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Home My WebLink AboutIR 7859 INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 7859 PkATE 0 August 30, 1994 FOR., To the Mayor and Members of the City Council T!'XA5 Subject: INFANT MORTALITY IN FORT WORTH APPEARS TO BE DECLINING 1873 Infant mortality has been a major concern of the residents of Fort Worth and their City Council since at least 1986 when Health Director Brooks Taylor released the first report on the subject. The issue has been much discussed and after some rather bad publicity in 1990 following the release of the 1989 Fort Worth statistics, which were much higher than the state average, we redoubled our efforts to address this problem. Since that time the health departments, the hospital district and the private sector have worked together to reduce our infant mortality. The data indicate that we are having some success. We are approaching the state average and this trend hopefully will continue. The rate has declined in each year since 1989 until 1993 when the provisional data indicate a rise to the 1991 level. The interpretation of rates such as this requires a long term analysis, not concentration on a single year. There will continue to be annual fluctuations in the rate; however the trend appears to be downward. There are no guarantees that this rate will continue to decline, but certainly continued government and private sector support for services designed to address the issue will significantly contribute to controlling infant mortality. What follows is information on what the health departments gave done both independently and in collaboration with others. These various efforts contribute to controlling infant mortality. INFANT MORTALITY.-RATE.(IMR) DEFINITION I MR is defined as the number of infants born live who die before their first birthday, divided by the number of live births during a period of one year. It is usually expressed per 1 ,000 live births. An infant is a baby less than 12 months old. Most abortions do not affect the infant mortality rate since these are not defined as live births and a birth certificate is not issued. Simply stated: the IMR represents the chance a newborn child has of surviving its first year of life. CITY ISSUED BY THE CITY MANAGER ART WORTH,TEXAS ................ ...................-1--.........................1-........... ...... --------------- ' INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 7859 TE August 30, 1994 To the Mayor and Members of the City Council Page 2 of 5 X Subject: INFANT MORTALITY IN FORT WORTH APPEARS TO BE DECLINING FACTORS AFFECTING THE IMR A community's IMR is an important health statistic, an indicator of the overall health status of the community. Complications of low birth weight (1-13W) are the main causes of death of infants. Babies weighing less than 5-1/2 pounds at birth are 40 times more likely to die during their first four weeks of life. Infants born prematurely or term babies who did not grow adequately prior to birth comprise this category. Low birth weight has been associated with: Poor prenatal nutrition Maternal illicit drug and alcohol abuse Maternal tobacco use Teenage pregnancy Infections diseases during pregnancy Genetic factors HEALTH DEPARTMENT INTERVENTIONS TO DECREASE FORT WORTH'S IMR (aimed at the MAJOR CAUSE: low birth weight) 0 PRENATAL CARE-This service provides essential services during pregnancy to the pregnant woman and her family. 0 Screening for Disease 0 Tobacco, drug and alcohol abuse counseling and referral 0 Fetal growth monitoring 0 Aggressive community outreach 0 Comprehensive educations, i.e., parenting skills, nutrition, biology of pregnancy, accessing community resources 0 Women, Infants and Children (WIC) Program 0 Outreach - This service aggressively seeks to overcome barriers to health services and to advocate on behalf of the pregnant woman and her family. 0 Case Management - Initiated 1992 ffFICIAL RECORD 0 Home Visits 0 Client transportation, e.g., taxi vouchers CITY SECRETARY F11. WORTH, TEL ISSUED BY THE CITY MANAGER FORT WORTH, TEXAS ~ INFORMAL REPORT TO CITY COUNCIL MEMBERS No, 7859 AATE August 30, 1994 Mon. To the Mayor and Members of the City Council Page 3 of 5 xp Subject: INFANT MORTALITY IN FORT WORTH APPEARS TO BE DECLINING 1873 • Adolescent Outreach- Initiated 1989- this program is designed to instill the values of self-esteem and responsibility in youth who are at increased risk for early onset of sexual intercourse and parenting. • Male Responsibility Classes • Mentoring Initiative • Family Planning - Initiated 1992 - This service provides counseling for family planning, educational programs and birth control technology to eligible individuals who are at least 18 years of age. 0 Well Woman Health Services • Education • Birth Control Methods • STD Screening and Prevention INTERVENTION THROUGH COLLABORATION WITH OTHER AGENCIES • Prenatal Program-with the Tarrant-County Hospital District Since 1988 the health departments have offered prenatal services in conjunction with the Hospital District and Obstetrics and Gynecology Associates at three (3) health department clinics in Fort Worth and one (1) in Arlington. The departments provide the clerks, nurses and nurse practitioners; the Hospital District provides the resident physicians; and Obstetrics and Gynecology Associates provides the staff physicians. The City Council approves the Fort Worth part of this agreement on an annual basis. • Prenatal Program with the University of North Texas Health Science Center Although not in Fort Worth, a similar cooperative program was initiated with UNTHSC in 1993. Services are provided at the Lake Worth Clinic, a T,irrant.jaowity...... facility. MICK RECORD • TRACS Program (Newborn Tracking System) CITY SECRETARY FT. WORTH, TEX. For about four years the TRACS Program has been operated by t �°___- Medical Center. The purpose of the program is to follow low birth weight babies for the first year of their life to insure that they receive needed health, nutritional ISSUED BY THE CITY MANAGER FORT WORTH,TEXAS ~ INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 7859 August 30, 1994 To the Mayor and Members of the City Council Page 4 of 5 Subject: INFANT MORTALITY IN FORT WORTH APPEARS TO BE DECLINING and, social services in order to increase their chances of becoming healthy and productive children and adults. Because of the close relationship between the objective of this program and the objectives of the departments, Children's Medical Center approached the health departments about locating their TRACS staff at 1800 University. Council approved this contract in 1993. Tarrant County Immunization Collaboration In 1991 representatives of the Fort Worth Junior League came to the health departments with a proposal to work in collaboration to improve immunization status in Fort Worth and decrease childhood disease and death resu,lting from vaccine preventable illnesses. This has grown into the Tarrant County Immuniza- tion Collaboration which now includes along with the health departments and the Fort Worth Junior League, theTarrant County Medical Auxiliary, the Junior League of Arlington, the Links, Children's medical Center and a number of other partners. They now sponsor the annual Zoo Day immunizations event as well as a variety of other immunization related activities throughout the County. � Healthy Start Consortium This group representing over fifty (50) organizations and agencies first carne together in the spring of 1991 for the purpose of applying for a federal infant [nQ[ta|i1y reduction grant. Fort Worth's VrOpOsO\ was not funded but some rn8nnb8rS Of the group continue t0 work on a variety of important child health projects including: � Immunization Tracking System 0 Standard Service Eligibility Form For All Providers � Child Death Review Board These three projects are still active. Organizations which continue to contribute to these efforts include the Children's Medical Center, Harris Methodist Health Syetorn' University of North Texas Health Science Center, Fort Worth Independent School District and the Tarrant County Hospital District. Though the Healthy Start Consortium no longer exists an an entity, work begun under i hi � continues. OfFICIAL RECORD CITY SICRETARY | | ^-- ISSUED BYTHE CITY MANAGER FORT WORTH,TEXAS ~ ~ INFORMAL REPORT TO CITY COUNCIL MEMBERS No. 7859 RTE To the Mayor and Members of the City Council, August 30, 1994 X Subject: INFANT MORTALITY IN FORT WORTH APPEARS TO BE DECLINING MAJOR UNRESOLVED PROBLEMS 0 There is one significant contributor to infant mortality in Fort Worth that �eems intractable; that is teen pregnancy. We continue to be at or near the top of the list for teen pregnancy in metropolitan areas year after year. Successful strategies to reduce this problem in our community are not yet at hand. This is primarily because we do not understand the motivations of the adolescent females most at risk for pregnancy. The health departments have undertaken a study of this problem and over the next two years hope to better define it and its potential 0 Infant mortality among Black children continues to be disproportionately high. Black infant mortality remains about three (3) times as high as White infant mortality. While Black infant mortality is found to be higher than White infant mortality across the nation, the proportional relationship is striking and of concern in Fort Worth. The health departments will continue to evaluate this phenomenon and develop specific strategies to address it. SUMMARY Fort Worth appears tnhe experiencing a trend Of decreasing infant mortality. Some Vfthis � deCrO@S8 can be attributed to enhanced service efforts on the part of the health departments and other public and private health service providers. Their efforts should continue and grow. Fort Worth remains significantly above the state |K4R level. Major steps rnuS1 be taken to decrease teen pregnancy. ob ATerre City Manager BT: OFFICIAL RECORD Attachments CITY' SECREFARY FT. WORTH, Trx �—' ISSUED BYTHE CITY MANAGER FORT WORTH^ TEXAS ------ U I I o ARV.11833S 03 u ro 0 0 cr r m 0 Lm !r v, s a ,° I d ;I N C� * c, 0 C r� C � � Ca co of ro o > r° a C o °d d O � � N d W �O CI' CV C7