In Turnabout, Infant Deaths Climb in South

[HM2VikingRN, RN]

very very disturbing......

from ny times:

by [color=#004276]erik eckholm

published: april 22, 2007

in turnabout, infant deaths climb in south

hollandale, miss. — for decades, [color=#004276]mississippi and neighboring states with large black populations and expanses of enduring poverty made steady progress in reducing infant death. but, in what health experts call an ominous portent, progress has stalled and in recent years the death rate has risen in mississippi and several other states.

the setbacks have raised questions about the impact of cuts in welfare and medicaid and of poor access to doctors, and, many doctors say, the growing epidemics of [color=#004276]obesity, [color=#004276]diabetes and [color=#004276]hypertension among potential mothers, some of whom tip the scales here at 300 to 400 pounds.

...

to the shock of mississippi officials, who in 2004 had seen the infant mortality rate — defined as deaths by the age of 1 year per thousand live births — fall to 9.7, the rate jumped sharply in 2005, to 11.4. the national average in 2003, the last year for which data have been compiled, was 6.9. smaller rises also occurred in 2005 in [color=#004276]alabama, [color=#004276]north carolina and [color=#004276]tennessee. [color=#004276]louisiana and [color=#004276]south carolina saw rises in 2004 and have not yet reported on 2005.

whether the rises continue or not, federal officials say, rates have stagnated in the deep south at levels well above the national average.

most striking, here and throughout the country, is the large racial disparity. in mississippi, infant deaths among blacks rose to 17 per thousand births in 2005 from 14.2 per thousand in 2004, while those among whites rose to 6.6 per thousand from 6.1. (the national average in 2003 was 5.7 for whites and 14.0 for blacks.) ...

[NRSKarenRN, BSN, RN]

from article:

in 2004, gov. [color=#004276]haley barbour came to office promising not to raise taxes and to cut medicaid. face-to-face meetings were required for annual re-enrollment in medicaid and chip, the children’s health insurance program; locations and hours for enrollment changed, and documentation requirements became more stringent.

as a result, the number of non-elderly people, mainly children, covered by the medicaid and chip programs declined by 54,000 in the 2005 and 2006 fiscal years. according to the mississippi health advocacy program in jackson, some eligible pregnant women were deterred by the new procedures from enrolling.

one former medicaid official, maria morris, who resigned last year as head of an office that informed the public about eligibility, said that under the barbour administration, her program was severely curtailed.

“the philosophy was to reduce the rolls and our activities were contrary to that policy,” she said....

dr. robinson said that the new procedures eliminated unqualified recipients. with 95 enrollment sites available, he said, no one should have had difficulty signing up.

as to ms. morris’s charge that information efforts had been curbed, dr. robinson said that because of the frequent turnover of medicaid directors — he is the sixth since 2000 — “our unified outreach program was interrupted.” he said it has now resumed.

the state health department has cut back its system of clinics, in part because of budget shortfalls and a shortage of nurses. some clinics that used to be open several days a week are now open once a week and some offer no prenatal care.

the department has also suffered management turmoil and reductions in field staff, problems so severe that the state legislature recently voted to replace the director.

oleta fitzgerald, southern regional director for the children’s defense fund, said: “when you see drops in the welfare rolls, when you see drops in medicaid and children’s insurance, you see a recipe for disaster. somebody’s not eating, somebody’s not going to the doctor and unborn children suffer.”...

pa infant death rate is above national level. nurses have convinced our governor and heatlh department to cover pregnant woment and all children without insurance as way decreasing overall medicaid healthcare costs. since advent of children's health insurance program - pennsylvania's program to provide health insurance to all uninsured children and teens ( see chip program )~ 15yrs ago childrens mortality rates have slowly come down along with decrease in hospitalizations. chip income level is now being expanded:

cover all kids is pennsylvania governor edward g. rendell's expansion of the chip progam. with cover all kids, all uninsured children and teens to age 19 in the commonwealth who are not eligible for medical assistance will have access to affordable, comprehensive health-care coverage. now, no family makes too much money for chip. it's the same great program, now available to all families. please click here for more information.

