The challenge of change : a mid-decade look at maternal and child health in Georgia

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Readers are invited to Reproduce and Circulate without Permission but we request that appropriate attribution be given to the
source of the material:
Perinatal Epidemiology Unit Epidemiology and Prevention Branch
Division of Public Health Georgia Department of Human Resources
2 Peachtree Street, N.W. Atlanta, GA 30303
Telephone: 404-657-6448 FAX: 404-657-7517
March of Dimes Birth Defects Foundation 2 Northside 75, Suite 100 Atlanta, GA 30318
Telephone: 404-350-9800 FAX: 404-355-7723
Publication Document tracking number: DPH97.53HW

Acknowledgements

Acknowledgments

Continuity of leadership and vision for the development of this report was provided by Virginia Floyd MD, MPH, (Family Health Branch), Lorie Mayer (March of Dimes) and Roger Rochat MD (Office of Perinatal Epidemiology). The design of the report began in 1993 and the report was completed in 1997. The computer programming in SAS for the tables was performed by a SPRANS grant-funded contract from Family Health Branch to Georgia State University; this was monitored by Gary Griffin and Mary Brantley. The March of Dimes, Georgia Chapter, funded the development of maps by Barbara Beavers, analysis of perinatal risk factors by Ben Kupronis, and the design and drafting of this report by Laurie Dopkins. This report serves as the Georgia March of Dimes perinatal health assessment for Georgia. Mary Brantley updated the tables to include the most recent 5 year period and completed the design and format of the text. Sandra Ford, a CDC Women's Executive Leadership Program participant, worked with the Office of Perinatal Epidemiology for 4 months in the analysis and design of data for graphics and tables. Several district health staff influenced the content of tables: we especially appreciated reviews by John McKinley and Gail Russell. We wish to acknowledge contributions of the following:
Georgia Department of Human Resources Commissioner: Tommy Olmstead
Division of Public Health: Patrick Meehan, Marjorie Young Center for Health Information: Karen Chapman Health Assessment Services Unit: Michael Rogers Vital Records Service: Michael Lavoie, Julie Biddy, Nancy Fields Epidemiology and Prevention Branch: Kathleen Toomey, Jack Kirby Epidemiology Section: Paul Blake Office of Perinatal Epidemiology: Roger Rochat, Mary Brantley, Mary Mathis, Ray Gangarosa, Paul Gangarosa, Leslie Lipscomb, Gary Griffin, Ed Tierney, D. Lee Warner, Rebekah Hudgins, Frank Millard, Susan Czechowicz, Gloria Gibson PRAMS: Cathy Rohweder, Tonya Johnson Family Health Branch: Virginia Floyd Teen Plus: Michele Ozumba Immunization: Mike Chaney M & I Council: Tee Rae Dismukes - Executive Director, Roberta M. Brown, Wilma Brown, Schley Gatewood Jr., Eugene H. Jackson, Mary Johnson, William P. Kanto Jr., Louis Levy, Lawrence Price, Hugh Randall Jr., William R. Sexson, Debbie Sibley, Charles T. Stafford, Richard A. Wherry, Nance White, Irma Works Womens Health Section: Carol Hadley, Diane Norris, Pat White

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
WIC Program: Lynda Pittman Cotton Disabilities Prevention: Carol Wilson, Lee Hackel, Judy Bodner Child Health Unit: Wendolyn Bell, Mary Ann Henson Laboratory: Elizabeth Franko, M. Ramachandran Operations Resource Development: Margaret Park, Willene Smith District Health Officers: 1-1Wade Sellers, 1-2 Joy Benson, 2 Melody Stancil, 3-1Virginia Galvin, 3-2 Eric Benning (Acting), 3-3 Lloyd Hofer (Acting), 3-4 Claude Burnett (Acting), 3-5 Paul Wiesner, 4 Lloyd Hofer, 5-1 Grady Longino, 5-2 Joseph Swatout, 6 Frank Rumph, 7 Craig Lichtenwalner, 8-1 Lynne Feldman, 8-2 Paul Newell, 9-1 Stephen King, 9-2 John T. (Ted) Holloway, 9-3 B. Brooks Taylor, 10 Claude Burnett
Georgia Department of Medical Assistance MCH Division: Jackie Foster-Rice, Lisa Norris, Shelba McDowell, Betty Jones, Michael Thompson, Bettye Saylor
Georgia Department of Family and Children Services Commissioner Mike Thurmond, David Hellwig, Becky Shoaf
Georgia Outreach Educators Grady/Emory: Alison Berry, Linda McCollum; Medical Center of Central Georgia: Laura Thomas, Conny Styons; Phoebe Putney Medical Center: Colleen Whatley, Linda Rajk; The Memorial Medical Center: Judy Layden, Linda Termotto; The Medical Center: Sherrie Tovey, Anne Morin; Medical College of Georgia: Debbie Sibley, Johnny Wilson, Brian Carter
Childrens Trust Fund Susan Phillips, Eva Patillo
March of Dimes, Georgia Chapter Lorie Mayer, Jocelyn Wheaton, Laurie Dopkins Research assistants: Deb Bauer, Cathy Campbell
Morehouse School of Medicine Preventive Medicine Residencies: Beverly Taylor (Director), Preventive Medicine Residents: Liz Schachne, Mona Saraiya
Georgia State University College of Business Administration, Department of Management: Merwyn Elliot, Joe D. Jordan

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Emory University Rollins School of Public Health: John Carter, Barbara Beavers, Ben Kupronis
Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion Division of Reproductive Health: Lynne Wilcox, Tom Starcher Pregnancy and Infant Health Branch: Hani Atrash, Vijaya Hogan Behavioral Epidemiology and Demographic Research Branch: Leo Morris Computer and Statistics Branch: Jack Smith (Chief), Liz Fitch, Paul Gargiullo, Mike Harrington, Cheryl Rodgers, Margaret Watson, Hoyt Wilson National Center for Environmental Health Division of Birth Defects and Developmental Disabilities: Godfrey Oakley Birth Defects and Genetic Diseases Branch: J David Erickson, Larry Edmonds Prevention Section: Joe Mulinare, Margaret Watkins Developmental Disabilities Branch Fetal Alchohol Syndrome Prevention Section: Louise Floyd Division of Environmental Health Laboratory Sciences: Eric Sampson Clinical Biochemistry Branch: Harry Hannon, Omar Henderson Epidemiology Program Office: John Horan, Art Liang, Betsy Thompson EIS Officers: Patty Dietz Preventive Medicine Residents: Lorenzo Botto, Isabela Danel, Hussain Yusuf, Kimberley Heath Caldwell, Tania Goldner WHO Perinatal Collaborative Center for Health Services Research: Brian McCarthy, Florina Serbanescu

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Table of Contents
Table of Contents
Foreword ................................................................................................................ 1
A Day in Georgia .................................................................................................. 3
Introduction ......................................................................................................... 5
Maternal and Infant Health Facts .................................................................... 11 q Pre-pregnancy Health ................................................................................ 12 s Unintended Pregnancy and Childbearing ............................................. 13 s Teenage Reproductive Health .............................................................. 15 s Contraception ...................................................................................... 18 s Teenage Contraceptive Use ................................................................ 20 s Tobacco, Alcohol and Illicit Drugs ...................................................... 21 s Sexually Transmitted Diseases ............................................................. 23 s Domestic Violence ............................................................................... 23
q Prenatal Health .......................................................................................... 25 s Utilization and Quality of Prenatal Care .............................................. 25 s Birth Certificate Risk Markers ............................................................. 31 s Medical Problems during Pregnancy and Delivery ............................. 34 s Maternal Mortality ............................................................................... 35 s Maternal Morbidity .............................................................................. 36
q Infant Health .............................................................................................. 37 s Infant Mortality .................................................................................... 39 s Birth Defects ........................................................................................ 45 s Genetic Diseases and Newborn Testing in Georgia ............................. 49 s Low Birth Weight ................................................................................ 50 s Pre-Term Infants .................................................................................. 52 s Sudden Unexplained Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS) ..................................................................... 53 s Breastfeeding ....................................................................................... 54 s Perinatal Infections .............................................................................. 56
Maternal and Child Health Services ................................................................ 59 q Resources and Opportunities ..................................................................... 60
Conclusion ........................................................................................................... 67 q Major Contextual Issues ............................................................................ 67 q Key Recommendations .............................................................................. 72

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Appendix 1: Glossary ......................................................................................... 75
Appendix 2: Bibleography ................................................................................. 85
MCH Indicator Tables........................................................................................ 91
q About the MCH Indicator Tables .............................................................. 91 q Definitions and Calculations ...................................................................... 94 q State Level Table ..................................................................................... 103 q Health District Unit Tables ...................................................................... 107 q Metropolitan Statistical Area Tables ........................................................ 147 q Perinatal Region Tables ........................................................................... 167 q County Level Tables ................................................................................ 181

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Table of Illustrations
Tables Table 1.1 - Comparison of Georgia to the United States on Selected Kids Count Indicators ............................................................................................... 6
Table 1.2 - Georgia and the Year 2000 Objectives for Maternal and Infant Health ................................................................................................................ 7
Table 1.3 - Comparison of Georgia and the United States on Key Demographic and Economic Indicators .................................................................................. 8
Table 2.1 - Contraceptive Methods Used by Teenagers in Georgia ............... 20 Table 2.2 - Number and Rate of Births with Congenital Anomalies among Singleton Livebirths, from Birth Certificate and MACDP Data, Georgia 19891994 ................................................................................................................ 46
Table 2.3 - Preventive Strategies for Some Congenital Anomalies ................ 48 Table 3.1 - What Georgia is Doing to Improve Results for Mothers and Infants ............................................................................................................. 61
Maps Map 2.1 - Percent of Mothers Who Did Not Receive Any Prenatal Care, Georgia 1990-1994 ......................................................................................... 28 Map 2.2 - Prenatal Care in the First Trimester, Georgia 1990-1994 .............. 29
Map 2.3 - Infant Mortality Rate, Georgia 1990-1994 .................................... 43 Map 2.4 - Birth Defects per 1,00 Live Births, Georgia 1990-1994 ............... 45
Figures Figure 2.1 - Unintended Pregnancies in Georgia, 1995 ................................. 14 Figure 2.2 - Consequences of Risky Sexual Behavior among Women Age 15 to 19 Years, Rates and the National Ranking, Georgia and United States, 1992 ................................................................................................................ 16
Figure 2.3 - Number of Teen Pregnancies by Women's Age at Conception and Race, Georgia 1995 ........................................................................................ 17
Figure 2.4 - Conception Rates to Girls under Age 18 by Race, Georgia 19901995 ................................................................................................................ 18

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Figure 2.5 - Percent of Live Births in Which the Mother Had Prenatal Care in the First Trimester of Pregnancy, by Race, Georgia 1982-1995 ..................... 26
Figure 2.6 - Percent of Live Births in Which the Mother Had No Prenatal Care, by Race, Georgia 1992-1995 ................................................................. 27
Figure 2.7 - Relative Risk of Infant Death by Maternal Risk Marker by Race, Georgia 1990-1994 ......................................................................................... 32
Figure 2.8 - Percent of Infants with Maternal Risk Factor by Race, Georgia 1989-1993 ....................................................................................................... 33
Figure 2.9 - Percent of Infants with Maternal Risk Factor (Total) 1990-1995 ....................................................................................................... 34
Figure 2.10 - Infant Mortality Rate by Race and Year, Georgia 1950-1995 .. 40
Figure 2.11 - Infant Mortality Rate by Race for Georgia and the United States, 1990-1995 ....................................................................................................... 41
Figure 2.12 - Five Leading Causes of Infant Mortality, Georgia 1990-1995 . 44
Figure 2.13 - Percent of Low Birthweight Births by Race, Georgia 1990 to 1995 ................................................................................................................ 51
Figure 2.14 - Early Syphilis Rate in Women 15 to 44 and Number of Cases of Congenital Syphilis, Georgia 1985 to 1995 .................................................... 56

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Table of Resources
This list is based on the resources described in the boxes in the report.
Babies Can't Wait (BCW) ................................................................................. 52 Eve Bogan, Babies Can't Wait Program, Division of Public Health, 2 Peachtree Street, NW, Room 7-315, Atlanta, Georgia 30303. The phone number is 404657-2726 or 1-888-651-8224.
Babies Can't Wait Information and Referral .................................................. 52 Parent-to-Parent of Georgia 800-229-2038 statewide or 770-451-5484 in Atlanta.
Children 1st ......................................................................................................... 37 Center for Family Resource Planning and Development, Family Health Branch, Division of Public Health, Upper Level, Room 5, 2600 Skyland Drive, NE, Atlanta, Georgia 30319. Phone number is 404-679-0531.
Children's Medical Services ............................................................................... 62 Laura Symmes, RN,MS, Nursing Program Specialist, Child and Adolescent Health Section, Family Health Branch. 404-679-0547
Council on Maternal and Infant Health ........................................................... 24 Tee Rae Dismukes, Council on Maternal and Infant Health, 2 Peachtree Street, NW, 7th Floor - Suite 200, Atlanta, Georgia 30303. The phone number is: 404657-2866.
Genetics Program................................................................................................ 50 Mary Ann Henson, MSN, Human Services Specialist, Genetics Program, Child and Adolescent Health Section, Family Health Branch. Phone 404-679-0541
Georgia Affiliate of the Sudden Infant Death Syndrome Alliance ................. 53 Dee and Rob Miller, Co-Presidents, 912-729- 2882.
Georgia SIDS / OID Information and Counseling Program........................... 53 Lee Hackel, Center for Family Resource Planning and Development, Family Health Branch, Division of Public Health, Upper Level, Room 5, 2600 Skyland Drive, NE, Atlanta, Georgia 30319. The phone number is 404-679-0531.
Georgia's Pregnancy Risk Assessment Monitoring System (PRAMS) .......... 30 Mary Mathis, Perinatal Epidemiology Unit, Division of Public Health, 4th Floor Annex, 2 Peachtree Street, NW, Atlanta, Georgia 30303. The phone number is 404-657-6453.
Home of New Beginnings ................................................................................... 22 March of Dimes, Beta Building, 2 Northside 75, Suite 100, Atlanta, Georgia 30318. The phone number is: 404-350-9800.

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Perinatal Epidemiology Unit ............................................................................. 64 Epidemiology and Prevention Branch. James Buehler, MD, Perinatal Epidemiology Unit, Division of Public Health, 4th Floor Annex, 2 Peachtree Street, NW, Atlanta, Georgia 30303. The phone number is 404-657-6448.
Parent-To-Parent of Georgia ............................................................................. 52 Cathy Spraetz, 2900 Woodcock Blvd., Suite 240, Atlanta, GA 30341. The phone number is: 770-451-5484 or 1-800-229-2038.
Postponing Sexual Involvement Program........................................................ 16 Dr. Marion Howard , Grady Memorial Hospital, Box 26158, 80 Butler Street, SE, Atlanta, Georgia 30335. The phone number is: 404-616-3513.
Powerline Project ............................................................................................... 66 The Toll Free Powerline at 1-800-822-2539, or Sally Roettger at Healthy Mothers, Healthy Babies Coalition, Powerline Project, 1776 Peachtree Road, Suite 221 N; Atlanta, GA 30309 (404) 873-1993.
Project Alpha ...................................................................................................... 16 Ronnie Jenkins at Alpha Phi Alpha Fraternity, Eta Lambda Chapter, 1286 East Washington Avenue, East Point, Georgia 30344. The phone nu350mber is 404766-5744.
Ryan White Title V Coordinated HIV Services and Access to Research for Children, Youth, Women and Families ............................................................. 58
Wyndolyn C. Bell, MD, Project Coordinator. Phone 404-679-0547. Deborah Bauer, Program Manager. Phone 404-876-4788.
Savannah's Healthy Start Initiative .................................................................. 39 Keith Bacon, Healthy Start Initiative, 2301 Bull Street, Savannah, Georgia, 31401. The phone number is 912-651-6630.
Starting Points .................................................................................................... 37 Center for Family Resource Planning and Development, Family Health Branch, Division of Public Health, Upper Level, Room 5, 2600 Skyland Drive, NE, Atlanta, Georgia 30319. Phone number is 404-679-0531.
Think Ahead Campaign ..................................................................................... 12 March of Dimes, Georgia Chapter, Beta Building, 2 Northside 75, Suite 100, Atlanta, Georgia 30318. The phone number is 404-350-9800.
Woodsong ............................................................................................................ 22 Jacquelin Dewey, Program Manager. The phone number is: 912-574-5905.

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Executive Summary
Executive Summary
In the five years since the March of Dimes and the Division of Public Health issued their first report on the status of maternal and infant health in Georgia, the children born in 1989--the latest year for which data were included--have grown from newborns to elementary school children. Health care in Georgia has grown, too. Babies born in Georgia today are more likely to survive their first year of life than their siblings born in the 1980's.
The good news is:
q The infant mortality rate decreased. q The perinatal mortality ratio decreased. q The pregnancy, or conception rate among girls younger than 18 decreased. q The percentage of women who smoked during pregnancy decreased.
q The percentage of women receiving prenatal care in the first trimester of pregnancy increased.
q The percentage of women receiving perinatal case management during their pregnancy increased.
These accomplishments in maternal and infant health are the result of innovative and progressive strategies and policies that are characterized by partnerships which cut across public and private sectors, state and local agencies, medical and social services. Still, too many Georgia infants are affected by one or more risk factors that make healthy development more difficult.
Every day in Georgia
q 40 school age girls (age 10-17) get pregnant q 30 school age girls (age 10-17) have babies
300 babies are born q 70 are born to mothers who have not finished high school q 57 are born to mothers who didn't start prenatal care in the 1st trimester q 42 are born to mothers who smoked during the last trimester of pregnancy q 29 are born premature q 27 are born with low birthweight q 27 are born to mothers who drank alcohol during the periconceptual period q 9 are born with a major birth defect q 7 are twins or super twins q 5 are born with very low birthweight q 3 are born to mothers who received no prenatal care q 3 die before their first birthday q 2 are born after perinatal exposure to cocaine
By compiling information on maternal and infant health into a single report, we hope to make these data more easily available to a wide circle of policy makers, program planners, advocates and health care providers. Today, more than ever, knowledge is a powerful resource. On behalf of Georgia's families, we need to harness this resource and use it to meet the challenges ahead.

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Recommendations
Because folic acid supplements effectively prevent neural tube defects, such as spina bifida, all women of childbearing age should be taking daily multivitamins with 400 mcg folic acid. This should be accomplished through educational programs and assurance that health insurance and public programs provide coverage for multivitamins.
Because sexual abstinence and contraception prevent uninintended teenage pregnancy, all teenagers should have age-appropriate reproductive health education and services. This should be accomplished through a collaboration of all community sectors: health, education, religious, communities and families.
Because smoking, alcohol, and illicit substances, including cocaine use directly contribute to poor health, comprehensive treatment programs and prevention policies should be implemented to eliminate exposure to smoking, alcohol, and illicit substances by women, infants and children. This should be accomplished through a holistic approach to healing that includes parenting education, prenatal care, promotion of medical, social and life skills, job training, and child care.
Because domestic violence impairs use of prenatal care and directly contributes to maternal and infant mortality, public policies and programs should seek to eliminate domestic violence. This should be accomplished by prenatal and other health care providers ascertaining exposure to domestic violence and assuring appropriate intervention services.
Because STDs and other infections directly contribute to prematurity, infant and maternal mortality and morbidity, reproductive age women should how to prevent infection, and pregnant women and infants should be screened and treated if found positive for infectious diseases. This should be accomplished through a comprehensive prevention program including sex education, use of barrier methods during sexual intercourse, good hygiene, etc., early and repeated prenatal care screening and follow up treatment of pregnant women, and early detection and treatment of infections in infants.
Because prenatal care is essential to ensuring a healthy outcome for mothers and infants, pregnant women should have universal access to prenatal care during the first trimester of pregnancy. This should be accomplished by innovative outreach strategies for all pregnant women.
Because SIDS is the number one cause of infant death between age one week and one year, effective SIDS prevention techniques should be fully implemented. This should be accomplished by educating the public to ensure that all healthy infants should be placed on their back to sleep, should not be exposed to passive smoke, and should be breastfed for the first 3 months of life.
Because Medicaid provides funding support for over half of women who deliver babies each year, Medicaid should continue supporting current medicaid eligibility criteria and perinatal case management and should add a waiver to provide family planning services for women during the first 12 months postpartum.
Because reliable perinatal data is vital to MCH health assessments, evaluation of public programs, managed health care, and other health care, the assurance of quality MCH health care, public health should ensure that perinatal data is complete, accurate, and reliable. This should be accomplished by improved training of those who provide data, by providing systematic feedback of information to those who provide data (doctors, hospitals and health departments), and strengthening the capacity of decisionmakers at all levels to use data for more effective and appropriate decisionmaking.

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Foreword
The good news is that babies are faring better in Georgia today than they were at the beginning of this decade. Fewer babies are dying before their first birthday. More women are beginning prenatal care in the first trimester of their pregnancy. These achievements are the result of partnerships which cut across public and private sectors, state and local agencies, medical and social services.
We are extremely happy to have been part of this change, advocating for mothers and babies across the state. The challenge of change has never been stronger as the nation responds to the social and financial changes being brought about by health care reform and shifting demographics.
Using this Report
We hope this report will serve as a starting point to assess the needs and to create effective intervention strategies to improve the health of mothers and infants throughout Georgia. It covers topics of long standing importance to the health of mothers and infants such as low birthweight births, maternal and infant deaths, and birth defects. It also includes other issues like sexually transmitted diseases, domestic violence, and substance abuse. In addition, the report examines behaviors and conditions that contribute to poor birth outcomes. Finally, key elements of the health care service system are discussed such as Medicaid, WIC, prenatal care and family planning.
To keep this report a manageable size, and to release the information in a timely fashion, we limited the scope of data presented in the text. The appended Maternal and Child Health Data Tables include data that are not addressed in the text. These data provide additional MCH health indicators, for monitoring maternal and child health in Georgia.
Other publications provide complementary data. The Georgia County Guide, for example, contains demographic and socio-economic data, while the Georgia Kids Count Factbook has more information on child and teen deaths. Child welfare is an important topic with many complex data issues and Georgia would benefit from a separate volume addressing this critical area of child well-being.

Foreword

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Information is organized into seven main parts: A Day in Georgia and Introduction.
Major developments in the first half of the decade are summarized. This part, includes comparisons of Georgia and United States, trend data for Georgia, the Year 2000 Objectives, and demographic and socio-economic data.
Maternal and Infant Health Facts.
Data are organized into three sections according to a reproductive health view of the life cycle. q Pre-pregnancy health describes the experience of reproductive-aged women. q Prenatal health addresses topics related to pregnancy and delivery. q Infant health discusses birth outcomes and health during the first year.
Maternal and Infant Health Services.
The principal programs serving mothers and infants in Georgia are briefly described.
Conclusion.
This part summarizes the major contextual issues raised in the report and presents key recommendations.
Glossary.
Medical and other terms with special meaning used in the book.
Bibleography.
Alphabetical listing of scientific references and other information sources used and/or cited in the document.
Maternal and Child Health Indicator Tables.
The tables are provided in 5 major geographic levels--state, health district units, metropolitan statistical areas, perinatal regions, and counties.
By compiling information on maternal and infant health into a single report, we hope to make these data more easily available to a wide circle of policy makers, program planners, advocates and health care providers. Today, more than ever, knowledge is a powerful resource. On behalf of Georgia's families, we need to harness this resource and use it to meet the challenges ahead.
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A Day in Georgia
A Day in Georgia
Every day in Georgia more than 300 babies are born. Most of these babies have a healthy start in life -- their mothers began prenatal care in the first trimester of their pregnancy, they are born full term and weigh more than 5 and a half pounds. But still too many Georgia infants are affected by one or more risk factors that make healthy development more difficult.
Every day in Georgia:
Prematurity and low birth weight
q 29 babies are born premature q 27 babies are born low birthweight q 7 babies are born who are twins or super twins q 5 babies are born very low birthweight
Adolescent pregnancy (under age 18)
q 40 school age girls (age 10-17) get pregnant q 30 school age girls (age 10-17) have babies
Maternal behavioral risk factors
q 70 babies are born to mothers who have not finished high school q 42 babies are born to mothers who smoked during the last trimester of preg-
nancy q 27 babies are born to mothers who drank alcohol during the periconceptual
period q 2 babies are born after perinatal exposure to cocaine
Prenatal care
q 57 babies are born to mothers who did not start prenatal care in the first trimester of pregnancy
q 3 babies are born to mothers who received no prenatal care
Birth defects and infant mortality
q 9 babies are born with a major birth defect q 3 babies die before their first birthday
Data Sources: 1) Perinatal Epidemiology Unit, Division of Public Health, Georgia Department of Human Resources. Data from birth certificates is used unless more accurate data is available; 2) Pregnancy Risk Assessment Monitoring System (PRAMS) data is used for smoking and alcohol use; 3) Metropolitan Atlanta Congenital Defects Program (MACDP) data is used for birth defects rates; 4) The 1994 Population-based Prevalence of Perinatal Exposure to Cocaine study data is used for cocaine rates.
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia 4

Introduction
It has been five years since the March of Dimes and the Division of Public Health issued their first report on the status of maternal and infant health in Georgia. The children born in 1989 - the latest year for which data were included - are in second grade now. Paralleling their growth from newborns to elementary school children, perinatal health and health care in Georgia has developed considerably.
The good news is:
q The infant mortality rate decreased 23% from 12.4 to 9.5 infant deaths per 1,000 live births between1990 and 1995.
q The perinatal mortality ratio decreased 16 % from 19.0 to 16.0 fetal and neonatal deaths per 1000 live births in the same period.
q The pregnancy, or conception, rate among girls younger than 18 decreased from 105 per 1,000 in 1990 to 100 in 1995.
q The percentage of women who smoked during pregnancy decreased from 16% in 1990 to 11% in 1995.
q The percentage of women receiving prenatal care in the first trimester of pregnancy increased from 72% in 1990 to 83% in 1995.
q The percentage of women receiving perinatal case management during their pregnancy increased from 5% in 1991 to 19% in 1995.
Without a doubt, babies born in Georgia today face a greater likelihood of surviving the first year of life than their sisters and brothers who were born in the 1980's.
The significant accomplishments in maternal and infant health are the result of forward thinking policies and innovative strategies aimed at assuring all women and children have access to quality care and to advances in medical care. These efforts are characterized by partnerships which cut across public and private sectors, state and local agencies, medical and social services.
Milestones reached in the 1990's include the following:
q The expansion of Medicaid coverage to 185% of the federal poverty level for pregnant women and children in 1989.
q The policy of presumptive eligibility for Medicaid which gives women immediate access to the health care they need. First implemented in 1992, Georgia is 1 of 30 states with presumptive eligibility.
q The development of Children 1st in 1992 to serve as a statewide tracking and referral system that screens all births and links families to needed services.

Introduction

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
While Georgia has unquestionably made substantial advances in the first half of the 1990's, it is important to view these gains in a larger context. How do we compare to other states and the nation as a whole? How close are we to reaching the targets we have set for ourselves? These are useful yardsticks to measure progress.
Table 1.1 shows that despite the progress made during the decade of the 1990's, Georgia continues to rank near the bottom on several key indicators of child wellbeing. The Annie E. Casey Foundation gave Georgia an overall ranking of 43rd among the fifty states and the District of Columbia. The infant mortality rate continues to be among the highest in the nation. In Georgia, a higher percentage of children are born low birth weight, die before their first birthday, have babies before reaching age 18, live in a family headed by a single parent, grow up poor, and are without any health insurance than in the country as a whole.

Table 1.1 - Comparison of Georgia to the United States on Selected Kids Count Indicators

Indicator
Infant mortality rate (deaths per 1,000 live births)

Georgia 10.2

National

US

Rank

8.0

48

Percent low birthweight babies
Teen birth rate, ages 15-17 (births per 1,000 females)
Percent of families with children headed by a single parent

8.6

7.3

43

49

38

43

29%

26%

44

Percent of children in poverty

21%

21%

32

Source: The Annie E. Casey Foundation, Kids Count Data Book, 1997. Data are for 1994.

Georgia has not reached the Year 2000 objectives for any of the indicators in Table 1.2. In some areas, such as tobacco use during pregnancy and initiation of prenatal care in the first trimester, significant progress has been made and the goal is within reach. But in several other areas, the state has a great deal of ground to cover in order to achieve these targets by the end of the decade.

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Introduction

Table 1.2 - Georgia and the Year 2000 Objectives for Maternal and Infant Health

Indicators Percent of pregnancies
that are unintended Teen pregnancy rate under age 18
(conceptions per 1,000 females) Percent of women smoking
during pregnancy Percent of women who began prenatal care
in first trimester of pregnancy Percent babies born low birthweight Percent babies born very low birthweight Infant mortality rate
(deaths per 1,000 live births) Neonatal mortality rate
(deaths per 1,000 live births) Post neonatal mortality rate
(deaths per 1,000 live births) Maternal mortality
(deaths per 100,000 live births `90-'92)

1990 -
105.1 16% 72%
9% 2% 12.4 8.2 4.2
-

1995 47% 100.2 11% 83%
9% 2% 9.5 6.3 3.2 21.9

Year 2000 Objective
30%
50
10%
90% 5% 1%
7
4.5
2.5
3.3

Source: Perinatal Epidemiology Unit, Division of Public Health, Georgia Department of Human Resources.

About Georgia Georgia is the largest state east of the Mississippi River and is divided into 159 counties. More than one-third of the state's population resides in the 20 county area which comprises the Atlanta metropolitan statistical area (MSA). In contrast, 55 of the counties have fewer than 10,000 residents.

Of the state's 159 counties, 118 are classified as rural (non-MSA). More than one-third (37%) of the state's population lives in rural areas, as compared to onefourth (25%) nationally. Many of the state's rural counties are losing population, have high rates of poverty and have poor availability of health care. Ninety- eight counties are currently designated by the federal government as whole or partial primary care Health Professional Shortage Areas. In addition, 144 Georgia counties are designated in whole or in part as medically underserved areas.

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Table 1.3 illustrates several important changes underway in Georgia. The child population is growing at a faster rate than in the nation as a whole and is becoming increasingly diverse. Especially noteworthy is the rapid increase among Hispanic and Asian/Pacific Islander children and youth. While the state has a lower percent of high school graduates than the nation as a whole, it has a higher percentage of residents with a bachelors degree or higher. The higher educational attainment levels contribute to the rising per capita income. However, poverty rates for children exceed the national average and nearly 1 in 7 children in Georgia are without health insurance.

Table 1.3 - Comparison of Georgia and the United States on Key Demographic and Economic Indicators

Indicators
Population (1993)
All children under age 18 (1994) Percent change 1990-1994
Race/Ethnicity of Children White (1992) Percent change 1990-1992 Black (1992) Percent change 1990-1992 Hispanic (1992) Percent change 1990-1992 Asian and Pacific Islander (1992) Percent change 1990-1992 American Indian/Alaska Native (1992) Percent change 1990-1992

Georgia
6,902,358
1,892,300 9%
1,127,900 3%
607,900 5%
37,700 14%
26,000 18%
3,200 0%

United States
257,783,004
68,018,100 6%
44,972,400 2%
9,759,600 4%
8,549,300 9%
2,248,000 12%
650,400 3%

Percent of population rural (1990)
Educational attainment, 25 years and older High school graduate or more (1994) Completed bachelors degree or more (1994)

37%
79% 25%

25%
81% 22%

Median income of families with children (1993) Percent change in per capita income (1994)

$33,500 5%

$35,800 3%

Percent of children in poverty (1993) Percent of children in extreme poverty
income below 50% of poverty level (1993) Percent of children living in working poor families
at least 1 parent working 50 weeks or more a year (1993)

23% 12%
11%

21% 9%
8%

Percent of children without health insurance (1993)

15%

13%

Sources: The Annie E. Casey Foundation, Kids Count Data Book, 1996 and Centers for Disease Control and Prevention. Georgia Health Profile, 1996.

Data are for year specified in parentheses.

8

These demographic and economic developments are being matched by major changes in the delivery and financing of health care. The climate, both nationally and in Georgia, is one of rapid change and constricting resources. In the first half of the 1990's the federal government sought to control the growth of spending by giving states increasing flexibility in administering key social programs, such as Medicaid and the new Temporary Assistance for Needy Families (TANF) program which replaces the Aid to Families with Dependent Children (AFDC) program. This has significant implications for maternal and infant health.
q When Medicaid recipients are grouped into age categories, 59% of all beneficiaries in Georgia in 1995 were children under age 21. Children, however, accounted for only 32.5% of the benefit payments. In comparison, persons 65 years and older comprise 12% of the beneficiaries but account for 27% of the benefit payments.
q More than half (55%) of all births in Georgia in 1995 were covered by Medicaid. The Perinatal Case Management program linked more than 46,000 pregnant women with the services they needed to insure a healthy baby. The cost of this preventive service is less than $110 per recipient.
q In Georgia, Medicaid covered family planning services and supplies for over 100,000 women in 1995-96 SFY. Currently, federal funding pays for 90% of the cost.
q The implications of the new TANF program on Medicaid eligibility are not clear. For example, in the past Medicaid was provided without separate eligibility standards and application procedures to recipients of Aid to Families with Dependent Children. The new TANF program may sever this historic tie.
A second important development in the first half of this decade is the growth of managed care. The movement away from fee-for-service care to managed care constitutes a significant change in Georgia's public and private health care delivery system. The Georgia Health Policy Center estimates in 1995 that statewide 9% of Georgians were enrolled in a Health Maintenance Organization (HMO) and another 7% were enrolled in a Point of Service (POS) plan. The Georgia Medicaid program is moving toward managed care by:
q Establishing a voluntary HMO available to Medicaid beneficiaries in Atlanta which enrolled 16,000 individuals as of December 1996. This program will be expanded statewide in the future.
q Creating Georgia Better Health Care (GBHC) as a pilot program in 7 counties in 1993. GBHC matches Medicaid beneficiaries with primary care physicians who coordinate their health care. By December of 1996, 426,000 Medicaid recipients in 71 counties were enrolled in GBHC.
9

Introduction

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia These major changes in the delivery and financing of health care in Georgia are
occurring in the context of heightened competition for resources. This creates significant challenges for maternal and infant health.
In summary, the expansion of Medicaid services, begun in 1989, is an important contributing factor in the lower infant mortality rates Georgia is currently experiencing. The challenge is to preserve these gains and to further improve access to the health and social services needed in pre-pregnancy, prenatal care and during the first year of life.
In addition, managed care has the potential to lower costs, as compared to traditional fee-for-service health plans. The challenge is to ensure that the quality of care is protected and that the essential function of monitoring quality is explicitly addressed. Public health will need to continue to assure access to health care and to monitor the adequacy of access to appropriate services for those enrolled and those not enrolled in health care plans.
10

Maternal and Infant Health Facts
Maternal and Infant Health Facts
This section presents data on a wide range of key indicators of maternal and infant health. Indicators are organized into three sections according to a reproductive health view of the life cycle.
q Pre-pregnancy health describes the experience of reproductive-aged women. q Prenatal health addresses topics related to pregnancy and delivery. q Infant health discusses birth outcomes and health during the first year.
To paint such a broad picture, information is drawn from three principle sources:
q Georgia's Vital Records--such as birth and death certificates, q Georgia's Women's Health Survey, 1995, and q Georgia's Pregnancy Risk Assessment Monitoring System.
The data from vital records are included for each of Georgia's 159 counties contained in the MCH Indicator Tables of this report. The data from the two surveys are available only at the state level.
Woven throughout this section are boxes containing supplementary information on programs, research findings, and public policies. When appropriate, addresses and phone numbers are provided.
11

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Pre-pregnancy Health
"Awareness of reproductive risks, health-enhancing behaviors and family planning options is essential to improving the outcome of pregnancy. A new strategy to reach each woman of childbearing age with reproductive awareness messages at every health encounter should be implemented. Reproductive health screening should be used by all health providers serving women in their reproductive years. New reproductive awareness messages, and strategies to deliver them, should be developed for men. Social marketing techniques may be effective in changing attitudes and behaviors among both men and women". (March of Dimes, Toward Improving the Outcome of Pregnancy, 1993, page 12)
The leading cause of infant mortality is birth defects. Most birth defects occur between 17 and 56 days after conception--usually before recognition of pregnancy and the first prenatal visit. To positively impact pregnancy outcomes in the future, emphasis must be shifted from early prenatal care to pre-pregnancy.
The likelihood of giving birth to a healthy baby is greatly increased when the parents' health behavior includes the following: they do not smoke, drink alcohol or use illicit drugs, they are free of sexually transmitted diseases, and they resolve conflicts without resorting to violence.
The March of Dimes Think Ahead Campaign focuses on the importance of pre-pregnancy awareness. Recommendations for couples include: starting folic acid vitamin supplements before conception; meeting with a genetics counselor if there have been problem pregnancies or birth defects in the family; avoiding exposure to toxic substances and chemicals; and reducing stress. For further information, contact the March of Dimes, Georgia Chapter, Beta Building, 2 Northside 75, Suite 100, Atlanta, Georgia 30318. The phone number is 404-350-9800.
Studies show that the B vitamin folic acid reduces the risk of birth defects of the spine and brain. Neural tube defects are among the most common and serious birth defects, affecting about 2,500 babies nationally each year (Georgia Epidemiology Report, March 1996). If all pregnant women consumed the recommended amount of folic acid (0.4 milligrams, or 400 micrograms) each day either through food or vitamin supplement, half of neural tube defects could be prevented. Although folic acid
12

Maternal and Infant Health Facts
can be found in many foods (e.g. cereal, beans, orange juice), the average woman consumes only half of the recommended amount daily. The most convenient approaches for ensuring that women obtain adequate amounts of folic acid to reduce the risk for spina bifida or anencephaly include daily consumption of either a vitamin supplement or a fortified breakfast cereal containing 0.4 milligrams of folic acid.
The Georgia Women's Health Survey found that: q 29% of Georgia women reported having heard or read that folic acid can
prevent birth defects.
q 20% reported taking daily multivitamins having at least the recommended 400 mcg folic acid.
q Groups most at risk of inadequate folic acid intake are blacks, teens (15-19), and women living in rural areas.
Georgia Womens Health Survey was conducted in 1995 by the Perinatal Epidemiology Unit, Division of Public Health, Georgia Department of Human Resources. It was a random telephone survey of a probability sample of noninstitutionalized women ages 15-44 years between January and July of 1995. In households with more than one woman of reproductive age, only one woman was interviewed. Of the 4,005 women selected in the sample, 3,130 (78%) responded.
Data presented in this report were weighted to adjust for the selection of a single woman in households with more than one eligible women, for overselection of women living in households with more than one residential phone number, for nonresponse and for absence of a telephone in the household.

Unintended Pregnancy and Childbearing A recent report by the Institute of Medicine entitled "The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families (1995)", demonstrates that a pregnancy which is planned is more likely to result in a healthy newborn and a stronger family. In the case of an unintended pregnancy, the mother is more likely to expose the fetus to harmful substances such as tobacco, alcohol, and other drugs and to seek prenatal care after the first trimester or not to obtain care at all. She may fail to seek treatment for a sexually transmitted disease and neglect her special nutritional needs.

q The Year 2000 Objective is for no more than 30% of pregnancies to be unintended.
q The Georgia rate is 47% overall, and 40% for those pregnancies ending in a livebirth.

13

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia Nationally, about 33.4% of infants born between 1990-1994 were not intended
at time of conception. Chart 2.1 shows that in Georgia, 47% of women pregnant between 1990-1994 said their last pregnancy was not intended when it was conceived. Moreover, 40% of those whose last pregnancy ended in a livebirth said it was not intended when it was conceived.
Figure 2.1 - Planning Status of the Last Pregnancy in the Last Five Years, by Race, Georgia, 1995
Source: Georgia Women's Health Survey, 1995
Unintended pregnancies are divided into two groups: mistimed (26%) and unwanted (17%). Mistimed means a woman wanted the pregnancy to occur at a later date. Unwanted means that the woman "did not want to get pregnant then or at any time in the future". And finally, an "intended" pregnancy is one for which the woman states that "just before" she got pregnant, she "wanted to get pregnant then".
Data on un intended pregnancy collected in interviews is associated with underreporting bias for two reasons. First, women do not report all induced abortions. Abortion under-reporting implies that unintended pregnancies will be under-
14

Maternal and Infant Health Facts
reported to the same extent that abortions are under-reported. Second, women retrospectively are asked to report whether they wanted to be pregnant at the time they conceived. Some may have changed their feelings after the child was born, and may be reluctant to admit that the pregnancy was unintended at conception. Therefore, the reported planning status of the last pregnancy represents an underestimate of mistimed and unwanted conceptions.
A study by S. Henshaw and J.D. Forrest for The Alan Guttmacher Institute estimates that in 1990, a total of 795,520 women ages 13-44 nationwide were at risk of unintended pregnancy. Sub-population estimates of interest include the following:
q Among females age 13 to 44 with family incomes less than 185% of the federal poverty level, nationally 251,800 are at risk of unintended pregnancy.
q Among women under age 20, nationally 132,420 are at risk of unintended pregnancy, and for girls 15-17, nationally 53,260 are at risk of unintended pregnancy.
These estimates were calculated using three criteria: s Women who are sexually active; s Women who are fecund; and s Women who are neither intentionally pregnant nor trying to become pregnant.

Teenage Reproductive health Georgia's teen pregnancy, birth and gonorrhea rates are among the highest in the nation (Figure 2.2). In Georgia in 1995, 58% of surveyed teens ages 15 to 19 reported being sexually active, and six percent of Georgia women under 18 had had a medically-diagnosed sexually transmitted disease.

q 1995 conception rate for women under 18 years of age was 100.2 per 1,000 women 15-17 years of age.

Many young people have sexual intercourse early in life. The 1995 National Youth Risk Behavior Surveillance Survey asked high school teens if they had ever had sex; 63% of the female respondents were sexually experienced; 9% had their first sexual experience before age 13, and 19% had 4 or more sexual partners in their lifetime. Multiple partners can be risk factors for pregnancy, physical and sexual abuse, STDs and AIDS. Partcipants in the Georgia Women's Health Survey, 1995, supported sex education in the schools, but only 36% of women under age 20 had received sex education before the ninth grade.

q Women under 18 who conceived a second time decreased from 25% in 1991 to 21% in 1995.
q 4,103 teenage women had conceived three times before they were 20 years of age in 1992. In 1995 this number decreased to 2,860.

15

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Groups most at risk of unintended pregnancy are: younger women, never and formerly married women, black women, and women with lower educational attainment. Teenagers are an especially high-risk group who need to be targeted for reproductive awareness and outreach. As Figure 2.2 shows, Georgia's teen pregnancy, birth and gonorrhea rates are among the highest in the nation.
Figure 2.2 - Consequences of Risky Sexual Behavior among Women 15-19 Years, Rates and the National Ranking, Georgia and United States, 1992
Source: Adolescent: State of the Nation - Centers for Disease Control and Prevention, 1995
Two Georgia Programs Aimed at Teens are Project Alpha and the Postponing Sexual Involvement Program. Project Alpha is a collaborative partnership of the March of Dimes and Alpha Phi Alpha Fraternity targeting African American males. Goals include reducing the rate of teen pregnancy and promoting responsibility among young men. For further information contact Ronnie Jenkins at Alpha Phi Alpha Fraternity, Eta Lambda Chapter, 1286 East Washington Avenue, East Point, Georgia 30344. The phone number is 404-766-5744. The Postponing Sexual Involvement Progam, developed by the Teen Services Program at Emory University /Grady Health System in Atlanta, targets teens younger than 16. Based on the philosophy that teens younger than 16 cannot grasp or cope with the potential consequences of their sexual actions, the program gives practical tips for coping with peer pressure and sexual involvement. For further information contact: Dr. Marion Howard , Grady Memorial Hospital, Box 26158, 80 Butler Street, SE, Atlanta, Georgia 30335. The phone number is: 404-616-3513.
16

Maternal and Infant Health Facts
The age of a woman at the time of birth strongly influences the future health and well-being of both the child and the mother. The younger the woman, the greater the chance that both she and her child will face economic, educational and health hurdles which diminish their quality of life. In summary, they are more likely to be poor, uneducated and in ill-health. Figure 2.3 shows that while most teen pregnancies occur to older teenagers, in 1995 nearly 1,800 girls under age 15 became pregnant and nearly 2,800 15-year-olds became pregnant.
Figure 2.3 - Number of Teen Pregnancies by Woman's Age at Conception and Race, Georgia, 1995

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health
To further illustrate the contrast between numbers of teenage pregnancies and births to teenagers, in 1995, a total of 27,688 girls age 10-19 became pregnant, but girls in this age group delivered "only" 18,195 babies. The contrast is more striking for very young girls. For example, 436 13-year-old girls and 1,273 14-year-old girls became pregnant in Georgia in 1995, but 13- and 14-year old girls delivered "only" 118 and 455 babies, respectively. Since 8 states do not count all pregnancies, pregnancy rates cannot be compared for all states; the only measure that can readily be used for state comparisons is the teenage birth rate, which is substantially lower than teenage pregnancy rates.

q The difference between number of pregnancies and number of live births is due to 2 factors: 1) pregnancies are calculated from the mother 's age at conception, and 2) pregnancies include additional outcomes--fetal deaths and induced abortions.

17

Rate*

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia To define the magnitude of the problem of teen pregnancy and monitor the ef-
fectiveness of teen pregnancy prevention efforts, all pregnancies from the age at which the girl became pregnant are counted as part of the total. Figure 2.4 shows the number of conceptions to girls under age 18 per 1,000 girls aged 15-17 since 1990. Throughout the first part of this decade, one out of every ten school-age girls became pregnant before their eighteenth birthday. The African-American rate (168 per 1000) is 2.4 times greater than the white rate (69 per 1000). Most of their pregnancies are unplanned; 22% of pregnancies among teens were terminated by abortion.
Figure 2.4 - Conception Rates to Girls Under Age 18 by Race (Black, White, Total), Georgia 1990-1995
* conception rate is per 1,000 women age 15-17 Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health
Contraception The Georgia Women's Health Survey, 1995 found that 60% of the women surveyed used contraception; 23% used surgical contraception (16% tubal ligation and 7% vasectomy) and 37% used reversible methods such as pills, implants, condoms, foams, diaphragms and natural family planning methods, such as withdrawal, and periodic abstinence.
18

Maternal and Infant Health Facts
Of the 40% of women not using contraception, 9% had never had intercourse, 7% were pregnant, postpartum or seeking pregnancy, 8% were sterile for noncontraceptive reasons (i.e. hysterectomy or nonfecund); 6% were not sexually active in the past 3 months, and 11% were sexually active (had intercourse in the 3 months prior to the survey). Answers total 41% due to rounding. More than one in ten Georgia women (11%) had an unmet need for contraception because they were sexually active, not pregnant, postpartum or seeking pregnancy, physically able to become pregnant, and not using a birth control method.
A 1994 study by J.D. Forrest found that more than half of unintended pregnancies occur among sexually active women who used no contraceptive protection. Programs which target women with unmet contraceptive needs could significantly decrease the number of unintended pregnancies. The other half of unintended pregnancies occur among women who are using contraceptives. Programs which emphasize effective patterns of contraceptive use (efficacy of various contraceptive methods, re-education about dose, application, and time) may be equally effective in decreasing the number of unintended pregnancies.
Women who were not using contraceptives tended to be young, unmarried, infertile, non-high school graduates, having no church affiliation and having no health insurance. The overall unmet need for contraception is higher among black women (13%) than among white women (9%). In a 1993 study by J.D. Forrest, black women were found to initiate sexual activity and childbearing earlier than white women, and reach an age when they want no more children earlier than white women. Conversely, in their early stages of reproductive life, black women are less likely to be married, and use contraceptives less frequently than white unmarried women. Regardless of age and marital status, Forrest concludes that black women are less likely to use contraception except among women with college degrees or higher, and those with a church affiliation who attend frequently.
Current contraceptive use varies sharply by age. Nearly 45% of women aged 1524 were using a method of contraception compared to 67% among women aged 2534 and 65% among women 35 years or older. The percentage of couples noncontraceptively sterile also increases with the woman's age from 2% at age 1524 to 22% at age 25-34 and 42% at age 35-44. The differences in overall sterility (contraceptive and surgical) within groups are partly explained by differences in sexual activity, which varies greatly with age. The percentage who had never had sexual intercourse was 28% among women aged 15-24, and 1% among older women. The percentage of women not currently sexually active is inversely correlated with age. Among women 15-24, 8% were not sexually active, while 5% of women 25-34 and 4% of women greater than 35 were not currently sexually active.
19

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

The choice of contraceptive methods varies markedly among black and white women although the overall percentage of women currently using a method varies slightly by race (61% of white women vs. 55% of black women). Among white women, the most prevalent contraceptive method was the pill, used by one in three current users, followed by female sterilization, used by one in four current users. Among black women, the leading method was tubal ligation, followed by the pill. Male sterilization was more commonly used by white couples (about one in seven current users), and Depo-Provera and Norplant were more likely to be used by black women.

Contraceptive use increased with the number of living children a woman had, ranging from 58% among childless women to over 75% among women with 2 or more children. Childless women and those with one child were more likely to use the pill or condoms, while women with 2 or more children primarily relied upon permanent methods. Women with some college education and college graduates were significantly more likely to use pills than women with less education. About one in three women with less than a college education was using female sterilization, whereas only one in four women with some college and one in seven college graduates were using this method. Women covered by private health insurance were more likely to report contraceptive use (63%) than women with no health insurance (53%) or women covered by Medicaid (51%). Urban residents were more likely to use the pill, while rural residents relied more on female sterilization.

Teenage Contraceptive Use Among all of the teenage respondents (women age 15 to 19 years) in the Georgia Women's Health Survey, 1995, 30% used contraceptives within the last 3 months; 77% of sexually experienced teens used a contraceptive method during their first sexual experience, and 74% of currently sexually active teenagers used contraceptives within the last 3 months (Table 2.1).

q In 1995, 12% of all teenage women had an unmet need for contraception. (Georgia Women's Health Survey, 1995)

Table 2.1 - Contraceptive Methods Among Teens Who Ever Had Sex or were Sexually Active

Among All Teens Used
Contraceptives Within the Last
3 Months

Condoms

15%

Pills

11%

Norplant or Injectables 3%

Other Methods

1%

Among Experienced Teens Used
Contraceptives During First
Sex Experience
54% 19% 0% 4%

Among Active Teens Used
Contraceptives Within the Last
3 Months
36% 28% 8% 2%

20

Maternal and Infant Health Facts

TOBACCO, ALCOHOL AND ILLICIT DRUGS Women often do not know exactly when they become pregnant. All fecund women who smoke, drink alcohol or use other drugs are at risk of having a pregnancy affected by substance abuse and need appropriate counseling and treatment.

Tobacco The Georgia Women's Health Survey found that 24% of women ages 15-44 are smokers, twice the Year 2000 Objective of 12%. White women are twice as likely as black women to smoke (28% vs. 14%).

