Maternal and child health profile, Kansas City, Missouri, 2009-2013 Measure Rate type 2020 objective White Black Disparity ratio Births to mothers ages 15-19 per 1,000 25.1 67.3 2.7 Births to mothers over 18 without high school education Percent 6.9 18.7 Births <1500 grams (very low birth weight) 1.4 1.1 2.9 2.6 Births <2500 grams (low birth weight) percent 7.8 6.2 12.7 2.0 First trimester care 77.9 82.2 61.5 0.7 Adequate prenatal care 77.6 83.8 63.3 0.8 Preterm birth rate 11.4 8.9 14.7 1.7 Very preterm birth rate (<32 weeks of gestation) 1.8 1.3 3.3 2.5 Obesity rate prior to pregnancy 19.3 30.9 1.6 Smoking rate during pregnancy 16.0 16.2 1.0 Smoking rate prior to pregnancy 20.8 20.5 Healthy weight prior to pregnancy 53.4 52.1 37.3 Breast feeding at discharge 81.9 84.4 60.8 Fetal deaths Per 1,000 5.9 5.3 10.5 Infant mortality rate 6.0 5.2 9.2 Death rate aged 1-4 Per 100,000 26.5 26.3 42.0 Death rate aged 5-9 12.4 13.9 28.5 Death rate aged 10-14 14.8 16.7 30.7 Death rate aged 15-19 54.3 57.8 145.5 Death rate aged 20-24 88.3 75.7 251.4 Twenty measures relating to maternal and child health in Kansas City, Missouri between 2009 and 2013 are presented here. When available, measures were presented by race and compared to the HealthyPeople 2020 objective. A disparity ratio was also calculated. A ratio greater than 1 represents a higher rate among black individuals compared to white individuals. A ratio equal to 1 represents the same rate between black and white individuals. A ratio less than 1 represents a lower rate among black individuals compared to white individuals. The rate of birth to mothers between the ages of 15 and 19 was nearly 3 times as high among black individuals as white individuals. Black women between the ages of 15 and 19 had a birth rate of 67 per 1,000 compared to 25 per 1,000 white women. For women without a high school education, the black birth rate was 19 per 1,000 while the rate was 7 per 1,000 white women. Black women again had a birth rate 3 times that of white women. Black women had a high percent of very low and low birth weight babies compared to white women (disparity ratio of 3), a higher very preterm and preterm birth rate (disparity ratios of 3 and 2, respectively), and higher rates of fetal death, infant deaths, and deaths up to age 24 years (disparity ratios ranging from 2-3). In addition, black women had a lower percentage of adequate prenatal care, first trimester care, healthy weight prior to pregnancy, and breastfeeding at discharge compared to white women. When compared to the HealthyPeople 2020 objectives, white women met the objectives for all measures except healthy weight prior to pregnancy and death rates for children aged 5-19 years. Black women did not meet the 2020 objectives for any measure.

The number of abortions among Kansas City, Missouri residents steadily declined between 2000 and 2013. Approximately 2,500 abortions were conducted in 2000 and 1,500 in 2013. This equates to a 40% decrease in the number of abortions committed. Similarly, the ratio of number of abortions to live births decreased in Kansas City, Missouri in the past 14 years.

The birth rate among women aged 15-19 years in Kansas City, Missouri declined between 2000 and 2013. In 2000, the total birth rate was 73 births per 1,000 women. The rate was lower for women aged 15-17 years and higher for women aged 18-19 years (45 and 114 per 1,000 women, respectively). In 2013, the total birth rate declined to below 50 births per 1,000 women, mostly driven by the decline seen in women aged 18-19 years (2013 rate of 53 births per 1,000 women). A similar, but less dramatic, decline was also seem among women aged 15-17 years who in 2013 had a birth rate of 36 per 1,000 women.

A steady increase in the percent of obesity prior to pregnancy was observed in Kansas City, Missouri women between 2004 and 2013 across both racial and ethnic groups. The highest percent of obesity prior to pregnancy was seen among black women which increased from 28% in 2004 to 32% in 2013, representing a 14% increase. Hispanic women’s obesity prior to pregnancy percent increased from 20% in 2004 to 28% in 2013, a 40% increase. The percent of obese women prior to pregnancy increased 2% among white women, representing an 11% increase over time. Overall, obesity prior to pregnancy increased from 22% in 2004 to 25% in 2013, representing a 14% increase in obesity prior to pregnancy, city wide.

Infectious disease rate at delivery by race/ethnicity, Kansas City, Missouri, 2010-2013 Number Births Gonorrhea Syphilis Chlamydia Hepatitis B Hepatitis C White 13,910 33 4 168 12 56 Black 10,013 188 21 736 27 25 Hispanic 3,884 13 6 Total 29,087 241 31 1,060 75 91 Rate per 1,000 live births 2.4 0.3 12.1 0.9 4.0 18.8 2.1 73.5 2.7 2.5 3.3 1.0 5.4 1.5 8.3 1.1 36.4 2.6 3.1 The number and rate of infectious disease diagnosis at birth in Kansas City, Missouri between 2010 and 2013 differed by race and ethnicity. More white babies were born between 2010 and 2013 than black and Hispanic babies (14,000, 10,000, and 4,000, respectively). However, more black babies were born with gonorrhea, syphilis, chlamydia, and Hepatitis B than white and Hispanic babies. More white babies were born with Hepatitis C than black or Hispanic babies. This corresponds to black babies’ having a greater rate of gonorrhea, syphilis, chlamydia, and Hepatitis B than any other babies. The rate of chlamydia among black babies was 74 babies per 1,000 live births. This compared to 12 white babies and 5 Hispanic babies. White babies had higher rates of Hepatitis C at 4 babies per 1,000 live births compared to 3 black babies and 2 Hispanic babies.

HP 2020 objective

HP 2020 objective

HP 2020 objective

HP 2020 objective

Preterm births----Group A

Preterm births----Group B

Preterm births----Group C