pa medical assistance programs provide two post partum/well child visits, requiring no homecare authorization; americhoice ma hmo provides three visits with auth, we request electronically.

philadelphia has welcome new family ensuring a homecare post partum and/or well child visit for parents/adoptees and caregivers without insurance. i arrange for about 20 -30 visits/month through my homecare agency. :)

other philly programs are: services to assist families to excel and nurse-family partnership program .

as a homecare nurse, seen this true time and again: ounce of prevention worth a pound of cure.

[purplemania, BSN, RN]

A friend is doing research on the perception of AA female adolescents regarding being overweight. Many girls do not consider themselves obese so it is hard to educate them towards wellness. Of course, AA girls are not the only ones, but my friend had to narrow her research and since she is AA she decided to go with that population. Bottom line: perceptions have to be addressed as well as other issues. I remember a patient's mom who spent nearly $10 for food in the vending machines when a meal was FREE to parents of sick kids. She "didn't like anything".

[pickledpepperRN]

My daughter went to a nurse practitioner. This NP spent 45 minutes with her showing her charts, explaining that her BP was already elevated while only in her 30s. She would probably become diabetic too. A computer program showed how her life expectancy was low but she could improve it with exercise and eating healthy food.

Since then she has lost 80 pounds.

Here she was Christmas in 1005 with a friend

And Christmas 2006

She continues to life a healthy way but that NP got through to her when Mom could not. She had to have healthcare access.

She is single with no children.

Look at the slide show with sound. Lots of intervention needed to help those people.

[HM2VikingRN, RN]

Space,

Good for your daughter. She is absolutely gorgeous.

[NRSKarenRN, BSN, RN]

philadelphia's 15th ob unit announced closure febuary 2007. there is just one ob unit out of 5 hospitals in the health system i work. average wait time to see ob is 5.5 weeks.

from maternity care coalition:

more ob units closing in philadelphia

follow the link for a complete list of hospital closings from 1997 to the present.

on february 16, 2007 the philadelphia inquirer reported an alarming announcement - the closure of jeanes hospital's ob services. on march 31, the philadelphia inquirer reported that chestnut hill hospital is reviewing its ob unit and might choose to close as well; thus becoming the 15th ob unit to close in a decade in our region.

maternity care coalition's report childbirth at a crossroads outlines critical crossroads for pregnant women and their families: shrinking healthcare options for women and the strained capacity of the health care delivery system. unfortunately, another hospital closing its obstetric services exacerbates this already dire situation. it remains unclear where the 1,500 births, previously delivered at jeanes, will be directed.

in 2006, fit pregnancy magazine ranked philadelphia 44th out of 50 u.s. cities when looking at "best places to have a baby." the magazine - certainly aimed at women who can afford the products advertised on its pages - looked at affordability of health care, breast-feeding rates, child-care availability, birthing options, and public-health childbirth statistics. the region flunked miserably.

http://www.momobile.org/obstetricsaccess.html

childbirth at a crossroads in the news:

• • momobile staff fears turn taken by maternity units (northeast times)
    
  • alarming news for childbearing families (northeast times)
    
  • remember all women in prescription for pennsylvania
    
  • midwives needed (philadelphia inquirer)
    
  • pa. creates new class of hospital payments to aid temple (philadelphia business journal)
    
  • birthing a new approach to health care: it's time to move to a system that takes care of everyone (philadelphia daily news)
    
  • philadelphia must improve its maternity care (philadelphia inquirer)
    
  • pregnant and uninsured (philadelphia inquirer)

[Spidey's mom, ADN, BSN, RN]

Is there any way to keep links from enlarging this thread (or any thread) to the point where I can't read the whole thing?

steph

spacenurse - lovely photos of your daughter.