A study by the Perinatal Epidemiology Unit (Georgia Epidemiology Report, May 1991) found that mothers who smoke during pregnancy are 1.6 to 1.9 times more likely than nonsmoking mothers to have a low birthweight infant--controlling for race, marital status, and maternal education. This is consistent with a large body of research showing that maternal smoking during pregnancy has adverse effects. These studies show a reduction in birthweight of 150 to 300 grams. Maternal smoking during pregnancy is also associated with an increased risk of spontaneous abortion, abruptio placentae, placenta previa, bleeding during pregnancy and sudden infant death syndrome. Parental smoking after delivery and during childhood also carries health risks for children. These include an increased risk of bronchitis, otis media, upper respiratory tract infections and pneumonia, and hospitalizations for these conditions.

The Center for Health Policy Research reports that nationwide 1 in 3 young people under age 18 uses tobacco. Everyday 3,000 youth become regular smokers. The average ages for trying a first cigarette and for initiating smoking on a daily basis are 14.5 years and 17.7 years.

Alcohol The Georgia Women's Health Survey found that more than half of women (55%) ages 15-44 drink alcohol at least occasionally and more than one in seven are "binge" or chronic drinkers. Groups most at risk of heavy drinking are white women, teenagers and women ages 20 to 24.

q The Year 2000 Objective is to reduce FAS to 0.12 per 1,000 live births.

Drinking among teenagers is of particular concern. One in four Georgia teenagers surveyed in 1993 reported taking five or more drinks on at least one occasion. One-third (32%) had their first drink before age 13.

Fetal Alcohol Syndrome (FAS) is a birth disorder caused by alcohol passing through the placenta to the developing fetus. Based on data for Atlanta, the incidence of FAS detected during the first year of life is estimated to be about one in 3,000 live births. For the approximately 110,000 live births per year in Georgia, at least 36 infants are born with FAS. Infants born with FAS suffer mental and growth retardation, physical abnormalities, and damage to the central nervous system. (Georgia Epidemiology Report, April 1994).

21

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Illicit drugs The use of illicit drugs during pregnancy can lead to abruptio placentae, low birthweight, prematurity, birth defects, and infant mortality. The National Institute on Drug Abuse estimates that 5 million women of childbearing age use illicit drugs, and 11% of newborns are prenatally exposed to illicit drugs. In Georgia, this would mean 12,210 infants are exposed to illicit drugs each year.
Cocaine is considered one of the most dangerous illicit drugs available today. In a study conducted by Perinatal Epidemiology, the Centers for Disease Control and Prevention, and the March of Dimes, nearly 15,000 Georgia babies born in 1994 were tested to detect the prevalence of prenatal exposure to cocaine. This study found that 1 in 200 newborns were exposed to cocaine before birth. Since babies born prematurely, low birthweight, or multiple births were excluded from the study, this under estimates the prevalence of prenatal exposure to cocaine (MMWR 1996: 45(41):887-890 and the Georgia Epidemiology Report, February 1997).
Although the study found diverse population groups throughout Georgia used cocaine during pregnancy, the data suggest a profile of the average mother whose baby tested positive for cocaine. The mothers are more likely to have the following characteristics: they smoke cigarettes or drink alcohol during pregnancy; have less than 12 years of education, are age 25 or older, have three or more previous children, reside in a large metropolitan area, report that they gained less than 25 pounds during pregnancy, report getting late or no prenatal care during pregnancy, and are African American. Still, 63% of the mothers received prenatal care during the first 2 trimesters of pregnancy, and 34% received prenatal care during the first trimester. This suggests that prenatal care programs have opportunity to treat these addiction problems and improve the health of mother and infant.
Two Substance Abuse Treatment Programs designed for women are Home of New Beginnings and Woodsong. Home of New Beginnings is a collaboration of the Georgia March of Dimes and St. Jude's Recovery Center to build a residential drug treatment facility for women. A comprehensive long term therapeutic community approach will address both the medical and social needs of high-risk mothers and their newborns in Metropolitan Atlanta. For further information contact: March of Dimes, Beta Building, 2 Northside 75, Suite 100, Atlanta, Georgia 30318. The phone number is: 404-350-9800. Woodsong is a residential treatment program for chemically dependent women and their children, between the ages of 1 and 10. They focus on providing places for women who are in imminent danger of losing custody of their children. The normal length of stay for residents is 9 to 12 months. For further information contact: Jacquelin Dewey, Program Manager, at 912-574-5905.
22

Maternal and Infant Health Facts

Sexually Transmitted Diseases The Georgia Women's Health Survey found that nearly one in ten (9%) Georgia women have had a medical diagnosis of a sexually transmitted disease (STD). These include: genital warts (3%); chlamydia (3%); gonorrhea (2%); and genital herpes (2%). Population groups at greatest risk include: women with 9 or more lifetime partners, living in a large metropolitan area, and with low family income. White women are most at risk for genital warts and herpes, black women for chlamydia and gonorrhea. Because not all infected women have symptoms, this understates the magnitude of STD infections in Georgia.
The Center for Health Policy Research estimates that nationwide 3 million teenagers, or about 1 in 8, contract a STD each year. Among sexually active teens, about 1 in 4 will contract a STD before age 20. The most common STD's among adolescents are gonorrhea and chlamydia. Young adults in their 20's account for 20% of all AIDS cases and probably contracted HIV as adolescents.
Untreated STD's falicitate transmission and aquisition of HIV, as well as, increase the likelihood of adverse outcomes during pregnancy and birth. Gonorrhea and chlamydia are the chief causes of pelvic inflammatory disease which can lead to infertility and ectopic pregnancies.

Domestic Violence Domestic violence has serious emotional, social, and health consequences. Women who are abused are at risk of injury and death, suicide and suicide attempts, depression, sleep and eating disorders, and anxiety. Statewide data on physical and sexual abuse of women are available from two surveys - the Georgia Women's Health Survey and Pregnancy Risk Assessment Monitoring System (PRAMS).
The Georgia Women's Health Survey asked reproductive age women whether they had been a victim of abuse by their "partner" or "ex-partner. The likelihood of abuse is inversely related to age and education - the younger the woman and the lower her educational attainment the greater the chance that she was a victim of abuse in the past twelve months.
Georgia's Pregnancy Risk Assessment Monitoring System (PRAMS) survey asks women who recently had a baby about physical abuse prior to and during pregnancy. Comparing physically abused to non-abused mothers, abused mothers are more likely to be unmarried, not high school graduates, and under age 20. Abused mothers were more likely to live in crowded households and to have received support from WIC during pregnancy. Abused women were also more likely to have had an unintended pregnancy and were four times more likely to have entered prenatal care in third trimester or to have received no care. The pattern of abuse was similar for whites and blacks.

q 28% of women have been physically abused by their "partner" or "ex-partner".

q 5% of new mothers were physically abused by a partner.

q 9% reported that

they had been in

a physical fight in

the

twelve

months before

giving birth.

23

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia Physical violence or threat of violence is often associated with sexual abuse. The
Georgia Women's Health Survey found that women who never experienced physical abuse were one-fifth as likely as physically abused women to have ever been raped. About one in five women (21%) report having been forced against their will to have sexual intercourse at some time in their lives. More than one in ten women had been raped before they turned age 20. In most instances, the victim knew the perpetrator.
The Council on Maternal and Infant Health recommends that: (1) physical violence be considered a risk factor for late entry into prenatal care; (2) all woman be screened for domestic violence and physical abuse; and (3) health care and social service providers be trained to enhance their skills in conducting physical abuse screens. For further information contact: Council on Maternal and Infant Health, 2 Peachtree Street, NW, 7th Floor - Suite 200, Atlanta, Georgia 30303. The phone number is: 404-657-2866.
24

Prenatal Health

Maternal and Infant Health Facts

" The outcome of pregnancy is influenced by both medical and social conditions; thus improvements will require medical and social interventions. Many of the same factors that are barriers to utilization of health care are contributors to poor health. While the organization and structure of regionalized perinatal care cannot change social conditions, it can work to assist and empower women by improving the interpersonal aspects of the system of care". (March of Dimes, Toward Improving the Outcome of Pregnancy, 1993, page. 70)

Nowhere is the intersection of medical and social conditions more evident than in prenatal health. First, there are multiple barriers to prenatal services--inadequate transportation, lack of health insurance, and maldistribution of providers. Second, a range of factors place pregnant woman at risk of adverse birth outcomes--low educational attainment, poverty, illicit drug, alcohol or tobacco use during pregnancy, and lack of social support. The highest risk women are often faced with multiple medical and social problems. The challenge is to develop new strategies which combine medical and social services into a coherent system which is family-centered and community-based.

Forsyth County Health Department received a grant from the March of Dimes to support a bilingual interpreter to improve communication with their growing Hispanic population. In addition to assisting with Perinatal Case Management, WIC, Family Planning, and Child Health services, the interpreter translated health education materials into Spanish. For further information contact: Jennifer Pulliam, Northeast Georgia Division of March of Dimes, P.O. Box 2512, Gainesville, GA 30503. The phone number is: 770-534-1332.

Utilization and Quality of Prenatal Care Prenatal care has been recognized as the cornerstone of our health care system for pregnant women since the beginning of the twentieth century. A growing body of research has demonstrated a relationship between the use of prenatal care services and improved maternal and infant health. Prenatal care typically includes regular visits to a physician's office, clinic, or other health care facility to monitor the health of mother and fetus. During the visit a physician, nurse, or health care provider will weigh the mother, take her blood pressure, listen to the fetal heartbeat, order necessary laboratory tests, and educate the mother on the effects of alcohol, tobacco and drugs during their pregnancy in addition to covering nutrition, birthing, parenting, and breastfeeding.

q The Year 2000 Objective is to have 90% or more women giving birth receiving prenatal care in their first trimester.
q The Georgia rate for 1st trimester prenatal care was 83% in 1995.

25

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Inadequate use of prenatal care has been associated with increased risks of low birthweight births, premature births, infant mortality and maternal mortality. The effectiveness of prenatal care depends upon timely access and appropriate content. These are discussed below in terms of utilization and quality of prenatal care.
Utilization of prenatal care In 1995, 83% of the more than 112,000 births in Georgia were to women receiving prenatal care that began in the first three months of pregnancy. This constitutes a significant increase over the 72% of women who began early prenatal care in 1982. Most of these gains were made since 1990 (Figure 2.5). The gap between white and black women has begun to close during this same time period, indicating that improvements were particularly great for groups of women with the lowest initial levels of prenatal care use.
Figure 2.5 - Percent of Live Births in Which the Mother Had Prenatal Care in The First Trimester of Pregnancy, by Race, Georgia 1982-1995

Source: Health Assessment Section, Center for Health Information, Georgia Division of Public Health

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Because of this considerable improvement, Georgia parallels the US rate of 80.2% in 1994. A higher proportion of black and white women receive early prenatal care in Georgia than for US as a whole (blacks: 71.6% as compared to 68.3%, and whites: 85.9% as compared to 82.8%). This finding underscores that gains that have been made in reaching out to historically under served populations.
At the other end of the continuum are births to women who received no prenatal care. Here too, Georgia has made substantial gains in the 1990's. After increasing during the 1980's, the percent of mothers who had no prenatal care began to decline in 1990 and has steadily decreased this decade, falling from 2.5% in 1990 to 1% in 1995. Figure 2.6 shows that reductions in no prenatal care have been particularly pronounced for black women, bringing the rate for this group much closer to the rate for whites.
Figure 2.6 - Percent of Live Births in Which the Mother Had No Prenatal Care, by Race (Total, Black, White), Georgia 1992-1995

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health

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Prenatal care use shows wide variation by geographic area. Pockets with low rates of prenatal care utilization are still found in Georgia. In three counties more than 4% of births were to women who received no prenatal care (Map 2.1) for the years 1990 through 1994--that is about 1 in 25 births for those counties which account for 13.3% of the births in Georgia.
Map 2.1 - Percent of Mothers Who Did Not Receive Any Prenatal Care, Georgia, 1990-1994

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health

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In three counties over 90% of pregnant women received prenatal care during the first trimester of their pregnancy (Map 2.2)--achieving the Year 2000 Objective that 90% of women should receive prenatal care during the first trimester. Another 70 counties have early prenatal care rates greater than the state average of 76.8%.
Map 2.2 - Prenatal Care in the First Trimester, Georgia 1990-1994

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health

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The reasons for such geographic variation have not been systematically studied. However, differences in income, education, insurance coverage, as well as prenatal care provider availability have been offered as explanations. Findings from The Georgia Woman's Health Survey provide the following social profile of prenatal care utilization.
q Maternal characteristics associated with higher percentages of first trimester prenatal care included: age (25-39), race (white), education (high school graduate), marital status (married), residence (Atlanta), delivery not paid by Medicaid, did not receive WIC and had breast fed an infant at some time.
q In contrast, higher percentages of no prenatal care occurred to women with the following attributes: age (20-24), race (black), education (less than complete high school), marital status (previously or never married), residence (rural), and those who had never breast fed. Many of these factors are also risk markers for adverse birth outcomes.
Quality of prenatal care Prenatal care utilization measures are primarily based on birth certificates and provide little information about the quality of prenatal care. Georgia is fortunate to have the Pregnancy Risk Assessment Monitoring System (PRAMS) to furnish a more complete picture of the prenatal health during the first half of the 1990's.

Georgias Pregnancy Risk Assessment Monitoring System (PRAMS) is a state-wide, population-based surveillance system. PRAMS questionnaires are used to collect information on women's behaviors before and during pregnancy, and after they deliver a live born infant. The data are linked to the baby's birth certificate, which provides more detail on the mother and infant. For further information contact Mary Mathis, Ph.D., Perinatal Epidemiology Unit, Division of Public Health, 4th Floor Annex, 2 Peachtree Street, NW, Atlanta, Georgia 30303. The phone number is 404-657-6453.

PRAMS survey data reveal that 21% of women feel they did not get prenatal care as early as they wanted. The reasons for this delayed entry into prenatal care are enlightening: nearly one-third (32%) didn't think they were pregnant; more than onequarter (28%) couldn't get an appointment with a health provider earlier in their pregnancy, one-fifth (20%) didn't have enough money or insurance to pay for a prenatal care visit, and 7% had no transportation. Many of these same barriers were cited by the one in fourteen women (7%) who did not receive as many prenatal visits as they wanted. Again, one-fifth (21%) did not have enough money to pay for prenatal care visits. The proportion citing transportation problems increased to 17% and 10% lacked child care.

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Maternal and Infant Health Facts
Georgia women appear satisfied with the prenatal care they receive. Nearly nine in ten women (89%) who received prenatal care were satisfied with amount of time the doctor or nurse spent with them and 94% were satisfied with advice they received on how to take care of themselves. Slightly fewer women (80%) were satisfied with the amount of time they had to wait after they arrived for their visit. While more than half (56%) the women were able to enter prenatal care within two weeks, 9% had to wait three weeks and 13% had to wait one month or more.
Birth Certificate Risk Markers To better utilize available resources, ensure appropriate care for all women, and improve the outcome of pregnancy, maternal risk assessment has become an important element of prenatal health care. An efficient and effective health care system requires early risk identification and the timely provision of appropriate care.
A study conducted by the Perinatal Epidemiology Unit for this report sheds light on the relative importance of risk markers drawn from birth certificates. By linking birth and death files, analysts identified 8 maternal behaviors from the birth certificate that affected at least 1000 infants each year and were associated with at least 140% higher infant mortality among singleton liveborn infants for the period 19891993. These behaviors, or risk markers, may not be causally related to infant mortality, but may simply identify a high risk group. Moreover these results cannot be explained by poverty status or other factors that are related to infant mortality.
Some other factors known to be associated with increased infant mortality risk include multiple gestation, prior pregnancies with fetal death outcome, and male gender of infant. As an example, because about 50% infants born from multiple gestation pregnancies, such as twins and triplets, are low birthweight, they experience higher mortality rates than singleton births. During the 1989-1995 period, 18,939 liveborn infants in Georgia resulted from multiple gestation pregnancies--and 976 died--for an infant mortality rate of 52 per 1000 liveborn twins.
Birth Certificate Risk Markers in the order of greatest risk for infant death are births where the mother: q Gained fewer than 25 pounds during pregnancy. q Did not provide the father's name on the birth certificate. q Did not graduate from high school. q Received no prenatal care. q Reported smoking tobacco during pregnancy. q Reported drinking alcohol during pregnancy. q Conceived fewer than six months after giving birth to a prior child. q Is younger than 18 years old.

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The presentation on risk analysis that follows begins with the relative risk of each marker. Next, data are presented on the frequency of the markers among babies born in Georgia between 1990 and 1994. Finally, the incidence data are looked at over time to ascertain which risk markers are becoming more prevalent and which are declining.
Figure 2.7 shows that the relative risk of no prenatal care, weight gain fewer than 25 pounds and not having a father's name on the birth certificate are greatest for both white and black infants. For the remaining five risk factors, the order is slightly different for the two groups.
Figure 2.7 - Relative Risk of Infant Death by Maternal Risk Marker by Race, Georgia, 1990-1994

* Reference group includes high school graduates and above ** Reference group includes women age 15-34 years
Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health

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The number of infant deaths that can be attributed to these markers is determined not only by the relative risk but also by the percentage of births with the characteristic. Figure 2.8 shows the percent of infants born in Georgia between 1990 and 1994 with one or more of these risk markers. Weight gain under 25 pounds is the most common, affecting one-third of infants. This marker had a relative risk in excess of 3 and this is cause for concern. No prenatal care, the marker with the greatest relative risk, is fortunately quite rare, affecting fewer than 2% of infants. Several indicators differ significantly for whites and blacks.
Figure 2.8 - Percent of Infants with Maternal Risk Factor by Race, Georgia, 1990-1994

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health

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Finally, it is useful to examine the incidence of these markers over time. Figure 2.9 shows that the presence of a risk marker decreased during the first half of the 1990's; the greatest improvement being in the reduction of no prenatal care. This may be due to the increased effectiveness of pre-pregnancy and prenatal health care strategies and programs, as well as to demographic and social changes.
Figure 2.9 - Percent of Infants with at least One Maternal Risk Factor 1990 to 1995

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health
Medical Problems During Pregnancy and Delivery In 1995, nearly 20,000 women (18%) experienced medical problems during their pregnancy or delivery. This is a slight improvement from the rate of 20% in 1990.

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Problems reported on the birth certificate include anemia, diabetes, genital herpes, hypertension, eclampsia, syphilis, and rubella, among others. These health problems are not reported consistently and accurately for all mothers which makes it difficult to evaluate patterns or trends.
Maternal Mortality Significant quality problems are also evident in the maternal mortality data. Georgia currently measures maternal mortality by manually reviewing all death certificates. A 1995 study by the Perinatal Epidemiology Unit found that this traditional method missed nearly one-third of the deaths. When supplemented with an analysis of linked birth and death files to identify women within one year of giving birth, a more complete picture of maternal mortality emerges.
Between 1990 and 1992, a total of 71 pregnancy-related deaths occurred in Georgia, for a rate of 22 per 100,000 live births. The leading causes were hemorrhage (23%), embolism (22%), infection (11%), cardiomyopathy (8%), pulmonary problems (8%), hypertension (6%), anesthesia complications (4%) and other causes (14%).
Ectopic pregnancy is the leading cause of maternal mortality during the first trimester of pregnancy. Causes for maternal deaths vary by pregnancy outcome. The 3 leading causes of maternal death for each pregnancy outcome are: q Live Birth - pregnancy-induced hypertension, embolism and hemorrhage
q Still Birth - hemorrhage, pregnancy-induced hypertension, and infection q Abortion - infection, hemorrhage, embolism
The National Year 2000 Objective is to reduce the maternal mortality rate to 3.3 per 100,000 live births overall and 5.0 per 100,000 live births among black women. Georgia's black women have 3.5 times higher risk of dying from pregnancy-related complications than white women. For each cause of death, the pregnancy-related mortality ratio was higher for black women than for white women. (Source: Hani Atrash et.al., Ob-Gyn Pregnancy-Related Mortality in the U.S. 1987-1990)
During 1990-1992, 41% of the non-pregnancy related deaths in Georgia among pregnant or postpartum women were homicides. Other non-pregnancy-related deaths were from motor vehicle accidents (29%), cancer (21%), AIDS/HIV (7%) and suicide (2%).

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Many maternal deaths could have been prevented at various stages of the pregnancy and delivery. The following case reports from death certificates of maternal deaths in Georgia reflect the complexity of medical and social problems associated with maternal deaths, and the necessity of appropriate and timely health care, including family planning.
q A 30 year old never-married woman died from toxemia of pregnancy. It was her tenth pregnancy. She had no prenatal care, was a diabetic, and had chronic hypertension and morbid obesity.
q A 21 year old married woman died from pneumonitis after delivering stillborn twins. It was her sixth pregnancy.
q A 20 year old student died after a self-induced coat hanger abortion. q A 17 year old student, with no prenatal care, bled to death after delivering a
stillborn infant.
Maternal Morbidity The Year 2000 Health Objective is to reduce severe complications of pregnancy to less than 15% of all deliveries. Pregnancy complications require an average of 2 million hospital days of care per year at a cost of $1 billion per year for hospital charges alone.
Nationally, black women have 1.4% higher risk of hospitalization during pregnancy than white women. An estimated 3,100 hospitalizations for pregnancy-related morbidity occur for each maternal death.
The leading pregnancy-related complications resulting in hospitalization in the U.S. are:
20% Preterm labor 8% Spontaneous abortion 8% Ectopic pregnancy 7% Genitourinary infection 6% Early pregnancy hemorrhage 6% Excessive vomiting 4% Diabetes 4% Pregnancy-induced hypertension
(Source: U.S. Maternal Health Update; August 15, 1996)

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Infant Health
"Infant care must extend beyond the walls of the hospital to achieve optimal child health. The responsibilities of the regional perinatal network include ensuring follow-up for NICU graduates and other infants with complex problems. Perinatal program linkages to a range of pediatric care for high-risk infants are essential to ensure comprehensive and effective early intervention services. Emphasis should be given to coordination and integration of existing programs and services." (March of Dimes, Toward Improving the Outcome of Pregnancy, 1993, page 41.)
More babies born healthy and surviving the first year of life are the desired results of pre-pregnancy and prenatal health care. When babies are born too small, too early, or with birth defects, they need appropriate interventions and follow-up. Just as important as the medical risk factors, are social indicators of vulnerability infants born to families that are too poor, too young, or otherwise ill prepared for parenthood. A growing body of research suggests that family and community nurturing capacities may be more powerful predictors of long-term child well-being than infant diagnoses.
As our focus expands and greater attention is given to accountability for results, stable, long-term monitoring and tracking is required as part of a broader familycentered, community-based system of care. Currently we collect data at birth and then not again until children begin their formal schooling five years later. While the opportunities for early intervention and prevention are plentiful, people often lack the information they need to access or deliver services in an efficient and effective manner.
Georgia is leading the nation in developing the cross-agency partnerships to enable state and local officials to coordinate and integrate their services to serve newborns and their families. Under the leadership of the Family Health Branch of the Division of Public Health, Georgia is piloting a new child tracking system.
Children 1st is a statewide initiative to help new parents provide their young children with a healthy start in life. All infants are screened at birth to identify factors which place them at risk for poor health and development and their families are linked to appropriate services. Starting Points is a pilot of the model system of contact and family support in three Georgia communities and receives support from the Carnegie Foundation. For further information contact the Center for Family Resource Planning and Development, Family Health Branch, Division of Public Health, Upper Level, Room 5, 2600 Skyland Drive, NE, Atlanta, Georgia 30319. Phone number is 404-679-0531.

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The human and fiscal costs of poor birth outcomes are enormous. Women who lose an infant, give birth to a low birthweight or pre-term infant, or a newborn with a birth defect are more likely to experience a subsequent adverse pregnancy outcome. What is perhaps most tragic is that the cycle might have been broken through medical and social services. For the state, poor birth outcomes mean lost productivity and human potential.

Medical expenses alone create huge financial burdens for both the family and society as a whole. Almost all very low birthweight infants require treatment in a neonatal intensive care unit at a cost of over $1,000 per day. The average cost of a stay is between $20,000 and $30,000. Based on data from Medicaid in Georgia, the cost of care for a very low birthweight baby can reach $500,000.

Georgia taxpayers spend approximately $536 million annually to support families of teen mothers.

The preventable social costs are clearest with teen births. According to the Division of Public Health, Georgia Department of Human Resources, a family begun by a teenager in Georgia in 1993 cost taxpayers an average of $18,390 by the time the baby reaches age 20. This includes AFDC, Medicaid and Food Stamps only. It does not include costs related to special medical care, housing, special education, child protective services and child care.

Kids Having Kids: A Robin Hood Foundation Special Report on the Costs of Adolescent Childbearing focuses on the roughly 175,00 adolescents nationwide each year who have their first baby at age 17 or younger, comparing outcomes for them and their children with those for women who have their first child at age 20 or 21. They found that children of teenagers are:
Twice as likely to be abused or neglected. If they are girls, 83% are more likely to become teenage mothers
themselves. If they are boys, up to 2.7 times as likely to land in prison. Fifty percent more likely to repeat a grade.
The study also found that 7 out of 10 adolescent mothers will drop out of high school and in their first 13 years of parenthood will earn an average of $5,600 annually--less than half the poverty level. Teen fathers will finish an average of 11.3 years of school by the age of 27 and earn, on average, $4,732 less annually than men who delay fatherhood until age 20 or 21. [Source: Robin Hood Foundation, 1996]

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Given the high social costs associated with poor birth outcomes in general and teen births in particular, it is evident that prevention and early intervention strategies are required if we are to break the upward spiral of remedial costs and strengthen the capacity of Georgia's families and communities to nurture their children.

Savannahs Healthy Start Initiative includes two programs that target male parents. The Male Involvement Program works with fathers and includes a "Male Only Clinic" and a father support group. Project Mind (Males Involved in Nurturing Development) works with a local alternative school and focuses on self-esteem, knowledge building, and conflict resolution. For further information contact, Keith Bacon, Healthy Start Initiative, 2301 Bull Street, Savannah, Georgia, 31401. The phone number is 912-651-6630.

INFANT MORTALITY Infant mortality is universally accepted as a core indicator of the health of a nation or community because of its close association with a variety of medical and socio-economic conditions. Maternal health, the utilization and quality of prenatal care, economic development, educational attainment, and public health practices are all linked with infant mortality.
Infant Mortality is divided into two stages to permit closer scrutiny of the causes and effective interventions. The two stages are:

The Year 2000 Objective is no more than 7 infant deaths per 1,000 live births.
The Georgia rate for 1995 is 9.5 per 1,000 live births.

Neonatal mortality or death of a live born infant during the first 27 days of life. Neonatal mortality is also divided into early neonatal mortality for infants who die during the first 6 days after birth and late neonatal mortality for those who die between 7 and 27 days of life.

Post-neonatal mortality or death of an infant from 28 through 364 days old.

The first part of the 1990's has witnessed a decline in both the neonatal and postneonatal mortality rates. In 1990, the neonatal mortality rate was 8.2 per 1,000 and the post neonatal mortality rate was 4.2 per 1,000. By 1995, the comparable rates were 6.3 and 3.2 per 1,000.

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As with infant mortality as a whole, the neonatal and post neonatal rates reflect a significant racial disparity with black infants dying at a rate twice that of white infants in both time periods. These rates are nearly identical to the US average. The Year 2000 Objective is to reduce neonatal mortality to 4.5 per 1,000.
Of the 112,244 infants born in Georgia in 1995, 1,068 died before their first birthday for a rate of 9.5 per 1,000 live births. This represents a significant improvement from the rate of 12.4 per 1,000 in 1990.
Figure 2.10 shows that the decline in infant deaths is part of a long-term trend that has been underway for many decades. While the progress signified in the chart is heartening, the persistent black/white gap is troubling. Over the multi-decade period, black infants die at a rate twice that of white infants. From another perspective, the decline in infant mortality for blacks lags about 20 years behind that for whites.
Figure 2.10 Infant Mortality Rate by Race (White, Black) and Year, Georgia, 1950-1995

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health

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Recent declines in Georgia have not kept pace with declines in other states. As a result, the Georgia ranking in infant mortality continues to be 47th. In part, the poor showing in national comparisons may be attributed to the persistent large disparity in the risk of infant death between whites and blacks. As Figure 2.11 shows, when Georgia is compared to the US total, the rates for whites and blacks are nearly identical. Thus, the lower overall average is, in part, a product of the racial composition of the population.
Figure 2.11 - Infant Mortality Rate by Race (White, Black, Total) for US and Georgia, 1990-1995

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health

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In 1992, a Reading Group was formed in the Division of Public Health to study the factors contributing to the Black-White gap in infant mortality (and low birthweight) and to recommend strategies to reduce the disparity. After reviewing a multi-disciplinary body of literature, the Reading Group recommended that: The Division of Public Health at every level incorporate all aspects of
cultural diversity into the formulation of health care policy, practice, and research. The role of spirituality in the African-American culture as a factor for shaping positive health outcomes be explored.
The concept of economic self-sufficiency in the African-American community be fostered and its implication for improving the birth outcomes of infants be considered.
Community residents be actively sought out and encouraged to get involved and to participate in the formulation of health care policy, practice, and research.
For further information about the Reading Group contact: Patricia White, Family Health Branch, Women's Health Section, 2 Peachtree St. NW, Atlanta, Georgia 30303. Or call 404-657-3141.

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Trends in infant mortality suggest that achievement of the Year 2000 Objective of 7 deaths per 1,000 live births will require substantial new efforts to improve perinatal health. This is particularly evident in Map 2.3 which shows the infant mortality rate in Georgia from 1990-1994. Fifteen counties have lowered their infant mortality rates below the Year 2000 Objective of 7 deaths per 1,000 live births. At the other end of the yardstick, fifteen counties have rates in the 17 to 26 per 1,000 range nearly twice the state average.
Map 2.3 - Infant Mortality Rate, Georgia, 1990-1994

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health

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Between 1990 and 1995, three of the 5 leading groups of causes of infant mortality--birth defects, sudden infant death syndrome, and respiratory distress syndrome-showed some decrease (Figure 2.12). Deaths from respiratory distress syndrome (RDS), a condition affecting premature and low birthweight infants, declined most dramatically from 192 to 92 infants--a decline of about 50% during these 5 years. Its decline began in 1989, stopped in 1992-94 and then began to decline again in 1995. This decline followed the availability and use of steroids to prevent and surfactant to treat infants with RDS.
Figure 2.12 - Five Leading Causes of Infant Mortality by Race, Georgia, 1990-1995

* These include maternal hypertensive disorders (760.0), maternal renal and urinary tract diseases (760.1), other chronic maternal circulatory and respiratory diseases (760.3), unspecified abnormality of chorion and amnion (762.9), exceptionally large baby (birthweight greater than 4500 grams) (766.0), post term infant not "heavy for dates" (766.2), fetal blood loss (772.0), unspecified condition originating in the perinatal period (779.9) International Classifications of Diseases, ninth edition.
Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division ofPublic Health

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BIRTH DEFECTS Birth defects (congenital anomalies) are the leading cause of infant mortality in Georgia and accounted for 17% of all infant deaths in 1994 and 19% in 1995. They also contribute to childhood morbidity and long-term disability. Infants with congenital anomalies often need special medical care, and account for 25%-30% of all pediatric hospital admissions nationwide. Estimated yearly expenditures are $1.4 billion dollars (Lynberg M, Edmonds L, CDC, 1994).
In 1995, 3 of every 100 infants born in Georgia had a major birth defect. Of an estimated 3,300 infants reportedly born with a congenital anomaly, 205 died before their first birthday. The remaining 3,095 survived beyond the age of 1 and are affected in various degrees. The percentages of births with a birth defect reported on the birth certificate from 1990 through 1994 varies by county from less than 0.5% to 13.4% (Map 2.4).
Map 2.4 - Percent of Infants with One or More Birth Defects, Georgia, 1990-1994

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health

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Data on congenital anomalies in Georgia is derived from statewide and local sources. Vital records include birth, death and fetal death certificates and are a statewide, population-based system at the Division of Public Health. The Metropolitan Atlanta congenital Defects Program (MACDP) has monitored congenital anomalies in five counties of metro Atlanta since 1968. Cases include all still and live-born infants with a major birth defect diagnosed within the first year of life. MACDP has active case-ascertainment, yielding data that is more complete, accurate and timely than systems that rely only on reports from hospitals, but it requires substantial resources and is confined to 5 of 159 Georgia counties. It is the only monitoring system in Georgia. The birth certificate detected only 28% of MACDP cases that were recognizable at birth, and 23% of infants identified by the birth certificate as cases had no congenital anomalies recorded in their medical records. According to birth certificates, the prevalence of congenital anomalies in Metro Atlanta is about 1%, compared to 3% reported by MACDP (Table 2.2). Applying this 3% estimate statewide, 3,300 newborns in Georgia are born each year with a major congenital anomaly, compared to the 1,131 reported on birth certificates.

Table 2.2- Number and Rate of Births with Congenital Anomalies among Singleton Live Births, from Birth Certificate and MACDP1 Data, Georgia, 1989-1994.

Defect Group

Birth Certificate

Georgia No. Rate

Metro-Atlanta No. Rate

MACDP1
Metro-Atlanta No. Rate2

All defects Selected defects3
Neural Tube Defects Anencephaly Spina Bifida
Hydrocephaly Microcephaly Cleft lip/palate Heart anomalies Esophageal atresia/TEF4 Anal atresia Omphalocele
/gastroschisis Diaphragmatic hernia Renal agenesis Clubfoot Trisomy 21

9,945
75 161 151
24 457 432
62 34
142 64 48
330 342

15.31
0.12 0.25 0.23 0.04 0.70 0.66 0.10 0.05
0.22 0.10 0.07 0.51 0.53

2,401 10.62
24 0.11 38 0.17 43 0.19
7 0.03 126 0.56 116 0.51
9 0.04 10 0.04
51 0.23 26 0.11 16 0.07 103 0.46 102 0.45

6,839 30.24

39 91 105 102 293 1,755 39 75

0.17 0.40 0.46 0.45 1.30 7.76 0.17 0.34

106 0.47 53 0.23 75 0.33
364 1.61 241 1.07

1 Metropolitan Atlanta Congenital Defects Program 2 Rate per 1,000 singleton live births 3 Except for heart anomalies, the selected anomalies are usually diagnosable at birth 4 Tracheoesophageal fistula

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Congenital heart defects are the most common, and account for 1/4 of all defects in MACDP (Table 2.2). Using rates from MACDP, we estimate that, statewide, anencephaly and spina bifida affect 60-70 infants each year .
The high proportion of infant deaths from congenital anomalies reflects not only the high prevalence at birth (3%), but also the high risk of death associated with some anomalies. The mortality of infants with congenital anomalies was greater than 50 times higher than the mortality experienced by infants with no congenital anomalies or low birth weight (16.4% vs 0.3%) and was 10 times higher than among infants with low birthweight alone.
The public is often concerned about environmental problems that may cause birth defects. Public concern about potential environmental causes of congenital anomalies, such as toxic waste sites, the Gulf War, atomic plants, nuclear waste storage sites, and places of employment often leads to public health investigations.
Neural tube defects, fetal alcohol syndrome, congenital syphilis, and diabetic and rubella embryopathies are examples of congenital anomalies that can be prevented by concerted efforts of health care providers, educators, communities, and families (Table 2).
Based on studies from MACDP and from the Division of Public Health, we estimate that from 1992 through 1994 about 200 infants in Georgia were born with anencephaly or spina bifida, half of whom would have not been affected had their mothers taken appropriate folic acid supplements from before conception; about 70 infants were born with fetal alcohol syndrome, and 275 infants with congenital syphilis.

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A practical challenge for prevention is that most harmful and/or protective factors may have already influenced the fetus by the time the pregnancy is recognized. A logical approach to prevention would then include planning the pregnancy, so that preventive measures can be implemented from before conception (Table 2.3). An estimated 50% of pregnancies in the U.S. are intended; increasing this proportion would decrease other adverse outcomes related to unintended pregnancies. Moreover, using barrier methods of contraception would also decrease the risk of syphilis infection.
Table 2.3 - Preventive Strategies for Some Congenital Anomalies
Pre-conceptional care folic acid supplements to prevent neural tube defects control maternal diabetes to prevent embryopathy reduce alcohol use to prevent Fetal Alcohol Syndrome promote planned pregnancy use barrier methods of contraception to prevent syphilis
Early prenatal care diagnose and treat syphilis to prevent congenital syphilis reduce alcohol use to prevent Fetal Alcohol Syndrome
Early Immunization Vaccinate prepuberal girls against rubella to prevent rubella embryopathy
Food Fortification Implement fortification of enriched flour with folic acid, to increase folic acid use by all women of reproductive age
Education on all of the above
Preconceptional education is a cornerstone of all these preventive efforts. Current efforts in Georgia to prevent neural tube defects through the use of folic acid center on education and supplement usage, and include training, development of educational materials, identification of fortified cereals for use in the WIC (Women and Infant Children) program. Nutritional counseling training of public health nurses and nutritionists, workshops on nutrition competency-based skills, and training in pre-conceptional health are conducted by the Office of Nutrition and sponsored by Women's Health. The March of Dimes is assisting public health to develop nutrition education materials on the use of folic acid.

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Surveillance is a critical component in the effort to further reduce the negative impacts of birth defects. A comprehensive surveillance system detects the occurrence of birth defects, alerts public health officials to clusters requiring investigation, and insures appropriate care for children in need of services. Although over 80% of birth defects are diagnosed at or shortly after birth, hospital medical records staff correctly record on birth certificates only about 1 in 5 birth defects that occur.

Monitoring anomalies must include both birth and fetal death certificates. In Atlanta fetal death certificates detected 2/3 of all cases of congenital anomalies registered by MACDP among stillbirths from 1989 through 1991 (M. Watkins, personal communication). However, MACDP medical record review could only confirm 1/4 of congenital anomalies reported on the fetal death certificate.
Monitoring systems must include all pregnancies, so that all unexpected clusters of birth defects will be detected, the impact of congenital anomalies will be correctly estimated, and the efficacy of prevention can be accurately measured.

The March of Dimes is advocating a national birth defects surveillance system that would enable health officials to identify and track clusters of birth defects.

How Texas Got a Birth Defects Surveillance System. In April 1991, nurses at Valley Regional Medical Center in Brownsville, Texas, were alarmed by the birth of three anencephalic infants in a 36-hour period. This incident sparked a study of area statistics by the Centers for Disease Control and Prevention and the Texas Department of Health that uncovered a staggering fact: Brownsville had the highest rate of anencephaly in the country. Immediately, the March of Dimes and other health organizations mobilized to assess the scope of the problem. A Scientific Advisory Committee was formed to explore the possible causes of this infant health crisis. March of Dimes advocacy efforts helped the Texas Legislature pass a bill establishing a statewide birth defects surveillance system.

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Genetic Diseases and Newborn Testing in Georgia The first objective of the Genetics Program is to identify individuals in the populations who have genotypes that are associated with disease so that medical management can be provided. The second objective is to identify individuals in the population with genotypes that may lead to disease in their descendants so that counseling can be provided. Its mission is to prevent morbidity and mortality attributed to genetic disorders.
The Georgia Newborn Screening Program was started in 1978 to detect, diagnose, and recommend early treatment for serious and life-threatening metabolic diseases and hemoglobinopathies. Every newborn infant in Georgia must be tested. Blood samples are typically obtained before discharge at the hospital or birthing center of delivery. For infants discharged before 3 days of age, a follow-up sample is obtained within 1 week. The state law requires screening for metabolic disease of all infants, but infants who die shortly after birth are usually not screened. Linkage of metabolic screening records and birth certificates shows that over 90% of infants are tested; but that infants who weigh less than 3 lbs 5 oz at birth or who die in the first few days after birth are unlikely to be tested.
During 1995 a total of 5,234 abnormal metabolic screening tests led to followup of 5,055 infants. Of these, 96 had clinically significant disorders requiring continuing medical intervention. An additional 65 required transitory treatment and/or genetic counseling.
Newborn Screening: All newborns are supposed to be screened for seven inherited metabolic disorders--phenylketonuria (PKU), galactosemia, tyrosemia, homocystinuria, hypothyroidism, maple syrup urine disease (MSUD), and congenital adrenal hyperplasia (CAH). Screening for sickle cell anemia and sickle cell trait is required for all newborns deemed to be a high risk for carrying the gene for, or having sickle hemoglobin and for infants of parents of unknown ancestry.
The retrieval, diagnosis, medical management and counseling of affected individuals is through cooperative or contractual arrangements between the Genetics Program, Division of Public Health, Emory University, Medical College of Georgia, Sickle Cell Foundation of Georgia, Hemophilia of Georgia and county health departments.
Other Genetic Services: Patients may be referred for screening, diagnosis, management and counseling services for a wide range of genetic disorders to Emory University, Medical College of Georgia or to a public health outreach clinic in Athens, Columbus, Dalton, Gainesville, Macon, Savannah, Albany, Waycross or Valdosta.
Contact: Mary Ann Henson,MSN,Phone 404-679-0541

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Maternal and Infant Health Facts

Low Birthweight

Low birthweight is a major threat to the health and well-being of infants born The Year 2000 today. Low birthweight infants are at much greater risk of dying before their first Objective is to re-
duce the low
birthday. Those who survive are at an increased risk of neurological problems (such birthweight rate as cerebral palsy and seizure disorders), mental retardation, lower respiratory tract to 5% of births.

conditions, and general morbidity.

The Georgia rate is 9%.

Reducing the prevalence of low birthweight births has been difficult. The low
Low birthweight
birth weight rate in Georgia has remained constant at 8.6% to 8.8% through the first infants weigh less

part of the 1990's. Figure 2.17 shows that the black rate is twice the white rate.

than 2500 grams

(5.5 pounds).

Figure 2.13 - Percent of Low Birthweight Births by Race (Total, White, Black), Georgia, 1990-1995]

Very low birth weight--less than 1500 grams (3.3 pounds)

Very, very low birthweight infants weighing less than 500 grams (1.1 pounds) rarely survive one day.

Source: Perinatal Epidemiology Unit, Epidemiology and Prevention Branch, Georgia Division of Public Health
As with infant mortality, the Georgia rates for whites and blacks are nearly identical to their national counterparts. The higher total rate for Georgia (8.6 percent compared to 7.3 percent for the US) can be attributed to different population distributions.

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Of the nearly 9,900 infants born low birthweight in 1995, 897 died before their first birthday. At greatest risk are those infants born very low birthweight.
In 1995, 1,939 infants were born very low birthweight or 1.7% of all live births. This rate has been stable throughout the early 1990's. As with low birthweight rates overall, the rate among black infants is more than twice that of white infants.
Pre-Term Most low birthweight infants are born pre-term (before 37 weeks of gestation). They weigh too little because they have not had enough time to develop fully. Low birthweight and prematurity are one of the leading causes of infant mortality in Georgia. They accounted for 165 infant deaths in 1994.
In 1995, 10,681 infants were born pre-term, a rate of 9.7%. This rate has remained constant over the first part of the 1990's. The pre-term rate among black infants is nearly twice that of white infants.
Many pre-term and low birthweight infants suffer from chronic disabling conditions like cerebral palsy, seizure disorders, blindness, mental retardation, behavioral problems and learning disabilities.
The Centers for Disease Control and Prevention has issued a major report on Racial Differences in Preterm Delivery (Am J Prev Med; 1993:9(6) Supplement) that lays out a new research paradigm that is needed to understand the high preterm delivery rate among African Americans. New research perspectives are essential to developing effective intervention strategies that will reduce prematurity rates.
Babies Cant Wait (BCW) is Georgia's statewide interagency service delivery system for infants and toddlers with developmental delays or disabilities and their families. BCW is established by a federal law which guarantees all children, regardless of their disability, access to services that will enhance their development. BCW has a statewide directory of information run by Parent-to-Parent of Georgia. The directory provides information about the BCW program located nearest to the child and family. To access the directory, call 1-800-229-2038 or 770-451-5484 in Atlanta. For further information contact Eve Bogan, Babies Can't Wait Program, Division of Public Health, 2 Peachtree Street, NW, Room 7315, Atlanta, Georgia 30303. The phone number is 404-657-2727 or 1888-651- 8224.

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Maternal and Infant Health Facts
Sudden Unexplained Infant Deaths (SUIDs) and Sudden Infant Death Syndrome (SIDS)
"Sudden, unexplained infant deaths (SUIDs) are those for which no cause of death was obvious when the infant died. Sudden Infant Death Syndrome (SIDS) (also known as crib death) is the most frequently determined cause of SUIDs. SIDS is the sudden death of an infant under 1 year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history." (Source: CDC MMWR Recommendations and Reports RR-10,Vol 45, dated 6/21/96) Georgia does not currently use CDC recommended investigation procedures.
SIDS is the third leading cause of infant mortality in Georgia and the number one cause of death in infants between one week and one year of age. SIDS deaths occur most frequently among two-to-four month old infants, and 90% of the infants who die are under six months of age. In 1995, 131 infant deaths in Georgia and approximately 3,300 infant deaths nationally were attributed to SIDS. Georgia's SIDS mortality rate decreased 20% from 1.5 deaths per 1,000 live births (163 infant deaths) in 1994 to 1.2 per 1,000 live births in 1995, which may be due, in part, to the inception of the Back to Sleep SIDS education and risk-reduction campaign.
Georgia Back to Sleep Program, which was introduced in 1994 and is on-going, presents an opportunity to educate expectant and new mothers about good health practices, SIDS risk factors and prevention.
The Georgia Sudden Infant Death Syndrome / Other Infant Death (SIDS / OID) Information and Counseling Program educates professionals and the general public, especially pregnant women and families of newborns, about reducing the risk of SIDS through early prenatal care, prenatal smoking cessation and maintaining a smoke-free environment, breast-feeding, use of firm bedding materials, maintaining a comfortable room temperature, and positioning the infant on its back to sleep. The project also provides bereavement support for Georgia families who have experienced an infant death.
The Georgia Affiliate of the Sudden Infant Death Syndrome Alliance is a statewide, voluntary health organization dedicated to the service of families, education of the public and health professionals, and elimination of SIDS through research. (Contact: Dee and Rob Miller, CoPresidents, 912-729-2882).
For further information contact Lee Hackel, Coordinator Georgia SIDS/ OID Program, Family Health Branch, Division of Public Health, Upper Level, Room 5, 2600 Skyland Drive, NE, Atlanta, Georgia 30319. The phone number is 404/679-0531.

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
The Georgia Women's Health Survey, 1995 found that 40% of mothers put their babies to sleep on the infant's back or side. During this period the percentage placed on their side increased from 13% to 52%; but the percent placed on their back remained constant at 5% until 1995 when it increased to 9%. Putting an infant to sleep on its back or side was associated with the following attributes of the mother: higher educational attainment, living in a large metropolitan area, being married, and receiving prenatal care in the first trimester of pregnancy. Nationally, the percentage of parents who placed their infants in a prone sleep position (on the infant's stomach) decreased from 75% in 1992 to less than 25% in 1995, following the 1992 recommendations of the American Academy of Pediatrics that infants be placed on their back or side to sleep. National SIDS infant mortality rates during the period 19921995 decreased 30%, which represented the largest decrease in SIDS mortality rates since the inception of SIDS data collection.
Breastfeeding Breastfeeding benefits infants and improves mother-infant bonding. The National Institute of Child Health and Human Development (NICHD) found that infants who died of SIDS were less likely to be breast-fed, which implies a protective effect from breastmilk. Colostrum, the liquid in a new mother's breasts before the milk actually comes in, is especially high in antibodies that protect the newborn against staphylococcus, polio virus, Coxsackie B virus, Escherichia coli. (Source: The New Our Bodies Ourselves). During the first few months of life, the infant acquires antibodies from its mother through breast milk. Breastfeeding has been shown to prevent gastrointestinal and respiratory illness, infections and certain immunologic disorders. (Source: Georgia Back to Sleep newsletter, March, 1997)
From 1993 to 1995, one half of white mothers in Georgia, and one third of black mothers breast-fed their infants at least one week. In 1995, more Hispanic women (61%) breast-fed their infants than non-Hispanic women (45%). Fifty percent of urban women and 34% of rural women breast-fed their infants 7 days or more. (PRAMS)

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Maternal and Infant Health Facts
During the first ten weeks postpartum, the percentage of mothers who breastfeed decreases steadily. By the time the infant is 4 months of age (seventeen weeks) virtually no mother, regardless of race, is breastfeeding. When PRAMS asked new mothers why they did not breastfeed or stopped breastfeeding, the leading answers were: lack of desire to breastfeed (43%), deterred by work or school (24%), unsuccessful attempts at breastfeeding (15%), mother decided bottle feeding was better (9%) and the mother was taking a prescription that prevented her from breastfeeding (7%). One mother talked about her fatigue at managing work and home priorities. She said "My job involved hard labor and I came home tired and agitated." Another mother expressed anxiety over a previous breastfeeding failure when she said "I tried it with the first one, and he didn't breastfeed well. I was afraid with my second one." A third feared she would underfeed her infant when she said "She developed a cold and I felt the only way for me to know what she was getting was by using the bottle."
Lactation counselors within hospitals, clinics and post-delivery services are teaching new mothers techniques for breastfeeding and strategies for continuation after resuming their normal daily routines, such as expressing the milk before there is need, and choosing a daycare center near the workplace so that the mother can breastfeed during the lunch hour. One respondent summed up the experience by saying "Breastfeeding is the best way to go, but it's not easy. More mothers should be encouraged to breastfeed, but there needs to be follow-up visits. Lactation nurses make it seem like an easy task, but try telling that to a new mother who has cracked nipples and a screaming baby."
PRAMS data presents the attributes of a mother who is most likely to breastfeed. She is married, over the age of 25, highly educated, an urban dweller, who does not smoke tobacco products or drink alcohol, and is not receiving WIC services.

