1. State of the Child: Madison County Developed and Presented by Cecilia Freer, MPA Freer Consulting April 25, 2012 1 Freer Consulting

2. Madison County Freer Consulting 2 From 2000 to 2009, Madison County’s population grew by 13.1%, compared to the 16% for the state Madison CountyState of Florida Total Population (2009 est)20,26418,537,969 White58.8%79.4% Black40.1%16.1% Other1.1%4.5% Hispanic or Latino Origin5.5%59.5%

3. Economic Indicators Freer Consulting 3 From 2000 to 2009, per capita income in Madison County increased by 34.8%, compared to 30.1% for the state. Madison has a rate of poverty 32% higher than that of the state. Madison CountyState of Florida Per Capita Income$16,486$26,503 Median Household Income$31,174$44,755 % 25+ With high school diploma74.4%84.9% % Living Below Poverty26.2%15% % ages 0-17 Living Below Poverty 38.9%21.5%

5. 5 Freer Consulting In Madison, the rate of infant mortality among Black babies has declined by over 75% in just 6 years. Rates of mortality among White infants has risen sharply after an initial decline Campaigns such as Back to Sleep, educating caregivers on proper sleep environments for baby, and more widely available prenatal care contribute to lower infant mortality rates.

6. 6 Freer Consulting Babies of mothers who do not get prenatal care are three times more likely to have low birth weight and five times more likely to die that those born to mothers who do get care.

7. 7 Freer Consulting Advances in newborn medical care have greatly reduced the number of deaths associated with low birth weight. However, a small percentage of survivors develop mental retardation, learning problems, cerebral palsy, and vision and hearing loss.

8. 8 Freer Consulting Interpregnancy intervals of less than 18 months increase likelihood of preterm labor, low birth weight, gestational diabetes, and infant death.

10. 10 Freer Consulting Single motherhood is associated with: Higher poverty rates & higher welfare rates among women Higher rates of depression (Graefe & Lichter)

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12. 12 Freer Consulting · Parenthood is a leading cause of school drop out among teen girls—30% of teen girls cited pregnancy or parenthood as a reason for dropping out of school. (www.thenationalcampaign.org) · Children of parents with low levels of education are less likely to succeed in school and more likely to live in poverty and have poor health. (www.rikidscount.org)

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14. 14 Freer Consulting · Babies born to mothers who smoke are more likely to have developmental and physical delays, as well as chronic illnesses such as asthma. (Lee, Hong, Park, et al., 2010) · Babies born to smoking mothers are 33% more likely to die in the first month. (Van Meurs, 1999)

15. Since 2008, MC Healthy Start Staff has seen a 35% decrease in number of clients At the same time, there has been a 30% increase in the number of services Focus on intensity and duration of services Targeting highest-risk mothers, unborn babies & infants Triaging women with fewer risks Greater overall impact in the community Healthy Start Services 15 Freer Consulting Madison County20062007200820092010 Number of Women147157156 149 Number of Encounters1268918807901815 Encounters/Woman8.635.855.175.785.47 Number of Services33373992334940823715 Services/encounter2.634.354.154.534.56

16. Thanks to: Samantha Shivers 16 Freer Consulting

17. Starting Earlier – Healthy Start for positive birth outcomes Prenatal Care Counseling and Monitoring Care Coordination Community Referrals Smoking Cessation Childbirth Education Breastfeeding Education and Support Interconceptional Care Counseling Parenting

18. Infant Development – A shift in prevention Parents as Teachers – an intervention for both addressing health behaviors beyond birth and building resilient families Vision - All children will learn, grow and develop to realize their full potential.

19. Who Did We Serve JMT is one of 1900 projects in the U.S. For Madison County, 42 families were served (29 infants and 13 prenatal) 31 were African American, 7 white, 4 latino, 5 teen, 7 married, 6 were first time parents, 6 completed high school/ GED, 26 were screened for developmental delays, & 354 home visits were completed –Ages (15) were 0-11 mos (11) 12-23 mos (3) 24-35 mos

20. Model Components Personal Visits Group Connections Screening Resource Network

21. Short-Term Outcomes Improved Parenting Capacity, Parenting Practices, and Parent-Child Relationships Early Detection of Developmental Delays and Health Issues Improved Family Health and Functioning –Family goal setting –Home Environment improvement –Linkages to other families/social connections –Increased resiliency through stress reduction

22. Intermediate Outcomes Improved Child Health and Development Prevention of Child Abuse and Neglect Increased School Readiness Increased Parent Involvement in Children’s Care and Education

23. Long-Term Outcomes Strong communitie s, thriving families, and children who are healthy, safe, and ready to learn.