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 population

Infant Mortality Rates Per 1000 Live Births Northeast Florida State Rate 9 8 8 8 7.3 7.1 7.2 7 6.5 6.2 6.5 6.4 6 6.1 6 6 5 4 2010 2011 2012 2013 2014 2015 Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

Infant Mortality Rate by Race Disparities on a local and state level 16 NEF White NEF Black/Other State White State Black/Other 14 12 10 8 6 4 2 0 2012 2013 2014 2015 Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

Causes of Infant Death, Northeast Florida 50 45 2013 2014 40 2015 35 30 25 20 15 10 5 0 Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

Low Birthweight (%) by Race (<2500 grams) per 1000 live births Black/Other White 12.96 2015 7.46 12.11 2014 7.32 12.20 2013 6.87 Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

Infant Age at Death 34% 33% 42% 67% 66% 58% 2013 2014 2015 < 28 days 28- 365 days Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

SUIDs Sudden Unexpected Infant Deaths 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 of the death scene, and a review of the clinical history.  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  Suffocation by soft bedding  Overlay.  Wedging  Strangulation

Number of SUIDs Deaths Northeast Florida SUIDs Death Rate Per 1000 live births 1.5 State Rate 1.4 1.6 1.3 1.2 1.4 1.2 1 0.8 n= n= n= 0.6 n= 26 24 26 21 0.4 0.2 0 2012 2013 2014 2015 Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

SUIDs Sudden Unexpected Infant Deaths SUIDs Includes: n=24 Accidental suffocation or • strangulation in bed 2, Bedsharing 8% 3, Other suffocation and • strangulation 13% Unsafe Sleep ( i.e. choking) Environment 5, Positional SIDS 14, • 21% 58% Many sources include “undetermined” • SUIDs in this category, however it is not included in this data.

A Closer Look at SUIDs (2012-2015) 98 days Average Age at time of death 84% of mothers 76% Mothers did not have Had at least a High Healthy Start School Education (2014-2015) Black and other non whites are 2 times more likely to die of SUIDs than whites 80% of babies *69% Fathers did not have Had at least a High Healthy Start School Education 70% WIC (2014-2015) 80% Medicaid

Fetal Deaths by Race 16 White Black/Other Total Fetal Deaths 14 12 10 8 6 4 2 0 2011 2012 2013 2014 2015 Source: Florida CHARTS, Division of Public Health Statistics and Performance Management, Florida Department of Health www.floridacharts.com

Neonatal Abstinence Syndrome (NAS) Northeast Florida 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. Source: Florida Department of Health Neonatal Abstinence Syndrome Data Summary, March 2015

NAS Rates per 10,000 Live Births Nassau 197.5 Baker Duval 121.7 185.9 Clay St. 168.1 Johns 83.5 Source: Florida Department of Health Neonatal Abstinence Syndrome Data Summary, March 2015

Infant Mortality Rate Baker County Baker County Total White Black/Other Infant Mortality Rate 30 11.9* 20 10 0 2012 2013 2014 2015 Low Birthweight Infants Baker Causes of Infant Death Black/Other White Baker n=4 8.3 Other Perinatal 2015 9.8 Conditions SUIDs 12.8 2014 25% 8.2 50% 18.8 2013 11.3 25% Congenital

Infant Mortality Rate Clay County Clay County Infant Mortality Rate Total White Black/Other 5.0 15 10 5 0 2012 2013 2014 2015 Causes of Infant Death Clay n=11 Low Birthweight Infants Clay Injury Other Black/Other White Other 9% 9% Perinatal Cond 11.2 2015 8.1 28% 14.2 2014 SUIDs 7.7 Congenital 27% 27% 9.5 2013 6.8

Infant Mortality Rate Duval County Duval County Total White Black/Other Infant Mortality Rate 15 7.9 10 5 0 2012 2013 2014 2015 Low Birthweight Infants Duval Causes of Infant Death, Duval n= 103 Black/Other White Injury Other Infections 3% 3% 3% 13.1 2015 7.5 Prematurity 11.9 2014 31% 7.5 SUIDs 19% 12.1 2013 6.9 Congenital Other 9% Perinatal Cond 32%

Infant Mortality Rate Nassau County Nassau County Total White Black/Other Infant Mortality Rate 5.0 20 10 0 2012 2013 2014 2015 Low Birthweight Infants Nassau Black/Other White Causes of Infant Death 20.8 2015 Nassau n= 4 8.2 11.3 2014 6.5 23 SUIDs 2013 5.6 25% Other Perinatal Cond Congenital 50% 25%

Infant Mortality Rate St. Johns County St. Johns County Total White Black/Other Infant Mortality Rate 15 4.6 10 5 0 2012 2013 2014 2015 Low Birthweight Infants St. Johns Causes of Infant Death St. Johns n= 10 Black/Other White 10.8 2015 5.9 Other Prematurity 10% 14.2 20% 2014 SUIDs 6.4 10% 13.7 2013 6.7 Other Perinatal Congenital Cond 30% 30%

FIMR 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 ”

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% Poverty 36% Pre-Existing 46% Conditions • Asthma Substance • HTN 39% Use • Diabetes (Except Tobacco) Pre-Term Labor Obesity

Parental Knowledge and Behavior 32% 54% 29% Late entry into Inconsistent Inadequate care prenatal care Birth Spacing 46% 36% Kept postpartum Substance Use appointments

Sleeping Infant Deaths (n=9) Location 78% Home (7) 22% Sitter (2) Sleeping Situation 44% Alone (4) 55% With Others (5) Sleeping Surface 44% Adult Bed (4) 22% Couch or Chair (2) 22% Infant Bed (2) 11% Other (1) Bedding 89% Soft (8) 11% Firm (1) Items in Bed 89% Unsafe Items (8) 11% Bottle (1) Caregiver + for substance 56% at time of death (except tobacco)

Without Strength Change Cannot Occur Grief Healthy Support Start 82% screen 54% Referrals Dad to needed Involved resources 82% 61% Family Insurance Support 79% 96%

Ideas to Action The Community Action Team

Recommendations Safe Sleep Address late entry into care Centralized location for Prenatal Information/ Resources

There is no foot too small that it cannot leave an imprint on this WORLD Author unknown