Wendy Martinez, MPH, CPH County of San Diego, Maternal, Child & Adolescent Health

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1 Wendy Martinez, MPH, CPH County of San Diego, Maternal, Child & Adolescent Health

2 Describe local trends in birth Identify 3 perinatal health problems Identify 3 leading causes of infant death

3

4 Age Class Male Female Source: San Diego Association of Governments Percent

5 Number of births 52,000 50,000 48,000 46,000 44,000 42,000 40,000 38,000 Source: State of California, Department of Public Health, Center for Health Statistics, Birth Statistical Master Files and Birth Public Use Files. Year

6 Rate (#live births per 1,000) Year Sources: State of California, Department of Public Health, Health Information & Research Section, Birth Statistical Master Files and Birth Public Use Files. SANDAG, Revised 1990's Estimates, Released February, 2004; Current Estimates, Released 8/15/2012.

7 Percent < Year Source: State of California, Department of Public Health, Center for Health Statistics, Birth Statistical Master Files and Birth Public Use Files.

8 % 0.1% 7.2% 7.3% African- American/Black Asian Hispanic 0.0% 5.6% 4.9% 10.2% African- American/Black Asian Hispanic 49.6% Native American/Alaskan Pacific-Islander 35.0% Native American/Alaskan Pacific-Islander 34.7% White 43.0% White Other Other 0.7% 0.4% Unknown 0.7% 0.5% Unknown Source: State of California, Department of Public Health, Center for Health Statistics, Birth Statistical Master Files and Birth Public Use Files.

9 Percent of the Federal Poverty Guideline Source: State of California, Department of Public Health, Epidemiology, Assessment and Program Development Branch of Maternal, Child & Adolescent Health Program, San Francisco Center on Social Disparities in Health, Maternal and Infant Health Assessment Survey >400% % % % 0-100% Percent

10 Speaks non-english language at home Born outside the U.S. Source: State of California, Department of Public Health, Epidemiology, Assessment and Program Development Branch of Maternal, Child & Adolescent Health Program, San Francisco Center on Social Disparities in Health, Maternal and Infant Health Assessment Survey Percent Percent

11 Rate (# live births per 1,000) Year Source: State of California, Department of Public Health, Health Information & Research Center, Birth Statistical Master Files. SANDAG, Current Estimates, Released 8/15/2012.

12

13 Source: State of California, Department of Public Health, Epidemiology, Assessment and Program Development Branch of Maternal, Child & Adolescent Health Program, San Francisco Center on Social Disparities in Health, Maternal and Infant Health Assessment Survey Pre-Pregnancy insurance Prenatal insurance Private or other Uninsured Medi-Cal Maternal postpartum insurance Percent

14 Percent Year Source: State of California, Department of Public Health, Center for Health Statistics, Birth Statistical Master Files.

15 Source: State of California, Department of Public Health, Epidemiology, Assessment and Program Development Branch of Maternal, Child & Adolescent Health Program, San Francisco Center on Social Disparities in Health, Maternal and Infant Health Assessment Survey Overweight before pregnancy Obese before pregnancy Percent

16 Source: State of California, Department of Public Health, Epidemiology, Assessment and Program Development Branch of Maternal, Child & Adolescent Health Program, San Francisco Center on Social Disparities in Health, Maternal and Infant Health Assessment Survey Any smoking, 3 months before pregnancy Any smoking, 1st or 3rd trimester Percent

17 Source: State of California, Department of Public Health, Epidemiology, Assessment and Program Development Branch of Maternal, Child & Adolescent Health Program, San Francisco Center on Social Disparities in Health, Maternal and Infant Health Assessment Survey Most critical period of fetal development Consume 400 µg daily Daily folic acid use, month before pregnancy 39.7%

18

19 Percent Year Source: State of California, Department of Public Health, Center for Health Statistics, Birth Statistical Master Files.

20 Percent Year Source: State of California, Department of Public Health, Health Information and Research Center, Birth Statistical Master Files.

21 Percent Race/Ethnicity Source: State of California, Department of Public Health, Center for Health Statistics, Birth Statistical Master Files.

22 Percent Year Source: State of California, Department of Public Health, Center for Health Statistics, Birth Statistical Master Files.

23

24 County numbers too small, unreliable California (2010) Rate: 9.2 California Pregnancy-Associated Mortality Review (CA-PAMR) project started in 2004 More than third of pregnancy-related deaths determined preventable Source: State of California, Department of Public Health, California Birth and Death Statistical Master Files,

25 Rate Fetal Death Rate Infant Mortality Rate Year Source: State of California, Department of Public Health, Health & Information Research Section, Birth and Fetal Death Statistical Master Files.

26 3.4% 1.8% 2.4% 1.6% Congenital malformations, deformations, and chromosomal abnormalities Sudden infant death syndrome 8.7% 13.7% 5.1% 31.7% Newborn affected by maternal complications of pregnancy Disorders related to short gestation and low birth weight, not elsewhere classified Newborn affected by complications of placenta, cord and membranes Neonatal hemorrhage 14.5% 17.0% Diseases of the circulatory system Respiratory distress of newborn Accidents (unintentional injuries) Source: State of California, Department of Public Health, Health Information & Research Section, Death and Birth Statistical Master Files.

27 Rate (# deaths per 100,000 live births) Back to Sleep (2010) = 77.3% Year Averages Sources: State of California, Department of Public Health, Health Information and Research Section, Vital Statistics Tables & Query System; Death and Birth Statistical Master Files. State of California, Department of Public Health, Epidemiology, Assessment and Program Development Branch of Maternal, Child & Adolescent Health Program, San Francisco Center on Social Disparities in Health, Maternal and Infant Health Assessment Survey

28 Source: State of California, Department of Public Health, Epidemiology, Assessment and Program Development Branch of Maternal, Child & Adolescent Health Program, San Francisco Center on Social Disparities in Health, Maternal and Infant Health Assessment Survey Any breastfeeding, 1 month after delivery Exclusive breastfeeding, 1 month after delivery Any breastfeeding, 3 months after delivery Exclusive breastfeeding, 3 months after delivery Percent

29 Wendy Martinez, MPH, CPH Health Information Specialist (619) MCFHS Website:

30 ANY QUESTIONS?

31

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