Cook County Department of Public Health Community Health Status Report 2010 Maternal Child Health
Cook County Department of Public Health
Community Health Status Report 2010
Maternal Child Health
Cook County Department of Public Health
Community Health Status Report 2010 Birth Rate- Page 1
Birth Rate
What is it? The crude birth rate is the number of live births for a specified geographic area divided by the total population for that area and multiplied by 1,000. i The birthrate, along with the crude death rate and migration, can determine the rate of growth for a population. Why is it important? In the 1900s, the birth rate in the U.S. was high and unstable. Over a century it has fluctuated but has been relatively stable for the past 20 years. Much of the stabilization can be attributed to family planning and contraceptives. Family planning is listed as one of the CDC’s Ten Great Public Health Achievements of the 20th Century and has lead to the ability to control family size and prevent unwanted pregnanciesii.
2000-2007
From 2000 to 2007, birth rates have remained stable for the U.S., Illinois, Suburban Cook County (SCC) and districts. The average birthrate in SCC (13.6/1,000) was slightly lower than the U.S. birthrate (14.5/1,000). Birthrates were similar between the districts with the exception of the West district which had a slightly higher birthrate (15.7/1,000).
Figure 1
Cook County Department of Public Health
Community Health Status Report 2010 Birth Rate- Page 2
2000-2002 vs. 2005-2007
By Race/Ethnicity
The birth rate decreased slightly between 2000-2002 and 2005-2007 in the Cook County Department of Public Health’s (CCDPH) jurisdiction (14/1,000 to 13.5/1,000). The birthrate among African Americans (AAs) changed very little and remained close to 17/100,000. Births to Asians increased slightly (19.5/1,000 to 20.8/1,000). Whites were the only group to experience a decrease in births and there over 7,000 fewer births in the 2005-2007 period. Hispanics had the highest birthrate and increased 13.6% from 27.3/1,000 in 2000-2002 to 30.9/1,000 in 2005-2007.
Figure 2
2005-2007 By Race/Ethnicity
Birthrates for Asians (20.2/1,000) and African Americans (16.9/1,000) in SCC were similar to national and state trends. Whites had a lower birthrate (8.8/1,000) in SCC compared to 11.6/1,000 in the U.S. Hispanics had a higher birthrate in SCC compared to the U.S. (30.8/1,000 and 27.8/1,000 respectively).
The greatest variation between race/ethnicity was in the South district, where Whites had a birth rate of 7.6/1,000 whereas Hispanics had a birthrate of 33.9/1,000.
Figure 3
Cook County Department of Public Health
Community Health Status Report 2010 Birth Rate- Page 3
Table 1
2000
-2007
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
U.S
.*4
,05
8,8
14
14
.44
,02
5,9
33
14
.34
,02
1,7
26
14
.34
,08
9,9
50
14
.54
,11
2,0
52
14
.64
,13
8,3
49
14
.74
,26
5,5
55
15
.1n
an
a
IL*
18
5,0
36
14
.91
84
,06
41
4.8
18
0,6
22
14
.51
82
,49
51
4.7
18
0,7
78
14
.51
79
,02
01
4.4
18
0,5
72
14
.5n
an
a
Subu
rban C
ook
34
,61
81
4.0
34
,67
31
4.0
33
,60
91
3.5
34
,02
81
3.7
33
,40
11
3.5
33
,14
41
3.4
33
,48
11
3.5
32
,94
51
3.3
CC
DP
H3
1,7
27
14
.13
1,8
90
14
.23
0,8
19
13
.73
1,2
21
13
.93
0,5
55
13
.63
0,3
04
13
.43
0,6
67
13
.63
0,1
70
13
.4
Nort
h1
2,0
94
13
.21
2,1
42
13
.31
1,5
95
12
.71
1,6
81
12
.81
1,5
49
12
.61
1,3
60
12
.41
1,4
75
12
.61
1,1
27
12
.2
West
8,2
06
16
.18
,25
11
6.2
8,0
84
15
.98
,05
31
5.8
7,9
40
15
.67
,67
91
5.1
7,8
75
15
.57
,77
91
5.3
Sw
est
4,4
26
12
.54
,57
01
2.9
4,4
96
12
.74
,64
21
3.2
4,5
15
12
.84
,56
21
2.9
4,5
11
12
.84
,52
31
2.8
South
7,0
01
14
.76
,92
71
4.5
6,6
44
13
.96
,84
51
4.3
6,5
51
13
.76
,70
31
4.0
6,8
06
14
.36
,74
11
4.1
na-n
ot availa
ble
Bir
th R
ate
s a
re liv
e b
irth
s p
er
1,0
00 p
opula
tion in s
pecifie
d g
roup
*Unspecifie
d e
stim
ate
(N
<5
)
-R
ate
not calc
ula
ted(N
<5)
Rate
s b
ased o
n 2
00
0 c
ensus p
opula
tion for
all
regio
ns
Sourc
e: ID
PH
Bir
th P
ull
File
2000-2
007, *N
ational C
ente
r fo
r H
ealth S
tatistics (
NC
HS
), D
ivis
ion o
f V
ital S
tatistics, N
ata
lity p
ublic
-use d
ata
2000-2
006
Cru
de
Bir
th R
ate
By R
egio
n
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
Cook County Department of Public Health
Community Health Status Report 2010 Birth Rate- Page 4
Table 2
2000-2002, 2005-2007
n rate n rate
Total 94,436 14.0 91,141 13.5
NH AfrAm 16,006 17.3 16,176 17.5
NH Asian 6,772 19.5 7,224 20.8
Hispanic 24,725 27.3 28,034 30.9
NH White 46,705 10.2 39,444 8.6
