1. 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 4.42.21.72.510.7 United States 1998-2000 3.72.31.41.99.3 Alameda County 1999-2001 3.22.61.11.68.5 Tulsa 1996- 2000 2.72.11.41.77.9 San Antonio 1999-2001 2.41.40.91.96.6

2. PPOR Map of Feto-Infant Mortality Among Births to Bexar County Mothers 1999 - 2001 Total Feto-Infant Deaths 479 Total Fetal Deaths and Live Births 71,753 Source: San Antonio Metropolitan Health District and Texas Department of Health

3. PPOR Map of Feto-Infant Mortality Among Births to Bexar County Mothers 1999 - 2001 500-1499 g 1500+ g Fetal Death Neonatal Post- neonatal 172 10367137 Source: San Antonio Metropolitan Health District and Texas Department of Health

4. PPOR Map of Feto-Infant Mortality Among Births to Bexar County Mothers 1999 - 2001 500-1499 g 1500+ 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

5. San Antonio, Texas PPOR 1999-2001 MH/PreMCNCIHFetal- Infant MR San Antonio 1999-2001 2.41.40.91.96.6 US Reference Group 1998- 2000 2.21.51.11.05.9 Excess Rates (San Antonio Rate – US Rate) 0.2-0.1-0.20.90.7 % Excess (excess rate/ total excess rate) 18%0082% San Antonio Total Deaths 1999-2001 = 479

6. 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 101/1.6 552 total deaths 64,492 total births Rate=8.5 deaths per 1,000 births Alameda County, 1999-2001

7. 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 1999-2001 Total Rate: 16.1 vs 7.1

8. 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 1999-2001 Total Rate: 16.1 vs 5.9

9. Alameda County PPOR 1999-2001 MH/PreMCNCIHFetal- Infant MR Alameda County 1999-2001 3.22.61.11.68.5 US Reference Group 1998-2000 2.21.51.11.05.9 Excess Rates (Alameda County Rate – US Rate) 1.00.900.62.6 % Excess (excess rate/ total excess rate) 38%35%023% Alameda Total Deaths 1999-2001 = 552

10. 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 158/3.7 537 total deaths 42,177 total births Rate=12.7 deaths per 1,000 births City of Detroit, 1999-2001 1999-2001 Birth Cohort Prepared by: DHWP-FHS on 3/15/04 For internal planning use only.

11. 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 1999-2001 Total Rate: 13.1 vs 10.7 1999-2001 Birth Cohort Prepared by: DHWP-FHS on 3/15/04 For internal planning use only.

12. Detroit PPOR 1999-2001 MH/PreMCNCIHFetal- Infant MR Detroit 1999-2001 5.81.51.73.712.7 US Reference Group 1998- 2000 2.21.51.11.05.9 Excess Rates (Detroit Rate – US Rate) 3.600.62.76.8 % Excess (excess rate / total excess rate) 53%09%40% Detroit Total Deaths 1999-2001 = 537

13. Deaths74Deaths OVERALL IMR t =Total t =351Deaths44,571 Fetal Losses & Stillbirths: 2.13 Total Stillbirths, Fetal and Infant Deaths Meeting PPOR t Model Criteria, 1996-2000: 29 - 365 days of life 24 weeks gestation - 28 days of life Infant Health 29 - 365 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 =7.88 130 Excluded Birth Outcomes (< 500 grams and/or < 24 weeks gestation) 500-1499 grams Newborn Care (Sum of 4 Blocks) 95Deaths 1.41 Birth Weight Live Births: > 1500 grams 63 24 weeks gestation - 28 days of life> 24 weeks gestation (fetal losses & stillbirths) Maternal Care > 24 weeks gestation

14. NumberRate 90 2.66 35 5.30 8 2.85 16 4.59 1 1.12 NumberRateNumberRateNumberRate White64 1.89 White61 1.80 White56 1.65 Black20 3.03 Black15 2.27 Black20 3.03 8 2.85 Native American3 1.07 Native American9 3.21 Other3 3.37 Hispanic3 0.86 Hispanic7 2.01 31 8.89 Other2 2.25 Other1 1.12 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 500-1499 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, 1996-2000: 29 - 365 days of life 24 weeks gestation - 28 days of life Tulsa County Residents by Race Fetal Losses & Stillbirths:Live Births: > 24 weeks gestation 9.98 13.62 Infant Health White Denominator t = 29 - 365 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) 7.87 16.34 (Sum of 4 Blocks) 10.83

15. Tulsa, Oklahoma PPOR 1996-2000 MH/PreMCNCIHFetal- Infant MR Tulsa 1996- 2000 2.72.11.41.77.9 US Reference Group 1998- 2000 2.21.51.11.05.9 Excess Rates (Tulsa Rate – US Rate) 0.50.60.30.72.0 % Excess (excess rate / total excess rate) 25%20%15%35%NA Tulsa Total Deaths 1996-2000 = 351

16. Age at Death 1500+ grams 500- 1499 grams Fetal-Infant Mortality Rates* All races, Marion County, Indiana 1998-2000 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 1,000 458 Fetal-Infant Deaths 42778 Fetal Deaths and Live Births Birthweight Fetal Neonatal Post Neonatal

17. 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, 1998-2000 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 1500+ grams 500- 1499 grams Fetal Infant Mortality Rate= 5.9 per 1,000 82 Fetal-Infant Deaths 13805 Fetal Deaths and Live Births Fetal Neonatal Post Neonatal

18. Marion County PPOR 1998-2000 MH/PreMCNCIHFetal- Infant MR Marion County 1998-2000 4.42.21.72.510.7 US Reference Group 1998- 2000 2.21.51.11.05.9 Excess Rates (Marion County Rate – US Rate) 2.20.70.61.54.8 % Excess (excess rate/ total excess rate) 46%15%13%31% Marion County Total Deaths 1998-2000 = 458

19. 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 1998-2000

20. Cook County, Illinois PPOR 1998-2000 MH/PreMCNCIHFetal- Infant MR Cook County 1998-2000 5.22.81.72.412.2 US Reference Group 1998- 2000 2.21.51.11.05.9 Excess Rates (Cook County Rate – US Rate) 3.01.30.61.46.3 % Excess (excess rate / total excess rate) 48%21%10%22% Cook County Total Deaths 1998-2000 = 3,018

21. Cook County, Illinois PPOR Excess Examples 1998- 2000 MH/PreMCNCIHFetal-Infant MR Cook County 1998-2000 5.22.81.72.412.2 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