Maternal and Child Health Library

This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html

September 11, 2009

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1. TOOL RELEASED TO HELP CYSHCN LEADERS ASSESS STATE CAPACITY

Examining State Capacity for Achieving a Community-Based Service System for Children and Youth with Special Health Care Needs (CYSHCN) is a tool designed to help CYSHCN leaders assess a state's capacity to implement community-based service systems. The tool, created by Champions for Inclusive Communities (ChampionsInC), is structured around the six performance measures for CYSHCN articulated in the Title V Block Grant. For each measure, a team of state stakeholders can identify (1) who are the needed partners at the state level; (2) what state-level policies and practices should be in place to achieve the outcomes; (3) how states can support community policies and practices; and (4) what are some data sources or ways to measure achievements for children, youth, and families. Resources for obtaining training and technical assistance related to performance outcomes are provided at the end of the document. The tool is available at http://www.championsinc.org/methods/assessment/Community_Level_Needs_Assess.pdf

• The infant mortality rate declined by 93 percent during the 20th century, from approximately 100 infant deaths per 1,000 live births in 1900 to 6.89 in 2000.
• The infant mortality rate was 6.86 in 2005, not significantly different from the rate of 6.89 in 2000.
• Large variations in infant mortality rates among racial and ethnic groups remain. Non-Hispanic black mothers had the highest infant mortality rate (13.63), followed by Puerto Rican (8.30) and American Indian (8.06) mothers.
• The percentage of low-birthweight (less than 2,500 g) births increased from a low of 6.8 percent in 1985 to 7.6 percent in 2000 and 8.2 percent in 2005. However, from 1985 to 2000, birthweight-specific infant mortality rates declined for all birthweight categories.
• The infant mortality rate from congenital malformations decreased by 5 percent from 2000 to 2005, and the sudden infant death syndrome (SIDS) rate decreased by 13 percent, although this change may be due in part to changes in the way SIDS is diagnosed. However, for CODs with a high percentage of deaths to low-birthweight infants, infant mortality rates either plateaued or increased from 2000 to 2005.
• In 2005, 10,364 out of a total of 28,384 infant deaths in the United States were due to preterm-related CODs. The percentage of infant deaths that were preterm-related increased from 35 percent in 2000 to 37 percent in 2005.
• The United States' international ranking in infant mortality fell from 12th lowest in 1960 to 23rd lowest in 1990.

• A total of 386 ob-gyns returned the survey, a response rate of 49.1 percent.
• Respondents largely overestimated the amount of caffeine in a serving of espresso, with only 14.3 percent providing a value in the accepted range. Accurate estimates for a serving of coffee, tea, and Diet Coke were provided by 66.70 percent, 63.90 percent, and 57.80 percent of respondents, respectively.
• When asked to report what was considered to be "high levels of maternal caffeine consumption," 15.8 percent wrote that they did not know, and 52.6 percent left the question blank.
• Ninety-six percent of those who provided an answer correctly indicated that caffeine can be passed through breast milk; however, only 24.8 percent indicated that the metabolism of caffeine slows as women progress through pregnancy.
• More than half of the respondents (61.7 percent) advise some clients to consume caffeine during pregnancy for the following reasons: alleviate headaches (51.8 percent), relieve caffeine withdrawal symptoms (32.8 percent), improve mood (2.8 percent), and other (4 percent).