Massachusetts Births 2005 Center for Health Information, Statistics, Research, and Evaluation Division of Research and Epidemiology Registry of Vital Records & Statistics MassCHIP Center for Community Health Massachusetts Department of Public Health

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation I.Overview of 2005 Births and Comparison with U.S. indicators II.Birth Trends III.Selected Maternal Characteristics IV.Infant & Fetal Mortality V.Cesarean Section (C-Section) Deliveries VI.Teen Births VII.Selected Communities VIII.Summary Outline

Overview of 2005 Births and Comparison with U.S. Births

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation 2005 Massachusetts Birth Characteristics On an average day 68 Cesarean sections 12 Teen births 17 Low birthweight 19 Preterm 10 Multiples 16 Inadequate prenatal care 1 Infant death 210 births

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation MA U.S. Fertility Rate (births /1000 ages 15-44) 55.6* 66.7 Teen Birth Rate (births/1000 ages 15-19) 21.7*40.4 % Low Birthweight (< 5.5 lbs) Infant Mortality Rate (IMR) 5.1* (deaths per 1,000 live births) % Smoking during pregnancy 7.2* ,3 % Prenatal Care 1st trimester 83.2* ,3 % C-Section 32.3* 30.2 A Comparison of 2005 Birth Indicators Massachusetts v. U.S National Vital Statistics Report, Preliminary Births for Released on November 22, Preliminary 2004 data. National Vital Statistics Reports, Vol. 54, No. 19, June 28, Data for the U.S. for 2005 have not yet been released. 3. Based on a 40- or 41-state reporting area. *Statistically Significant (p ≤.05)

Birth Trends in Massachusetts

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Massachusetts Births 1995 & 2005 Number of Births76,824 -6%* Teen Birth Rate (births/1000 ages 15-19) %* % Smoking during pregnancy %* Infant Mortality Rate (deaths per 1,000 live births) - White non-Hispanic IMR % - Black non-Hispanic IMR % - Hispanic IMR % % Low Birthweight %* % C-Section %* % Multiple Births %* % change and 2005 * Statistically Significant (p≤.05)

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation A trend analysis tool developed by the National Cancer Institute Creates a “model” (graph) that best describes the trend in events Points where the trend turns around are called “joinpoints” Shows the Annual Percentage Change (APC) for each line segment in the model Joinpoint Analysis (JPA)

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Trend in the Number of Births Massachusetts: ,460 76, % * APC -2.0% * APC % APC 2002 * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Number of Births by Mother’s Age (< 30 and 30+) Massachusetts: Ages > 30 Ages < 30

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Age-specific Birth Rates Massachusetts vs. U.S.: 2005 MA US US Source: Births: Preliminary Data for 2005, NCHS. November 21, 2006

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Percent of Births by Race and Hispanic Ethnicity Massachusetts: Asian non-Hispanic Black non-Hispanic Hispanic

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation % Non-U.S. Born Mothers Massachusetts: % APC +5.4% * APC * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Ethnicity % Change Brazilian1,033 2,058+99%* African 689 1,197+74%* Ghanaian Moroccan Kenyan Salvadoran 736 1, %* Haitian1,026 1,136+11% Cape Verdean % Births by Selected Mothers’ Ethnicities * Statistically Significant (p ≤.05)

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Number of Multiple Births Massachusetts: % * APC % * APC +2.0% APC % APC * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Low Birthweight (<2500g or 5.5lbs) Massachusetts: % * APC * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Low Birthweight Adjusted by Plurality 1 Massachusetts: Plurality-adjusted LBW rate using 1990 plurality distribution as standard

Selected Maternal Characteristics

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Births by Race and Hispanic Ethnicity Massachusetts: 2005 BIRTHS (n=76,824)

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Birth Characteristics by Maternal Education Massachusetts: 2005 Less than high school (age 20+) College graduate or higher * Statistically Significant (p ≤.05) * * * * * *

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Birth Characteristics by Funding Source of Prenatal Care, Massachusetts: 2005 Privately funded Medicaid * Statistically Significant (p ≤.05) * * * * * *

Infant & Fetal Mortality

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Infant Mortality Rate Massachusetts: %* APC -0.6% APC * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation IMR by Race & Hispanic Ethnicity Massachusetts: White non-Hispanic Black non-Hispanic Hispanic

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Black Non-Hispanic IMR Massachusetts: % APC -11.3% APC +1.7% APC -12.6% APC * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Black Non-Hispanic IMR with Linear Trend Massachusetts: % * APC * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Hispanic IMR Massachusetts: % * APC +5.4% per year * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Infant Mortality Rate Effect of Excluding <500g (1.1lb) Infants 1 Massachusetts: Calculated using birth-infant death linked files. IMR all weights IMR w/o < 500g 46%

