Boston Births and Infant Deaths, 2000 Barbara Ferrer, PhD, MPH - PowerPoint PPT Presentation

Boston Births and Infant Deaths, 2000 Barbara Ferrer, PhD, MPH Deputy Director Boston Public Health Commission February 26, 2002

Boston Births,1990-2000 12,000 11,000 10,332 Number of Births 9,700 10,000 9,273 8,808 9,000 8,450 8,079 8,017 8,034 7,883 7,822 7,717 8,000 7,000 6,000 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

Live Births by Race/Ethnicity of the Mother Boston, 2000 White Other/Unknown 35.2% 3.8% Asian 8.3% Hispanic 21.7% Black 31.0% DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

Births by Age of Mother Boston and Massachusetts, 2000 35.0% Percentage of All Births Within Age Group 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% Ages Ages Ages Ages Ages <20 20-24 25-29 30-34 35+ 10.0% 19.0% 24.9% 28.1% 18.1% Boston % 6.6% 14.7% 24.2% 32.9% 21.6% MA % DATA SOURCE: Boston resident live births and Massachusetts resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

Multiple Births as a Percentage of All Births by Race/Ethnicity by Year Boston, 1991-1998 White Black 5.0% 5.0% 4.0% 4.0% 3.0% 3.0% 2.0% 2.0% 1.0% 1.0% 0.0% 0.0% 1992 1993 1994 1995 1996 1997 1998 1999 2000 1992 1993 1994 1995 1996 1997 1998 1999 2000 Hispanic Asian 5.0% 5.0% 4.0% 4.0% 3.0% 3.0% 2.0% 2.0% 1.0% 1.0% 0.0% 0.0% 1992 1993 1994 1995 1996 1997 1998 1999 2000 1992 1993 1994 1995 1996 1997 1998 1999 2000 DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

PROMISING INDICATORS

Birth Rates Among Adolescents Ages 15-19 By Year and Race/Ethnicity of the Mother Boston, 1992-2000 140.0 Births per 1,000 Females Ages 15-19 120.0 100.0 80.0 60.0 40.0 20.0 0.0 1992 1993 1994 1995 1996 1997 1998 1999 2000 16.3 18.8 14.2 14.5 11.6 9.5 13.3 10.8 10.2 White 104.3 101.3 98.3 88.1 75.0 76.8 74.6 63.3 63.7 Black 98.5 99.3 120.1 94.9 92.1 101.1 95.1 78.8 71.6 Hispanic 18.1 19.2 18.1 19.3 18.2 26.6 9.8 10.1 10.3 Asian 54.9 54.4 53.2 47.4 43.0 44.9 44.3 37.3 35.3 Boston DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

Self-Reported Smoking During Pregnancy By Race/Ethnicity of the Mother Boston, 1992-2000 Percentage of All Births Within Race/Ethnicity 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 1992 1993 1994 1995 1996 1997 1998 1999 2000 24.4% 17.4% 17.0% 14.6% 14.5% 11.7% 12.0% 9.4% 7.9% White 13.5% 11.8% 12.5% 9.8% 10.6% 8.9% 8.4% 6.8% 7.3% Black 5.5% 4.5% 5.1% 4.3% 4.7% 5.0% 4.1% 3.9% 3.6% Hispanic 2.1% 1.1% 1.1% 0.9% 0.5% 1.9% 1.4% 2.1% 1.7% Asian DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

PRENATAL CARE

Source of Payment for Prenatal Care by Race/Ethnicity, Boston, 2000 90.0% Percentage of Births Within Race/Ethnicity 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% White Black Hispanic Asian 77.9% 37.3% 25.9% 57.3% Private Public 20.9% 61.9% 72.6% 41.8% 1.2% 0.8% 1.5% 0.9% Other* *Includes self pay, Worker's Compensation, and other unspecified sources of payment DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

Adequate/Adequate Plus Prenatal Care* By Race/Ethnicity, Boston,1999 and 2000 95.0% Percentage of All Births Within Race/Ethnicity 90.0% 85.0% 80.0% 75.0% 70.0% 65.0% White Black Hispanic Asian BOSTON 89.9% 80.1% 83.5% 85.0% 84.3% 1999 90.0% 77.4% 76.1% 82.9% 83.7% 2000 *Kotelchuck Index DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

Adjusted Odds Ratios for No Prenatal Care Boston, 1999 No Prenatal Care Adjusted Lower Upper Odds Ratio 95% CI 95% CI Race/Ethnicity † White 1.00 Black 3.53 1.57 7.96 Hispanic 0.78 0.20 2.96 Asian/Pacific Islander and Other 2.85 0.97 8.39 Smoking During Pregnancy No † 1.00 Yes 6.17 3.09 12.35 Method of Payment † Private Insurance 1.00 Non-Private Insurance 5.07 1.92 13.38 †Reference group NOTE: The following variables were excluded from the final regression model because they were not significantly associated with the odds of receiving no PNC: mother's marital status, mother's level of education, mother's age, DATA SOURCE: Boston resident births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

