Post on 26-Dec-2015
transcript
Author(s)
Date
2014 Title V Needs Assessment of
Maternal, Child, Adolescent Health in XXX County:
How are we doing?
Insert Local MCAH/Health Department Logo
1. Provide a brief overview of the Title V Maternal and Child Health Program
2. Discuss the Title V 5-year Needs Assessment Requirement
3. Review community composition and local context related to health and well-being
4. Present local data highlights, including bright spots, areas for improvement and data of interest
5. Provide a summary list of areas for improvement
Objectives of this presentation
Enacted in 1935 as a part of the Social Security Act, the Title V Maternal and Child Health (MCH) Program is a Federal-State partnership.
The Federal Title V Maternal and Child Health Program has provided a foundation for ensuring the health of the Nation’s mothers, women, children, and youth, including children and youth with special health care needs, and their families.
Title V converted to a Block Grant Program in 1981.
What is the Title V MCH Program?
1. Assure access to quality care, especially for those
with low-incomes or limited access to care
2. Reduce infant mortality
3. Provide and ensure access to comprehensive
prenatal and postnatal care, especially for low-
income and at-risk pregnant women
4. Increase the number of children receiving health
assessments and follow-up diagnostic and
treatment services
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Title V Maternal and Child Health Program seeks to:
5. Provide and ensure access to preventive and child
care services as well as rehabilitative services for
certain children
6. Implement family-centered, community-based
systems of coordinated care for children with
special healthcare needs
7. Provide toll-free hotlines and assistance in
applying for services to pregnant women with
infants and children who are eligible for Title XIX
(Medicaid – known as Medi-Cal in CA).5
Title V Maternal and Child Health Program seeks to (cont.):
Source: http://mchb.hrsa.gov/programs/titlevgrants/
State Title V programs: required to conduct a statewide, comprehensive Needs Assessment every five years
California: decentralized the statewide needs assessment process and each local health jurisdiction conducts a needs assessment of their population of women and children
Key Goals -
1. Build local health jurisdiction needs assessment capacity
2. Obtain extensive stakeholder input at the local level
3. Identify “needs” and issues that would be missed by only analyzing state-level information
4. Focus local MCAH efforts by having each jurisdiction identify priority areas they will focus on during the next 5 years
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Title V Maternal, Child Adolescent Health Needs Assessment
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Our Community Residents
County StateTotal Population 37,570,307 Total Population African American 2,195,986 Total Population American Indian/Alaska Native 163,262 Total Population Asian/Pacific Islander 4,994,232 Total Population Hispanic 14,277,952 Total Population White 14,995,619 Total Live Births 501,994
Source: California Department of Finance Population Estimates, 2011
Socio-Ecological Models
Lifecourse Model
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Health Happens where we
LIVELEARNWORK
and PLAY
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About our CommunityCount
yStat
e
Poverty rate for people age 18 to 64 (0-200% FPL)Source: Small Area Health Insurance Estimates (SAHIE), 2009-2011
33.8
Poverty rate for children age 0 to 64 (0-200% FPL)Source: Small Area Health Insurance Estimates (SAHIE), 2009-2011
45.4
Children in foster care per 1,000 children age 0 to 17Source: California Child Welfare Indicators Project, UCB, 2009-2011
6.7
% of Single mothers living in poverty (0-100% FPL)Source: American Community Survey 1-Year Estimates, 2012
39.4
Unemployment rateSource: State of California Employment Development Department., 2009-2011
12.3
% of Children receiving free or reduced price meals at schoolSource: As cited on kidsdata.org, California Dept. of Education, Free/Reduced Price Meals Program & CalWORKS Data Files, 2012
57.5
High school dropout rate in grades 9-12Source: California Dept. of Education, California Basic Educational Data System (CBEDS), 2009-2011
14.7
Number of days with ozone above regulatory standardsSource: Centers for Disease Control and Prevention, National Environmental Public Health Tracking Network (Jul. 2013), 2011
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Bright spots - where we are doing significantly better than the State, have met Healthy People (HP) 2020 goals, or have improved over time
Areas for improvement – where we are doing significantly worse than the State, have gotten worse over time, or are not meeting HP 2020 goals
Additional data of interest – indicators that are of particular concern or interest even though comparisons with the State or previous points in time might not be possible
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Data Highlights
Bright spots –
Our % of Uninsured children1 ages 0 to 18 is lower than the state rate {or the 2000-2002 rate} (insert local rate vs. State rate or rate from before)
Our % of Uninsured women1 ages 18 to 64 is lower than the state rate {or the 2000-2002 rate} (insert local rate vs. State rate or rate from before)
Areas for improvement –
Significantly fewer women are accessing prenatal care in their first trimester2 than in 2000-2002 (insert current local rate vs. previous local rate)
African American women have lower rates of first trimester2 prenatal care than White women (insert AA rate vs. White rate)
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Indicators of Access to and Utilization of Care
Source: 1Small Area Health Insurance Estimates (SAHIE), 2009-2011, 2California Center for Health Statistics, Vital Statistics, Births
Statistical Master File, 2009-2011
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6.4%
15.5%9.3%
22.1%
CountyState
Bright Spot: Children and Women without Health Insurance
