Giving Children a Level Playing Field: Perinatal Health Disparities

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Giving Children a Level Playing Field Perinatal
Health Disparities
Rev. Jeannine R. Smalls, MSW, M.Div. Planning
Development Consultant Faith-Based and Community
Initiatives SC DHEC February 21, 2005
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More than a number..

• Infant mortality is a critical indicator of the
  health of a society.
• Overall state of reproductive age womens health
• Quality and accessibility of primary health care
• Predictor of the health of the next generation

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Live Births by Race of MotherSouth Carolina,
1977 - 2002
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South Carolina and United States Infant Death
Rates
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SC Infant Mortality Ratesby Race, Residence
Data, 1984 - 2002
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Leading Causes of Infant Death, SC Residence
Data, 2002
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South Carolina and the United States Neonatal
Death Rates by Race
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South Carolina and the United States
Postneonatal Death Rates by Race
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Percentage of Infant Deaths by Birthweight
GroupSC residence data, 2001 - 2002
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South Carolina Low Birth WeightInfants by Race
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South Carolina Women Entering Prenatal Care in
the First Trimester
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Infant Mortality Rate for Multiple Births in SC,
All Race, 1998 -2002
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Percent of Unintended PregnanciesSouth Carolina,
1993-2001
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Perinatal Regionalization

• System for organizing and maximizing resources
• Levels of Care established for inpatient
  obstetrical and neonatal services
• Most high risk mothers and infants cared for in
  Regional Perinatal Centers
• Ensure education
• Provide surveillance of population

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South Carolina Perinatal Regions
Midlands Perinatal Region
Cherokee
Palmetto Richland Memorial Hospital
York
Greenville
Spartanburg
Pickens
Oconee
Union
Chester
Pee Dee
Lancaster
Marlboro
Chesterfield
Anderson
Perinatal Region
Laurens
Fairfield
Dillon
McLeod Regional
Kershaw
Darlington
Medical Center
Newberry
Piedmont
Abbeville
Lee
Perinatal Region
Marion
Greenwood
Saluda
Richland
Florence
Greenville Hospital System
McCormick
Lexington
(Greenville, Pickens, Anderson, Oconee,Abbeville,
Laurens, Greenwood, Saluda, Edgefield, McCormick)
Sumter
Horry
Edgefield
Calhoun
Clarendon
Williamsburg
Aiken
Spartanburg Regional
Georgetown
Medical Center
Orangeburg
(Spartanburg, Cherokee,
Union, Chester)
Barnwell
Bamberg
Berkeley
Dorchester
Allendale
Colleton
Hampton
Charleston
Jasper
Beaufort
Low Country
Perinatal Region
Medical University of South Carolina
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Fetal and Infant Mortality Reviews (FIMR)

• Community-owned effort to better understand the
  pattern and occurrence of fetal and infant deaths
  and to develop local strategies to reduce these
  deaths.

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Other traditional strategies

• Early Adequate prenatal care
• WIC enrollment
• Caring for Tomorrows Children Program
• Healthy Start projects 3 grants in SC

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The African Methodist Episcopal Churchs Response

• To Infant Mortality

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A Faith Based Structure for Success
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AMEC Structure Continued

• Therefore we have,
• 609 Congregations with more than
• 246,000 congregants statewide.
• Local Church pastors are accountable to the
  Presiding Elder of the districts, and the
  Presiding elders are accountable to the
  Conference and the Presiding Bishop.

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Strategic Goal Number 2 is one of the Priority
Area

• To Develop an AME Health Agenda targeting
  Children.
• Short-term Outcome
• of congregation members who can identify 2 ways
  to prevent infant mortality

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Partnership with Faith Community

• AMEC Ministers Wives and Widows Alliance SKIING
  Initiative.
• Grant from March of Dimes
• Infant Mortality Curriculum
• Vitamins for Brides kits
• Baby Showers and Baskets for Expecting Parents
• Oral Health Initiative for Pregnant Women

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SKIING Supporting Kids and Infants Into the
Next Generation

• SKIING is aimed at reducing infant mortality in
  the African American Communities of SC through
  the education of AME Leaders, members, and
  interdenominational partners.

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Infant Mortality Curriculum

• Provides for on-going training about infant
  mortality, its causes and ways to reduce risks,
  using a table top binder with a curriculum
  designed in partnership with SC DHEC.

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Vitamins for Brides

• An Initiative of the Ministers Wives and Widows
  Alliance to increase intake of folic acid. As a
  part of their pre-marital counseling sessions,
  ministers will distribute a kit with information
  to educate and encourage women to consume folic
  acid every day.

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Basket for Parents to Be

• An Initiative of the Ministers Wives and Widows
  Alliance to educate parents to be about
  prematurity, the role of the fathers, and the
  implementation of strategies in congregations to
  improve birth outcomes.

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Oral Health Pregnancy

• Studies have shown that infections caused by
  peridontal disease (gum disease) can raise a
  womans risk of having a baby too early and too
  small.
• The Womens Missionary Society of the AMEC
  adopted this initiative to educate pregnant woman
  on the risk of peridontal disease.

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Oral Health Initiatives

• In the month of February, the Bishop declares
  Oral Health Sunday for all AMEC statewide.
• Oral Health Summit designed to educate Missionary
  Ladies on the risk of oral health problem in
  pregnant women and to encourage additional
  interdenominational partnerships.

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Continued..

• District Oral Health Initiatives were developed
  by several of the districts to
• 1. Encourage and maintain adequate
  nutrition
• 2. Encourage regular brushing flossing
• 3. Use a fluoride rinse daily
• 4. Maintain routine dental visits.

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Other Strategies for Reducing Infant Mortality in
SC

• Increase Emphasis on Preconceptional Health
• Providers
• Public Awareness
• Decrease Unintentional Pregnancies
• Closing the Health Gap African
  American-Focused Risk Reduction

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SC Infant Mortality Rates by Race (Updated)

• Per 1,000 live Births in 2003 for..
• All Races 8.3 compared to 9.3 in 2002
• Whites 5.9 compared to 5.9 in 2002
• Black Other 13.0 compared to 15.4 in 2002.

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TOGETHER WE CAN MAKE A DIFFERENCE

• Rev. Jeannine R. Smalls, M.S.W., M.Div.
• Office of Minority Health, SC DHEC.