Update on Maternal and Infant Health Data in

Update on Maternal and Infant Health Data in Hawaii Donald Hayes, MD MPH CDC Assigned Epidemiologist Family Health Services Division, Hawai‘i Department of Health Centers for Disease Control & Prevention Jan 14, 2016 Hawaii Maternal and Infant Health Collaborative Conference Honolulu, HI

Infant Mortality Infant mortality: the death of an infant in the first 365 days of life Infant Mortality Rate (IMR) usually expressed as deaths per 1, 000 live births

http: //hawaii. gov/health/statistics/vital-statistics/trend_graph/infant_chart. html

Infant Mortality Rate

Source: Family Health Services Division. FHSD Profiles. 2014. Hawaii Department of Health. http: //health. hawaii. gov/about/publications/

Source: Family Health Services Division. FHSD Profiles. 2014. Hawaii Department of Health. http: //health. hawaii. gov/about/publications/

Source: Family Health Services Division. FHSD Profiles. 2014. Hawaii Department of Health. http: //health. hawaii. gov/about/publications/

Infant Mortality Rate 2004 -2013 State Estimate: 5. 6 Source: 2016 Primary Care Needs Assessment Databook

Leading Causes of Infant Death in Hawaii, 2009 -2014 Cause of Death Number Percent of Infant Deaths Preterm related 202 33. 8% Other perinatal 87 14. 6% Congenital malformations 85 14. 2% SUID 64 10. 7% Maternal complications 61 10. 2% Small numbers limit ability to look at trends over time for individual causes – Preterm related and other perinatal show slight increase (3 year rolling averages) – Congenital malformations show slight decrease (3 year rolling averages) – SUID and maternal complications little change (3 year rolling averages) Note: Limited to Hawaii Residents. Infants defined as < 1 year of age. 2014 Data is provisional. FHSD calculations of Office of Health Status Monitoring Death Certificate Data

Intended Pregnancy

Healthy Weight Prior to Conception

Smoking During Pregnancy

Preterm Birth

Back Sleeping

Exclusive Breastfeeding

A brief transition

Short Interpregnancy Interval By Community, 2008 -2013 State Estimate 32. 4%

Source: Family Health Services Division. FHSD Profiles. 2014. Hawaii Department of Health. http: //health. hawaii. gov/about/publications/

http: //health. hawaii. gov/mchb/home/hawaii-pregnancy-risk-assessment-monitoring-system-prams/

Other Facts: • Hawaii’s unintended pregnancy rate is 2 nd in the nation. • Hawaii’s teens have the lowest rate of condom use in the nation. • Hawaii’s teens have the 9 th highest rate of unintended pregnancy. • Hawaii’s teens have the 12 th highest rate of chlamydia in the U. S. Sources: YRBS, Guttmacher Institute, and others

Summary • Since 2004, significant improvement in some indicators • Smoking, breastfeeding, back sleeping • Little change in other indicators • Infant mortality rate, preterm, intendedness, healthy weight • There are disparities across indicators (e. g. , geography race, age, insurance status, income, etc…) • Increasing awareness of preconception and interconception health • HMIHC has work groups with opportunities to get involved that address infant mortality and preterm birth reduction

Acknowledgements Maternal and Infant Health Collaborative Hawaii Department of Health Centers for Disease Control and Prevention Email: Don. Hayes@doh. hawaii. gov

http: //health. hawaii. gov/mchb/home/hawaii-pregnancy-risk-assessment-monitoring-system-prams/