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Ann Salyer-Caldwell, MPH, RD, LD Anita K. Kurian, DrPH, MBBS

Assessing Feto-infant Mortality Rates Using Perinatal Periods Of Risk (PPOR) Approach To Identify Strategic Areas For Community-based Intervention In Tarrant County. Ann Salyer-Caldwell, MPH, RD, LD Anita K. Kurian, DrPH, MBBS. INFANT MORTALITY TASK FORCE Tarrant County Public Health

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Ann Salyer-Caldwell, MPH, RD, LD Anita K. Kurian, DrPH, MBBS

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  1. Assessing Feto-infant Mortality Rates Using Perinatal Periods Of Risk (PPOR) Approach To Identify Strategic Areas For Community-based Intervention In Tarrant County Ann Salyer-Caldwell, MPH, RD, LD Anita K. Kurian, DrPH, MBBS

  2. INFANT MORTALITY TASK FORCE • Tarrant County Public Health • City of Fort Worth Public Health Department • Catholic Charities • Local Hospitals • School Districts • Local Universities

  3. The task force has been in place for 5 yrs. • Infant mortality data is analyzed every year and results (just the descriptives) are presented at the Infant Mortality Summit.

  4. Where do we go from here?

  5. Age at Death Birth Weight Fetal Post-Neonatal Neonatal Maternal Health/Prematurity 500-1499 g Maternal Care Newborn Care Infant Health 1500+ g RESEARCH QUESTION

  6. PPOR Phase I Analysis was conducted: • In 2004 with 2000-2002 data • In 2006 with 2001-2003 data

  7. METHODS • Data Source • Linked birth and death files • Provided by Texas Department of State Health Services • Used the Death Cohort • Missing birth weights data • Infant deaths – 17.4% • Fetal deaths – 10% • Analysis was completed in 2 weeks • Used the external reference group

  8. FETO-INFANT MORTALITY RATES, ALL RACIAL/ETHNIC GROUPS: 2001-2003

  9. FETO-INFANT MORTALITY RATES, ALL RACIAL/ETHNIC GROUPS: 2001-2003 *Maternal *Maternal *Maternal *Maternal *Newborn *Newborn *Infant *Infant Health/ Health/ Prematurity Prematurity Care Care Care Care Health Health Tarrant County Tarrant County 3.1 3.1 1.7 1.7 1.4 1.4 1.7 1.7 White White 2.5 2.5 1.5 1.5 1.3 1.3 1.5 1.5 Black Black 6.0 6.0 2.2 2.2 2.1 2.1 3.6 3.6 Hispanic Hispanic 2.7 2.7 1.5 1.5 1.3 1.3 1.4 1.4

  10. CONCLUSIONS • Maternal Health/Prematurity was identified as the primary indicator of infant mortality in Tarrant County. • Improving preconceptual health is imperative in reducing infant mortality in Tarrant County.

  11. RESPONSE TO THE RESULTS • “Call to action” report • Healthy Kids need healthy moms • Honey Child pilot project addressing preconceptual health issues- March of Dimes

  12. CHALLENGES PPOR COMMUNITY CHALLENGES • Getting the data in a timely manner • Explaining the value of doing PPOR analysis to stakeholders • Dispelling preconceived notions- attributing high infant mortality rates in Tarrant County to high teen pregnancy rates and inadequate access to care

  13. CHALLENGES ACKNOWLEGEMENT Tarrant County Infant Mortality Task Force Research and Oversight Committee Ann Salyer-Caldwell Jerry Roberson Anita K Kurian Dorian Villegas Michelle Markham Sally Northam Kristen Priddy Amy Raines Alan Lobaugh Kelly LaMendola Suzanne Tolbert Latawnya Peachy

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