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2007 COMMUNITY HEALTH DATA ANALYSIS
Maternal and Child Health Indicators
Adequate Prenatal Care
In 2005 the rate for adequate prenatal care (care begun in the first trimester) for Cape Girardeau County exceeds the sate rate. Cape Girardeau County = 91.7, State of Missouri = 87.9 and Cape Girardeau County has only a 7.3 rate for inadequate prenatal care, compared to the state rate of 10.2.
Teen Births
2005 Cape Girardeau County = 30.7 per 1000 | 2005 Missouri = 32.5 per 1000.
Although the sheer numbers and rates of teen births are lower than those for the state, over the last decade, they did not decrease at the same rate as the states' and from 1999–2003, there has been an increase in the county rates — while that state rate continues to decrease. However, from 2004–2005 the county rate did decrease.
Among the contributing factors to teen pregnancy and resulting births are single parent households, percent of children living in poverty, and births to mothers with less than a high school diploma.
Children Living in Single Parent Household :
1990 Cape Girardeau County = 16.6 | 1990 Missouri = 19.5
2000 Cape Girardeau County = 21.2 | 2000 Missouri = 24.3
Children Living in Poverty:
1990 Cape Girardeau County = 14.6 | 1990 Missouri = 17.7
2000 Cape Girardeau County = 11.4 | 2000 Missouri = 15.3
Births to mothers without H.S. Diploma :
1998 Cape Girardeau County = 16.1 | 1998 Missouri = 19.4
2002 Cape Girardeau County = 14.3 | 2002 Missouri = 18.9
2005 Cape Girardeau County = 15.6 | 2005 Missouri = 18.2
Even though the rates are less than the state rates, Cape Girardeau County has increased in all three of these categories over the last ten years .
Birth Spacing
According to MICA, Cape Girardeau County has had a steady decrease in the rateof prenatals that have closely spaced pregnancies(less than 18 months) from 2000 (11.9) to 2005 (11.4). Of those prenatals with closely spaced births, the rates are highest in the black population and those with a 9th–11th grade education. The rate for closely spaced births decreased with the higher the education level. Though individual year data is not statistically reliable, pooled statistics from 2000–2005 show that the 15–17 age group is at highest risk for closely spaced births. WIC participation assessments indicate that from 2004 to 2005, Cape Girardeau County saw a slight decrease rate (from 33.2 to 29.4) in the number of women with closely spaced pregnancies (less than 16 months).
Smoking During Pregnancy
In 2005 the Cape Girardeau County rate for mothers who smoked during pregnancy was 22.1 and the state rate was 18.2. According to MICA the Cape Girardeau County rate has stayed fairly consistent from 2000–2005. In 2005 the age group with the highest rate was the 18–19 year olds (Rate = 49.4) and higher in those with only a 9th–11th grade education level. The higher the education level, the lower the rate for smoking during pregnancy. The black population had a higher rate than the white population (27.7 vs. 21.7). From 2000–2005 WIC participants had the highest smoking rate in 2000 at 34.5 and the lowest smoking rate in 2003 at 23.9. At 30.0, the 2005 rate was higher than the county as a whole.
Births/Mother Education Level
In 2005 Cape Girardeau County had a rate of 15.6 for births to women with less than 12 years of education; the state had an 18.3 rate. Both Cape Girardeau County (17.4) and the state (19.3) had a decrease form the 2000 rates. WIC assessment data indicate that the average educational level for Cape Girardeau County residents was 12 years.
Infant Mortality
Cape Girardeau County has had a decrease in the infant mortality rate from 6.2 for 2000–2004, to 5.6 from 2001 to 2005. The state has seen a stable rate of 7.7 for both time periods. Although the leading causes of infant deaths for Cape Girardeau County (or any county) is not readily identifiable on MICA or the Community Data Profile, the State of Missouri indicates that on a state level, leading causes include very low birth weight (VLBW), Infections, Injuries, and SIDS. Contributing factors to VLBW include preterm delivery, multi–fetal pregnancies, urinary infections, vaginal infections, STD, and uterine or cervical abnormalities. From 1996–2000 infants born with neural tube defects had a lower rate in Cape Girardeau County (2.5) than the rest of the state (6.4). In 2005 MICA data indicates that the rate for multi–fetal pregnancies was 3.8. This rate has been consistent over the past 5 years and is comparable to the state rate.
The low birth weight rate for Cape Girardeau County from 2000–2004 was 7.8 — the state had a 7.9 rate. In 2005 women aged 18–19 years had the highest rate of incidence for low birth weight (16.9) followed by the 25–29 year age group (8.0). Surprisingly women 40 and older only had a rate of 5.0. The rate ran highest in individuals with 12 years of education. The rate was slightly higher in the black population (8.9) as compared than the white population (7.9). There was a small difference between Medicaid (8.9) and non-Medicaid (7.2) participants. Women with no prenatal care ran a 20.0 rate.
Improper Weight Gain
In 2005 prenatals in Cape Girardeau County had a slightly lower rate (8.3) for inadequate weight gain (<15lbs.) than did the state (8.7). The rates ran higher in the 40 plus year old age group followed by the 35–39 year old group, and then the 25–29 year olds. The incidence of inadequate weight gain in the black population (19.5) was over double that in the whit population (7.0). Among WIC postpartum data indicate that the number decreased from 72 (15%) in 2004 to 61 (14%) in 2005.
WIC Participation
Cape Girardeau County Profile: The total number of unduplicated participants has increased from FY03-Fy 07 by 15%. Approximately 77% participants are white, 21% are black, and 2% all other. 6% of the participants are of Hispanic origin. Prenatal, infant, child, and postpartum participation have increased, while teen prenatal participation has decreased.