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Congenital and Perinatal Infections It is estimated that maternal infections affect 2-8% of all livebirths in the US. In Georgia in 1995, perinatal and other infections were the fourth leading cause of death of infants after congenital anomalies, prematurity/low birthweight, and SIDS. They were the second leading cause of deaths of infants 7 to 27 days old.
Congenital Syphilis Fetal infection occurs with high frequency in untreated early infections of syphilis in pregnant women. It often causes spontaneous abortion or stillbirth, and may cause infant death due to preterm delivery of low birthweight infants or from generalized systemic disease. Figure 2.14 illustrates the relationship of rates of early syphilis in women of child bearing age to cases of congenital syphilis during a period of increased cases.
Most cases of congenital syphilis can be prevented if women are screened for syphilis and treated early through prenatal care. Rates in the U.S., as well as Georgia, have declined steadily between 1991 and 1995 from 107.3 to 39.0 per 100,000 livebirths in the US and 126.0 to 40.4 per 100,000 livebirths in Georgia. (Source: Beneson, 1995 and STD Surveillance,1995).
Figure 2.14 - Early Syphilis Rate in Women Age 15 to 44 and Congenital Syphilis Cases, Georgia 1985 to 1995

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Maternal and Child Health Services
Maternal and Child Health Services
Reviewing Georgia's health care system as it exists today is a difficult undertaking. Changes in Medicaid are imminent. Managed care is growing rapidly. The role of public health is being debated. However, a review is worthwhile because the health improvements achieved during the first half of the 1990's are in no small measure due to improvements in the availability and quality of maternal and infant services. Real progress has been made towards the goal of providing optimal care to improve the health of Georgia's women and infants. The challenge for the remainder of the decade will be to sustain these gains in the face of the rapidly changing health care landscape and heightened efforts to cut costs.
Georgia is building a comprehensive system of services which includes a mix of public and private, health and non-health, state and local resources tailored to meet the needs of women and infants around the state. This emergent system recognizes that preventive services are the most cost effective way to improve health outcomes in the long run. The challenge is how to meet the demand for crisis or remedial services, while shifting toward a preventive approach. It is important to bear in mind that the new system is in a formative stage - one can see both the legacy of the past and the promise of the future.
This section of the report traces the contours of the maternal and child health care system and describes some of its key components.
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Resources and Opportunities
In the first half of the decade, Georgia has taken several significant steps in improving life for its children and families. The state is fortunate to have a number of public and private initiatives, collaborative efforts and programs working to improve the well being of children and families. Key to these efforts has been the development, in 1994, of the Georgia Policy Council for Children and Families to serve as an umbrella to unite and integrate the state's many family-centered, community-based programs.
One of the most significant resources is the Georgia Title V Maternal and Child Health Services Block Grant Program. These federal and state funds are administered through the Family Health Branch of the Georgia Division of Public Health. Under Title V, the state conducts a needs assessment, and then develops policies, plans, and programs to improve the health of women, infants, children, adolescents, and families in Georgia.
In the first half of the decade, the state's MCH budget increased from $164.0 million in 1990, where $14.4 million was contributed from Title V federal funds to $209.3 million in 1995, where $16.7 million was contributed from federal funds. For the 1997 fiscal year, federal funds to the state of Georgia were $16.7 million, and the state's budget for family health services was approximately $211.5 million.
Programs that typically receive funds under Title V include Family Planning, Immunizations, Children 1st, Family Connection, and the Policy Council for Children and Families. In 1995, the Title V program funded services to 87,895 pregnant and post-partum women; 514,728 infants; and 14,474 children with disabilities and their families.
The Georgia Division of Public Health and Department of Medical Assistance (Medicaid) have spearheaded advances in the delivery of health care services to the state's women and infants, particularly low income mothers and infants. In collaboration with other state agencies and councils; professional medical and allied health associations; advocates and non-profit agencies; religious, civic, and business organizations; community based groups; the Centers for Disease Control and Prevention, and other federal entities, they have worked to assure a more comprehensive approach to the delivery of services from preconception through infancy. Chart 3.1 lists many of the programs which aim to improve prepregnancy, prenatal care, and infant health in Georgia.
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Maternal and Child Health Services

Table 3.1 - What Georgia Is Doing to Improve Results for Mothers and Infants

Pre-pregnancy

Prenatal

Family Planning Preconceptual Health Education Nutrition Substance abuse treatment Smoking cessation STD screening and treatment Domestic violence help line

Expansion of Medicaid Presumptive Eligibility Perinatal Case Management Right from the Start Medicaid Nutrition- WIC Provision of Prenatal Care Midwifery Program
Regionalized Perinatal System

Infant
Children 1st Health Check Babies Can't Wait Healthy Families WIC- Nutrition Immunization Back to Sleep Program First Steps

At the local level, health care services are principally provided and coordinated by the 159 county public health departments. One-fifth of Georgia's population, approximately 1.2 million people, receive their health care within the public health department system network. However, this is increasingly supplemented by a broad array of services delivered by other public agencies, as well as private and nonprofit organizations.

Family Health Branch 1996 At the state level, the Family Health Branch contains the Center for Family Resource Planning and Development, Child and Adolescent Health Unit, the Immunization Program, Office of Nutrition, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Women's Health Services.

The Center for Family Resource Planning and Development works collaboratively with other agencies and organizations to improve results for children and families. The Center manages two innovative initiatives--Children lst and Starting Points.

Children lst is Georgia's emerging state system of identification, linking and monitoring which seeks to assist parents in providing their young children with a healthy start in life. The system is designed to screen all children and families at the time of birth, identify families needing support and services to help them with a child's health and development up to age three, assist families in linking these children to a primary health care provider, and generate data necessary for planning and program development.

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Georgia's Starting Points Initiative is pilot testing the "Model System of Family Contact, Support and Service Coordination at Birth", a service strategy which incorporates Children lst, and other existing systems in Georgia designed to more effectively use resources. The Model System supports all families at the time of the birth of an infant, beginning in the birthing hospital. Families receive personal contact and are offered support and guidance about parenting and resources. Families at higher risk receive an assessment of strengths, resources and needs; linkages to appropriate services; and continuous follow up in the community.
Babies Can't Wait (BCW) is Georgia's comprehensive, coordinated, statewide, interagency service delivery system that provides services, including multi- disciplinary evaluation and assessment, development of an Individual Family Service Plan, and service coordination, for infants and toddlers with developmental delays or conditions that will result in a developmental delay. The Program serves children from birth up to the third birthday, regardless of income, who meet program criteria.
The Child and Adolescent Health Unit includes those programs providing preventive health services and services to children with special health care needs. Sections of the The Child and Adolescent Health Unit include: Children's Medical Services, the Genetics Program and Ryan White (Title V) Coordinated HIV Services and Access to Research for Children, Youth, Women and Families.
Childrens Medical Services (CMS) is the state and federally funded (Title V) program. Its mission is to assure that eligible children with chronic health conditions who are residents of the state of Georgia receive specialty medical care. Eligibility for the program includes a financial eligibility which is updated annually--based on the federal poverty level guidelines. Children who are Medicaid enrolled, receive SSI or are in foster care, are eligible for CMS services.
CMS provides or pays for an array of services which include: comprehensive physical assessment, diagnostic testing, inpatient/outpatient hospitalization, medications and other medical treatments, therapy, durable and disposable medical equipment, hearing aids, dental care if related to the CMS eligible condition, health education, referral to and coordination of care with other providers. Social work services and genetics consultations are also available. CMS promotes standards of care which are both cost effective and appropriately address the unique needs of children with special health care needs.
Referral to the CMS program may be made through the local county health department or directly to the CMS program.
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Maternal and Child Health Services
The Immunization Program provides guidance and technical assistance to county health departments and private providers on immunizations and their related issues. One of the primary duties of the Program has been to provide vaccines to district and county health departments. This service has expanded to include community health centers, homeless programs, and private providers. The adequacy of immunization levels of two year old children increased from 35% in 1986 to 88% in 1996.
The Office of Nutrition (OON) coordinates nutrition services provided to women and children in Georgia. These include: WIC, "5 A Day" Surveillance (a cancer risk reduction program), Food Stamp education, and breast-feeding coordination and promotion.
The WIC Program is 100% federally funded, at a 1997 level of about $112 million, through the United States Department of Agriculture to provide nutrition food supplements, nutrition education, and breastfeeding support and promotion for purposes of improving the health and nutritional status of low income pregnant, breast-feeding, and post partum women, infants and children up to age five who are 185% of the federal poverty level. WIC is offered through Georgia's health departments, community health centers and two contracted agencies (Southside, Inc. and Grady Memorial Hospital in Atlanta).
The Women's Health Section has the primary responsibility for public health services to pregnant women, including ensuring continuity of services with Family Planning. The Section includes support of Family Planning, Maternal High Risk Pregnancy, Perinatal Case Management, Regional Perinatal System, Certified Nurse Midwifery, and Prenatal Care Services. As of July 1997, the certified nurse midwifery and the Maternal High Risk Pregnancy Program will be combined to form a new program called Babies Born Healthy. The purpose is to promote healthy babies in Georgia by assisting women in accessing compehensive, quality, perinatal services. The Regional Perinatal System provides services for high risk pregnant women and infants in 6 designated tertiary level hospitals in Georgia. The centers are strategically located to provide accessible comprehensive high risk care, maternal and neonatal consultation services, transport support, coordination of medical follow-up care, educational and quality assessment support for perinatal facilities.
Family Planning services include physical exams; screening for cervical cancer, breast cancer and anemia; pregnancy testing; and dispensing of contraceptive methods. Education and counseling are also provided in the areas of reproductive and preventive health including STD/HIV risks, testing and treatment. No one is refused services because of inability to pay.
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
The Georgia Division of Public Health contracted with the World Health Organization (WHO) Collaborating Center in Perinatal Health to conduct a statewide review of the perinatal system in Georgia. This review resulted in 5 recommendations enhancing the underlying foundation of total cohort accountability, that will address each aspect of the health system--individuals and communities, providers, government--accountable for ensuring optimal perinatal care be given the entire population of women and infants. Implementation has begun with the appointment of a statewide perinatal Task Force who will define the actions needed to transition to a more coordinated state perinatal system.
Epidemiology and Prevention Branch The Epidemiology Section of the Epidemiology and Prevention Branch (EPB) investigates outbreaks of infectious and environmentally-related diseases, analyze morbidity and mortality data and disseminates information relative to disease patterns, conduct studies to determine risk factors for disease and injuries and evaluate the effectiveness of intervention programs. The Perinatal Epidemiology Unit is located in EPB.
In July 1992, the Georgia Legislature established an Office of Perinatal Epidemiology, now called the Perinatal Epidemiology Unit, with 4 positions and $300,000 (with 50% matching funds from Medicaid) to study the causes and contributing factors for Georgia's high rate of infant mortality and other maternal and child health problems. The following are examples of Perinatal Epidemiology Unit's work: The Perinatal Epidemiology Unit evaluated and Medicaid-funded Perinatal Case Management program and found it effective in providing earlier prenatal care. Perinatal Epidemiology Unit staff collaborated with CDC and the Georgia March of Dimes in the 1994 statewide study of perinatal cocaine exposure that showed that at least 0.5% of infants are born with cocaine in their blood. In 1995 Perinatal Epidemiology Unit staff collaborated with CDC in a statewide survey of 3,130 women to evaluate women's health problems. In early 1996 the CDC-funded Pregnancy Risk Assessment Monitoring System (PRAMS) team was transferred to Perinatal Epidemiology Unit so that Perinatal Epidemiology Unit staff could evaluate the maternal behavioral risks for poor infant health. During its development period, Perinatal Epidemiology Unit also provided training in maternal and child health epidemiology to over 100 public health professionals and trainees. Perinatal Epidemiology Unit staff developed the database used in this publication and provided the analyses in the text of this report.
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Maternal and Child Health Services
Medicaid Several Medicaid services have resulted in increased access and improved the quality of health care for women and children in Georgia.
Right From the Start Medicaid (RSM) began in 1989. RSM provides health care for: q Pregnant women and infants whose family income does not exceed 185% of
the federal poverty level ($28,028 for a family of 4); q Children ages 1 through 5 whose family income does not exceed 133% of the
federal poverty level ($20,149 for a family of 4); q Children ages 6 through 18 whose family income does not exceed 100% of
the federal poverty level ($15,150 for a family of 4).
In 1995 RSM represented 29% of all Medicaid recipients and 19% of all benefits expenditures. Presumptive Eligibility for Medicaid gives women same day access to care based on non-verifiable information given by the women. Georgia received national recognition for its RSM outreach component which took more than 139,000 applications over a 3-year period by stationing 195 staff in community settings and during non-traditional hours.
Perinatal Case Management (PCM) reduces barriers to prenatal care and links pregnant women with needed services. In 1995, 46,505 pregnant women received PCM services at cost of $107 per recipient.
Pregnancy Related Services include postpartum home visits during the first year. In 1995, 18,889 pregnant women received Pregnancy Related Services at a cost of $92 per recipient.
Health Check, formerly known as Early and Periodic Screening, Diagnosis and Treatment (EPSDT) provides preventive health care, including comprehensive physical examinations and immunizations, to all children from birth to age 21 who are covered by Medicaid. In 1995, 307,716 children received care under HEALTH CHECK at a per recipient cost of only $87.
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

qThe Georgia March of Dimes is part of the Healthy Mother / Healthy Baby Coalition which implements the Powerline

Other Maternal and Infant Health Initiatives Other initiatives to improve maternal and infant health include a statewide hotline for obtaining health care, two child abuse prevention initiatives, a major new teen pregnancy prevention project, and a new initiative to help women who are on welfare obtain jobs.
The Powerline Project is a statewide toll-free referral line to assist women, children, and families in obtaining needed health care services. The Powerline is especially sensitive to those women and teens at high risk for poor pregnancy outcomes. In addition to providing referrals to health care providers and health resources, Powerline caseworkers identify and document barriers to health care access encountered by Georgia families, and therefore provide the state with a powerful advocacy resource for changes in policy and practice implementation.
Two child abuse prevention programs that focus on infants and their families are Healthy Families Georgia and First Steps.

Healthy Families Georgia is part of a national effort to strengthen families using the Hawaii Healthy Start Model. The program achieves its goals through systematic hospital or clinic-based screening and assessment of families at the time of birth, combined with voluntary long-term home visits for identified high risk families. Healthy Families Georgia targets first-time births and builds on established First Steps programs.
First Steps is a child abuse prevention program of the Georgia Council on Child Abuse which uses trained volunteers and paraprofessionals to offer emotional support, parenting education, referrals to community services, crisis counseling and follow up contacts to expectant and new parents in hospital/clinic settings.
The Work First Initiative aims to help families move off of welfare and into jobs by providing child care, Medicaid and other services. Through the RSM partnership, Work First participants receive Medicaid health care services.
A number of endeavors, at the state and local level, are underway in Georgia to reduce teen pregnancy. One noteworthy collaborative effort begun in 1996, is between RSM and the Georgia Coalition for Adolescent Pregnancy Prevention (GCAPP) to promote proactive teen pregnancy prevention efforts. This partnership supports Work First efforts which were introduced in Georgia by DFCS in 1995.
The resources described above, although not inclusive of all of the efforts to improve the well being of Georgia's women, infants, and children, highlight some of the significant steps in perinatal health that the state has taken in the first half of the decade. The second half of the 1990's presents many opportunities--and challenges-- to furthering these efforts.

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Conclusion
This section is divided into two parts. The first part briefly reviews the major contextual issues raised in the report which are shaping maternal and infant health in the 1990's. The second part presents key recommendations based on data presented in the report.
Major Contextual Issues
Although progress has been made in improving prenatal care coverage and infant health in Georgia, much still remains to be done to ensure optimal health for every mother and infant in the State. The current climate is one of swift changes in the delivery and financing of health care in the context of heightened competition for resources. This creates significant challenges for maternal and infant health.
Medicaid Georgia, like the federal and most other state governments, is considering ways to curb escalating Medicaid costs. In 1995, Georgia spent $3 billion to provide assistance to over 1 million people through the Medicaid program. According to projections by the Georgia State Economics Forecasting Center, Medicaid is expected to grow $400 million each year for the next six years. At this rate, Georgia will spend $5.4 billion in 2002.
The State's Department of Medical Assistance (DMA) is utilizing a managed care approach to control Medicaid costs and reform Georgia's Medicaid delivery system. In implementing its managed care approach, the DMA has developed two key strategies: a primary care case management program called Georgia Better Health Care and a Health Maintenance Organization option.
The Georgia Better Health Care (GBHC) program was initiated in October 1993 as a three county pilot through a Health Care Financing Administration 1915(b) Waiver. GBHC's goals include: improving access to medical care, particularly primary care services; enhancing continuity of care through the creation of a "medical home"; and reducing unnecessary use of medical services. The program matches Medicaid recipients to a primary care provider who acts as a "gatekeeper". Membership is mandatory for all Medicaid recipients residing in a GBHC county except for Right From the Start Medicaid participants (pregnant women) and individuals residing in nursing facilities, personal care homes, and mental health hospitals. Medicaid recipients who do not select a primary care provider will be automatically assigned to a provider. Statewide implementation is currently underway.

Conclusion

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
A pilot Health Maintenance Organization (HMO) program was begun by the DMA in January 1996 in five metropolitan Atlanta counties. The goals of the Medicaid HMO program include: reducing expenditures; providing budget predictability; reducing inappropriate utilization; improving access; establishing a "medical home" for recipients; improving birth outcomes; and raising Health Check and immunization rates.
A vital component of DMA's approach to controlling Georgia's Medicaid costs is the reshaping of the current delivery system. In November 1995, Governor Miller and DMA Commissioner Smith asked the Georgia Coalition for Health to develop specific recommendations for Medicaid reform.
The Georgia Coalition for Health (Coalition), is a non-profit organization composed of representatives from health care providers, the business community as health care purchasers, public sector health care organizations, and Georgia Health Decisions. The Coalition's mandate is to recommend a program that allows policy makers to predict annual costs while ensuring access to services. At the end of 1996, the Coalition recommended that the state continue to move toward managed care in the Medicaid program.
Since many of the positive health outcomes highlighted in this report occurred during the time of Medicaid expansion, it is important to ask of all proposed changes-- how will this impact the individuals and families who use Medicaid. For example: Will pregnant women be able to access prenatal care in the first trimester? Will more infants be born healthy and survive their first year of life?
Among the methods proposed to achieve budget predictability and to slow Medicaid growth is a managed care system. In a Policy Brief entitled Medicaid and Managed Care, the Kaiser Commission on the Future of Medicaid identifies several issues for states to consider as they move toward managed care in their Medicaid programs:
q To realize the potential benefits, plans must reflect the unique needs and characteristics of the Medicaid population. Outreach, coordination, and consumer education are necessary to help recipients learn how to navigate the managed care system and to ensure they receive the needed support services.
q Savings are likely to be modest if only the least costly of the Medicaid population groups are enrolled in managed care. To date, the focus has been on children and adults in low income families--a group which accounts for a relatively small part of Medicaid expenditures. The challenge is to adequately serve the elderly and disabled.
q Protection and enforcement are needed to assure access to quality services in a managed care system. This requires monitoring and oversight to identify problems of underutilization and availability of appropriate care.
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Managed Care In the first half of the decade, Georgia has experienced a rapid move from traditional, fee-for- service health insurance to managed care plans. The shift has been seen not only in the private sector but state and local government as well.
Managed care has the potential to provide access to quality health care while containing costs. There are concerns that the financial incentives associated with some plans may lead to under-utilization and inadequate care. Another area of concern focuses on the challenges of learning how to enroll in a managed care plan, how to choose among plans, and how to operate under new constraints about where, and from whom, services may be received.
The potential negative impact of managed care on services for mothers and infants has already been demonstrated by the growing trend in the first half of the decade for managed care and some health insurance companies to require discharge within 24 hours or less of a normal delivery and two to three days after a cesarean delivery. In Georgia, newborn metabolic screening, observation for jaundice and other problems in infants, observations for problems in mothers (i.e., heavy bleeding, infections) and patient education were adversely impacted by this development.
In response to the move toward early discharge, the Newborn Baby and Mother Protection Act was passed by the Georgia General Assembly and signed by Governor Miller in 1996. This law requires Medicaid, the state employees insurance plan, and all private health benefits policies that include maternity benefits to provide mothers and infants with at least 48 hours of hospital care following a normal vaginal birth and at least 96 hours of hospital care after a cesarean delivery.
Welfare Reform Because of the historic linkage between welfare and Medicaid, the newly enacted Personal Responsibility and Work Opportunity Reconciliation Act of 1996 is likely to impact the access to health care services by low-income women and children. Potential changes in eligibility and benefits may restrict access to health care and related services for some populations and limit the capacity of programs to provide maternal and child health services.
The new welfare reform law eliminated the 61 year old Aid to Families with Dependent Children (AFDC) program, and replaced it with a new block grant cash assistance program to the states called Temporary Assistance to Needy Families (TANF).
Under the old law, Medicaid was provided without separate application for AFDC recipients. The receipt of welfare was in and of itself an eligibility category for Med-
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
icaid. Medicaid remains an entitlement program for those eligible and the application process is now separate from TANF. Since the new TANF law establishes a lifetime limit of 4 years for welfare payments and most adults are required to work within 2 years of receiving aid, some women and children may be ineligible for Medicaid and be unable to pay for private health insurance. Medicaid coverage for legal aliens is provided only at state option. Illegal aliens may be denied all Medicaid benefits.
A key intent of TANF is to reduce the incidence of births to single mothers and to promote two parent families. States are allowed to enact family cap provisions prohibiting women on welfare who have a child from receiving additional benefits when additional children are born. The new law also establishes an abstinence education program through the Title V Maternal and Child Health Block Grant and provides bonuses to the top five states that reduce the number of out-of-wedlock births without increasing abortion rates. The abstinence program, effective January 1998, mandates teaching that "sexual activity outside the context of marriage is likely to have harmful psychological and physical effects."
The legislation also requires the US Department of Health and Human Services to implement a strategy to assure that at least 25% of US communities have teenage pregnancy prevention programs in place. Of particular concern is the law's elimination of a requirement to make family planning services available to welfare recipients. Under TANF states are permitted, but not required, to spend a portion of block grant funds on family planning services. In Georgia, the TANF policy and the entire welfare reform strategy strongly support family planning.
Uninsured The Kaiser Commission on the Future of Medicaid estimated that in 1990-1992 Georgia had more than one million uninsured residents under age 65. This is 19% of the population in this age range. When considering residents with incomes below the federal poverty line, the proportion increases to 33%, or 1 in every 3 low income residents under age 65.
A new study by the Employee Benefit Research Institute estimates that 393,905 Georgia women ages 18-44 were without health insurance in 1995. This number exceeds the 260,296 women of childbearing age who received Medicaid or other public health insurance.
The increasing costs of health insurance, loss of Medical eligibility, and policy limitations on pre- existing conditions have created barriers for many Georgians. Changes currently underway in the Medicaid and welfare programs raise the possibility of a growing number of women and children who are uninsured or have inadequate health care coverage.
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Barriers to health care In addition to providing referrals and resources to health care services, the Powerline Project of the Healthy Mothers, Healthy Babies Coalition of Georgia also documents barriers that prevent families from gaining access to health care. Powerline caseworkers have found that lack of health insurance is not the only impediment to health care. One of the primary barriers is ignorance. Powerline caseworkers have found that many families are not aware of the services available to them under their private insurance plans, nor are they aware of public health services such as presumptive eligibility or case management services.
Another barrier to health care access is transportation. Powerline documents that lack of Non-Emergency Transportation (NET) Services around the state, including the metro-Atlanta area, is one of the primary reasons for women to miss their prenatal appointments. This problem is exacerbated by a third primary barrier which is the lack of physicians who accept Medicaid. Powerline documents that in particular, women on presumptive eligibility are often turned away and asked to return for a visit only after they have received a permanent Medicaid card, and often once they receive their permanent Medicaid card, many doctors have filled their practice with a designated number of Medicaid patients and will not accept new patients.
In addition, women on Medicaid are often discouraged from changing doctors during their pregnancy, regardless of how dissatisfied they may be, because Medicaid obstetricians typically do not accept new patients past their sixth month of pregnancy even if previous prenatal care is documented.
Also, the increasing diversity of Georgia's population and the growth of nonEnglish speaking populations will need to be monitored for its impact on access to care.
Data To effectively monitor health outcomes and track the health status of women and infants requires a commitment to collecting accurate and meaningful data and making it available in a timely and accessible fashion. Such accountability data are especially important in the current context of significant changes in delivery and financing of health care.

Conclusion

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Key Recommendations
This is a critical time for maternal and infant health services in Georgia and throughout the nation. Great strides have been made during the first half of the decade. The well-being of mothers and infants must remain a priority, at the state and national level, as health care and welfare reform unfold and budgetary reductions occur. The challenge for the remainder of the 1990's is to maintain and expand the programs that are working, bringing them to new parts of the state, and to develop innovative strategies to address those needs that are not being met.
The format for summarizing the recommendations follows the structure of the report.
Maternal and Health Facts Recommendations from this part of the report are organized by section.
Pre-pregnancy
q Increase educational efforts that target women of childbearing age to increase their knowledge of folic acid and the importance of taking daily multivitamins.
q Expand public and private health insurance coverage to include multivitamins for women of childbearing age to help prevent neural tube defects.
q Expand public and private health insurance coverage to include a pre-pregnancy visit to a health professional for a risk assessment.
q Support Georgia's Department of Human Resources program for reducing unintended pregnancies by supporting the appropriations request for an initiative that facilitates collaboration among communities, families, and other state agencies to assure a coordinated array of services that expand the capacity of families and communities to raise healthy adolescents free of unintended pregnancies (particularly younger teens).
q Continue to support and expand comprehensive long-term substance abuse programs tailored specifically for women in general and pregnant women in particular. Included in these programs should be a holistic approach to healing that includes parenting education; prenatal care; promotion of medical, social and life skills; job training; and child care.
q Continue to support the Council on Maternal and Infant Health recommendation that women be screened and assisted in preventing domestic violence, in part, because it leads to delays in obtaining prenatal care.
q Create opportunities for health professionals to learn how to screen for, refer, and treat women who have experienced domestic violence.
q Survey health insurance companies to determine coverage for treatment and prevention of STD's.
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Prenatal
q Conduct a comprehensive study of the 3 counties with more than 4% of births to women who received no prenatal care.
q Develop innovative outreach strategies to address barriers leading to delayed entry into prenatal care.
q Implement new methods of identifying and investigating all maternal deaths to improve the accuracy of maternal mortality data and to ensure that lessons learned for preventing deaths are reported to health care providers.
q Continue the Right from the Start Perinatal Case Management program to get women into early prenatal care.
Infant
q Support the efforts of the Division of Public Health's Black -White Infant Mortality Gap Reading Group and look at more culturally appropriate strategies for decreasing black infant mortality and low birthweight births.
q Continue Georgia Back to Sleep program to reduce SIDS death rate.
q Implement CDC's recommended standard investigation of Sudden Unexpected Infant Deaths to more accurately monitor SIDS deaths and other infant deaths and associated preventable risk factors.
q Implement statewide standards for investigating fetal and infant deaths, including statewide epidemiologic analysis of causes and frequency of presence of specific risk factors for fetal and infant deaths. Standards established by the American College of Obstetricians and Gynecologists should be used as the basis for developing standards for Georgia.
q Implement statewide birth defects surveillance system.
q Assure that children have access to appropriate health care services in managed care systems. Assure that those providers are trained to appropriately evaluate the unique health needs of infants and children.
Maternal and Child Health Services
q Expand Children 1st program to operate statewide.
q Support the completion of the work of the Council on Maternal and Infant Health to set comprehensive standards for providers of perinatal care in Georgia and call for the aggressive promotion of these standards.
q Support the Task Force that has been appointed to implement the state perinatal plan.
q Maintain current Medicaid eligibility categories for pregnant women and children.
q Strengthen programs that emphasize preventive care for women and children.

Conclusion

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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia q Institute more innovative programs that improve access to health care by: 1) Eiminating barriers that prevent women and infants from seeking or receiving care such as lack of insurance, non- English speaking, transportation, and child care and 2) Promoting practical incentives and motivational tools for higher risk populations. q Establish a Medicaid waiver to provide family planning services during the first year after delivery.
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Appendix 1. Glossary
Appendix I: Glossary
Abortion Interrupting a pregnancy before the fetus has been carried to term. The procedure normally occurs within the first trimester of pregnancy (within 13 weeks of conception) and may be voluntarily induced or spontaneous (occurs from natural causes).
Abruptio placentae Premature separation of a normally implanted placenta. The separation may be complete or partial and very often is considered a medical emergency.
Alien (Legal and Illegal) A foreign-born resident who has not become a naturalized citizen. Legal alien residents who possess visas permitting them to temporarily or permanently stay in the U.S. carry a green card which states the conditions and duration of their stay. Persons who have stayed beyond their allowed time period or who did not obtain permission to cross U.S. borders are considered illegal aliens, and they face immediate deportation, although children of illegal aliens who are born on U.S. soil may claim dual citizenship.
Anencephaly Congenital absence of brain and cranial vault, with the cerebral hemispheres completely missing or reduced to small masses. This condition is incompatible with life.
Anomaly Deviation from the average or norm, structurally unusual, irregular or contrary to a general rule.
Barren Physically unable to become pregnant.
Birth Defect A structural abnormality present at birth.
Birthweight An infants weight immediately following delivery. Birthweight is divided into four categories: Normal (greater than 2500 grams); Low (less than 2500 grams); Very low (less than 1500 grams) and Very very low (0-499 grams). Low birthweight affects infant survival, and those that survive have an increased risk of neurological problems (such as cerebral palsy, and seizure disorders), mental retardation, lower respiratory tract conditions, blindness, behavioral problems and learning disabilities.
Cardiomyopathy (Also Known as Myocardiopathy) A heart disease of the myocardium. In the puerperium period it may cause congestive heart failure in the absence of any known causes of heart disease.
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Cerebral Palsy A nonprogressive paralysis resulting from developmental defects in the brain or trauma at birth.
Cesarean Section A lifesaving operation involving a transverse or bilateral incision of the lower abdomen and uterine muscle of a pregnant woman to deliver an infant when the woman has problems before or during labor, such as severe preeclampsia, serious diabetes, transverse lie of the baby, failure of the baby to descend at all, cord prolapse, placenta previa, baby too large for the birth canal, active herpes lesions, or sudden unexplained fetal distress.
Chlamydia The bacterium Chlamydia trachomatis is the most common bacterial sexually transmitted disease (STD) within the United States, and as a sexual pathogen, it is associated with urethral infection, cervicitis, pelvic inflammatory disease, infertility, and complications during pregnancy and birth. Four fifths of infected women are asymptomatic. The most common symptom is increased vaginal discharge, which usually develops 7 to 14 days after exposure. Painful urination, unusual vaginal bleeding, bleeding after sex, and low abdominal pain are additional symptoms. Tetracycline is the drug of choice for treatment of chlamydia.
Culture (1) The shared values, norms, traditions, customs, arts, history, folklore anf institutions of a group of people. (2) Used most frequently in the currently accepted sense in western countries, that is, as the artistic and intellectual life and the set of symbolic objects created by the members of a society.
Cultural Competence A set of knowledge and interpersonal skills that allows individuals to increase their understanding and appreciation of cultural differences and similarities within, among and between groups.
Culturally Responsive Demonstrating both sensitivity to cultural differences and similarities, and effectiveness in using cultural symbols to communicate a message.
Congenital (Defects, Anomalies etc.) A mental or physical trait, pecularity, malformation, disease etc. existing at birth that occurred as a result of genetic or hereditary attributes or events that occurred within the prenatal environment. Prenatal tests such as ultrasound, amniocentesis and alpha-fetoprotein (AFP) screening, can provide specific information about the condition of the fetus. With these test results, doctors can identify spina bifida, Down syndrome, cystic fibrosis and some types of muscular dystrophy.
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Appendix I: Glossary
Contextual Issues The whole situation, background, or environment relevant to the issue at hand.
Eclampsia Occurence of convulsions and coma unrelated to epilepsy or cerebral hemorrhage in a patient with preeclampsis. It may occur in the third trimester of pregnancy or following delivery, and may develop and worsen suddenly (within 2-3 hours). Precipitous signs and symptoms include high blood pressure, large amounts of protein in the urine and a decrease in the amount of urine. A blood screening for albumin (protein in the urine) is used to diagnosis the condition.
Ectopic Pregnancy (also known as a tubal pregnancy) a fertilized egg implants itself in a location other than the uterus, most commonly the wall of the fallopian tube.
Embolism A blood clot or air bubble that obstructs a blood vessel because it is too large to pass through the blood vessel.
Epilepsy A chronic disease of the nervous system characterized by convulsions and periods of unconsciousness. Mild and severe forms of the disease are known as petit and gran mal seizures, respectively.
Ethnicity The concept of an ethnic group forms the connection between culture and society. The term designates the social group which sets itself apart from other groups on account of specific cultural traits, not only in a few details (food, clothing), but also in a complex of fundamental options (cosmogony, system of values, political organization). Every person shares culture at different levels from local (village) to regional national and beyond).
FAS (Fetal Alcohol Syndrome) a birth disorder caused by alcohol passing through the placenta to the fetus.
Fecund Able to conceive and bear children.
Fertility Childbearing. The fertility rate is the number of live births per 1,000 women of that age or age group.
Fetal Death death of an unborn child greater than 20 weeks gestation.
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Fetus From conception to the end of the eighth week of pregnancy the offspring is referred to as an embryo and from the ninth week of pregnancy to birth it is known as a fetus.
Folic Acid One of the vitamins of the B complex that is essential for production of normal red blood cells. It is found in liver, green vegetables, yeast, cereals, and orange juice.
Genital Herpes Infection of the genital and anorectal skin and mucosa with herpes simplex virus type 2. It is usually spread by sexual contact and is classified as an STD. This viral infection may be transmitted to the fetus during delivery and may be fatal. While there is no known cure, the drug of choice to control symptoms (prodromal tingling and itching skin followed by the eruption of painful sores) is acyclovir. Symptoms usually occur 2 to 20 days after exposure.
Genital wart Wart of the genitalia caused by human papilloma virus (HPV). It is estimated that as many as 1 million new cases of genital warts occur each year in the United States. There is no completely safe and effective therapy available for genital warts.
Gestation Period of time from conception to end of pregnancy, which for livebirths is approximately 280 days.
Gonorrhea A disease spread by sexual contact that affects the mucosa of the genital tract. Women may be asymptomatic, except for a vaginal discharge. It can produce infection after childbirth, if present in the cervix at the time of delivery. The infection can infect the infant's eyes at birth.
Hemorrhage Profuse bleeding
HIV Human immunodeficiency virus, the causative agent for AIDS.
Hypertension (pregnancy induced) High blood pressure during pregnancy or postpartum in the six weeks immediately following the completion of labor.
Illicit Drugs Drugs that are neither licensed for commercial distribution by prescription or as "over the counter" preparations. Examples include heroin, cocaine, and marijuana.
Incidence The number of new cases occurring in a population over a period of time.
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Appendix 1: Glossary
Infant Mortality The death of a live-born infant before its first birthday. The rate is calculated by dividing the number of infant deaths by the number of live births during the same time period and multiplying the product by 1,000.
Infertility Inability to conceive.
Lactation Counselor A health provider who explains the benefits of breastfeeding, techniques for breastfeed and expressing milk at times when it's not possible to breastfeed, strategies for incorporating breastfeeding in an active lifestyle, and alternatives when breastfeeding is not an option.
Low Birthweight A live birth in which the infant weighs less than 2,500 grams (5 lbs 8 oz)
Managed Care A health system that enrolls clients, collects premiums, allows beneficiaries to choose their health provider from a limited list of providers and locations, and reimburses providers or beneficiaries after their deductible has been met.
Maternal Morbidity A medical condition resulting from complications of pregnancy, childbirth, or puerperium.
Maternal Mortality A death resulting from complications of pregnancy, childbirth, or puerperium. (Puerperium is approximately six weeks from childbirth until the uterus returns to normal size.) Georgia routinely collects data on maternal deaths up to 90 days after completion of pregnancy, the national standard definition requires collection of deaths during the first year after a pregnancy ends; and some rare conditions, such as Sheehan's Syndrome may lead to death years after the pregnancy-related complication occurs.
Medicaid Federal and state sponsored medical insurance plan for indigents and persons with catastrophic health conditions.
Midwifery Certified Nurse Midwives are educated in graduate programs as specialists in normal pregnancy and birth and in well-woman care. They follow an organized program of study designed to meet standards for knowledge, skill and judgment. Graduates are evaluated and certified after passing examinations, and each state licenses nursemidwives to practice under its own regulations.
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Minority Originally used to refer to blacks and other people of color who were victims of overt racial discrimmination in this country. The term has been broadened to include a variety of groups who have been disadvantaged in one way or another (homosexuals, women). Morbid Obesity Weight which is sufficient to prevent normal activity, and respiratory failure is brought on by slight exertion or by assuming a horizontal position. A person who is greater than 30% above the recommended body mass index ratio is considered morbidly obese. Being overweight is associated with maternal mortality. The calculation is kg/(m2) [height is in meters, weight is in kilograms].
Multiple gestation Gestation of more than one fetus, i.e. twins or triplets.
Neonatal Mortality Death of a live-born infant from birth through 27 days of life.
Neural Tube Defects Group of congenital malformations that involves defects of the spinal column caused by failure of the neural tube to close during embryonic development. It includes anencephaly, spina bifida, meningocele, and myelomeningocele and affects.
NICU Neonatal Intensive Care Unit.
Nonfecund Sterile, unable to conceive. This condition could be temporary, when controlled by reversible forms of contraceptives, such as the pill, or permanent, as in the case of a tubal ligation or hysterectomy. Nonfecund women may be congenitally sterile from birth.
OB-GYN A physician trained in obstetrics and gynecology who are surgical specialists, trained to diagnose and treat diseases of the reproductive organs, manage childbirth complications, and perform gynecological surgery, such as c-sections, hysterectomies and tubal ligations.
Perinatal Case Management A service in which nurses or social workers assess the needs of pregnant women for medical, socioeconomic, educational, and behavioral services, make referrals to other agencies or caregivers, monitor progress and provide problem solving assistance and advocacy as needed.
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Appendix 1: Glossary
Placenta Previa Abnormal implantation of the placenta in the lower uterus which completely or partially obstructs the cervical opening.
Point-of-Service Plan Type of health care insurance where the care is provided by any licensed health care provider and who does not have to be a member of the organization providing the payment.
Postpartum Period after labor and childbirth.
Post-neonatal Mortality Death of a live-born infant after 27 days of life and before its first birthday.
Poverty Level The federal government has established poverty guidelines based upon income and family size. For example, the term "poverty" applies to a family of 4 whose combined annual income is below $15,150.
PRAMS (Pregnancy Risk Assessment Monitoring System) PRAMS is a state-wide, population-based surveillance system. PRAMS questionnaires collect information on women's behaviors and health care before and during pregnancy, and after they deliver a liveborn infant. The data are linked to the baby's birth certificate, which provides more details on the mother and infant. In 1996, Georgia was one of 18 states that participated in PRAMS.
Preeclampsia (Also Known as Toxemia) Late in pregnancy, some women develop a combination of high blood pressure, edema and protein in the urine as symptoms of preeclampsia. It is more common among women who are pregnant for the first time.
Premature Birth before 37 weeks of gestation. Also know as preterm.
Pre-pregnancy Describes the experience of reproductive-aged women who are fecund but not pregnant.
Preterm Birth Delivery occurring before 37 weeks of gestation. Also know as prematurity.
Prevalence Statistical measurement of the the number of existing cases in a given population within a specific period of time.
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Respiratory Distress Syndrome (RDS) Severe breathing impairment, which commonly occurs among premature newborns.
Risk Factor A medical condition, behavior or disease sequelae that increases the probability of causing another disease. For example smoking is a risk factor for lung cancer, and morbid obesity is a risk factor for diabetes.
Risk Marker A condition that is statistically correlated to another disease or behavior, but for which we lack good information on causality of relationship. For example, a mother who does not have a high school education is more at risk of having a low birthweight infant than those who do have at least a high school education.
Rubella (Also Known as German or 3-day Measles) Viral disease characterized by a red rash, tenderness and swelling of the lymph nodes in the back of the neck and mild joint pain. If contracted in the first 16 weeks of pregnancy the fetus may be blind or have other health problems. Early in prenatal care women are tested for rubella antibodies, and if rubella is contracted, fetal health may be assessed so that the woman may decide to continue or interrupt the pregnancy.
Sexually Transmitted Diseases (STDs) A variety of diseases usually transmitted by direct sexual contact with an infected partner.
Spina Bifida One of the most severe neural tube defects. The neural tube which forms the brain, spinal cord and spinal column does not close properly, and usually leaves an open lesion at any point on the tube. If the opening is along the backbone the condition is known as spina bifida. The severity will depend on whether the lesion is covered with skin, whether nerve tissue protrudes from the defect, and the size and location of the lesion.
Sterile Contraceptively, surgically or hereditarily prevented from conceiving.
Sterilization Permanently preventing conception. Female sterilization methods include hysterectomy and tubal ligation. Male sterilization is attained by performing a vasectomy.
Sudden Infant Death Syndrome (SIDS) The sudden death of an infant under 1 year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.
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Appendix 1: Glossary
Syphilis A disease that is transmitted by the spirochete Treponema pallidum from direct intimate contact with an infected person, or it may be perinatally acquired. It is characterized by lesions that may involve an organ or tissue, and carriers may be asymptomatic for many years. Most strains are treatable with penicillin but a resistant strain does exist.
Total cohort accountability The term "total cohort accountability" (TCA) is taken from the March of Dimes second publication on "Toward Improving the Outcome of Pregnancy" (TIOP - II), page 17. The Regional Perinatal Centers in Georgia have "Total Cohort Accountability" -- they are responsible for the outcome of pregnancies that deliver within their defined geographical catchment area, even if the Center was not directly responsible for the perinatal care of the pregnant woman or her infant. The Perinatal Centers should be aware of the outcomes of all pregnancies that deliver in their areas, and in the context of the Committee on Perinatal Health's review of the perinatal services in Georgia, it could be stated that this regional monitoring of perinatal health is the joint responsibility of the District Public Health Officer in collaboration with the Regional Center.
Toxemia (Also Known as Preeclampsia) Late in pregnancy some women develop high blood pressure, edema, and protein in the urine as symptoms of preeclampsia. Signs and symptoms include continuous headache, and swelling of the face or fingers.
Trimester of Pregnancy One of three periods into which pregnancy is divided; the first trimester is from the first day of the last menstrual period until 12 weeks; the second trimester is from 13 weeks to 27 weeks, and the third trimester is from 28 weeks to 40 weeks or delivery.
Tubal Ligation An irreversible method of birth control in which the woman's fallopian tube is cut and tied so the egg and sperm cannot meet. This contraceptive method is known as female sterilization
Unintended Pregnancy A pregnancy identified as either unwanted (mother reported that she did not want a child at the time of conception or any time in the future) or mistimed (pregnancy occurred sooner than the mother would have liked).
WIC Special Supplemental Food Program for Women, Infants, and Children funded by the United States Department of Agriculture, but usually administered by public health programs to improve the health of women, infants and children.
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia WHO World Health Organization. Year 2000 Objective Health goals for the U.S. population in the year 2000, identified by the United States Public Health Service.
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Appendix 2. Bibliography
Appendix 2: Bibliography
Abma JC, Chandra A, Mosher WD, Peterson LS, Piccinino LJ: Vital and Health Statistics. Series 23: National Survey of Family Growth No. 19 "Fertility, Family Planning, and Women's Health: New data from the 1995 National Survey of Family Growth." (Table 14) May 1997
Adams MM, Wilson HG, Casto DL, Berg CH, McDermott JM, Gaudino JA, McCarthy B: "Constructing Reproductive Histories by Linking Vital Records". American Journal of Epidemiology 1997; 145(4): 339-348.
Annie E. Casey Foundation. Kids Count Data Book: State Profiles of Child WellBeing, 1996. Baltimore, MD: Annie E. Casey Foundation, 1996.
Campaign for Healthier Babies. Fighting the Problem of Low Birthweight in New York City. Greater New York March of Dimes, 1986.
CDC. "Knowledge About Folic Acid and Use of Multivitamins Containing Folic Acid Among Reproductive- Aged. Women- Georgia, 1995", MMWR 1996, 45(37):793- 795; and Georgia Epidemology Report; 12(12):1-3.
CDC. "Population-Based Prevalence of Perinatal Exposure to Cocaine - Georgia, 1994", MMWR 1996, 45(41):887-891; and Georgia Epidemiology Report, 1997:13(2).
CDC. "State Specific Pregnancy and Birth Rates Among Teenagers - United States, 1991-1992", MMWR 1995, 44(41):677-684.
CDC. "Prevention of Perinatal Group B Streptococcal Disease: A Public Health Perspective", MMWR 1995, 45(RR-7).
Center for Health Policy Research. "Adolescents and STD's", Health Policy and Child Health, 1996; 3(1):1- 3.
Center for Health Policy Research. "Youth and Tobacco", Health Policy and Child Health, 1996; 3(2):1- 5.
Committee on Perinatal Health. Toward Improving the Outcome of Pregnancy: the 1990's and Beyond. White Plains, NY: March of Dimes Birth Defects Foundation, 1993.
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Custer WS. "Changes in Health Plan Design", Georgia Health Policy Center Report, 1996; 1(1): April.
David and Lucille Packard Foundation. Future of Children: U.S. Health Care for Children, 1992; 2(2): Winter.
David and Lucille Packard Foundation. Future of Children: Low Birthweight, 1995; 5(1): Spring.
Dietz P, Adams M, Mathis M, Rochat R: "Does the Reporting of Prenatal Smoking on Georgia Birth Certificates Vary by Infant Birth Weight?" (Presented at SPER, June 1997)
Dietz P, Adams M, Rochat, R, Mathis M. "Prenatal Smoking in Two Consecutive Pregnancies in Georgia, 1989-1992". Maternal and Child Health Journal, Spring 1997 (in press)
Dietz P, Rochat R, Goldner T, Griffin G, Berg C, Thompson B: "Pregnancy Status Poorly Reported on Death Certificates". Georgia Epidemiology Report 1995;:11:(6):2-3.
Division of STD Prevention. STD Surveillance, 1995. U.S. Department of Health and Human Services, Public Health Service. Atlanta: CDC, September 1996.
Elam-Evans LD, Delaney KM, Adams MA, Wilson HG, Rochat RW, McCarthy BJ: "Patterns of Prenatal Care Initiation in Georgia", 1980-1992, Obstetrics and Gynecology, 1997; in press.
Gaudino JA, Blackmore-Prince C, Yip R, Rochat RW: "Quality Assessment of Fetal Death Records in Georgia: A Method for Improvement", AJPH: 1997; (July) in press.
Georgia Department of Human Resources. "Pregnancy Status Poorly Reported on Death Certificates", Georgia Epidemiology Report 1995; 11 (6): 2-3.
Georgia Department of Human Resources. "The Pregnancy risk Assessment Monitoring System (PRAMS): Defining Behaviors and Experiences of Mothers in Georgia", Georgia Epidemiology Report 1995; 11 (7):1-3.
Georgia Department of Human Resources. "Physical Abuse Immediately Preceding or During Pregnancy Among Georgia Women Delivering a Live Birth, 199394", Georgia Epidemiology Report 1995; 11 (11):1-3.
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Appendix 2. Bibliography
Georgia Department of Human Resources. "Congenital Anomalies in Georgia", Georgia Epidemiology Report 1996; 12 (3):1-3.
Georgia Department of Human Resources. Title V. Grant Application. 1996.
Georgia Department of Human Resources. "Unintended Pregnancy Among Women Who Have Had a Live Birth" Georgia PRAMS, 1995; 1(1).
Georgia Department of Medical Assistance. Annual Report 1995.
Gorrie, TM., McKinney, ES., & Murray, SS. Foundations of Maternal-Newborn Nursing. Philadelphia: W.B. Saunders Company, 1994.
Governor's Council on Developmental Disabilities. The Human Side of Medicaid. Atlanta, GA: Governor's Council on Developmental Disabilities, 1996.
Griffin GW, Gaudino JA, Rochat RW: "Two Techniques for evaluating the accuracy of record linkages", Am J Pub Health 1995; 85(9):1294-5.
Hudgins R, Botto L, Rochat R: "Congenital Anomalies in Georgia". Georgia Epidemiology Report; 1996;12(3):1-3.
Henshaw, S. & Forrest, JD. Women at Risk of Unintended Pregnancy, 1990 Estimates. New York, NY: The Alan Guttmacher Institute.
Institute of Medicine. Benefits and Systems of Care for Maternal and Child Health Under Health Care Reform: Workshop Highlights. Washington, DC: National Academy Press, 1994.
Institute of Medicine. Protecting and Improving Quality of Care for Children Under Health Care Reform: Workshop Highlights. Washington, DC: National Academy Press, 1994.
Institute of Medicine. The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families. Washington, DC: National Academy Press, 1995.
Johnson, K. Birth Defects and Infant Mortality. White Plains, NY: March of Dimes Birth Defects Foundation, 1991.
Kaiser Commission on the Future of Medicaid. "Medicaid and Managed Care", Policy Brief, April 1995.
87

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Klerman LV. Alive and Well? A Research and Policy Review of Health Programs for Poor Young Children. NY, NY: National Center for Children in Poverty, 1991.
Lewis, CT, Mathews TJ & Heuser RL. Prenatal Care in the United States, 1980-94. National Center for Health Statistics. Vital Health Stat 21(54) 1996.
Lynberg M, Edmonds L. "State use of birth defects surveillance". In: From Data to Action. L. Wilcox, J. Marks (Eds), U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, 1994.
Mathis M, Lavoie M: "Fetal Alcohol Syndrome: The Need for Improved Reporting". Georgia Epidemiology Report 1994;10(4):2-3.
May, KA. & Mahlmeister, LR. Maternal and Neonatal Nursing: Family-Centered Care. Philadelphia: J.B. Lippincott Company, 1994.
Maternal and Child Health Institute. A Guide to the Issues: Your Preview to Select Issues of the 1997 Georgia General Assembly. Atlanta, GA: Maternal and Child Health Institute, 1996.
McCarthy BJ, Terry J, Rochat RW, Quave S, Tyler CW Jr: "The under-registration of neonatal deaths": Georgia, 1974-77. Amer J Public Health 70:977-982, 1980
McCarthy BJ, Rochat RW, Cundiff B, Gould PA, Quave S: "The child abuse registry in Georgia: three years of experience". Southern Medical Journal, 1981; 74:11-16
McCarthy BJ, Sachs BP, Layde PM, Burton A, Terry JS, Rochat RW: "The epidemiology of neonatal death in twins". Am J Obstet Gynecol 1981; 141(3):252256
McDermott J et al: article on prenatal care based on longitudinal linked file
National Center for Health Statistics. Health: United States, 1995. Hyattsville, MD: Public Health Service, 1996.
Reeder, SJ, Martin, LL, & Koniak, D. Maternity Nursing: Family, Newborn, and Women's Health Care. Philadelphia: J.B. Lippincott Company, 1992.
Rowley D, Tosteson H (Eds.): "Racial Differences in Preterm Delivery--Developing a New Research Paradigm". American Journal of Preventive Medicine; 1993: 9(6) Supplement (cited in report on page 51.)
88

Appendix 2. Bibleography
Rubin GL, Peterson HB, Rochat RW, McCarthy BJ, Terry JS: "Maternal mortality after caesarean section in Georgia". Amer J Obstet Gynecol 1981; 139:681-685
Serbanescu F & Rochat R. Georgia Women's Health Survey, 1995: A Preliminary Report. Georgia Department of Human Resources, Division of Public Health, October, 1996.
Sachs BP, Arks JS, McCarthy BJ, Burton A, Rochat RW, Terry JS: "Neonatal transport in Georgia: Implications for maternal transport of high-risk pregnancies". Southern Medical Journal 1983; 76:1397-1400
Sacks, JJ, Brantley MD, Holmgreen P, Rochat RW: "Evaluation of an Intervention to Reduce Playground Hazards in Atlanta Child-Care Centers". Am J of Public Health, March 1992, Vol 82, No.3, 429
Shuptrine SC, Grant VC & McKenzie, GG. Uninsured Children in the South. Columbia, SC: Southern Institute on Children and Families, 1992.
Taber's Cyclopedic Medical Dictionary. Philadelphia: F.A. Davis Company, 1993. U.S. Public Health Service. Healthy People 2000: National Promotion and Disease
Prevention Objectives. Washington, DC: Government Printing Office, 1991. U.S. Public Health Service. Georgia Health Profile, 1996. Washington, DC: Govern-
ment Printing Office, 1996. Watkins M et al: Article on birth defects reporting on birth certificates in metro
Atlanta, AJPH 1996: Wilcox, LS & Marks, JS (editors). From Data to Action: CDC's Public Health Sur-
veillance for Women, Infants, and Children. CDC Maternal and Child Health Monograph, 1994. Wong, DL Whaley & Wong's Nursing Care of Infants and Children. St. Louis: Mosby, 1995.
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Maternal and Child Health Indicator Tables

