1. Right Start in Michigan 2009 Michigan League for Human Services 1115 South Pennsylvania Avenue, Suite 202, Lansing, MI 48912-1658 (517) 487-5436 Fax: (517) 371-4546 Web site: http://www.MiLHS.org A United Way Agency An Overview by Jane Zehnder-Merrell Sr. Research Associate, Michigan League for Human Services janez@michleagueforhumansvs.org

2. Maternal and Infant Health Maternal risk characteristics –Age – teen/repeat teen –Marital status –Education –Prenatal care –Smoking during pregnancy Birth outcomes/infants –Low-birthweight –Preterm

3. Michigan Overview Births to teens Repeat births to teens Births to unmarried women Less than 12 years education Late or no prenatal care Smoked during pregnancy Low-birthweight babies Preterm births Percent Change in Rate WORSE BETTER 20 10 0 10 20 30 40

4. County Group Analysis: Geography by Population Density Urban – 28 (over 65,000) Mid-sized – 36 (20,000-65,000) Rural – 19 (under 20,000)

5. Michigan County Groups* Right Start 2009 *Based on population Source: Population Reference Bureau

6. Demographics in the County Groups Source: Michigan Department of Community Health, Vital Records and Health Data Development

7. Michigan county groups reflected similar levels of risk by maternal age and education. Source: Michigan Department of Community Health, Vital Records and Health Data Development

8. Urban counties had the highest rates of low-birthweight babies and preterm births. Source: Michigan Department of Community Health, Vital Records and Health Data Development

9. Unlike non-marital birth rates, maternal smoking during pregnancy varied dramatically among county groups. Source: Michigan Department of Community Health, Vital Records and Health Data Development

10. In 2007 the largest numbers of Michigan's non-marital births occurred to women in their 20s. Source: Michigan Department of Community Health, Vital Records and Health Data Development

11. The percent of births to single women escalated in all Michigan county groups. Source: Michigan Department of Community Health, Vital Records and Health Data Development Percent of total live births

12. The percentage of low-birthweight babies worsened in all county groups. Source: Michigan Department of Community Health, Vital Records and Health Data Development

13. The percentage of mothers with less than 12 years education declined the most in rural counties. Source: Michigan Department of Community Health, Vital Records and Health Data Development

14. Maternal smoking during pregnancy declined sharply in urban counties. Source: Michigan Department of Community Health, Vital Records and Health Data Development

15. Policy Implications Early childhood – begin at the beginning Targeting scarce resources at high risk demographic and geographic groups – executive order cuts Medicaid matters – provider rates Women’s health