Freer Consulting 1

State of the Child:Madison County

Developed and Presented by Cecilia Freer, MPAFreer Consulting

April 25, 2012

2

Madison County

Freer Consulting

• From 2000 to 2009, Madison County’s population grew by 13.1%, compared to the 16% for the state

  Madison County State of Florida

Total Population (2009 est) 20,264 18,537,969

White 58.8% 79.4%

Black 40.1% 16.1%

Other 1.1% 4.5%

Hispanic or Latino Origin 5.5% 59.5%

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Economic Indicators

• From 2000 to 2009, per capita income in Madison County increased by 34.8%, compared to 30.1% for the state.

• Madison has a rate of poverty 32% higher than that of the state.

  Madison County State of Florida

Per Capita Income $16,486 $26,503

Median Household Income $31,174 $44,755

% 25+ With high school diploma 74.4% 84.9%

% Living Below Poverty 26.2% 15%

% ages 0-17 Living Below Poverty

38.9% 21.5%

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• In Madison, the rate of infant mortality among Black babies has declined by over 75% in just 6 years.

• Rates of mortality among White infants has risen sharply after an initial decline

• Campaigns such as Back to Sleep, educating caregivers on proper sleep environments for baby, and more widely available prenatal care contribute to lower infant mortality rates.

2.8 2.6 2.3

7.48

17.2 17.6

5.6

8.3

5.45.5 5.5 5.4 5.45.2

13.5 13.2 13.2 13 13.1

0

2

4

6

8

10

12

14

16

18

20

2003-2005 2004-2006 2005-2007 2006-2008 2007-2009

Rat

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er 1

,000

Po

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on

Infant Mortality by Race - 3-Year Rolling Rates - State & County Comparison

Madison -White

Madison -Black &Other

State -White

State -Black &Other

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• Babies of mothers who do not get prenatal care are three times more likely to have low birth weight and five times more likely to die that those born to mothers who do get care.

2001 2002 2003 2004 2005 2006 2007 2008 2009 20100%

5%

10%

15%

20%

25%

30%

35%

40%

Madison County Percent Inadequate Prenatal Care, By Race

Madison White Madison Black & Other State White State Black & Other

Year

Pe

rce

nt

(%)

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• Advances in newborn medical care have greatly reduced the number of deaths associated with low birth weight. However, a small percentage of survivors develop mental retardation, learning problems, cerebral palsy, and vision and hearing loss.

2001 2002 2003 2004 2005 2006 2007 2008 2009 20100%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

Madison County Percent Birth Weight <2500g, By Race

Madison White Madison Black & Other State White State Black & Other

Year

Pe

rce

nt

(%)

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2001 2002 2003 2004 2005 2006 2007 2008 2009 20100%

10%

20%

30%

40%

50%

Madison County Percent Birth Interval <18 Months, By Race

Madison White Madison Black & Other State White State Black & Other

Year

Pe

rce

nt

(%)

• Interpregnancy intervals of less than 18 months increase likelihood of preterm labor, low birth weight, gestational diabetes, and infant death.

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• Single motherhood is associated with:• Higher poverty rates & higher welfare rates among

women • Higher rates of depression (Graefe & Lichter)

2001 2002 2003 2004 2005 2006 2007 2008 2009 20100%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Percentage of Births to Unmarried Mothers

All Races White Black & Other

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2001 2002 2003 2004 2005 2006 2007 2008 2009 20100%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Births to Unmarried Mothers by Race

White Black & Other

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· Parenthood is a leading cause of school drop out among teen girls—30% of teen girls cited pregnancy or parenthood as a reason for dropping out of school. (www.thenationalcampaign.org)

· Children of parents with low levels of education are less likely to succeed in school and more likely to live in poverty and have poor health. (www.rikidscount.org) 

2001 2002 2003 2004 2005 2006 2007 2008 2009 20100%

5%

10%

15%

20%

25%

30%

35%

40%

Births to Mothers with < High School Diploma

Madison White Madison Black & OtherState White State Black & Other

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2004 2005 2006 2007 2008 2009 201020%

30%

40%

50%

60%

70%

80%

Madison County Percent Overweight and Obese Mothers (combined), By Race

Madison White Madison Black & Other State White State Black & Other

Year

Pe

rce

nt

(%)

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· Babies born to mothers who smoke are more likely to have developmental and physical delays, as well as chronic illnesses such as asthma. (Lee, Hong, Park, et al., 2010)· Babies born to smoking mothers are 33% more likely to die in the first month. (Van Meurs, 1999)

2001 2002 2003 2004 2005 2006 2007 2008 2009 20100%

5%

10%

15%

20%

25%

Madison County Percent Mothers That Smoke, By Race

Madison White Madison Black & Other State White State Black & Other

Year

Pe

rce

nt

(%)

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• Since 2008, MC Healthy Start Staff has seen a 35% decrease in number of clients

• At the same time, there has been a 30% increase in the number of services

• Focus on intensity and duration of services• Targeting highest-risk mothers, unborn babies &

infants• Triaging women with fewer risks

• Greater overall impact in the community

Healthy Start Services

Madison County 2006 2007 2008 2009 2010

Number of Women 147 157 156 156 149

Number of Encounters 1268 918 807 901 815

Encounters/Woman 8.63 5.85 5.17 5.78 5.47

Number of Services 3337 3992 3349 4082 3715

Services/encounter 2.63 4.35 4.15 4.53 4.56

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Thanks to:• Samantha Shivers

Starting Earlier – Healthy Start for positive birth outcomes

Prenatal Care Counseling and MonitoringCare CoordinationCommunity ReferralsSmoking CessationChildbirth EducationBreastfeeding Education and SupportInterconceptional Care CounselingParenting

Infant Development – A shift in prevention

Parents as Teachers – an intervention for both

addressing health behaviors beyond birth and building

resilient familiesVision - All children will learn, grow and develop to

realize their full potential.

Who Did We Serve• JMT is one of 1900 projects in the U.S.• For Madison County, 42 families were

served (29 infants and 13 prenatal) 31 were African American, 7 white, 4 latino, 5 teen, 7 married, 6 were first time parents, 6 completed high school/ GED, 26 were screened for developmental delays, & 354 home visits were completed – Ages (15) were 0-11 mos (11) 12-23 mos (3)

24-35 mos

Model Components• Personal Visits• Group Connections• Screening• Resource Network

Short-Term Outcomes• Improved Parenting Capacity, Parenting

Practices, and Parent-Child Relationships• Early Detection of Developmental Delays

and Health Issues• Improved Family Health and Functioning

– Family goal setting– Home Environment improvement– Linkages to other families/social connections– Increased resiliency through stress reduction

Intermediate Outcomes• Improved Child Health and

Development• Prevention of Child Abuse and

Neglect• Increased School Readiness• Increased Parent Involvement in

Children’s Care and Education

Long-Term OutcomesStrong

communities, thriving families, and children who are healthy, safe, and ready to learn.