Maternal and Child Health Indicator Tables

About the MCH Indicator Tables

Database Resources
The database source is indicated in parentheses after the indicator event name in the definitions.
q Birth certificates (B), death certificates (D), reports of sponteneous (S) and induced (I) abortions, and records of marriage (M) databases are provided by Georgia Vital Records (VR).
q Child Abuse data is provided by Georgia Department of Family and Children Services (DFACS)
q Child Fatality Investigations data is provided by the Georgia Children's Trust Fund Commission (CTFC)
q 1991-1994 Population estimates are provided by the Georgia Office of Planning and Budget (OPB)
q 1990 Populations are from the 1990 U.S. Census (USC)
q WIC data is provided by Georgia Women, Infants and Children Program (WIC) and linked to the birth certificate data by the Perinatal Epidemiology Unit
q Medicaid data is provided by the Depatment of Medical Assistance (DMA) and linked to the birth certificate data by the Perinatal Epidemiology Unit

Data aggregation

Geographic layers

Population subsets Chronological trends

q State Total

q All races

q 19 Health District Units

q White only

q 9 Metropolitan Statistical Areas q Black only

q 6 Perinatal Regions

q 159 Counties

q Calendar year of event q 5-year cumulative totals

Technical considerations
Specific selections q Women and children who are residents of Georgia. q Events that occur in Georgia.
Specific corrections q OPB populations have been adjusted to include institutionalized persons--
such as those located on military bases or on college campuses, etc. using an algorithm developed by Georgia Vital Records, DOAS

91

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
q Denominators for the black population were created from the non-white population in the OPB database using an algorithm developed at the Rollins School of Public Health of Emory University
q Denominators for non-standard age group populations were created from the standard 5-year age groups in the OPB database using an algorithm developed at the Rollins School of Public Health of Emory University
q Events and rates describing maternal characteristics are corrected for twins, triplets, etc. by specific selection criteria that selects only one event per woman.
Limitations
q Unavailable Information - information not available for analysis is noted by a period (.) in the tables.
q Missing data in a record - where specific information in a record is missing for a given indicator, the record is not included in any of the calculations for that indicator. Example: If weight gain is missing in the numerator for a given record, then that record is also dropped from the denominator when the rate is calculated.
q Small numbers - rates are not calculated when the numerator is less than 5; and are noted with an asterisk (*) in the tables.
Notes of interest
Number formats q Event numbers represent actual persons or incidents counted and are reported
as integers q Medians, rates and ratios are statistical calculations and are reported in tenths
Period data ratios vs linked data rates q Period data ratios are produced from numerators and denominators from dif-
ferent cohorts (databases) of the same time period. Example: children who died in 1993 and were less than 1 year old divided by all children born in 1993 equals an infant mortality ratio. q Linked data rates are based on events from the same cohort (database) where the numerator and denominator are linked within each record. Example: children born in 1993 but died before the age of 1 year divided by all children born in 1993 produces an infant mortality rate.
Reported child abuse q Child abuse and neglect is reported in numbers of confirmed reports. A report
may describe several types of abuse and/or neglect, therefore the sub-categories are not mutually exclusive. q Other child abuse, not included in the tables because of small numbers, includes emotional abuse, homicide, and addiction at birth.
92

Maternal and Child Health Indicator Tables Age at Conception
Pregnancy-related events and rates that include the age of the woman as part of the definition of the indicator use the age of the woman at the time of conception of the pregnancy, rather than the age at the end of the pregnancy, for consistancy across the three pregnancy-related datasets--births, abortions and fetal deaths. Birth Defects The accuracy of reporting of birth defects on the birth certificate, like the reporting of other medical findings, varies among hospitals, and may result in substantial variations in numbers and rates from year-to-year and/or area-toarea. Linked data The Perinatal Epidemiology Unit links Medicaid and WIC data to the birth certificate data using a probablistic linkage procedure developed by the Perinatal Epidemiology Unit. Infant birth and death certificates are linked prospectively by Georgia Vital Statistics.
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Definitions and Calculations
Indicator Numbers
Base Populations
Women age 15-44 years (OPB, USC) Population of women of reproductive age. Women age 15-17 years (OPB, USC) Population of women of reproductive age that have not reached the legal age of majority.
Woman's median age at:
Conception of first birth (VR-B) Median age at conception of women conceiving for the first time and whose pregnancy ended in a livebirth Conception of first induced abortion (VR-I) Median age at conception of women conceiving for the first time and whose pregnancy ended in an abortion First marriage (VR-M) Median age of women at the time of marriage of those marrying for the first time.
Pregnancies and perinatal outcomes
Conceptions to women under age 18 years (VR-B,S,I) Total number of pregnancies to women under age 18 at the time of conception and resulting in a livebirth, a fetal death, or an induced abortion. q Repeat conceptions to women under age 18 years (VR-B,S,I)
Second or higher order conceptions to women under age 18 at the time of conception and resulting in a livebirth, a fetal death, or an induced abortion.
Total livebirths (VR-B) Total number of liveborn infants. q Livebirths to women under 18 years (VR-B)
Total number of women under age 18 at the time of conception who gave birth to a liveborn infant. q Livebirths to unmarried women (VR-B) Total number of women who were not married at the time of birth of a liveborn infant.
Early fetal deaths (VR-S) Number of stillborn infants born before 20 weeks gestation. Fetal deaths at 20 or more weeks gestation (VR-S) Number of stillborn infants born at 20 weeks or more gestation.
Total induced abortions (VR-I) Total number of induced abortions. q Induced abortions to women under age 18 years (VR-I)
Number of induced abortions to women under 18 at the time of conception.
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Maternal and Child Health Indicator Tables
Infant and child survival
Infant deaths (VR-D) Total number of deaths of children less than 1 year old. q Neonatal deaths (VR-D)
Number of deaths of infants in the first 27 days after birth.
q Postneonatal deaths (VR-D) Number of deaths of infants between 28 and 365 days (inclusive) after birth.
Perinatal deaths (VR-B,S) Number of neonatal deaths plus fetal deaths occurring at 20 or more weeks gestation. Deaths of young children (VR-D) Total number of deaths to children 1-4 years old. Deaths of older children and adolescents (VR-D) Total number of deaths to children age 5-17 years old.
Infant Health
Low birthweight (VR-B) Number of liveborn children with birthweights of less than 2500 grams. q Very low birthweight (VR-B)
Number of liveborn children with birthweights of less than 1500 grams. q Birthweight under 500 grams (VR-B)
Number of liveborn children with birthweights of less than 500 grams. Preterm gestation (VR-B) Number of mothers with estimated gestations of less than 37 weeks.
Multiple gestation (VR-B) Number of mothers who had twins, triplets or other multiple gestation and at least one child was liveborn.
Born with birth defect (VR-B) Number of infants born with a congenital abnormality.
Maternal risk markers for lowered infant survival of liveborn infants
Weight gain less than 25 lbs. during pregnancy (VR-B) Number of mothers who had a total weight gain during pregnancy of less than 25 lbs. Father not named on birth certificate (VR-B) Number of mothers who did not list the father's name on the birth certificate. Maternal education less than high school (VR-B) Number of mothers with less than high school education at the time of the child's birth. No prenatal care (VR-B) Number of mothers who did not receive prenatal care
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
Maternal smoking during pregnancy (VR-B) Number of mothers of liveborn infants who smoked cigarettes during the pregnancy. Maternal alcohol use during pregnancy (VR-B) Number of mothers who used alcohol during the pregnancy. Interpregnancy interval less than 6 months (VR-B) Number of mothers whose previous pregnancy ended in a livebirth and was delivered within 6 months of the conception of this live birth.
Abuse and neglect* of persons under age 18
Physical abuse (DFACS) Number of confirmed reports of physical abuse. Sexual abuse (DFACS) Number of confirmed reports of sexual abuse. Child neglect (DFACS) Number of confirmed reports of neglect.
Interventions to improve infant survival
Prenatal care first trimester (VR-B) Number of women who began prenatal care in the first trimester of their pregnancy Primary C-Section delivery (VR-B) Number of women who had a primary C-section. WIC + Medicaid during pregnancy (VR-B, WIC, DMA linked) Number of women who received public assistance during their pregnancy through Medicaid and participated in the WIC program WIC during pregnancy (VR-B,WIC linked) Number of women who participated in the WIC program during their pregnancy Medicaid during pregnancy (VR-B, DMA linked) Number of women who received public assistance during their pregnancy through Medicaid q Perinatal case management (VR-B, DMA linked)
Number of women who received public assistance from Medicaid and participated in the Perinatal Case Management Program Vaginal Birth after Previous C-Section (VR-B) Number of women who had a vaginal delivery after a previous C-section.
Child fatality investigations (CTFC) Number of deaths of children under age 18 years whose death was investigated as mandated by the 1990 Georgia law on Child Fatality Reviews.
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Maternal and Child Health Indicator Tables
Indicator Rates and Calculations
Perinatal outcomes
Crude birth rate Total number of liveborn infants (LB) per 1,000 total population (TP). Calculation: (LB / TP) * 1,000 q General fertility rate
Total number of liveborn infants per 1,000 women age 15-44 (RW) Calculation: (LB / RW) * 1,000
q Total fertility rate The sum of the age-specific maternal birth rates (ASLB) per 1,000 women by 5 year age group (ASRW) across all ages of the reproductive period. Calculation: sum(ASLB / ASRW) * 5
q % Livebirths to unmarried women The number of unmarried women (UW) who had a livebirth per 100 livebirths. Calculation: (UW / LB) * 100
Crude abortion rate Induced abortions (IA) per 1,000 total population. Calculation: (IA / TP) * 1,000 q General abortion rate
Induced abortions per 1,000 women age 15-44 Calculation: (IA/ RW) * 1,000
q Total abortion rate The sum of the age-specific abortion rates (ASIA) per 1,000 women by 5 year age group (ASRW) across all ages of the reproductive period. Calculation: sum(ASIA / ASRW) * 5
q Abortion ratio Induced abortions per 1,000 reported pregnancies Calculation: IA / (IA+FD+LB) * 1,000
Fetal death rate Fetal deaths (FD) per 1,000 women age 15-44 (RW) Calculation: (FD / RW) * 1,000
Adolescent pregnancy and perinatal outcome rates
Conceptions to women under age 18 years Number of pregnancies to women under age 18 at the time of conception and resulting in a livebirth, a fetal death, or an induced abortion (AP) per 1,000 women age 15-17 years (AW). Calculation: (AP / AW) * 1,000
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
q % Repeat conceptions to women under age 18 years Number of pregnancies to women under age 18 at the time of conception whose pregnancy is a repeat (second or higher order) pregnancy that results in a livebirth, a fetal death, or an induced abortion (RAP) per 100 pregnancies to women age 15-17 years (APG). Calculation: (RAP / APG) * 100
Livebirths to women under age 18 years Livebirths to women under age 18 years (ALB) per 1,000 women age 15-17 years. Calculation: (ALB / AW) * 1,000 q % Livebirths to unmarried women under age 18 years
Livebirths to unmarried women under age 18 (UALB) per 100 livebirths to women under age 18 Calculation: (UALB / ALB) * 100
Induced abortions to women under age 18 years Induced abortions to women under age 18 years (AIA) per 1,000 women age 1517 years. Calculation: (AIA / AW) * 1,000 q % Abortions to unmarried women under age 18 years
Induced abortions to unmarried women under age 18 (UAA) per 100 abortions to women under age 18 Calculation: (UAIA / AIA) * 100
Fetal deaths to women under age 18 years Fetal deaths to women under age 18 years (AFD) per 1,000 women age 15-17 years. Calculation: (AFD / AW) * 1,000
Infant and child survival rates
Infant mortality (period data) Number of infant deaths (ID) per 1,000 livebirths Calculation: (ID / LB) * 1000 q Neonatal mortality (period data)
Number of deaths to infants less than 28 days old (ND) per 1,000 livebirths. Calculation: (ND / LB) * 1000
q Postneonatal mortality (period data) Number of deaths to infants age 28 days to 1 year (PD) per 1,000 livebirths minus neonatal deaths. Calculation: (PND / (LB - ND) * 1,000
Perinatal mortality (linked data) Number of fetal deaths (LFD) at 20 weeks or more gestation and neonatal deaths (ND) per 1,000 late fetal deaths plus live births. Calculation: (LFD+ND) / (LFD + LB) * 1000
Deaths of young children Deaths of children age 1-4 years (D1-4) per 1,000 children age 1-4 years (C1-4). Calculation: (D1-4 / C1-4) * 1000
98

Maternal and Child Health Indicator Tables
Deaths of older children and adolescents Deaths of children age 5-17 years (D5-17) per 1,000 children age 5-17 years (C517) Calculation: (D5_17 / POP5_17) * 1000
Infant Health
% Low birthweight Number of liveborn infants with a birthweight of less than 2500 (LB25) grams per 100 livebirths. Calculation: (LB25 / LB) * 100 q % Very low birthweight
Number of liveborn infants with a birthweight of less than 1500 grams (LB15) per 100 livebirths. Calculation: (LB15 / LB) * 100 q % Birthweight under 500 grams Number of liveborn infants with a birthweight of less than 500 grams (LB5) per 100 livebirths. Calculation: (LB5 / LB) * 100 % Preterm gestation Number of mothers of liveborn infants whose gestation was less than 37 weeks (GA) per 100 mothers of liveborn infants (MLB). Calculation: (GA / MLB) * 100 % Multiple gestation Number of mothers of liveborn infants who had multiple gestation (MG) per 100 mothers of liveborn infants. Calculation: (MG / MLB) * 100 % Born with a birth defect Number of liveborn infants with any birth defect (BD) per 100 livebirths. Calculation: (BD / LB) * 100
Maternal risk markers for lowered infant survival of liveborn infants
% Weight gain less than 25 lbs. during pregnancy Number of mothers who gained less than 25 pounds during the pregnancy (WG) per 100 mothers of liveborn infants. Calculation: (WG / MLB) * 100 % Father not named on birth certificate Number of mothers who did not list a fathers name on the birth certificate (NoFN) per 100 mothers of liveborn infants. Calculation: (NoFN / MLB) * 100 % Maternal education less than high school Number of mothers who had less than high school education (HS) per 100 mothers of liveborn infants. Calculation: (HS / MLB) * 100
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia
% No prenatal care Number of mothers who did not receive any prenatal care (NoPNC) per 100 mothers of liveborn infants. Calculation: (NoPNC / MLB) * 100
% Maternal smoking during pregnancy Number of mothers who smoked during the pregnancy (UT) per 100 mothers of liveborn infants. Calculation: (UT / MLB) * 100 % Maternal alcohol use during pregnancy Number of mothers who used alcohol during the pregnancy (ETOH) per 100 mothers of liveborn infants. Calculation: (ETOH / MLB) * 100
% Interpregnancy interval less than 6 months Number of mothers who have had at least 1 previous livebirth and whose interpregnancy interval was less than 6 months (IPI6) per 100 mothers of liveborn infants who have had at least 1 previous live birth. Calculation: (IPI6 / MLB) * 100
Abuse and neglect* of persons under age 18 years
Physical abuse Confirmed reports of physical abuse (PA) per 1,000 persons under age 18 years (CP). Calculation: (PA / CP) * 1,000
Sexual abuse Confirmed reports of sexual abuse (SA) per 1,000 persons under age 18 years. Calculation: (SA / CP) * 1,000 Child neglect Confirmed reports of neglect (CN) per 1,000 persons under age 18 years. Calculation: (CN/ CP) * 1,000
Interventions to improve infant survival
% Prenatal care first trimester Number of mothers of liveborn infants who received prenatal care beginning in the first trimester of pregnancy (PNC1) per 100 mothers of liveborn children. Calculation: (PNC1 / MLB) * 100 % Primary C-Section delivery Number of mothers of liveborn infants who had a primary C-section (PCS) per 100 mothers of liveborn children (excluding those who had repeat C-sections (RCSECT) and vaginal deliveries after previous C-section (VAGCSET). Calculation: (PCS / MLB-RCSECT-VAGCSET) * 100
% Vaginal delivery after previous C-Section delivery Number of mothers of liveborn infants who had a vaginal delivery after a C-section delivery (VCS) per 100 mothers of liveborn children who had either repeat Csections (RCSECT) or vaginal deliveries after previous C-section (VAGCSET). Calculation: (VCS / RCSECT+VAGCSET) * 100
100

Maternal and Child Health Indicator Tables % WIC during pregnancy Number of mothers of liveborn infants who participated in the WIC program (WIC) per 100 mothers of liveborn children. Calculation: (WIC / MLB) * 100 % Medicaid during pregnancy Number of mothers of liveborn infants who received public assistance from Medicaid (MA) per 100 mothers of liveborn children. Calculation: (MA / MLB) * 100 % WIC + Medicaid during pregnancy Number of mothers of liveborn infants who received public assistance from Medicaid and participated in the WIC program (WIC&MA) per 100 mothers of liveborn children. Calculation: (WIC&MA / MLB) * 100 q % Perinatal case management
Number of mothers of liveborn infants who received public assistance from Medicaid and participated in the Perinatal Case Management program per 100 mothers of liveborn children. Calculation: (MA&PCM / MLB) * 100
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The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events

Total
1990 1991 1992 1993 1994 5-year

Population

6478216 6600537 6721863 6844218 6965539 33610373

Women age 15-44

1616490 1631495 1646318 1661328 1676176 8231807

Women age 15-17

136989 138391 139773 141175 142559 698887

Woman's median age at:

Conception of first birth

22.0

22.0

22.1

22.2

22.2

22.1

Conception of first abortion

20.3

20.6

20.6

20.8

20.7

20.6

First marriage

22.0

22.0

23.0

23.0

23.0

23.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

14404 14073 13769 13857 14063 70166

Repeat conceptions to women under 18

3570

3574

3580

3327

3178 17229

Total Livebirths

112608 110271 111094 110491 110986 555450

Livebirths to women under 18

10493 10513 10270 10397 10699 52372

Livebirths to unmarried women

36518 37653 38397 39052 38938 190558

Early fetal deaths

8147

8667

8560

8096

7588 41058

Fetal deaths 20 weeks or more gestation

1240

1229

1156

1025

1029

5679

Total induced abortions

36989 36314 35693 35156 33516 177668

Induced abortions to women under 18

3455 3086 3041 3015 2934 15531

Infant and child survival

Infant deaths

1396

1262

1148

1155

1131

6092

Neonatal deaths

923

835

752

754

727

3991

Postneonatal deaths

473

427

396

401

404

2101

Perinatal deaths

2160

2054

1899

1768

1745

9626

Deaths of children 1-4 years

218

220

184

227

229

1078

Deaths of children 5-17 years

481

494

499

474

466

2414

Infant health

Low birthweight

9770

9480

9502

9669

9576 47997

Very low birthweight

1936

1873

1853

2001

1922

9585

Under 500 grams

224

234

200

221

244

1123

Preterm gestation

10992 10700 10634 10758 10571 53655

Multiple gestation

1302

1290

1359

1366

1433

6750

Born with birth defect

1631

1582

1753

2196

1232

8394

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

28822 27086 27107 28535 31143 142693

Father not named on birth certificate

20130 20535 20842 20457 20165 102129

Maternal education less than high school

27950 27909 27285 26547 25717 135408

No prenatal care

2748 2462 2172 1652 1372 10406

Maternal smoking during pregnancy

16955 15012 14214 13168 12627 71976

Maternal alcohol use during pregnancy

2842 2310 2037 1719 1704 10612

Interpregnancy interval less than 6 months

5256

5264

5387

4791

4500 25198

Abuse & neglect to persons under age 18 years

Physical

.

1625

4278

4372

4229 14504

Sexual

.

1346

3467

3357

3009 11179

Neglect

.

7638 18070 18390 18970 63068

Interventions to improve infant & child survival

Prenatal care first trimester

80038 79763 82118 84912 88582 415413

Primary C-section delivery

15756 14927 14506 14380 14326 73895

Vaginal birth after previous C-section

2095 2163 2324 2502 2584 11668

WIC during pregnancy

45393 52451 50752 53900 52185 254681

Medicaid during pregnancy

36302 42794 46840 53686 50917 230539

WIC and Medicaid during pregnancy

28021 35812 37043 42664 40528 184068

Perinatal case management

.

5252 12488 17837 21010 56587

Child fatality investigations

174

396

283

499

492

1844

State of Georgia

White
1990 1991 1992 1993 1994 5-year
4600148 4678919 4757153 4835921 4914152 23786293 1108068 1115064 1121958 1128950 1135842 5609882
88841 89601 90352 91112 91861 451767

23.2 20.5 22.0

23.2 20.7 22.0

23.4 20.8 22.0

23.5 21.1 22.0

23.6 21.1 22.0

23.4 20.8 22.0

6650 1304 70517 4705 10431 4984
523 19177
1764

6222 1146 68242 4531 10951 5302 503 17970 1496

6015 1166 68737 4479 11457 5215
479 16685
1357

6058 1152 68569 4523 12119 5008 395 16268 1360

6148 1067 69549 4633 12463 4643
447 14991 1312

31093 5835
345614 22871 57421 25152
2347 85091
7289

635

514

492

501

491

2633

421

335

299

314

302

1671

214

179

193

187

189

962

944

842

778

695

746

4005

123

116

97

112

102

550

302

295

282

273

261

1413

4355 748 81
5321 763 971

4185 694
73 5159
731 938

4104 675 54
5049 786
1099

4310 760
49 5192
800 1442

4406 743 69
5262 865 794

21360 3620 326
25983 3945 5244

16025 5238
15814 931
12846 1536 2228

14426 5485
15441 767
11491 1211 2172

14696 5681
15187 675
10961 983
2229

15558 5686
14762 504
10348 833 2062

16909 5778
14295 474
9963 916
2006

77614 27868 75499
3351 55609
5479 10697

.

785

1931

2154

2072

6942

.

816

2212

2149

1897

7074

.

3058

6902

7501

7930 25391

55477 10285
1273 20305 14903 11383
. 80

54411 9594 1278
24102 18319 15308
2668 137

55459 9193 1356
23710 20589 16337
6381 109

56750 8909 1547
25367 24614 18916
8087 220

59090 8828 1700 25099 23767 18614 9726
210

281187 46809
7154 118583 102192 80558 26862
756

Black
1990 1991 1992 1993 1994 5-year
1746565 1768622 1790408 1812465 1834252 8952312 472228 473987 475692 477457 479161 2378525 45244 45469 45687 45912 46130 228443

19.7 19.8 25.0

19.7 20.0 25.0

19.8 20.1 25.0

19.8 20.0 26.0

19.6 20.0 26.0

19.7 20.0 25.0

7656 2245 40480 5755 25937 2883
705 16310
1631

7728 2409 40248 5926 26540 3076 705 16715 1532

7627 2387 40332 5747 26700 3114
654 17417
1613

7659 2148 39791 5811 26631 2853 610 17343 1588

7785 2092 39003 5984 26112 2652
559 17232
1583

38455 11281 199854 29223 131920 14578
3233 85017
7947

747 492 255 1192 93 174

738 496 242 1188 104 196

640 441 199 1088
86 208

648 435 213 1045 114 195

626

3399

414

2278

212

1121

970

5483

125

522

200

973

5293 1165
142 5538
523 643

5171 1166 161 5428 541 622

5268 1155
145 5442
560 626

5207 1213 170 5395 548 719

5014 1159
172 5131
550 419

25953 5858 790
26934 2722 3029

12445 14819 11871
1794 4045 1294 2968

12274 14951 12152
1671 3454 1092 3025

11963 15010 11732
1473 3165 1040 3081

12457 14572 11382
1124 2740
876 2655

13539 14153 11030
872 2597
777 2419

62678 73505 58167
6934 16001
5079 14148

.

618

1776

1809

1830

6033

.

366

879

952

937

3134

.

3749

9145

9323

9638 31855

23461 5259 797
24681 21170 16484
. 88

24085 5102 849
27745 24105 20206
2538 226

25154 5079 930
26399 25749 20338
5990 160

26565 5254 918
27671 28279 23157
9521 266

27565 5233
832 26156 26300 21292 10970
260

126830 25927
4326 132652 125603 101477
29019 1000
104

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
State of Georgia

17.4 69.7
2.1 32.8
5.7 22.9
0.7 231.7
6.2
105.1 24.8 76.6 75.3 25.2 98.0
4.8
12.4 8.2 4.2
19.0 0.5 0.4
8.7 1.7 0.2 9.9 1.2 1.5
32.9 18.1 25.3
2.5 15.5
2.6 8.6
. . .
72.3 15.7 18.9 40.8 32.6 25.2
.

16.7 67.6
2.0 34.6
5.5 22.3
0.7 231.1
6.5
101.7 25.4 76.0 77.6 22.3 98.0 4.6
11.4 7.6 3.9
18.4 0.5 0.4
8.6 1.7 0.2 9.8 1.2 1.5
32.4 18.8 25.9
2.3 14.1
2.2 8.8
0.9 0.8 4.3
73.6 15.2 19.8 48.1 39.3 32.9
4.8

16.5 67.5 2.0 35.0 5.3 21.7 0.6 227.3 6.2
98.5 26.0 73.5 78.6 21.8 98.2 4.6
10.3 6.8 3.6
16.9 0.4 0.4
8.6 1.7 0.2 9.7 1.2 1.6
31.3 19.0 25.1
2.0 13.4
1.9 8.6
2.4 1.9 10.1
74.9 14.7 20.9 46.3 42.7 33.8 11.4

16.1 66.5
2.0 35.8
5.1 21.2
0.6 226.6
5.7
98.2 24.0 73.6 80.3 21.4 97.9
4.1
10.5 6.8 3.7
15.9 0.5 0.4
8.8 1.8 0.2 9.9 1.3 2.0
31.8 18.8 24.5
1.5 12.4
1.6 7.8
2.4 1.8 10.1
77.7 14.6 23.1 49.4 49.2 39.1 16.4

15.9 66.2 2.0 35.6 4.8 20.0 0.6 218.3 5.4
98.6 22.6 75.0 80.8 20.6 98.3 4.2
10.2 6.6 3.7
15.6 0.5 0.4
8.6 1.7 0.2 9.7 1.3 1.1
31.0 18.4 23.7
1.3 11.8
1.6 7.5
2.3 1.6 10.2
80.8 14.5 23.7 47.6 46.5 37.0 19.2

16.5 67.5
2.0 34.8
5.3 21.6
0.6 227.0
6.0
100.4 24.6 74.9 78.5 22.2 98.1
4.4
11.0 7.2 3.8
17.2 0.5 0.4
8.6 1.7 0.2 9.8 1.2 1.5
31.9 18.6 24.9
1.9 13.5
2.0 8.3
2.0 1.5 8.7
75.8 15.0 21.3 46.4 42.0 33.6 12.9

15.3 63.6
1.9 15.0
4.2 17.3
0.5 200.7
5.3

14.6 61.2
1.9 16.2
3.8 16.1
0.5 194.5
5.5

14.4 61.3 1.9 16.9 3.5 14.9 0.4 182.6 5.3

14.2 60.7
1.9 17.9
3.4 14.4
0.4 179.8
5.0

14.2 61.2 1.9 18.2 3.1 13.2 0.4 166.9 4.7

14.5 61.6
1.9 16.8
3.6 15.2
0.5 185.1
5.2

74.9 19.6 53.0 48.7 19.9 97.0
3.1

69.4 18.4 50.6 52.3 16.7 97.0
3.0

66.6 19.4 49.6 54.2 15.0 96.9 2.9

66.5 19.0 49.6 58.0 14.9 96.6
2.5

66.9 17.4 50.4 58.7 14.3 97.4 2.9

68.8 18.8 50.6 54.4 16.1 97.0
2.9

9.0 6.0 3.1 13.3 0.5 0.4

7.5 4.9 2.6 12.2 0.4 0.4

7.2 4.3 2.8 11.2 0.4 0.3

7.3 4.6 2.7 10.1 0.4 0.3

7.1 4.3 2.7 10.7 0.4 0.3

7.6 4.8 2.8 11.5 0.4 0.3

6.2

6.1

6.0

6.3

6.3

6.2

1.1

1.0

1.0

1.1

1.1

1.0

0.1

0.1

0.1

0.1

0.1

0.1

7.6

7.7

7.4

7.7

7.7

7.6

1.1

1.1

1.2

1.2

1.3

1.2

1.4

1.4

1.6

2.2

1.2

1.5

28.4 7.5
22.9 1.3
18.7 2.2 6.1

27.3 8.1
23.1 1.1
17.6 1.9 6.1

27.1 8.4 22.6 1.0 16.7 1.5 6.1

27.6 8.4
22.0 0.7
15.8 1.3 5.6

26.9 8.4
21.0 0.7 15.0 1.4 5.5

27.4 8.2
22.3 1.0
16.8 1.7 5.9

.

0.7

1.7

1.8

1.7

1.5

.

0.7

1.9

1.8

1.6

1.5

.

2.7

6.0

6.4

6.7

5.5

79.7 16.4 17.8 29.1 21.4 16.3
.

80.8 15.8 18.6 35.7 27.1 22.7
4.0

81.6 15.1 19.6 34.9 30.3 24.0
9.4

83.6 14.6 22.5 37.4 36.3 27.9 11.9

85.9 14.3 24.5 36.6 34.6 27.1 14.2

82.3 15.3 20.6 34.7 29.9 23.6
9.9

23.2 85.7
2.5 65.0
9.3 34.5
1.0 269.0
8.1

22.8 84.9
2.4 66.9
9.5 35.3
1.0 274.0
8.5

22.5 84.8 2.5 67.2 9.7 36.6 1.0 282.0 8.4

22.0 83.3
2.4 67.9
9.6 36.3
1.0 285.4
7.6

21.3 81.4 2.4 67.9 9.4 36.0 1.0 289.1 7.0

22.3 84.0
2.4 67.0
9.5 35.7
1.0 279.9
7.9

169.2 29.3 127.2 97.1 36.0 99.2
8.1

170.0 31.2
130.3 97.2 33.7 99.1 7.8

166.9 31.3
125.8 97.8 35.3 99.4 7.9

166.8 28.0
126.6 97.9 34.6 99.0 7.4

168.8 26.9
129.7 98.2 34.3 99.0 6.8

168.3 29.3
127.9 97.6 34.8 99.1 7.6

18.5 12.2
6.4 28.9
0.7 0.4

18.3 12.3
6.1 29.0
0.7 0.5

15.9 10.9 5.0 26.5 0.6 0.5

16.3 10.9
5.4 25.9
0.8 0.5

16.1 10.6 5.5 24.5 0.9 0.5

17.0 11.4
5.7 27.0
0.7 0.5

13.1

12.9

13.1

13.1

12.9

13.0

2.9

2.9

2.9

3.0

3.0

2.9

0.4

0.4

0.4

0.4

0.4

0.4

13.9

13.7

13.7

13.8

13.4

13.7

1.3

1.4

1.4

1.4

1.4

1.4

1.6

1.6

1.6

1.8

1.1

1.5

41.3 37.1 29.9
4.6 10.3
3.3 12.4

41.6 37.7 30.9
4.3 8.8 2.8 12.7

38.9 37.8 29.7 3.7 8.2 2.7 12.6

39.3 37.1 29.2
2.9 7.1 2.3 11.3

38.2 36.8 28.9 2.3 6.8 2.0 11.0

39.8 37.3 29.7
3.6 8.3 2.6 12.0

.

1.1

3.0

3.0

3.0

2.5

.

0.6

1.5

1.6

1.5

1.3

.

6.4

15.4

15.5

15.8

13.3

59.3 14.6 20.9 61.8 53.0 41.3
.

61.3 14.3 21.7 69.9 60.7 50.9
6.4

63.3 14.2 22.9 66.4 64.8 51.2 15.1

67.5 14.8 24.2 70.5 72.1 59.0 24.3

71.6

64.5

15.1

14.6

21.9

22.3

68.0

67.3

68.4

63.7

55.4

51.5

28.5

18.5

105

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 1 Unit 1 - Rome

1990
405819 93987
8845
20.8 19.0 20.0
895 195 6565 712 1557 294 55 1338 160
85 50 35 104 14 25
506 100 13 555 62 112
1802 806
2172 162
1439 128 280
. . .
4827 967 75
2636 1871 1463
. 8

1991
412445 94674 8862
20.8 19.0 20.0
861 171 6444 714 1612 426
56 1271 124
53 35 18 90 13 29
449 82 9
520 61
109
1444 816 2207 128 1378
99 276
111 99
405
4691 836
69 3313 2378 2115 144
7

Total
1992 1993

418999 95344
8876

425633 96020 8894

20.9 19.2 21.0

21.3 18.9 21.0

810 179 6255 670 1624 420
74 1142
118

829 167 6271 673 1591 422
53 1075 125

60

46

39

26

21

20

113

76

12

13

32

39

445

477

76

84

10

4

512

495

61

65

157

620

1292 781
2067 84
1173 75
287

1627 744 1995
56 1234
67 236

250

298

242

237

882

944

4678 796 81
2944 2554 2101
516 8

4977 790 108 3212 2887 2391 672
7

1994 5-year
432178 2095074 96707 476732 8909 44384

21.0 19.2 21.0

20.9 19.0 20.0

846 137 6399 678 1687 339
54 1031
143

4241 849
31934 3447 8071 1901 292 5857 670

60

304

37

187

23

117

88

471

10

62

40

165

486

2363

78

420

9

45

565

2647

69

318

105

1103

1716 799
1915 66
1303 55
214

7881 3946 10356
496 6527
424 1293

265

924

205

783

928

3159

5206 771 142
3179 2849 2348
938 22

24379 4160 475
15284 12539 10418
2270 52

White
1990 1991 1992 1993 1994 5-year

372741 85814 7952

378936 86466 7969

385095 87106 7983

391290 87759 8001

397436 1925498 88400 435545 8016 39921

21.0 19.0 20.0

21.0 19.0 20.0

21.1 19.3 20.0

21.4 18.8 21.0

21.2 19.1 21.0

21.1 19.0 20.0

746 154 5855 598 1070 258
43 1147
135

729 129 5783 601 1165 381
47 1072 104

682 141 5661 574 1214 367
58 940
93

712 139 5707 583 1208 371
37 900 104

737 117 5802 586 1269 297
43 871 127

3606 680
28808 2942 5926 1674 228 4930 563

63

44

42

38

47

234

35

27

28

23

27

140

28

17

14

15

20

94

77

74

87

57

67

362

14

12

10

12

8

56

21

25

29

30

34

139

417

365

365

400

401

1948

74

67

58

73

60

332

8

7

4

3

4

26

463

446

433

429

487

2258

56

52

56

58

62

284

90

99

139

521

93

942

1560 571
1931 126
1349 97
225

1250 587 1964
92 1292
81 228

1095 557
1871 63
1115 54
236

1415 554 1816
34 1171
50 211

1501 584
1740 45
1248 44
184

6821 2853 9322
360 6175
326 1084

.

82

215

256

237

790

.

72

213

218

192

695

.

304

673

708

730

2415

4404 864 65
2212 1545 1206
. 6

4345 729
64 2824 1992 1775 112
7

4344 719 72
2562 2161 1789
431 5

4614 707
92 2807 2495 2055 561
6

4812 692 120
2771 2460 2029
818 16

22519 3711 413
13176 10653
8854 1922
40

1990
29964 7378 831

1991
30338 7403 831

Black
1992 1993

30709 7428 832

31084 7454 832

1994 5-year

31453 7479 833

153549 37142
4159

19.2 18.0 24.0

19.2 18.9 25.0

19.2 18.6 26.0

19.4 19.2 24.0

19.2 19.5 25.0

19.2 18.7 25.0

147

130

122

112

106

617

41

42

38

27

19

167

680

632

553

525

559

2949

114

113

95

88

90

500

484

445

403

376

409

2117

26

35

44

43

31

179

12

8

15

14

11

60

153

165

164

147

136

765

23

18

20

19

15

95

22

9

18

8

13

70

15

8

11

3

10

47

7

1

7

5

3

23

26

15

25

17

21

104

0

1

2

1

2

6

4

4

3

8

6

25

85

82

78

74

82

401

26

15

17

10

17

85

5

2

6

1

5

19

87

72

75

61

73

368

6

8

5

7

6

32

21

10

17

94

11

153

234

188

184

194

204

1004

235

227

219

184

209

1074

237

237

189

170

170

1003

33

35

21

21

21

131

88

83

57

59

53

340

31

17

21

17

11

97

54

48

50

24

30

206

.

8

28

28

24

88

.

10

19

12

9

50

.

47

133

158

127

465

401

327

309

334

374

1745

101

104

73

80

77

435

9

3

9

16

22

59

418

476

364

385

388

2031

320

377

376

374

369

1816

254

332

299

323

304

1512

.

31

84

106

112

333

2

0

3

1

6

12

108

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 1 Unit 1 - Rome

1990
16.2 69.9
2.1 24.0
3.3 14.2
0.3 161.8
3.9
101.2 21.8 80.5 54.4 18.1 96.2
4.0
12.9 7.6 5.4
15.7 0.6 0.3
7.7 1.5 0.2 8.5 1.0 1.8
32.5 12.4 33.7
2.5 23.1
2.1 7.9
. . .
74.7 16.5 11.9 40.5 28.8 22.5
.

1991
15.6 68.1
2.1 25.3
3.1 13.4
0.3 154.6
5.3
97.2 19.9 80.6 56.1 14.0 97.5
3.7
8.2 5.4 2.8 13.8 0.5 0.4
7.0 1.3 0.1 8.2 1.0 1.9
27.6 12.8 34.9
2.0 24.1
1.7 8.1
1.0 0.9 3.7
74.6 14.4 12.0 51.9 37.2 33.1
2.3

Total
1992 1993

14.9 65.6 2.0 26.2 2.7 12.0 0.3 144.3 5.4

14.7 65.3
2.0 25.7
2.5 11.2
0.3 137.2
5.1

91.3 22.1 75.5 61.4 13.3 98.3
4.3

93.2 20.1 75.7 61.0 14.1 99.2
4.3

9.6 6.2 3.4 17.9 0.5 0.4

7.3 4.1 3.2 12.0 0.5 0.5

7.1

7.6

1.2

1.3

0.2

*

8.3

8.0

1.0

1.0

2.8

11.0

25.3 12.6 33.8
1.4 21.2 1.4
8.3

30.6 12.0 32.5
0.9 22.2
1.2 7.1

2.3

2.7

2.2

2.1

8.0

8.4

77.0 14.1 14.9 47.5 41.2 33.9
8.3

81.1 14.1 18.2 51.8 46.5 38.6 10.8

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

14.8 66.2 2.0 26.7 2.4 10.7 0.3 131.5 4.2

15.2 67.0
2.0 25.6
2.8 12.3
0.3 146.1
4.8

95.0 16.2 76.1 61.0 16.1 100.0
3.3

95.6 20.0 77.7 58.7 15.1 98.2
3.9

9.4 5.8 3.6 13.6 0.4 0.5

9.5 5.9 3.7 14.6 0.5 0.4

7.6

7.4

1.2

1.3

0.1

0.1

8.9

8.4

1.1

1.0

1.8

3.8

31.0 12.6 30.8
1.1 22.9 1.0
6.4

29.5 12.5 33.1
1.6 22.7
1.5 7.6

2.3

2.1

1.8

1.8

8.2

7.1

83.3 13.5 22.4 50.2 45.0 37.1 14.8

78.1 14.5 15.9 48.3 39.7 33.0
9.0

15.7 68.2
2.1 18.5
3.1 13.4
0.3 156.8
3.7

15.3 66.9
2.0 20.3
2.8 12.4
0.3 146.8
5.2

14.7 65.0 2.0 21.7 2.4 10.8 0.3 133.4 5.1

14.6 65.0
2.0 21.4
2.3 10.3
0.3 128.0
4.8

14.6 65.6 2.0 22.1 2.2 9.9 0.3 124.0 4.0

15.0 66.1
2.0 20.8
2.6 11.3
0.3 138.0
4.5

93.8 20.6 75.2 46.0 17.0 95.5
2.8

91.5 17.7 75.4 48.4 13.1 97.1
4.0

85.4 20.7 71.9 55.1 11.6 97.8
3.5

89.0 19.5 72.9 55.6 13.0 99.0
4.0

91.9 15.9 73.1 55.7 15.8 100.0
3.5

90.3 18.9 73.7 52.1 14.1 97.8
3.6

10.8 6.0 4.8
13.1 0.6 0.3

7.6 4.7 3.0 12.7 0.5 0.4

7.4 4.9 2.5 15.2 0.4 0.4

6.7

8.1

8.1

4.0

4.7

4.9

2.6

3.5

3.3

9.9

11.5

12.5

0.5

0.3

0.5

0.4

0.5

0.4

7.1

6.3

6.4

7.0

6.9

6.8

1.3

1.2

1.0

1.3

1.0

1.2

0.1

0.1

*

*

*

0.1

8.0

7.8

7.7

7.6

8.5

7.9

1.0

0.9

1.0

1.0

1.1

1.0

1.6

1.9

2.8

10.2

1.8

3.6

31.5 9.8
33.5 2.2
24.4 1.8 7.2

26.7 10.2 34.5
1.6 25.4
1.6 7.5

23.7 9.9 33.7 1.1 22.5 1.1 7.6

29.4 9.8
32.5 0.6
23.3 1.0 6.9

29.9 10.2 30.7 0.8 24.3 0.9
6.1

28.3 10.0 33.0
1.3 24.0
1.3 7.0

.

0.8

2.2

2.5

2.3

2.0

.

0.7

2.1

2.2

1.9

1.7

.

3.1

6.8

7.0

7.1

6.0

76.4 16.5 11.8 38.1 26.6 20.8
.

76.8 13.9 12.7 49.3 34.7 31.0
2.0

78.7 14.0 15.1 45.7 38.6 31.9
7.7

82.6 13.8 17.5 49.7 44.2 36.4
9.9

84.9 13.3 21.8 48.3 42.8 35.3 14.2

79.9 14.3 15.8 46.2 37.3 31.0
8.5

22.7 92.2
2.6 71.9
5.1 20.7
0.5 175.5
5.3

20.8 85.4
2.4 71.3
5.4 22.3
0.5 195.7
6.2

18.0 74.4 2.1 73.7 5.3 22.1 0.6 210.5 8.3

16.9 70.4
2.0 72.6
4.7 19.7
0.5 201.6
7.6

17.8 74.7 2.2 74.2 4.3 18.2 0.5 183.8 6.0

19.2 79.4
2.3 72.7
5.0 20.6
0.5 193.0
6.7

176.9 27.9 137.2 98.2 27.7 100.0 15.6

156.4 32.3
135.9 97.3 21.7
100.0 *

146.7 31.1
114.2 98.9 24.1
100.0 12.0

134.6 24.1
105.7 96.6 22.8
100.0 6.0

127.3 17.9
108.1 94.4 18.0
100.0 *

148.4 27.1
120.2 97.2 22.8
100.0 7.2

32.4 22.1 10.5 37.6
* *

14.2 12.7
* 23.4
* *

32.5 19.9 12.9 44.0
* *

15.2 *
9.6 31.5
* 1.1

23.3 17.9
* 36.8
* 0.8

23.7 15.9
7.9 34.6
0.5 0.7

12.5

13.0

14.1

14.1

14.7

13.6

3.8

2.4

3.1

1.9

3.0

2.9

0.7

*

1.1

*

0.9

0.6

12.9

11.6

13.8

11.8

13.2

12.7

0.9

1.3

0.9

1.4

1.1

1.1

3.1

1.6

3.1

18.3

2.1

5.3

40.7 34.9 35.9
5.0 13.4
4.7 13.9

36.0 36.4 39.0
5.8 13.8
2.8 13.4

39.0 40.0 35.3
4.0 10.8 4.0 16.6

40.4 35.5 33.6
4.1 11.7
3.4 8.6

41.5 37.9 32.2
3.9 10.1 2.1 10.5

39.5 36.8 35.3
4.6 12.1
3.4 12.8

.

0.8

2.8

2.8

2.4

2.2

.

1.0

1.9

1.2

0.9

1.3

.

4.8

13.5

15.8

12.5

11.7

60.5 17.0 11.3 62.0 47.5 37.7
.

54.0 18.6
* 76.3 60.4 53.2
5.0

59.0 15.2 13.6 66.5 68.7 54.7 15.4

64.9 17.6 25.0 74.3 72.2 62.4 20.5

68.4

61.1

16.4

17.0

26.8

16.5

70.3

69.7

66.8

62.3

55.1

51.9

20.3

14.9

109

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 1 Unit 2 - Dalton

1990
232605 56571
4905
22.2 20.0 20.0
446 101 4169 370 656 282 22 822 64
36 25 11 47
2 15
289 47
2 316 33 45
1164 354
1283 45 917 129 167
. . .
3152 567 77
1380 1141
901 . 6

1991
239403 57407 4961
22.3 20.1 20.0
396 87
4111 334 648 308
30 807
54
39 24 15 53
4 22
262 46 6
310 45 48
1027 364 1216
36 819 108 150
91 87 266
3141 522
87 1629 1276 1108 418
7

Total
1992 1993

246170 58238
5016

252967 59072 5070

22.8 19.5 21.0

22.5 19.8 21.0

415 80
4017 318 736 287 28 758 78

402 67
4194 337 796 262
24 713
54

35

19

20

11

15

8

47

34

8

8

19

20

260

300

45

45

5

2

306

319

35

43

51

32

1038 365
1202 25
728 86
124

1125 370 1239
28 735
80 125

175

183

189

180

514

645

3136 504 83
1571 1381 1157
649 2

3238 529
93 1804 1803 1456 751
9

1994 5-year
259725 1230870 59907 291195 5125 25077

22.3 19.3 21.0

22.4 19.7 21.0

464 75
4174 370 817 293 35 683 79

2123 410
20665 1729 3653 1432 139 3783 329

30

159

20

100

10

59

51

232

9

31

14

90

259

1370

59

242

6

21

304

1555

49

205

34

210

1188 356
1173 36
697 73
113

5542 1809 6113
170 3896
476 679

176

625

184

640

636

2061

3280 502 117
1671 1643 1336
893 14

15947 2624 457 8055 7244 5958 2711 38

1990
224483 54627
4723

1991
230777 55367 4767

White
1992 1993

237062 56108
4812

243361 56848
4856

1994 5-year
249631 1185314 57587 280537
4900 24058

22.2 19.9 20.0

22.3 20.1 20.0

22.8 19.5 21.0

22.5 19.9 21.0

22.3 19.4 21.0

22.4 19.8 21.0

430 98
4066 359 614 251 21 762 62

375 80
4013 320 601 277
27 750
49

392 76
3906 303 680 263 27 707 73

378 64
4064 322 734 231
22 659
47

437 71
4063 355 766 266 35 625 69

2012 389
20112 1659 3395 1288 132 3503 300

36

36

34

19

30

155

25

22

19

11

20

97

11

14

15

8

10

58

46

49

45

32

51

223

2

4

8

7

9

30

15

21

18

20

13

87

276

254

248

275

247

1300

45

44

40

42

55

226

2

5

5

1

6

19

300

299

290

298

290

1477

32

45

34

39

49

199

45

47

50

30

33

205

1127 332
1255 44
908 123 162

1005 334 1192
30 809 102 142

1009 336
1178 23
718 81
121

1087 337 1206
27 721
73 119

1145 331
1155 34
687 65
109

5373 1670 5986
158 3843
444 653

.

78

147

162

151

538

.

82

166

170

175

593

.

219

458

559

553

1789

3087 551 74
1333 1097
867 . 6

3093 510
83 1565 1228 1063 400
4

3069 490 80
1516 1334 1117
623 2

3157 505
92 1725 1732 1394 714
9

3197 486 114
1604 1585 1283
868 13

15603 2542 443 7743 6976 5724 2605 34

1990
4924 1234
128

1991
5054 1247 129

Black
1992 1993

5183 1261
130

5313 1274 131

1994 5-year

5443 1288
132

25917 6304 650

20.8 20.2 24.5

20.4 20.1 25.0

19.4 18.5 26.0

20.4 18.1 24.0

19.8 16.5 29.0

20.1 18.3 26.0

14

16

17

20

20

87

3

6

4

3

3

19

83

84

87

99

84

437

11

13

13

15

11

63

41

45

53

55

48

242

11

7

8

11

5

42

0

0

1

2

0

3

35

37

33

40

43

188

1

3

4

5

8

21

0

2

1

0

0

3

0

2

1

0

0

3

0

0

0

0

0

0

0

1

2

2

0

5

0

0

0

1

0

1

0

1

1

0

1

3

12

8

11

21

9

61

2

2

5

3

3

15

0

1

0

1

0

2

14

11

14

16

10

65

1

0

1

4

0

6

0

1

0

1

1

3

29

16

25

33

33

136

21

27

27

30

24

129

23

20

21

26

17

107

1

5

1

1

2

10

9

9

9

9

8

44

6

6

4

7

8

31

5

6

3

6

3

23

.

4

6

4

11

25

.

2

4

3

6

15

.

7

19

26

39

91

51

41

51

57

64

264

14

10

14

18

11

67

3

3

3

1

3

13

40

55

50

63

58

266

40

43

42

55

50

230

31

41

35

48

45

200

.

16

22

28

20

86

0

0

0

0

0

0

110

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 1 Unit 2 - Dalton

1990
17.9 73.7
2.2 15.9
3.5 14.5
0.3 154.5
5.9
90.9 22.6 75.4 40.5 13.0 93.7
4.1
8.6 6.0 2.7 11.2
* 0.3
6.9 1.1
* 7.6 0.8 1.1
33.8 8.6
31.2 1.1
22.8 3.2 7.4
. . .
76.3 15.2 19.2 33.4 27.6 21.8
.