Total Unduplicated Participants FY2003 = 2,480 FY2007= 2,859
Teen Prenatal (10–17) | 42 on WIC in FY07 — only 29 teen births in CY2007
Mild-Moderate anemia as risk factor (low hematocrit /hemoglobin count):
Prenatal FY2006: 114 | FY2007: 143 (increase)
Infants/Children FY2006: 330 | FY2007: 319
Breastfeeding rates for Cape Girardeau County have increased from 37.9 in 2000 to 42.3 in 2005. More white postpartum breastfeed than do other races and the Cape Girardeau County rate is less than the state rate. The group with the highest rate is the white, married, 30–34 year old, college plus.
The rate of obesity among children enrolled in WIC is lower than the state rate. In 2000, the rate was 7.5 in Cape Girardeau County — state was 5.0. By 2005 the Cape Girardeau rate had decreased to 3.5, while the state rate remained at 5.0. In Cape Girardeau County more of these children were. The highest rate for black participants was among the 3–5 month (age at WIC entry) age group.
Potential WIC eligible being served:
It has been challenging to first of all determine the number of individuals who are eligible for WIC and then to determine of that number how many actually participated in WIC, mainly because like data does not consistently exist from one year to the next, nor between program and state reports. It was not possible to determine from the data sources available just how many infants, children and women might be eligible and had never enrolled in Medicaid. For the purposes of this assessment the following were used to determine this indicator:
Number of Potential WIC eligible = number enrolled in Medicaid during a CY (infant, child, prenatal). This was all on MICA or the Community Data Profile.
Number Actually participating in WIC = The number of infants and children on WIC for a given time came from MICA. The following general statements can be made:
CY2005—52.9% of all infants born participated in WIC (state was 56.9%), 45.7% of white infants (state was 50.6%) and over 100% of black infants. The reason for the greater than 100 participation rate for black infants could be due to the fact that some infants not born in the county move here soon after birth and participate in WIC. (State was 92.4%). This rate of participation has increased slightly since 2000.
CY2005—45.4% of all infants born were enrolled on Medicaid. 85.8% of those Medicaid infants participated in WIC. In Cape Girardeau County, 45.9% of prenatals (based on number of births) participated in WIC, (41.9% of white prenatals, 81.2% of black prenatals).
CY2006—Of the 1831 children (age 1–5) enrolled in Medicaid, 54% participated in WIC. (CY 2005 WIC participation rates were used).
In summary, Cape Girardeau County has had a lower PN Medicaid participation rate than the state since 1990, and a lower PN WIC participation rate since 1996.
Immunization Rates/Health Screenings
For 2005 the rate for WIC infants up–to–date on their immunizations was 96.2%. The rate for the state was only 77.6%. In CY2003, Cape Girardeau County had and immunization rate of 95.1% for children at 24 months of age. These children had received at least 3 DTP, 2 Polio and 1 MMR. In CY2004, the rate remained stable at 94.4%.
Child Death Rates
The Child Death rate for Cape Girardeau County from 1994– 2004 is 18.5. This is lower than the state rate of 25.9 for the same time period. Child death rates decreased in Cape Girardeau County from 21.3 (1994-1998) to 16.2 (1999-2003). The state also had a decrease during these same time periods.
Leading Causes of Death 1–14 years, 1994–2004:
- Unintentional Injury Cape Girardeau County
9.6 | State 10.8
- Cancer Cape Girardeau County 0.7 | State 2.4
- Birth Defects Cape Girardeau County 0.7 | State 2.0
- Homicide/Legal Int. Cape Girardeau County 1.5 | State 2.0
- Heart Disease Cape Girardeau County 0.7 | State 0.9
Unintentional Injury deaths 0–14yrs: From 1994–2004 there were 13 (9.6) deaths due to unintentional injury — the state rate during that period was 10.8. About half of these deaths are attributable to motor vehicle accidents. Other common causes include falls, drug overdoses, fires, and drownings.
Motor Vehicle Deaths 0–14yrs : From 1994–2004 there were 7 or a rate of 5.2. The state had a rate of 55. The Cape Girardeau County rate was lower than the state rate. The difference is considered non-significant due to the smaller numbers in Cape Girardeau County.
Suicide 15–24yrs .: From 1994–2004, Cape Girardeau County had an 11.6 rate in this age group compared to a state rate of 10.6. Again, this difference in rate is considered non-significant statistically.
Lead Screening
The number and percentage of children aged 1–6 years screened for blood lead has increased consistently from CY1995–CY2003, but has since decreased. In Cape Girardeau County in CY1995 64 (1% of target population) were screened, while 10% were screened statewide. By CY2003, the percent for Cape Girardeau County increased to 19% — passing the state percentage of 15%. In CY2006 these numbers had decreased with only 13.10% tested compared to 19.25% statewide.
Medicaid enrollees<1 receiving initial EPSDT
The rate of infants enrolled in Medicaid in Cape Girardeau County increased from 42.7 in 2002 to 47.6 in 2006. The state also had an increase in rates, from 35.4 in 2002 to 49.5 in 2006. In 2006, 449 infants were enrolled in Medicaid, 74.2% were white and 22.7% were black. This represented 47.6% of births. 2006 provincial data indicates that of those infants enrolled in Medicaid (which made them WIC eligible), 79% actually participated in WIC. According to the 2005 assessment 74.5% of Medicaid enrollees received an initial EPSDT during their first year of life.
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