Maternal Health Needs and Resources in a Changing Community

1
Maternal Health Needs and Resources in a Changing
Community

• Monterey County Health Department,
• Salinas, California

2
DUI Project Team

• Krista Hanni, Research Analyst, Presenter
• Dr. Linda Velasquez, Health Officer
• Dr. Alicia Paris-Pombo, Epidemiologist
• Susan McNelley, Perinatal Services Coordinator
• Darryl Tyler, GIS Analyst, Information Technology
• Robbie Gonzales Dow, Perinatal Outreach
  Coordinator
• Joyce Brown, Head of Public Health Nursing
• Linda McGlone, Injury Prevention
• Judy Garrison, Program Director, Cancer Detection
  Programs

3
Monterey County
Salinas

• 3,322 mi2
• 417,185 people
• 126 persons/mi2
• Largest city Salinas 151,030

4
1990 to 2000 Growth in Median Household Income
5
Latinos A Growing Minority

• 72,000 not citizens out of 181,000 Latinos in
  county

6
County Latino Profile

• Compared to Whites in 2000, Latinos
• Younger
• Lower household income
• Larger household size
• Households more overcrowded
• Less likely to own house
• Less education

7
County Health Profile 2002

• Monterey County saw improvements for most of 36
  indicators over past ten years
• Met HP 2010 objective for 6 indicators
• Better than California for 24 indicators
• Disparity in health within county?

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Socioeconomic Disparities and Health

• Socioeconomic disparities shown to affect health
  outcome
• Poverty one of the better geographic indicators
  of health
• Mothers use of services correlated with
  childrens health

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Objective

• Identify hot spots for maternal health
  indicator within Monterey County in relation to
  services

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Identification

• Area-based Socioeconomic Measure
• in Poverty
• Maternal Health Indicators
• Births by payment method
• Birth weight
• Entry to prenatal care
• Teen births
• Born in Mexico
• Services
• Hospitals
• Clinics

11
How we did it

• GIS Geographic Information Service
• Focus on Salinas for todays presentation
• 1990 and 2000 census data by census tract
• 1998 and 2002 county birth data with addresses
• Use address to map out birth locations

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Where People Live in Salinas
13
in Poverty in 1990 by Census Tract
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in Poverty in 2000 by Census Tract
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Maternal Health Indicators
Percent of teen births
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Hot Spots

• Density 1000 x 1000 ft sq grabs data within
  square mile
• Square is color coded to indicate range
• low middle high

• Deeper red areas are our hot spots

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MediCal No Insurance Births in 2002
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Low Birth Weight Births in 2002
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Late Entry to Care Births in 2002
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Teen (15-17 Years Old) Births in 2002
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Change Hot Spots

• Negative Little Change Positive
• Extremes are most () or () difference between
  1998 and 2002

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Medi-Cal No Insurance Change in Births 1998 to
2002
23
Low Birth Weight Change in Births 1998 to 2002
24
Late Entry to Prenatal Care Change in Births 1998
to 2002
25
Teen (15-17 Years Old) Change in Births 1998 to
2002
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Mexican Born Teen (15-17 Years Old) Change in
Births 1998 to 2002
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Medi-Cal Births and Hospitals
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Medi-Cal OB Providers Clinics in 2002
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Summary

• Hot spot East Salinas
• Hospitals located fine, but concern about closure
  of hospital with most Medi-Cal deliveries
• Identified area of need for obstetric providers
  and clinics accepting Medi-Cal

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Accomplishments

• Identified meaningful indicators
• Spatially represented birth data
• Beginning to develop similar projects for
  children, injury, and cancer

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Lessons Learned

• Difficult to match data to community resources
• Watch for database error
• Teamwork is essential for useful final result
• Include community partners

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Thanks CityMatCH-DUI!We are learning from you.