The Silent Epidemic Uniting to Reduce Infant Mortality

Infant Mortality in Virginia

Significance of Infant Mortality World View

Infant Mortality: The Problem World Rank

Infant mortality rate ranked 18 th highest in the nation by the CDC in 2006 Only ranks within the top 30 states for protecting the lives of infants Infant mortality rate twice as high for African-Americans Infant Mortality: The Problem – Virginia

Infant Mortality: Comparative Deaths

Just the Beginning of the Uphill Climb 123 more babies lived in 2008

Healthy People 2010: 4.5 Total Infant Mortality Rates Per 1,000 Births in Virginia

Healthy 2010 Goal: 4.5 Infant Mortality – Recent History

Infant Mortality: 5 Year Death Rates by Race/Ethnicity

Infant Mortality Rates Per 1,000 Births By Race/Ethnicity

Cause of Death Disorders Related to Short Gestation and Low Birth Weight Congenital Malformations, Deformations, and Chromosomal Abnormalities SIDS8160 Maternal Complications of Pregnancy6348 Other Conditions in the Perinatal Period4224 Abnormal Clinical Findings2936 Complications of Placenta, Cord, and Membranes2624 Unintentional Injury (Accidents)25 Top Causes of Death

Top 4 Causes of Infant Death, Virginia

Infant Mortality by Age at Death

Infant Mortality: Maternal Age 2008

Infant Mortality by Education and Race/Ethnicity Less than 12 Years12 Years> 12 Years

Resident Infant Death Rates by Method of Payment and Race/Ethnicity MedicaidPrivate InsuranceSelf Pay

Infant Mortality: By Geography Infant Deaths 2008 VA residents by number of live births

Prematurity: The Rising Trend

Prematurity*- the problem *Less than 37 weeks Healthy 2010 Goal: 7.6

Virginia Resident and Cesarean Births

Prematurity and Late Preterm Births 35 Weeks 39 Weeks

A premature infant less than 37 weeks sleeping prone is 85 times more likely to die of SIDS A premature infant lying on its side is 40 times more likely to die of SIDS Prematurity and SIDS

Prematurity: SIDS Rate and Sleep Position Rates of SIDS Deaths Babies Sleeping on their Backs

Engage Healthcare Providers Pregnant women and their families Community Groups Health Insurers Changing Attitudes

Accessible prenatal care Promote breastfeeding Education about preterm labor signs and symptoms Decrease smoking and exposure to second- hand smoke Interventions that May Reduce Prematurity/Infant Deaths

Assess for substance use and intervene Assess for domestic violence and intervene Reduce major stress levels Refer to community services Interventions That May Reduce Prematurity/Infant Deaths

Breastfeeding: The Benefits Lower rates of SIDS Fewer ear infections Fewer asthma/allergy cases Less obesity Less diabetes Fewer childhood leukemia cases Fewer infections in premature babies

Educate mothers before birth Provide support from family, friends, healthcare workers, employers, society Provide safe places to nurse and pump Promote Breastfeeding

Prematurity and Smoking Exposure to smoking is associated with 20% of all low birth weight babies 8% of preterm births SIDS

Prematurity: Smoking and Pregnancy Successful treatment of tobacco dependence 20% reduction in low- birth-weight babies 17% decrease in preterm births

Prematurity Birth Defects SIDS Infant Mortality: Causes

Good prenatal nutrition Maternal health behaviors/effects Planned pregnancy with early, quality prenatal care Prevention of preterm & low birth weight babies Infant Mortality: Solutions

Infant sleep position and environment Family/caretaker violence prevention & safe home Home visiting nurses Infant Mortality: Solutions

Infant Mortality Reduction: Spread the Word Control Weight Don’t Smoke Don’t Drink Take Vitamins with Folic Acid Visit Your Dentist Breastfeed

Communicate the facts Provide intervention tips Support the Commissioner’s Infant Mortality Workgroup Infant Mortality Reduction: Raise Awareness

Commissioner’s Working Group on Infant Mortality Expanded stakeholder concept Social network Multi-prong approach Goal: decrease overall rate AND racial disparities

“Saving Babies” Initiative Save babies from dying in their first year of life Focus on results Targeting 10 localities with the highest number of infant deaths Collaborating with other stakeholders

Saving Babies Localities Each locality funded $100,000

“Saving Babies” Outcomes Determining women at high risk Increasing awareness of signs/symptoms of premature labor Promoting safe sleep education

“Saving Babies” Outcomes Improving coordination/ efforts of private and public providers Enhancing outcomes through folic acid promotion, insurance coverage and transportation to prenatal care

Pediatrics 101 Interactive education Pediatric residents

Infant Mortality Reduction: Practice Safe Sleep Habits Baby should… Sleep alone Sleep on his/her back Sleep in a crib without soft toys, bumper pads or quilts

Text 4 BABY Text informational messages Public health focus Pregnancy and Infancy

Folic Acid Initiative Local health districts All women of child-bearing age

Pregnancy Authorization Decrease time for Medicaid-eligible women to enter care

Hampton WalMart Employee IM Project Teach employees basic public health activities and messages around safe sleep, prematurity, healthy pregnancy

Healthy People 2020 Education to General Assembly members, Cabinet and Agency leadership Goal: use 2020 metrics in bill language, legislative discussions

Grandmother’s Campaign Increase grandmother engagement Partner with AARP: Online community Q&A with Commissioner Article, fact sheet

The Silent Epidemic Uniting to Reduce Infant Mortality