Infant Mortality Albemarle, Charlottesville and Virginia 1995-2006

Infant Mortality by Race Albemarle and Charlottesville 1995-2005

Infant Mortality Among Black Infants TJHD, Virginia, U.S. 1998-2004

Neonatal Death Rate (<28 Days) Albemarle, Charlottesville and Virginia 1995-2005

Top 5 Causes of Infant Mortality TJHD, 2002-2006 Source: Division of Women’s and Infant’s Health, Virginia Department of Health

Percent of Low Weight (<2500g) Births Albemarle, Charlottesville, Virginia 1997-2004 Low birth weight is a predictor of infant mortality. LBW can be due to pre-term delivery or small size for gestational age Low birth weight (<2500g)= 40 times greater risk of mortality in neonatal period, very low birth weight(<1500g)= 100 times greater risk1 1 Mathews et al. 2002 NBW = Normal birth weight ( > 2500 grams) LBW = Low birth weight (1500 to 2499 grams) VLBW = Very low birth weight (1000 to 1499 grams) ELBW = Extremely low birth weight (400 to 999 grams)

Percent of Low Weight Births for Black Infants Charlottesville-Albemarle, Virginia, U.S. 1997-2004 Women living in poverty are far more likely to have LBW babies, and Black women more likely to deliver LBW infants than White women, even adjusted for age and poverty.2 The reasons for this disparity are still largely unknown. 2 Ellen, 2000.

% of Infant Deaths by Number of Prenatal Visits Thomas Jefferson Health District, 2002-2006 Source: Division of Women’s and Infant’s Health, Virginia Department of Health

Percent of Births With >10 Prenatal Visits Albemarle and Charlottesville,1999-2004 13-14 visits recommended by ACOG Risk for infant mortality more than 30% higher for women who receive little or no prenatal care Source: National Center for Health Statistics Women who do not have access to or fail to obtain prenatal care may have other risk factors for poor outcomes1 Ensuring that all pregnant women receive prenatal care can help to avoid the behavioral factors that contribute to poor birth outcomes (nutrition, smoking) 1 1 Alexander, et al. 1987

Local Barriers to Prenatal Care Study of Medicaid-eligible moms who delivered at UVA between Dec. 2007 and Feb. 2008 Phone survey Only able to reach 32 of the 125 moms Mean age = 25 (18-38) 50% graduated from high school 78% had not planned pregnancy 97% received some prenatal care (4-20 visits) 78% not married Suggestions from participants: More flexibility in scheduling Schedule appointments over phone

Local Barriers to Prenatal Care Difficulty making appointments Long lag time in getting first appointment Multiple steps Mailed appointment time (in English) rather than scheduling by phone Transportation problems Problems communicating with healthcare providers Feeling too sick to go to appointment Suggestions from participants: More flexibility in scheduling Schedule appointments over phone 11

No 1st Trimester Prenatal Care and Low Birth Weight City of Charlottesville, 1990-2006 The Meadows Greenbrier Barracks Road Barracks Rugby Venable Locust Grove Lewis Mountain Rose Hill North Downtown 10th & Page Starr Hill Martha Jefferson Jefferson Park Ave. Fifeville Woolen Mills Ridge St. Johnson Village Belmont Fry’s Spring

Births To Mothers With Less Than 12th Grade Education, Albemarle, Charlottesville, and Virginia 2002-2005

Fry’s Spring Ridge St. Belmont Barracks/ Rugby Greenbrier 10th & Page Venable Locust Grove Ridge St. Belmont 10th & Page Greenbrier Barracks/ Rugby

Black Mothers’ Education Less than 12 Years South Barracks/Rugby 54% (26) Ridge St./North area 51% (399) 10th and Page 44. 36% (266) Central Fry’s Spring 44% (25) Southwest Belmont 42% (19) Ridge St./South 42% (236) Southeast Venable 40% (75)

Teen Pregnancy Rate Albemarle, Charlottesville, and Virginia 3-Year Rolling Averages, 1997-2005