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Transcript of Massachusetts Births 2005 Center for Health Information, Statistics, Research, and Evaluation...
Massachusetts Births 2005
Center for Health Information, Statistics, Research, and Evaluation
Division of Research and Epidemiology
Registry of Vital Records & Statistics
MassCHIPCenter for Community Health
Massachusetts Department of Public Health
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
I. Overview of 2005 Births and Comparison with U.S. indicators
II. Birth Trends
III. Selected Maternal Characteristics
IV. Infant & Fetal Mortality
V. Cesarean Section (C-Section) Deliveries
VI. Teen Births
VII. Selected Communities
VIII. Summary
Outline
Overview of 2005 Births and
Comparison with U.S. Births
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
2005 Massachusetts Birth Characteristics
On an average day
68 Cesarean sections
12 Teen births
17 Low birthweight
19 Preterm
10 Multiples16 Inadequate prenatal care
1 Infant death
210 births
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
MA U.S.
Fertility Rate (births /1000 ages 15-44) 55.6* 66.7 Teen Birth Rate (births/1000 ages 15-19) 21.7* 40.4
% Low Birthweight (< 5.5 lbs) 7.9 8.2
Infant Mortality Rate (IMR) 5.1* 6.82
(deaths per 1,000 live births) % Smoking during pregnancy 7.2* 10.22,3
% Prenatal Care 1st trimester 83.2* 83.92,3
% C-Section 32.3* 30.2
A Comparison of 2005 Birth IndicatorsMassachusetts v. U.S.1
1. National Vital Statistics Report, Preliminary Births for 2005. Released on November 22, 2006. 2. Preliminary 2004 data. National Vital Statistics Reports, Vol. 54, No. 19, June 28, 2006. Data for the U.S. for 2005 have not yet been released. 3. Based on a 40- or 41-state reporting area.
*Statistically Significant (p ≤ .05)
Birth Trends in Massachusetts
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Massachusetts Births1995 & 2005
Number of Births 76,824 -6%*Teen Birth Rate (births/1000 ages 15-19) 21.7 -28%*% Smoking during pregnancy 7.2 -47%*
Infant Mortality Rate 5.1 - -(deaths per 1,000 live births)
- White non-Hispanic IMR 4.3 -2%- Black non-Hispanic IMR 9.4 -15%- Hispanic IMR 7.8 +8%
% Low Birthweight 7.9 +23%*% C-Section 32.3 +57%*% Multiple Births 4.6 +44%*
% change 2005 1995 and 2005
* Statistically Significant (p≤.05)
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
• A trend analysis tool developed by the National Cancer Institute
• Creates a “model” (graph) that best describes the trend in events
• Points where the trend turns around are called “joinpoints”
• Shows the Annual Percentage Change (APC) for each line segment in the model
Joinpoint Analysis (JPA)
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
70
75
80
85
90
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005Year
Nu
mb
er
of
Bir
ths i
n 1
000s
Trend in the Number of Births Massachusetts: 1990-2005
92,460
76,824
-1.9%* APC
-2.0%* APC
1996
0.2% APC
2002
* Statistically Significant (p ≤.05) APC = Annual Percentage Change
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
54,238
34,429
18,351
42,391
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
1980 1985 1990 1995 2000 2005
Year
Nu
mb
er
of
bir
ths
Number of Births by Mother’s Age (< 30 and 30+) Massachusetts: 1980-2005
Ages > 30
Ages < 30
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
107.7115.6
0
20
40
60
80
100
120
140
15-19 20-24 25-29 30-34 35-39 40-44
Mother's Age
Bir
th r
ate
(p
er
10
00
liv
e b
irth
s)
Age-specific Birth Rates Massachusetts vs. U.S.: 2005
MA
US
US Source: Births: Preliminary Data for 2005, NCHS. November 21, 2006
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Percent of Births by Race and Hispanic Ethnicity
Massachusetts: 1990-2005
7.7
7.9
3.6
6.8
9.1
13.1
0
2
4
6
8
10
12
14
1990 1991 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Pe
rce
nt
of
bir
ths
Asian non-Hispanic
Black non-Hispanic
Hispanic
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
% Non-U.S. Born Mothers Massachusetts: 1990-2005
26.1%
14.7%
0%
10%
20%
30%
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Pe
rce
nt
of
bir
ths
1995 +1.3% APC
+5.4%* APC
* Statistically Significant (p ≤.05) APC = Annual Percentage Change