1991
17.2 71.6
2.2 15.9
3.4 14.1
0.3 152.7
6.4
79.8 22.0 67.3 47.3 10.9 98.1
2.6
9.5 5.8 3.7 12.8
* 0.5
6.4 1.1 0.1 7.6 1.1 1.2
31.2 9.0
30.1 0.9
20.8 2.8 6.9
1.4 1.4 4.1
77.5 14.3 20.5 40.1 31.4 27.3 10.3

Total
1992 1993

16.3 69.0 2.1 18.5 3.1 13.0 0.3 148.0
5.9

16.6 71.0
2.2 19.2
2.8 12.1
0.3 136.7
5.2

82.7 19.3 63.4 55.2 15.6 96.2 4.6

79.3 16.7 66.5 56.4 10.7 100.0
2.8

8.7

4.5

5.0

2.6

3.8

1.9

11.6

8.1

0.5

0.5

0.4

0.4

6.5

7.2

1.1

1.1

0.1

*

7.7

7.7

0.9

1.0

1.3

0.8

31.7 9.2
30.5 0.6 18.8 2.3 5.6

31.7 8.9
30.1 0.7
18.2 2.0 5.4

2.6

2.7

2.9

2.6

7.8

9.5

80.0 14.2 19.4 39.5 34.7 29.1 16.3

80.3 14.4 20.1 43.5 43.5 35.1 18.1

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

16.1 69.7 2.2 19.8 2.6 11.4 0.4 131.2
5.8

16.8 71.0
2.2 17.9
3.1 13.0
0.3 144.7
5.8

90.5 16.2 72.2 58.7 15.4 94.8 4.1

84.7 19.3 68.9 51.5 13.1 96.3
3.6

7.2 4.8 2.4 12.1 0.5 0.3

7.7 4.8 2.9 11.2 0.4 0.4

6.2

6.6

1.4

1.2

0.1

0.1

7.4

7.6

1.2

1.0

0.8

1.0

32.2 8.6
28.8 0.9 17.4 1.8 5.1

32.1 8.8
30.2 0.8
19.6 2.4 6.1

2.5

2.3

2.6

2.4

9.1

7.7

81.7 13.6 27.4 40.5 39.8 32.4 21.6

79.2 14.3 21.3 39.4 35.4 29.1 16.6

18.1 74.4
2.3 15.2
3.4 13.9
0.3 148.8
5.4

17.4 72.5
2.2 15.2
3.2 13.5
0.3 147.2
6.0

16.5 69.6 2.2 17.6 3.0 12.6 0.3 143.4
5.6

16.7 71.5
2.2 18.3
2.7 11.6
0.3 131.9
4.8

16.3 70.6 2.2 19.1 2.5 10.9 0.3 124.9
5.5

17.0 71.7
2.2 17.1
3.0 12.5
0.3 139.3
5.5

91.0 22.8 76.0 38.7 13.1 95.1
3.0

78.7 21.3 67.1 44.9 10.3 97.9
2.3

81.5 19.4 63.0 53.3 15.2 95.9 4.2

77.8 16.9 66.3 54.4
9.7 100.0
2.5

89.2 16.2 72.4 58.1 14.1 94.1 3.9

83.6 19.3 69.0 49.8 12.5 96.3
3.2

8.9 6.1 2.7 11.3
* 0.4

9.0 5.5 3.5 12.1
* 0.5

8.7 4.9 3.9 11.4 0.5 0.4

4.7

7.4

7.7

2.7

4.9

4.8

2.0

2.5

2.9

7.8

12.4

11.0

0.4

0.6

0.4

0.4

0.3

0.4

6.8

6.3

6.3

6.8

6.1

6.5

1.1

1.1

1.0

1.0

1.4

1.1

*

0.1

0.1

*

0.1

0.1

7.4

7.5

7.5

7.4

7.2

7.4

0.8

1.1

0.9

1.0

1.2

1.0

1.1

1.2

1.3

0.8

0.8

1.0

33.5 8.2
31.3 1.1
23.1 3.1 7.4

31.1 8.4
30.2 0.8
21.1 2.7 6.7

31.6 8.7
30.8 0.6 19.1 2.2 5.6

31.5 8.4
30.2 0.7
18.4 1.9 5.3

31.8 8.2
29.1 0.9 17.7 1.7 5.1

31.9 8.4
30.3 0.8
19.9 2.3 6.0

.

1.3

2.3

2.5

2.3

2.1

.

1.3

2.6

2.6

2.6

2.3

.

3.6

7.2

8.6

8.3

7.0

76.7 15.1 18.9 33.1 27.2 21.5
.

78.1 14.4 20.1 39.5 31.0 26.8 10.1

80.4 14.2 19.1 39.2 34.5 28.9 16.1

80.8 14.1 20.6 42.9 43.1 34.7 17.8

81.8 13.5 27.3 40.0 39.5 32.0 21.6

79.5 14.3 21.3 38.9 35.0 28.8 16.4

16.9 67.3
2.0 50.0
7.1 28.4
0.6 267.2 10.5

16.6 67.3
2.0 53.6
7.3 29.7
0.6 286.8
6.4

16.8 69.0 2.1 62.4 6.4 26.2 0.6 253.8
7.9

18.6 77.7
2.4 57.3
7.5 31.4
0.9 263.2
10.2

15.4 65.2 2.0 57.1 7.9 33.4 1.0 323.3 4.7

16.9 69.3
2.1 56.1
7.3 29.8
0.7 278.5
7.9

109.4 *
85.9 100.0
* * *

124.0 37.5
100.8 100.0
* * *

130.9 *
100.1 100.0
* * *

152.8 *
114.6 100.0
38.2 * *

151.6 *
83.4 90.9 60.7 100.0
*

133.9 21.8 97.0 98.4 32.3 100.0 *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

11.4

*

*

*

*

*

*

*

*

*

*

*

*

14.5

9.5

12.6

21.2

10.7

14.0

*

*

5.7

*

*

3.4

*

*

*

*

*

*

17.1

13.3

16.3

16.8

11.9

15.1

*

*

*

*

*

1.4

*

*

*

*

*

*

48.3 25.6 28.4
* 11.7
7.8 10.9

31.4 32.1 23.8
6.0 11.1
7.8 12.2

39.1 31.4 25.0
* 11.0
* *

44.6 31.3 27.4
* 9.7 7.6 12.8

45.2 28.6 20.5
* 9.8 9.8
*

42.2 29.9 25.1
2.3 10.6
7.6 10.0

.

*

3.9

*

6.7

4.0

.

*

*

*

3.7

2.4

.

4.7

12.3

16.4

23.9

14.5

62.2 19.4
* 48.8 48.8 37.8
.

51.3 13.5
* 65.5 51.2 48.8 19.0

60.7 18.2
* 58.1 48.8 40.7 25.6

59.4 22.0
* 65.6 57.3 50.0 29.2

78.0

62.3

14.7

17.6

*

25.0

69.0

61.6

59.5

53.2

53.6

46.3

23.8

24.6

111

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 2 Unit 0 - Gainesville

1990
304462 69168
6236
21.3 19.9 21.0
504 87 4736 412 989 327 36 946 84
45 30 15 65 11 19
363 52
6 349 50 94
839 476 1443 55 675 66 161
. . .
3661 683 58
2174 1425 1200
. 2

1991
311562 69854 6272
21.5 19.9 21.0
569 110 4644 444 1059 416
28 892 100
38 26 12 57 13 25
344 50 5
357 37 86
733 522 1456
26 626
48 143
98 134 415
3862 557
72 2411 1669 1521
377 20

Total
1992 1993

318605 70523
6307

325718 71208 6343

22.2 19.8 21.0

22.2 20.0 21.0

529 105 4752 407 1040 402
35 916 101

522 91
4707 413 1059 359
26 925
88

43

49

29

35

14

14

63

61

7

7

29

21

352

353

64

82

6

8

324

350

60

49

97

79

822 526 1316
32 595
56 167

706 507 1387
36 504
35 166

228

258

270

225

708

904

3982 521 91
2245 1810 1539
620 14

4073 457
95 2238 2067 1735 491
17

1994 5-year
332736 1593083 71874 352627 6377 31535

22.1 20.2 21.0

21.9 19.9 21.0

524 91
4883 426
1148 335 23 799 83

2648 484
23722 2102 5295 1839 148 4478 456

30

205

19

139

11

66

42

288

8

46

21

115

347

1759

62

310

4

29

291

1671

55

251

70

426

813 569 1349
19 463
28 156

3913 2600 6951
168 2863
233 793

235

819

192

821

884

2911

4371 526 88
2236 2097 1733
626 20

19949 2744 404
11304 9068 7728 2114 73

White
1990 1991 1992 1993 1994 5-year

278766 62998 5590

284728 63506 5617

290668 64008 5641

296636 64513 5668

302547 1453345 65009 320034 5693 28209

21.6 19.9 21.0

21.7 19.9 21.0

22.5 19.8 21.0

22.4 20.1 21.0

22.4 20.3 21.0

22.2 20.0 21.0

419 71
4289 341 682 289 30 800 71

475 84
4202 373 754 381
23 733
82

448 85
4362 345 775 363 28 766 84

450 74
4318 360 800 332
20 799
72

458 75
4489 375 883 299 21 689 71

2250 389
21660 1794 3894 1664 122 3787 380

41

26

37

39

27

170

26

19

23

25

16

109

15

7

14

14

11

61

56

45

50

45

37

233

11

12

6

6

7

42

17

24

29

20

20

110

306

284

293

290

302

1475

44

37

50

59

50

240

5

4

3

8

2

22

297

300

274

295

261

1427

44

32

59

44

51

230

82

67

85

72

57

363

715 318 1288
39 638
51 126

622 371 1303
17 597
34 111

732 379 1173
29 572
45 139

632 360 1254
26 485
33 142

737 426 1240
15 443
23 130

3438 1854 6258
126 2735
186 648

.

65

165

204

199

633

.

81

206

189

153

629

.

206

431

618

669

1924

3411 616 55
1841 1178
993 . 1

3529 495
66 2062 1392 1264
312 12

3703 484 84
1978 1568 1341
546 11

3777 423
85 1983 1830 1538
433 15

4053 479 82
1980 1858 1536
577 15

18473 2497 372 9844 7826 6672 1868 54

1990
19259 4695 535

1991
19621 4719 535

Black
1992 1993

19978 4743 535

20341 4767 535

1994 5-year

20697 4790 535

99896 23714
2676

18.8 19.0 25.0

19.6 19.4 23.0

18.6 18.7 26.0

19.1 18.5 27.0

19.0 21.9 25.0

19.0 19.1 25.0

79

91

78

66

59

373

16

26

20

16

16

94

421

417

355

341

325

1859

68

71

62

50

48

299

301

304

254

243

241

1343

27

30

35

25

31

148

6

5

7

5

2

25

99

112

100

95

87

493

10

15

14

13

8

60

4

12

6

9

4

7

6

9

0

5

0

0

9

12

12

14

0

1

1

1

2

1

0

0

3

34

3

29

0

5

5

52

1

4

1

4

55

56

55

59

43

268

7

13

13

21

12

66

1

1

2

0

2

6

48

57

46

49

27

227

6

5

1

5

4

21

10

16

10

5

11

52

121

106

84

70

60

441

154

149

140

136

126

705

145

145

129

110

86

615

16

9

3

10

4

42

34

28

22

19

17

120

15

14

11

2

5

47

33

31

28

22

24

138

.

13

20

36

24

93

.

7

19

14

21

61

.

114

121

213

135

583

237

316

253

256

262

1324

65

58

34

33

35

225

3

6

6

9

3

27

321

338

254

230

214

1357

237

274

230

213

205

1159

200

254

190

177

166

987

.

65

70

53

38

226

0

0

0

1

1

2

112

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 2 Unit 0 - Gainesville

1990
15.6 68.5
2.0 21.1
3.1 13.7
0.4 155.9
5.6
80.8 17.3 66.1 50.4 13.5 94.0
2.4
9.5 6.3 3.2 13.6 0.6 0.4
7.7 1.1 0.1 7.5 1.1 2.0
31.2 10.2 31.2
1.2 15.0
1.5 6.8
. . .
78.5 16.0 13.6 46.4 30.4 25.6
.

1991
14.9 66.5
2.0 23.0
2.9 12.8
0.4 148.6
6.7
90.7 19.3 70.8 55.1 15.9 96.9
4.6
8.2 5.6 2.6 12.2 0.7 0.5
7.4 1.1 0.1 7.8 0.8 1.9
30.6 11.3 32.1
0.6 14.2
1.1 6.6
1.3 1.7 5.4
83.9 13.1 20.5 52.3 36.2 33.0
8.2

Total
1992 1993

14.9 67.4 2.0 22.2 2.9 13.0 0.4 149.5 6.5

14.5 66.1
2.0 22.7
2.8 13.0
0.4 153.4
5.6

83.9 19.8 64.5 54.6 16.0 97.0 4.1

82.3 17.4 65.1 55.1 13.9 96.5
4.4

9.0 6.1 3.0 13.2 0.4 0.5

10.4 7.4 3.0
12.9 0.4 0.4

7.4

7.5

1.3

1.7

0.1

0.2

6.9

7.5

1.3

1.1

2.1

1.8

33.1 11.2 29.4
0.7 13.3
1.3 6.9

29.3 10.9 30.6
0.8 11.5
0.8 6.9

2.9

3.2

3.4

2.8

9.0

11.3

84.7 12.2 21.5 47.9 38.6 32.8 13.2

87.2 10.6 27.2 48.1 44.4 37.3 10.5

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

14.7 67.9 2.1 23.8 2.4 11.1 0.3 131.9 5.2

14.9 67.3
2.0 22.6
2.8 12.7
0.4 147.8
5.9

82.2 17.4 66.8 59.8 13.0 97.5 2.7

84.0 18.3 66.7 55.0 14.5 96.4
3.6

6.1

8.6

3.9

5.9

2.3

2.8

8.6

12.1

0.4

0.5

0.4

0.4

7.1

7.4

1.3

1.3

*

0.1

6.0

7.1

1.1

1.1

1.5

1.9

18.8 11.8 29.2
0.4 10.2
0.6 6.6

27.3 11.1 30.5
0.7 12.8
1.0 6.7

2.9

2.6

2.3

2.6

10.8

9.2

90.0 11.8 22.8 46.3 43.4 35.9 13.0

84.9 12.7 20.9 48.2 38.6 32.9 11.3

15.4 68.1
2.1 16.1
2.9 12.7
0.4 147.3
5.4

14.8 66.2
2.0 18.1
2.6 11.5
0.3 136.7
6.7

15.0 68.1 2.1 18.0 2.6 12.0 0.3 138.3 6.4

14.6 66.9
2.1 18.7
2.7 12.4
0.3 145.7
5.7

14.8 69.1 2.1 19.9 2.3 10.6 0.3 125.0 5.1

14.9 67.7
2.1 18.2
2.6 11.8
0.3 138.6
5.9

75.0 16.9 61.0 41.4 12.7 93.0
2.5

84.6 17.7 66.4 47.0 14.6 97.5
4.3

79.4 19.0 61.2 47.2 14.9 96.4 4.3

79.4 16.4 63.5 49.2 12.7 95.7
4.2

80.5 16.4 65.9 54.4 12.5 97.1 2.3

79.8 17.3 63.6 48.0 13.5 96.0
3.5

9.6 6.1 3.5 13.0 0.7 0.4

6.2 4.5 1.7 10.7 0.8 0.5

8.5 5.3 3.2 11.4 0.4 0.6

9.0 5.8 3.3 10.4 0.4 0.4

6.0

7.8

3.6

5.0

2.5

2.8

8.2

10.7

0.4

0.5

0.4

0.4

7.1

6.8

6.7

6.7

6.7

6.8

1.0

0.9

1.1

1.4

1.1

1.1

0.1

*

*

0.2

*

0.1

7.0

7.2

6.4

6.9

5.9

6.7

1.0

0.8

1.4

1.0

1.1

1.1

2.0

1.7

2.0

1.7

1.3

1.7

29.9 7.5
30.8 0.9
15.6 1.3 5.9

28.9 8.9
31.7 0.4
15.0 0.9 5.7

32.3 8.8 28.6 0.7 13.9 1.1 6.2

28.1 8.4
30.2 0.6
11.9 0.8 6.4

18.4 9.6
29.1 0.3 10.5 0.5 5.9

26.3 8.7
30.1 0.6
13.4 0.9 6.1

.

0.9

2.4

2.9

2.7

2.2

.

1.2

2.9

2.6

2.1

2.2

.

3.0

6.2

8.7

9.2

6.8

80.7 16.0 14.3 43.4 27.8 23.4
.

84.7 12.9 20.6 49.4 33.4 30.3
7.5

85.8 12.4 21.8 46.0 36.5 31.2 12.7

88.0 10.7 26.3 46.4 42.8 36.0 10.1

90.8 11.8 22.6 44.6 41.9 34.6 13.0

86.1 12.7 20.9 45.9 36.5 31.1 10.9

21.9 89.7
2.5 72.4
5.1 21.1
0.5 178.7
7.2

21.3 88.4
2.5 73.8
5.7 23.7
0.6 198.6
7.4

17.8 74.9 2.1 71.8 5.0 21.1 0.5 200.4 9.3

16.8 71.5
2.1 72.5
4.7 19.9
0.4 203.9
6.3

15.7 67.8 2.0 74.8 4.2 18.2 0.5 194.2 7.5

18.6 78.4
2.2 73.0
4.9 20.8
0.5 194.8
7.5

147.7 20.3 127.1 95.6 18.7 100.0
*

170.1 28.6
132.7 97.2 28.0
100.0 9.3

145.7 25.6
115.8 95.2 26.2
100.0 *

123.3 24.2 93.4
100.0 24.3
100.0 *

110.2 27.1 89.7
100.0 14.9
100.0 *

139.4 25.2 111.7 97.3 22.4
100.0 6.0

* * * 21.1 * *

28.8 16.8 12.2 28.4
* *

16.9 16.9
* 33.1
* *

26.4 26.4
* 40.5
* *

* * * 15.3 * *

18.3 15.6
2.7 27.6
* *

13.1

13.4

15.5

17.3

13.2

14.4

1.7

3.1

3.7

6.2

3.7

3.6

*

*

*

*

*

0.3

11.6

13.8

13.0

14.6

8.4

12.4

1.4

1.2

*

1.5

*

1.1

2.4

4.0

3.0

1.7

4.0

3.0

43.7 37.0 35.1
3.9 8.4 3.7 14.5

45.7 36.2 35.7
2.2 7.1 3.6 14.0

42.9 39.5 36.9
* 6.8 3.4 14.5

48.3 40.5 33.4
3.0 6.7
* 11.9

23.8 39.1 28.3
* 6.4 1.9 14.3

40.0 38.3 34.1
2.3 7.2 2.8 13.9

.

2.1

3.2

5.6

3.7

3.7

.

1.1

3.0

2.2

3.2

2.4

.

18.6

19.3

33.4

20.8

23.1

57.1 17.2
* 77.2 57.0 48.1
.

76.7 15.2 19.4 82.0 66.5 61.7 15.8

71.9 10.7 16.7 71.8 65.0 53.7 19.8

76.2 10.5 39.1 68.5 63.4 52.7 15.8

80.9

72.0

11.6

13.3

*

18.2

66.5

73.8

63.7

63.0

51.6

53.6

11.8

15.9

113

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
1990

Population

518865

Women age 15-44

142721

Women age 15-17

10215

Woman's median age at:

Conception of first birth

25.3

Conception of first abortion

21.4

First marriage

23.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

711

Repeat conceptions to women under 18

144

Total Livebirths

8986

Livebirths to women under 18

402

Livebirths to unmarried women

1470

Early fetal deaths

801

Fetal deaths 20 weeks or more gestation

70

Total induced abortions

3877

Induced abortions to women under 18

290

Infant and child survival

Infant deaths

85

Neonatal deaths

61

Postneonatal deaths

24

Perinatal deaths

129

Deaths of children 1-4 years

15

Deaths of children 5-17 years

36

Infant health

Low birthweight

604

Very low birthweight

121

Under 500 grams

10

Preterm gestation

714

Multiple gestation

111

Born with birth defect

107

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

1730

Father not named on birth certificate

739

Maternal education less than high school

1226

No prenatal care

226

Maternal smoking during pregnancy

1288

Maternal alcohol use during pregnancy

254

Interpregnancy interval less than 6 months

290

Abuse & neglect to persons under age 18 years

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

Prenatal care first trimester

7065

Primary C-section delivery

1294

Vaginal birth after previous C-section

206

WIC during pregnancy

1867

Medicaid during pregnancy

1501

WIC and Medicaid during pregnancy

1059

Perinatal case management

.

Child fatality investigations

14

Health District 3 Unit 1 - Cobb-Douglas

1991
536894 145385
10477
25.6 21.6 23.0
687 114 8654 403 1571 874
66 3812 255
57 38 19 105 11 29
561 100
15 654 107
71
1493 802 1228 197 1102 191 292
126 94
386
6917 1213 168 2341 1876 1490 163
30

Total
1992 1993

554907 148048 10739

572940 150713
11002

25.5 21.6 24.0

25.7 22.2 24.0

695 147 8635 425 1713 816
74 3751
244

730 155 8982 433 1808 773
55 3767 277

53

62

36

42

17

20

110

96

10

11

27

34

571

620

112

117

9

9

678

690

99

123

61

71

1549 883
1195 146
1021 127 266

1750 863 1224
91 1011 118 270

294

274

175

102

746

643

7252 1137
155 2257 2239 1622
768 19

7725 1131 233 2716 2859 2101 1170
30

1994 5-year
590958 2774564 153373 740240
11263 53696

25.7 22.3 24.0

25.6 21.8 24.0

731 133 9212 479 2041 776
79 3585
235

3554 693
44469 2142 8603 4040 344
18792 1301

61

318

39

216

22

102

117

557

13

60

26

152

621

2977

112

562

18

61

678

3414

143

583

66

376

1981 1002 1211
76 1008
142 249

8503 4289 6084
736 5430
832 1367

274

968

113

484

817

2592

8122 1145
267 2713 2861 2132 1425
35

37081 5920 1029
11894 11336
8404 3526
128

White
1990 1991 1992 1993 1994 5-year

456693 122934
8969

467071 123546
9092

477444 124159
9214

487826 124772
9337

498199 2387233 125383 620794
9460 46071

25.4 21.0 23.0

25.8 21.3 23.0

25.7 21.4 23.0

25.9 22.1 23.0

25.9 22.3 24.0

25.7 21.5 23.0

568 107 7449 309 891 611
44 2759
245

510 71
7063 298 942 641
40 2627 195

511 96
6953 327
1021 625 44
2451 170

513 108 7073 302 1043 542
31 2387 201

476 75
7211 305
1177 526 46
2087 160

2578 457
35749 1541 5074 2945 205
12311 971

59

44

30

33

35

201

42

26

19

20

22

129

17

18

11

13

13

72

86

67

63

49

67

332

14

9

8

9

8

48

31

27

22

30

24

134

434

391

390

403

393

2011

78

63

65

70

61

337

5

9

2

3

6

25

539

489

484

476

459

2447

97

81

73

92

105

448

88

55

47

53

54

297

1392 437
1036 153
1178 213 205

1187 470 1014 133 1005 165 210

1219 537
1006 105 943 111 187

1330 461 977
54 907
98 177

1481 560 957 48 906 121 167

6609 2465 4990
493 4939
708 946

.

73

160

171

133

537

.

74

129

82

85

370

.

218

460

369

452

1499

6012 1063
168 1244 1057
718 .
12

5823 983 144 1557 1299 1007 106
26

5968 898 107
1484 1562 1104
524 11

6232 879 185 1723 1919 1346 768
25

6476 867 208
1726 1930 1396
928 20

30511 4690 812 7734 7767 5571 2326 94

1990
49751 16243
944

1991
51489 16490
968

Black
1992 1993

53225 16736
993

54963 16983
1017

1994 5-year

56700 17229 1042

266127 83682
4964

24.4 23.5 25.0

24.4 23.5 26.0

24.6 22.1 26.0

24.3 22.3 27.0

24.1 22.2 26.0

24.4 22.5 26.0

136 35 1379 92 566 111 26 928 39

159 43
1420 99
609 142
23 976
52

166 46
1471 92
666 124
27 1135
67

198 44
1652 126 730 156
22 1196
66

239 58
1763 166 837 140 24
1339 71

898 226 7685 575 3408 673 122 5574 295

25

13

22

29

23

112

19

12

16

22

15

84

6

1

6

7

8

28

43

35

43

44

39

204

1

2

2

2

4

11

5

2

3

4

2

16

160

154

169

195

214

892

41

37

44

46

47

215

5

6

7

6

12

36

165

157

184

193

204

903

14

22

23

28

37

124

19

15

13

18

11

76

311

280

293

362

448

1694

294

319

330

379

421

1743

169

192

165

209

240

975

72

62

41

35

27

237

107

96

72

92

98

465

40

26

16

18

21

121

83

73

70

81

76

383

.

34

100

86

122

342

.

11

28

16

23

78

.

132

199

239

308

878

928

960

1111

1282

1437

5718

212

205

214

233

253

1117

34

23

44

42

54

197

594

734

720

908

918

3874

426

541

630

841

855

3293

329

449

487

684

679

2628

.

53

225

365

461

1104

2

4

6

5

12

29

114

Maternal and Child Health Rates
1990

Perinatal outcome rates

Crude birth rate

17.3

General fertility rate

63.0

Total fertility rate

1.9

% Livebirths to unmarried women

16.6

Crude abortion rate

7.5

General abortion rate

27.2

Total abortion rate

0.9

Abortion ratio

280.4

Fetal Death rate

6.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

69.6

% Repeat conceptions to women under 18

20.3

Livebirths to women under 18

39.4

% Livebirths to unmarried women under 18

66.9

Induced abortions to women under 18

28.4

% Abortions to unmarried women under 18

97.9

Fetal deaths to women under 18

3.6

Infant and child survival rates

Infant mortality

9.5

Neonatal mortality

6.8

Postneonatal mortality

2.7

Perinatal mortality ratio

14.2

Deaths of children 1-4 yrs

0.5

Deaths of children 5-17 yrs

0.4

Infant health rates

% Low birthweight

6.7

% Very low birthweight

1.3

% Under 500 grams

0.1

% Preterm gestation

8.0

% Multiple gestation

1.3

% Birth defect

1.2

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

25.5

% with father not named on birth certificate

8.3

% with maternal education less than high school

13.9

% No prenatal care

2.6

% Maternal smoking during pregnancy

14.6

% Maternal alcohol use during pregnancy

2.9

% Interpregnancy interval less than 6 months

6.3

Child abuse and neglect rates

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

% Prenatal care first trimester

79.2

% Primary C-section delivery

16.3

% Vaginal birth after previous C-section

22.0

% WIC during pregnancy

21.0

% Medicaid during pregnancy

16.9

% Medicaid and WIC during pregnancy

11.9

% Perinatal case management

.

Health District 3 Unit 1 - Cobb-Douglas

1991
16.1 59.5
1.8 18.4
7.1 26.2
0.8 282.9
6.9
65.6 16.6 38.5 72.7 24.3 97.6
3.4
6.6 4.4 2.2 12.0 0.3 0.3
6.5 1.2 0.2 7.7 1.3 0.8
24.0 9.4
14.5 2.3
13.0 2.3 6.4
0.9 0.7 2.8
80.6 15.8 19.2 27.4 21.9 17.4
1.9

Total
1992 1993

15.6 58.3 1.8 20.1
6.8 25.3 0.8 281.7
6.3

15.7 59.6
1.8 20.4
6.6 25.0
0.8 276.4
5.9

64.7 21.2 39.6 71.1 22.7 99.2 3.4

66.4 21.2 39.4 75.5 25.2 97.1
2.5

6.1 4.2 2.0 12.6 0.3 0.3

6.9 4.7 2.2 10.6 0.3 0.3

6.6

6.9

1.3

1.3

0.1

0.1

7.9

7.8

1.2

1.4

0.7

0.8

24.3 10.3 14.1 1.7 12.0 1.5 5.8

24.3 9.7
13.9 1.0
11.5 1.3 5.6

2.1

1.8

1.2

0.7

5.2

4.3

84.5 14.7 19.3 26.4 26.2 19.0
9.0

86.4 14.2 26.2 30.7 32.3 23.7 13.2

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

15.6 60.1 1.8 22.5
6.1 23.4 0.7 261.1
6.1

16.0 60.1
1.8 19.6
6.8 25.4
0.8 276.4
6.4

64.9 18.2 42.5 78.3 20.9 98.7 2.2

66.2 19.5 39.9 73.1 24.2 98.1
3.0

6.6 4.2 2.4 12.6 0.4 0.2

7.2 4.9 2.3 12.4 0.4 0.3

6.7

6.7

1.2

1.3

0.2

0.1

7.5

7.8

1.6

1.3

0.7

0.8

23.7 11.1 13.5 0.8 11.2 1.6 5.1

24.3 9.8
14.0 1.7
12.4 1.9 5.8

1.8

1.7

0.7

0.8

5.3

4.4

88.7 14.1 28.0 29.9 31.6 23.5 15.7

83.9 15.0 23.1 27.1 25.8 19.2 10.1

16.3 60.6
1.8 12.1
6.0 22.4
0.7 252.9
5.7

15.1 57.2
1.7 13.5
5.6 21.3
0.7 252.2
5.9

14.6 56.0 1.7 14.8
5.1 19.7 0.6 242.7
5.6

14.5 56.7
1.7 15.0
4.9 19.1
0.6 237.0
4.9

14.5 57.5 1.8 16.6
4.2 16.6 0.5 210.6
4.9

15.0 57.6
1.8 14.4
5.2 19.8
0.6 239.5
5.4

63.3 18.8 34.5 59.6 27.3 97.5
2.9

56.1 13.9 32.8 66.3 21.4 97.4
2.5

55.5 18.8 35.5 64.2 18.5 98.8 2.4

54.9 21.1 32.3 67.2 21.5 96.5
1.5

50.3 15.8 32.2 68.1 16.9 98.1 1.5

56.0 17.7 33.4 65.0 21.1 97.6
2.1

7.9

6.2

4.3

4.7

4.9

5.6

5.6

3.7

2.7

2.8

3.1

3.6

2.3

2.6

1.6

1.8

1.8

2.0

11.5

9.4

9.0

6.9

9.2

9.2

0.5

0.3

0.3

0.3

0.3

0.3

0.4

0.3

0.3

0.3

0.3

0.3

5.8

5.5

5.6

5.7

5.5

5.6

1.0

0.9

0.9

1.0

0.8

0.9

0.1

0.1

*

*

0.1

0.1

7.3

7.0

7.0

6.8

6.5

6.9

1.3

1.2

1.1

1.3

1.5

1.3

1.2

0.8

0.7

0.8

0.8

0.8

24.3 5.9
14.2 2.1
16.1 2.9 5.4

22.9 6.7
14.6 1.9
14.5 2.4 5.6

23.3 7.8
14.7 1.5 13.8 1.6 5.1

23.2 6.6
14.1 0.8
13.1 1.4 4.7

22.4 7.9
13.6 0.7 12.8 1.7 4.3

23.2 7.0
14.2 1.4
14.1 2.0 5.0

.

0.6

1.3

1.4

1.1

1.1

.

0.6

1.1

0.7

0.7

0.8

.

1.9

3.9

3.0

3.7

3.1

81.2 16.1 21.8 16.9 14.4
9.8 .

83.2 15.7 19.9 22.3 18.6 14.4
1.5

86.2 14.4 16.6 21.6 22.7 16.0 7.6

88.4 14.1 25.6 24.7 27.5 19.3 11.0

90.3 13.7 27.6 24.3 27.2 19.7 13.1

85.8 14.8 22.5 21.9 22.0 15.8
8.3

27.7 84.9
2.4 41.6 18.7 57.1
1.6 376.6
9.7

27.6 86.1
2.5 43.5 19.0 59.2
1.7 379.8
10.6

27.6 87.9 2.5 46.1 21.3 67.8 1.9 410.5
9.5

30.1 97.3
2.8 45.0 21.8 70.4
2.0 394.3
10.9

31.1 102.3
3.0 48.5 23.6 77.7 2.2 408.6 10.2

28.9 91.8
2.6 45.1 20.9 66.6
1.9 395.1 10.2

144.1 25.7 97.5 92.3 41.3 100.0
7.4

164.2 27.0
102.2 91.9 53.7
100.0 9.3

167.2 27.7 92.7 95.7 67.5
100.0 8.1

194.6 22.2
123.9 96.8 64.9 98.5 9.8

229.4 24.3
159.4 96.9 68.2
100.0 6.7

180.9 25.2
115.8 95.1 59.4 99.7 8.3

18.1 13.8
4.4 30.6
* 0.5

9.2 8.5
* 24.3
* *

15.0 10.9 4.1 28.7
* *

17.6 13.3
4.3 26.3
* *

13.0 8.5 4.6 21.8
* *

14.6 10.9
3.7 26.1
0.5 0.3

11.6

10.9

11.5

11.8

12.1

11.6

3.0

2.6

3.0

2.8

2.7

2.8

0.4

0.4

0.5

0.4

0.7

0.5

12.1

11.2

12.7

11.9

11.8

12.0

1.0

1.6

1.6

1.7

2.1

1.6

1.4

1.1

0.9

1.1

0.6

1.0

31.7 21.6 12.5
5.3 7.9 3.0 11.2

29.7 22.8 13.9
4.5 6.9 1.9 9.5

29.4 22.8 11.5 2.8 5.0 1.1 8.6

28.9 23.4 13.0
2.2 5.7 1.1 8.9

28.9 24.4 14.0 1.6 5.7 1.2 8.3

29.6 23.1 13.0
3.2 6.2 1.6 9.2

.

2.1

6.1

5.0

6.9

5.1

.

0.7

1.7

0.9

1.3

1.2

.

8.3

12.1

14.0

17.4

13.1

68.3 17.5 22.5 43.5 31.2 24.1
.

68.0 16.3 16.1 52.4 38.6 32.1
3.8

76.3 16.4 30.6 49.8 43.5 33.7 15.5

78.0 15.8 28.6 56.0 51.8 42.2 22.5

82.0

75.0

16.4

16.4

29.7

25.7

53.2

51.3

49.5

43.6

39.3

34.8

26.7

17.8

115

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 3 Unit 2 - Fulton

1990
648951 172947 12097
23.2 21.4 25.0
1922 649
11912 1275 6055 996 186 7727 573
176 113 63 298 23 49
1283 270 30
1531 154 146
1978 3737 2727
702 1386
567 724
. . .
7336 1436
351 5331 4651 3497
. 35

1991
655727 172614
12122
23.1 21.6 26.0
1835 633 11810 1249 6029 1043 208 7626 511
156 93 63
299 28 48
1292 259
24 1485 154 173
1875 3736 2779 627 1222 476 746
107 58
748
7702 1440 341 6101 5296 4368
343 77

Total
1992 1993

662502 172280 12146

669282 171947
12171

23.2 21.8 26.0

23.5 21.9 26.0

1848 670
11699 1214 6032 1134 170 7716 565

1921 601 12296 1331 6248 954 161 7593 523

131

147

87

97

44

50

256

259

13

27

55

53

1311 271 28
1499 163 124

1316 309
33 1489 173
90

2056 3639 2814
584 1005
399 770

2448 3683 2961 454 984 386 742

434 172 3124

419 194 2819

7806 1416
340 5606 5702 4328
748 44

8978 1496 355 6214 6696 5243 1373
73

1994 5-year
676054 3312516 171614 861402
12195 60730

24.0 22.1 26.0

23.4 21.8 26.0

1770 570
11895 1222 5715 921 149 7064 505

9296 3123 59612 6291 30079 5048
874 37726
2677

128

738

70

460

58

278

215

1327

32

123

28

233

1171 230 22
1321 183 85

6373 1339
137 7325
827 618

3203 3371 2783
258 989 414 669

11560 18166 14064
2625 5586 2242 3651

337 118 2178

1297 542
8869

9270 1440
324 5591 5850 4557 1885
51

41092 7228 1711
28843 28195 21993
4349 280

White
1990 1991 1992 1993 1994 5-year

309901 78224 4220

314101 78458 4245

318297 78690 4269

322498 78924 4293

326696 1591493 79158 393454 4317 21344

27.6 23.3 25.0

27.7 23.1 26.0

28.1 23.3 26.0

28.3 23.7 26.0

28.9 23.8 26.0

28.1 23.5 26.0

231 55 4104 132 533 363 34 2313 92

207 43
4135 124 528 377 37 2180 75

232 51
4151 134 554 408 27
2098 95

243 48
4507 147 613 404 25 2194 93

230 51
4726 140 535 410 32
2004 86

1143 248
21623 677
2763 1962
155 10789
441

30

27

19

37

18

131

18

17

12

30

8

85

12

10

7

7

10

46

52

53

40

53

42

240

3

4

5

4

7

23

6

10

12

8

2

38

210

226

238

239

265

1178

39

29

35

61

33

197

7

2

2

4

2

17

303

286

310

332

325

1556

48

48

52

61

89

298

39

47

27

28

38

179

531

465

551

674

975 3196

284

296

294

316

289

1479

572

594

596

638

653

3053

84

71

79

55

50

339

375

318

260

259

287

1499

151

100

88

81

154

574

106

111

125

113

114

569

.

8

24

29

33

94

.

10

25

37

18

90

.

66

213

271

161

711

3214 494 103 607 456 306 . 4

3360 532 111 777 573 417
22 12

3443 526 101 738 653 461 68 12

3890 552 124 858 973 648 114
13

4165 536 147 831 861 611 143 1

18072 2640 586 3811 3516 2443 347 42

Black
1990 1991 1992 1993 1994 5-year

324008 90705 7569

327391 90516 7584

330774 90327 7600

334159 90139 7615

337540 1653872 89950 451638 7630 37998

19.7 19.9 25.0

19.7 20.3 26.0

19.5 20.4 26.0

19.3 20.4 26.0

19.6 20.4 26.0

19.6 20.3 26.0

1680 589
7612 1139 5494
601 151 5127 475

1611 586 7460 1118 5476 640 168 5126 427

1607 615
7341 1079 5450
702 139 5320 463

1660 551 7561 1177 5600 527 133 5089 420

1532 516
6880 1077 5142
481 111 4834 417

8090 2857 36854 5590 27162 2951
702 25496
2202

145

128

106

108

109

596

94

75

69

65

61

364

51

53

37

43

48

232

243

243

211

201

167

1065

20

24

8

23

25

100

41

38

42

45

26

192

1059 227 23
1208 105 105

1052 230
22 1189 104 122

1053 235 26
1173 108 95

1058 243
28 1140 110
58

894

5116

196

1131

20

119

976

5686

90

517

47

427

1423 3441 2112
613 1008
415 615

1370 3423 2133 553 903 375 633

1459 3321 2175
502 740 309 636

1724 3338 2270 394 721 304 622

2149 3059 2082
205 698 259 549

8125 16582 10772
2267 4070 1662 3055

.

97

382

363

269

1111

.

47

129

152

95

423

.

673

2724

2403

1897

7697

3988 920 243
4669 4162 3173
. 30

4198 889 225 5243 4677 3914 319
65

4212 865 236
4790 4999 3827
677 31

4923 922 226 5259 5638 4530 1253
60

4873 869 170
4654 4907 3887 1727
49

22194 4465 1100
24615 24383 19331
3976 235
116

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 3 Unit 2 - Fulton

1990
18.4 68.9
2.1 51.5 11.9 44.7
1.3 370.2
7.1
158.9 33.8 105.4 94.1 47.4 98.8
7.8
14.8 9.5 5.3
24.6 0.6 0.4
10.8 2.3 0.3
13.1 1.3 1.2
30.0 31.8 23.4
6.1 12.0
4.9 11.1
. . .
63.6 13.5 32.1 45.3 39.6 29.7
.

1991
18.0 68.4
2.1 51.8 11.6 44.2
1.3 367.8
7.5
151.4 34.5
103.0 95.9 42.2 98.4 7.3
13.2 7.9 5.4
24.9 0.7 0.4
10.9 2.2 0.2
12.8 1.3 1.5
29.5 32.1 24.2
5.5 10.7
4.2 11.4
0.7 0.4 4.7
66.7 13.6 31.7 52.4 45.4 37.5
2.9

Total
1992 1993

17.7 67.9 2.1 52.3 11.6 44.8 1.4 371.9 7.7

18.4 71.5
2.2 51.6 11.3 44.2
1.3 361.1
6.6

152.1 36.3
100.0 94.5 46.5 98.2 7.2

157.8 31.3
109.4 94.4 43.0 98.4 7.1

11.2 7.4 3.8
21.6 0.3 0.5

12.0 7.9 4.1
20.8 0.7 0.5

11.2 2.3 0.2
13.0 1.4 1.1

10.7 2.5 0.3
12.3 1.4 0.7

30.4 31.6 24.6
5.1 9.1 3.6 11.3

30.1 30.4 24.6
3.8 8.3 3.3 10.5

2.7 1.1 19.3

2.6 1.2 17.2

67.4 13.5 32.0 48.6 49.4 37.5
6.5

73.5 13.5 33.6 51.3 55.3 43.3 11.3

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

17.6 69.3 2.1 48.8 10.4 41.2 1.3 352.0 6.5

18.0 69.2
2.1 51.2 11.4 43.8
1.3 364.7
7.1

145.1 32.2
100.2 93.7 41.4 99.2 4.9

153.1 33.6 103.6 94.5 44.1 98.6
6.9

10.8 5.9 4.9
17.9 0.8 0.2

12.4 7.7 4.7
21.9 0.6 0.4

9.8

10.7

1.9

2.2

0.2

0.2

11.4

12.5

1.6

1.4

0.7

1.0

30.0 28.8 24.0
2.2 8.5 3.6 10.3

30.0 30.9 24.2
4.5 9.7 3.9 10.9

2.0 0.7 13.1

2.0 0.8 13.6

79.3 13.4 32.9 47.8 50.0 38.9 16.1

70.2 13.5 32.5 49.1 48.0 37.4
9.3

13.2 52.5
1.5 13.1
7.5 29.6
0.9 338.4
5.4

13.2 52.7
1.5 12.9
6.9 27.8
0.9 323.1
5.5

13.0 52.8 1.5 13.5 6.6 26.7 0.8 313.3 5.7

14.0 57.1
1.7 13.8
6.8 27.8
0.9 307.5
5.5

14.5 59.7 1.8 11.5
6.1 25.3 0.8 279.1 5.7

13.6 55.0
1.6 13.0
6.8 27.4
0.9 311.9
5.5

54.7 23.8 31.3 59.5 21.8 97.8
2.6

48.8 20.8 29.2 68.9 17.7 93.3
2.6

54.4 22.0 31.4 61.9 22.3 94.6
*

56.6 19.8 34.2 64.4 21.7 95.7
1.2

53.3 22.2 32.4 57.9 19.9 98.8
1.6

53.6 21.7 31.7 62.4 20.7 96.1
1.7

7.3 4.4 2.9 12.6
* 0.2

6.5 4.1 2.4 12.7
* 0.3

4.6

8.2

2.9

6.7

1.7

1.6

9.6

11.7

0.4

*

0.3

0.2

3.8

6.1

1.7

3.9

2.1

2.1

8.8

11.0

0.5

0.3

*

0.2

5.1

5.5

5.7

5.3

5.6

5.4

1.0

0.7

0.8

1.4

0.7

0.9

0.2

*

*

*

*

0.1

7.5

7.0

7.6

7.5

7.0

7.3

1.2

1.2

1.3

1.4

1.9

1.4

1.0

1.1

0.7

0.6

0.8

0.8

22.2 7.0
14.3 2.1 9.4 3.8 5.4

20.7 7.2
14.8 1.8 7.9 2.5 5.5

23.8 7.2 14.8 1.9 6.4 2.2 6.0

22.0 7.1
14.5 1.2 5.9 1.8 5.0

22.9 6.2
14.3 1.1 6.3 3.4 4.9

22.4 6.9
14.5 1.6 7.1 2.7 5.4

.

0.1

0.4

0.5

0.6

0.4

.

0.2

0.4

0.6

0.3

0.4

.

1.2

3.7

4.7

2.7

3.1

80.4 13.5 25.6 15.0 11.2
7.5 .

83.2 14.4 28.6 19.0 14.0 10.2
0.5

83.5 14.1 28.2 18.0 16.0 11.3 1.7

86.8 13.6 33.2 19.3 21.9 14.6
2.6

89.1 12.6 37.0 17.9 18.6 13.2
3.1

84.8 13.6 30.6 17.9 16.5 11.5
2.0

23.5 83.9
2.4 73.2 15.8 56.5
1.6 379.3
8.6

22.8 82.4
2.4 74.5 15.7 56.6
1.6 382.0
9.2

22.2 81.3 2.4 75.4 16.1 58.9 1.7 393.5 9.5

22.6 83.9
2.5 75.2 15.2 56.5
1.7 381.8
7.5

20.4 76.5 2.3 75.8 14.3 53.7 1.6 392.0 6.9

22.3 81.6
2.4 74.8 15.4 56.5
1.6 385.6
8.3

222.0 35.1 150.5 98.2 62.8 98.9 10.8

212.4 36.4
147.4 99.2 56.3 99.3 10.2

211.5 38.3
142.0 98.7 60.9 99.1 11.1

218.0 33.2
154.6 98.2 55.2 99.0 10.5

200.8 33.7
141.2 98.4 54.7 99.3 6.8

212.9 35.3
147.1 98.5 58.0 99.1 9.9

19.0 12.3
6.8 31.3
0.8 0.6

17.2 10.1
7.2 31.9
1.0 0.5

14.4 9.4 5.1 28.2 0.3 0.6

14.3 8.6 5.7
26.1 0.9 0.6

15.8 8.9 7.0 23.9 1.0 0.4

16.2 9.9 6.4
28.4 0.8 0.5

13.9 3.0 0.3
16.2 1.4 1.4

14.1 3.1 0.3
16.3 1.4 1.6

14.4 3.2 0.4 16.3 1.5 1.3

14.0 3.2 0.4
15.3 1.5 0.8

13.0 2.8 0.3 14.5 1.3 0.7

13.9 3.1 0.3
15.7 1.4 1.2

34.7 45.8 28.3
8.3 13.7
5.7 13.6

34.2 46.5 29.3
7.6 12.5
5.2 14.2

33.8 45.9 30.2 7.0 10.8 4.5 13.6

35.0 44.8 30.6
5.3 10.0
4.2 13.3

35.0 45.1 30.9 3.1 10.3 3.8 13.6

34.6 45.6 29.9
6.3 11.5
4.7 13.7

.

1.0

3.8

3.5

2.6

2.7

.

0.5

1.3

1.5

0.9

1.0

.

6.7

26.8

23.3

18.1

18.8

54.2 13.5 35.9 62.2 55.4 42.3
.

57.5 13.3 33.1 71.3 63.6 53.2
4.3

58.0 13.2 34.0 66.2 69.1 52.9
9.4

65.6 13.6 33.6 70.6 75.7 60.8 16.8

72.4

61.4

14.0

13.5

29.7

33.4

68.6

67.7

72.3

67.1

57.3

53.2

25.4

13.8

117

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 3 Unit 3 - Clayton

1990
182052 50075
4079
23.0 20.0 22.0
357 71 3440 207 957 305 34 1622 136
49 38 11 72
4 8
266 65 12 318 39 64
607 468 668 109 612 107 139
. . .
2144 494 96
1099 817 562 . 9

1991
185850 50531 4127
22.2 20.2 22.0
436 73
3394 274 1056 290
40 1721 147
39 25 14 64
6 9
261 54 9
306 35 51
533 525 679
97 461
58 107
49 25 118
2267 483
79 1473 1195 974 289
14

Total
1992 1993

189641 50984 4174

193440 51441 4221

22.3 21.0 23.0

22.3 20.6 23.0

354 64
3288 227
1057 240 32
1620 114

441 83
3368 295 1251 203
23 1648 137

32

31

19

16

13

15

51

39

6

5

8

18

275

300

62

62

9

6

315

330

52

37

35

26

489

557

569

589

649

695

72

56

361

335

37

30

126

136

112

128

71

87

480

472

2268 474 71
1400 1337
973 371
18

2467 462
91 1704 1662 1287 465
27

1994 5-year

197233 51896 4268

948216 254927
20868

22.5 21.1 23.0

22.5 20.6 23.0

365 77
3462 243
1357 203 20
1500 115

1953 368
16952 1246 5678 1241 149 8111 649

33

184

19

117

14

67

37

263

2

23

16

59

290

1392

47

290

2

38

339

1608

41

204

28

204

703

2889

695

2846

678

3369

43

377

287

2056

28

260

133

641

172

461

57

240

501

1571

2724 392 110
1732 1710 1330
552 24

11870 2305 447 7408 6721 5126 1677 92

White
1990 1991 1992 1993 1994 5-year

131729 33634 2949

132164 33305 2907

132595 32976 2865

133031 32648 2823

133462 32319 2781

662981 164882
14325

22.5 19.5 21.0

22.1 19.8 21.0

22.2 20.1 22.0

21.6 19.9 22.0

22.2 20.5 22.0

22.1 19.9 21.0

220 36
2202 126 450 177 17 809 82

259 39
2086 165 468 158 16 825 86

208 32
1950 138 440 133 14 686 64

238 39
1873 169 526 114 10 681 61

193 32
1826 140 559 101 7 531 49

1118 178
9937 738
2443 683 64
3532 342

26

12

14

13

13

78

20

9

5

4

5

43

6

3

9

9

8

35

37

26

19

13

11

106

1

5

2

1

1

10

7

4

7

11

10

39

141

137

129

131

114

652

30

28

24

24

14

120

7

4

2

1

0

14

178

178

141

145

154

796

25

21

34

20

21

121

44

30

15

16

17

122

378

317

291

318

318

1622

204

231

213

228

247

1123

500

477

460

484

448

2369

58

44

31

24

14

171

528

391

318

292

234

1763

71

45

24

18

11

169

77

59

65

68

70

339

.

25

64

53

74

216

.

17

47

62

37

163

.

54

272

262

276

864

1434 309 59 590 484 324 . 7

1457 307 48 763 685 541 165 3

1391 281 45 709 754 544 230 8

1401 241 63 814 844 639 219 16

1485 212 73 809 854 651 256 14

7168 1350
288 3685 3621 2699
870 48

1990
43403 14479
939

1991
44309 14581
950

Black
1992 1993

45212 14683
961

46118 14786
972

1994 5-year

47022 14888
983

226064 73418
4804

23.6 21.2 25.0

21.7 21.5 26.0

22.4 22.3 26.0

23.6 20.8 26.0

22.9 21.5 26.0

23.0 21.5 26.0

125 31
1115 73 490 112 17 729 50

169 32
1175 105 571 125 24 822 57

136 31
1203 84
599 98 18
843 45

190 42
1363 119 701
81 11 873 70

158 43
1466 93
753 97 13
900 62

778 179 6322 474 3114 513
83 4167
284

22

26

18

18

19

103

17

15

14

12

13

71

5

11

4

6

6

32

34

37

32

24

25

152

2

1

3

4

1

11

1

4

1

6

5

17

116

120

140

156

161

693

33

25

38

37

32

165

5

5

7

5

2

24

129

124

163

175

171

762

12

14

17

17

19

79

19

20

19

10

11

79

201

189

178

219

348

1135

254

285

343

345

414

1641

132

157

146

172

183

790

49

50

40

31

26

196

81

66

41

40

52

280

35

13

13

12

17

90

55

38

54

63

58

268

.

23

41

64

89

217

.

6

22

19

18

65

.

52

187

188

183

610

651

727

791

978

1120

4267

171

162

176

210

170

889

33

30

25

27

34

149

469

650

638

818

842

3417

309

470

536

761

776

2852

219

400

395

602

621

2237

.