BIRTHWEIGHT and GESTATIONAL AGE

Low, Very Low, and Extremely Low Birthweight Infants As a Percentage of all Births, By Weight and by Year Boston, 1992-2000 14.0% LBW (<2,500 grams) VLBW (<1,500 grams) 12.0% ELBW (<500 grams) Percentage of All Live Births 10.0% 9.2% 9.0% 8.9% 8.8% 8.8% 8.8% 8.8% 8.7% 8.5% 8.0% 6.0% 4.0% 2.1% 2.1% 2.0% 1.9% 1.9% 1.9% 1.9% 1.9% 1.6% 2.0% 0.28% 0.24% 0.23% 0.24% 0.26% 0.21% 0.22% 0.17% 0.18% 0.0% 1992 1993 1994 1995 1996 1997 1998 1999 2000 DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

LBW by Race/Ethnicity of the Mother Boston, 1999 and 2000 14.0% Percentage of All Births Within Race/Ethnicity 12.0% 10.0% 8.0% 6.0% 4.0% 2.0% 0.0% White Black Hispanic Asian 6.2% 12.4% 7.0% 5.5% 1999 6.7% 13.1% 7.9% 6.7% 2000 DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

VLBW by Race/Ethnicity of the Mother Boston, 1999 and 2000 4.5% Percentage of All Births Within Race/Ethnicity 4.0% 3.5% 3.0% 2.5% 2.0% 1.5% 1.0% 0.5% 0.0% White Black Hispanic Asian 1.1% 3.5% 1.1% 1.0% 1999 1.0% 3.9% 1.6% 1.1% 2000 DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

Adjusted Odds Ratios for Very Low Birthweight Boston, 1999 Very low birthweight (<1,500 grams) Adjusted Lower Upper Odds Ratio 95% CI 95% CI Race/Ethnicity White, non-Hispanic † 1.00 Black, non-Hispanic 3.8 2.53 5.84 Hispanic 1.9 0.90 4.03 Asian/Pacific Islander and Other 1.4 0.77 2.68 Plurality Singleton † 1.00 Twins or Higher 12.5 8.41 18.47 Smoking During Pregnancy No † 1.00 Yes 1.89 1.12 3.20 Maternal Birthplace US-Born † 1.00 Foreign-Born ‡ 0.65 0.44 0.96 †Reference group ‡Includes US territories NOTE: The following variables were included in the original model, but excluded because they did not attain statistical significance: source of payment, adequacy of prenatal care, mother's marital status, mother's level of education, mother's age. DATA SOURCE: Boston resident births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

Preterm Births by Race/Ethnicity of the Mother Boston, 2000 16.0% 14.2% Percentage of Births Within Race/Ethnicity 14.0% 12.0% 10.0% 8.9% 8.0% 7.6% 8.0% 6.0% 4.0% 2.0% 0.0% White Black Hispanic Asian Preterm Birth: Less than 37 completed weeks’ gestation DATA SOURCE: Boston resident live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

Adjusted Odds Ratios for Preterm Birth Boston, 1999 Preterm Birth (<37 weeks) Adjusted Odds Lower Upper Ratio 95% CI 95% CI Race/Ethnicity White, non-Hispanic † 1.00 Black, non-Hispanic 1.77 1.47 2.14 Hispanic 1.13 0.90 1.43 Asian/Pacific Islander and Other 1.11 0.79 1.57 Plurality Singleton † 1.00 Twins or higher 18.84 14.36 24.71 Smoking During Pregnancy No † 1.00 Yes 1.47 1.10 1.95 Prenatal Care Adequate Prenatal Care † 1.00 Intermediate Prenatal Care 0.88 0.71 1.10 Inadequate Prenatal Care 0.86 0.57 1.31 No Prenatal Care 3.64 1.71 7.73 Method of Payment Private Insurance † 1.00 Non-Private Insurance 1.90 1.24 2.92 †Reference group NOTE: The following variables were excluded from the final regression model because they were not significantly accociated witth the odds of preterm birth: mother's marital status, mother's level of education, mother's age, mother's birthplace. DATA SOURCE: Boston resident births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office

INFANT MORTALITY

Boston Infant Mortality Rate, 1990-2000 12.0 10.6 9.8 9.1 10.0 8.4 Deaths per 1,000 Births 10.2 8.0 7.4 8.4 7.3 6.0 6.7 6.7 6.3 4.0 2.0 0.0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 DATA SOURCE: Boston resident deaths and live births, Massachusetts Department of Public Health DATA ANALYSIS: Boston Public Health Commission, Research Office