Marion County Women’s Health Issues

Virginia A. Caine, M.D.

Director, Marion County Public Health Department

Associate Professor, Indiana University School of Medicine, Division of Infectious Diseases

MaternalHealth/

Prematurity

1. Pre & Inter-Conception Care

2. Health Behaviors3. Prenatal Care

Infant

Health

1. Safety I ssues2. Breast -Feeding3. Family &

Parenting I ssues

-Public education campaigns-Reproductive Health plans-Mentoring programs-Better control ofChronic Diseases& Obesity-Expand Medicaid for FP & I C Care, Mental health and Substance Abuse Programs-PNC Coordination

-Safe Sleep & Home Safety education

-Breastfeeding

-Long term CC services

-Substance Abuse

Screening & Treatment

Focus Areas Action Areas

Actions

Strategic Actions to Improve Birth

Outcomes in Marion County

FP-Family Planning, IC-Interconception Care, PNC Prenatal Care Coordination, CC-Care Coordination

Based on Perinatal Periods of Risk (PPOR) data for Marion County 2001-2005

Infant Mortality Rate in Marion County by Race/Ethnicity1993-2009

0

5

10

15

20

25

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Year

IMR

(d

eath

s p

er 1

,000

liv

e b

irth

s)

Overall White non-Latino Black non-Latino Latino

Infant Mortality Rate by Race/Ethnicity

Source: 2009 Birth certificates DR1306

Figure 1 Percent of maternal smoking in pregnancy, Marion County 2009

0

5

10

15

20

25

30

35

40

45

50

10-14 15-17 18-19 20-24

W hite non-Latino Black non-Latino

Smoking during pregnancy, 2000

Smoking during pregnancy, 2006

0

5

10

15

20

25

30

35

40

45

50

10-14 15-17 18-19 20-24

White non-Latino Black non-Latino

Teen Pregnancy (ages 15-19) Rates for Marion

County by Race/Ethnicity

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010Marion County 58.8 59.2 58.8 58.4 56.7 59.9 57.8 53.6 53.8 45.4

White non-Hispanic 49.6 51.8 50.1 47.5 44.6 45.2 47.5 41.6 39.9 33.7Black non-Hispanic 79.4 72.4 75.2 72.2 68.4 77.2 66.8 67.1 68.7 59.2

Hispanic 66.3 84.1 78.3 99.7 111.8 111.4 115.4 102.7 103.7 86.3

Maternal Smoking Race by Race/Ethnicity: All Marion County

Mothers

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010Marion County 19.1 18.1 17.6 16.2 16.6 15.2 15.2 15.8 15.4 15.7

White non-Hispanic 24.2 23.5 23.3 21.6 23.2 22.1 21.7 23.9 23.3 23.5Black non-Hispanic 14.8 14.3 14.4 13.7 13.5 12.8 12.4 12.9 11.9 12.9

Hispanic 3.8 2.7 1.4 1.8 1.9 0.9 2.6 1.4 2.0 1.8

Maternal Smoking Rate by all Age Groups

(Women who reported smoking during pregnancy)

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010Marion County 19.1 18.1 17.6 16.2 16.6 15.2 15.2 15.8 15.4 15.7

15-19 25.0 23.5 21.6 19.9 19.8 15.6 16.9 17.7 16.3 16.120-24 25.1 24.5 24.2 21.6 23.0 19.8 21.1 20.7 20.6 20.525-34 14.7 13.4 13.5 13.0 12.8 12.8 12.1 13.4 13.1 14.035+ 14.9 14.7 13.0 11.2 12.4 11.8 9.3 10.2 10.6 10.2

Maternal Smoking Rate by Race/Ethnicity and Age

Group(Women who reported smoking during pregnancy)

White non-Hispanic 24.2 23.5 23.3 21.6 23.2 22.1 21.7 23.9 23.3 23.515-19 43.0 41.2 37.8 37.7 39.6 31.8 32.5 34.7 33.2 32.620-24 36.9 36.4 37.6 33.5 37.3 33.5 33.1 34.8 35.4 35.125-34 16.8 15.3 15.9 15.3 15.6 15.8 14.8 17.9 17.3 18.835+ 15.2 15.4 13.5 11.6 13.4 13.5 10.8 13.3 14.5 12.9

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Maternal Smoking Rate by Race/Ethnicity and Age

Group(Women who reported smoking during pregnancy)

Black non-Hispanic 14.8 14.3 14.4 13.7 13.5 12.8 12.4 12.9 11.9 12.915-19 11.1 9.8 10.0 8.5 7.2 6.2 5.6 8.1 6.8 6.120-24 16.2 15.4 15.3 14.7 15.0 12.9 13.2 12.6 12.1 13.725-34 14.6 14.8 15.3 15.2 14.5 15.7 14.9 15.5 14.3 15.035+ 20.7 18.1 17.8 15.2 16.4 16.1 12.7 12.7 11.2 13.0

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Maternal Smoking Rate by Race/Ethnicity and Age

Group(Women who reported smoking during

pregnancy)

Hispanic 3.8 2.7 1.4 1.8 1.9 0.9 2.6 1.4 2.0 1.815-19 8.4 4.8 1.9 2.2 2.3 1.3 3.5 1.8 3.2 4.220-24 3.5 3.2 1.9 1.7 2.3 0.8 3.4 2.0 1.7 1.925-34 3.0 2.0 0.9 1.7 1.4 1.0 2.0 1.1 1.9 1.635+ 2.1 0.0 0.8 2.4 1.8 0.6 1.1 0.9 1.3 0.4

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Top 10 Contributing Factors IHB-FIMR Program CRT Aggregate DV Summary for January 1 - December 31, 2010

(n=75)

01020304050607080

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Deliberation Value

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