V Needs Assessment of Maternal Child Adolescent Health in XXX County How are we doing Insert Local MCAHHealth Department Logo Provide a brief overview of the Title V Maternal and Child Health Program ID: 783684
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Slide1
Author(s)Date
2014 Title V Needs Assessment ofMaternal, Child, Adolescent Health in XXX County: How are we doing?
Insert Local MCAH/Health Department Logo
Slide2Provide a brief overview of the Title V Maternal and Child Health ProgramDiscuss the Title V 5-year Needs Assessment RequirementReview community composition and local context related to health and well-being
Present local data highlights, including bright spots, areas for improvement and data of interestProvide a summary list of areas for improvementObjectives of this presentation
Slide3Enacted 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?
Slide4Assure access to quality care, especially for those with low-incomes or limited access to care
Reduce infant mortalityProvide and ensure access to comprehensive prenatal and postnatal care, especially for low-income and at-risk pregnant women
Increase
the number of children receiving health assessments and follow-up diagnostic and treatment
services
4
Title V Maternal and Child
Health Program
seeks to
:
Slide5Provide and ensure access to preventive and child care services as well as rehabilitative services for certain children
Implement family-centered, community-based systems of coordinated care for children with special healthcare needsProvide 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/
Slide6State Title V programs: required to conduct a statewide, comprehensive Needs
Assessment every five yearsCalifornia: decentralized the statewide needs assessment process and each local health jurisdiction conducts a needs assessment of their population of women and childrenKey Goals -
Build
local
health jurisdiction
needs assessment capacity
Obtain
extensive stakeholder input at the local level Identify
“needs” and issues that would be missed by only analyzing state-level information Focus local MCAH efforts by having each jurisdiction identify priority areas they will focus on during the next 5 years
6Title V Maternal, Child Adolescent Health Needs Assessment
Slide77Our Community Residents
CountyState
Total 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
Slide8Socio-Ecological Models
Slide9Lifecourse
Model
Slide1010
Health Happens where weLIVE
LEARN
WORK
and PLAY
Slide1111About our Community
CountyState
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 17
Source: 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 rate
Source: State of California Employment Development Department., 2009-2011
12.3
% of Children receiving free or reduced price meals at school
Source: 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 9-12
Source: California Dept. of Education, California Basic Educational Data System (CBEDS), 2009-2011
14.7
Number of days with ozone above regulatory standards
Source: Centers for Disease Control and Prevention, National Environmental Public Health Tracking Network (Jul. 2013), 2011
16
Slide12Bright spots - where we are doing significantly better than the State, have met Healthy People (HP) 2020 goals, or have improved over timeAreas for improvement
– where we are doing significantly worse than the State, have gotten worse over time, or are not meeting HP 2020 goalsAdditional 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 possible12Data Highlights
Slide13Bright 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 trimester
2
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)
13
Indicators of
Access to
and Utilization of
Care
Source
:
1
Small
Area Health Insurance Estimates (SAHIE
), 2009-2011,
2
California Center for Health Statistics, Vital Statistics, Births Statistical Master File, 2009-2011
Slide1414
Bright Spot: Children and Women without Health Insurance
Source
: Small Area Health Insurance Estimates (SAHIE
), 2009-2011
Slide1515
Data of interest: Children and women who visited a doctor in the last year
Source
:
CHIS (California
Health Interview
Survey), 2011-2012
Slide16Areas 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)
16
Health Indicators for
Women and Mothers
Sources:
1
California
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
Slide1717
Area for improvement: Smoking during 1st
or 3
rd
Trimester of Pregnancy
+ Regional Data
Source: MIHA
(Maternal Infant Health Assessment Survey
), 2011
Slide18Data 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)
18
Health Indicators for
Women
and Mothers
Sources:
1
California State Department of
Justice, Office of the Attorney
General,
Domestic Violence-Related Calls for Assistance, 2009-2011;
2
Office of Statewide Health Planning and Development (OSHPD). Hospital discharge data, 2009-2011
Slide19Bright 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%)
19
Indicators of Infant Health
Source: California Center for Health Statistics, Vital Statistics, Births Statistical Master File, 2009-2011
Slide20Bright 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
20
Nutrition and Physical Activity Indicators
Slide2121
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
Slide22Bright Spot - Teen birthsBirths 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 achievedBirths declined from 19.9 per 1,000 females age 15 to 17 in 2000-2002 to 13.5 in 2009-201122Child and Adolescent
Health Indicators
Source
: California Center for Health Statistics, Vital Statistics, Births Statistical Master File, 2009-2011
Slide23Areas for improvement - Births within 24 months of a previous birth per 100 females under 20 years old delivering a live birthIncreased from
51.2% in 2000-2002 to 67.0% in 2009-2011Significant increasing trend for White females under 20 to giving birth within 24 months of a previously giving birth23Child and Adolescent Health Indicators
Source: California Center for Health Statistics, Vital Statistics, Births Statistical Master File, 2009-2011
Slide24Areas 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)24
Child and Adolescent
Health
Indicators
Source: Office
of Statewide Health Planning and Development (OSHPD). Hospital discharge data, 2009-2011
Slide2525
Area for Improvement: Death Rates
Source: Death
Statistical Master
files, 2009-2011
Slide26Summary 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 1
st
or 3
rd
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
Slide27Summary 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 1
st
or 3
rd
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