6 Sites and U.S. Results MH/PreMCNCIHFetal- Infant MR Detroit 1999-2001 5.81.51.73.712.7 Cook County 1998-2000 5.22.81.72.412.2 Marion County 1998-2000.

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Presentation transcript:

6 Sites and U.S. Results MH/PreMCNCIHFetal- Infant MR Detroit Cook County Marion County United States Alameda County Tulsa San Antonio

PPOR Map of Feto-Infant Mortality Among Births to Bexar County Mothers Total Feto-Infant Deaths 479 Total Fetal Deaths and Live Births 71,753 Source: San Antonio Metropolitan Health District and Texas Department of Health

PPOR Map of Feto-Infant Mortality Among Births to Bexar County Mothers g g Fetal Death Neonatal Post- neonatal Source: San Antonio Metropolitan Health District and Texas Department of Health

PPOR Map of Feto-Infant Mortality Among Births to Bexar County Mothers g g Fetal Death Neonatal Post- neonatal Maternal Health/Prematurity 2.4 Maternal Care 1.4 Newborn Care.93 Infant Health 1.9 Source: San Antonio Metropolitan Health District and Texas Department of Health

San Antonio, Texas PPOR MH/PreMCNCIHFetal- Infant MR San Antonio US Reference Group Excess Rates (San Antonio Rate – US Rate) % Excess (excess rate/ total excess rate) 18%0082% San Antonio Total Deaths = 479

Overall Distribution and Rates of Fetal-Infant Mortality Maternal Health/ Prematurity 210/3.2 Maternal Care 167/2.6 Newborn Care 74/1.1 Infant Health 101/ total deaths 64,492 total births Rate=8.5 deaths per 1,000 births Alameda County,

Fetal-Infant Mortality Rates by Race Maternal Health/ Prematurity 7.1 vs 2.4 Maternal Care 4.6 vs 2.2 Newborn Care 1.3 vs 1.5 Infant Health 3.0 vs 0.9 African American vs White, Alameda County Total Rate: 16.1 vs 7.1

Fetal-Infant Mortality Rates Maternal Health/ Prematurity 7.1 vs 1.9 Maternal Care 4.6 vs 1.9 Newborn Care 1.3 vs 1.0 Infant Health 3.0 vs 1.0 African American vs Internal Reference Group: Asian women 20+, 13+ yrs education, Alameda County Total Rate: 16.1 vs 5.9

Alameda County PPOR MH/PreMCNCIHFetal- Infant MR Alameda County US Reference Group Excess Rates (Alameda County Rate – US Rate) % Excess (excess rate/ total excess rate) 38%35%023% Alameda Total Deaths = 552

Overall Distribution and Rates of Fetal-Infant Mortality Maternal Health/ Prematurity 244/5.8 Maternal Care 63/1.5 Newborn Care 72/1.7 Infant Health 158/ total deaths 42,177 total births Rate=12.7 deaths per 1,000 births City of Detroit, Birth Cohort Prepared by: DHWP-FHS on 3/15/04 For internal planning use only.

Fetal-Infant Mortality Rates by Race Maternal Health/ Prematurity 6.2 vs 3.7 Maternal Care 1.3 vs 2.4 Newborn Care 1.7 vs 1.8 Infant Health 4.0 vs 2.9 Black American vs White American, Detroit Total Rate: 13.1 vs Birth Cohort Prepared by: DHWP-FHS on 3/15/04 For internal planning use only.

Detroit PPOR MH/PreMCNCIHFetal- Infant MR Detroit US Reference Group Excess Rates (Detroit Rate – US Rate) % Excess (excess rate / total excess rate) 53%09%40% Detroit Total Deaths = 537

Deaths74Deaths OVERALL IMR t =Total t =351Deaths44,571 Fetal Losses & Stillbirths: 2.13 Total Stillbirths, Fetal and Infant Deaths Meeting PPOR t Model Criteria, : days of life 24 weeks gestation - 28 days of life Infant Health days of life 1.66 Tulsa County Residents (1 lb 1.5 oz - 3 lbs 4 oz) ( > 3 lbs 5 oz) Deaths119 per 1000 eligible live and stillbirths Maternal Health/Prematurity 2.67 (Sum of 4 Blocks) (reported live births, stillbirths and fetal losses >500 grams and>24 weeks gestation) Denominator t = Excluded Birth Outcomes (< 500 grams and/or < 24 weeks gestation) grams Newborn Care (Sum of 4 Blocks) 95Deaths 1.41 Birth Weight Live Births: > 1500 grams weeks gestation - 28 days of life> 24 weeks gestation (fetal losses & stillbirths) Maternal Care > 24 weeks gestation

