Michigan Council for Maternal and Child Health Friday notes

September 26, 2014
In this issue
U.S. Still Lags in Infant Mortality Rates, Report Finds
Department of Labor Launches #LeadOnLeave Campaign
House Health Policy Hears Maternal Mortality Presentation
U.S. Still Lags in Infant Mortality Rates, Report Finds
More babies are dying before they turn 1-year-old in the United States than in most of Europe and several other developed countries, a new U.S. government report says.

A greater proportion of premature births and deaths of full-term babies are driving the higher rate, which puts the United States below 25 other countries, according to the report, released Sept. 24 by the Centers for Disease Control and Prevention.

"I think we've known for a long time that the U.S. has a higher preterm birth rate, but this higher infant mortality rate for full-term, big babies who should have really good survival prospects is not what we expected," said lead author Marian MacDorman, a senior statistician and researcher in the CDC's National Center for Health Statistics.

The report compares infant mortality rates in the United States to those of European countries plus Australia, Israel, Japan, Korea and New Zealand in 2010, the most recent year for which data is available.

In the United States, 6.1 infants die per every 1,000 live births, more than double the rates of Finland, Japan, Portugal, Sweden, the Czech Republic and Norway. Still, the U.S. rate is an improvement since 2005, when the rate was 6.87 and had not budged much for five years, according to the report.

The reasons for the higher U.S. rate are complex. Improvements in prenatal care have led to more preemies, who are at higher risk for death, instead of stillbirths, said Dr. Deborah Campbell, a professor of clinical pediatrics at Albert Einstein College of Medicine in New York City. Stillbirths are not included in infant mortality statistics.

But disparities in prenatal care play a role as well, she said.

"The U.S. lags behind other developed countries because there remain significant gaps in access to and utilization of prenatal and preconception care," said Campbell, who is also director of division of neonatology at Children's Hospital at Montefiore Medical Center in New York City. "There is a well-delineated history of racial and ethnic disparities in maternal and infant outcomes in the U.S., with black women and their infants being at greatest risk and having the highest rates of poor outcomes," she said.

Campbell added that it can take three to four generations to overcome effects from past health problems such as malnutrition, discrimination and lack of access to quality health care.

At the same time, it appears that more babies are born before 24 weeks in the United States than in other countries, MacDorman said.

When her study team excluded births before 24 weeks, the U.S. rate improved to 4.2 deaths per 1,000 live births but still lagged behind nine other countries and remained about double that of Denmark, Finland and Sweden.

The infant mortality rate specifically among early preemies (24 to 31 weeks) was mostly similar in the United States and Europe, but the U.S. rate for babies born between 32 and 36 weeks was poorer. For babies born at 37 weeks or later, the United States ranked last.

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Department of Labor Launches #LeadOnLeave Campaign
The Department of Labor has started a social media campaign, calling on states to offer paid family leave. The #LeadOnLeave information, including a video and data on the economic impacts of paid family leave, is available on the department's website here. The U.S. is the only industrialized nation without any paid family leave law.

The Family and Medical Leave Act guarantees unpaid, job-protected leave for men and women to care for their newborn or newly adopted children, seriously ill family members, or their own health needs. However, many workers are unable to take unpaid time off because they cannot afford to do so. In recent years a few states have implemented paid leave programs to ensure that workers have the economic security to meet their families' needs. Paid leave programs have been shown to improve health outcomes for children, ill adults and seniors; reduce turnover and increase employee retention, which cuts down on training costs for businesses; keep workers attached to the labor force; and boost earnings over time.
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House Health Policy Hears Maternal Mortality Presentation
MCMCH Executive Board member Dr. Cheryl Gibson Fountain joined Dr. Matthew Davis, the chief medical executive with the Department of Community Health, for a presentation on maternal mortality in Michigan before the House Health Policy Committee on Tuesday.

The state has seen an increase in maternal mortality--defined as the death of a woman while pregnant or within a year of the end of her pregnancy--since 1990, Dr. Davis noted.

This mirrors an increase nationally. In Michigan, between 2005 and 2011, deaths increased from 6.7 per 100,000 live births to 29 per 100,000, he said.

Dr. Sonia Hassan also presented and said in the state 50 to 60 percent of maternal deaths are preventable. She said the woman's overall health and getting prenatal care with knowledge of the woman's health history is key to preventing death.

Dr. Davis explained the key to addressing maternal mortality is providing health care for all women of reproductive age whether they are pregnant or not. But Michigan's Medicaid program only provides health care during pregnancy for low income women, and that the traditional approach to Medicaid coverage in the state is missing pre-conception health and postpartum health.

Dr. Gibson Fountain noted that while Michigan has a robust system for reviewing maternal deaths, there is currently no requirement that such deaths be reported in a consistent manner. She said DCH has to be the "detective" and keep tabs on those deaths.

Rep. George Darany (D-Dearborn), vice chair of the committee, shared his intention to introduce a bill in the near future to mandate reporting.
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Contributors to this Issue
Gongwer News Service
HealthDay
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Quick Links . . .

Health Endowment Board Announces Final Listening Tour Dates The Michigan Health Endowment Fund board is conducting a listening tour to gain a deeper understanding of the health issues confronting Michigan residents, and to familiarize the public with the Michigan Health Endowment Fund. The listening tour sessions will be an opportunity for participants to respond to questions about health concerns in their community, the barriers preventing people from achieving good health, and approaches that are working well to improve the health and well-being of children and the elderly. Requests for funding are not being accepted at this time. Members of the general public and representatives of health-related organizations are invited to attend. Each session will begin with a presentation by a Michigan Health Endowment Fund board member, followed by facilitated discussion in response to structured questions. The agenda for the listening tour sessions and registration can be found here.
The remaining tour dates and locations are:
October 14, Grand Traverse Resort;
October 20, UAW-GM Center for Human Resources, Detroit; and
November 2, Salvation Army Kroc Community Center, Grand Rapids
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Healthy Michigan Tops 400,000 Enrollments
Not quite six full months after the state's Healthy Michigan plan was opened, the number of enrollments topped 400,000, Governor Rick Snyder announced on Thursday.
When the plan was opened for enrollment on April 1, estimates were that it would have 320,000 enrollees during 2014 and up to 470,000 enrollees in 2015. But the state hit the 320,000 mark by early summer and could conceivably top 470,000 enrollees by the end of 2014. Community Health Director Nick Lyon said the sheer number who have enrolled in six months shows that Michigan residents are ready to take better control of their health.
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MDCH Schedules Sixth Public Input Forum on Integrated Care Demonstration
MDCH will be hosting the sixth public input forum on the state's plan to integrate care for individuals who are dually eligible for Medicare and Medicaid on October 14, 2014, at the Radisson Plaza Hotel and Suites in downtown Kalamazoo. The MI Health Link Forum will be held in the Arcadia Ballroom from 10 a.m. to noon, and MDCH will provide a conference line for interested stakeholders to participate by phone.
For directions to the Radisson Plaza Hotel and Suites, information about participating by phone, or other information about the quarterly forums, visit michigan.gov/mihealthlink.
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Nominations Accepted for 2015 MI-AIMH Conference Awards
At the 2015 MI-AIMH Biennial Conference, "Working Together for the Health and Well-Being of Infants, Toddlers and Their Families: Caring for the Whole Child," MI-AIMH will recognize three individuals who will be awarded the Selma Fraiberg, Betty Tableman and Hiram E. Fitzgerald Awards. The Conference will take place May 17-19, 2015 at the Kalamazoo Radisson in Kalamazoo.
Nominations are due no later than December 5, 2014. Learn more here.