Terry L' Richardson, PhD, MPA,

1
ASSESSING MATERNAL AND INFANT MORTALITY USING
GEOGRAPHIC ANALYSIS AND OTHER NON-TRADITIONAL
TECHNIQUES IN AN URBAN ENVIRONMENT

• Terry L. Richardson, PhD, MPA,
• Leslie Lawson, MPH, MPA
• Neal Rosenblatt, MS
• Melinda G. Rowe, MD, MPH

2
Community Assessment and Planning Project (CAPP)

• The Jefferson County Health Department joined
  forces with the County Department for Human
  Services in an initiative to assess the health of
  the community. This assessment planning
  project was coordinated by the two departments
  and included an array of community stakeholders.
• In June, Jefferson County Fiscal Court provided
  50,000 for the endeavor for the 1996-1997 Fiscal
  Year.
• The Alliant Health System Community Health Trust
  provided supplemental funding.

3
Why Community Assessment?

• Identifies strengths and concerns.
• Engages citizens as resources and stakeholders.
• Promotes shared responsibility.
• Creates a snapshot of where we are today.
• Leads to prioritization and action planning.

4
Phase I Create a Snap-Shot(completed July
1997)

• Training and leadership development
• Identified, sought, and collected data
• Analyzed data by Neighborhood Place areas
• Published Community Profile of Jefferson County
  and poster

5
Methods

• The assessment project enlisted quantitative as
  well as qualitative data collection approaches.
• Quantitative data was compiled from a variety of
  sources
• Qualitative data gathered through a community
  engagement process
• Geographical analysis of case level data was
  employed to subdivide the county into ten
  assessment areas for comparison and analysis
  purposes.

6
Results

• Final product of the assessment part of the
  project was a Community Profile
• Neighborhood Place Councils, made up of persons
  who live or work in the service area, determined
  priorities for each area based on reviews of this
  data and other information.
• The overall findings highlight the advantages of
  creatively implementing data from a variety of
  sources to supplement traditional data.

7
Community Profile of Jefferson County, Kentucky
8
(No Transcript)
9
Chapters of the Profile

• Who are we?
• Where do we live?
• What is our social and economic well being?
• How safe are we?
• How healthy are we?
• How are we educating ourselves for the future?
• What is the community saying?

10
How healthy are we?
11
Low Birthweight Babies (2500 Grams of Less) as a
Percent of Total Live Births
12
An Example of Employing GIS Analysis in Further
Assessment and Program Development Activities
13
We start with a question

• Within the Healthy Start area, how many children
  under the age of two years are presently living
  in dwellings that have been cited for lead hazard
  violation(s)?

14
(No Transcript)
15
(No Transcript)
16
(No Transcript)
17
(No Transcript)
18
Phase II Prioritization(completed July 1998)

• Each Council/staff group reviewed and discussed
  information in the Profile
• Each Council/staff group prioritized issues based
  on the following criteria
• The issues were significant to their area
• Community efforts need to be improved to address
  the issues
• Addressing the issue is consistent with the
  Neighborhood Place Mission and Vision
• The Neighborhood Place is likely to impact the
  issue positively with existing resources.

19

• Issues Listed Most Frequently by Councils

• Low school attendance rates and dropouts
• Poverty and sustaining jobs
• Unfavorable pregnancy outcomes

20
Unfavorable Pregnancy Outcomes

• Infant mortality/low birthweight babies/ drinking
  during pregnancy
• Initiation of prenatal care
• Birthrate among teens, and its relationship to
  appropriate recreational/educational activities
• Low birthweight babies born to females under the
  age of 14, and the need to enhance prenatal,
  nutritional and education services to this group.

21
CAPP Phase III Action Planning

• Conduct additional data analysis, so that each
  group can possibly refine its recommendations
  (for example, determine specific target
  populations by age, neighborhood, gender,
  ethnicity, etc.)
• Continue training all participants
• Create a cross-site work group around each of the
  three adopted issues and identify stakeholders to
  participate in planning actions

22
Conclusions

• Whereas county-level data has been traditionally
  used as a factor in deciding local public health
  policy and program interventions, this research
  expands on this factor by investigating health
  disparities across geographic areas within an
  urban environment.
• Comprehensive statistical methods in community
  health planning and assessment activities are
  valuable in establishing local public health
  priorities.

23
Public Policy Implications

• As a result of such sub-level analyses,
  Neighborhood Place Community Councils, the Board
  of Health and other policy or advisory boards,
  are better able to respond to the communitys
  health, education, and human service needs.
• Another important implication found in this
  research is in the importance of involving
  community members as partners in such a process.

24
Thank You