Local facts of life

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As part of its Virginia 2010 health initiatives, the state sought to reduce its infant mortality rate to less than seven deaths per 1,000 live births by June 2010. A statistician at the state Department of Health says that 2010 infant mortality counts will not be available before September.

A map from the Thomas Jefferson Health District shows the frequency of low birth weight in neighborhoods with 50 or more mothers without first trimester care from 1990 to 2006.

However, the state will have to improve upon its recent infant mortality rates to meet the National Department of Health’s Healthy People 2020 target, which lowers the infant mortality rate to fewer than 6.5 deaths per 1,000 live births. To help meet the national goal, Virginia will need to address the infant mortality rate in Charlottesville, which has hovered roughly three deaths per 1,000 births above the state average for the last several years.

To account for annual fluctuations in infant mortality rates, the Virginia Department of Health uses five-year rolling averages. From 2005 to 2009, the most recent five-year span, Virginia posted an infant mortality rate of 7.2 deaths per 1,000 live births—the same average it posted between 1999 and 2003.

During the same time periods, Albemarle County’s infant mortality rate increased to 6.5 from 5.6. And while Charlottesville’s infant mortality rate has decreased, the city’s rate remains 43 percent higher than the state average for the period spanning 2005 to 2009.

“Infant mortality is one of the key indicators in public health to characterize the health of the community,” says Peggy Brown Paviour, a health promotion consultant for the Thomas Jefferson Health District. “In our community, particularly in Charlottesville, we have a higher-than-average infant mortality rate.”

Combined with the county population, that rate is noticeably higher among African Americans—a trend that Paviour sees across Virginia and the country, often in urban areas. In 2009 alone, Charlottesville posted an average infant mortality rate of 8.8 deaths per 1,000 live births. That rate grew to 17.5 per 1,000 live births when measured explicitly among African American residents.

In 2007, the local health department launched a community assessment project called Mobilizing for Action through Planning and Partnerships (MAPP). One of MAPP’s products was the Improving Pregnany Outcomes initative, which created and distributed a pregnancy and parenting resource guide in the area. Paviour notes that more than half of area infant deaths occurred in situations where mothers did not plan their pregnancies.

In addition to providing resource guides, the Improving Pregnancy Outcome workgroup encouraged the UVA Obstetrics/Gynecological Clinic to improve patient access. Since 2009, implemented changes include the elimination of blood tests to confirm pregnancy, which were previously required before patients were allowed to make new appointments, and clinic follow-up with expectant mothers who missed appointments. Clinic Manager Erin Callas did not return multiple requests for comment.

Paviour says that the clinic also offers phone interpretation services and clinic workers with Spanish language skills for patients with limited English. According to the 2010 census counts, the Hispanic population has increased by 167 percent in Albemarle County and 102 percent in Charlottesville during the past 10 years.

Local mothers and those expecting have other resources close at hand. On March 5, Charlottesville will host its first perinatal services fair called Healthy Birth, Healthy Baby, at the Herman Key Recreation Center from 10am to 5pm. The event, says coordinator and Birth Matters VA secretary Kate White, will gather numerous health agencies and nonprofits to provide attendees with information about local birth services.
 

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