Rates based on 2000 census population for all regions
Source: IDPH Birth Pull File 2005-2007, *National Center for Health Statistics (NCHS), Division of Vital
Statistics, Natality public-use data 2004-2006
Race
Rates are live births per 1,000 population
-Rate not calculated(N<5)
Crude Birth Rate
Race/Ethnicity & Age Groups, CCDPH
2000-2002 2005-2007
*Unspecified estimate (N<5)
Cook County Department of Public Health
Community Health Status Report 2010 Birth Rate- Page 5
Table 3
Cru
de
Bir
th R
ate
20
05
-20
07
nra
ten
rate
nra
ten
rate
nra
ten
rate
nra
ten
rate
TO
TA
L1
2,5
15
,95
61
4.8
54
0,3
70
14
.59
9,5
70
13
.49
1,1
41
13
.53
3,9
62
12
.42
3,3
33
15
.31
3,5
96
12
.82
0,2
50
14
.1
NH
Afr
Am
1,7
79
,77
81
6.9
92
,35
01
6.3
17
,22
51
6.9
16
,17
61
7.5
1,0
28
18
.72
,73
21
4.7
1,3
56
18
.61
1,0
60
18
.1
NH
Asia
n6
65
,20
11
9.3
27
,67
32
0.9
8,3
24
20
.27
,22
42
0.8
5,9
26
21
.36
09
17
.94
09
20
.62
80
17
.4
His
pa
nic
2,9
70
,93
12
7.8
13
0,4
38
28
.22
9,3
21
30
.82
8,0
34
30
.98
,66
63
1.0
12
,81
72
9.7
3,0
39
33
.23
,51
23
3.9
NH
Wh
ite
6,8
85
,09
11
1.6
28
8,8
16
11
.34
4,3
86
8.8
39
,44
48
.61
8,2
37
8.6
7,1
14
8.2
8,7
59
10
.05
,33
47
.6
Ra
ce
/Eth
nic
ity b
y R
eg
ion
U.S
.A.*
IL*
SC
CC
CD
PH
Ra
tes b
ase
d o
n 2
00
0 c
en
su
s p
op
ula
tio
n f
or
all
reg
ion
s
No
rth
So
uth
*Un
sp
ecifie
d e
stim
ate
(N
<5
)
-R
ate
no
t ca
lcu
late
d(N
<5
)
So
urc
e:
IDP
H B
irth
Pu
ll F
ile 2
00
5-2
00
7,
*Na
tio
na
l C
en
ter
for
He
alth
Sta
tistics (
NC
HS
), D
ivis
ion
of
Vita
l S
tatistics,
Na
talit
y p
ub
lic-u
se
da
ta 2
00
4-2
00
6
So
uth
we
st
We
st
Race
Ra
tes a
re liv
e b
irth
s p
er
1,0
00
po
pu
latio
n
Cook County Department of Public Health
Community Health Status Report 2010 Birth Rate- Page 6
i "Statistical Measures and Definitions". NAPHSIS. May 19, 2010
<http://www.naphsis.org/index.asp?bid=1205>.
ii Centers for Disease Control and Prevention. (1999). Achievements in Public Health, 1900-1999: Family
Planning. Morbidity and Mortality Weekly Report (48), 1073-1080.
Cook County Department of Public Health
Community Health Status Report 2010 Fertility Rate- Page 1
Fertility Rate
What is it? The general fertility rate is the number of live births for a specified geographic area divided by the female population ages 15-44 years for that area, and the resulting fraction multiplied by 1,000.i Why is it important? The fertility rate is the number of births to women of child bearing age. Fertility affects the age structure of a population and helps drive population growth.ii A high fertility rate indicates there will be more young people in a population and faster growth. Great variance in fertility rates exists between races in the United States, with some racial/ethnic groups growing at a faster rate than others. Nationwide, Hispanics have the highest fertility rate and the greatest rate of growth, whereas non-Hispanic Whites have very low fertility and population growth overall. iii
2000-2007
From 2000 to 2007, fertility rates have remained stable in Suburban Cook County (SCC) and was lower, on average (64.0/1,000), than Illinois (66.3/1,000) and the United States (66.6/1,000). Fertility rates varied little between districts, with the exception of the West district which has had the highest fertility rate (73.4/1,000). This may be due in part to a larger population of Hispanic women of child bearing age living in the West district. Figure 1
Cook County Department of Public Health
Community Health Status Report 2010 Fertility Rate- Page 2
2000-2002 vs. 2005-2007
By Race/Ethnicity
Overall there was a slight decrease in fertility rates between 2000-2002 and 2005-2007 in the Cook County Department of Public Health’s jurisdiction (CCDPH). Whites had the lowest fertility rate, decreasing 15.6% from 45.5/1,000 in 2000-2002 to 38.4/1,000 in 2005-2007. Hispanics had the highest fertility rate increasing 13.4% from 111.8/1,000 in 2000-2002 to 126.8/1,000 in 2005-2007.
Figure 2
2005-2007 By Race/Ethnicity
The SCC fertility rate (63.0/1,000) was similar to that of the U.S. (67.7/1,000) and Illinois (65.7/1,000). Whites in SCC had a lower fertility rate (38.9/1,000) than Whites in the U.S. and Illinois (56.0 and 46.5/1,000 respectively). African Americans and Asians had very similar fertility rates (approximately 70/1,000), both regionally and nationally. Compared to other racial/ethnic groups, Hispanics had the highest fertility rate in the U.S., Illinois, SCC and all districts. The highest Hispanic fertility rate occurred in the South district with a rate of 73.2 per 1,000.
