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DHMIC 9 th Annual Summit

DHMIC 9 th Annual Summit. 4/9/13 David A. Paul, MD Chair, Delaware Healthy Mother and Infant Consortium Professor of Pediatrics, Thomas Jefferson University Interim Chair, Department of Pediatrics, Christiana Care Health System Attending Neonatologist, Kent General Hospital. Welcome.

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DHMIC 9 th Annual Summit

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  1. DHMIC 9th Annual Summit 4/9/13 David A. Paul, MD Chair, Delaware Healthy Mother and Infant Consortium Professor of Pediatrics, Thomas Jefferson University Interim Chair, Department of Pediatrics, Christiana Care Health System Attending Neonatologist, Kent General Hospital

  2. Welcome @DEThrives #DHMICsummit www.healthywomende.com

  3. Delaware Progress • 13.5% drop in infant mortality since inception of DHMIC • 10.5 % drop in premature birth rate

  4. Delaware Progress 2013-2014 • Beebe Medical Center Certified as Baby Friendly • Christiana Hospital Established Center for Women’s Emotional Wellness • DOSE Program • Every Birth Hospital with 39 week initiative

  5. Delaware Challenges • Disparity ratio of 2.5 • Root causes of disparity? • How far can we go with medical model?

  6. Income/Longevity GapNYT, March 16, 2014 Fairfax, VA McDowell, WV Population 22,000 Household income $ 22,900 Adult obesity 30% Unemployment 8.8% 1/3 adults smoke 1/18 adults with college degrees • Population 1 million • Household income $107,000 • Adult obesity 24% • Unemployment 6.3% • 1/8 adults smokes • 6/10 adults with college degrees

  7. Income/Longevity GapNYT, March 16, 2014 Fairfax, VA McDowell, WV Male life expectancy 64 y Female life expectancy 75 y Similar to Iraq • Male life expectancy 82 y • Female life expectancy 85 y • Similar to Sweden

  8. Housing • 4498 women in low income census tract 1994-1998 randomized to: • Vouchers/move to higher income tract and counseling • Vouchers/move and counseling (no change in census tract) • Prevalence of BMI > 35, HgB A1C >6.5% lower in group moving to higher income census tract Ludwig, NEJM, 2011

  9. Proportion of Delaware Children Living in Poverty %

  10. White Reproductive Potential Risk Factors African American Protective Factors Life Course 0 5ys Puberty Pregnancy The Racial Gap in Reproductive Potential: A Life-Course Perspective Lu and Halfon,MCHJ, 2003

  11. DHMIC Next 5 Years • Reduce Disparities • Safe sleeping campaign • Breast feeding • Mental health • Life course approach • Community health workers

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