1. Perinatal Periods of Risk Results 2003-2005 Jacksonville, FL Thomas Bryant III Administrator/Senior Researcher Institute for Health, Policy and Evaluation Research Duval County Health Department

2. Duval County Overview

3. Higher rate than Florida & U.S. –All infant deaths, neonatal deaths, postneonatal deaths, and SIDS deaths –LBW & VLBW Lower rate than Florida & U.S. –Getting prenatal care 1st trimester –Early & adequate prenatal care

4. Duval County Overview

5. Higher rate than Florida & U.S. –Births to adolescent females 15-17 per 1000 females –Repeat births to females 15-19 per 1000 previous teen birth (compared to FL only) –Percent of live births born pre-term

6. 500- 1499g 1500+g Fetal (24+ Wks Gestation) NeonatalPostneonatal Maternal Health/Prematurity N=150 Rate= 3.84 Maternal Care N=95 Rate=2.43 Newborn Care N=46 Rate=1.18 Infant Care N=107 Rate=2.74 Total Feto-Infant Death Rate = 10.55 Rate = #Deaths/(Live Births + Fetal Deaths) * 1000 Total Live Births + Fetal Deaths = 39,047 Total Infants Deaths = 412 PPOR Results 03-05 All Races

7. PPOR Results 03-05 by Race 500- 1499g 1500+g Fetal (24+ Wks Gestation) NeonatalPostneonatal Maternal Health/Prematurity Black N=81, Rate = 6.00 White N=64, Rate = 2.77 RR=2.18 95% CI (1.57, 3.02) Maternal Care Black N=49, Rate=3.63 White N=44, Rate=1.90 RR=1.91 95% CI (1.27, 2.88) Newborn Care Black N=19, Rate=1.41 White N=23, Rate=1.00 RR=1.42 95% CI (0.77, 2.61) Infant Care Black N=40, Rate=2.96 White N=61, Rate=2.64 RR=1.13 95% CI (0.76, 1.68) Total Feto-Infant Death Rate = 13.99 (Black) 8.31 (White) Rate = #Deaths/(Live Births + Fetal Deaths) * 1000 Denominators: 13,507 (Black) 23,111 (White)

8. Internal Reference Group 20 years of age or older Non-Hispanic white women 13 or more years of education Used as the standard because they have the best outcomes

9. 500- 1499g 1500+g Fetal (24+ Wks Gestation) Neonatal Postneonatal Maternal Health/Prematurity All Races: 3.84-2.64=1.20 Black: 6.00-2.64=3.36 White: 2.77-2.64=0.13 Maternal Care All Races: 2.43-1.57=0.87 Black: 3.63-1.57=2.06 White: 1.90-1.57=0.34 Newborn Care All Races: 1.18- 0.82=0.35 Black: 1.41-0.82=0.58 White: 1.00-0.82=0.17 Infant Care All Races: 2.74-1.32=1.42 Black: 2.96-1.32=1.64 White: 2.64-1.32=1.32 Total Difference between Ref Group & All Races: 3.84 Total Difference between Ref Group & Blacks: 7.64 Total Difference between Ref Group & Whites: 1.96 Excess Death Rates as Determined by Using Internal Reference Group

10. Contribution to Mortality Difference Birth Weight Bwt Dist. Mortality Rate Bwt Dist. Mortality Rate 500-7490.8%625.00.4%800.0 750-9990.6%255.80.2%83.3 1000-12490.7%163.30.2%133.3 1250-14990.9%114.00.3%166.7 1500-19992.6%68.21.4%63.2 2000-24998.0%27.94.3%23.2 2500+86.3%5.593.1%2.8 Total100%17.9100%8.5 Black Women Internal Reference Group

11. Contribution to Mortality Difference (continued) Birth WeightBirth Weight Distribution Mortality Rate Combined 500-7493.3-1.12.3 750-9990.80.71.5 1000-12490.70.10.9 1250-14990.7-0.30.4 1500-19990.80.10.9 2000-24991.00.31.3 2500+-0.32.52.2 Total6.92.49.3