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Healthy Families

Healthy Families. Better Beginnings. A Report on the Health of Women, Children, and Families in Spokane. Amy S. Riffe, MA, MPH/Elaine Conley, Director Spokane Regional Health District Community Health Assessment, Planning, and Evaluation. Demographics – Spokane County.

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Healthy Families

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  1. Healthy Families Better Beginnings A Report on the Health of Women, Children, and Families in Spokane Amy S. Riffe, MA, MPH/Elaine Conley, Director Spokane Regional Health District Community Health Assessment, Planning, and Evaluation

  2. Demographics – Spokane County 472,650 residents in 2011 111,470 women of childbearing age 5,867 births • Births 2007-2011 • 8% 15-19 years • 59% 20-29 years • 31% 30-39 years • 2% 40-49 years • 47% Medicaid • 90% White • 11% <High school ed

  3. Demographics - continued Birth rate 12.4 per 1,000 residents Decreased from 07-11 Lower than WA Teen birth rate, 15-17 11.3 per 1,000 women No trend Similar to WA

  4. Cost of a Birth – Spokane County 2007-2011 • The average hospital stay for a newborn was 3 days • The average charge was $10,000 • Full term infant • 93% of full term ≤ 3 days • $6,800 • Preterm infant • 40% ≤ 3 days • $55,900 • 6.5% of births • 64% of charges

  5. Preconception Health Poor mental health 17.0% of women 18-44 No trend Similar to WA No difference by age Decreased with income

  6. Preconception Health • Pre-pregnancy obesity • 24.1% obese before becoming pregnant • Increased from 07-11 • Lower than WA • Increased with age • Higher for Medicaid • Higher for black, AIAN

  7. Preconception Health • Unintended pregnancy • 36.1% of birth were unintended pregnancies • Similar to WA • Decreased with age • Higher for Medicaid • No difference by race

  8. Family Health • Family Structure, Spokane County, 2011 • 108,605 children 0-17 years • 52,489 family households with children • 23.4% were a female householder, no husband • 6,196 children 0-5 years live with a single mother • 8.7% were a male householder, no wife

  9. Family Health • ACEs • 12% of kids K-6 have 3+ • 46% of women have 4-8 • Higher than WA • No difference by age • Decreased with income • Low social support • 18.9% with low support • No trend • Similar to WA • No difference by age • Decreased with income

  10. Family Health • Child abuse • 5,264 victims in 2011 • Increased from 07-11 • Higher than WA • Smoking in home • 16.9% allow it • No trend • Higher than WA • No difference by age • Decreased with income

  11. Family Health • Stressors • 13.5% of mothers had 4+ stressors during 06-11 • Higher for women 20-29 • Higher for Medicaid • Higher for non-whites • Women with 4+ stressors • Nearly 10x more likely to have postpartum depression • Almost 6x more likely to have a LBW infant

  12. Maternal Health • Short IPI • 40.8% had a short IPI • Decreased from 07 to 11 • Higher than WA • No difference by income or race • Decreased with age • Prenatal care, 1st tri • 88.7% had 1st tri PNC • Increased from 07 to 11 • Higher than WA • Increased with age • Lower for Medicaid • Lower for non-white

  13. Maternal Health • Maternal smoking • 15.9% smoked • Decreased from 07-11 • Higher than WA • Decreased with age • Higher for Medicaid • Higher for black, AIAN • Alcohol use • 37.3% drank in last trimester • Similar to WA • No difference by age, Medicaid, or race

  14. Child Health • Low quality of life • 23.7% of youth reported a low QOL • Decreased from 06 to 10 • Higher for low education • Higher for blacks

  15. Child Health • Kindergarten readiness • Washington Kindergarten Inventory of Developing Skills • Fall 2012 • Social/emotional • Physical • Language • Cognitive • Literacy • Math

  16. Summary • Better than WA • Dental sealants • Hypertension • Prenatal care first trimester • Pre-pregnancy obesity • Vaccine preventable illness • Worse than WA • ACEs • Birth defects • Breastfeeding • Child abuse • Chlamydia • Immunization exemption • Maternal smoking • No flu shot in the last year • Short IPI • SIDS • Smoking allowed in home

  17. Summary • Good trend • Breastfeeding • Low quality of life • Maternal smoking • Prenatal care first trimester • Preterm birth • Short IPI • Vaccine preventable illness • Bad trend • Child abuse • Chlamydia • Diabetes • Good general health • Hypertension • Immunization exemption • Pre-pregnancy obesity

  18. Concerns • Many of the indicators are getting worse • Many of the measures show a disproportionate impact on: • Individuals on Medicaid • Racial minorities • Many of the issues are deeply rooted in inequities such as: • Educational attainment • Household income • Neighborhoods in which people live

  19. What Can We Do? • Traditional public health approaches are not sufficient to address many of these problems • Community wide initiatives that impact the root causes of these issues will need to be initiated and/or expanded

  20. What Can We Do? (continued) • Need a continuum of activities that address all levels of the socio-ecological model

  21. What Can We Do? (continued) • Focus on policy and system-level change while simultaneously focusing on social, organizational and individual behavior change • We must develop a shared vision for the future of children and families in the community

  22. Recommendations Four major areas of recommendations…..

  23. Recommendations (Continued) • Mitigate and/or prevent the impacts of ACEs on children and families • Build community resilience by promoting community connectivity • Support a variety of providers, organizations parents and community members in adopting trauma-sensitive practices in their work and in the community • Promote positive community norms about parenting programs and acceptable parenting behaviors

  24. Recommendations (Continued) • Mitigate and/or prevent the impacts of ACEs on children and families (Continued) • Continue to support best practice one-on-one interventions such as Nurse Family Partnership for the most vulnerable families • Invest in mental health resources • Strengthen safe, stable, nurturing relationships at the community level • Establish peer support models for expectants mothers • Build connectivity among women through low cost activities like exercise

  25. Recommendations (Continued) • Ensure That Children Enter School Ready to Learn • Develop and implement universal developmental screening for children 0-5 years of age. • Invest in quality early childhood education • Address the achievement gap between white and non-white students

  26. Recommendations (Continued) • Address Inequities in Spokane County • Promote policies that meet families’ basic needs including: • Affordable housing • Access to food • Access to health care • Provide adequate income support for young families • Increase minority representation on governing boards to assist in decision making that supports all people • Develop policies utilizing a child and family sensitive lens and advocate for a “health in all policies” standard

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