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Ethnicity 2000 2005 % Change
Brazilian 1,033 2,058 +99%*African 689 1,197 +74%*
Ghanaian 112 188 Moroccan 64 149
Kenyan 47 110
Salvadoran 736 1,046 +42%*Haitian 1,026 1,136 +11%Cape Verdean 773 872 +13%
Births by Selected Mothers’ Ethnicities
* Statistically Significant (p ≤.05)
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
3,565
2,411
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
1990 1991 1992 1993 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Nu
mb
er
of
Bir
ths
Number of Multiple Births Massachusetts: 1990-2005
1998
+3.8%* APC
1995
+8.0%* APC
+2.0% APC
2002
-2.0% APC
* Statistically Significant (p ≤.05) APC = Annual Percentage Change
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
5.8
7.9
4
5
6
7
8
9
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Pe
rce
nt
of
LB
W B
irth
s (
%)
Low Birthweight (<2500g or 5.5lbs)Massachusetts: 1990-2005
+2.2%* APC
* Statistically Significant (p ≤.05) APC = Annual Percentage Change
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Low Birthweight Adjusted by Plurality1 Massachusetts: 1990-2005
5.8
7.9
6.9
4
5
6
7
8
9
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Pe
rce
nt
of
LB
W B
irth
s (
%)
LBW % Adjusted by plurality*
1 Plurality-adjusted LBW rate using 1990 plurality distribution as standard
Selected Maternal Characteristics
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Births by Race and Hispanic Ethnicity Massachusetts: 2005
White non-Hispanic
69.6%
Unknown0.1%
Other2.4%
Asian6.8%
Hispanic13.1%
Black non- Hispanic
7.9%
BIRTHS(n=76,824)
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
9%
80%85%84%
26%
71%
19%
67%
2% 5%
33%28%
6%8%
0%
20%
40%
60%
80%
100%
LBW Smoking PubliclyFinanced
C-Section MultipleBirths
Breastfeed AdequatePrenatal
Care
Pe
rce
nt
(%)
Birth Characteristics by Maternal Education Massachusetts: 2005
Less than high school (age 20+) College graduate or higher
* Statistically Significant (p ≤.05)
*
* *
*
* *
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
5%9%
69%69%
28%
75%
35%
89%
8%7%0.7%
84%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Under 18years
LBW Not married Adequateprenatal care
Breastfeed C-section
Pe
rce
nt
Birth Characteristics by Funding Source of Prenatal Care, Massachusetts: 2005
Privately funded Medicaid
* Statistically Significant (p ≤.05)
*
*
**
*
*
Infant & Fetal Mortality
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
4.6
5.1
7.0
0
1
2
3
4
5
6
7
8
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Year
IMR
(#
dea
ths/
1,00
0 liv
e b
irth
s)Infant Mortality Rate
Massachusetts: 1990-2005
1996
-5.3%* APC
-0.6% APC
* Statistically Significant (p ≤.05) APC = Annual Percentage Change
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
0
2
4
6
8
10
12
14
16
18
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Year
IMR
(#
dea
ths/
1,00
0 liv
e b
irth
s)IMR by Race & Hispanic Ethnicity
Massachusetts: 1990-2005
White non-Hispanic
Black non-Hispanic
Hispanic
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
0
2
4
6
8
10
12
14
16
18
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005Year
IMR
(#
dea
ths/
1,00
0 liv
e b
irth
s)Black Non-Hispanic IMR
Massachusetts: 1990-2005
1992
19952003
+7.1% APC
-11.3% APC
+1.7% APC
-12.6% APC
* Statistically Significant (p ≤.05) APC = Annual Percentage Change
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
0
2
4
6
8
10
12
14
16
18
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005Year
IMR
(#
dea
ths/
1,00
0 liv
e b
irth
s)Black Non-Hispanic IMR with
Linear TrendMassachusetts: 1990-2005
-1.8%* APC
* Statistically Significant (p ≤.05) APC = Annual Percentage Change
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
0
1
2
3
4
5
6
7
8
9
10
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005Year
IMR
(#
dea
ths/
1,00
0 liv
e b
irth
s)Hispanic IMR
Massachusetts: 1990-2005
1999
-5.7%* APC
+5.4% per year
* Statistically Significant (p ≤.05) APC = Annual Percentage Change
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Infant Mortality Rate Effect of Excluding <500g (1.1lb) Infants1
Massachusetts: 1997-2005
5.15.3
3.53.7
0
1
2
3
4
5
6
7
8
9
10
1997 1998 1999 2000 2001 2002 2003 2004 2005
IMR
(#
of
dea
ths
per
1,0
00 l
ive
bir
ths)
