State of the Child: Madison County Developed and Presented by Cecilia Freer, MPA Freer Consulting April 25, 2012 1 Freer Consulting
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
e p
er 1
,000
Po
pu
lati
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.