Figure 3
Cook County Department of Public Health
Community Health Status Report 2010 Fertility Rate- Page 3
Table 1
2000
-2007
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
U.S
.*4
,05
8,8
14
65
.94
,02
5,9
33
65
.34
,02
1,7
26
65
.34
,08
9,9
50
66
.44
,11
2,0
52
66
.74
,13
8,3
49
67
.14
,26
5,5
55
69
.2n
an
a
IL*
18
5,0
36
67
.51
84
,06
46
7.1
18
0,6
22
65
.91
82
,49
56
6.5
18
0,7
78
65
.91
79
,02
06
5.3
18
0,5
72
65
.8n
an
a
Subu
rban C
ook
34
,61
86
5.7
34
,67
36
5.8
33
,60
96
3.8
34
,02
86
4.6
33
,40
16
3.4
33
,14
46
2.9
33
,48
16
3.5
32
,94
56
2.5
CC
DP
H3
1,7
27
66
.93
1,8
90
67
.23
0,8
19
64
.93
1,2
21
65
.83
0,5
55
64
.43
0,3
04
63
.93
0,6
67
64
.63
0,1
70
63
.6
Nort
h1
2,0
94
64
.01
2,1
42
64
.31
1,5
95
61
.41
1,6
81
61
.81
1,5
49
61
.11
1,3
60
60
.11
1,4
75
60
.71
1,1
27
58
.9
West
8,2
06
75
.48
,25
17
5.8
8,0
84
74
.38
,05
37
4.0
7,9
40
73
.07
,67
97
0.6
7,8
75
72
.47
,77
97
1.5
Sw
est
4,4
26
61
.14
,57
06
3.1
4,4
96
62
.14
,64
26
4.1
4,5
15
62
.44
,56
26
3.0
4,5
11
62
.34
,52
36
2.5
South
7,0
01
67
.06
,92
76
6.3
6,6
44
63
.66
,84
56
5.5
6,5
51
62
.76
,70
36
4.2
6,8
06
65
.16
,74
16
4.5
na-n
ot availa
ble
Bir
th R
ate
s a
re liv
e b
irth
s p
er
1,0
00 p
opula
tion (
15-4
4yr
Fem
ale
s)
*Unspecifie
d e
stim
ate
(N
<5
)
-R
ate
not calc
ula
ted(N
<5)
Rate
s b
ased o
n 2
00
0 c
ensus p
opula
tion for
all
regio
ns
Sourc
e: ID
PH
Bir
th P
ull
File
2000-2
007, *N
ational C
ente
r fo
r H
ealth S
tatistics (
NC
HS
), D
ivis
ion o
f V
ital S
tatistics, N
ata
lity p
ublic
-use d
ata
2000-2
006
Fert
ilit
y R
ate
(15-4
4yrs
)
By R
egio
n
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
Cook County Department of Public Health
Community Health Status Report 2010 Fertility Rate- Page 4
Table 2
2000-2002, 2005-2007
n rate n rate
Total 94,436 66.3 91,141 64.0
NH AfrAm 16,006 68.6 16,176 69.3
NH Asian 6,772 68.4 7,224 72.9
Hispanic 24,725 111.8 28,034 126.8
NH White 46,705 45.5 39,444 38.4
Birth Rates are live births per 1,000 population (15-44yr Females)
Source: IDPH Birth Pull File 2005-2007, *National Center for Health Statistics (NCHS), Division of Vital
Statistics, Natality public-use data 2004-2006
Race
Fertility Rate (15-44yrs)
Race/Ethnicity & Age Groups, CCDPH
2000-2002 2005-2007
Rates based on 2000 Census Population for SCC
*Unspecified estimate (N<5)
-Rate not calculated(N<5)
Cook County Department of Public Health
Community Health Status Report 2010 Fertility Rate- Page 5
Table 3
Fert
ilit
y R
ate
(15-4
4yrs
)
2005
-2007
nra
ten
rate
nra
ten
rate
nra
ten
rate
nra
ten
rate
TO
TA
L1
2,5
15
,95
66
7.7
54
0,3
70
65
.79
9,5
70
63
.09
1,1
41
64
.03
3,9
62
59
.92
3,3
33
71
.51
3,5
96
62
.62
0,2
50
64
.6
NH
Afr
Am
1,7
79
,77
86
9.6
92
,35
06
8.1
17
,22
56
6.9
16
,17
66
9.3
1,0
28
66
.32
,73
25
8.9
1,3
56
67
.11
1,0
60
73
.2
NH
Asia
n6
65
,20
17
4.5
27
,67
37
1.3
8,3
24
69
.97
,22
47
2.9
5,9
26
74
.46
09
63
.34
09
73
.32
80
66
.0
His
panic
2,9
70
,93
11
15
.21
30
,43
81
15
.82
9,3
21
12
5.7
28
,03
41
26
.88
,66
61
27
.31
2,8
17
11
8.9
3,0
39
14
1.7
3,5
12
14
7.5
NH
White
6,8
85
,09
15
6.0
28
8,8
16
46
.54
4,3
86
38
.93
9,4
44
38
.41
8,2
37
37
.87
,11
43
7.8
8,7
59
43
.95
,33
43
4.1
Ra
ce
/Eth
nic
ity b
y R
egio
n
U.S
.A.*
IL*
SC
CC
CD
PH
N
ort
hS
outh
*Unspecifie
d e
stim
ate
(N
<5
)
-R
ate
not calc
ula
ted(N
<5)
Rate
s b
ased o
n 2
00
0 C
ensus P
op
ula
tion for
SC
C
Sourc
e: ID
PH
Bir
th P
ull
File
2005-2
007, *N
ational C
ente
r fo
r H
ealth S
tatistics (
NC
HS
), D
ivis
ion o
f V
ital S
tatistics, N
ata
lity p
ublic
-use d
ata
2004-2
006
So
uth
we
st
West
Bir
th R
ate
s a
re liv
e b
irth
s p
er
1,0
00 p
opula
tion (
15-4
4yr
Fem
ale
s)
Race
Cook County Department of Public Health
Community Health Status Report 2010 Fertility Rate- Page 6
i "Statistical Measures and Definitions". NAPHSIS. May 19, 2010
<http://www.naphsis.org/index.asp?bid=1205>.
ii Yaukey, D. a. (2001). Demography, The Studyof Human Population (2nd ed.). Prospect Heights, IL:
Waveland Press.
iii Martin JA, H. B. (2010). Births: Final data for 2007. National vital statistics reports , 58 (20).
Cook County Department of Public Health
Community Health Status Report 2010 Teen Birth- Page 1
Teen Birth (15-19 yrs)
What is it? The teen birth rate is measured as the number of births to teens ages 15-19 per 1,000 females in the population 15-19. Why is it important? Teen mothers are more likely to have negative birth outcomes such as. Teen mothers are also less likely to be married or have social support. They are also more likely to smoke and less likely to initiate prenatal care in the first trimester, which can lead to poor birth outcomes such as preterm delivery and low birth weight babies.i ii
2000-2007
The national rates of teen births declined between 2000 and 2005, but experienced an increase in 2006. This trend was also seen in Suburban Cook County (SCC), but overall there was a slight decrease in teen birth rate from 37.2/1,000 in 2000 to 33.2/1,000 in 2007. While the teen birth rate in SCC was lower than the U.S., the South and West districts had the highest rates of teen births in the county with both districts having an average teen birth rate near 50/1,000.
