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The Silent Epidemic

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  1. The Silent Epidemic Uniting to Reduce Infant Mortality

  2. Infant Mortality in Virginia

  3. Significance of Infant MortalityWorld View

  4. Infant Mortality: The ProblemWorld Rank

  5. Infant Mortality: The Problem World Rank

  6. Infant Mortality: The Problem – Virginia • Infant mortality rate ranked 18th highest in the nation by the CDC in 2006 • Only ranks within the top 30 states for protecting the lives of infants • Infant mortality rate twice as high for African-Americans

  7. Infant Mortality: Comparative Deaths

  8. Just the Beginning of the Uphill Climb 123 more babies lived in 2008

  9. Total Infant Mortality Rates Per 1,000 Births in Virginia Healthy People 2010: 4.5

  10. Infant Mortality – Recent History Healthy 2010 Goal: 4.5

  11. Infant Mortality: 5 Year Death Rates by Race/Ethnicity

  12. Infant Mortality Rates Per 1,000 BirthsBy Race/Ethnicity 1998-2008

  13. Top Causes of Death

  14. Top 4 Causes of Infant Death, Virginia 1998-2008

  15. Infant Mortality by Age at Death

  16. Infant Mortality: Maternal Age 2008

  17. Infant Mortality by Education and Race/Ethnicity Less than 12 Years 12 Years > 12 Years

  18. Resident Infant Death Rates by Method of Payment and Race/Ethnicity Medicaid Private Insurance Self Pay

  19. Infant Mortality: By Geography • Infant Deaths 2008 VA residents by number of live births

  20. Prematurity: The Rising Trend

  21. Prematurity*- the problem Healthy 2010 Goal: 7.6 *Less than 37 weeks

  22. Virginia Resident and Cesarean Births

  23. Prematurity and Late Preterm Births 35 Weeks 39 Weeks

  24. Prematurity and SIDS • A premature infant less than 37 weeks sleeping prone is85 timesmore likely to die of SIDS • A premature infant lying on its side is40 timesmore likely to die of SIDS

  25. Prematurity: SIDS Rate and Sleep Position Rates of SIDS Deaths Babies Sleeping on their Backs

  26. Changing Attitudes • Engage • Healthcare Providers • Pregnant women and their families • Community Groups • Health Insurers

  27. Interventions that May Reduce Prematurity/Infant Deaths • Accessible prenatal care • Promote breastfeeding • Education about preterm labor signs and symptoms • Decrease smoking and exposure to second-hand smoke

  28. Interventions That May Reduce Prematurity/Infant Deaths • Assess for substance use and intervene • Assess for domestic violence and intervene • Reduce major stress levels • Refer to community services

  29. Breastfeeding: The Benefits • Lower rates of SIDS • Fewer ear infections • Fewer asthma/allergy cases • Less obesity • Less diabetes • Fewer childhood leukemia cases • Fewer infections in premature babies

  30. Promote Breastfeeding • Educate mothers before birth • Provide support from family, friends, healthcare workers, employers, society • Provide safe places to nurse and pump

  31. Prematurity and Smoking • Exposure to smoking is associated with • 20% of all low birth weight babies • 8% of preterm births • SIDS

  32. Prematurity: Smoking and Pregnancy • Successful treatment of tobacco dependence • 20% reduction in low-birth-weight babies • 17% decrease in preterm births

  33. Infant Mortality: Causes • Prematurity • Birth Defects • SIDS

  34. Infant Mortality: Solutions • Good prenatal nutrition • Maternal health behaviors/effects • Planned pregnancy with early, quality prenatal care • Prevention of preterm & low birth weight babies

  35. Infant Mortality: Solutions • Infant sleep position and environment • Family/caretaker violence prevention & safe home • Home visiting nurses

  36. Infant Mortality Reduction: Spread the Word • Control Weight • Don’t Smoke • Don’t Drink • Take Vitamins with Folic Acid • Visit Your Dentist • Breastfeed

  37. Infant Mortality Reduction: Raise Awareness • Communicate the facts • Provide intervention tips • Support the Commissioner’s Infant Mortality Workgroup

  38. Commissioner’s Working Group on Infant Mortality • Expanded stakeholder concept • Social network • Multi-prong approach • Goal: decrease overall rate • AND • racial disparities

  39. “Saving Babies” Initiative • Save babies from dying in their first year of life • Focus on results • Targeting 10 localities with the highest number of infant deaths • Collaborating with other stakeholders

  40. Saving Babies LocalitiesEach locality funded $100,000

  41. “Saving Babies” Outcomes • Determining women at high risk • Increasing awareness of signs/symptoms of premature labor • Promoting safe sleep education

  42. “Saving Babies” Outcomes • Improving coordination/ efforts of private and public providers • Enhancing outcomes through folic acid promotion, insurance coverage and transportation to prenatal care

  43. Pediatrics 101 • Interactive education • Pediatric residents

  44. Infant Mortality Reduction: Practice Safe Sleep Habits • Baby should… • Sleep alone • Sleep on his/her back • Sleep in a crib without soft toys, bumper pads or quilts

  45. Text 4 BABY • Text informational messages • Public health focus • Pregnancy and Infancy

  46. Folic Acid Initiative • Local health districts • All women of child-bearing age

  47. Pregnancy Authorization • Decrease time for Medicaid-eligible women to enter care

  48. Hampton WalMart Employee IM Project • Teach employees basic public health activities and messages around safe sleep, prematurity, healthy pregnancy

  49. Healthy People 2020 • Education to General Assembly members, Cabinet and Agency leadership • Goal: use 2020 metrics in bill language, legislative discussions

  50. Grandmother’s Campaign • Increase grandmother engagement • Partner with AARP: • Online community • Q&A with Commissioner • Article, fact sheet