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Improving Infant Health in Madison County: Addressing Obesity During Pregnancy and Access to Care

This report highlights the current state of infant health in Madison County and identifies key issues such as high rates of low birth weight and obesity during pregnancy. It also suggests solutions such as improving access to care and advocating for rural allocations at the state level.

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Improving Infant Health in Madison County: Addressing Obesity During Pregnancy and Access to Care

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  1. Healthy Start Coalition of Jefferson, Madison & Taylor Counties, Inc. State of the Infant Madison County 2014

  2. Madison County Birth Counts • 205 babies born in 2013 (212 in 2012) • 99 White (112 in 2012) • 101 Black (97 in 2012) • 5 Other (3 in 2012)

  3. Population Estimates 2012

  4. Infant Mortality – a volatile indicator • No infant deaths 2013 • Rolling three year averages 7.7 infant deaths per 1,000 2011-2013 FL is 6.2 • From worst (2010-2012) in state 9 babies rate = 14.1

  5. Volatility explained

  6. Fetal Death Rate Improves • 2 fetal deaths in 2013 • Rolling three year average = 7.7 fetal deaths per 1,000 deliveries 2011-2013 FL is 7.2 • second worst in state (2010-2012) 7 babies rate = 10.9

  7. Low Birth Weight • Currently, highest rate in the State of Florida • 84 babies born below 2500g (5.5 lbs) • Rate is 13 per 1,000 live births • Was ALSO worst in state 2011-2012; 75 babies rate = 11.8 • Why is it moving in the wrong direction?

  8. Is it Obesity During Pregnancy ??

  9. Is it Pregnancy Intervals? 35.4% of pregnancies in Madison County are not adequately spaced

  10. Is it the support system? 61.1% of births in Madison County are to an unwed mother, 4th highest in state

  11. Worth Mention • 23.8% of adults over the age of 25 (2011) in Madison County had NO high school diploma Gadsden tied • Madison area has second highest positive screening rate for Healthy Start 47% (Gadsden 56%, State is 24%)

  12. Healthy Start Prenatal Screening • 163 of 205 pregnant women responded (screened) 2012-2013 • Results

  13. More results

  14. Madison Healthy Start • Of the total births in Madison County in FY 12/13, 79% were screened for Healthy Start (n=163) • 77 were positive for risks for poor birth outcomes, another 18 were professionally referred • 87 NEW pregnant women were reached by Healthy Start and funneled into care

  15. More… • A total of 158 pregnant women received a Healthy Start service in Madison County • 17 of these were high-risk • 87 infants (ages 0-3) received a Healthy Start service; 10 were highest risk • 18 infants/families received Parents as Teachers

  16. Good News/ Bad News • Madison County has THE lowest rate of REPEAT births to teens ages 15-19 (7.7 per 1,000 2011-2013) Gadsden is third highest at 22.4 • Breastfeeding rates are going in the wrong direction

  17. More good… • Madison County traditionally has high rates of EARLY entry into prenatal care -82.2% of pregnant women seek care in the first trimester (2011-13) Florida avg. is 80%, Gadsden is 78.4%

  18. Root Causes • Obesity contributing to preterm birth, low birth weight • Access to care – Health Department is a SAFETY NET • Health Literacy • Perpetual Poverty • Cyclical FASD

  19. Fetal Alcohol Spectrum Disorder • An underlying cause of poor school readiness rates • An underlying cause of poor school performance • An underlying cause of disproportionate rates of juvenile offenses, and subsequent D.O.C. involvement

  20. Types of FASD • Fetal Alcohol Syndrome (FAS): FAS represents the severe end of the FASD spectrum. Fetal death is the most extreme outcome from drinking alcohol during pregnancy. People with FAS might have abnormal facial features, growth problems, and central nervous system (CNS) problems. People with FAS can have problems with learning, memory, attention span, communication, vision, or hearing. They might have a mix of these problems. People with FAS often have a hard time in school and trouble getting along with others. • Alcohol-Related Neurodevelopmental Disorder (ARND): People with ARND might have intellectual disabilities and problems with behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control. • Alcohol-Related Birth Defects (ARBD): People with ARBD might have problems with the heart, kidneys, or bones or with hearing. They might have a mix of these.

  21. Completely preventable

  22. Why focus on minority health? • Highlights of the Minority Health profile • Black infant death rate was 13.2, compared to 3.0 for whites (2011-13) • Fetal death rate was 6.5, compared to 6.0 for whites (2011-13) • Individuals below the poverty level 33.1% for blacks, 13.6% for whites (2006-10) • Births to unwed mothers 2.4:1 ratio (2010-12)

  23. Why focus on minority health? • -cont’d highlights • Births < 37weeks gestation 17.6% for blacks, compared to 11.5% for whites (2010-12) • Births to obese mothers 1.6:1 ratio (2010-12) • Death rate for coronary disease 1.9:1 (10-12) • Hospitalization rate for stroke 2.2:1(10-12) • Incidence rate for prostrate cancer 1.9:1(08-10) • Death rate from diabetes 3.3:1 (10-12)

  24. Food for thought

  25. Solutions • Whole Child Connection • Medical Home Linkages for African American women • Education to consumers on Medicaid Reform • Advocate at state level for rural allocations • Quality Programming • Nutrition and Obesity prevention

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