115

128

223

271

737

2

10

9

9

10

40

118

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 3 Unit 3 - Clayton

1990
18.9 68.7
2.0 28.1
8.9 32.4
1.0 299.4
7.1
87.5 19.9 50.7 75.1 33.3 97.8
4.2
14.2 11.0
3.2 20.7
* 0.2
7.7 1.9 0.3 9.4 1.1 1.9
26.2 13.8 20.1
3.3 18.3
3.2 8.3
. . .
65.3 16.2 27.9 32.3 24.0 16.5
.

1991
18.3 67.2
2.0 31.4
9.3 34.1
1.0 315.3
6.8
105.7 16.7 66.4 73.9 35.6 97.9 4.1
11.5 7.4 4.2
18.6 0.5 *
7.7 1.6 0.3 9.1 1.0 1.5
25.2 15.6 20.7
3.0 13.9
1.7 6.4
0.9 0.5 2.3
69.4 16.1 22.3 43.8 35.6 29.0
8.6

Total
1992 1993

17.3 64.5 1.9 32.7
8.5 31.8 0.9 312.1 5.6

17.4 65.5
2.0 37.6
8.5 32.0
1.0 313.8
4.6

84.8 18.1 54.4 74.9 27.3 98.2 3.4

104.5 18.8 69.9 82.7 32.5 97.0 2.1

9.7 5.8 4.0 15.4 0.5 0.2

9.2 4.8 4.5 11.5 0.4 0.5

8.4

8.9

1.9

1.8

0.3

0.2

9.7

9.9

1.6

1.1

1.1

0.8

25.9 17.6 20.7 2.3 11.2 1.2 7.2

26.5 17.7 21.5
1.7 10.1
0.9 7.5

2.1

2.4

1.3

1.6

9.1

8.7

70.7 16.2 23.4 43.3 41.3 30.1 11.5

74.4 15.4 27.7 51.1 49.9 38.6 14.0

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

17.6 66.7 2.0 39.7
7.6 28.9 0.9 289.1 4.4

17.9 66.5
2.0 33.9
8.6 31.8
1.0 306.0
5.7

85.5 21.1 56.9 83.5 26.9 99.1 2.1

93.6 18.8 59.7 78.2 31.1 98.0
3.2

9.5 5.5 4.1 10.6
* 0.4

10.9 6.9 4.0
15.4 0.4 0.3

8.4

8.2

1.4

1.7

*

0.2

9.9

9.6

1.2

1.2

0.8

1.2

25.2 20.3 20.1 1.3 8.4 0.8 7.2

25.8 17.0 20.6
2.3 12.4
1.6 7.3

3.1

2.2

1.0

1.1

9.1

7.3

79.6 12.8 31.3 50.6 50.0 38.9 16.1

71.9 15.3 26.6 44.2 40.1 30.6 12.6

16.7 65.5
1.9 20.7
6.1 24.1
0.7 251.5
6.1

15.8 62.6
1.9 22.7
6.2 24.8
0.7 266.8
5.4

14.7 59.1 1.8 23.0
5.2 20.8 0.6 246.0 4.6

14.1 57.4
1.7 28.4
5.1 20.9
0.6 254.1
3.9

13.7 56.5 1.7 31.0
4.0 16.4 0.5 215.2 3.4

15.0 60.3
1.8 24.9
5.3 21.4
0.6 247.9
4.7

74.6 16.4 42.7 64.5 27.8 97.5
4.7

89.1 15.1 56.8 58.9 29.6 96.4
3.4

72.6 15.4 48.2 61.6 22.3 98.4 2.4

84.3 16.4 59.9 73.4 21.6 93.3
2.8

69.4 16.6 50.3 72.7 17.6 100.0 1.8

78.0 15.9 51.5 66.3 23.9 97.0
3.1

11.8

5.8

7.2

6.9

7.1

7.8

9.1

4.3

2.6

*

2.7

4.3

2.7

*

4.6

4.8

4.4

3.5

16.7

12.4

9.7

6.9

6.0

10.6

*

0.6

*

*

*

0.2

0.3

*

0.3

0.5

0.4

0.3

6.4

6.6

6.6

7.0

6.2

6.6

1.4

1.3

1.2

1.3

0.8

1.2

0.3

*

*

*

*

0.1

8.2

8.6

7.4

7.8

8.5

8.1

1.1

1.0

1.8

1.1

1.2

1.2

2.0

1.4

0.8

0.9

0.9

1.2

23.9 9.4
23.4 2.7
24.6 3.3 7.2

22.7 11.2 23.5
2.2 19.0
2.2 5.9

24.3 11.1 24.6 1.6 16.7 1.3 6.3

25.4 12.3 26.8
1.3 15.8
1.0 6.9

21.7 13.7 25.2 0.8 13.0 0.6 7.4

23.5 11.4 24.6
1.8 18.1
1.7 6.7

.

0.7

1.9

1.6

2.2

1.6

.

0.5

1.4

1.8

1.1

1.2

.

1.6

8.0

7.7

8.1

6.3

67.9 15.8 26.2 27.1 22.2 14.9
.

71.8 16.6 22.6 36.9 33.2 26.2
8.0

72.6 16.2 25.0 37.0 39.4 28.4 12.0

76.1 14.6 31.0 43.9 45.5 34.5 11.8

82.3 13.2 36.0 44.8 47.3 36.0 14.2

73.9 15.4 28.2 37.5 36.9 27.5 11.4

25.7 77.0
2.3 44.5 16.8 50.3
1.5 368.9
9.1

26.5 80.6
2.4 49.1 18.6 56.4
1.7 382.1
10.6

26.6 81.9 2.5 50.5 18.6 57.4 1.7 389.0 8.2

29.6 92.2
2.8 52.0 18.9 59.0
1.8 373.9
6.7

31.2 98.5 3.0 52.0 19.1 60.5 1.9 363.2 7.5

28.0 86.1
2.6 49.9 18.4 56.8
1.7 375.2
8.4

133.1 24.8 77.7 95.9 53.2 100.0
*

177.9 18.9
110.5 97.1 60.0
100.0 7.4

141.5 22.8 87.4 97.6 46.8
100.0 7.3

195.6 22.1
122.5 99.2 72.0
100.0 *

160.8 27.2 94.7 98.9 63.1 98.4 *

162.0 23.0 98.7 97.9 59.1 99.6 4.6

19.7 15.2
4.6 30.0
* *

22.1 12.8
9.5 30.9
* *

15.0 11.6
* 26.2
* *

13.2 8.8 4.4
17.5 *
0.6

13.0 8.9 4.1
16.9 *
0.5

16.3 11.2
5.1 23.7
0.5 0.3

10.4

10.2

11.6

11.4

11.0

11.0

3.0

2.1

3.2

2.7

2.2

2.6

0.4

0.4

0.6

0.4

*

0.4

11.7

10.7

13.7

13.0

11.8

12.2

1.1

1.2

1.4

1.3

1.3

1.3

1.7

1.7

1.6

0.7

0.8

1.3

30.5 23.0 12.2
4.6 7.5 3.2 9.8

29.1 24.5 13.9
4.5 5.8 1.1 6.1

28.4 28.9 12.7 3.5 3.5 1.1 8.4

28.0 25.6 13.1
2.3 3.0 0.9 8.4

29.1 28.6 12.7 1.8 3.6 1.2 7.2

29.0 26.3 12.9
3.2 4.5 1.5 7.9

.

1.5

2.7

4.1

5.6

3.5

.

0.4

1.4

1.2

1.1

1.1

.

3.5

12.3

12.1

11.6

9.9

61.1 17.2 30.0 42.6 28.0 19.9
.

65.3 15.7 22.6 55.9 40.4 34.4
9.9

68.0 16.4 21.6 53.7 45.2 33.3 10.8

72.7 17.1 22.1 60.7 56.5 44.7 16.6

77.1

69.5

13.0

15.8

24.1

24.0

58.1

54.7

53.6

45.7

42.9

35.8

18.7

14.3

119

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 3 Unit 4 - Lawrenceville

1990
448809 123153
9350
25.3 20.6 23.0
622 130 8007 363 1177 607 59 2917 239
72 50 22 108 15 28
461 91
7 562 97 112
1467 576
1084 108 979 198 220
. . .
6511 1061
228 1577 1271
954 .
16

1991
470413 127021
9729
25.4 20.9 23.0
567 111 8055 328 1283 653
71 2716 227
68 50 18 121 13 33
558 113
13 646 111
95
1419 611 1155
91 1041
153 236
52 28 244
6470 1145 201 2130 1712 1420 347
16

Total
1992 1993

491979 130881
10105

513585 134750
10484

25.5 21.0 23.0

25.6 21.3 23.0

573 121 8143 355 1344 623
61 2746
205

558 101 8411 341 1450 619
66 2618 203

46

67

33

46

13

21

93

110

10

18

32

24

476

557

84

125

6

12

617

699

104

113

112

104

1602 655
1115 115
1037 155 214

1728 667 1084
69 956 110 197

189

189

124

99

587

563

6681 998 203
2062 1878 1481
604 11

7125 994 205 2528 2469 1885 774
21

1994 5-year
535158 2459944 138611 654416
10861 50528

26.0 21.6 23.0

25.6 21.0 23.0

615 108 8791 404 1529 598
68 2561
200

2935 571
41407 1791 6783 3100 325
13558 1074

69

322

44

223

25

99

114

546

12

68

14

131

557

2609

116

529

11

49

726

3250

109

534

71

494

1941 660
1110 64
875 151 225

8157 3169 5548
447 4888
767 1092

181

611

80

331

604

1998

7692 997 250
2428 2359 1866
729 26

34479 5195 1087
10725 9689 7606 2454 90

White
1990 1991 1992 1993 1994 5-year

402057 109177
8380

418468 111709
8660

434856 114236
8939

451264 116767
9219

467655 2174300 119296 571185
9498 44695

25.4 20.2 23.0

25.6 20.6 23.0

25.6 20.7 23.0

25.7 20.8 23.0

26.2 21.4 23.0

25.7 20.6 23.0

508 91 6910 287 750 514 47 2247 205

439 80
6807 249 817 556
56 1993
183

429 71
6874 269 879 509 44
1934 150

425 76
6980 255 919 518
50 1808
157

459 75
7313 286 984 494 52
1772 162

2260 393
34884 1346 4349 2591 249 9754 857

53

45

33

48

54

233

38

34

25

30

35

162

15

11

8

18

19

71

85

90

68

80

89

412

12

9

8

11

8

48

25

30

24

21

13

113

350

428

355

403

409

1945

58

84

56

75

81

354

3

9

5

5

7

29

451

509

488

538

566

2552

78

96

89

94

93

450

97

79

92

84

57

409

1207 361 916 80 912 172 152

1145 364 936
70 968 131 173

1266 415 912 77 960 131 147

1390 407 854
46 878
96 140

1504 404 892 44 808 121 161

6512 1951 4510
317 4526
651 773

.

36

127

124

105

392

.

26

95

73

58

252

.

150

369

366

377

1262

5757 903 201
1141 952 713 . 15

5607 951 179 1503 1252 1016 272
11

5777 837 183
1486 1376 1084
446 9

6038 814 169 1759 1794 1322 555
18

6523 822 216
1726 1713 1342
518 20

29702 4327 948 7615 7087 5477 1791 73

1990
31887 9755 684

1991
33344 10001
703

Black
1992 1993

34795 10245
723

36253 10491
742

1994 5-year

37706 10736
761

173985 51228
3613

23.6 23.4 25.0

23.2 22.7 26.0

24.1 22.1 27.0

23.6 22.4 27.0

23.0 22.5 27.0

23.5 22.7 26.0

103

114

127

124

136

604

37

29

46

23

32

167

849

913

928 1014 1033 4737

74

75

81

83

105

418

415

448

444

499

497

2303

72

73

84

72

78

379

9

14

13

13

14

63

478

513

553

584

576

2704

25

34

43

40

31

173

17

20

13

19

12

81

10

15

8

16

7

56

7

5

5

3

5

25

18

29

21

27

22

117

2

4

2

7

3

18

3

3

6

2

1

15

94

104

99

129

121

547

30

26

25

42

32

155

4

4

1

7

4

20

92

115

112

131

135

585

16

11

14

16

14

71

13

12

16

15

9

65

216

211

258

240

321

1246

210

236

226

235

229

1136

138

178

167

181

169

833

27

20

33

21

15

116

62

67

67

74

59

329

25

22

20

13

27

107

59

47

55

48

47

256

.

10

46

38

51

145

.

2

17

15

8

42

.

63

159

153

143

518

575

621

645

770

800

3411

129

145

114

137

139

664

23

11

17

28

25

104

398

540

488

614

573

2613

292

396

424

528

501

2141

224

349

340

448

427

1788

.

56

123

165

150

494

1

5

1

2

3

12

120

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 3 Unit 4 - Lawrenceville

1990
17.8 65.0
1.9 14.9
6.5 23.7
0.8 250.9
5.7
66.5 20.9 38.8 64.6 25.6 97.9
3.1
9.0 6.2 2.8 13.4 0.5 0.3
5.8 1.1 0.1 7.1 1.2 1.4
24.2 7.3
13.9 1.4
12.5 2.5 5.6
. . .
82.1 15.1 26.1 19.9 16.1 12.1
.

1991
17.1 63.4
1.9 16.2
5.8 21.4
0.7 235.2
6.1
58.3 19.6 33.7 64.9 23.3 98.7
2.4
8.4 6.2 2.2 14.9 0.4 0.4
6.9 1.4 0.2 8.1 1.4 1.2
24.2 7.7
14.8 1.2
13.3 2.0 6.0
0.4 0.2 1.9
81.2 16.0 25.1 26.8 21.6 17.9
4.4

Total
1992 1993

16.6 62.2 1.9 16.7
5.6 21.0 0.7 236.7 5.4

16.4 62.4
1.9 17.5
5.1 19.4
0.6 223.2
5.2

56.7 21.1 35.1 73.0 20.3 96.1 2.0

53.2 18.1 32.5 73.5 19.4 98.0
1.9

5.6 4.1 1.6 11.3 0.3 0.3

8.0 5.5 2.5 13.0 0.5 0.2

5.8

6.6

1.0

1.5

0.1

0.1

7.7

8.4

1.3

1.4

1.4

1.2

25.4 8.2
14.1 1.4 13.1 2.0 5.1

24.8 8.0
13.2 0.8
11.7 1.4 4.6

1.4

1.3

0.9

0.7

4.3

3.9

83.2 13.8 25.4 25.7 23.4 18.4
7.5

86.2 13.2 26.8 30.5 29.8 22.7
9.3

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

16.4 63.4 1.9 17.6
4.8 18.5 0.6 212.8 4.9

16.8 63.3
1.9 16.6
5.5 20.7
0.7 231.6
5.5

56.6 17.6 37.2 71.3 18.4 96.0 1.9

58.1 19.5 35.4 69.5 21.3 97.4
2.2

7.8 5.0 2.9 12.9 0.3 0.1

7.8 5.4 2.4 13.1 0.4 0.3

6.3

6.3

1.3

1.3

0.1

0.1

8.4

8.0

1.3

1.3

0.8

1.2

25.1 7.6
13.0 0.7 10.5 1.8 5.0

24.8 7.8
13.8 1.1
12.2 1.9 5.3

1.2

1.1

0.5

0.6

4.0

3.6

88.4 12.6 32.0 28.0 27.2 21.5
8.4

84.3 14.1 27.0 26.2 23.7 18.6
7.4

17.2 63.3
1.9 11.0
5.6 20.6
0.7 230.5
5.4

16.3 60.9
1.8 12.2
4.8 17.8
0.6 210.7
5.9

15.8 60.2 1.8 13.0
4.4 16.9 0.6 206.1 5.0

15.5 59.8
1.8 13.4
4.0 15.5
0.5 193.0
5.0

15.6 61.3 1.9 13.6
3.8 14.9 0.5 183.7 4.7

16.0 61.1
1.9 12.6
4.5 17.1
0.6 204.9
5.2

60.6 17.9 34.2 57.0 24.5 98.0
2.7

50.7 18.2 28.8 56.9 21.1 98.3
2.1

48.0 16.6 30.1 65.9 16.8 95.3 1.8

46.1 17.9 27.7 65.7 17.0 97.4
1.8

48.3 16.3 30.1 62.6 17.1 96.9 1.7

50.6 17.4 30.1 61.6 19.2 97.3
2.0

7.7 5.5 2.2 12.2 0.4 0.3

6.6 5.0 1.6 13.1 0.3 0.4

4.8

6.9

7.4

6.7

3.6

4.3

4.8

4.6

1.2

2.6

2.6

2.0

9.8

11.4

12.1

11.7

0.3

0.4

0.3

0.3

0.3

0.2

0.1

0.3

5.1

6.3

5.2

5.8

5.6

5.6

0.8

1.2

0.8

1.1

1.1

1.0

*

0.1

0.1

0.1

0.1

0.1

6.6

7.6

7.2

7.8

7.8

7.4

1.1

1.4

1.3

1.4

1.3

1.3

1.4

1.2

1.3

1.2

0.8

1.2

22.8 5.3
13.6 1.2
13.5 2.6 4.5

22.9 5.4
14.2 1.1
14.6 2.0 5.2

23.7 6.1
13.6 1.1 14.3 2.0 4.2

23.9 5.9
12.5 0.7
13.0 1.4 4.0

23.5 5.6
12.5 0.6 11.7 1.7 4.3

23.4 5.7
13.3 0.9
13.4 1.9 4.4

.

0.3

1.1

1.0

0.8

0.8

.

0.2

0.8

0.6

0.5

0.5

.

1.3

3.1

3.0

3.0

2.6

84.1 14.9 26.1 16.7 13.9 10.4
.

83.3 15.8 25.6 22.4 18.7 15.1
4.1

85.1 13.7 26.8 21.9 20.3 16.0
6.6

87.8 13.0 27.1 25.6 26.1 19.2
8.1

89.9 12.5 32.4 23.9 23.7 18.6
7.2

86.1 14.0 27.5 22.1 20.6 15.9
6.5

26.6 87.0
2.4 49.9 15.0 49.0
1.3 338.5
8.7

27.4 91.3
2.5 49.7 15.4 51.3
1.4 337.1
9.6

26.7 90.6 2.5 48.6 15.9 54.0 1.5 349.3 10.0

28.0 96.7
2.7 50.0 16.1 55.7
1.5 346.6
8.3

27.4 96.2 2.7 48.8 15.3 53.7 1.5 338.0 8.8

27.2 92.5
2.6 49.4 15.5 52.8
1.4 342.0
9.1

150.6 35.9 108.2 95.9 36.5 96.0
8.8

162.1 25.4
106.6 92.0 48.3
100.0 7.1

175.8 36.2
112.1 97.5 59.5 97.6 *

167.1 18.5
111.9 97.6 53.9
100.0 *

178.7 23.5
137.9 97.0 40.7 93.3 6.6

167.2 27.6
115.7 96.1 47.9 97.6 6.4

20.0 11.8
8.3 21.0
* *

21.9 16.4
5.6 31.3
* *

14.0 8.6 5.4 22.3
* *

18.7 15.8
* 26.3
2.4 *

11.6 6.8 4.9 21.0
* *

17.1 11.8
5.3 24.4
1.3 0.4

11.1

11.4

10.7

12.7

11.7

11.6

3.5

2.9

2.7

4.1

3.1

3.3

*

*

*

0.7

*

0.4

11.1

12.7

12.3

13.1

13.2

12.5

1.9

1.2

1.5

1.6

1.4

1.5

1.5

1.3

1.7

1.5

0.9

1.4

34.8 25.2 16.8
3.3 7.5 3.0 13.9

32.1 26.1 20.0
2.2 7.5 2.5 10.5

36.5 24.8 18.7 3.7 7.4 2.2 10.4

29.6 23.5 18.4
2.1 7.5 1.3 9.2

34.6 22.5 16.8 1.5 5.9 2.7 8.8

33.5 24.4 18.1
2.5 7.2 2.3 10.4

.

1.0

4.3

3.4

4.4

3.3

.

*

1.6

1.3

0.7

1.0

.

6.1

14.7

13.6

12.2

11.8

68.2 17.2 28.4 47.8 35.1 26.9
.

68.5 17.3 16.7 59.8 43.9 38.6
6.2

70.5 14.0 17.5 53.5 46.4 37.2 13.5

77.4 15.3 26.7 61.5 52.9 44.9 16.5

79.0

73.0

14.9

15.7

28.7

23.9

56.2

56.0

49.2

45.9

41.9

38.3

14.7

12.9

121

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 3 Unit 5 - DeKalb

1990
545837 150136 10280
24.6 21.2 25.0
1199 295
9275 683
3386 620 104
5894 479
120 86 34 187 16 35
884 184 29 1058 112 112
1442 1837 1337
317 716 259 388
. . .
6430 1234
249 3463 2210 1738
. 35

1991
553523 149707
10343
24.9 21.4 25.0
1133 351 9151 700 3498 767 122 5936 404
112 74 38
195 17 32
890 219
26 1050 128 123
1429 1875 1401 321 644 203 413
106 54
329
6526 1211 247 4032 2915 2406 153
62

Total
1992 1993

561204 149277 10405

568890 148848
10467

24.7 21.3 26.0

25.0 21.4 26.0

1136 327
9308 673
3648 716 114
5835 430

1052 280 8944 586 3443 642 123 5899 449

113

114

75

83

38

31

187

204

14

13

28

32

874

851

221

194

23

34

1048

971

120

136

105

59

1618 1949 1457
221 584 200 477

1848 1794 1330 147 439 137 336

404

296

132

119

738

598

6883 1219
271 4132 3417 2708
593 43

7202 1163 226 3962 3933 3019 1222
46

1994 5-year
576569 2806023 148417 746385
10529 52023

25.1 21.8 26.0

24.8 21.4 26.0

1072 288
9273 666
3447 623 111
5779 381

5592 1541 45951 3308 17422 3368
574 29343
2143

95

554

62

380

33

174

177

950

19

79

35

162

897 217
31 1001
115 52

4396 1035
143 5128
611 451

2504 1830 1391
116 523 153 332

8841 9285 6916 1122 2906
952 1946

227

1033

116

421

616

2281

7861 1241
231 4298 3793 3138 1731
46

34902 6068 1224
19887 16268 13009
3699 232

White
1990 1991 1992 1993 1994 5-year

292310 71962 4111

292449 70635 4086

292584 69309 4062

292723 67982 4037

292858 1462924 66656 346544 4012 20308

27.4 22.0 25.0

27.6 22.0 25.0

27.7 22.6 25.0

27.9 23.1 26.0

28.1 23.2 26.0

27.7 22.5 25.0

240 42 3670 108 498 227 24 1817 128

195 41
3386 106 442 258
19 1627
86

169 31
3286 96
444 256
27 1367
72

157 34
3075 80
416 248
19 1295
70

160 36
3233 93
440 218
14 1280
63

921 184 16650 483 2240 1207 103 7386 419

35

17

22

21

11

106

25

11

15

12

8

71

10

6

7

9

3

35

48

32

42

32

24

178

7

6

3

3

10

29

12

9

4

8

6

39

219

213

164

162

214

972

40

43

29

24

30

166

9

2

4

2

5

22

296

274

257

217

249

1293

44

49

42

45

47

227

40

42

38

16

23

159

511

467

486

539

692

2695

214

218

196

210

233

1071

435

439

474

407

480

2235

69

66

42

32

31

240

364

291

247

192

228

1322

118

79

61

51

74

383

103

106

109

76

95

489

.

10

25

21

15

71

.

17

19

13

18

67

.

61

68

55

78

262

2940 456 104 619 331 232 . 10

2754 458
95 679 476 371
30 16

2712 411 94 712 560 423 92 7

2661 371
91 652 733 506 170
8

2844 380 100 814 748 594 279 5

13911 2076 484 3476 2848 2126 571 46

Black
1990 1991 1992 1993 1994 5-year

230425 71814 5606

233670 71578 5640

236912 71341 5674

240157 71104 5708

243399 1184562 70867 356704 5742 28370

21.6 20.4 25.0

21.9 20.7 26.0

21.8 20.6 26.0

22.6 20.4 27.0

22.5 20.7 26.0

22.1 20.6 26.0

941 251 5279 568 2854 369 77 3757 341

909 301 5405 573 3019 479
98 3909 310

936 291 5626 564 3160 433
81 4122
340

861 240 5452 486 2953 367
99 4246 366

883 243 5547 554 2939 379
93 4176
309

4530 1326 27309 2745 14925 2027
448 20210
1666

79

93

86

92

83

433

57

63

56

70

53

299

22

30

30

22

30

134

133

158

134

166

148

739

9

11

11

9

9

49

22

22

22

23

27

116

636

645

680

670

644

3275

138

172

184

165

180

839

19

24

19

32

24

118

736

741

753

729

712

3671

63

77

75

90

65

370

70

76

63

38

25

272

846 1607
845 240 347 137 266

883 1634 889 247 345 123 298

1043 1724
886 173 334 138 352

1188 1533 811 110 242
84 247

1635 1548
803 78
291 79
219

5595 8046 4234
848 1559
561 1382

.

79

215

197

192

683

.

33

53

82

89

257

.

240

416

394

487

1537

3284 737 142
2760 1843 1481
. 25

3525 716 145 3227 2359 1973 120
43

3877 772 169
3271 2740 2189
487 33

4220 745 128 3134 3020 2377 998
35

4616 803 121
3259 2836 2383 1368
39

19522 3773 705
15651 12798 10403
2973 175
122

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 3 Unit 5 - DeKalb

1990
17.0 61.8
1.8 37.0 10.8 39.3
1.2 370.0
5.1
116.6 24.6 66.4 91.8 46.6 98.7
4.1
12.9 9.3 3.7
19.9 0.5 0.4
9.5 2.0 0.3 11.6 1.2 1.2
26.3 20.1 14.8
3.5 7.9 2.9 8.2
. . .
71.2 14.9 28.9 37.8 24.1 19.0
.

1991
16.5 61.1
1.8 38.8 10.7 39.7
1.2 370.7
6.2
109.5 31.0 67.7 89.5 39.1 99.0 3.2
12.2 8.1 4.2
21.0 0.5 0.3
9.7 2.4 0.3 11.7 1.4 1.3
27.6 20.8 15.7
3.6 7.2 2.3 8.9
0.8 0.4 2.5
72.4 14.8 30.3 44.7 32.3 26.7
1.7

Total
1992 1993

16.6 62.4 1.9 39.8 10.4 39.1 1.2 364.8 5.7

15.7 60.1
1.8 39.1 10.4 39.6
1.2 377.5
5.3

109.2 28.8 64.7 91.9 41.3 99.3 4.7

100.5 26.6 56.0 92.9 42.9 97.9 2.8

12.1 8.1 4.1
19.8 0.4 0.3

12.7 9.3 3.5
22.5 0.4 0.3

9.4 2.4 0.2 11.4 1.3 1.1

9.5 2.2 0.4 11.0 1.5 0.7

27.7 21.2 15.9
2.4 6.5 2.2 9.5

28.3 20.4 15.2
1.7 5.0 1.6 7.2

3.0

2.2

1.0

0.9

5.5

4.4

74.5 14.7 31.4 45.0 37.2 29.5
6.5

81.0 14.3 32.9 45.0 44.7 34.3 13.9

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

16.1 62.5 1.9 37.7 10.0 38.9 1.2 365.6 5.1

16.4 61.6
1.9 38.5 10.5 39.3
1.2 369.7
5.5

101.8 26.9 63.3 92.1 36.2 98.9 3.7

107.5 27.6 63.6 91.6 41.2 98.8
3.7

10.2 6.7 3.6
18.9 0.6 0.4

12.1 8.3 3.8
20.4 0.5 0.3

9.7

9.6

2.3

2.3

0.3

0.3

11.0

11.3

1.3

1.3

0.6

1.0

29.2 20.0 15.4
1.3 5.8 1.7 7.0

28.0 20.5 15.4
2.5 6.5 2.1 8.2

1.6

1.9

0.8

0.8

4.4

4.2

85.7 14.8 30.8 47.0 41.4 34.3 18.9

77.0 14.7 30.8 43.9 35.9 28.7 10.2

12.6 51.0
1.5 13.7
6.2 25.2
0.8 315.8
3.7

11.6 47.9
1.4 13.3
5.6 23.0
0.7 307.0
4.0

11.2 47.4 1.4 13.7 4.7 19.7 0.6 276.4 4.2

10.5 45.2
1.3 13.8
4.4 19.0
0.6 278.9
4.0

11.0 48.5 1.5 13.8
4.4 19.2 0.6 269.5 3.6

11.4 48.0
1.4 13.7
5.0 21.3
0.7 290.9
3.9

58.4 17.5 26.3 62.0 31.1 96.1
1.2

47.7 21.0 25.9 55.7 21.0 97.6
*

41.6 18.3 23.6 66.0 17.7 98.6
*

38.9 21.7 19.8 67.1 17.3 93.9
2.0

39.9 22.5 23.2 54.4 15.7 98.4 1.7

45.4 20.0 23.8 60.8 20.6 96.8
1.3

9.5 6.8 2.7 13.0 0.6 0.3

5.0

6.7

6.8

3.2

4.6

3.9

1.8

2.1

2.9

9.4

12.7

10.3

0.5

*

*

0.3

*

0.2

3.4

6.4

2.5

4.3

*

2.1

7.4

10.6

0.8

0.5

0.2

0.2

6.0

6.3

5.0

5.3

6.6

5.8

1.1

1.3

0.9

0.8

0.9

1.0

0.2

*

*

*

0.2

0.1

8.2

8.2

7.9

7.2

7.8

7.9

1.2

1.5

1.3

1.5

1.5

1.4

1.1

1.2

1.2

0.5

0.7

1.0

21.1 5.9
12.1 1.9
10.1 3.3 5.8

22.1 6.5
13.3 2.0 8.8 2.4 6.5

22.1 6.0 14.7 1.3 7.8 1.9 6.5

23.0 6.9
13.6 1.1 6.4 1.7 5.1

23.7 7.3
15.3 1.0 7.3 2.4 5.9

22.5 6.5
13.8 1.5 8.2 2.4 6.0

.

0.2

0.5

0.4

0.3

0.3

.

0.3

0.4

0.3

0.3

0.3

.

1.2

1.3

1.1

1.5

1.3

81.8 14.0 28.2 17.1
9.1 6.4
.

82.4 15.2 30.4 20.4 14.3 11.1
0.9

83.0 14.0 31.5 21.9 17.3 13.0 2.8

87.2 13.3 37.6 21.5 24.2 16.7
5.6

89.3 13.0 37.5 25.6 23.5 18.7 8.8

84.6 13.9 32.5 21.2 17.4 13.0
4.5

22.9 73.5
2.2 54.8 16.3 52.3
1.6 395.6
6.4

23.1 75.5
2.3 56.7 16.7 54.6
1.7 394.1
8.5

23.7 78.9 2.4 57.0 17.4 57.8 1.8 401.2 7.4

22.7 76.7
2.3 55.1 17.7 59.7
1.8 417.3
6.7

22.8 78.3 2.4 53.6 17.2 58.9 1.8 409.0 6.9

23.1 76.6
2.3 55.4 17.1 56.7
1.7 403.6
7.2

167.9 26.7 101.3 98.1 60.8 99.7
6.4

161.2 33.1
101.6 97.5 55.0 99.7 5.3

165.0 31.1 99.4 97.7 59.9 99.4 8.1

150.8 27.9 85.1 98.3 64.1 98.9 3.5

153.8 27.5 96.5 99.1 53.8 99.0 5.4

159.7 29.3 96.8 98.1 58.7 99.3 5.7

15.0 10.8
4.2 24.8
0.5 0.4

17.2 11.7
5.6 28.7
0.6 0.4

15.3 10.0 5.4 23.5 0.6 0.4

16.9 12.8
4.1 29.9
0.5 0.4

15.0 9.6 5.5 26.2 0.5 0.5

15.9 10.9
5.0 26.6
0.5 0.4

12.1 2.6 0.4
14.2 1.2 1.3

11.9 3.2 0.4
13.9 1.4 1.4

12.1 3.3 0.3 13.6 1.4 1.1

12.3 3.0 0.6
13.6 1.7 0.7

11.6 3.2 0.4 13.0 1.2 0.5

12.0 3.1 0.4
13.7 1.4 1.0

29.6 30.8 16.3
4.7 6.8 2.7 9.4

31.0 30.7 16.8
4.7 6.6 2.3 10.5

30.8 31.1 16.0 3.1 6.2 2.6 11.1

30.9 28.6 15.2
2.1 4.6 1.6 8.3

31.5 28.2 14.7 1.4 5.3 1.4 7.5

30.9 29.9 15.8
3.2 5.9 2.1 9.4

.

1.1

2.8

2.6

2.5

2.2

.

0.4

0.7

1.1

1.1

0.8

.

3.2

5.5

5.1

6.2

5.0

63.9 15.6 29.8 53.0 35.4 28.4
.

66.2 14.8 30.1 60.5 44.3 37.0
2.3

69.4 15.4 31.0 59.0 49.4 39.5
8.8

77.8 15.1 30.1 58.4 56.3 44.3 18.6

83.9

72.4

16.0

15.4

26.3

29.5

59.4

58.1

51.7

47.5

43.5

38.6

24.9

13.7

123

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 4 Unit 0 - LaGrange

1990
452351 107772 10371
21.2 19.4 21.0
1010 245
7484 739
2243 581 75
1888 233
67 47 20 122 23 38
643 110
5 657 106 167
1745 1166 2105
146 1310
114 337
. . .
5317 970 150
2959 2359 1851
. 3

1991
463886 109556
10535
21.4 19.2 21.0
993 219 7362 712 2290 524
73 1801 244
77 46 31 118 16 33
562 104
9 645
82 262
1700 1111 1975 148 1230
97 321
105 112 525
5429 1001
156 3390 2722 2338 123
14

Total
1992 1993

475309 111328 10695

486858 113122
10861

21.6 19.4 22.0

21.7 19.4 22.0

1062 252
7608 796
2330 672 80
1819 221

946 189 7581 714 2451 600
58 1697 202

62

66

43

38

19

28

123

96

18

13

35

22

570

654

93

143

9

9

647

715

85

91

253

312

1787 1156 2035
114 1131
104 324

1858 1228 1936
96 1123
80 313

243 358 1408

295 352 1444

5651 1068
142 3332 3126 2541
692 14

5793 1064 157 3551 3601 2897 738
19

1994 5-year
498294 2376698 114893 556671
11020 53481

21.8 19.4 22.0

21.6 19.4 22.0

1027 216
7515 757
2406 539 79
1673 212

5038 1121 37550 3718 11720 2916
365 8878 1112

67

339

42

216

25

123

120

579

18

88

31

159

618

3047

108

558

14

46

699

3363

87

451

183

1177

1955 1153 1814
68 973
92 329

9045 5814 9865
572 5767
487 1624

311 276 1475

954 1098 4852

6020 909 215
3248 3322 2655
849 43

28210 5012 820
16480 15130 12282
2402 93

White
1990 1991 1992 1993 1994 5-year

352671 82302 7614

362609 83866 7759

372476 85411 7902

382417 86980 8048

392296 1862469 88527 427086 8190 39512

22.3 19.6 21.0

22.7 19.4 21.0

22.6 19.6 21.0

22.8 19.5 21.0

23.1 19.3 22.0

22.7 19.5 21.0

566 122 5314 395 775 424
40 1301
154

552 100 5273 369 828 404
39 1221 165

581 108 5517 409 861 479
43 1219
143

520 85
5516 372 1006 425
30 1073 135

546 91
5517 386 996 403 40
1078 134

2765 506
27137 1931 4466 2135 192 5892 731

39

43

29

37

35

183

31

23

22

20

19

115

8

20

7

17

16

68

71

61

66

50

59

307

17

12

12

8

9

58

28

24

19

16

27

114

339

279

307

369

375

1669

54

48

40

74

59

275

4

4

2

3

4

17

386

372

388

444

450

2040

77

48

60

60

55

300

117

199

205

231

147

899

1090 375
1309 57
1116 58
166

1037 386 1235
45 1037
51 163

1138 402
1258 45
983 63
178

1182 459 1203
34 999
46 172

1250 439
1107 23
872 56
205

5697 2061 6112
204 5007
274 884

.

63

152

195

207

617

.

90

236

266

205

797

.

277

697

796

867

2637

4124 737 112
1572 1220
943 . 2

4244 750 120 1850 1469 1242
55 5

4398 780 118
1889 1750 1404
305 7

4528 780 119 2008 2055 1565 374
12

4682 662 163
1849 1941 1480
422 32

21976 3709 632 9168 8435 6634 1156 58

1990
95709 24316
2646

1991
97324 24517
2666

Black
1992 1993 1994 5-year

98910 24712
2685

100527 24915 2706

102117 25110 2725

494586 123570
13429

19.0 18.5 24.0

19.1 18.9 24.0

18.8 18.5 26.0

19.1 19.2 25.0

19.1 19.1 25.0

19.0 18.9 25.0

441 122 2131 344 1465 150
35 535 77

438 119 2039 343 1460 111
34 537
76

478 144 2034 387 1463 186
35 540
76

424 103 2001 342 1441 161
28 585
65

480 125 1933 370 1401 131
38 563
78

2261 613
10138 1786 7230 739 170 2760 372

28

34

33

28

31

154

16

23

21

17

22

99

12

11

12

11

9

55

51

57

55

46

60

269

6

4

6

5

9

30

9

9

16

5

4

43

300

280

263

278

238

1359

56

56

53

69

49

283

1

5

7

6

10

29

267

267

257

267

242

1300

29

33

25

27

32

146

49

62

47

80

34

272

642

653

639

662

690

3286

790

724

751

767

708

3740

790

736

771

726

700

3723

88

102

68

59

43

360

192

191

145

118

100

746

55

45

39

34

35

208

171

158

145

140

123

737

.

32

51

77

96

256

.

17

73

46

60

196

.

213

542

498

566

1819

1164 226 38
1382 1132
904 . 0

1149 247
35 1530 1248 1092
68 7

1204 282 24
1432 1364 1129
384 7

1215 276
37 1528 1527 1320
361 7

1285 241 48
1385 1364 1162
425 11

6017 1272
182 7257 6635 5607 1238
32
124

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 4 Unit 0 - LaGrange

1990
16.5 69.4
2.1 30.4
4.2 17.5
0.5 187.4
6.5
97.4 24.3 71.3 72.1 22.5 97.8
4.8
9.0 6.3 2.7 16.1 0.8 0.4
8.6 1.5 0.1 8.9 1.4 2.3
30.4 15.8 28.8
2.0 18.1
1.6 8.1
. . .
72.0 14.7 19.7 40.1 32.0 25.1
.

1991
15.9 67.2
2.1 31.5
3.9 16.4
0.5 183.4
6.0
94.3 22.1 67.6 72.4 23.2 97.9
4.0
10.5 6.2 4.2
15.9 0.6 0.4
7.6 1.4 0.1 8.9 1.1 3.6
29.3 15.3 27.3
2.0 17.0
1.3 8.0
0.8 0.9 4.1
74.5 15.4 20.5 46.6 37.4 32.1
1.7

Total
1992 1993

16.0 68.3 2.1 31.0 3.8 16.3 0.5 178.1 7.1

15.6 67.0
2.1 32.7
3.5 15.0
0.5 170.3
6.1

99.3 23.7 74.4 73.6 20.7 98.2 4.9

87.1 20.0 65.7 77.4 18.6 97.5
3.0

8.1 5.7 2.5 16.0 0.6 0.4

8.7 5.0 3.7 12.6 0.4 0.2

7.5

8.6

1.2

1.9

0.1

0.1

8.6

9.5

1.1

1.2

3.3

4.1

28.8 15.4 27.2
1.5 15.1
1.4 7.6

28.7 16.4 26.0
1.3 15.1
1.1 7.5

1.8 2.7 10.7

2.2 2.6 10.7

74.6 15.8 18.6 44.3 41.6 33.8
9.2

76.6 15.7 22.5 47.4 48.1 38.7
9.9

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

15.1 65.4 2.0 32.4 3.4 14.6 0.4 170.1 5.6

15.8 67.5
2.1 31.6
3.7 15.9
0.5 177.9
6.3

93.2 21.0 68.7 79.1 19.2 98.0 6.2

94.2 22.3 69.5 74.9 20.8 97.9
4.6

8.9 5.6 3.3 15.8 0.6 0.3

9.0 5.8 3.3 15.3 0.6 0.3

8.2

8.1

1.4

1.5

0.2

0.1

9.4

9.1

1.2

1.2

2.4

3.2

28.3 15.5 24.5
0.9 13.2
1.2 8.1

29.1 15.7 26.8
1.5 15.7
1.3 7.8

2.3

1.8

2.0

2.1

10.7

9.1

80.6 13.7 27.4 43.7 44.7 35.7 11.4

75.7 15.0 21.8 44.4 40.8 33.1
8.1

15.1 64.6
2.0 14.8
3.7 15.8
0.5 183.1
5.9

14.5 62.9
2.0 15.9
3.4 14.6
0.5 175.0
5.7

14.8 64.6 2.0 15.8 3.3 14.3 0.4 167.4 6.4

14.4 63.4
2.0 18.4
2.8 12.3
0.4 151.9
5.5

14.1 62.3 1.9 18.2 2.7 12.2 0.4 152.7 5.3

14.6 63.5
2.0 16.7
3.2 13.8
0.4 166.0
5.8

74.3 21.6 51.9 49.4 20.2 96.8
3.0

71.1 18.1 47.6 49.5 21.3 97.5
2.7

73.5 18.6 51.8 51.8 18.1 97.2 4.3

64.6 16.3 46.2 58.8 16.8 96.3
2.0

66.7 16.7 47.1 59.9 16.4 96.9 3.8

70.0 18.3 48.9 53.8 18.5 96.9
3.2

7.3 5.8 1.5 13.3 0.8 0.4

8.2 4.4 3.8 11.5 0.6 0.3

5.3 4.0 1.3 11.9 0.6 0.3

6.7

6.3

6.7

3.6

3.4

4.2

3.1

2.9

2.5

9.0

10.6

11.2

0.4

0.4

0.5

0.2

0.4

0.3

6.4

5.3

5.6

6.7

6.8

6.2

1.0

0.9

0.7

1.3

1.1

1.0

*

*

*

*

*

0.1

7.4

7.1

7.1

8.1

8.2

7.6

1.5

0.9

1.1

1.1

1.0

1.1

2.2

3.8

3.7

4.2

2.7

3.3

26.5 7.2
25.2 1.1
21.7 1.1 5.8

24.5 7.4
23.8 0.9
20.0 1.0 5.8

25.2 7.4 23.2 0.8 18.1 1.2 5.9

25.2 8.4
22.2 0.6
18.4 0.8 5.7

24.8 8.0
20.4 0.4 16.1 1.0 6.9

25.2 7.7
22.9 0.8
18.8 1.0 6.0

.

0.7

1.6

2.0

2.0

1.6

.

0.9

2.4

2.7

2.0

2.0

.

2.9

7.2

8.0

8.5

6.7

78.6 15.8 19.8 30.1 23.3 18.0
.

81.2 16.1 21.7 35.4 28.1 23.8
1.1

79.9 16.0 20.3 34.6 32.1 25.7
5.6

82.2 15.9 22.1 36.8 37.7 28.7
6.9

85.4 13.6 28.3 33.9 35.5 27.1
7.7

81.5 15.4 22.5 34.2 31.4 24.7
5.4

22.3 87.6
2.5 69.8
5.6 22.0
0.6 186.3
8.4

21.0 83.2
2.3 72.7
5.5 21.9
0.6 196.1
6.6

20.6 82.3 2.3 72.9 5.5 21.9 0.6 192.4 9.4

19.9 80.3
2.3 73.1
5.8 23.5
0.7 210.1
7.9

18.9 77.0 2.2 73.7 5.5 22.4 0.6 210.7 7.0

20.5 82.0
2.3 72.4
5.6 22.3
0.6 199.0
7.9

166.7 27.7 130.0 97.9 29.1 100.0
9.8

164.3 27.2
128.6 96.8 28.5 98.6 7.5

178.0 30.1
144.1 96.6 28.3
100.0 6.3

156.7 24.3
126.4 97.7 24.0
100.0 6.3

176.1 26.0
135.8 99.2 28.6
100.0 13.6

168.4 27.1
133.0 97.6 27.7 99.7 8.7

13.1 7.5 5.7
23.5 0.8 0.4

16.7 11.3
5.5 27.5
* 0.4

16.2 10.3 6.0 26.6 0.8 0.7

14.0 8.5 5.5
22.7 0.7 0.2

16.0 11.4 4.7 30.4 1.2
*

15.2 9.8 5.5
26.1 0.8 0.4

14.1

13.7

12.9

13.9

12.3

13.4

2.6

2.7

2.6

3.4

2.5

2.8

*

0.2

0.3

0.3

0.5

0.3

12.7

13.3

12.8

13.5

12.7

13.0

1.4

1.6

1.2

1.4

1.7

1.5

2.3

3.0

2.3

4.0

1.8

2.7

40.6 37.6 38.0
4.2 9.3 2.7 13.2

42.4 36.1 37.0
5.1 9.6 2.3 13.5

38.7 37.4 38.6 3.4 7.3 2.0 12.0

38.4 38.9 36.9
3.0 6.0 1.7 12.2

38.2 37.2 37.0 2.3 5.3 1.9 11.8

39.6 37.4 37.5
3.6 7.5 2.1 12.6

.

1.0

1.5

2.3

2.8

1.9

.

0.5

2.2

1.4

1.8

1.5

.

6.6

16.4

14.8

16.6

13.7

55.5 11.9 19.6 65.8 53.9 43.0
.

57.1 13.7 17.2 76.2 62.2 54.4
3.4

59.7 15.4 13.5 71.3 67.9 56.2 19.1

60.9 15.2 23.4 77.5 77.5 67.0 18.3

66.9

59.9

14.2

14.0

23.9

19.5

72.8

72.6

71.7

66.4

61.1

56.1

22.3

15.7

125

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 5 Unit 1 - Dublin

1990
120530 26321
2791
20.1 19.8 21.0
278 63 1904 241 734 98 29 268 35
33 20 13 49
3 9
192 33
3 178 20 25
512 429 627 20 301 37 110
. . .
1299 329 13
1098 916 748 . 0

1991
121394 26431 2798
20.3 19.3 22.0
293 69
1920 245 766 105
27 264
40
26 19
7 48
5 11
151 31 6
136 15 23
446 448 654
23 277
23 121
34 20 220
1304 297
15 1254 1030 906 536
3

Total
1992 1993

122191 26542 2804

123056 26655 2811

20.6 19.1 22.0

20.3 18.4 21.0

250 62
1795 203 731 108 22 272 35

254 46
1784 206 741
97 15 242 40

26

21

14

13

12

8

34

29

4

5

10

7

137

158

23

25

3

1

127

151

12

23

27

34

471

444

416

372

560

529

15

24

253

231

29

20

121

83

90

126

70

105

359

473

1261 295 17
1114 1052
894 767
3

1317 272
14 1170 1134 982 728
8

1994 5-year

123858 26757 2816

611029 132706
14019

20.6 19.1 22.0

20.4 19.3 21.0

265 45
1821 215 762 117 15 244 42

1340 285
9224 1110 3734
525 108 1290 192

32

138

19

85

13

53

34

194

5

22

17

54

173

811

44

156

8

21

174

766

24

94

40

149

479

2352

406

2071

546

2916

15

97

214

1276

23

132

75

510

101

351

91

286

523

1575

1366 291 21
1154 1109
947 826
12

6547 1484
80 5790 5241 4477 2857
26

1990
82286 17171
1678

1991
82715 17185
1677

White
1992 1993

83100 17197
1676

83530 17212
1675

1994 5-year

83918 17220
1674

415549 85985
8380

21.6 19.7 20.0

21.4 19.5 21.0

21.8 19.9 21.0

21.7 19.1 20.0

22.3 19.7 21.0

21.8 19.6 21.0

127 23
1055 103 159 61 10 164 25

136 24
1102 103 190
60 13 156 26

98 20 1023 76 192 59 7 158 18

109 14
1033 85
195 53 6
142 22

99 10 1049 77 198 76 5 126 19

569 91
5262 444 934 309 41 746 110

10

9

15

8

14

56

6

5

10

5

7

33

4

4

5

3

7

23

16

21

15

11

11

74

1

1

0

2

2

6

5

7

7

3

8

30

74

56

56

47

60

293

11

10

9

6

13

49

1

1

1

0

2

5

81

53

68

63

82

347

12

8

6

7

10

43

12

8

19

16

19

74

244

245

237

225

245

1196

87

99

102

79

92

459

316

342

289

277

260

1484

1

3

4

3

8

19

216

211

191

175

173

966

13

9

14

7

7

50

35

40

50

34

32

191

.

17

47

65

49

178

.

13

45

63

59

180

.

71

157

190

223

641

840

877

824

862

872

4275

191

181

175

168

176

891

10

10

10

11

14

55

469

583

517

552

553

2674

357

454

457

501

491

2260

286

392

387

423

413

1901

.

217

328

307

355

1207

0

1

1

3

3

8

1990
37453 8973 1089

1991
37723 9010 1092

Black
1992 1993

37973 9048 1096

38243 9086 1099

1994 5-year

38495 9121 1102

189887 45238 5477

19.0 20.2 24.0

19.3 18.6 24.0

19.1 18.6 25.0

18.8 17.9 25.0

18.9 18.3 25.0

19.0 18.6 24.0

150

157

152

145

164

768

40

45

42

32

35

194

845

815

767

743

759

3929

138

142

127

121

136

664

574

576

539

546

563

2798

37

45

49

44

40

215

19

14

15

9

10

67

102

106

111

98

116

533

9

14

17

18

23

81

23

17

11

13

18

82

14

14

4

8

12

52

9

3

7

5

6

30

33

27

19

18

23

120

2

4

4

3

3

16

4

4

3

4

9

24

118

95

81

111

112

517

22

21

14

19

31

107

2

5

2

1

6

16

97

82

59

88

92

418

8

7

6

16

14

51

13

15

8

18

21

75

268

201

233

216

230

1148

341

349

314

293

313

1610

310

310

270

250

283

1423

19

20

11

21

7

78

85

65

62

56

41

309

24

14

15

13

16

82

75

81

71

47

43

317

.

16

36

52

50

154

.

6

21

38

29

94

.

133

190

253

279

855

457

424

432

448

486

2247

136

116

120

103

114

589

3

5

7

3

7

25

627

670

597

616

595

3105

556

575

595

630

613

2969

460

513

507

557

529

2566

.

318

439

419

467

1643

0

2

2

5

9

18

126

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 5 Unit 1 - Dublin

1990
15.8 72.3
2.1 39.0
2.2 10.2
0.3 116.0
5.2
99.6 22.7 86.3 72.3 12.5 97.1
2.1
17.3 10.5
6.9 25.3
* 0.4
10.1 1.7 * 9.4 1.1 1.3
37.5 22.8 33.4
1.1 16.0
2.0 10.1
. . .
70.1 19.6
6.4 58.3 48.6 39.7
.