Figure 1
Cook County Department of Public Health
Community Health Status Report 2010 Teen Birth- Page 2
2000-2002 vs. 2005-2007
By Race/Ethnicity
There was a slight decrease in the teen birth rate in the Cook County Department of Public Health’s (CCDPH) jurisdiction between 2000-2002 and 2005-2007. This was seen for all racial/ethnic groups except Hispanics, where the fertility rate slightly increased from 86.6 to 88.1/1,000. Teen birth rates were highest amongst African Americans (AAs) and Hispanics, 69.1 and 88.1/1,000 respectively. The teen birth rate for Hispanics (88.1/1,000 ) was nearly ten times the rate for White teens (9.0/1,000).
Figure 2
2005-2007 By Race/Ethnicity
The total teen birth rate for SCC (30.8/1,000) fell below both the national (42.9/1,000) and Illinois (40.4/1,000) rates. Teen birth rates for Asians and Whites in SCC were much lower than rates for the U.S. and Illinois. The South district had the highest teen birth rate (49.8/1,000), while North district had the lowest (17.2/1,000). Forty five percent of all births in SCC occur among Hispanics. Furthermore, the highest teen birth rate was among Hispanics in the South district (97.9/1,000).
Figure 3
Cook County Department of Public Health
Community Health Status Report 2010 Teen Birth- Page 3
Table 1
2000
-2007
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
U.S
.*4
68
,99
04
7.7
44
5,9
44
45
.44
25
,49
34
3.3
41
4,5
80
42
.24
15
,26
24
2.3
41
4,5
93
42
.24
35
,43
64
4.3
na
na
IL*
20
,71
44
8.0
19
,75
84
5.8
18
,21
74
2.2
17
,40
54
0.3
17
,52
04
0.6
17
,04
13
9.5
17
,75
24
1.1
na
na
Su
bu
rba
n C
oo
k2
,82
53
5.1
2,7
21
33
.92
,59
63
2.3
2,4
85
30
.92
,44
43
0.4
2,3
71
29
.52
,54
93
1.7
2,5
18
31
.3
CC
DP
H2
,67
93
7.2
2,5
77
35
.82
,47
13
4.3
2,3
67
32
.92
,34
93
2.6
2,2
74
31
.62
,43
93
3.9
2,3
92
33
.2
No
rth
52
31
9.5
52
21
9.4
48
41
8.0
43
01
6.0
45
31
6.9
45
01
6.8
49
71
8.5
44
01
6.4
We
st
89
55
4.4
85
95
2.2
84
55
1.4
78
24
7.5
76
24
6.3
71
14
3.2
79
94
8.6
77
24
6.9
Sw
est
31
52
7.4
30
72
6.7
28
42
4.7
27
42
3.8
28
32
4.6
29
42
5.6
28
92
5.1
28
22
4.5
So
uth
94
65
4.9
88
95
1.6
85
84
9.8
88
15
1.2
85
14
9.4
81
94
7.6
85
44
9.6
89
85
2.2
na
-no
t a
va
ilab
le
Teen
Bir
th (
15-1
9yrs
)
By R
egio
n
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
Bir
th R
ate
s a
re liv
e b
irth
s p
er
1,0
00
po
pu
latio
n (
15
-19
yr
Fe
ma
les)
*Un
sp
ecifie
d e
stim
ate
(N
<5
)
-R
ate
no
t ca
lcu
late
d(N
<5
)
Ra
tes b
ase
d o
n 2
00
0 c
en
su
s p
op
ula
tio
n f
or
all
reg
ion
s
So
urc
e:
IDP
H B
irth
Pu
ll F
ile 2
00
0-2
00
7,
*Na
tio
na
l C
en
ter
for
He
alth
Sta
tistics (
NC
HS
), D
ivis
ion
of
Vita
l S
tatistics,
Na
talit
y p
ub
lic-u
se
da
ta 2
00
0-2
00
6
Cook County Department of Public Health
Community Health Status Report 2010 Teen Birth- Page 4
Table 2
2000-2002, 2005-2007
n rate n rate
Total 7,727 35.8 7,105 32.9
NH AfrAm 2,774 73.1 2,622 69.1
NH Asian 77 6.4 52 4.3
Hispanic 3,203 86.6 3,258 88.1
NH White 1,648 12.8 1,155 9.0
Birth Rates are live births per 1,000 population (15-19yr Females)
Race
Teen Birth (15-19yrs)
Race/Ethnicity & Age Groups, CCDPH
2000-2002 2005-2007
Rates based on 2000 Census Population for SCC
*Unspecified estimate (N<5)
-Rate not calculated(N<5)
Source: IDPH Birth Pull File 2005-2007, *National Center for Health Statistics (NCHS), Division of Vital
Statistics, Natality public-use data 2004-2006
Cook County Department of Public Health
Community Health Status Report 2010 Teen Birth- Page 5
Table 3
Teen
Bir
th (
15-1
9yrs
)
2005
-2007
nra
ten
rate
nra
ten
rate
nra
ten
rate
nra
ten
rate
TO
TA
L1
,26
5,2
91
42
.95
2,3
13
40
.47
,43
83
0.8
7,1
05
32
.91
,38
71
7.2
2,2
82
46
.28
65
25
.12
,57
14
9.8
NH
Afr
Am
29
7,8
28
67
.51
8,6
90
78
.72
,75
26
5.4
2,6
22
69
.11
13
49
.84
72
65
.41
66
60
.01
,87
17
2.8
NH
Asia
n1
9,1
50
15
.33
35
7.5
58
3.8
52
4.3
33
3.5
12
10
.6*
-*
-
His
pa
nic
41
5,6
19
93
.21
6,6
32
86
.03
,36
78
5.6
3,2
58
88
.19
12
88
.91
,57
18
5.6
35
28
7.2
42
39
7.9
NH
Wh
ite
50
3,5
29
26
.51
6,5
51
20
.31
,24
28
.61
,15
59
.03
24
5.5
22
39
.93
40
12
.72
68
12
.8
No
rth
So
uth
*Un
sp
ecifie
d e
stim
ate
(N
<5
)
-R
ate
no
t ca
lcu
late
d(N
<5
)
Ra
tes b
ase
d o
n 2
00
0 C
en
su
s P
op
ula
tio
n f
or
SC
C
So
urc
e:
IDP
H B
irth
Pu
ll F
ile 2
00
5-2
00
7,
*Na
tio
na
l C
en
ter
for
He
alth
Sta
tistics (
NC
HS
), D
ivis
ion
of
Vita
l S
tatistics,
Na
talit
y p
ub
lic-u
se
da
ta 2
00
4-2
00
6
So
uth
we
st
We
st
Bir
th R
ate
s a
re liv
e b
irth
s p
er
1,0
00
po
pu
latio
n (
15
-19
yr
Fe
ma
les)
Race
Ra
ce
/Eth
nic
ity b
y R
egio
n
U.S
.A.*
IL*
SC
CC
CD
PH
Cook County Department of Public Health
Community Health Status Report 2010 Teen Birth- Page 6
i Centers for Disease Control and Prevention. (2009). Sexual and reproductive heatlh of persons aged 10-24
years - United States, 2002-2007. Surveillance Summaries, Morbidity and Mortality Weekly , 58 (SS-6).
ii Ventura SJ, M. T. (2001). Births to teenagers in the United States, 1940–2000. National Vital Statistics
Report , 49 (10).