NumberRate NumberRateNumberRateNumberRate White White White Black Black Black Native American Native American Other Hispanic Hispanic Other Other WHITE IMR t =White Total t =90Deaths33867 BLACK IMR t =Black Total t =28DeathsBlack Denominator t =6607 NAT. AMERICAN IMR t =Nat. Am. Total t =29DeathsNat. American Denominator t =2807 HISPANIC IMR t =Hispanic Total t =57DeathsHispanic Denominator t =3488 OTHER IMR t =Other Total t =7DeathsOther Denominator t =889 Birth Weight ( > 3 lbs 5 oz) Native American Maternal Health/Prematurity White Other Hispanic grams Newborn Care ( < 3 lbs 4 oz) Black > 1500 grams 24 weeks gestation - 28 days of life> 24 weeks gestation (fetal losses & stillbirths) Maternal Care Native American Hispanic Total Stillbirths, Fetal and Infant Deaths Meeting PPOR t Model Criteria, : days of life 24 weeks gestation - 28 days of life Tulsa County Residents by Race Fetal Losses & Stillbirths:Live Births: > 24 weeks gestation Infant Health White Denominator t = days of life 130 Excluded Birth Outcomes (< 500 grams and/or < 24 weeks gestation) Race and Hispanic Ethnicity determined by mother's race and ethnicity as coded on the birth certificate. NOTE: Some deaths may be included in a race category as well as in the Hispanic ethnicity catagory. (Sum of 4 Blocks) (reported live births, stillbirths and fetal losses >500 grams and>24 weeks gestation) (Sum of 4 Blocks) 10.83

Tulsa, Oklahoma PPOR MH/PreMCNCIHFetal- Infant MR Tulsa US Reference Group Excess Rates (Tulsa Rate – US Rate) % Excess (excess rate / total excess rate) 25%20%15%35%NA Tulsa Total Deaths = 351

Age at Death grams grams Fetal-Infant Mortality Rates* All races, Marion County, Indiana Fetal Neonatal Post Neonatal Maternal Health/Prematurity 4.4 (189) Maternal Care 2.2 (92) Newborn Care 1.7 (72) Infant Health 2.5 (105) Fetal Infant Mortality Rate=10.7 per 1, Fetal-Infant Deaths Fetal Deaths and Live Births Birthweight Fetal Neonatal Post Neonatal

Age at Death Fetal-Infant Mortality Rates** Reference Group*** Maternal Health/Prematurity 2.2 Maternal Care 1.5 Newborn Care 1.1 Infant Health 1.0 *Note: Over 10% imputed combined deaths, 10% or more imputed fetal deaths. Units with 10% or more imputed deaths overall were considered having major reporting problems. ** Source, NCHS data, Calculations by CityMatCH *** Reference group consists of non-Hispanic, white women with at least 13 years of education by residence at time of birth or fetal death (national standard). Birthweight grams grams Fetal Infant Mortality Rate= 5.9 per 1, Fetal-Infant Deaths Fetal Deaths and Live Births Fetal Neonatal Post Neonatal

Marion County PPOR MH/PreMCNCIHFetal- Infant MR Marion County US Reference Group Excess Rates (Marion County Rate – US Rate) % Excess (excess rate/ total excess rate) 46%15%13%31% Marion County Total Deaths = 458

Overall Distribution and Rates of Fetal-Infant Mortality Maternal Health/ Prematurity 1344/5.2 Maternal Care 729/2.8 Newborn Care 426/1.7 Infant Health 619/2.4 3,018 total deaths 255,573 total births Rate=12.2 deaths per 1,000 births Cook County, IL

Cook County, Illinois PPOR MH/PreMCNCIHFetal- Infant MR Cook County US Reference Group Excess Rates (Cook County Rate – US Rate) % Excess (excess rate / total excess rate) 48%21%10%22% Cook County Total Deaths = 3,018

Cook County, Illinois PPOR Excess Examples MH/PreMCNCIHFetal-Infant MR Cook County Excess (US as Reference) 3.0 (48%) 1.3 (21%) 0.6 (10%) 1.4 (22%) 6.3 Excess (Illinois as Reference) 2.7 (45%) 1.2 (20%) 0.6 (10%) 1.4 (23%) 6.0 Excess (Cook County Reference Group) 2.6 (43%) 1.3 (22%) 0.4 (7%) 1.6 (27%) 6.0