FIMR Project Impact Update Tracy Claveau, RN, BAN FIMR Project - - PowerPoint PPT Presentation
FIMR Project Impact Update Tracy Claveau, RN, BAN FIMR Project Coordinator What is Infant Mortality? The death of a baby before his or her first birthday. The is often used as an indicator to measure the health and well being of a
Project Impact Update
Tracy Claveau, RN, BAN
FIMR Project Coordinator
The death of a baby before his or her first birthday.
The is often used as an indicator to measure the health and well being of a population What is Infant Mortality?
Infant Mortality Rates
Per 1000 Live Births
7.3 6.5 7.2 8 8 7.1 6.5 6.4 6 6.1 6 6.2 4 5 6 7 8 9 2010 2011 2012 2013 2014 2015 Northeast Florida State Rate
Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com
2 4 6 8 10 12 14 16 2012 2013 2014 2015 NEF White NEF Black/Other State White State Black/Other
Infant Mortality Rate by Race
Disparities on a local and state level
Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com
Causes of Infant Death, Northeast Florida
5 10 15 20 25 30 35 40 45 50 2013 2014 2015
Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com
6.87 7.32 7.46
12.20 12.11 12.96
2013 2014 2015
Black/Other White
Low Birthweight (%) by Race (<2500 grams)
per 1000 live births
Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com
2013 2014 2015
58% 66% 67% 42% 34% 33% < 28 days 28- 365 days
Infant Age at Death
Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com
Most SUID are reported as 1 of 3 types of infant deaths
Sudden Infant Death Syndrome cannot be explained after a thorough
investigation is conducted, including a complete autopsy, examination
Unknown Cause The sudden death of an infant that cannot be explained
because a thorough investigation was not conducted and cause of death could not be determined. Accidental Suffocation and Strangulation in Bed
SUIDs
Sudden Unexpected Infant Deaths
0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 2012 2013 2014 2015 1.2 1.5 1.3 1.4
SUIDs Death Rate
Per 1000 live births
n= 21 n= 26 n= 24 n= 26
State Rate
Number of SUIDs Deaths
Northeast Florida
Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com
SUIDs
Sudden Unexpected Infant Deaths
Includes:
strangulation in bed
strangulation ( i.e. choking)
in this category, however it is not included in this data.
14, 58% 5, 21% 2, 8% 3,
13%
SUIDs
n=24 Bedsharing Unsafe Sleep Environment Positional SUIDs
A Closer Look at SUIDs
(2012-2015)
98 days Average Age at time of death
70% WIC 80% Medicaid 80% of babies did not have Healthy Start (2014-2015)
*69% Fathers Had at least a High School Education
84% of mothers did not have Healthy Start (2014-2015)
76% Mothers Had at least a High School Education Black and other non whites are 2 times more likely to die of SUIDs than whites
Fetal Deaths by Race
2 4 6 8 10 12 14 16 2011 2012 2013 2014 2015 White Black/Other Total Fetal Deaths
Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com
A condition experienced by newborns exposed to opiod prescription or illicit drugs during pregnancy. Northeastern Florida has been identified as an area of very high concern. Neonatal Abstinence Syndrome (NAS)
Northeast Florida
Source: Florida Department of Health Neonatal Abstinence Syndrome Data Summary, March 2015
Baker Clay 168.1 Duval Nassau St. Johns 185.9 197.5 121.7 83.5
NAS Rates per 10,000 Live Births
Source: Florida Department of Health Neonatal Abstinence Syndrome Data Summary, March 2015
Baker County
10 20 30 2012 2013 2014 2015
Infant Mortality Rate
Baker County
Total White Black/Other
11.3 8.2 9.8 18.8 12.8 8.3 2013 2014 2015
Low Birthweight Infants
Baker Black/Other White
50% 25% 25% Causes of Infant Death
Baker n=4
SUIDs Other Perinatal Conditions Congenital
Infant Mortality Rate 11.9*
Clay County
5 10 15 2012 2013 2014 2015
Infant Mortality Rate
Clay County
Total White Black/Other
Infant Mortality Rate
6.8 7.7 8.1 9.5 14.2 11.2 2013 2014 2015
Low Birthweight Infants
Clay Black/Other White
Other Perinatal Cond 28% Congenital 27% SUIDs 27% Injury 9% Other 9%
Causes of Infant Death Clay n=11 5.0
Duval County
5 10 15 2012 2013 2014 2015
Infant Mortality Rate
Duval County
Total White Black/Other
6.9 7.5 7.5 12.1 11.9 13.1 2013 2014 2015
Low Birthweight Infants
Duval Black/Other White
Infant Mortality Rate
Prematurity 31% Other Perinatal Cond 32% Congenital 9% SUIDs 19% Infections 3% Injury 3% Other 3%
Causes of Infant Death, Duval n= 103
7.9
Nassau County
10 20 2012 2013 2014 2015
Infant Mortality Rate
Nassau County
Total White Black/Other
5.6 6.5 8.2 23 11.3 20.8 2013 2014 2015
Low Birthweight Infants
Nassau Black/Other White
Infant Mortality Rate
Other Perinatal Cond 50% Congenital 25% SUIDs 25%
Causes of Infant Death
Nassau n= 4
5.0
5 10 15 2012 2013 2014 2015
Infant Mortality Rate
Total White Black/Other
6.7 6.4 5.9 13.7 14.2 10.8 2013 2014 2015
Low Birthweight Infants
Black/Other White
Prematurity 20% Other Perinatal Cond 30% Congenital 30% SUIDs 10% Other 10%
Causes of Infant Death
Infant Mortality Rate 4.6
Fetal and Infant Mortality Review
“to determine specific medical, social, financial and other issues that may have impacted the poor birth outcome” “It’s not about finding fault, it’s about figuring out where the system failed ”
FIMR
Source: FIMR Overview for new CRT and/or CAT members, Publication of the National Fetal and Infant Mortality Review Program, ACOG, 2014.
Contributing Factors
46% 68% 39% 46% 36%
Poverty Pre-Existing Conditions
Substance Use
(Except Tobacco)
Pre-Term Labor Obesity
32%
Late entry into care
54%
Inconsistent prenatal care
29%
Inadequate Birth Spacing
36%
Substance Use
Parental Knowledge and Behavior
46%
Kept postpartum appointments
Location Home (7)
78%
Sitter (2)
22%
Sleeping Situation Alone (4)
44%
With Others (5)
55%
Sleeping Surface Adult Bed (4)
44%
Couch or Chair (2)
22%
Infant Bed (2)
22%
Other (1)
11%
Bedding Soft (8)
89%
Firm (1)
11%
Items in Bed Unsafe Items (8)
89%
Bottle (1)
11%
Caregiver + for substance at time of death (except tobacco)
56%
Sleeping Infant Deaths (n=9)
Grief Support 82% Dad Involved 82% Referrals to needed resources 61%
Insurance
79% Family Support 96% Healthy Start screen 54%
Without Strength Change Cannot Occur
Ideas to Action The Community Action Team
Centralized location for Prenatal Information/ Resources
Address late entry into care Safe Sleep
Recommendations
is no foot toosmall that it cannot leave an
Author unknown