Cook County Department of Public Health
Community Health Status Report 2010 Low Birth Weight- Page 1
Singleton Low Birth Weight
What is it? Singleton Low birth weight (LBW) refers to infants weighing less than 5 pounds 8 ounces (2,500 grams). This percentage is calculated by the number of low birth weight singleton births per 100 singleton births (multiple births which often result in low birth weight infants are excluded). Low birth weight is most often attributed to preterm birth (less than 37 weeks gestation) and maternal factors, most commonly maternal smoking.i Why is it important: Low birth weight is the greatest factor for neonatal mortality (occurring within the first 28 days of life).ii Low birth weight babies are also more likely to have disabilities and suffer greater morbidity later in life.iii
2000-2007
The LBW rate increased in Suburban Cook County (SCC) from 5.9% in 2000 to 6.6% in 2007. The average LBW rate was the same locally as it was nationally (6.1%). Most variability in LBW occurred in the South district, which also has had the highest LBW rate (8.8%) from 2000 to 2oo7. However, the disparity in LBW rates between the North and the South districts narrowed from 75.5% higher in 2000 to 58.5% higher in 2007. This, however, was not due to a decrease in the LBW rate in the South district, but an increase in the LBW rate in the North district(4.9% in 2000 to 5.3% in 2007).
Figure 1
Cook County Department of Public Health
Community Health Status Report 2010 Low Birth Weight- Page 2
2000-2002 vs. 2005-2007
By Race/Ethnicity
From 2000-20002 to 2005-2007, the overall LBW rate (5.9%) remained the same in the Cook County Department of Public Health’s (CCDPH) jurisdiction. CCDPH did not Healthy People (HP) 2010 goal of 5% of babies born with LBW.iv LBW rates were highest among African Americans (AAs) in CCDPH. However, there has been a slight reduction in the LBW rate among AAs (11.3% in 2000-2002 to 10.8% in 2005-2007). LBW rates among Asians decreased from 7.1 to 6.2%. The slight increase in the LBW rate (from 4.9% to 5.2%) among Hispanics resulted in the rate being above the HP2010 goal.
Figure 2
2005-2007 By Race/Ethnicity
From 2005 to 2007, the LBW rate for SCC was 5.9%. Most of the districts were close to this percentage except the South district which had LBW rate of 8.2%. The LBW rate among AAs in SCC (10.8%) was more than double the HP2010 goal. Asians were above the HP2010 goal of 5% in all CCDPH districts, while LBW rate among Hispanics was very close to 5% in each district. The LBW rate among Whites (4.4%) in SCC was the lowest compared to other racial/ethnic groups.
Figure 3
Cook County Department of Public Health
Community Health Status Report 2010 Low Birth Weight- Page 3
Table 1
2000
-2007
n
%n
%
n
%n
%
n
%n
%
n
%n
%
U.S
.*2
35
,67
96
.02
35
,40
46
.02
37
,99
96
.12
45
,10
46
.22
50
,44
46
.32
56
,06
56
.42
67
,21
86
.5n
an
a
IL*
11
,12
56
.21
1,0
57
6.2
10
,87
66
.31
1,0
80
6.3
11
,16
16
.41
1,3
45
6.6
11
,59
46
.7n
an
a
Su
bu
rba
n C
oo
k1
,97
75
.91
,90
85
.71
,90
95
.91
,90
05
.82
,03
06
.32
,04
56
.42
,09
26
.52
,00
36
.3
CC
DP
H1
,82
06
.01
,75
85
.71
,75
45
.91
,75
75
.91
,87
56
.41
,88
96
.51
,93
76
.61
,85
06
.4
No
rth
56
64
.95
38
4.6
52
54
.75
17
4.6
54
14
.95
31
4.9
58
75
.35
72
5.3
We
st
44
45
.64
74
5.9
46
35
.94
63
5.9
47
06
.14
87
6.6
48
76
.44
78
6.4
Sw
est
23
35
.52
19
5.0
21
95
.02
40
5.4
26
36
.02
47
5.6
27
26
.32
57
5.9
So
uth
57
78
.65
27
7.9
54
78
.65
37
8.1
60
19
.56
24
9.6
59
19
.05
43
8.4
na
-no
t a
va
ilab
le
20
06
20
07
So
urc
e:
IDP
H B
irth
Pu
ll F
ile 2
00
0-2
00
7,
*Na
tio
na
l C
en
ter
for
He
alth
Sta
tistics,
Co
mp
resse
d N
ata
lity F
ile 2
00
0-2
00
6
Lo
w B
irth
Weig
ht
By R
egio
n
20
00
20
01
20
02
20
03
20
04
20
05
-R
ate
no
t ca
lcu
late
d(N
<5
)
Pe
rce
nt
of
sin
gle
ton
bir
ths w
ith
bir
th w
eig
ht
less t
ha
n 2
,50
0 g
ram
s
*Un
sp
ecifie
d e
stim
ate
(N
<5
)
Cook County Department of Public Health
Community Health Status Report 2010 Low Birth Weight- Page 4
Table 2
2000-2002, 2005-2007
n % n %
Total 5,241 5.9 5,412 5.9
NH AfrAm 1,709 11.3 1,746 10.8