1 Calculated using birth-infant death linked files.
IMR all weights
IMR w/o < 500g
46%
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
4.5 4.54.9
5.85.1 5.3
10.4 10.310.0
9.49.1
10.3
9.510.1
4.54.64.65.15
4.64.85.35.35.3
0
2
4
6
8
10
12
1998 1999 2000 2001 2002 2003 2004 2005
Infa
nt,
Fet
al, a
nd
Fet
o-I
nfa
nt
Dea
ths
per
100
0 fe
tal d
eath
s an
d in
fan
t b
irth
s
Infant & Fetal Mortality RateMassachusetts: 1998-2005
Infant & Fetal Mortality
Fetal Mortality
Infant Mortality1
1 Infant Mortality = # of infant deaths/(fetal deaths + live births)
N=848 N=841 N=810 N=791 N=741 N=830 N=780 N=798
Deliveries by
Cesarean Section
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
30.2
22.2
32.3
22.5
18
22
26
30
34
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Per
cen
tInfants Delivered by C-Section
Massachusetts and the U.S. : 1990-2005
US
Massachusetts
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
18
22
26
30
34
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Per
cen
tInfants Delivered by C-Section
Massachusetts: 1990-2005
-2.0%* APC
+6.7%* APC
1997
* Statistically Significant (p ≤.05) APC = Annual Percentage Change
Teen Births
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
White non-Hispanic 12.9* 26.0Black non-Hispanic 36.4* 60.9Asian2 15.3 16.9Hispanic 73.2 81.5
Massachusetts United States1
Teen Births 4,539 414,406
Teen Birth Rates 21.7* 40.4 (births per 1,000 females ages 15-19)
1 National Vital Statistics Report, Preliminary Births for 2005. Released November 22, 2006 2 For U.S. data, Asian category includes persons of Hispanic and non-Hispanic origins
Births to Teens (15-19 years)Massachusetts and U.S. : 2005
*Statistically Significant (p ≤.05)
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
40.4
51.0
21.7
28.7
0
10
20
30
40
50
60
70
1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Bir
ths
pe
r 1
,00
0 W
om
en
Ag
es
15
-19 United States
Massachusetts
Teen Birth RatesMassachusetts and U.S. : 1985-2005
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
28.7
21.7
0
5
10
15
20
25
30
35
40
1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Bir
ths
pe
r 1
,00
0 W
om
en
Ag
es
15
-19
Teen Birth RatesMassachusetts : 1985-2005
+5.6%* APC
-3.5%* APC
* Statistically Significant (p ≤.05)
1990
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Highest Teen Birth Rates (Among Communities with at Least 75 Teen Births)
Massachusetts: 2005
BirthRank1
Rate2
1 96.8 -23%2 75.0 -10%3 71.7 -38% *4 71.6 -14%5 58.9 -12%6 51.4 -39% *7 49.5 -19%8 47.3 -37% *9 40.7 -40% *
10 37.2 -34% *21.7 -28% *
% Change1995 & 2005
HOLYOKECHELSEALAWRENCESPRINGFIELD
LYNN
WORCESTER
Massachusetts
NEW BEDFORDLOWELLFALL RIVER
BROCKTON
1 Ranking by highest teen birth rates among communities with at least 75 teen births2 Births to females 15-19 per 1,000 females ages 15-19 * Statistically Significant (p ≤.05)
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Central22.6
Southeast23.1
Northeast22.9
Western31.0
Boston29.4Metro
West8.3
Teen Birth Rates by DPH Regions, Massachusetts Births 2005
Region's Teen Birth Rateper 1,000 15-19 Female Population
Significantly higher than state rate
Not different from state rate
Significantly lower than state rate
MA Rate: 21.7
Teen Birth Rates by MDPH Regions Massachusetts: 2005
Birth Outcomes for Selected Communities
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Highest Infant Mortality RatesAmong the 30 Largest Communities1
Massachusetts: 2005
1Selected among the 30 Massachusetts communities with the largest populations. IMR = infant deaths per 1,000 live births. 2A Confidence Interval for a population parameter is a range in which you are 95% certain that the true population estimate is within. It is a function of variability and the number of events.
