Springfield DPH Presentation April 28, 2010

Appreciation to: Massachusetts DPH Springfield Health and Human Services Massachusetts SIDS Center Springfield MCH/FIMR Tim Hogan

Springfield Department of Health and Human Services Maternal Child health Commission Mission To promote a community that nurtures all families to have healthy pregnancies and healthy children

Community Partners Networking and support of Community Events and Ideas Annual Teen Conference Annual Community Baby Shower Subcommittees: FIMR/Healthy Start

Maternal Child Health Commission Boston Medical Center Health Net Plan Family Life Center for Maternity Mercy Medical Center New North Citizens Council WIC Tapestry Health Systems THOM Springfield Infant Toddler Services Square One HCS Head Start Greater Springfield Healthy Families Spring of Hope HOGIC NEON YWCA Page Plus Program Martin Luther King Jr. Family Services

MA DPH Western Regional Health Office The Child Guidance Clinic - BHN Baystate Medical Center MSPCC Springfield Mason Square Neighborhood Health Center & Task Force Cherish Every Child – Irene E. & George A. Davis Foundation Mercy Cares Forest Park Gandara Center Spfld. YMCA Teen Parent Program J.C. Williams Community Center Center for Human Development Early Childhood Center VACA Planned Parenthood Caring Health Center Spfld. Family Support Program

Springfield FIMR The death of one child is a family tragedy; the death of many is a community tragedy. We can think of no indicator that reflects the health of the community more than its infant mortality rate.

Ask Yourself “WHY?” Springfield: 3.1% of Massachusetts live births Springfield: 4.8% of Massachusetts infant deaths Or 61 “extra” infant deaths in 9 years

Highest Infant Mortality Rates Among the 30 Largest Communities in Massachusetts: Rate = infant deaths per 1,000 live births * Statistically Significantly higher from state rate (p ≤.05) Revere10.4* (n=22) Springfield 9.2* (n=68) Worcester 9.0* (n=70) New Bedford 8.7* (n=37) Fall River 8.5* (n=31) MA Overall 4.9 (n=1,152)

Springfield Infant Mortality 2008 Age at death: 23 (85.2%) were neonatal deaths (<28 days old) –2 (8.7%) less than one hour old –16 (69.6%) one hour to less than 24 hours old –5 (21.7%) one day to 27 days old 4 (14.8%) were post-neonatal deaths ( days old) Primary Underlying Cause of Death 23 neonatal deaths –19 (82.6%) from conditions originating in the perinatal period 2 –1 (4.4%) from congenital malformations 3 –3 (13.0%) from other causes 4 post-neonatal death –1 (25.0%) from SIDS –1 (25.0%) from unintentional injuries –1 (25.0%) from congenital malformations 3 –1 (25.0%) from other causes

Springfield Infant Mortality infant deaths Maternal age: 4 (14.8%) were <20 years old 19 (70.4%) were years old 4 (14.8%) were 35 years or older Prematurity: 3 (11.1%) were full term (37-42 weeks) 24 (88.9%) were preterm (<37 weeks) Of these 24: –2 (8.3%) were weeks –1 (4.2%) was weeks –21 (87.5%) were <25 weeks

Racial disparities in birth outcomes: Springfield, MA

Results PAR % for VLBW in Springfield:

Springfield FIMR Focus Groups focus groups of African-American women who gave birth in the past 10 years, each in different time spans KEY FINDINGS Experience of racism Relationships with provider and support important Experience of care given included being scared, impersonal treatment and desire for more information Barriers to accessing health care transportation, child care, time off from work, insurance

Post-Neonatal Deaths Co-sleeping? –Implicated in 3 deaths in 2009

T. Frieden, MD: AJPH 4/10

PROJECT BABY Bringing Awareness to Baby and You Preconception Care for Women Promote health education and prevention Improve quality of Prenatal Care Strengthening of Families and Community Decrease infant mortality in the City of Springfield Addressing social and health disparities “Every Baby Deserves a Great Beginning”

The Road Show-Reaching Out Springfield Health Disparities Project Community Baby Shower March of Dimes Prematurity Summit Community Health Workers Network Springfield Public Health Council

Healthy Start Healthy Start… healthy start… healthy start!!!

A 7-Point Plan 1. Provide interconception care to women with prior adverse pregnancy outcomes 2. Increase access to preconception care for African-American women in an integrated, caring system 3. Improve the quality of prenatal care 4. Strengthen father involvement in African American families 5. Close the local education gap 6. Support working mothers and families 7. Undo racism

Questions/Feedback/To Lend a Hand Sandra Johnson Andrew Balder, MD Alice Hodge