NH Asian 462 7.1 445 6.2
Hispanic 1,178 4.9 1,451 5.2
NH White 1,875 4.4 1,754 4.4
Percent of singleton births with birth weight less than 2,500 grams
*Unspecified estimate (N<5)
-Rate not calculated(N<5)
Source: IDPH Birth Pull File 2000-2007, *National Center for Health Statistics, Compressed Natality File 2000-2006
Low Birth Weight
Race/Ethnicity & Age Groups, CCDPH
CCDPH
2000-2002 2005-2007
Race
Cook County Department of Public Health
Community Health Status Report 2010 Low Birth Weight- Page 5
Table 3
Lo
w B
irth
Weig
ht
2005
-2007
n%
n%
n%
n%
n%
n%
n%
n%
TO
TA
L7
73
,72
76
.43
4,1
00
6.6
5,8
63
5.9
5,4
12
5.9
1,6
15
4.8
1,3
76
5.9
76
25
.61
,65
98
.2
NH
Afr
Am
20
3,4
91
11
.81
1,1
88
12
.61
,84
21
0.7
1,7
46
10
.88
58
.33
18
11
.61
53
11
.31
,19
01
0.8
NH
Asia
n4
2,2
28
6.5
1,8
39
6.9
52
96
.44
45
6.2
34
95
.94
57
.43
17
.62
07
.1
His
pa
nic
16
4,8
71
5.7
7,1
88
5.6
1,5
27
5.2
1,4
51
5.2
42
34
.96
98
5.4
16
45
.41
66
4.7
NH
Wh
ite
35
4,8
28
5.3
13
,83
35
.01
,94
54
.41
,75
44
.47
51
4.1
30
94
.34
14
4.7
28
05
.2
Ra
ce
/Eth
nic
ity b
y R
egio
n
U.S
.A.*
IL*
SC
CC
CD
PH
N
ort
hS
ou
thS
ou
thw
est
We
st
-R
ate
no
t ca
lcu
late
d(N
<5
)
So
urc
e:
IDP
H B
irth
Pu
ll F
ile 2
00
5-2
00
7,
*Na
tio
na
l C
en
ter
for
He
alth
Sta
tistics,
Co
mp
resse
d N
ata
lity F
ile 2
00
4-2
00
6
Race
Pe
rce
nt
of
sin
gle
ton
bir
ths w
ith
bir
th w
eig
ht
less t
ha
n 2
,50
0 g
ram
s
*Un
sp
ecifie
d e
stim
ate
(N
<5
)
Cook County Department of Public Health
Community Health Status Report 2010 Low Birth Weight- Page 6
i Ventura, S. J. (2003). Trends and Variations in Smoking During Pregnancy and Low Birth Weight: Evidence
From the Birth Certificate, 1990–2000. Pediatrics , 1176-1180.
ii Eberstein, I. W. (1990). Infant Mortality by CaU.S.e of Death: Main and Interaction Effects. Demography ,
27 (3), 413-430.
iii U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal
and Child Health Bureau. (2010). Child Health U.S.A 2010.
iv U.S. Department of Health and Human Services. (2000). Healthy People 2010: Understanding and
Improving Health. (2nd Ed.).
Cook County Department of Public Health
Community Health Status Report 2010 IPNC- Page 1
Inadequate Prenatal Care
What is it? Inadequate prenatal care (IPNC) is measured by the percentage of births to women beginning prenatal care after the 3rd month of pregnancy or receiving no prenatal care. Why is it important:? Beginning prenatal care in the first trimester of pregnancy is important because it allows the health of the fetus to be monitored. Women who do not begin prenatal care early are more likely to have poor outcomes such as preterm birth and low birth weight babies. i Nationally, African Americans (AA) and Hispanics are two times more likely than Whites to receive IPNC.ii
2000-2007
The overall percentage of women who received IPNC declined in Suburban Cook County (SCC) from 13.6% in 2000 to 11.5 % in 2007 and nationally from 16.4% in 2000 to 10.6% in 2006. The South district has had the highest rates of IPNC, though rates have improved from 19.1% in 2000 to 15.5% in 2007.
Figure 1
Cook County Department of Public Health
Community Health Status Report 2010 IPNC- Page 2
2000-2002 vs. 2005-2007
By Race/Ethnicity
The IPNC rate decreased for all racial/ethnic groups, between 2000-2002 and 2005-2007, in the Cook County Department of Public Health’s (CCDPH) jurisdiction. IPNC rates for African Americans (AAs) decreased from 21.8% to 17.6% and from 18.6% to 14.9% for Hispanics. The decrease in the IPNC rate for Asians (from 10.9% to 9.3%) resulted in Asians meeting the HP 2010 goal of 10% in 2005-2007. IPNC rates among Whites did not change.
Figure 2
2005-2007 By Race/Ethnicity
The IPNC rate for SCC (11.3%) was slightly above the HP2010 goal. Compared to other districts, IPNC rates among racial/ethnic groups in the West district were the least disparate. The IPNC rate among Hispanics in the North district (19.2%) was higher than respective rates in other districts, the U.S. and Il. The IPNC rate among AAs in the South district (19.0%) was higher than respective rates in other districts, and the U.S.