* Statistically Significant (p ≤.05)
IMR 95% CI2 Number of Deaths
State 5.1 [4.6, 5.6] 391
Worcester 13.9* [9.4,18.4] 36
Malden 11.4 [4.0, 18.7] 9Revere 10.9 [2.9, 18.9] 7Springfield 10.6* [6.4, 14.7] 25
New Bedford 8.6 [3.8, 13.5] 12
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Infant Mortality RatesSpringfield: 1990-2005
11.0
4.6
10.610.2
0
2
4
6
8
10
12
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Infa
nt
Dea
ths
per
100
0 in
fan
t b
irth
s
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Infant Mortality RatesWorcester: 1990-2005
7.0
12.1
4.3
7.7
13.9
0
2
4
6
8
10
12
14
16
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Infa
nt
Dea
ths
per
100
0 in
fan
t b
irth
s
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Percent of Mothers Receiving Adequate Prenatal Care for 30 Largest Communities1
Massachusetts: 2005
Massachusetts 84.0%
Best Brookline 94.7%*Cambridge 89.5%*Fall River 85.7%Boston 84.1%
WorstPittsfield 61.0%*Lowell 68.2%*
1Selected among the 30 Massachusetts communities with the largest populations. *Statistically Significant (p ≤.05) Based on the Adequacy of Prenatal Care Utilization (APNCU) Index
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Percent Low Birthweight for 30 Largest Communities1
Massachusetts: 2005
Massachusetts 7.9%
BestLeominster 5.5%*Barnstable 4.0%
WorstBrockton 11.5%*Revere 10.9%*New Bedford 10.6%*Springfield 9.8%*Lowell 9.2%
1Selected among the 30 Massachusetts communities with the largest populations. *Statistically Significant (p ≤.05)
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Summary – Successes
Many Massachusetts perinatal health indicators are better than those of the U.S.
Continued decline in teen birth rates
Fewer women are smoking during pregnancy
4 out of 5 women receive adequate prenatal care
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Trends that must be closely monitored:
Low birthweight & preterm births
Multiple births
C-Section deliveries
Decline in overall number of births
Slight up-tick in IMR from 2004 and increase in selected communities
Summary– Challenges
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
• Black non-Hispanic IMR is twice as high as the white non-Hispanic IMR
• Hispanic teen birth rate is almost 6 times that for white non-Hispanics
• Cambodian, Central American, and African mothers are less likely to receive prenatal care in their first trimester
• Low birthweight rates in Brockton, Revere, and New Bedford are at least 2 times the statewide rate
• Less educated mothers have worse birth outcomes than more educated mothers
Disparities Persist by Race, Geography, and SES
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Infant Mortality Rate Massachusetts: 1842-2005
0
50
100
150
200
250
Year
De
ath
s p
er
1,0
00
liv
e b
irth
s
2005
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
How Can You Access theMassachusetts Births 2005 Report?
• Hard Copies: (617) 740-2670
• TDD/TTY: (617) 624-6001
• DPH Website:
mass.gov/dph/bhsre/resep/resep.htm#birth
Source: Massachusetts Department of Public Health, Center for Health Information, Statistics, Research, and Evaluation
Accessing Massachusetts Births 2005 Data on MassCHIP
• MassCHIP (DPH’s Internet-based public health information service)
•Website: http://masschip.state.ma.us
•Telephone: 1-888-MASCHIP (Mass only) (617) 624-5629
•New Release (Version 3.0 r 316)
- Massachusetts Births 2005
- Updated Data Sets
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