1991
15.8 72.6
2.1 40.2
2.2 10.0
0.3 113.5
5.3
104.7 23.5 87.6 76.5 14.3
100.0 4.6
13.5 9.9 3.7
24.7 0.7 0.4
7.9 1.6 0.3 7.1 0.8 1.2
34.3 23.5 34.6
1.2 14.6
1.2 10.8
1.0 0.6 6.6
69.4 17.8
6.3 65.9 54.1 47.6 28.2

Total
1992 1993

14.7 67.6 2.0 41.1 2.2 10.2 0.3 123.6 5.0

14.5 66.9
2.0 42.1
2.0 9.1 0.3 112.9 4.4

89.2 24.8 72.4 78.8 12.5 97.1 4.3

90.4 18.1 73.3 80.2 14.2 100.0
4.6

14.5 7.8 6.7 18.7 * 0.4

11.8 7.3 4.5
16.1 0.7 0.3

7.6

8.9

1.3

1.4

*

*

7.1

8.6

0.7

1.3

1.5

1.9

36.9 23.4 31.6
0.9 14.3
1.6 11.3

34.4 21.1 30.1
1.4 13.1
1.1 7.9

2.7 2.1 10.7

3.7 3.1 14.0

72.3 18.9 7.7 62.6 59.1 50.2 43.1

75.0 17.9
5.8 66.4 64.4 55.8 41.3

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

14.7 68.1 2.0 42.4 2.0 9.1 0.3 110.7 5.2

15.1 69.5
2.1 40.9
2.1 9.7 0.3 115.4 5.0

94.1 17.0 76.3 80.3 14.9 97.6 5.3

95.6 21.3 79.2 77.4 13.7 98.4
4.2

17.6 10.4 7.2 18.5 0.7 0.7

15.0 9.2 5.8
20.8 0.6 0.4

9.5

8.8

2.4

1.7

0.4

0.2

9.7

8.4

1.3

1.0

2.2

1.6

35.5 22.6 30.5
0.8 11.9
1.3 7.4

35.8 22.7 32.1
1.1 14.0
1.5 9.6

3.0 2.7 15.4

2.6 2.1 11.7

76.7 18.5 9.2 64.2 61.7 52.7 45.9

72.6 18.6
7.0 63.4 57.4 49.1 39.4

12.8 61.4
1.9 15.3
2.0 9.6 0.3 126.3 4.6

13.3 64.1
2.0 17.4
1.9 9.1 0.3 116.8 4.5

12.3 59.5 1.8 18.9 1.9
9.2 0.3 126.5 4.0

12.4 60.0
1.8 19.0
1.7 8.3 0.2 114.7 3.7

12.5 60.9 1.9 19.0 1.5
7.3 0.2 100.1 4.9

12.7 61.2
1.9 17.9
1.8 8.7 0.3 116.9 4.3

75.7 18.1 61.4 40.6 14.9 96.0
*

81.1 17.6 61.4 47.6 15.5 100.0
6.0

58.5 20.4 45.3 46.1 10.7 94.4
*

65.1 12.8 50.7 53.6 13.1 100.0
*

59.2 10.1 46.0 48.7 11.4 100.0 3.6

67.9 16.0 53.0 47.0 13.1 98.2
2.9

9.5 5.7
* 15.0
* 0.3

8.2 4.5
* 18.8
* 0.5

14.7 9.8 4.9
14.6 * *

7.7 4.8
* 10.6
* *

13.3 6.7 6.7
10.4 *
0.5

10.6 6.3 4.4
14.0 0.3 0.4

7.0

5.1

5.5

4.6

5.7

5.6

1.0

0.9

0.9

0.6

1.2

0.9

*

*

*

*

*

0.1

7.8

4.8

6.7

6.1

7.9

6.7

1.2

0.7

0.6

0.7

1.0

0.8

1.1

0.7

1.9

1.5

1.8

1.4

31.3 8.3
30.3 *
20.7 1.2 6.3

31.5 9.0
31.4 *
19.4 0.8 6.4

31.2 10.0 28.6
* 18.9
1.4 8.7

29.3 7.7
27.1 *
17.1 0.7 5.8

30.3 8.8
25.1 0.8 16.7 0.7 5.5

30.7 8.8
28.5 0.4
18.6 1.0 6.5

.

0.9

2.4

3.2

2.4

2.2

.

0.7

2.3

3.1

2.9

2.2

.

3.6

7.9

9.5

11.1

8.0

81.3 20.6
8.8 45.0 34.2 27.4
.

80.5 18.8
7.5 53.3 41.5 35.8 19.8

82.7 19.6 8.1 50.9 45.0 38.1 32.3

84.8 19.0
7.7 53.8 48.8 41.2 29.9

84.3 19.6 9.9 53.2 47.2 39.7 34.1

82.7 19.5
8.4 51.2 43.3 36.4 28.9

22.6 94.2
2.6 68.6
2.7 11.4
0.3 101.4
6.6

21.6 90.5
2.5 71.4
2.8 11.8
0.3 107.7
7.0

20.2 84.8 2.3 71.1 2.9 12.3 0.3 117.7 7.2

19.4 81.8
2.3 75.1
2.6 10.8
0.3 109.4
6.1

19.7 83.2 2.3 75.6 3.0 12.7 0.3 124.9 5.9

20.7 86.9
2.4 72.2
2.8 11.8
0.3 112.0
6.5

137.7 26.7 126.7 95.6
8.3 100.0
5.5

143.7 28.7
130.0 97.9 12.8
100.0 *

138.7 27.6
115.9 98.4 15.5
100.0 7.3

132.0 22.1
110.1 99.2 16.4
100.0 8.2

148.9 21.3
123.4 98.5 20.9 95.7 8.2

140.2 25.3
121.2 97.9 14.8 98.8 6.4

27.2 16.6 10.8 38.2
* *

20.9 17.2
* 32.6
* *

14.3 *
9.2 24.3
* *

17.5 10.8
6.8 23.9
* *

23.7 15.8 8.0 29.9
* 0.9

20.9 13.2
7.7 30.0
1.1 0.5

14.0 2.6 *
11.6 1.0 1.5

11.7 2.6 0.6
10.2 0.9 1.8

10.6 1.8
* 7.8 0.8 1.0

15.0 2.6 *
12.1 2.2 2.4

14.8 4.1 0.8 12.4 1.9 2.8

13.2 2.7 0.4
10.8 1.3 1.9

45.9 40.7 37.2
2.3 10.2
2.9 14.2

38.7 43.2 38.8
2.6 8.1 1.7 16.3

45.5 41.3 35.8 1.5 8.2 2.0 14.3

41.9 40.3 34.5
2.9 7.7 1.8 10.2

43.2 42.0 38.3 1.0 5.5 2.2 10.2

43.1 41.5 36.9
2.1 8.0 2.1 13.2

.

1.2

2.7

3.9

3.7

2.9

.

0.5

1.6

2.9

2.2

1.8

.

10.1

14.4

19.0

20.9

16.1

55.9 18.2
* 74.9 66.4 55.0
.

54.0 16.5
4.8 83.0 71.3 63.6 39.4

58.1 18.1 7.2 78.6 78.3 66.7 57.8

61.3 16.4
* 84.7 86.7 76.6 57.6

66.0

58.9

17.3

17.3

8.0

5.2

79.9

80.1

82.3

76.6

71.0

66.2

62.7

54.1

127

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 5 Unit 2 - Macon

1990
417381 100354
9192
20.8 19.6 22.0
996 215 6885 733 2766 407 92 1885 241
107 67 40 161 11 33
699 145 26 819 89 51
2239 1452 1804
116 977 117 337
. . .
5036 961 117
3117 2746 2085
. 1

1991
421022 100556
9221
21.4 19.9 22.0
935 233 6796 707 2834 325
67 1878 206
109 80 29
145 8
45
682 149
25 789
82 51
2100 1479 1770 129 702 101 389
139 145 675
4843 911 141 3359 3090 2430
12 18

Total
1992 1993

424593 100738
9249

428202 100935
9276

20.9 19.9 23.0

21.3 19.5 23.0

940 230 6782 704 2980 274
82 1870
226

894 202 6570 672 2970 295
75 1891 209

93

104

58

70

35

34

139

144

16

13

37

30

673

650

123

143

16

22

713

713

91

80

59

127

2199 1476 1766
150 866
91 376

2228 1510 1695 126 671
78 304

326 301 1158

290 223 1122

4927 835 190
3286 3267 2483
239 30

4891 857 165 3351 3687 2742 1142
72

1994 5-year
431775 2122973 101122 503705
9304 46241

21.1 19.7 23.0

21.1 19.7 23.0

955 202 6659 744 3010 270
69 1806
195

4720 1082 33692 3560 14560 1571
385 9330 1077

110

523

74

349

36

174

142

731

14

62

38

183

686

3390

154

714

22

111

773

3807

89

431

60

348

2108 1495 1622
164 791
81 288

10874 7412 8657 685 4007 468 1694

274 255 1313

1029 924
4268

5051 921 138
3325 3501 2632 1043
24

24748 4485 751
16438 16291 12372
2436 145

White
1990 1991 1992 1993 1994 5-year

257502 58536 4867

259617 58526 4890

261689 58501 4913

263793 58492 4934

265873 1308474 58472 292527 4957 24560

22.6 19.7 21.0

23.6 20.4 21.0

23.0 20.3 22.0

23.0 19.8 22.0

23.5 20.0 22.0

23.2 20.0 22.0

381 56 3583 255 559 223 27 968 116

322 66
3433 219 556 194
19 891
90

319 56
3435 228 649 157 20 857 90

288 58
3354 193 646 173
26 825
89

309 48
3428 227 686 153 17 730 70

1619 284
17233 1122 3096 900 109 4271 455

29

29

35

30

53

176

21

18

18

19

34

110

8

11

17

11

19

66

50

36

38

46

50

220

3

4

4

7

6

24

18

19

17

13

17

84

251

232

209

223

233

1148

47

43

36

40

47

213

8

5

7

4

6

30

318

281

245

252

287

1383

43

37

36

43

42

201

15

23

20

43

23

124

1005

898

978

1000

979

4860

270

264

301

296

308

1439

724

693

675

678

648

3418

18

24

25

19

38

124

680

519

602

518

585

2904

61

50

23

32

39

205

111

141

89

94

91

526

.

68

132

131

123

454

.

79

183

131

141

534

.

196

341

366

419

1322

2967 577 54
1093 832 652 . 1

2826 553
70 1190 928 768
4 5

2843 464 89
1133 997 773 86 10

2791 462
88 1212 1243 894 338
27

2917 493 62
1225 1145
888 380
7

14344 2549 363 5853 5145 3975 808 50

Black
1990 1991 1992 1993 1994 5-year

155605 40548 4227

156649 40541 4236

157662 40525 4244

158693 40518 4251

159705 40504 4260

788314 202636
21218

19.4 19.4 25.0

19.5 19.2 25.0

19.3 19.2 25.0

19.6 19.1 25.0

19.2 19.3 25.0

19.4 19.2 25.0

609 159 3251 476 2203 181
63 870 121

611 167 3307 487 2273 129
48 942 115

614 171 3282 476 2325 114
62 955 129

603 144 3152 479 2315 118
48 1011 117

643 154 3154 515 2317 113
52 1039
124

3080 795
16146 2433
11433 655 273
4817 606

77

80

57

74

57

345

45

62

40

51

40

238

32

18

17

23

17

107

108

109

101

97

92

507

8

4

12

6

8

38

15

26

19

17

21

98

442

447

461

421

450

2221

97

104

87

103

106

497

18

20

9

18

16

81

494

505

464

454

478

2395

46

45

55

37

47

230

35

28

39

84

37

223

1216 1180 1074
97 295
56 224

1190 1214 1072 105 182
51 246

1202 1173 1084
124 262
68 282

1210 1212 1011 107 151
45 208

1111 1184
965 126 201
42 194

5929 5963 5206
559 1091
262 1154

.

45

156

140

123

464

.

53

85

67

99

304

.

406

681

684

764

2535

2031 379 63
2020 1908 1430
. 0

1978 347
69 2155 2153 1656
8 1

2038 363 97
2136 2257 1702
153 20

2056 383
77 2115 2419 1829 800
45

2073 416 74
2076 2335 1729
656 14

10176 1888 380
10502 11072
8346 1617
80
128

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 5 Unit 2 - Macon

1990
16.5 68.6
2.0 40.7
4.5 18.8
0.6 202.7
5.3
108.4 21.6 79.7 80.6 26.2 98.3 3.4
15.5 9.7 5.9
23.1 0.4 0.4
10.2 2.1 0.4
12.1 1.3 0.7
36.8 21.4 26.6
1.7 14.4
1.7 8.6
. . .
74.2 15.8 16.4 45.9 40.4 30.7
.

1991
16.1 67.6
2.0 42.2
4.5 18.7
0.6 206.3
4.3
101.4 24.9 76.7 84.1 22.3 99.0 3.7
16.0 11.8
4.3 21.1
0.3 0.5
10.0 2.2 0.4
11.8 1.2 0.8
36.8 22.0 26.5
2.0 10.5
1.5 9.9
1.2 1.3 5.9
74.0 15.1 20.2 50.0 46.0 36.2
0.2

Total
1992 1993

16.0 67.3 2.0 44.6 4.4 18.6 0.6 207.2 3.7

15.3 65.1
2.0 45.8
4.4 18.7
0.6 213.8
3.8

101.6 24.5 76.1 86.5 24.4 99.1 2.3

96.4 22.6 72.4 86.7 22.5 99.0
2.0

13.7 8.6 5.2 20.3 0.6 0.4

15.8 10.7
5.2 21.7
0.5 0.4

9.9 1.8 0.2 10.7 1.4 0.9

9.9 2.2 0.3 11.0 1.2 1.9

36.9 22.1 26.5
2.3 13.0
1.4 9.5

37.4 23.3 26.2
2.0 10.4
1.2 8.0

2.8

2.5

2.6

1.9

10.1

9.7

74.0 14.0 26.2 49.1 48.8 37.1
3.6

75.1 14.9 23.2 51.7 56.9 42.3 17.6

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

15.4 65.9 2.0 45.8 4.2 17.9 0.5 204.7 3.5

15.9 66.9
2.0 43.8
4.4 18.5
0.6 206.9
4.1

102.6 21.2 80.0 89.4 21.0 98.4 3.3

102.1 22.9 77.0 85.5 23.3 98.8
2.9

16.5 11.1 5.5 21.1 0.5 0.5

15.5 10.4
5.2 21.5
0.5 0.4

10.3 2.3 0.3 11.8 1.4 0.9

10.1 2.1 0.3
11.5 1.3 1.0

34.6 22.8 24.8
2.5 12.1
1.2 7.6

36.5 22.3 26.1
2.1 12.1
1.4 8.7

2.3

2.2

2.2

2.0

11.2

9.2

76.5 15.7 20.1 50.6 53.3 40.1 15.9

74.7 15.1 21.3 49.4 49.0 37.2
9.2

13.9 61.2
1.8 15.8
3.8 16.5
0.5 201.2
4.4

13.2 58.7
1.8 16.4
3.4 15.2
0.5 195.6
3.9

13.1 58.7 1.8 19.1 3.3 14.6 0.5 191.5 3.1

12.7 57.3
1.7 19.5
3.1 14.1
0.4 188.1
3.5

12.9 58.6 1.8 20.3 2.7 12.5 0.4 168.4 3.0

13.2 58.9
1.8 18.2
3.3 14.6
0.5 189.3
3.6

78.3 14.7 52.4 52.5 23.8 99.1
2.3

65.9 20.5 44.8 56.2 18.4 98.9
3.3

64.9 17.6 46.4 62.2 18.3 97.8 1.0

58.4 20.1 39.1 57.3 18.0 100.0
1.4

62.3 15.5 45.8 67.8 14.1 97.1 2.8

65.9 17.5 45.7 59.1 18.5 98.7
2.2

8.1 5.9 2.2 13.9
* 0.4

8.4 5.2 3.2 10.4
* 0.4

10.2 5.2 5.0 11.0 * 0.4

8.9 5.7 3.3 13.6 0.5 0.3

15.5 9.9 5.6
14.5 0.4 0.4

10.2 6.4 3.9
12.7 0.3 0.4

7.0

6.8

6.1

6.6

6.8

6.7

1.3

1.3

1.0

1.2

1.4

1.2

0.2

0.1

0.2

*

0.2

0.2

9.0

8.3

7.2

7.6

8.5

8.1

1.2

1.1

1.1

1.3

1.2

1.2

0.4

0.7

0.6

1.3

0.7

0.7

30.1 7.6
20.5 0.5
19.2 1.7 5.8

29.4 7.8
20.4 0.7
15.3 1.5 7.6

30.9 8.8 19.9 0.7 17.8 0.7 4.7

31.7 8.9
20.5 0.6
15.7 1.0 5.0

30.5 9.1
19.2 1.1 17.4 1.2 4.7

30.5 8.4
20.1 0.7
17.1 1.2 5.5

.

1.1

2.1

2.1

2.0

1.8

.

1.3

2.9

2.1

2.2

2.1

.

3.2

5.5

5.9

6.6

5.3

83.7 18.6 12.4 30.9 23.5 18.4
.

84.0 18.5 17.3 35.1 27.3 22.6
*

84.0 15.5 22.0 33.3 29.3 22.7
2.5

83.6 16.0 21.1 36.6 37.6 27.0 10.2

85.7 16.4 16.1 36.2 33.8 26.2 11.2

84.2 17.0 17.7 34.4 30.2 23.3
6.0

20.9 80.2
2.3 68.7
5.6 21.5
0.6 198.4
6.5

21.1 81.6
2.3 69.7
6.0 23.2
0.7 211.8
4.9

20.8 81.0 2.3 72.1 6.1 23.6 0.7 215.8 4.6

19.9 77.8
2.2 74.5
6.4 25.0
0.7 233.2
4.3

19.7 77.9 2.2 74.6 6.5 25.7 0.7 237.9 4.3

20.5 79.7
2.3 71.9
6.1 23.8
0.7 219.3
4.9

144.1 26.1 112.6 96.0 28.6 97.5
4.7

144.3 27.3
115.0 96.7 27.2 99.1 4.2

144.7 27.9
112.2 98.1 30.4
100.0 3.8

141.8 23.9
112.7 98.5 27.5 98.3 2.8

150.9 24.0
120.9 99.0 29.1 99.2 4.0

145.2 25.8
114.7 97.7 28.6 98.8 3.9

23.7 13.8 10.0 32.6
0.7 0.4

24.2 18.7
5.5 32.5
* 0.7

17.4 12.2 5.2 30.2 1.0 0.5

23.5 16.2
7.4 30.3
0.5 0.5

18.1 12.7 5.5 28.7 0.7 0.6

21.4 14.7
6.7 30.9
0.7 0.5

13.6 3.0 0.6
15.4 1.4 1.1

13.5 3.1 0.6
15.6 1.4 0.8

14.0 2.7 0.3 14.4 1.7 1.2

13.4 3.3 0.6
14.6 1.2 2.7

14.3 3.4 0.5 15.4 1.5 1.2

13.8 3.1 0.5
15.1 1.4 1.4

45.0 36.8 33.6
3.1 9.2 1.8 11.4

45.8 37.2 33.0
3.3 5.6 1.6 12.1

43.9 36.4 33.7 3.9 8.1 2.1 14.0

44.1 39.0 32.6
3.5 4.9 1.5 11.1

39.6 38.1 31.2 4.1 6.5 1.4 10.6

43.6 37.5 32.8
3.6 6.9 1.7 11.9

.

0.9

3.0

2.7

2.4

2.2

.

1.0

1.6

1.3

1.9

1.5

.

7.9

13.2

13.2

14.6

12.2

63.6 12.9 23.5 63.0 59.5 44.6
.

63.2 11.7 23.8 66.0 66.0 50.8
0.2

63.5 12.5 31.2 66.2 70.0 52.8
4.7

66.1 13.6 26.6 68.1 77.9 58.9 25.7

66.3

64.5

14.8

13.1

25.3

26.2

66.8

66.0

75.2

69.6

55.6

52.5

21.1

12.7

129

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 6 Unit 0 - Augusta

1990
384880 93017
8528
21.0 19.3 22.0
992 234 6963 726 2748 535 85 2044 231
99 61 38 147 16 40
679 141 11 769 89 117
2935 1568 1908
149 1112
151 363
. . .
4997 942 90
3132 2466 1948
. 13

1991
390176 93949 8631
21.0 19.3 22.5
981 244 7037 748 2895 513
86 1937 206
92 66 26 153 20 32
706 135
17 703
93 94
3084 1623 1951 149 1035 154 343
44 38 246
5242 860 113 3744 3069 2670 101
11

Total
1992 1993

395414 94881
8735

400699 95814 8840

21.3 19.5 23.0

21.2 19.4 23.0

897 245 6689 667 2889 543
76 1799
191

910 218 6626 720 2876 520
60 1701 166

71

70

47

48

24

22

121

109

10

11

28

30

637

641

105

132

9

18

632

685

75

75

110

86

2317 1681 1808
123 963 131 387

2286 1596 1717
74 878 110 299

132

205

109

130

578

898

4878 897 130
3456 3254 2641
258 6

5014 928 110 3586 3620 2922 803
10

1994 5-year
405927 1977096 96735 474396 8944 43678

20.9 18.9 23.0

21.1 19.3 23.0

956 202 6322 725 2726 483
59 1636
198

4736 1143 33637 3586 14134 2594
366 9117
992

69

401

47

269

22

132

104

634

14

71

29

159

629

3292

137

650

13

68

632

3421

88

420

71

478

2059 1522 1591
79 722 110 252

12681 7990 8975 574 4710 656 1644

251 110 1077

632 387 2799

4937 934 116
3377 3369 2683
911 7

25068 4561 559
17295 15778 12864
2073 47

White
1990 1991 1992 1993 1994 5-year

233174 53624 4448

235925 53935 4495

238631 54239 4541

241377 54549 4589

244081 1193188 54849 271196 4635 22708

22.3 19.5 22.0

22.7 19.5 22.0

22.8 19.4 22.0

22.7 20.2 22.0

22.8 19.2 22.0

22.7 19.5 22.0

383 73 3647 266 606 314 19 941 105

327 66
3603 226 670 283
31 856
87

306 69
3400 212 647 290 29 778 84

311 56
3489 240 708 302
22 744
62

336 60
3304 255 664 260 24 693 70

1663 324
17443 1199 3295 1449 125 4012 408

32

38

26

25

23

144

21

24

15

17

14

91

11

14

11

8

9

53

40

55

44

36

37

212

7

9

6

2

3

27

27

17

16

15

16

91

210

233

210

230

228

1111

37

35

34

34

40

180

3

1

2

4

3

13

277

267

240

265

263

1312

39

44

38

40

46

207

51

43

51

43

36

224

1198 1238

959

986

950

5331

305

321

336

387

334

1683

801

770

716

702

652

3641

25

28

15

16

17

101

740

716

675

648

530

3309

73

80

62

56

59

330

111

104

132

98

83

528

.

23

69

94

107

293

.

25

64

72

62

223

.

110

179

257

334

880

2966 540 47
1085 721 558 . 8

2988 500
46 1279 960 813
26 5

2740 519 62
1244 1070
844 63 2

2879 523
59 1322 1296 980 276
4

2777 495 62
1276 1203
933 335
3

14350 2577 276 6206 5250 4128 700 22

Black
1990 1991 1992 1993 1994 5-year

143855 37009 3881

145290 37284 3908

146704 37559 3936

148137 37834 3964

149544 38104 3992

733530 187790
19682

19.7 18.7 24.0

19.5 18.9 24.0

19.6 19.3 25.0

19.5 18.9 25.0

19.5 18.3 25.0

19.5 18.8 25.0

606 161 3231 460 2131 214
66 1025
123

651 178 3337 521 2223 219
55 1015 117

587 175 3187 454 2235 248
46 959 105

589 157 3053 474 2151 213
38 902 100

615 141 2929 467 2048 211
35 897 127

3048 812
15737 2376
10788 1105 240 4798 572

66

54

45

45

44

254

39

42

32

31

32

176

27

12

13

14

12

78

106

98

76

72

67

419

9

11

4

9

11

44

13

14

12

15

11

65

464

465

421

405

398

2153

102

100

70

97

97

466

8

16

7

13

10

54

485

428

385

411

366

2075

49

48

36

35

41

209

65

51

58

42

35

251

1712 1258 1096
124 365 78 247

1814 1298 1169 121 316
73 236

1334 1341 1074
106 275
69 250

1283 1201 1006
58 219
51 195

1088 1178
929 61
186 49
165

7231 6276 5274
470 1361
320 1093

.

14

53

102

124

293

.

13

41

50

41

145

.

123

373

616

700

1812

1962 388 40
2032 1733 1382
. 4

2172 344
65 2446 2093 1849
73 5

2052 368 64
2196 2172 1790
195 3

2071 398
49 2236 2299 1928 524
6

2084 424 53
2074 2142 1732
572 3

10341 1922 271
10984 10439
8681 1364
21
130

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 6 Unit 0 - Augusta

1990
18.1 74.9
2.2 40.0
5.3 22.0
0.6 211.5
7.1
116.3 23.6 85.1 80.1 27.1 98.3
5.0
14.2 8.8 5.5
20.9 0.6 0.5
9.8 2.0 0.2 11.2 1.3 1.7
44.2 22.8 27.9
2.2 16.3
2.2 9.1
. . .
72.2 15.1 13.9 45.6 35.9 28.3
.

1991
18.0 74.9
2.3 41.7
5.0 20.6
0.5 201.7
6.7
113.7 24.9 86.7 86.4 23.9 97.5 4.5
13.1 9.4 3.7
21.5 0.8 0.4
10.0 1.9 0.2
10.1 1.3 1.3
45.9 23.4 28.3
2.2 15.1
2.3 8.5
0.4 0.3 2.2
74.8 13.8 16.4 54.0 44.2 38.5
1.5

Total
1992 1993

16.9 70.5 2.1 43.7 4.5 19.0 0.5 197.0 6.8

16.5 69.2
2.1 43.9
4.2 17.8
0.5 190.5
6.3

102.7 27.3 76.4 86.4 21.9 98.4 5.4

102.9 24.0 81.4 87.3 18.8 97.6 3.3

10.6 7.0 3.6
17.9 0.4 0.3

10.6 7.2 3.3
16.3 0.4 0.4

9.5

9.7

1.6

2.0

0.1

0.3

9.6

10.5

1.1

1.1

1.7

1.3

35.9 25.4 27.5
1.9 14.7
2.0 9.9

35.4 24.4 26.3
1.1 13.5
1.7 7.9

1.2

1.8

1.0

1.1

5.1

7.9

73.2 15.2 18.8 52.3 49.2 40.0
3.9

75.9 15.9 15.3 54.7 55.3 44.6 12.3

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

15.6 65.4 2.0 43.7 4.0 16.9 0.4 192.0 5.8

17.0 70.9
2.1 42.6
4.6 19.2
0.5 198.9
6.5

106.9 21.1 81.1 86.6 22.1 98.5 4.4

108.4 24.1 82.1 85.4 22.7 98.1
4.5

10.9 7.4 3.5
16.3 0.5 0.3

11.9 8.0 4.0
18.6 0.5 0.4

9.9

9.8

2.2

1.9

0.2

0.2

10.1

10.3

1.4

1.3

1.1

1.4

33.7 24.4 25.7
1.3 11.6
1.8 7.1

39.2 24.1 27.2
1.7 14.3
2.0 8.5

2.2

1.4

1.0

0.9

9.3

6.2

78.4 16.9 16.8 54.2 54.1 43.1 14.6

74.8 15.3 16.3 52.1 47.5 38.7
7.9

15.6 68.0
2.0 16.8
4.0 17.5
0.5 190.5
6.5

15.3 66.8
2.0 18.8
3.6 15.9
0.4 178.8
6.1

14.2 62.7 1.9 19.3 3.3 14.3 0.4 172.7 6.0

14.5 64.0
2.0 20.5
3.1 13.6
0.4 163.0
6.1

13.5 60.2 1.9 20.4 2.8 12.6 0.3 161.7 5.3

14.6 64.3
2.0 19.1
3.4 14.8
0.4 173.8
6.0

86.1 19.1 59.8 49.0 23.6 96.2
3.6

72.7 20.2 50.3 62.2 19.4 96.6
3.6

67.4 22.5 46.7 60.2 18.5 97.6 2.9

67.8 18.0 52.3 66.5 13.5 96.7
2.2

72.5 17.9 55.0 65.6 15.1 98.6 3.5

73.2 19.5 52.8 60.5 18.0 97.0
3.1

8.8 5.8 3.0 10.9 0.5 0.7

10.5 6.7 3.9
15.1 0.7 0.4

7.6 4.4 3.2 12.8 0.4 0.4

7.2 4.9 2.3 10.3
* 0.3

7.0 4.2 2.7 11.1
* 0.4

8.3 5.2 3.1 12.1 0.4 0.4

5.8

6.5

6.2

6.6

6.9

6.4

1.0

1.0

1.0

1.0

1.2

1.0

*

*

*

*

*

0.1

7.7

7.5

7.1

7.7

8.1

7.6

1.1

1.2

1.1

1.2

1.4

1.2

1.4

1.2

1.5

1.2

1.1

1.3

34.2 8.5
22.3 0.7
20.7 2.0 5.7

35.9 9.0
21.8 0.8
20.4 2.3 5.4

29.3 10.0 21.4 0.4 20.2 1.9
7.1

29.0 11.2 20.4
0.5 18.9
1.6 5.2

29.8 10.3 20.1
0.5 16.4
1.8 4.6

31.7 9.8
21.2 0.6
19.4 1.9 5.6

.

0.4

1.2

1.6

1.8

1.2

.

0.4

1.1

1.2

1.0

0.9

.

1.9

3.0

4.3

5.5

3.7

81.6 16.7 12.7 30.1 20.0 15.5
.

83.3 15.8 11.7 36.0 27.0 22.9
0.7

80.9 17.4 16.6 37.0 31.8 25.1 1.9

82.6 17.1 15.0 38.3 37.6 28.4
8.0

84.3 17.2 16.4 39.2 36.9 28.7 10.3

82.5 16.8 14.5 36.0 30.5 24.0
5.1

22.5 87.3
2.5 66.9
7.1 27.7
0.7 225.1
8.0

23.0 89.5
2.6 67.7
7.0 27.2
0.7 218.7
7.8

21.7 84.9 2.5 71.0 6.5 25.5 0.7 215.2 8.3

20.6 80.7
2.4 71.3
6.1 23.8
0.6 213.7
7.0

19.6 76.9 2.3 70.9 6.0 23.5 0.6 219.5 6.8

21.5 83.8
2.5 69.5
6.5 25.5
0.7 218.5
7.6

156.1 26.6 118.5 98.0 31.7 100.0
7.0

166.6 27.3
133.3 97.3 29.9 98.2 5.9

149.1 29.8
115.3 98.7 26.7 99.0 8.4

148.6 26.7
119.6 97.9 25.2 98.0 4.8

154.1 22.9
117.0 98.1 31.8 98.4 5.5

154.9 26.6
120.7 98.0 29.1 98.8 6.3

20.4 12.1
8.5 32.2
0.8 0.4

16.2 12.6
3.6 28.9
1.0 0.4

14.1 10.0 4.1 23.5
* 0.3

14.7 10.2
4.6 23.3
0.8 0.4

15.0 10.9 4.1 22.6 0.9 0.3

16.1 11.2
5.0 26.2
0.8 0.4

14.4 3.2 0.2
15.3 1.5 2.0

13.9 3.0 0.5
13.0 1.5 1.5

13.2 2.2 0.2 12.2 1.1 1.8

13.3 3.2 0.4
13.6 1.2 1.4

13.6 3.3 0.3 12.7 1.4 1.2

13.7 3.0 0.3
13.4 1.3 1.6

56.0 39.5 34.6
3.9 11.5
2.5 12.4

57.1 39.5 35.8
3.7 9.7 2.3 11.6

43.3 42.6 34.3
3.4 8.8 2.2 12.7

43.2 39.8 33.5
1.9 7.3 1.7 10.6

38.5 40.8 32.4
2.1 6.5 1.7 9.9

47.9 40.4 34.2
3.0 8.8 2.1 11.5

.

0.3

1.0

2.0

2.4

1.4

.

0.3

0.8

1.0

0.8

0.7

.

2.4

7.4

12.0

13.5

8.9

61.2 13.3 14.9 63.8 54.4 43.4
.

65.3 11.5 22.3 74.4 63.7 56.3
2.2

64.6 13.0 20.6 69.8 69.0 56.9
6.2

68.3 14.7 15.6 74.1 76.2 63.9 17.4

71.5

66.0

16.4

13.7

17.4

18.2

71.8

70.8

74.2

67.3

60.0

55.9

19.8

11.1

131

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 7 Unit 0 - Columbus

1990
332111 76366
7245
20.7 18.8 22.0
937 232 6170 692 2492 339 86 1493 224
95 66 29 150
5 26
579 115 14 592 69 81
1995 1568 1681
152 1045
169 348
. . .
3978 932 81
3118 2493 1942
. 2

1991
334851 76839 7292
20.4 19.1 22.0
924 235 5999 710 2579 380
64 1468 180
74 49 25 112 14 25
547 108
13 584
67 72
1994 1610 1750 160 964 131 343
111 84
729
3676 840 134 3474 2787 2252 445
5

Total
1992 1993

337463 77283 7333

340208 77758 7378

20.6 19.3 22.0

20.4 19.6 22.0

891 227 6204 724 2533 397
78 1429
149

919 254 5694 713 2489 397
50 1428 168

71

73

58

51

13

22

139

96

8

10

25

21

613

534

122

112

16

19

637

577

84

69

76

70

2005 1620 1688
168 899 118 353

1910 1480 1560 101 762 100 307

321 220 1720

309 190 1570

3755 826 126
3344 2981 2236
471 3

3599 734 154 3411 3211 2579 845
9

1994 5-year
342836 1687469 78206 386452 7420 36668

20.4 19.3 23.0

20.5 19.1 22.0

872 221 5618 670 2458 332
51 1399
175

4543 1169 29685 3509 12551 1845
329 7217
896

75

388

50

274

25

114

101

598

12

49

26

123

565

2838

105

562

15

77

614

3004

77

366

53

352

2065 1471 1436
112 618
68 288

9969 7749 8115
693 4288
586 1639

346 210 1633

1087 704
5652

3723 727 103
3221 2949 2313
889 25

18731 4059 598
16568 14421 11322
2650 44

White
1990 1991 1992 1993 1994 5-year

188174 40411 3413

188540 40269 3410

188857 40115 3404

189212 39969 3399

189536 39816 3393

944319 200580
17018

22.1 19.3 21.0

22.3 19.7 21.0

22.4 19.6 21.0

22.4 20.3 22.0

22.4 20.0 22.0

22.3 19.8 22.0

303 59 2936 201 453 140 25 705 96

269 43
2795 196 496 148
21 690
65

238 41
2864 181 414 175 24 614 49

255 65
2681 188 471 161
10 633
61

251 48
2627 184 439 129 15 553 61

1316 256
13903 950
2273 753 95
3195 332

33

20

21

22

14

110

22

13

13

11

9

68

11

7

8

11

5

42

46

34

37

20

26

163

3

10

1

4

3

21

16

15

9

13

12

65

157

187

186

163

171

864

25

23

39

27

24

138

3

3

3

2

3

14

190

196

219

212

198

1015

18

27

36

25

23

129

36

24

30

23

22

135

805

725

726

701

809

3766

249

281

256

265

245

1296

672

642

610

598

502

3024

33

36

36

23

19

147

673

627

587

516

426

2829

58

44

38

35

17

192

105

84

97

88

72

446

.

35

107

110

109

361

.

30

112

76

107

325

.

252

495

472

495

1714

2234 478 38
1033 621 477 . 0

2023 419
56 1182 765 601 170
2

2023 436 49
1163 797 603 183 0

1918 354
75 1188 980 743 313
1

1979 358 52
1158 848 656 321 4

10177 2045 270 5724 4011 3080 987 7

Black
1990 1991 1992 1993 1994 5-year

136112 33821 3679

137146 33994 3698

138115 34150 3715

139149 34323 3733

140126 34482 3750

690647 170770
18576

19.2 18.2 23.0

18.9 18.1 23.0

19.0 18.5 24.0

19.0 18.5 24.0

19.0 18.5 24.0

19.0 18.4 24.0

628 173 3158 490 2036 173
60 751 123

653 191 3136 513 2078 214
43 743 114

653 186 3245 543 2109 217
54 789 100

660 188 2931 523 2010 235
40 761 105

615 173 2889 481 1992 195
35 803 113

3209 911
15359 2550
10225 1034 232 3847 555

61

54

49

50

60

274

44

36

45

40

40

205

17

18

4

10

20

69

102

78

101

76

74

431

2

4

7

6

9

28

10

10

16

8

14

58

417

357

420

368

383

1945

89

84

81

85

81

420

11

10

13

17

12

63

399

385

410

359

405

1958

49

40

48

43

52

232

44

48

44

46

31

213

1173 1317 1004
119 367 109 240

1250 1327 1101 123 322
86 253

1250 1359 1070
131 300
80 250

1180 1211 951
78 238
65 216

1221 1210
906 92
185 51
210

6074 6424 5032
543 1412
391 1169

.

59

170

168

195

592

.

44

94

96

85

319

.

412

1071

981

1008

3472

1694 440 42
2061 1867 1460
. 1

1603 412
78 2268 2014 1646 275
3

1671 378 75
2149 2169 1622
285 3

1633 373
79 2181 2217 1827 527
8

1685 359 50
2017 2071 1638
560 21

8286 1962
324 10676 10338
8193 1647
36
132

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 7 Unit 0 - Columbus

1990
18.6 80.8
2.4 40.9
4.5 19.6
0.6 183.9
6.0
129.3 24.8 95.5 84.0 30.9 99.6
4.6
15.4 10.7
4.8 24.0
0.2 0.4
9.4 1.9 0.2 9.7 1.1 1.3
34.1 25.7 27.7
2.5 17.3
2.8 9.6
. . .
64.7 17.1 12.8 51.2 40.9 31.9
.

1991
17.9 78.1
2.3 43.5
4.4 19.1
0.6 184.7
6.3
126.7 25.4 97.4 87.2 24.7 97.8 5.9
12.3 8.2 4.2
18.5 0.6 0.4
9.1 1.8 0.2 9.8 1.1 1.2
34.8 27.1 29.5
2.7 16.4
2.2 9.7
1.2 0.9 7.8
61.7 15.9 20.1 58.5 47.0 37.9
7.5

Total
1992 1993

18.4 80.3 2.4 41.4 4.2 18.5 0.5 175.6 6.5

16.7 73.2
2.2 44.2
4.2 18.4
0.5 188.0
6.1

121.5 25.5 98.7 86.3 20.3
100.0 4.6

124.6 27.6 96.6 88.5 22.8 97.6 7.7

11.4 9.3 2.1 22.1 0.4 0.4

12.8 9.0 3.9
16.7 0.4 0.3

9.9 2.0 0.3 10.4 1.4 1.2

9.4 2.0 0.3 10.3 1.2 1.2

34.0 26.5 27.6
2.8 14.8
1.9 9.7

35.5 26.3 27.8
1.8 13.7
1.8 9.5

3.4 2.3 18.3

3.3 2.0 16.6

60.8 15.2 18.7 54.7 48.7 36.5
7.7

63.5 14.6 26.2 60.6 57.1 45.8 15.0

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

16.4 71.8 2.2 44.4 4.1 17.9 0.5 188.2 5.3

17.6 76.8
2.3 42.8
4.3 18.7
0.5 183.9
6.0

117.5 25.3 90.3 88.8 23.6 97.7 5.4

123.9 25.7 95.7 86.9 24.4 98.5
5.6

13.3 8.9 4.5
17.8 0.5 0.4

13.1 9.2 3.9
19.9 0.4 0.4

10.1 1.9 0.3 11.1 1.4 1.0

9.6 1.9 0.3 10.3 1.2 1.2

38.7 26.6 26.0
2.0 11.3
1.2 9.3

35.4 26.4 27.7
2.4 14.8
2.0 9.5

3.6 2.2 17.1

2.9 1.9 15.0

66.7 14.7 17.3 58.2 53.3 41.8 16.1

63.4 15.5 19.0 56.5 49.2 38.6 11.4

15.6 72.7
2.2 15.5
3.7 17.4
0.5 184.7
4.4

14.8 69.4
2.1 17.9
3.7 17.1
0.5 188.2
4.5

15.2 71.4 2.1 14.6 3.3 15.3 0.5 166.6 5.2

14.2 67.1
2.0 17.7
3.3 15.8
0.5 180.7
4.7

13.9 66.0 2.0 16.9 2.9 13.9 0.4 165.8 3.9

14.7 69.3
2.1 16.5
3.4 15.9
0.5 177.4
4.5

88.8 19.5 58.9 51.3 28.1 100.0
3.2

78.9 16.0 57.5 60.2 19.1 98.4
2.6

69.9 17.2 53.2 52.5 14.4 100.0 3.2

75.0 25.5 55.3 62.7 17.9 95.1
2.6

74.0 19.1 54.2 63.9 18.0 94.8 2.7

77.3 19.5 55.8 58.1 19.5 97.9
2.9

11.2

7.2

7.3

8.2

5.3

7.9

7.5

4.7

4.5

4.1

3.4

4.9

3.8

2.5

2.8

4.1

1.9

3.0

15.5

12.1

12.8

7.4

9.8

11.6

*

1.0

*

*

*

0.4

0.5

0.5

0.3

0.4

0.4

0.4

5.3

6.7

6.5

6.1

6.5

6.2

0.9

0.8

1.4

1.0

0.9

1.0

*

*

*

*

*

0.1

6.5

7.1

7.7

8.0

7.6

7.4

0.6

1.0

1.3

0.9

0.9

0.9

1.2

0.9

1.1

0.9

0.8

1.0

28.4 8.5
23.1 1.1
23.3 2.0 6.5

26.8 10.1 23.2
1.3 22.9
1.6 5.6

26.4 9.1 21.6 1.3 21.0 1.4 6.1

27.2 10.0 22.5
0.9 19.6
1.3 6.1

32.1 9.4 19.3 0.7 16.6 0.7 5.3

28.1 9.4
22.0 1.1
20.8 1.4 5.9

.

0.8

2.5

2.5

2.5

2.1

.

0.7

2.6

1.8

2.5

1.9

.

5.8

11.4

10.9

11.4

9.9

76.2 18.4 12.1 35.4 21.3 16.4
.

72.7 17.1 17.8 42.7 27.6 21.7
6.1

70.8 17.4 15.2 41.1 28.2 21.3 6.5

71.8 14.9 26.0 44.7 36.9 28.0 11.8

75.7 15.4 19.3 44.5 32.6 25.2 12.3

73.4 16.7 17.9 41.6 29.1 22.4
9.1

23.2 93.4
2.7 65.6
5.5 22.2
0.6 180.7
7.3

22.9 92.3
2.6 67.1
5.4 21.9
0.6 178.7
8.2

23.5 95.0 2.7 66.0 5.7 23.1 0.7 182.3 8.6

21.1 85.4
2.5 69.6
5.5 22.2
0.6 191.4
8.3

20.6 83.8 2.4 70.3 5.7 23.3 0.7 203.7 7.3

22.2 89.9
2.6 67.6
5.6 22.5
0.6 187.1
7.9

170.7 27.5 133.2 97.3 33.4 99.2
6.0

176.6 29.2
138.7 97.6 30.8 97.3 9.2

175.8 28.5
146.2 97.6 26.9
100.0 6.2

176.8 28.5
140.1 97.9 28.1 99.0 12.9

164.0 28.1
128.3 98.5 30.1 99.1 8.3

172.7 28.4
137.3 97.8 29.9 98.9 8.5

19.3 13.9
5.5 31.7
* 0.3

17.2 11.5
5.8 24.5
* 0.3

15.1 13.9
* 30.6 0.6 0.5

17.1 13.6
3.5 25.6
0.5 0.2

20.8 13.8 7.0 25.3 0.8 0.4

17.8 13.3
4.6 27.6
0.5 0.3

13.2 2.8 0.3
12.9 1.6 1.4

11.4 2.7 0.3
12.4 1.3 1.5

12.9 2.5 0.4 12.9 1.5 1.4

12.6 2.9 0.6
12.4 1.5 1.6

13.3 2.8 0.4 14.3 1.8 1.1

12.7 2.7 0.4
13.0 1.5 1.4

40.0 42.5 32.4
3.8 11.9
3.5 12.2

42.2 42.8 35.6
4.0 10.5
2.8 12.7

40.9 42.5 33.6 4.1 9.4 2.5 12.5

43.4 41.9 33.0
2.7 8.3 2.3 12.4

44.8 42.7 32.0 3.3 6.6 1.8 12.3

42.2 42.5 33.3
3.6 9.4 2.6 12.4

.

1.3

3.6

3.5

4.0

3.1

.

0.9

2.0

2.0

1.8

1.7

.

8.7

22.5

20.5

20.9

18.2

54.0 15.8 13.5 66.4 60.2 47.1
.

51.6 14.9 23.0 73.2 65.0 53.1
8.9

51.8 13.2 22.1 67.3 67.9 50.8
8.9

56.1 14.4 27.1 75.5 76.7 63.2 18.2

58.9

54.4

14.3

14.5

15.8

20.2

71.1

70.6

73.0

68.4

57.8

54.2

19.7

13.7

133

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 8 Unit 1 - Valdosta

1990
195448 45803
4555
20.1 19.2 21.0
455 126 3318 423 1213 222 45 138 15
54 36 18 84 10 22
258 57
8 317 16 60
1295 636
1156 57 576 54 181
. . .
2332 439 36
1715 1412 1144
. 10

1991
197381 46098 4551
20.3 19.0 21.0
456 140 3283 410 1279 198
43 157
21
32 20 12 60 11 21
307 57 6
342 37 31
1186 652 1142
27 479
36 181
76 45 381
2178 373
39 1878 1663 1374 475
19

Total
1992 1993

199261 46382 4545

201198 46679 4541

19.9 19.5 21.0

20.1 19.5 22.0

460 110 3251 431 1264 225
27 131
10

443 115 3237 418 1334 214
24 130
18

44

44

28

30

16

14

56

53

8

16

19

21

287

269

51

46

6

4

323

328

41

40

53

58

1207 660
1108 37
523 36
174

1359 684 1056
36 469
25 182

149

179

172

200

796

1014

2323 343 61
1850 1803 1485
836 2

2356 350
56 1930 2004 1609 925
30

1994 5-year

203080 46969 4536

996368 231931
22728

20.0 19.7 22.0

20.1 19.4 21.0

507 128 3417 473 1365 182
34 150
17

2321 619
16506 2155 6455 1041 173 706 81

32

206

20

134

12

72

55

308

7

52

15

98

306

1427

55

266

8

32

321

1631

35

169

69

271

1241 645
1130 38
484 36
162

6288 3277 5592
195 2531
187 880

167 179 1117

571 596 3308

2545 371 70
1992 2020 1617 1175
17

11734 1876 262 9365 8902 7229 3411 78

White
1990 1991 1992 1993 1994 5-year

134322 30488 2748

135266 30547 2735

136192 30606 2720

137137 30664 2706

138067 30723 2692

680984 153028
13601

21.4 19.2 20.0

21.6 18.8 21.0

20.9 19.4 20.0

21.3 20.3 21.0

21.6 20.4 21.0

21.3 19.4 21.0

171 40 1928 152 284 133 26 96 12

165 33
1881 148 323 116 14 93 11

200 38
1942 186 342 130 8 75 8

171 38
1875 158 352 125 10 77 8

201 45
2028 181 380 116 16 80 8

908 194 9654 825 1681 620
74 421
47

24

10

19

20

13

86

16

6

10

16

7

55

8

4

9

4

6

31

42

19

18

25

23

127

7

3

1

8

2

21

12

12

6

15

6

51

92

117

127

123

137

596

12

15

19

19

26

91

1

1

1

1

2

6

135

150

162

161

155

763

8

20

22

24

18

92

28

15

32

27

39

141

675

602

635

719

646

3277

144

155

168

172

177

816

573

552

563

535

560

2783

18

8

8

15

14

63

439

375

411

385

390

2000

20

9

10

8

15

62

75

72

67

87

73

374

.

20

55

78

85

238

.

19

97

137

104

357

.

73

245

380

418

1116

1522 288 20 735 541 422 . 3

1402 236 23 854 690 571 199 6

1524 219 37 895 810 669 396 0

1470 222 40 884 881 673 402 16

1600 243 43 958 931 714 573 6

7518 1208
163 4326 3853 3049 1570
31

1990
58667 14666
1760

1991
59247 14754
1759

Black
1992 1993

59815 14838
1757

60395 14926
1756

1994 5-year

60962 15012
1754

299086 74196
8786

18.5 19.4 24.0

18.6 19.9 23.0

18.6 21.4 24.0

18.7 17.1 24.0

18.2 19.1 24.0

18.5 19.3 24.0

281 84
1371 268 926 86 18 40 3

289 107 1377 262 955
79 29 58
8

260 72
1287 245 919 95 19 52 2

271 77
1335 260 977
89 14 46
9

305 83
1358 292 980 62 18 65 9

1406 423
6728 1327 4757
411 98
261 31

30

22

25

24

19

120

20

14

18

14

13

79

10

8

7

10

6

41

41

41

38

28

32

180

3

8

7

8

5

31

9

9

13

6

9

46

165

189

159

145

168

826

45

42

32

27

29

175

7

5

5

3

6

26

178

192

161

167

163

861

8

17

19

15

17

76

31

16

21

29

30

127

615

577

567

635

588

2982

490

496

490

509

466

2451

576

584

540

517

563

2780

39

19

29

21

23

131

137

103

111

83

93

527

34

27

26

17

21

125

105

109

107

95

89

505

.

23

62

63

68

216

.

13

46

46

61

166

.

196

311

457

611

1575

800

759

145

136

16

15

974 1017

867

970

719

801

.

275

6

13

783

869

925

4136

121

124

126

652

24

15

27

97

951

1039

1020

5001

989

1116

1080

5022

814

931

897

4162

440

518

596

1829

2

13

11

45

134

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 8 Unit 1 - Valdosta

1990
17.0 72.4
2.1 36.7
0.7 3.0 0.1 36.7 6.7
99.9 27.7 92.9 74.0
3.3 93.3
4.6
16.3 10.8
5.5 25.0
0.8 0.5
7.8 1.7 0.2 9.7 0.5 1.8
43.2 19.3 35.2
1.7 17.6
1.7 9.2
. . .
71.7 14.8 10.7 51.9 42.7 34.6
.