Figure 3
Cook County Department of Public Health
Community Health Status Report 2010 IPNC- Page 3
Table 1
2000
-2007
n
%n
%
n
%n
%
n
%n
%
n
%n
%
U.S
.*6
65
,42
81
6.4
65
4,0
58
16
.26
41
,44
41
5.9
60
3,7
06
14
.85
18
,55
71
2.6
44
8,4
99
10
.84
51
,06
81
0.6
na
na
IL*
31
,97
41
7.3
28
,78
81
5.6
26
,56
61
4.7
25
,57
81
4.0
24
,76
71
3.7
23
,71
31
3.2
23
,91
71
3.2
na
na
Su
bu
rba
n C
oo
k4
,71
11
3.6
4,4
54
12
.84
,19
71
2.5
4,1
17
12
.13
,95
41
1.8
3,7
65
11
.43
,84
31
1.5
3,6
83
11
.2
CC
DP
H4
,34
61
3.7
4,1
72
13
.13
,93
61
2.8
3,8
38
12
.33
,73
31
2.2
3,5
58
11
.73
,64
01
1.9
3,4
90
11
.6
No
rth
1,4
05
11
.61
,28
11
0.6
1,2
68
10
.91
,22
51
0.5
1,1
34
9.8
1,2
26
10
.81
,13
79
.91
,16
51
0.5
We
st
1,1
20
13
.61
,03
51
2.5
99
61
2.3
94
91
1.8
89
01
1.2
83
61
0.9
87
21
1.1
80
81
0.4
Sw
est
48
41
0.9
50
11
1.0
41
99
.34
51
9.7
43
89
.74
14
9.1
44
49
.84
73
10
.5
So
uth
1,3
37
19
.11
,35
51
9.6
1,2
53
18
.91
,21
31
7.7
1,2
71
19
.41
,08
21
6.1
1,1
87
17
.41
,04
41
5.5
na
-no
t a
va
ilab
le
So
urc
e:
IDP
H B
irth
Pu
ll F
ile 2
00
0-2
00
7,
*Na
tio
na
l C
en
ter
for
He
alth
Sta
tistics,
Co
mp
resse
d N
ata
lity F
ile 2
00
0-2
00
6
Inad
eq
uate
Pre
nata
l C
are
By R
egio
n
20
00
20
01
20
02
20
03
20
06
20
07
-R
ate
no
t ca
lcu
late
d(N
<5
)
Pe
rce
nta
ge
of
all
live
bir
ths t
o w
om
en
be
gin
nin
g p
ren
ata
l ca
re a
fte
r th
e 3
rd m
on
th o
f p
reg
na
ncy o
r re
ce
ivin
g n
o p
ren
ata
l ca
re
*Un
sp
ecifie
d e
stim
ate
(N
<5
)
20
04
20
05
Cook County Department of Public Health
Community Health Status Report 2010 IPNC- Page 4
Table 2
2000-2002, 2005-2007
n % n %
Total 12,454 13.2 10,688 11.7
NH AfrAm 3,493 21.8 2,844 17.6
NH Asian 741 10.9 674 9.3
Hispanic 4,587 18.6 4,168 14.9
NH White 3,590 7.7 2,975 7.5
Percentage of all live births to women beginning prenatal care after the 3rd month of pregnancy or receiving no prenatal care
*Unspecified estimate (N<5)
-Rate not calculated(N<5)
Source: IDPH Birth Pull File 2000-2007, *National Center for Health Statistics, Compressed Natality File 2000-2006
Inadequate Prenatal Care
Race/Ethnicity & Age Groups, CCDPH
CCDPH
2000-2002 2005-2007
Race
Cook County Department of Public Health
Community Health Status Report 2010 IPNC- Page 5
Table 3
Inad
eq
uate
Pre
nata
l C
are
2005
-2007
n%
n%
n%
n%
n%
n%
n%
n%
TO
TA
L1
,41
8,1
24
11
.37
2,3
97
13
.41
1,2
91
11
.31
0,6
88
11
.73
,52
81
0.4
2,5
16
10
.81
,33
19
.83
,31
31
6.4
NH
Afr
Am
29
1,6
09
16
.42
1,4
87
23
.32
,96
71
7.2
2,8
44
17
.61
53
14
.93
66
13
.42
22
16
.42
,10
31
9.0
NH
Asia
n7
7,0
51
11
.62
,68
79
.77
57
9.1
67
49
.35
38
9.1
57
9.4
41
10
.03
81
3.6
His
pa
nic
47
6,8
89
16
.12
2,4
57
17
.24
,30
81
4.7
4,1
68
14
.91
,66
11
9.2
1,5
10
11
.83
97
13
.16
00
17
.1
NH
Wh
ite
53
0,5
82
7.7
25
,58
98
.93
,23
27
.32
,97
57
.51
,16
56
.45
75
8.1
66
97
.65
66
10
.6
Ra
ce
/Eth
nic
ity b
y R
egio
n
U.S
.A.*
IL*
SC
CC
CD
PH
N
ort
hS
ou
thS
ou
thw
est
We
st
-R
ate
no
t ca
lcu
late
d(N
<5
)
So
urc
e:
IDP
H B
irth
Pu
ll F
ile 2
00
5-2
00
7,
*Na
tio
na
l C
en
ter
for
He
alth
Sta
tistics,
Co
mp
resse
d N
ata
lity F
ile 2
00
4-2
00
6
Race
Pe
rce
nta
ge
of
all
live
bir
ths t
o w
om
en
be
gin
nin
g p
ren
ata
l ca
re a
fte
r th
e 3
rd m
on
th o
f p
reg
na
ncy o
r re
ce
ivin
g n
o p
ren
ata
l ca
re
*U
nsp
ecifie
d e
stim
ate
(N
<5
)
Cook County Department of Public Health
Community Health Status Report 2010 IPNC- Page 6
i "Pediatric and Pregnancy Surveillance System". CDC. February 2011
<http://www.cdc.gov/pednss/what_is/pnss_health_indicators.htm>.
ii Martin J.A., H. B. (2010). Births: Final data for 2007. National vital statistics reports , 58 (20).
Cook County Department of Public Health
Community Health Status Report 2010 Infant Mortality- Page 1
Infant Mortality What is it? Infant mortality is the number of deaths to infants under one year of age per 1,000 live births in a given year. The single greatest factor contributing to infant mortality is low birth weight.i Factors that contribute to low birth weight are preterm birth and maternal factors such as smoking and substance abuse. Not only does maternal smoking contribute to low birth weight it is also associated Sudden Infant Death Syndrome (SIDS) which has historically been a significant cause of infant mortality. ii
Why is it important? The infant mortality rate is often used as a basic tool to measure the health of a population and for comparison between populations. iii
Touted as one of the greatest public health achievements of the 20th century, great progress has been made to reduce the rate of infant mortality since 1900.iv Efforts included improved medical interventions to help sick and premature babies and the Back-to-Sleep Campaign which reduced the number of SIDS-related deaths.
2000-2007
Between 2000 and 2007, the average rate of infant mortality in Suburban Cook County (SCC) was very close to the U.S. rate (7.2/1,000 and 6.8/1,000 respectively). Due to small numbers of infant deaths, there was great variation between years and between districts. From 2000 to 2007, on average, the South district had the highest infant mortality rate, 10.8/1,000, which was double the infant mortality rate of the North district, 4.8/1,000.
Figure 1
Cook County Department of Public Health
Community Health Status Report 2010 Infant Mortality- Page 2
2000-2002 vs. 2005-2007
By Race
The infant mortality rate for the Cook County Department of Public Health’s (CCDPH) jurisdiction decreased slightly from 7.3/1,000 in 2000-2002 to 6.9/1,000 in 2005-2007.
