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Evelyn Delgado, Assistant Commissioner

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1 Healthy Texas Babies: A Stakeholder-Driven Approach to Infant Mortality Reduction
Evelyn Delgado, Assistant Commissioner Division for Family and Community Health Services Texas Department of State Health Services

2 Infant Mortality Rate (IMR) Low Birth Weight (LBW) Preterm Birth (PTB)
Birth Outcomes Data Infant Mortality Rate (IMR) Texas: 6.1* African Americans: 9.9 Low Birth Weight (LBW) Texas: 8.5 African Americans: 14.0 Preterm Birth (PTB) Texas: 13.2 African Americans: 17.1 Maternal Age** Less than 20: 13.5% of TX births; LBW 9.6; PTB 14.9 Greater than 40: 2% of TX births; LBW 12.3; PTB 18.6 US Context – IMR: 6.6; LBW: US 8.2; Preterm birth US 12.3 – UNDERLINED are rates that are higher in Texas than the US. African Americans – We see major disparities between African Americans and other groups. Rates for IMR, LBW and PTB in whites and Latinas are similar. Re: Maternal Age – Main points: While Teens make up a larger proportion of the births (in yellow: 13.5%), the outcomes for babies born to mothers over 40 are worse (in yellow), though preterm birth is worse than the state average for both groups. *Data is rate per 1000 live births in 2008 ,Texas Natality and Mortality Files, Texas Department of State Health Services; National Vital Statistics Reports, National Center for Health Statistics, , available at https://www.cdc.gov/nchs/products/nvsr.htm. **Data from March of Dimes PeriStats averaged data.

3 What is Healthy Texas Babies?
Healthy Texas Babies (HTB) is an initiative to decrease infant mortality Goals of Healthy Texas Babies Initiative: Provide local partnerships and coalitions with major roles in shaping programs in their communities Use evidence-based interventions Decrease preterm birth rate by 8% over 2 years Save ~ $7.2 million in Medicaid costs over 2 years

4 Simultaneous Policy Actions
Legislature passed three related perinatal health bills HB 1983 – Eliminates Medicaid payment for elective inductions and c-sections before the 39th week HB 824 – Creates an outreach campaign to promote fathers' involvement with their children before birth HB 2636 – Creates a council to study neonatal intensive care unit regionalization Legislature appropriated $4.1 million in General Revenue funds to DSHS funding the Healthy Texas Babies initiative

5 What We Have Accomplished So Far
NICU Regionalization Dissemination of NICU & OB survey under direction of HHSC HHSC convening NICU council using materials developed by workgroup 39-Weeks initiative Medicaid rules change for reimbursement of non-indicated pre-39 week deliveries March of Dimes and WIC collaboration Development of web-based well-woman curriculum for WIC participants

6 What We Have Accomplished So Far
Increased public awareness of the issue Healthy Texas Babies website & media campaign Tools, best practices and community updates Text4baby – DSHS is lead outreach partner for Texas Fatherhood initiatives WIC is distributing Office of the Attorney General “Maps for Dads” publication in all WIC sites DSHS, OAG working on development of fatherhood survey

7 Distribution of HTB Information & Funds
Fund local initiatives led by coalitions of stakeholders and government organizations Provider education Community Health Worker/Promotor(a) trainings DSHS Grand Rounds Series Texas Health Steps module In-person trainings statewide

8 Moving forward Expand Expert Panel membership
Multi-agency Work Group develops additional deliverables Link to faith community, academic community, etc. Implement programming based on NICU & OB Survey results, results of fatherhood survey and other data collection activities Align HTB objectives with existing programs at the state and local levels

9 National Perspective ASTHO Presidential Challenge DHHS – HRSA
Best Practice Subcommittee for ASTHO Healthy Babies Project DHHS – HRSA Region 4 & 6 Infant Mortality Summit Big 5 – March of Dimes AMCHP Action Learning Collaborative HHS Secretary’s Advisory Committee on Infant Mortality Main points: Multiple opportunities for visibility for this issue at the local level (working with providers, community members) up to the national level. ASTHO Presidential Challenge – Impetus for states to focus on this issue, with Texas serving as a model. Dr. Lakey and other DSHS & HHSC staff participating on Healthy Babies Best Practice Subcommittee. DHHS-HRSA – Region 4 & 6 Infant Mortality Summit to receive technical assistance from HRSA. Collaborative effort among state partners, ASTHO, AMCHP & HRSA on the national stage. Big 5 – March of Dimes invited Evelyn and Rebecca to participate with other Big 5 states to look at data collected and practice change results of the initiative. AMCHP Action Learning Collaborative - looks at role of racism and social determinants of health in the context of infant mortality and data-driven responses (AMCHP, CityMatCH). HHS Advisory Committee on Infant Mortality – feeds into other multistate and federal agency efforts to establish best practices in national programming.

10 For more information or to get involved in the Healthy Texas Babies Initiative:
Aisling McGuckin RN, MSN, MPH Texas Department of State Health Services Office of Title V & Family Health (512) Thank you


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