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“How we did it?” Our PPOR Phase II story. Sarojini Kanotra, PhD, MPH Louisville Department of Public Health & Wellness. Resources. Being part of Healthy Start program Director- Dr Adewale Troutman Division Director Program Administrator
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“How we did it?” Our PPOR Phase II story Sarojini Kanotra, PhD, MPH Louisville Department of Public Health & Wellness
Resources • Being part of Healthy Start program • Director- Dr Adewale Troutman • Division Director • Program Administrator • Continuous monitoring of Maternal and Child Health status in the community
Data Sources • Vital records • Birth • Death • Still Birth • Medical Examiner’s Database • Healthy Start database
Analytic Methods and Directions • Feto-infant mortality maps/graphs • Excess mortality rates and gaps • Kitagawa analysis • Logistic Regression • Use of GIS • Community health assessment • Fetal Infant Mortality Review
MH/P 89/3.00 MH/P 136/4.6 MC 71/2.4 NC 36/1.2 IH 67/2.3 MC 68/2.25 NC 37/1.25 IH 61/2.05 Fetal-Infant Mortality Rates, All Races 2000-2002 255 total deaths 29,707 total births 2001-2003 310 total deaths 29,357total live births Highest mortality was attributable to MHP followed by MC
Trend in PPOR category specific mortality in Louisville in African Americans (per 1,000 births) 2000-2002 2001-2003 8.0 7.1 6.0 4.9 4.8 4.3 4.0 2.3 2.1 1.9 2.0 1.3 0.0 MHP MC NC IH
Kitagawa analysis by race 2 fold mortality excess in % attributable to VLBW in MHP category among African Americans compared to Whites
Community Involvement in Phase II Analysis • Use PPOR as part of practicum training of MPH students • Introduce PPOR in the MPH curriculum • Discussion in the Healthy Start Advocates meetings • Barriers- • Time, commitment, other competing issues
Dissemination of the Results • New Health Department Director • Health Status Assessment Committee • Healthy Start Advocates Meetings attended by the Medical Examiner and State Representative • March of Dimes Prematurity Summit • Child Fatality Review Meetings(State & Local) • Community Partnership for Protection of Children • Local Birthing Hospital • Special meeting organized for State Legislators serving the Healthy Start area
Initiatives in Louisville • Mayor’s Healthy Hometown Movement • Center for Health Equity • MAPP process • Translation of Data into Policy Grant • Safe-Sleeping Campaign • Crib for Kids Campaign • State applying for the PRAMS grant
Some Policy Directions • Focus on Women’s health: Address preconceptional and interconceptional health • Implement FIMR • Prevent SIDS and deaths due to unsafe sleeping behavior • Sustain the programs such as Healthy Start • Center for Health equity-address disparities
E-mail: Sarojini.Kanotra@louisvilleky.gov Acknowledgements “Supported in part by project(H49 MC 00152) from Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services.”