From 2000-2002 to 2005-2007, while the infant mortality rate among Asians increased slightly from 3.4 to 4.3/1,000, the rate was below the Healthy People (HP) 2010 goal of 4.5/1,000. The infant mortality rate among African Americans (AA) in the same time periods remained the same (approximately 14.3/1,000).
Infant mortality rates decreased slightly for Hispanics (from 6.3 to 5.5/1,000) and for Whites (from 5.5 to 5.0/1,000).
Figure 2
2005-2007 By Race/Ethnicity
During 2005-2007, the infant mortality rate for SCC was 15.1 per 1,000, slightly higher than the Illinois and U.S. rates (14.5 and 14.1/1,000 respectively). The infant mortality rate in the South district was 11.3/1,000 which was more than double that of the North district, which was 4.4/1,000. In all regions, the rates of infant mortality for African Americans was approximately double that of Whites and Hispanics. The West district had the highest rate of infant mortality for African Americans (17.8 per 1,000), followed by the South district (14.3 per 1,000).
Figure 3
Cook County Department of Public Health
Community Health Status Report 2010 Infant Mortality- Page 3
Table 1
2000
-2007
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
n
rate
U.S
.*2
8,0
35
6.9
27
,56
86
.82
8,0
34
7.0
28
,02
56
.92
7,9
36
6.8
28
,44
06
.92
8,5
27
6.7
na
na
IL*
1,5
68
8.5
1,4
13
7.7
1,3
39
7.4
1,4
12
7.7
1,3
49
7.5
1,3
28
7.4
1,3
09
7.2
na
na
Su
bu
rba
n C
oo
k2
87
8.3
25
37
.32
40
7.1
24
57
.22
23
6.7
24
47
.42
59
7.7
19
76
.0
CC
DP
H2
56
8.1
22
77
.12
01
6.5
22
77
.32
13
7.0
21
77
.22
38
7.8
17
85
.9
No
rth
51
4.2
67
5.5
63
5.4
68
5.8
51
4.4
39
3.4
63
5.5
47
4.2
We
st
82
10
.06
17
.45
87
.25
36
.66
07
.67
39
.56
27
.94
45
.7
Sw
est
42
9.5
35
7.7
23
5.1
26
5.6
24
5.3
23
5.0
33
7.3
21
4.6
So
uth
81
11
.66
49
.25
78
.68
01
1.7
78
11
.98
21
2.2
80
11
.86
69
.8
na
-no
t a
va
ilab
le
20
06
20
07
So
urc
e:
IDP
H B
irth
/De
ath
Pu
ll F
ile 2
00
0-2
00
7,
*Na
tio
na
l C
en
ter
for
He
alth
Sta
tistics,
Co
mp
resse
d N
ata
lity/M
ort
alit
y F
ile 2
00
0-2
00
6
Infa
nt
Mo
rtality
By R
egio
n
20
00
20
01
20
02
20
03
20
04
20
05
~R
ate
no
t ca
lcu
late
d (
N<
20
), -
Ra
te n
ot
ca
lcu
late
d(N
<5
)
Nu
mb
er
of
infa
nt
de
ath
s (
less t
ha
n 1
yr
old
) p
er
1,0
00
liv
e b
irth
s
**U
nsp
ecifie
d e
stim
ate
(N
<2
0),
*U
nsp
ecifie
d e
stim
ate
(N
<5
)
Cook County Department of Public Health
Community Health Status Report 2010 Infant Mortality- Page 4
Table 2
2000-2002, 2005-2007
n rate n rate
Total 685 7.3 632 6.9
NH AfrAm 225 14.1 233 14.4
NH Asian 23 3.4 31 4.3
Hispanic 155 6.3 153 5.5
NH White 259 5.5 197 5.0
Number of infant deaths (less than 1yr old) per 1,000 live births
*Unspecified estimate (N<5)
-Rate not calculated(N<5)
Source: IDPH Birth Pull File 2000-2007
Infant Mortality
Race/Ethnicity & Age Groups, CCDPH
CCDPH
2000-2002 2005-2007
Race
Cook County Department of Public Health
Community Health Status Report 2010 Infant Mortality- Page 5
Table 3
Infa
nt
Mo
rta
lity
20
05
-20
07
nra
ten
rate
nra
ten
rate
nra
ten
rate
nra
ten
rate
TO
TA
L8
4,9
03
6.8
3,9
86
7.4
69
97
.06
32
6.9
14
94
.41
78
7.6
77
5.7
22
81
1.3
NH
Afr
Am
25
,06
31
4.1
1,3
42
14
.52
60
15
.12
33
14
.49
8.8
48
17
.61
81
3.3
15
81
4.3
NH
Asia
n2
,39
03
.68
02
.93
64
.33
14
.32
54
.2*
-*
-*
-
His
panic
16
,78
05
.67
93
6.1
17
05
.81
53
5.5
37
4.3
79
6.2
13
4.3
24
6.8
NH
White
38
,97
85
.71
,68
05
.82
13
4.8
19
75
.07
13
.94
96
.94
24
.83
56
.6
Ra
ce
/Eth
nic
ity b
y R
eg
ion
U.S
.A.*
IL*
SC
CC
CD
PH
N
ort
hS
outh
South
west
West
-R
ate
not calc
ula
ted(N
<5)
Sourc
e: ID
PH
Bir
th/D
eath
Pull
File
2005-2
007, *N
ational C
ente
r fo
r H
ealth S
tatistics, C
om
pre
ssed N
ata
lity/M
ort
alit
y F
ile 2
004-2
006
Race
Num
ber
of in
fant death
s (
less than 1
yr
old
) per
1,0
00 liv
e b
irth
s
*Unspecifie
d e
stim
ate
(N
<5
)
Cook County Department of Public Health
Community Health Status Report 2010 Infant Mortality- Page 6
i Martin J.A., (2010). Births: Final data for 2007. National vital statistics reports , 58 (20).
iiAnderson, M. J. (2005). Sudden Infant Death Syndrom and prenatal maternal smoking: rising
attributed risk in the Back to Sleep era. BMC Medicine , 3 (4).
iii Allotey, D. D. (2003). Infant mortality rate as an indicator of population health. J Epidemiology
Community Health , 57:344-346 .
iv Centers for Disease Control and Prevention. (2002). Infant Mortality and Low Birth Weight
Among Black and White Infants United States, 1980–2000. Morbidity and Mortality Weekly Report
(51), 589-592.