On a Typical Day in North Carolina Resident Events 1997 2017 Live - - PDF document
Department of Health and Human Services Division of Public Health Womens & Childrens Health Section Womens Health Branch Maternal Health NC Belinda Pettiford, Branch Head On a Typical Day in North Carolina Resident Events
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Department of Health and Human Services Division of Public Health Women’s & Children’s Health Section Women’s Health Branch Maternal Health – NC Belinda Pettiford, Branch Head
On a Typical Day in North Carolina
Source: NC State Center for Health Statistics, Vital Statistics
Resident Events 1997 2017 Live Births 293 329 Low Birthweight Births (<2500 grams) 26 31 Teen Births, Ages 15 - 19 41 19 Infant Deaths 3 2
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Yearly Totals in North Carolina
Source: NC State Center for Health Statistics, Vital Statistics
Resident Events 1997 2017 Live Births 106,949 120,099 % of Low Birthweight Births (<2500 grams) 8.8 9.4 % of Births to Women <18 years 5.5 1.5 Infant Death Rate 9.2 7.1
Characteristics of NC Women Giving Birth
Source: NC State Center for Health Statistics, Vital Statistics 10.9 10.6 10.3 9.8 9.3 8.9 8.7 71.2 71.3 70.3 68.2 67.8 69 68.6 48 48.5 49.6 49.8 50.5 51.8 53.2
10 20 30 40 50 60 70 80 2011 2012 2013 2014 2015 2016 2017
Percent of women giving birth who ...
Had 1st Trimester PNC Began pregnancy overweight or
Smoked during pregnancy
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Source: NC State Center for Health Statistics, PRAMS
NC Percent of Unintended Pregnancies, 2016 NC Pregnancy Risk Assessment Monitoring System (PRAMS)
Unintended Pregnancy Question: Thinking back to just before you got pregnant with your new baby how did you feel about becoming pregnant? Those who chose “I wanted to be pregnant later” or “I did not want to be pregnant then or at any time in the future” were classified UNINTENDED PREGNANCY.
Total 32.2 By Age <25 years 47.5 25 to 34 years 28.2 35+ years 19.8 By Race White, NH 25.6 Black, NH 45.3 Other, NH 33.4 Hispanic 34.1
Source: NC State Center for Health Statistics
NC Birth Rates for Teens Ages 15 to 17 and 18 to 19 2007 to 2017
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Characteristics of NC Infants
Source: NC State Center for Health Statistics, Vital Statistics 30.4 30.6 30.3 29.5 29.3 29.4 29.4 9 8.8 8.8 8.9 9.2 9.2 9.4 1.7 1.7 1.7 1.7 1.8 1.6 1.7 12.1 11.5 9.9 9.8 10.2 10.4 10.5
5 10 15 20 25 30 35 2011 2012 2013 2014 2015 2016 2017
Percent of Babies Born …
at Low Birth Weight (<2500g) by C-Section at Very Low Birth Weight (<1500g) Preterm (<37 weeks gestation) Source: NC DHHS North Carolina State Center for Health Statistics
NC Resident Infant Death Rates, 2007-2017 Racial Distribution
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NC Infant Mortality Disparity Ratio* 1998-2017
*Ratio of Non-Hispanic Black to Non-Hispanic White Infant Mortality Rates Source: North Carolina State Center for Health Statistics, 2017 Infant Mortality Report
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Ratio 2.57 2.33 2.36 2.52 2.64 2.64 2.56 2.33 2.44 2.42 2.45 2.87 2.40 2.35 2.53 2.52 2.51 2.19 2.68 2.50 0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50
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Number of Pregnancy-Associated Deaths
North Carolina Residents 1999 – 2014
SOURCE: NC DHHS State Center for Health Statistics, June 2018 NOTE: Data source for ascertainment of pregnancy associated cases are variable over this time period. The criteria for a “pregnancy related case” is not consistent over time. NC is part of a working group with CDC to develop a “best practice” protocol to standardize case ascertainment nationally 64 36 38 75 71 70 67 50 75 69 75 56 47 57 58 62 10 20 30 40 50 60 70 80 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Total Deaths
35% of all pregnancy associated deaths 1999-2014 were pregnancy related
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SOURCE: NC DHHS State Center for Health Statistics, June 2018
Cardiovascular leading cause of maternal mortality in NC
# of NC Maternal Deaths from 2005-2014
# of Maternal Deaths in 2014
Severe Maternal Morbidity (SMM)
CY 2016 & 2017
1Say et al., Best Pract Res Cl OB 2009
SOURCE: NC DHHS State Center for Health Statistics August 2018. Report based on Alliance for Innovation on Maternal Health (AIM) Project; http://safehealthcareforeverywoman.org/aim-data/
Definition: “A woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.”1 Total Deliveries in NC Hospitals = 222,113 Number Rate per 10,000 deliveries Overall SMM 3,834 172 SMM excluding transfusions 1,702 76
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Some Maternal Health Efforts
−Preconception Health Strategic Plan −Perinatal Health Strategic Plan −Maternal Mortality Review Committee −Perinatal Systems of Care Task Force
North Carolina Preconception Health Strategic Plan Priority Areas:
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North Carolina Preconception Health Strategic Plan Supplement Priority Areas:
Life Planning Mental Wellness Access to Services
Expanded Priority Population
Women AND Men
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W H AT D O E S Y O U R F U T U R E H O L D ?
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G E N E R AL F E E L I N G O F W E L L B E I N G
M AK E I T E AS Y F O R M E
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CONTRIBUTING PARTNERS
North Carolina Preconception Health Strategic Plan Supplement 2014
North Carolina Perinatal Health Strategic Plan Focus Areas:
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Social Determinants of Social Determinants of Health (SDOH) Health (SDOH)
Image Source: Healthy People 2020 website - https://www.healthypeople.gov/2020/topics-objectives/topic/social- determinants-of-health
Early Programming
Cumulative Pathways
Optimal Life Trajectory Life Trajectory Affected by Inequity
Health potential
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Health equity is every individual having access to the resour resources ces and oppor
tunities es that promote good health. Health equity Health equity is more than t is more than the absence he absence of healt
disparit ities ies The Perinatal Health Strategic Plan Goals Goals:
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Goal 1 – Improve Health Care for Women and Men
Point 1. Provide interconception care to women with prior adverse pregnancy outcomes Point 2. Increase access to preconception care Point 3. Improve the quality of prenatal care Point 4. Expand healthcare access over the life course
Goal 2 – Strengthen families and communities
Point 5. Strengthen father involvement in families Point 6. Enhance coordination and integration of family support services Point 7. Support coordination and cooperation to promote reproductive health within communities Point 8. Invest in community building and urban renewal
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Goal 3 – Addressing social and economic inequities
Point 9. Close the education gap Point 10. Reduce poverty among families Point 11. Support working mothers and families Point 12. Undo racism
The Perinatal Health Strategic Plan Team
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Work Groups:
Align and Amplify efforts
− Focus ages 0-8 − Healthy Babies goal – Babies across NC from all backgrounds will have a healthy start
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Few Other Efforts….
− Pregnancy associated deaths − Pregnancy related deaths − Legislation – December 1, 2015 − Nine member committee along with Specialty Consultants
− Partnership with NC IOM − Session Law 2018-93