Source: Small Area Health Insurance Estimates (SAHIE), 2009-2011
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Childen 0 - 17 Women 18 and over
91.1%
86.5%89.4%
85.9%
CountyState
Data of interest: Children and women who visited a doctor in the last year
Source: CHIS (California Health Interview Survey), 2011-2012
Areas for improvement -
Births within 24 months of a previous pregnancy1 per 100 females age 15 to 44 delivering a live birth (County = 24.2 vs. CA = 21.0)
Substance use diagnoses2 per 1,000 hospitalizations of pregnant females age 15 to 44 (County = 69.8 vs. CA = 13.8)
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Health Indicators for Women and Mothers
Sources: 1California Center for Health Statistics, Vital Statistics, Births Statistical Master File, 2009-2011; 2Office of Statewide Health Planning and Development
(OSHPD). Hospital discharge data, 2009-2011
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Smoking during the 1st or 3rd trimester per 100 females with live
births
28.3%
8.1%County+State
Area for improvement: Smoking during 1st or 3rd Trimester of Pregnancy
+ Regional Data
Source: MIHA (Maternal Infant Health Assessment Survey), 2011
Data of interest -
Rate of Domestic Violence1 per 100,000 population in higher than state rate (County = 674 vs. State = 439)
Rate of mood disorder hospitalizations2 per 100,000 female population age 15 to 44 in 2009-2011 is higher than state rate (County= 1,763 vs. State = 1,030), and higher than it was in 2000-2002 (County = 1,602)
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Health Indicators for Women and Mothers
Sources: 1California State Department of Justice, Office of the Attorney General, Domestic Violence-Related Calls for Assistance, 2009-2011; 2Office of Statewide Health Planning and
Development (OSHPD). Hospital discharge data, 2009-2011
Bright spots -
Rate of live births weighing less than 2,500 grams at birth is lower than the state (County = 6.0% vs. CA = 6.8%)
HP 2020 Objectives achieved for:
Low birth weight (6.0%)
Very low birth weight (1.0%)
Premature births - less than 37 weeks (8.2%)
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Indicators of Infant Health
Source: California Center for Health Statistics, Vital Statistics, Births Statistical Master File, 2009-2011
Bright spot -
Exclusive in-hospital breastfeeding – better than the state (County = 85.6% vs. CA = 62.6%)
Source: California Department of Public Health, Center for Family Health, Genetic Disease Screening Program, Newborn Screening Data, 2012
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Nutrition and Physical Activity Indicators
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Public school students in grades 5, 7, 9, & 11
Females age 15 to 44
34.1%
54.5%
Data of interest: Overweight and obesity among students and women
Source (Students): Babey, S. H., et al. (2011). A patchwork of progress: Changes in overweight and obesity among California 5th-, 7th-, and 9th-graders, 2005-2010.Source (Women): CHIS (California Health Interview Survey), 2011-2012
Bright Spot -
Teen births
Births per 1,000 females age 15 to 17 in 2009-2011 are lower than the State (County = 13.5 vs. CA = 16.8), HP2020 Objective achieved
Births declined from 19.9 per 1,000 females age 15 to 17 in 2000-2002 to 13.5 in 2009-2011
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Child and Adolescent Health Indicators
Source: California Center for Health Statistics, Vital Statistics, Births Statistical Master File, 2009-2011
Areas for improvement -
Births within 24 months of a previous birth per 100 females under 20 years old delivering a live birth
Increased from 51.2% in 2000-2002 to 67.0% in 2009-2011
Significant increasing trend for White females under 20 to giving birth within 24 months of a previously giving birth
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Child and Adolescent Health Indicators
Source: California Center for Health Statistics, Vital Statistics, Births Statistical Master File, 2009-2011
Areas for improvement -
Substance abuse hospitalizations per 100,000 population age 15 to 24 higher than State rate (County = 1055 vs. CA = 638.9)
Data of interest -
Mental health hospitalizations per 100,000 population age 15 to 24 higher than state rate (County = 1,734 vs. CA = 1,282)
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Child and Adolescent Health Indicators
Source: Office of Statewide Health Planning and Development (OSHPD). Hospital discharge data, 2009-2011
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69.0
129.8
41.7070.30
CountyState
Area for Improvement: Death Rates
Source: Death Statistical Master files, 2009-2011
Summary of Potential Bright Spots
• Accessing prenatal care in their first trimester
• Births within 24 months of a previous birth per 100 females age 15 to 44 delivering a live birth
• Births within 24 months of a previous birth per 100 females under 20 years old delivering a live birth
• Substance use diagnoses per 1,000 hospitalizations of pregnant females age 15 to 44
• Smoking during 1st or 3rd Trimester of Pregnancy
• Overweight and obesity among public school students
• Overweight and obesity among females ages 15-44
• Substance abuse hospitalizations per 100,000 population age 15 to 24
• Deaths per 100,000 population age 15 to 19
• Deaths per 100,000 population age 20 to 24
Summary of Potential Areas for Improvement
• Accessing prenatal care in their first trimester
• Births within 24 months of a previous birth per 100 females age 15 to 44 delivering a live birth
• Births within 24 months of a previous birth per 100 females under 20 years old delivering a live birth
• Substance use diagnoses per 1,000 hospitalizations of pregnant females age 15 to 44
• Smoking during 1st or 3rd Trimester of Pregnancy
• Overweight and obesity among public school students
• Overweight and obesity among females ages 15-44
• Substance abuse hospitalizations per 100,000 population age 15 to 24
• Deaths per 100,000 population age 15 to 19
• Deaths per 100,000 population age 20 to 24