mortality. William C. VanNess II, MD State Health Commissioner April 4, 2014. Indiana State Department of Health. ISDH Mission: To promote and provide essential public health services ISDH Vision: A healthier and safer Indiana. ISDH- Top Priorities.

topaz
Télécharger la présentation

Infant Mortality

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Infant Mortality William C. VanNess II, MD State Health Commissioner April 4, 2014

  2. Indiana State Department of Health • ISDH Mission: • To promote and provide essential public health services • ISDH Vision: • A healthier and safer Indiana

  3. ISDH- Top Priorities • Governor Pence “Good to Great” book • National Health Rankings has placed Indiana 41st least healthy out of 51 (D.C.) • After extensive review of our priorities, ISDH named the following public health needs as the top 3 priorities for Indiana for the nextfour years: #1. Reduction in Infant Mortality rates #2. Reduction in Adult Obesity rates #3. Reduction in Adult Smoking rates

  4. Good to Great 2014 Top Priorities • Reduce Infant Mortality (#1 priority) • Defined as the death of a baby before first birthday • Infant Mortality Rate (IMR) is an the number of infant deaths for every 1,000 live births • Infant Mortality is the #1 indicator of health status in the world! • Indiana: • In 2011 final results, Indiana had 7.68 deaths/1000 • In 2011, USA had 6.05 deaths/1000 • Indiana rankings for 2011= 45th/51 (D.C.) • Indiana consistently one of the worst in USA • Indiana only <7.0 once in 113 yrs!! • 6.945 in 2008 • Preliminary” 2012 = 7.3* • 600 Infant Deaths/82,251 Births • “Real Time” 2013 = 7.27* • 595 Infant Deaths/81,810 Births

  5. What are the general risk factors? 1. Born with a serious birth defect 2. Born too small or too early • Pre-term • < 39 weeks • Low birth weight infant (LBW) • weigh less than 5 lbs 8 ounces (2500 grams) at birth • Very low birth weight infant (VLBW) • less than 3 pounds, 5 ounces (1500 grams) at birth 3.Sudden Infant Death Syndrome (SIDS) 4. Affected by maternal complications of pregnancy • Diabetes, Hypertension, Obesity, etc 5. Victims of injuries (e.g. suffocation deaths) Source: Centers for Disease Control and Prevention, http://www.cdc.gov/reproductivehealth/MaternalInfantHealth/InfantMortality.htm

  6. Indiana top 5 causes of IM in 2011(643 deaths) 1. Perinatal Risks=45.7% (294 deaths) • Examples include..Pre-term, LBW, VLBW, placental complications, premature rupture of membranes, bacterial sepsis, respiratory conditions, etc 2. Congenital malformations=26.3% (169) 3. SIDS/SUIDS/Accidents=15.6% (95) • 51 SIDS • accidental suffocations=28 • accidents= 16 4. Assault/Neglect=1.4% 5. All Other=11% (71)

  7. Factors in Indiana • Prematurity & Low Birth Weight Causes • Smoking (ISDH #3 priority) • 16.6% pregnant mothers in Indiana smoke • 30% Medicaid Mom’s smoke while pregnant!!! • 50% of deliveries in Indiana are Medicaid • Indiana is 6th most smoking state in US • Obesity (ISDH #2 priority) • Obese=25% chance prematurity • Morbidly Obese= 33% prematurity • Indiana is 8th most Obese state in US • Elective deliveries before 39 weeks gestation • Racial/Ethnic • Black IM • 2006 was 18.1deaths/1000 • 2011 was 12.3 deaths/1000!! • White IM • 2008 was 5.5 deaths/1000 • 2011was 6.9 deaths/1000

  8. Factors (Con’t) • Limited Prenatal Care • Only 68.1% pregnant mothers in Indiana receive PNC in 1st trimester • Unsafe Sleep (15.6% deaths 2011) • Socio-economic • Poverty • Can affect access to prenatal care • Lower income people tend to smoke more which is a leading cause to LBW and prematurity • Tend to have less safe sleeping environments which can lead to more suffocations • e.g. co-sleeping with parent • Limited breastfeeding in Indiana • Breastfeeding at hospital discharge was 74% in 2011 • Every day after Mom/Baby leaves the hospital, the number tends to decrease

  9. PLAN • Decrease smoking among pregnant mothers • ISDH is partnering with Indiana Medicaid • “Safe Sleep” • “Back to Sleep” campaign • 1994 • Reduced SIDS by 50% • “Safe to Sleep” campaign • Expansion of “Back to Sleep” • Describes actions parents/caregivers can take to reduce the risk of other sleep-related causes of infant death, e.g. accidental suffocation • “Hard Stop” hospital policies on preventing elective deliveries occurring before 39 weeks • 7/1/14 Medicaid not pay for Early Elective Deliveries prior to 39 weeks! • Anthem considering the same

  10. PLAN (Con’t) • Decrease obesity among pregnant mothers • ISDH Division of Nutrition & Physical Activity • Encourage hospitals to become certified as “Baby Friendly” by W.H.O. to increase breastfeeding • Certification of OB & NICU’s to ensure they meet designated level of care • 27% increase in death within 1st hour after delivery from 2010 to 2011 • Analyze data, convert to useful info & distribute back to: • Regional partnerships which include the following members: • Hospitals, LHD’s, CHC’s, Minority Health Coalitions, March of Dimes, etc

  11. PLAN (Con’t) • Public/Private Collaboration • “Sister” state agencies • FSSA, Medicaid, DOE, DCS, etc • Anthem • Fairbanks School of PH • Learn from areas/regions/states that have been successful in improving their infant mortality • Share with regional coalitions • Home Visiting Programs • Regionalization (S.C.) • Medicaid not paying for Early Elective Deliveries (e.g. TX & GA)

  12. Go Out and Make a Difference! Questions...

More Related