1. The Silent Epidemic Uniting to Reduce Infant Mortality

2. Infant Mortality in Virginia

3. Significance of Infant Mortality World View

4. Infant Mortality: The Problem World Rank

6. Infant mortality rate ranked 18 th highest in the nation by the CDC in 2006 Only ranks within the top 30 states for protecting the lives of infants Infant mortality rate twice as high for African-Americans Infant Mortality: The Problem – Virginia

7. Infant Mortality: Comparative Deaths

8. Just the Beginning of the Uphill Climb 123 more babies lived in 2008

9. Healthy People 2010: 4.5 Total Infant Mortality Rates Per 1,000 Births in Virginia

10. Healthy 2010 Goal: 4.5 Infant Mortality – Recent History

11. Infant Mortality: 5 Year Death Rates by Race/Ethnicity

12. Infant Mortality Rates Per 1,000 Births By Race/Ethnicity 1998-2008

13. Cause of Death20072008 Disorders Related to Short Gestation and Low Birth Weight 194163 Congenital Malformations, Deformations, and Chromosomal Abnormalities 135130 SIDS8160 Maternal Complications of Pregnancy6348 Other Conditions in the Perinatal Period4224 Abnormal Clinical Findings2936 Complications of Placenta, Cord, and Membranes2624 Unintentional Injury (Accidents)25 Top Causes of Death

14. Top 4 Causes of Infant Death, Virginia 1998-2008

15. Infant Mortality by Age at Death

16. Infant Mortality: Maternal Age 2008

17. Infant Mortality by Education and Race/Ethnicity Less than 12 Years12 Years> 12 Years

18. Resident Infant Death Rates by Method of Payment and Race/Ethnicity MedicaidPrivate InsuranceSelf Pay

19. Infant Mortality: By Geography Infant Deaths 2008 VA residents by number of live births

20. Prematurity: The Rising Trend

21. Prematurity*- the problem *Less than 37 weeks Healthy 2010 Goal: 7.6

22. Virginia Resident and Cesarean Births

23. Prematurity and Late Preterm Births 35 Weeks 39 Weeks

24. A premature infant less than 37 weeks sleeping prone is 85 times more likely to die of SIDS A premature infant lying on its side is 40 times more likely to die of SIDS Prematurity and SIDS

25. Prematurity: SIDS Rate and Sleep Position Rates of SIDS Deaths Babies Sleeping on their Backs

26. Engage Healthcare Providers Pregnant women and their families Community Groups Health Insurers Changing Attitudes

27. Accessible prenatal care Promote breastfeeding Education about preterm labor signs and symptoms Decrease smoking and exposure to second- hand smoke Interventions that May Reduce Prematurity/Infant Deaths

28. Assess for substance use and intervene Assess for domestic violence and intervene Reduce major stress levels Refer to community services Interventions That May Reduce Prematurity/Infant Deaths

29. Breastfeeding: The Benefits Lower rates of SIDS Fewer ear infections Fewer asthma/allergy cases Less obesity Less diabetes Fewer childhood leukemia cases Fewer infections in premature babies

30. Educate mothers before birth Provide support from family, friends, healthcare workers, employers, society Provide safe places to nurse and pump Promote Breastfeeding

31. Prematurity and Smoking Exposure to smoking is associated with 20% of all low birth weight babies 8% of preterm births SIDS

32. Prematurity: Smoking and Pregnancy Successful treatment of tobacco dependence 20% reduction in low- birth-weight babies 17% decrease in preterm births

33. Prematurity Birth Defects SIDS Infant Mortality: Causes

34. Good prenatal nutrition Maternal health behaviors/effects Planned pregnancy with early, quality prenatal care Prevention of preterm & low birth weight babies Infant Mortality: Solutions

35. Infant sleep position and environment Family/caretaker violence prevention & safe home Home visiting nurses Infant Mortality: Solutions

36. Infant Mortality Reduction: Spread the Word Control Weight Don’t Smoke Don’t Drink Take Vitamins with Folic Acid Visit Your Dentist Breastfeed

37. Communicate the facts Provide intervention tips Support the Commissioner’s Infant Mortality Workgroup Infant Mortality Reduction: Raise Awareness

38. Commissioner’s Working Group on Infant Mortality Expanded stakeholder concept Social network Multi-prong approach Goal: decrease overall rate AND racial disparities

39. “Saving Babies” Initiative Save babies from dying in their first year of life Focus on results Targeting 10 localities with the highest number of infant deaths Collaborating with other stakeholders

40. Saving Babies Localities Each locality funded $100,000

41. “Saving Babies” Outcomes Determining women at high risk Increasing awareness of signs/symptoms of premature labor Promoting safe sleep education

42. “Saving Babies” Outcomes Improving coordination/ efforts of private and public providers Enhancing outcomes through folic acid promotion, insurance coverage and transportation to prenatal care

43. Pediatrics 101 Interactive education Pediatric residents

44. Infant Mortality Reduction: Practice Safe Sleep Habits Baby should… Sleep alone Sleep on his/her back Sleep in a crib without soft toys, bumper pads or quilts

45. Text 4 BABY Text informational messages Public health focus Pregnancy and Infancy

46. Folic Acid Initiative Local health districts All women of child-bearing age

47. Pregnancy Authorization Decrease time for Medicaid-eligible women to enter care

48. Hampton WalMart Employee IM Project Teach employees basic public health activities and messages around safe sleep, prematurity, healthy pregnancy

49. Healthy People 2020 Education to General Assembly members, Cabinet and Agency leadership Goal: use 2020 metrics in bill language, legislative discussions

50. Grandmother’s Campaign Increase grandmother engagement Partner with AARP: Online community Q&A with Commissioner Article, fact sheet

51. The Silent Epidemic Uniting to Reduce Infant Mortality