1. RISK FACTORS ASSOCIATED WITH LOW-BIRTH-WEIGHTS in NORTHEAST FLORIDA Walter Bowman Northeast Florida Regional Council Carol Brady Healthy Start Coalition of Northeast Florida

2. FLORIDA Healthy Start Coalition of Northeast Florida Northeast Florida Regional Council Jacksonville 2000 – 2002 49,240 Births

3. Northeast Florida 8.9% 4,367 Births Florida 8.2% United States 7.7%

4. Methodology Logistic Regression Analysis via SPSS University of Alabama Birmingham (Infant Mortality Assessment Manual) Data Florida Department of Health Official Matched Data File Goals Build Analytical Capacity Utilize State Data HSC Service Delivery Plan

5. TWO MODELS African Americans Others

6. RESULTS Hypertension Smoking Previous Low-Birth-Weight or Premature Baby Previous Death of Child First Born Short Pregnancy Interval Long Pregnancy Interval Older Mothers CORE RISK FACTORS (Both Models)

7. RESULTS UNIQUE RISK FACTORS African Americans Teen Mothers Others Father on Birth Certificate Low Education

8. RESULTS Hypertension Smoking Short Pregnancy Interval Long Pregnancy Interval Older Mothers Teen Mothers Father on Birth Certificate Low Education MODIFIABLE RISK FACTORS

11. RESULTS Added as Treatment Effect Statistically Significant in Both Models Definition/Data Issues Five Measurement Indices Exuberant Reporting (88% and 95%) PRE-NATAL CARE

12. APPLICATIONS DUVAL COUNTY HEALTHY START COALITION Targeted Service Plan Duval County Health Department and Shands Hospital Jacksonville will provide intensive services to pregnant women with key risk factors. First Coast Family Center, a new HSC provider, will provide education and support services to other pregnant women.

13. EXCLUDED RISK FACTORS Unwed Mothers High Parity High Education Diabetes Alcohol High Risk Zip Codes Previous High-Birth-Weight Baby Optimal Pregnancy Interval Medicaid and WIC

14. UNAVAILABLE RISK FACTORS Socioeconomic Characteristics Drugs Chronic Illnesses Weight Disorders Health and Fitness Stress Environmental Issues Family Planning Issues Previous C-Sections

15. MORE INFORMATION Carol Brady Executive Director Healthy Start Coalition of Northeast Florida 904-279-0885 x140 cbrady@nefrc.org Walter Bowman Manager – Information Services and Data Analysis Northeast Florida Regional Council 904-279-0880 x168 wbowman@nefrc.org

16. THANKS William Sappenfield U.S. Centers for Disease Control and Prevention Dan Thompson Florida Department of Health Thomas Bryant III Duval County Florida Health Department

18. POTENTIAL IMPROVEMENTS Multinomial Logistic Regression Multi-Level Modeling Data for 1998, 1999, 2003, 2004 Pre-Natal Screen, HCMS, PRAMS data Pre-Natal Care Data Medicare and WIC Data Additional Stratified Models Infant Mortality