The Goal

Note: Age at death was not available for year s 1947-1948.

Source: VDH, Division of Health Statistics, April, 2011

How do we get there?

An example- Heart Attacks

By The Numbers

Virginia Heart Attacks^

^ Myocardial infarctions (MI)† Age-adjusted mortality rates / 100,000 population. Population data from U.S. Census Bureau‡ Unadjusted hospitalization rates / 100,000 population. Population data from U.S. Census BureauData Source: Mortality rate data – VDH Division of Health Statistics. Hospitalization rate data - Virginia Health Information via the VDH Data Warehouse Prepared by: Health Informatics & Integrated Surveillance Systems – Division of Disease Prevention - Office of Epidemiology

45% Drop in overall

heart attack mortality rates† between 2000-

2009

1,872 Fewer Virginians died from heart attacks in 2009

than 2000

22%2000

1%2009

% disparity between white and black female

heart attack rates ‡

Heart Attack^ Rates† Among Virginia Residents by Race, 2000 - 2009

^ Acute myocardial infarctions, based on ICD-9 code 410. † Unadjusted rates of reported Virginia hospitalization data / 100,000 population. Population data from U.S. Census BureauData Source: Hospital inpatient data provided to VDH Data Warehouse via Virginia Health Information. Prepared by: Health Informatics & Integrated Surveillance Systems staff – Division of Disease Prevention - Office of Epidemiology

Heart Attack^ Rates† Among Virginia Females by Race, 2000 - 2009

^ Acute myocardial infarctions, based on ICD-9 code 410. † Unadjusted rates of reported Virginia hospitalization data / 100,000 population. Population data from U.S. Census BureauData Source: Hospital inpatient data provided to VDH Data Warehouse via Virginia Health Information. Prepared by: Health Informatics & Integrated Surveillance Systems staff – Division of Disease Prevention - Office of Epidemiology

An example- Heart Attacks

The Goal

Infant Mortality – The last Sixty Years

Comparative Deaths - Virginia 2009

740755

937

366

2 1325

2447

0

100

200

300

400

500

600

700

800

900

1000

Motor Vehicle Suicide Homicide Infant Mortality

Num

ber of D

eath

s

>18 years

<18 years

< 1 year

Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 1999-2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Black 14.5 12.9 12.4 15.5 14.5 13.9 14.4 14.4 13.8 15.5 12.2 13.7

Total 7.4 7.2 6.8 7.4 7.3 7.6 7.4 7.4 7.1 7.7 6.7 7.0

Hispanic 5.1 5.7 5.6 5.0 5.1 6.3 5.7 5.2 4.1 6.8 6.1 6.8

White 5.5 5.6 5.4 5.3 5.6 6.1 5.8 5.9 5.5 6.0 5.4 5.6

Asian 1.6 3.3 3.4 2.7 3.7 3.8 2.5 3.2 4.2 3.3 4.0 2.4

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

18.0

Infa

nt

De

ath

s p

er

1,0

00

Liv

e B

irth

sResident Infant Death Rates By Race/Ethnicity

Virginia, 1998-2009

Black

Total

Hispanic

White

Asian

Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 1999-2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

Top 10 Causes of Infant Death Virginia, 2009

Disorders Related to Short Gestation and Low Birth

Weight , 146

Congenital Malformations, Deformations, and

Chromosomal Abnormalities, 127

SIDS, 78

Maternal Complications of Pregnancy , 54

Complications of Placenta, Cord, and Membranes, 37

Other Conditions in the Perinatal Period, 36

Necrotizing Enterocolitis of Newborn, 24

Unintentional Injury (Accidents) , 25

Abnormal Clinical Findings , 21

Respiratory Distress, 21

Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 1999-2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

Resident Preterm* BirthsVirginia, 1990-2009

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Pre

term

Bir

ths

Preterm Births Number 8,079 7,902 8,471 7,971 8,353 8,546 8,996 8,942 9,431 9,658 10,321 9,904 10,236 10,810 11,405 11,333 11,151 11,621 11,211 10,678

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 1999-2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

7.2

7.8

6.8

6.9

7.0

7.1

7.2

7.3

7.4

7.5

7.6

7.7

7.8

7.9

2005 2006 2007 2008 2009

Year

Pe

rce

nt

of

late

pre

term

bir

ths

(34

-36

co

mp

lete

d w

ee

ks)

The rate of late preterm births declined by 8% from 2005 to 2009.

