2013 Year End Report The Lucas County Initiative to Improve Birth Outcomes (Pathways) was formed in 2006 as a community-wide collaborative effort funded by local foundations to improve birth outcomes among those at greatest risk. The program focuses on increasing outcome-oriented care coordination services in Lucas County, Ohio, where an average of 9%* of babies are born at a low or very low birth weight compared to the state* (8.6%) and national** (7.99%) rates. Currently, the Pathways program funds community care coordinators at six agencies (including two major hospital systems, the health department, federally qualified health center and two neighborhood based organizations) that find pregnant women who are at risk for poor birth outcomes and assist them with needed connections to prenatal care, social services, and education. The goal of Pathways is for the women enrolled to have a full term, healthy birth weight baby and complete a postpartum assessment.

2013 Program Highlights

Enrollment in the Lucas County Initiative to Improve Birth Outcomes increased 17% from last year, enrolling 340 women in 2013.

Of the women served, 74% represent a minority population, with 66% being African American.

Women enrolled in the Pathways program in 2013 average 7.1 social risk factors, compared to 5.9 in 2012. The top risk factors identified: African American; low income; unmarried; personal problems; and mental illness. Other risk factors identified include late entry into prenatal care; drug use; tobacco use; domestic violence; uninsured; no transportation; and homelessness. In 2013, 9% of all program births were low birth weight, which is equivalent to the rate for all of Lucas County.

African American women in the program had a low birth weight rate of 9.5%, compared to 13.4% for African Americans in Lucas County.

Program participants who delivered in 2013 averaged 7 prenatal visits during their time in the program, compared to 6.5 in 2012.

74% of women who delivered had a documented post-partum visit 21-56 days after delivery.

*Source: Ohio Department of Health, 2012 **Source: CDC National Vital Statistics Report: Births Preliminary Data, 2012

Low Birth Weight Rate By Race/Ethnicity

Ohio 2012*

Lucas County 2012*

Pathways 2012

Pathways 2013

White Non-Hispanic 7.4% 7.4% 4.3% 7.7%

African American Non-Hispanic

13.8% 13.4% 13.2% 9.5%

1 Risk factors include: African American; less than 18 years or over 35 years; low income; prior poor birth outcomes; tobacco use; alcohol use; drug use; homeless/poor living environment; personal problems; no transportation; domestic violence (current or history).

2 Women referred to social services in multiple years are counted in both of those years, however, cumulatively; the number reflects the total number of women connected to a social service (non-duplicated).

Pathways Enrollment

2013 2012 2007-2013

Pregnant Women Enrolled 340 291 1355

Enrolled First Trimester of Pregnancy 18% 14% 28%

Enrolled Second Trimester of Pregnancy 57% 63% 52%

Enrolled Third Trimester of Pregnancy 24% 23% 20%

Average Number of Risk Factors1 at Enrollment 7.1 5.9 6.1

Number of women that have had a documented post-partum visit (that have delivered more than 6 weeks ago) 73% 81% 77%

Pathways Social Service Referrals

2013 2012 2007-2013

Total Number of Social Services Care Coordinators connected women to

377 335 955

Number of women connected to at least one social service (some women duplicated between years)2 214 174 548

Average Number of Social Services enrolled women are connected to

1.7 1.9 1.7

The Lucas County Initiative to Improve Birth Outcomes is a program of the Northwest Ohio Pathways HUB.

For More Information Contact: Jan Ruma (jruma@hcno.org) or Carly Miller (cmiller@hcno.org) at the Hospital Council of Northwest Ohio at 419-842-0800.

Pathways Birth Outcomes

2013 2012 2007-2013

Number of Births 240 (including twins) 232 (excluding twins)

177 (including twins) 167 (excluding twins)

956 (including twins)

919 (excluding twins)

Healthy Birth Outcome >/= 5 pounds & 8 ounces (excluding twins)

211 (91.0%) 149 (89.2%) 815 (88.7%)

Low Birth Weight < 5lbs. 8 oz., > 3lbs. 4 oz. (excluding twins)

20 (8.6%) 17 (10.2%) 94 (10.2%)

Very Low Birth Weight </= 3 pounds & 4 ounces (excluding twins)

1 (0.4%) 1 (0.6%) 10 (1.1%)

Full Term: >/= 37 weeks gestation (excluding twins)

206 (88.8%) 148 (88.6%) 818 (89%)

Preterm: <37 weeks gestation (excluding twins)

26 (11.2%) 19 (11.4%) 101 (11%)

Total Number of Babies with Days in the NICU (excluding twins)

16 (6.9%) 9 (5.5%) 58 (6.3%)

Average Number of Prenatal Visits Attended for Women who Have

Delivered

7.0 6.5 8.4

Number of women that have had a documented post-partum visit

74% 79% 53%