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Infant & Fetal Mortality Rate Massachusetts: Infant & Fetal Mortality Fetal Mortality Infant Mortality 1 1 Infant Mortality = # of infant deaths/(fetal deaths + live births) N=848 N=841 N=810N=791 N=741 N=830N=780N=798

Deliveries by Cesarean Section

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Infants Delivered by C-Section Massachusetts and the U.S. : US Massachusetts

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Infants Delivered by C-Section Massachusetts: % * APC +6.7% * APC 1997 * Statistically Significant (p ≤.05) APC = Annual Percentage Change

Teen Births

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation White non-Hispanic 12.9* 26.0 Black non-Hispanic 36.4*60.9 Asian Hispanic Massachusetts United States 1 Teen Births 4, ,406 Teen Birth Rates 21.7* 40.4 (births per 1,000 females ages 15-19) 1 National Vital Statistics Report, Preliminary Births for Released November 22, For U.S. data, Asian category includes persons of Hispanic and non-Hispanic origins Births to Teens (15-19 years) Massachusetts and U.S. : 2005 *Statistically Significant (p ≤.05)

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation United States Massachusetts Teen Birth Rates Massachusetts and U.S. :

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Teen Birth Rates Massachusetts : %* APC -3.5%* APC * Statistically Significant (p ≤.05) 1990

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Highest Teen Birth Rates (Among Communities with at Least 75 Teen Births) Massachusetts: Ranking by highest teen birth rates among communities with at least 75 teen births 2 Births to females per 1,000 females ages * Statistically Significant (p ≤.05)

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation MA Rate: 21.7 Teen Birth Rates by MDPH Regions Massachusetts: 2005

Birth Outcomes for Selected Communities

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Highest Infant Mortality Rates Among the 30 Largest Communities 1 Massachusetts: Selected among the 30 Massachusetts communities with the largest populations. IMR = infant deaths per 1,000 live births. 2 A Confidence Interval for a population parameter is a range in which you are 95% certain that the true population estimate is within. It is a function of variability and the number of events. * Statistically Significant (p ≤.05) IMR95% CI 2 Number of Deaths State 5.1[4.6, 5.6]391 Worcester13.9* [9.4,18.4] 36 Malden11.4[4.0, 18.7]9 Revere10.9[2.9, 18.9]7 Springfield10.6* [6.4, 14.7] 25 New Bedford8.6[3.8, 13.5]12

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Infant Mortality Rates Springfield:

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Infant Mortality Rates Worcester:

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Percent of Mothers Receiving Adequate Prenatal Care for 30 Largest Communities 1 Massachusetts: 2005 Massachusetts84.0% Best Brookline 94.7%* Cambridge89.5%* Fall River85.7% Boston84.1% Worst Pittsfield61.0% * Lowell68.2% * 1 Selected among the 30 Massachusetts communities with the largest populations. *Statistically Significant (p ≤.05) Based on the Adequacy of Prenatal Care Utilization (APNCU) Index

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Percent Low Birthweight for 30 Largest Communities 1 Massachusetts: 2005 Massachusetts 7.9% Best Leominster 5.5%* Barnstable 4.0% Worst Brockton 11.5%* Revere 10.9%* New Bedford 10.6%* Springfield 9.8%* Lowell 9.2% 1 Selected among the 30 Massachusetts communities with the largest populations. *Statistically Significant (p ≤.05)

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Summary – Successes l Many Massachusetts perinatal health indicators are better than those of the U.S. l Continued decline in teen birth rates l Fewer women are smoking during pregnancy l 4 out of 5 women receive adequate prenatal care

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation l Trends that must be closely monitored:  Low birthweight & preterm births  Multiple births  C-Section deliveries  Decline in overall number of births l Slight up-tick in IMR from 2004 and increase in selected communities Summary– Challenges

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Black non-Hispanic IMR is twice as high as the white non-Hispanic IMR Hispanic teen birth rate is almost 6 times that for white non-Hispanics Cambodian, Central American, and African mothers are less likely to receive prenatal care in their first trimester Low birthweight rates in Brockton, Revere, and New Bedford are at least 2 times the statewide rate Less educated mothers have worse birth outcomes than more educated mothers Disparities Persist by Race, Geography, and SES

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Infant Mortality Rate Massachusetts:

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation How Can You Access the Massachusetts Births 2005 Report? Hard Copies: (617) TDD/TTY: (617) DPH Website: mass.gov/dph/bhsre/resep/resep.htm#birth

Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation Accessing Massachusetts Births 2005 Data on MassCHIP MassCHIP (DPH’s Internet-based public health information service) Website: Telephone: MASCHIP (Mass only) (617) New Release (Version 3.0 r 316) - Massachusetts Births Updated Data Sets

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