Source: Virginia Department of Health, Division of Health Statistics, compiled by the Office of Family Health Services, Division of Child and Family Health, 2005-2009

Virginia’s Late Preterm Birth Rate is Declining

Virginia’s Teenage Pregnancy Rate is Declining

Source: Virginia Department of Health, Division of Health Statistics, compiled by the Office of Family Health Services, Division of Child and Family Health, 2000-2009

The rate of pregnancies to teens ages 10-19 years declined by 22%

from 2000 to 2009.

24.3

31.3

20.0

22.0

24.0

26.0

28.0

30.0

32.0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Year

Te

en

Pre

gn

an

cy R

ate

p

er

1,0

00

fe

ma

les

ag

ed

10

-19

ye

ars

Source: Virginia Department of Health, Division of Health Statistics, compiled by the Office of Family Health Services, Division of Child and Family Health

By the Numbers

580

Fewer late preterm births in Virginia from 2005 to 2009

1,085

More full-term births in Virginia

from 2005 to 2009

22%

Decline in Virginia’s teen

pregnancy rates from 2000

to 2009

Induced Terminations: National ComparisonUnited States Virginia

Number of Induced Terminations, 2008 1.21 million 25,822

Induced Terminations Rate per 1,000 females ages 15-44, 2008

19.6 per 1,000 16.1 per 1,000

Largest proportion of Induced Terminations:

Race/ethnicity, 2008 Non-Hispanic White (36%) Non-Hispanic White (42%)

Age group, 2008 20-29 years (58%) 20-29 years (57%)

Marital Status, 2008 Unmarried (85%) Unmarried (72%)

Previous Induced Terminations, 2008 No previous induced terminations (50%)

No previous induced terminations (45%)

Previous Live Births, 2008 One or more previous live births (61%)

One or more previous live births (60%)

National Data Sources: (1) Guttmacher Institute, Facts on Induced Abortions in the United States, January 2011; (2)Jones RK, Finer LB, and Singh S, Characteristics of US Abortion Patients, 2008, New York, Guttmacher Institute 2010. Virginia Data Sources: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

Induced Terminations: Percent of Total

Pregnancies, Virginia 1999-2009

Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 1999-2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

19.119.419.119.218.4

20.8 20.4

18.818.919.5

18.5

0

5

10

15

20

25

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Pe

rcen

t o

f T

ota

l Pre

gn

anci

es

0

5000

10000

15000

20000

25000

30000

35000

10-14 15-17 18-19 20-24 25-29 30-34 35-39 40-44 45UP

Tota

l Bir

ths a

nd In

duce

d Te

rmin

ation

s

Maternal Age in years

Resident Live Births and Induced TerminationsVirginia 2009

Births

ITOP

104,979 Live Births26,356 Induced Terminations

Source: VDH Division of Health Statistics Resident Live Birth and Induced Terminations of Pregnancy Certificates compiled by the Policy & Assessment Unit, Office of Family Health Services, 2009.

Virginia State Profile 2009

Virginia

Birth Rate(per 1,000 total population)

13.3 per 1,000

Pregnancy Rate(per 1,000 females ages 15-44)

84.5 per 1,000

Infant Mortality Rate(per 1,000 live births)

7.0 per 1,000

Teen Pregnancy Rate(per 1,000 females ages 10-19)

24.3 per 1,000

Induced Terminations Rate (per 1,000 females ages 15-44)

16.1 per 1,000

Immunization Rate(Percent Up-to-Date 4:3:1:3:3:1 Immunizations per 100 24 month old health district clients)1

56.1%

Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, Induced Terminations of Pregnancy, and Infant Death Certificates, and NCHS population estimates 2009, compiled by the Policy & Assessment Unit, Office of Family Health Services. 1VDH Division of Immunization.

Plan First Monthly Enrollment

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

Women Men

*DMAS estimated eligibles based on 2006 Guttmacher Institute WIN data and 2008 Census Bureau percentage of women under 200%FPL who are uninsured and living in Virginia (35.7%) .

*Estimated eligibles: 92,247

The Seen Epidemic

Obesity Trends Among U.S. AdultsBRFSS, 1985

No Data <10% 10%–14%

Obesity Trends Among U.S. AdultsBRFSS, 1990

No Data <10% 10%–14%

Obesity Trends Among U.S. AdultsBRFSS, 1995

No Data <10% 10%–14% 15%–19%

Obesity Trends Among U.S. AdultsBRFSS, 2000

No Data <10% 10%–14% 15%–19% 20%–24%

Obesity Trends Among U.S. AdultsBRFSS, 2002

Source: Behavioral Risk Factor Surveillance System, CDC

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

How do we get there?