improving infant mortality in ohio - Maternal and Child Health ...

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depth investigation of each infant (and perhaps fetal) death. (Ithink the State of Florida conducts FIMR State-wide, so perhapsthey might be a model for us to study).b. Mandate Safe-Sleep education prior to discharge from the hospital.10. Marketing: (We have to end the relative silence that exists in Ohio about theimportance of infant mortality. On April 4, 2012 the Ohio chapter of the Marchof Dimes released the Ohio 2010 infant mortality rates to 825 media outletsthroughout the State. Only one radio station in Cleveland responded! While thereare no doubt many reasons for such a lack of interest in these numbers (whichwere substantially worse than the preliminary USA 2010 infant mortality rates.One has to go back to 1995 to find National infant mortality rates comparable toOhio’s 2010 infant mortality rates). ONE out of 825 media outlets was interestedin this story. Our silence on this issue makes it impossible to create the“community will” we need to improve these rates.)a. September is Infant Mortality Month. What are we doing?b. Begin a media campaign in conjunction with all of the workgroups to havea major Statewide article to distribute about some element of infantmortality. With 5 workgroups, this would mean each workgroup would beresponsible for an article every fifth month.c. Challenge ODH to consider the development and annual release of a muchmore comprehensive annual document that provides more details aboutinfant mortality in our State.11. Decreasing Teen Birth Rate:In Ohio in 2010, 2.7 percent of all resident live births were to females between 15and 17 years of age. This is slightly lower than in previous years (teenagers aged15-17 made up 3.0 percent of live births in 2009 and 3.2 percent of births in2008). Nationally the birth rate for teenagers ages 15-17 decreased from 19.6 per1,000 in 2009 to 17.3 per 1,000 in 2010, according to the National Vital StatisticsSystem. Ohio has also experienced a decline in the teenage birth rate from 2009to 2010, with rates for teenagers aged 15-17 lower than national figures (18.7 per1000 in 2009 and 15.6 per 1000 in 2010). Racial disparities among 15-17 yearolds giving birth are apparent. The birth rate for white teenagers aged 15-17 inOhio in 2010 was 11.4 per 1,000. This compared to 31.5 per 1,000 blackteenagers and 29.7 per 1,000 Hispanic teenagers aged 15-17 in the same year.The decline in teen births in Ohio suggests that programs to prevent teenpregnancy have had a positive effect. But data from the national Youth RiskBehavior Survey (YRBS) do not indicate a significant decline in the percentage ofstudents who have ever had sexual intercourse from 1999 (49.9, 95% CI 46.1-53.7) to 2011 (47.8, 95% CI 45.1-50.6). The percentage of students havingintercourse in the past three months who also used birth control pills to preventpregnancy before the last sexual intercourse did not change between 1993 and
2011 (22.8 percent in 2011). On the other hand, among students havingintercourse in the past three months, the percentage that used either birth controlpills or Depo-Provera increased over the period, from 22.0 percent in 1999 to 31.8percent in 2011.Ohio’s State Health Improvement Plan (SHIP) has identified decreasing birthrates among adolescents as a key strategy of the Infant Mortality/Preterm BirthPriority. Using the Ohio Adolescent Health Partnership Plan as a guide, thefollowing objectives are included in the SHIP: Increase the number of schools with comprehensive health educationincluding reproductive health. Improve the knowledge, skills and behavior of health care providers toprovide reproductive health services to adolescents and their families. Increase the use of effective and appropriate contraception amongadolescents.12. Elimination of Racial Disparity in Birth Outcomes, establish “Parity” as theOhio goal for infant mortality.a. Life Courseb. Social Determinants of Healthc. Much more investment from public health and clinical health has to bemade.d. Consider establishment of REACH teams in Ohio REACH: Racial and Ethnic Approaches to Community Health, is aCDC sponsored approach to assisting local community efforts toimprove infant mortality. At this time there is not a REACHproject in the State of Ohio.1. Might we consider developing a REACH project inFranklin County as a next step to the Action LearningCollaborative of CPH?2. An example of a REACH project occurs in GeneseeCounty, Michigan where In 2010 Genesee County recordedits lowest infant mortality rate in the last 25 years with anoverall IMR of 5.7/1,000 live births (compared to 9.4 in2009), white IMR of 4.8 (compared to 5.2 in 2009), andblack IMR of 7.9 (compared to 20.3 in 2009).3. The Genesee County REACH (Racial and EthnicApproaches to Community Health) 2010 initiative,conducted between 2000 and 2007, focused on reducinginfant mortality, particularly the disparity in rates amongAfrican Americans and European Americans, in GeneseeCounty, Michigan. The Community Action Plan (CAP)was derived from a community-based participatory
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Page 24 and 25: 1. Family and fatherhood: multi-lev
Page 26 and 27: 1. To measure positive (thriving) a

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