1991
16.6 71.2
2.0 39.4
0.8 3.4 0.1 42.4 5.6
100.2 30.7 90.1 77.0 4.6
100.0 6.2
9.7 6.1 3.7 18.0 0.8 0.5
9.4 1.7 0.2 10.6 1.1 0.9
41.4 20.1 35.5
0.9 14.9
1.1 9.4
1.3 0.8 6.7
69.9 12.7 12.3 57.9 51.3 42.4 14.6

Total
1992 1993

16.3 70.1 2.0 39.4 0.7 2.8 0.1 35.8 6.0
101.2 23.9 94.8 73.1 2.2 90.0 5.9
13.5 8.6 5.0 17.1 0.6 0.5
8.8 1.6 0.2 10.1 1.3 1.6
40.0 20.6 34.7
1.2 16.4
1.1 9.5
2.6 3.0 14.0
72.9 12.0 17.2 57.6 56.2 46.2 26.0

16.1 69.3
2.0 41.7
0.6 2.8 0.1 35.7 5.8
97.6 26.0 92.1 78.6
4.0 94.4
2.2
13.6 9.3 4.4
16.3 1.2 0.5
8.3 1.4
* 10.3
1.3 1.8
43.7 21.4 33.1
1.1 14.8
0.8 9.9
3.1 3.5 17.6
73.2 12.1 19.1 60.4 62.7 50.3 28.9

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

16.8 72.8 2.1 40.4 0.7 3.2 0.1 39.3 5.2

16.6 71.2
2.0 39.5
0.7 3.0 0.1 38.0 5.9

111.8 25.2
104.3 79.5 3.7 94.1 5.3

102.1 26.7 94.8 76.5
3.6 95.1
4.8

9.4 5.9 3.5 15.9 0.5 0.4

12.5 8.1 4.4
18.5 0.8 0.5

9.0

8.6

1.6

1.6

0.2

0.2

9.5

10.0

1.0

1.0

2.0

1.6

37.5 19.1 33.5
1.1 14.4
1.1 8.2

41.1 20.1 34.4
1.2 15.6
1.2 9.2

2.9 3.1 19.3

2.5 2.6 14.4

74.8 12.0 23.6 58.9 59.8 47.8 34.8

72.6 12.7 16.4 57.3 54.5 44.3 26.2

14.4 63.2
1.8 14.8
0.7 3.1 0.1 43.6 5.9

13.9 61.6
1.8 17.4
0.7 3.0 0.1 43.9 4.7

62.2 23.4 55.3 37.7
4.4 91.7
3.3

60.3 20.0 54.1 42.2
4.0 100.0
2.9

12.4 8.3 4.2
21.5 0.9 0.5

5.3 3.2
* 10.0
* 0.5

4.8

6.2

0.6

0.8

*

*

7.1

8.1

0.4

1.1

1.5

0.8

38.2 7.5
30.0 0.9
23.0 1.0 6.8

35.9 8.3
29.9 0.4
20.4 0.5 7.0

.

0.6

.

0.6

.

2.2

80.4 16.6 10.5 38.3 28.2 22.0
.

77.0 14.2 11.8 45.9 37.1 30.7 10.7

14.3 63.5 1.9 17.8 0.6 2.5 0.1 34.6 5.0

13.7 61.1
1.8 19.0
0.6 2.5 0.1 36.6 4.9

73.5 19.0 68.4 42.2 2.9 87.5 4.0

63.2 22.2 58.4 46.8
3.0 100.0
2.6

9.8

10.7

5.1

8.5

4.7

*

9.2

13.3

*

1.0

0.2

0.6

6.5

6.6

1.0

1.0

*

*

8.4

8.7

1.1

1.3

1.7

1.5

35.0 8.8 29.4 0.4 21.6 0.5 6.5

39.8 9.3
29.0 0.8
21.0 0.4 8.3

1.6

2.3

2.9

4.1

7.3

11.2

79.8 12.8 17.4 46.6 42.2 34.8 20.6

78.9 13.2 23.7 47.8 47.6 36.4 21.7

14.7 66.0 2.0 18.9 0.6 2.6 0.1 35.4 4.9
74.7 22.4 67.2 51.7 3.0 87.5 5.2
6.4 3.5 3.0 11.3
* 0.2
6.8 1.3
* 7.7 0.9 1.9
32.7 8.8
27.9 0.7 19.5 0.8 6.3
2.5 3.1 12.3
79.2 13.2 24.9 47.7 46.3 35.5 28.5

14.2 63.1
1.9 17.6
0.6 2.8 0.1 38.8 5.1
66.8 21.4 60.7 44.3
3.5 93.6
3.6
8.9 5.7 3.2 13.1 0.5 0.4
6.2 0.9 0.1 8.0 1.0 1.5
36.3 8.5
29.2 0.7
21.1 0.7 7.0
1.8 2.6 8.3
79.1 14.0 17.3 45.2 40.3 31.9 20.5

23.4 93.5
2.5 67.9
0.7 2.7 0.1 26.1 8.3

23.2 93.3
2.5 70.3
1.0 3.9 0.1 37.4 7.7

21.5 86.7 2.3 72.4 0.9 3.5 0.1 35.5 8.5

22.1 89.4
2.4 74.0
0.8 3.1 0.1 30.6 8.1

22.3 90.5 2.5 73.2 1.1 4.3 0.1 43.0 5.9

22.5 90.7
2.4 71.5
0.9 3.5 0.1 34.5 7.7

159.7 29.9 152.3 94.7
* * 6.8

164.3 37.0
148.9 96.6 4.5
100.0 11.4

148.0 27.7
139.5 96.7 * * 9.1

154.3 28.4
148.1 97.7 5.1 88.9 *

173.9 27.2
166.5 96.9 5.1
100.0 5.1

160.0 30.1
151.0 96.5 3.5 96.8 6.8

21.9 14.6
7.4 29.5
* 0.6

16.0 10.2
5.9 29.2
1.5 0.6

19.4 14.0 5.5 29.1 1.3 0.8

18.0 10.5
7.6 20.8
1.5 0.4

14.0 9.6 4.5 23.3 0.9 0.6

17.8 11.7
6.2 26.4
1.2 0.6

12.0 3.3 0.5
13.2 0.6 2.3

13.7 3.1 0.4
14.2 1.3 1.2

12.4 2.5 0.4 12.7 1.5 1.6

10.9 2.0 *
12.6 1.1 2.2

12.4 2.1 0.4 12.2 1.3 2.2

12.3 2.6 0.4
13.0 1.1 1.9

50.7 36.0 42.6
2.9 10.2
2.5 12.3

49.3 36.5 43.6
1.5 7.7 2.0 12.4

47.8 38.6 42.8 2.3 8.8 2.1 13.4

49.8 38.5 39.2
1.6 6.3 1.3 12.2

45.0 34.8 42.1 1.7 7.0 1.6 11.0

48.5 36.9 42.1
2.0 8.0 1.9 12.3

.

1.0

2.8

2.8

3.0

2.4

.

0.6

2.1

2.0

2.7

1.9

.

8.9

14.0

20.4

27.0

17.6

59.7 11.9 11.2 71.5 63.6 52.8
.

59.8 11.0 12.4 74.9 71.4 59.0 20.3

62.4 10.7 16.9 74.9 77.9 64.1 34.7

65.5 10.3 12.3 78.7 84.5 70.5 39.2

68.5

63.2

10.3

10.9

22.7

15.0

76.2

75.2

80.7

75.5

67.0

62.6

44.5

34.6

135

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 8 Unit 2 - Albany

1990
320427 73750
8093
19.8 19.0 21.0
881 229 5596 785 2540 429 65 534 75
78 54 24 119 16 22
581 116 11 504 77 104
1976 1319 1965
40 586 87 350
. . .
4035 812 39
3078 2868 2249
. 6

1991
322326 73945 8099
19.7 18.8 22.0
911 269 5379 809 2643 471
78 525
70
69 43 26 120 15 29
501 84 10
478 56 84
1981 1336 1957
46 482
70 354
100 74
429
3969 824
46 3148 3015 2472 433
25

Total
1992 1993

324136 74120 8107

326038 74312 8114

19.7 18.9 22.0

19.8 19.3 22.0

866 240 5346 773 2610 376
51 509
71

869 248 5082 763 2531 442
60 538
63

60

63

37

39

23

24

88

99

11

14

32

36

498

526

101

108

13

10

538

534

60

52

72

82

1826 1311 1957
54 521
73 357

1649 1263 1805
52 610
99 301

228

176

167

213

977

880

4146 739 34
3214 3264 2653 1085
15

3815 744
42 3201 3383 2767 1810
29

1994 5-year
327842 1620769 74486 370613 8120 40533

19.9 20.0 22.0

19.8 19.2 22.0

848 203 5072 752 2545 474
42 547
55

4375 1189 26475 3882 12869 2192
296 2653
334

58

328

37

210

21

118

79

505

14

70

38

157

520

2626

116

525

12

56

542

2596

62

307

49

391

1677 1205 1755
42 557
48 283

9109 6434 9439
234 2756
377 1645

236 211 1273

740 665 3559

3956 724 50
3185 3222 2672 2295
34

19921 3843 211
15826 15752 12813
5623 109

White
1990 1991 1992 1993 1994 5-year

189102 40610 3994

189503 40454 3998

189862 40293 4003

190255 40131 4007

190613 39969 4011

949335 201457
20013

21.6 18.8 20.0

21.4 19.4 21.0

21.2 19.3 21.0

21.3 19.1 21.0

21.7 20.1 21.0

21.5 19.3 21.0

263 51 2600 224 445 207 23 227 35

236 44
2464 199 453 219
29 216
27

265 55
2498 232 507 178 15 196 25

264 54
2358 228 475 209
13 207
24

225 38
2346 189 473 228 11 199 19

1253 242
12266 1072 2353 1041 91 1045 130

27

15

18

18

19

97

19

9

11

14

11

64

8

6

7

4

8

33

42

38

26

26

22

154

6

4

3

4

4

21

9

9

19

13

10

60

188

170

130

172

145

805

28

26

16

24

23

117

4

3

3

1

2

13

176

198

194

197

186

951

41

30

21

23

26

141

40

35

26

34

15

150

786

754

728

635

632

3535

209

212

256

222

206

1105

726

665

776

684

609

3460

21

16

23

16

13

89

366

337

359

411

412

1885

26

20

22

26

13

107

91

87

109

91

76

454

.

41

88

72

104

305

.

43

101

105

89

338

.

104

271

313

368

1056

2138 446 22 964 772 597 . 2

2042 423
22 1024 849 709 136
5

2095 367 19
1118 1030
830 308
6

1957 363
22 1115 1100 883 512
4

2038 377 28
1089 1015
832 691
15

10270 1976 113 5310 4766 3851 1647 32

Black
1990 1991 1992 1993 1994 5-year

128391 32482 4026

128954 32496 4015

129489 32502 4006

130053 32514 3995

130582 32519 3985

647470 162513
20027

18.7 19.2 24.0

18.5 18.4 24.0

18.6 18.6 24.0

18.7 19.8 24.0

18.4 19.8 25.0

18.5 19.2 24.0

616 178 2976 560 2093 220
42 302
39

673 225 2900 609 2189 250
48 300
42

598 183 2825 538 2097 196
36 309
46

603 194 2712 534 2052 233
47 326
38

622 165 2708 562 2067 244
31 339
36

3112 945
14121 2803
10498 1143 204 1576 201

51

53

42

45

39

230

35

33

26

25

26

145

16

20

16

20

13

85

77

81

62

73

57

350

10

11

8

10

10

49

13

20

13

23

28

97

391

330

368

352

374

1815

88

58

85

84

93

408

7

7

10

9

10

43

326

279

343

336

355

1639

36

26

39

28

35

164

64

49

46

47

34

240

1186 1109 1233
19 220
61 259

1219 1124 1288
30 144
50 265

1090 1052 1172
30 160
51 246

1010 1040 1117
36 198
73 210

1038 998
1144 29
144 35
206

5543 5323 5954
144 866 270 1186

.

40

108

90

116

354

.

17

56

91

103

267

.

226

544

435

743

1948

1881 364 17
2108 2092 1648
. 4

1916 398
24 2118 2165 1762 297
20

2035 369 15
2089 2228 1818
776 9

1850 379
20 2082 2278 1880 1296
25

1906 346 22
2085 2200 1834 1600
18

9588 1856
98 10482 10963
8942 3969
76
136

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 8 Unit 2 - Albany

1990
17.5 75.9
2.3 46.1
1.7 7.2 0.2 79.9 7.5
108.9 26.0 97.0 84.0
9.3 100.0
5.3
13.9 9.6 4.3
21.0 0.8 0.3
10.4 2.1 0.2 9.1 1.4 1.9
39.1 23.9 35.7
0.7 10.8
1.6 10.7
. . .
73.6 16.2
7.9 55.8 52.0 40.8
.

1991
16.7 72.7
2.2 49.7
1.6 7.1 0.2 80.6 8.3
112.5 29.5 99.9 87.0 8.6 90.0 7.0
12.8 8.0 4.9
22.0 0.7 0.4
9.3 1.6 0.2 9.0 1.1 1.6
40.8 25.1 36.8
0.9 9.3 1.4 11.1
1.0 0.8 4.5
75.3 17.2
8.5 59.2 56.7 46.4
8.1

Total
1992 1993

16.5 72.1 2.1 49.4 1.6
6.9 0.2 79.5 7.4

15.6 68.4
2.0 50.4
1.7 7.2 0.2 87.0 7.6

106.8 27.7 95.3 82.6 8.8 94.3 5.3

107.1 28.5 94.0 85.4 7.8 95.2 6.5

11.2 6.9 4.3
16.3 0.5 0.5

12.4 7.7 4.8
19.3 0.7 0.5

9.3 1.9 0.2 10.2 1.1 1.4

10.4 2.1 0.2
10.6 1.0 1.7

38.1 24.8 37.1
1.0 10.1 1.4 11.2

37.0 25.1 35.9
1.0 12.4
2.0 10.0

2.4

1.8

1.7

2.2

10.2

9.2

78.8 15.7 6.0 60.8 61.7 50.2 20.5

76.1 16.7
7.4 63.7 67.3 55.0 36.0

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

15.5 68.1 2.0 50.8 1.7
7.3 0.2 88.7 7.3

16.3 71.4
2.1 49.2
1.6 7.2 0.2 83.0 7.6

104.4 23.9 92.6 88.1 6.8 96.3 6.2

107.9 27.2 95.8 85.4
8.2 95.2
6.1

11.4 7.3 4.2
15.4 0.6 0.5

12.4 7.9 4.5
18.9 0.7 0.4

10.3

9.9

2.3

2.0

0.2

0.2

10.8

9.9

1.2

1.2

1.0

1.5

36.3 24.1 35.1
0.8 11.4
1.0 9.8

38.3 24.6 36.1
0.9 10.8
1.5 10.6

2.4

1.9

2.2

1.7

13.2

9.3

78.4 16.2 9.2 63.6 64.3 53.3 45.8

76.4 16.4
7.8 60.5 60.2 49.0 27.2

13.7 64.0
2.0 17.4
1.2 5.6 0.2 73.7 6.2
65.8 19.4 56.1 51.4
8.8 100.0
2.5
10.4 7.3 3.1
16.0 0.6 0.3
7.2 1.1
* 6.9 1.6 1.6
32.6 8.2
28.4 0.8
14.7 1.0 6.4
. . .
83.1 19.2
9.2 37.6 30.1 23.3
.

13.0 60.9
1.9 18.6
1.1 5.3 0.2 73.2 6.6
59.0 18.6 49.8 54.8
6.8 77.8
4.0
6.1 3.7 2.4 15.2
* 0.3
6.9 1.1
* 8.1 1.2 1.5
33.6 8.7
27.3 0.7
14.6 0.9 6.3
0.9 0.9 2.2
83.7 19.4
8.5 42.1 34.9 29.1
5.6

13.2 62.0 2.0 20.5 1.0
4.9 0.1 66.8 5.9
66.2 20.8 58.0 45.0
6.2 83.3 3.7
7.2 4.4 2.8 10.3
* 0.5
5.2 0.6
* 7.8 0.8 1.1
31.7 10.3 31.4 0.9 15.2 0.9 7.9
1.9 2.2 5.8
84.6 16.6 7.0 45.1 41.6 33.5 12.4

12.4 58.8
1.8 20.4
1.1 5.2 0.2 73.7 6.1
65.9 20.5 56.9 57.1
6.0 87.5
3.5
7.6 5.9
* 11.0
* 0.4
7.3 1.0
* 8.5 1.0 1.5
29.8 9.5
29.4 0.7
18.3 1.2 6.8
1.5 2.3 6.7
83.6 17.7
7.9 47.8 47.2 37.9 22.0

12.3 58.7 1.8 20.4 1.0
5.0 0.2 71.2 6.3
56.1 16.9 47.1 57.4
4.7 94.7 5.0
8.1 4.7 3.4 9.3
* 0.3
6.2 1.0
* 8.0 1.1 0.7
29.3 8.9
26.3 0.6 18.6 0.6 5.9
2.2 1.9 7.9
87.2 18.2 11.3 47.0 43.8 35.9 29.8

12.9 60.9
1.9 19.4
1.1 5.2 0.2 71.7 6.2
62.6 19.3 53.6 52.9
6.5 89.1
3.7
7.9 5.2 2.7 12.5 0.4 0.3
6.6 1.0 0.1 7.8 1.2 1.3
31.4 9.1
28.6 0.7
16.2 0.9 6.7
1.6 1.8 5.7
84.4 18.2
8.7 43.8 39.3 31.8 17.2

23.2 91.6
2.5 71.4
2.4 9.3 0.3 84.4 9.2

22.5 89.2
2.4 76.2
2.3 9.2 0.3 84.7 10.5

21.8 86.9 2.4 75.3 2.4
9.5 0.3 89.8 9.5

20.9 83.4
2.3 76.5
2.5 10.0
0.3 97.1
9.9

20.7 83.3 2.3 77.4 2.6 10.4 0.3 101.5 9.0

21.8 86.9
2.4 75.3
2.4 9.7 0.3 91.3 9.6

153.0 28.9 139.1 97.1
9.7 100.0
8.2

167.6 33.4
151.7 97.4 10.5 97.6 10.2

149.3 30.6
134.3 98.9 11.5
100.0 7.0

150.9 32.2
133.7 97.5 9.5
100.0 9.8

156.1 26.5
141.0 98.4 9.0 97.1 7.5

155.4 30.4
140.0 97.8 10.0 99.0 8.5

17.1 11.8
5.4 25.5
1.0 0.4

18.3 11.4
7.0 27.5
1.0 0.6

14.9 9.2 5.7 21.7 0.7 0.4

16.6 9.2 7.4
26.5 0.9 0.7

14.4 9.6 4.8 20.8 0.9 0.8

16.3 10.3
6.1 24.4
0.9 0.6

13.1 3.0 0.2
11.1 1.2 2.2

11.4 2.0 0.2 9.7 0.9 1.7

13.0 3.0 0.4 12.3 1.4 1.6

13.0 3.1 0.3
12.5 1.0 1.8

13.8 3.4 0.4 13.3 1.3 1.3

12.9 2.9 0.3
11.8 1.2 1.7

45.1 37.8 42.2
0.7 7.6 2.1 14.0

46.9 39.1 44.9
1.1 5.1 1.8 14.6

44.0 37.8 42.1 1.1 5.8 1.9 13.7

43.7 38.7 41.6
1.4 7.5 2.8 12.5

42.3 37.3 42.9 1.1 5.4 1.3 12.9

44.5 38.2 42.8
1.1 6.3 2.0 13.6

.

0.8

2.3

1.9

2.4

1.9

.

0.4

1.2

1.9

2.2

1.4

.

4.8

11.4

9.1

15.6

10.2

65.1 13.6
6.7 71.9 71.3 56.2
.

68.0 15.4
8.5 73.7 75.4 61.3 10.3

73.7 14.8 5.1 75.0 80.0 65.3 27.9

69.7 15.8
6.9 77.5 84.8 70.0 48.3

70.8

69.4

14.6

14.8

7.4

6.9

78.0

75.1

82.3

78.6

68.6

64.1

59.9

36.0

137

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 9 Unit 1 - Savannah

1990
242622 57629
4836
21.5 19.7 22.0
596 168 4510 437 1693 440 50 1332 129
55 35 20 86
6 17
447 97 15 479 45 44
1473 1002 1081
129 742 71 245
. . .
3283 725 64
1668 1706 1136
. 5

1991
246421 58096 4896
21.2 19.4 23.0
606 158 4292 457 1691 442
46 1255 123
60 44 16 89
5 14
458 103
19 522
44 38
1317 1005 1068 106 607
85 258
51 20 159
3224 700
76 2074 1943 1533
10 31

Total
1992 1993

250218 58567 4957

254012 59028 5017

21.4 19.8 23.0

21.5 20.2 23.0

560 150 4368 443 1716 450
37 1249
92

589 160 4364 453 1858 441
47 1196 103

70

61

48

37

22

24

84

83

6

8

17

14

432

460

92

93

15

16

489

540

51

59

45

56

1362 1001 1016
87 634
75 241

1581 1064 1013
84 502
47 229

134

157

85

97

482

519

3265 666 104
1984 2078 1486
70 32

3241 727 144 2356 2392 1876 438
41

1994 5-year
257806 1251079 59498 292818 5077 24783

21.1 19.6 23.0

21.3 19.8 23.0

626 142 4262 492 1814 263
38 1116
112

2977 778
21796 2282 8772 2036 218 6148 559

54

300

38

202

16

98

76

418

6

31

13

75

444

2241

81

466

14

79

473

2503

51

250

36

219

1716 991 960 80 418 36 194

7449 5063 5138
486 2903
314 1167

136

478

79

281

476

1636

3149 730 112
1949 2190 1500
461 35

16162 3548 500
10031 10309
7531 979 144

White
1990 1991 1992 1993 1994 5-year

152513 35007 2587

155002 35300 2625

157494 35595 2664

159976 35885 2702

162467 36180 2740

787452 177967
13318

23.5 20.5 22.0

23.2 19.8 22.0

23.4 20.6 22.0

23.8 20.4 23.0

23.8 20.3 23.0

23.5 20.3 22.0

209 42 2388 145 344 246 18 649 51

212 38
2166 144 334 215
13 590
60

158 36
2208 121 323 231 9 555 34

178 42
2197 132 407 219
13 526
43

178 31
2147 132 378 134 15 473 39

935 189 11106 674 1786 1045
68 2793
227

20

14

23

18

18

93

10

13

13

12

12

60

10

1

10

6

6

33

29

26

23

23

27

128

2

2

3

0

0

7

12

5

8

6

5

36

149

138

147

153

153

740

23

28

25

26

20

122

3

5

3

3

2

16

168

185

183

198

179

913

23

16

27

27

27

120

32

17

26

22

20

117

655

550

570

648

697

3120

192

184

183

225

174

958

477

423

400

368

342

2010

26

18

16

15

15

90

512

411

443

355

302

2023

36

35

31

19

13

134

74

63

75

69

61

342

.

24

41

52

53

170

.

13

50

54

41

158

.

68

168

170

161

567

2001 431 28 522 483 319 . 2

1868 378 30 633 564 419 4 7

1855 362 48 622 617 419 14 10

1833 380 62 739 727 502 92 12

1821 393 61 615 660 396 109 9

9378 1944
229 3131 3051 2055
219 40

1990
86228 21506
2151

1991
87430 21635
2175

Black
1992 1993

88631 21765
2198

89831 21893
2222

1994 5-year

91031 22023
2246

443150 108823
10992

19.4 18.9 24.0

19.3 18.8 24.0

19.2 19.2 25.0

19.0 19.9 25.0

19.0 18.8 24.0

19.2 19.1 24.0

385 124 2093 292 1349 188
32 662 76

387 120 2077 309 1348 215
31 639
61

400 113 2083 320 1378 211
27 672
58

407 118 2101 320 1442 216
34 643
58

446 111 2037 358 1429 125
23 629
73

2025 586
10391 1599 6946 955 147 3245 326

35

45

46

43

36

205

25

31

34

25

26

141

10

14

12

18

10

64

57

61

59

60

49

286

4

3

3

8

6

24

5

9

9

8

8

39

295

318

280

303

288

1484

74

74

65

67

61

341

12

14

12

13

12

63

309

333

299

335

289

1565

22

27

24

32

24

129

11

20

18

33

14

96

807

753

775

913

984

4232

809

817

810

838

813

4087

602

636

601

634

613

3086

103

86

69

67

64

389

227

192

181

142

113

855

35

50

42

28

21

176

171

194

163

159

131

818

.

26

91

92

75

284

.

5

31

33

37

106

.

81

305

318

298

1002

1261 286 36
1143 1222
817 . 3

1319 312
46 1425 1362 1101
6 24

1345 295 54
1338 1436 1052
55 21

1350 342
81 1596 1640 1360
344 29

1264 328 49
1311 1507 1092
347 25

6539 1563
266 6813 7167 5422
752 102
138

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 9 Unit 1 - Savannah

1990
18.6 78.3
2.3 38.0
5.5 23.1
0.6 209.1
9.2
123.2 28.2 90.4 79.9 26.7 97.6
7.4
12.2 7.8 4.5
18.9 0.4 0.4
9.9 2.2 0.3 10.7 1.0 1.0
34.8 22.4 24.4
2.9 16.7
1.6 9.3
. . .
73.6 18.1 14.2 37.4 38.2 25.4
.

1991
17.4 73.9
2.2 39.8
5.1 21.6
0.6 206.1
9.3
123.8 26.1 93.3 82.0 25.1 96.7 5.9
14.0 10.3
3.8 20.5
0.3 0.3
10.7 2.4 0.4
12.3 1.0 0.9
32.8 23.7 25.4
2.5 14.4
2.0 10.3
0.8 0.3 2.4
75.6 18.6 15.9 48.8 45.8 36.1
0.2

Total
1992 1993

17.5 74.6 2.2 39.7 5.0 21.3 0.6 203.7
8.8

17.2 73.9
2.2 43.2
4.7 20.3
0.6 197.4
8.5

113.0 26.8 89.4 83.5 18.6 97.8 5.4

117.4 27.2 90.3 87.6 20.5 99.0 7.2

16.0 11.0 5.1 19.1 0.4 0.4

14.0 8.5 5.5
18.8 0.5 0.3

9.9 2.1 0.3 11.3 1.2 1.0

10.5 2.1 0.4
12.6 1.4 1.3

32.5 23.2 23.7
2.0 14.8
1.7 9.4

37.9 24.7 23.7
2.0 11.7
1.1 8.9

2.0

2.3

1.3

1.4

7.1

7.5

74.9 17.4 20.9 45.9 48.1 34.4
1.6

74.5 19.3 26.6 54.8 55.6 43.6 10.2

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

16.5 71.6 2.2 43.1 4.3 18.8 0.5 196.3
5.2

17.4 74.4
2.2 40.7
4.9 21.0
0.6 202.7
8.2

123.3 22.7 96.9 88.5 22.1 99.1 5.3

120.1 26.1 92.1 84.4 22.6 98.0
6.3

12.7 8.9 3.8 17.7 0.4 0.3

13.8 9.3 4.5
19.0 0.4 0.3

10.4 1.9 0.3 11.2 1.2 0.8

10.3 2.1 0.4
11.6 1.2 1.0

41.8 23.5 22.9
1.9 10.0
0.9 8.1

36.0 23.5 24.0
2.3 13.5
1.5 9.2

1.9

1.7

1.1

1.0

6.7

6.0

74.3 19.6 22.7 46.3 52.0 35.6 11.0

74.6 18.6 20.3 46.6 47.9 35.0
5.7

15.7 68.2
2.0 14.6
4.3 18.5
0.5 195.6
8.0

14.0 61.4
1.8 15.6
3.8 16.7
0.5 195.8
7.3

14.0 62.0 1.9 14.8 3.5 15.6 0.4 184.1
7.1

13.7 61.2
1.9 18.8
3.3 14.7
0.4 177.6
6.6

13.2 59.3 1.8 17.8 2.9 13.1 0.4 170.8
4.1

14.1 62.4
1.9 16.3
3.5 15.7
0.4 185.2
6.6

80.8 20.1 56.0 47.2 19.7 98.0
5.8

80.8 17.9 54.9 51.4 22.9 96.7
3.0

59.3 22.8 45.4 48.3 12.8 97.0
*

65.9 23.6 48.9 65.6 15.9 100.0
*

65.0 17.4 48.2 63.1 14.2 97.4
3.3

70.2 20.2 50.6 55.0 17.0 97.8
3.0

8.4 4.2 4.2 12.1
* 0.5

6.5 6.0
* 11.9
* *

10.4 5.9 4.6
10.4 *
0.3

8.2 5.5 2.7 10.4
* 0.2

8.4 5.6 2.8 12.5
* 0.2

8.4 5.4 3.0 11.5 0.2 0.3

6.2

6.4

6.7

7.0

7.1

6.7

1.0

1.3

1.1

1.2

0.9

1.1

*

0.2

*

*

*

0.1

7.1

8.6

8.4

9.1

8.4

8.3

1.0

0.7

1.2

1.2

1.3

1.1

1.3

0.8

1.2

1.0

0.9

1.1

28.7 8.1
20.2 1.1
21.7 1.5 5.9

26.5 8.6
19.8 0.8
19.3 1.6 5.5

26.7 8.4 18.4 0.7 20.4 1.4 6.2

30.6 10.4 17.1
0.7 16.5
0.9 5.8

33.3 8.2
16.2 0.7 14.3 0.6 5.2

29.2 8.7
18.4 0.8
18.5 1.2 5.7

.

0.7

1.1

1.4

1.4

1.1

.

0.4

1.4

1.4

1.1

1.1

.

1.9

4.5

4.5

4.2

3.8

84.4 20.1 12.7 22.1 20.4 13.5
.

86.8 19.7 13.1 29.5 26.2 19.5
*

84.2 18.7 19.6 28.5 28.3 19.2 0.6

83.7 20.1 22.5 34.1 33.6 23.2
4.2

84.9 21.2 22.6 29.0 31.1 18.7 5.1

84.8 20.0 18.5 28.5 27.8 18.7
2.5

24.3 97.3
2.7 65.2
7.7 30.8
0.8 220.9
11.3

23.8 96.0
2.7 65.8
7.3 29.5
0.8 214.0
12.5

23.5 95.7 2.7 66.9 7.6 30.9 0.8 223.3 11.7

23.4 96.0
2.7 69.8
7.2 29.4
0.8 214.3
11.7

22.4 92.5 2.7 71.1 6.9 28.6 0.8 223.1
6.9

23.4 95.5
2.7 67.7
7.3 29.8
0.8 219.1 10.8

179.0 32.2 135.8 96.2 35.3 98.6
9.8

177.9 31.0
142.1 96.4 28.0 96.7 9.2

182.0 28.2
145.6 96.6 26.4 98.3 10.5

183.2 29.0
144.0 96.9 26.1 98.3 14.0

198.6 24.9
159.4 98.0 32.5
100.0 8.0

184.2 28.9
145.5 96.9 29.7 98.4 10.3

16.7 11.9
4.8 26.8
* 0.2

21.7 14.9
6.8 28.9
* 0.4

22.1 16.3 5.9 28.0
* 0.4

20.5 11.9
8.7 28.1
1.1 0.4

17.7 12.8 5.0 23.8 0.8 0.4

19.7 13.6
6.2 27.1
0.7 0.4

14.1 3.5 0.6
14.9 1.1 0.5

15.3 3.6 0.7
16.3 1.3 1.0

13.4 3.1 0.6 14.5 1.2 0.9

14.4 3.2 0.6
16.2 1.5 1.6

14.1 3.0 0.6 14.4 1.2 0.7

14.3 3.3 0.6
15.3 1.3 0.9

41.9 39.1 29.4
5.0 11.0
1.7 12.5

39.8 39.9 31.3
4.2 9.4 2.5 14.5

39.0 39.3 29.4 3.4 8.8 2.0 12.3

46.0 40.5 31.0
3.3 6.9 1.4 12.0

50.9 40.4 30.6 3.2 5.6 1.0 11.0

43.5 39.8 30.3
3.8 8.4 1.7 12.5

.

0.9

3.1

3.0

2.4

2.4

.

0.2

1.0

1.1

1.2

0.9

.

2.8

10.2

10.5

9.6

8.3

61.2 15.5 15.7 55.2 59.0 39.4
.

64.0 17.3 18.8 69.5 66.5 53.7
0.3

64.8 16.3 22.0 65.0 69.7 51.1
2.7

64.5 18.9 30.9 77.2 79.3 65.8 16.6

62.6

63.4

18.3

17.3

22.5

22.1

65.2

66.4

74.9

69.9

54.3

52.9

17.3

9.2

139

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 9 Unit 2 - Waycross

1990
271422 62910
6376
19.8 19.3 21.0
668 160 4423 569 1533 340 56 475 70
44 26 18 83 12 24
380 71
5 525 42 51
1468 836
1564 59 868 161 232
. . .
3014 690 35
2505 1946 1608
. 1

1991
274292 63277 6352
19.7 20.1 21.0
649 142 4328 590 1568 362
54 444
42
51 33 18 91
8 22
320 54 7
444 48 49
1398 843 1562
43 760 102 231
82 116 608
2933 681
54 2826 2245 2005 596
3

Total
1992 1993

277046 63621
6328

279940 63999 6304

20.2 19.9 21.0

20.1 20.0 21.0

619 158 4474 536 1631 412
52 433
49

661 148 4232 586 1603 364
33 406
45

39

40

27

22

12

18

80

59

11

11

30

20

383

352

74

63

7

6

458

414

60

34

46

41

1416 903
1505 48
767 78
250

1369 827 1456
41 733
77 181

162 271 1106

186 266 1253

3051 701 42
2724 2540 2132 1552
4

2995 756
34 2794 2745 2347 1677
17

1994 5-year
282714 1385414 64354 318161 6282 31641

20.0 20.0 21.0

19.9 19.8 21.0

672 133 4155 608 1589 341
35 413
46

3269 741
21612 2889 7924 1819 230 2171 252

45

219

29

137

16

82

65

378

13

55

28

124

350

1785

75

337

11

36

405

2246

44

228

51

238

1451 821
1439 37
627 46
204

7102 4230 7526
228 3755
464 1098

183 243 1207

613 896 4174

3014 767 49
2720 2664 2271 1805
29

15007 3595 214
13569 12140 10363
5630 54

White
1990 1991 1992 1993 1994 5-year

205056 47148 4453

207132 47366 4431

209140 47568 4410

211239 47793 4388

213261 1045828 47999 237874 4367 22049

20.7 19.4 20.0

20.4 20.3 20.0

20.7 20.0 20.0

20.6 19.9 20.0

20.7 20.1 21.0

20.6 19.9 20.0

353 68 2942 296 538 225 24 310 44

379 66
2942 342 592 259
20 325
29

323 71
3026 287 614 289 23 272 24

378 73
2950 331 676 240
15 271
28

373 73
2876 333 654 225 17 252 30

1806 351
14736 1589 3074 1238 99 1430 155

26

26

19

30

26

127

15

18

13

16

16

78

11

8

6

14

10

49

40

40

38

33

33

184

5

4

7

9

6

31

17

17

17

14

16

81

212

160

187

192

192

943

38

21

37

32

37

165

2

3

4

2

2

13

325

279

263

255

249

1371

28

27

39

26

27

147

31

33

30

27

35

156

891

814

863

864

932

4364

285

300

299

315

297

1496

958

986

969

967

928

4808

23

25

19

20

20

107

705

638

634

624

539

3140

87

73

35

35

25

255

100

107

123

90

110

530

.

50

109

114

105

378

.

76

192

180

166

614

.

307

604

590

641

2142

2203 496 25
1424 1013
848 . 0

2169 464
32 1684 1255 1123
290 1

2277 490 31
1615 1442 1217
863 2

2270 529
24 1722 1666 1399
984 14

2234 529 40
1692 1620 1357 1065
14

11153 2508 152 8137 6996 5944 3202 31

1990
62950 15004
1832

1991
63558 15090
1825

Black
1992 1993

64139 15170
1818

64753 15258
1811

1994 5-year

65340 15340
1805

320740 75861
9092

18.3 18.7 25.0

18.5 19.1 25.0

18.5 19.7 24.0

18.5 19.9 24.0

18.2 19.5 25.0

18.5 19.4 25.0

315 92
1467 273 994 114 32 158 26

268 76
1369 246 972 102
34 115
13

295 86
1428 249
1016 122 28 157 25

282 75
1261 254 925 122
18 132
17

299 60
1257 275 931 110 18 159 16

1459 389
6782 1297 4838
570 130 721 97

18

25

20

10

19

92

11

15

14

6

13

59

7

10

6

4

6

33

43

51

41

26

32

193

7

4

4

2

7

24

7

5

12

6

12

42

167

158

195

155

156

831

33

33

37

28

38

169

3

4

3

4

9

23

200

163

192

154

155

864

14

21

21

7

17

80

20

15

16

13

15

79

571

578

545

499

516

2709

551

542

604

509

521

2727

603

570

534

483

505

2695

36

17

29

18

17

117

162

118

131

108

83

602

74

29

42

42

21

208

132

124

127

88

94

565

.

31

45

64

65

205

.

36

63

74

66

239

.

261

420

586

475

1742

800 192
10 1080
928 759
. 1

754 213
22 1132 977 872
305 2

763 207
11 1102 1092
910 685
2

714 222
9 1059 1070 941
688 2

764 232
9 1017 1031
905 733
15

3795 1066
61 5390 5098 4387 2411
22
140

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 9 Unit 2 - Waycross

1990
16.3 70.3
2.0 35.0
1.8 7.6 0.2 89.4 6.6
104.8 24.0 89.2 69.1 11.0 98.6
6.7
9.9 5.9 4.1 18.5 0.7 0.4
8.6 1.6 0.1 12.0 1.0 1.2
36.1 19.1 35.9
1.4 20.0
3.7 9.0
. . .
69.4 17.5
7.8 57.2 44.4 36.7
.

1991
15.8 68.4
2.0 36.6
1.6 7.0 0.2 85.1 7.0
102.2 21.9 92.9 67.4 6.6
100.0 5.5
11.8 7.6 4.2
20.8 0.5 0.4
7.4 1.2 0.2 10.4 1.1 1.1
35.3 19.7 36.7
1.0 18.0
2.4 9.6
1.1 1.5 8.1
69.3 17.8 11.9 66.0 52.4 46.8 13.9

Total
1992 1993

16.1 70.3 2.0 37.0 1.6
6.8 0.2 80.4 7.5

15.1 66.1
1.9 38.2
1.5 6.3 0.2 80.5 6.3

97.8 25.5 84.7 70.5 7.7 98.0
9.0

104.9 22.4 93.0 69.8 7.1 97.8 7.0

8.7 6.0 2.7 17.7 0.7 0.5

9.5 5.2 4.3 13.8 0.6 0.4

8.6

8.3

1.7

1.5

0.2

0.1

10.4

9.9

1.4

0.8

1.0

1.0

35.3 20.5 34.3 1.1 17.7 1.8
9.5

36.4 19.7 35.0
1.0 17.8
1.9 7.7

2.1 3.6 14.6

2.4 3.5 16.4

70.4 18.1 7.9 61.8 57.6 48.3 35.2

72.4 20.3
7.2 66.6 65.4 55.9 40.0

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

14.7 64.6 1.9 38.7 1.5
6.4 0.2 83.3 6.1

15.6 67.9
2.0 37.1
1.6 6.8 0.2 83.8 6.7

107.0 19.8 96.8 69.0 7.3 97.8 4.8

103.3 22.7 91.3 69.1
8.0 98.4
6.6

10.8 7.0 3.9 15.5 0.8 0.5

10.1 6.3 3.8
17.3 0.7 0.4

8.4

8.3

1.8

1.6

0.3

0.2

9.9

10.5

1.1

1.1

1.2

1.1

37.9 20.0 35.3 0.9 15.5 1.1
9.4

36.2 19.8 35.4
1.1 17.8
2.2 9.1

2.4 3.2 15.7

2.0 2.9 13.7

74.1 21.3 9.5 66.2 64.8 55.3 43.9

71.1 19.0
8.8 63.5 56.8 48.5 33.1

14.3 62.4
1.8 18.5
1.5 6.6 0.2 88.3 5.5

14.2 62.1
1.8 20.3
1.6 6.9 0.2 91.3 6.2

79.3 19.3 66.5 43.2
9.9 97.7
4.7

85.5 17.4 77.2 47.6
6.5 100.0
4.3

8.8 5.1 3.8 13.5 0.4 0.4

8.8 6.1 2.7 13.5
* 0.4

7.2

5.4

1.3

0.7

*

*

11.2

9.6

1.0

0.9

1.1

1.1

32.5 9.8
33.0 0.8
24.5 3.0 6.2

30.0 10.3 34.0
0.9 22.3
2.5 6.8

.

1.0

.

1.5

.

5.9

76.0 18.9
8.8 48.9 34.8 29.1
.

75.3 17.7 10.7 57.7 43.0 38.5
9.9

14.5 63.6 1.9 20.6 1.3
5.7 0.2 75.2 6.7
73.2 22.0 65.1 48.3 5.4 95.8
5.7
6.3 4.3 2.0 12.5 0.6 0.4
6.2 1.2
* 8.8 1.3 1.0
31.4 10.0 32.6 0.6 21.6 1.2
7.2
2.1 3.7 11.6
77.2 18.7 8.4 54.1 48.3 40.8 28.9

14.0 61.7
1.8 23.1
1.3 5.7 0.2 77.9 5.4
86.1 19.3 75.4 49.2
6.4 96.4
6.2
10.2 5.4 4.8
11.1 0.8 0.4
6.5 1.1
* 8.7 0.9 0.9
32.9 10.8 33.3
0.7 21.9
1.2 5.6
2.2 3.4 11.3
78.6 20.5
7.0 58.9 57.0 47.9 33.7

13.5 59.9 1.8 23.0 1.2
5.3 0.1 74.5 5.3
85.4 19.6 76.3 45.9
6.9 96.7
3.9
9.0 5.6 3.5 11.4 0.5 0.4
6.7 1.3
* 8.7 0.9 1.2
35.2 10.4 32.7 0.7 19.3 0.9
7.5
2.0 3.2 12.2
79.2 21.1 11.6 59.4 56.9 47.6 37.4

14.1 61.9
1.8 21.1
1.4 6.0 0.2 81.5 5.8
81.9 19.4 72.1 46.9
7.0 97.4
4.9
8.6 5.3 3.3 12.4 0.5 0.4
6.4 1.1 0.1 9.4 1.0 1.1
32.4 10.3 33.1
0.7 21.9
1.8 6.7
1.8 2.9 10.2
77.2 19.4
9.3 55.8 48.0 40.7 27.4

23.3 97.8
2.6 68.5
2.5 10.5
0.3 88.7 10.5

21.5 90.7
2.4 72.2
1.8 7.6 0.2 70.5 9.8

22.3 94.1 2.6 72.3 2.4 10.3 0.3 90.1 10.3

19.5 82.6
2.3 73.8
2.0 8.7 0.2 85.9 9.4

19.2 81.9 2.2 75.1 2.4 10.4 0.3 102.7 8.6

21.1 89.4
2.4 72.3
2.2 9.5 0.3 87.5 9.7

171.9 29.2 149.0 97.1 14.2 100.0 12.0

146.8 28.4
134.8 95.1 7.1
100.0 8.8

162.3 29.2
137.0 96.3 13.8
100.0 17.1

155.7 26.6
140.2 96.8 9.4
100.0 9.4

165.7 20.1
152.4 97.1 8.9
100.0 7.2

160.5 26.7
142.7 96.5 10.7
100.0 10.9

12.3 7.5 4.8
28.7 1.4 0.4

18.3 11.0
7.4 36.4
* 0.3

14.0 9.8 4.2 28.2
* 0.7

7.9 4.8
* 20.3
* 0.4

15.1 10.3 4.8 25.1 1.3 0.7

13.6 8.7 4.9
27.9 0.9 0.5

11.4 2.2 *
13.8 1.0 1.4

11.6 2.4 *
12.1 1.6 1.1

13.7 2.6
* 13.7 1.5 1.1

12.3 2.2 *
12.3 0.6 1.0

12.4 3.0 0.7 12.5 1.4 1.2

12.3 2.5 0.3
12.9 1.2 1.2

43.5 37.9 41.7
2.5 11.2
5.1 13.8

47.2 40.2 42.7
1.3 8.8 2.2 15.1

43.8 43.0 38.2 2.1 9.4 3.0 14.1

44.5 40.6 38.9
1.5 8.6 3.4 11.9

44.4 42.1 41.2 1.4 6.7 1.7 13.5

44.7 40.7 40.5
1.8 9.1 3.1 13.7

.

1.4

2.0

2.8

2.9

2.3

.

1.6

2.8

3.3

2.9

2.6

.

11.7

18.7

25.9

20.9

19.3

55.9 14.9
6.3 74.4 63.9 52.3
.

56.3 17.9 14.1 84.0 72.5 64.7 22.6

55.9 16.7 6.7 78.4 77.7 64.8 48.8

58.2 19.7
7.0 84.4 85.3 75.0 54.9

62.2

57.6

21.6

18.0

5.4

7.9

82.1

80.5

83.2

76.1

73.0

65.5

59.2

46.0

141

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 9 Unit 3 - Brunswick

1990
175682 42289
3536
21.0 19.1 21.0
327 57 3716 273 914 228 46 375 40
38 22 16 68
8 16
294 48
9 347 45 68
1007 530 795 69 659 68 171
. . .
2434 584 58
1711 924 762 . 6

1991
179731 43135 3627
20.7 20.0 21.0
329 74
3278 277 909 278
20 433
36
51 28 23 48
5 14
278 62 5
337 38 54
812 528 735
43 513
70 155
63 53 403
2245 412
43 1830 1064 909
74 20

Total
1992 1993

183762 43973 3717

187820 44827 3808

21.2 19.9 22.0

20.8 18.9 22.0

348 88
4131 308
1078 189 18 421 36

353 78
3738 306 1011 193
30 370
37

43

36

21

25

22

11

39

57

4

16

14

9

337

310

56

61

2

7

386

389

52

42

58

39

1023

927

637

570

786

685

42

36

571

460

68

41

176

195

181

179

137

144

852

861

2916 513 97
2236 1167
980 661
6

2715 439 101 2129 1262 1052 658
24

1994 5-year

191847 45667 3897

918842 219891
18584

20.5 20.0 22.0

20.9 19.6 21.0

371 75
3758 329
1073 186 26 386 33

1728 372
18621 1493 4985 1074 140 1985 182

42

210

35

131

7

79

61

273

14

47

12

65

323

1542

64

291

14

37

360

1819

57

234

39

258

1158 560 670 25 504 42 169

4927 2825 3671
215 2707
289 866

163

586

90

424

802

2918

2755 401 91
2079 1286 1060
679 19

13065 2349 390 9985 5703 4763 2072 75

White
1990 1991 1992 1993 1994 5-year

120791 28411 2263

123439 28838 2320

126069 29263 2377

128728 29694 2434

131361 30120 2492

630388 146326
11886

21.4 19.0 20.0

21.2 20.2 21.0

21.5 20.0 21.0

21.4 19.3 21.0

21.1 19.7 21.0

21.3 19.7 21.0

182 27
2402 153 319 122 24 209 24

174 35
2089 150 305 173
8 205
19

191 43
2605 163 368 101 4 194 24

170 31
2446 148 359 116
14 173
18

181 36
2451 162 389 92 15 176 16

898 172 11993 776 1740 604
65 957 101

21

26

25

21

18

111

14

16

13

14

14

71

7

10

12

7

4

40

38

24

18

28

29

137

3

3

3

9

5

23

10

6

5

5

5

31

147

131

157

160

166

761

31

25

22

21

25

124

4

2

0

1

3

10

198

176

199

198

194

965

22

20

26

29

39

136

33

30

38

22

21

144

563

458

567

530

648

2766

193

177

216

172

193

951

519

466

490

420

400

2295

29

17

11

20

8

85

524

411

459

383

418

2195

44

42

37

23

24

170

86

79

84

103

90

442

.

28

81

89

80

278

.

18

75

91

51

235

.

183

446

410

366

1405

1763 380 34 930 432 353 . 1

1567 260 27 993 517 427 27 5

1984 318 59
1249 552 463 288 3

1903 282 65 1232 630 514 340 12

1922 242 49
1222 652 524 363 9

9139 1482
234 5626 2783 2281 1018
30

1990
50029 12383
1194

1991
51158 12644
1223

Black
1992 1993

52283 12904
1251

53416 13168
1280

1994 5-year

54539 13428
1308

261425 64528
6255

20.0 19.6 23.0

19.9 19.4 23.0

20.3 19.6 23.0

19.6 18.3 23.0

19.4 20.1 23.0

19.9 19.4 23.0

144 29
1248 119 592 100 22 156 16

152 39
1122 125 597
99 12 206 17

153 45
1427 141 692 85 14 209 12

178 44
1211 153 642
77 15 183 19

187 38
1229 165 669 90 11 195 16

814 195 6237 703 3192 451
74 949
80

17

25

18

15

23

98

8

12

8

11

20

59

9

13

10

4

3

39

30

23

21

26

31

131

5

2

1

7

9

24

6

8

9

4

7

34

141

144

176

145

153

759

17

36

34

39

38

164

5

3

2

6

10

26

144

159

183

182

160

828

22

16

25

12

18

93

35

24

19

16

17

111

429

341

439

383

484

2076

336

346

413

391

361

1847

269

262

274

256

259

1320

39

26

31

16

17

129

117

92

100

70

78

457

24

27

30

18

17

116

80

75

91

86

76

408

.

25

80

65

65

235

.

15

39

42

34

130

.

169

292

329

342

1132

629

630

865

757

779

3660

192

138

184

151

146

811

24

16

32

35

41

148

750

799

942

859

827

4177

487

543

605

619

617

2871

406

478

508

528

527

2447

.

47

367

313

310

1037

5

14

2

11

9

41

142

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 9 Unit 3 - Brunswick

1990
21.2 87.9
2.5 24.9
2.1 8.9 0.2 85.7 6.8
92.5 17.4 77.2 68.0 11.3 95.0
5.4
10.2 5.9 4.3
18.1 0.6 0.5
7.9 1.3 0.2 9.4 1.2 1.9
29.9 14.4 21.7
1.9 18.8
1.9 8.0
. . .
65.9 17.9 14.2 46.6 25.2 20.7
.

1991
18.2 76.0
2.2 28.1
2.4 10.0
0.3 107.7
7.2
90.7 22.5 76.4 68.4
9.9 97.2
5.5
15.6 8.5 7.1
14.6 0.4 0.4
8.5 1.9 0.2 10.4 1.2 1.9
29.7 16.3 22.9
1.3 18.0
2.5 8.3
1.2 1.0 7.7
68.7 14.2 12.7 56.5 32.9 28.1
2.3

Total
1992 1993

22.5 93.9 2.7 26.5 2.3 9.6 0.3 88.3
5.0
93.6 25.3 82.9 72.5 9.7 94.4 1.6
10.4 5.1 5.4 9.4 * 0.4
8.2 1.4
* 9.5 1.3 1.6
29.5 15.6 19.3
1.0 16.0
1.9 7.5
3.4 2.6 16.0
70.8 14.1 21.7 54.8 28.6 24.0 16.2

19.9 83.4
2.4 27.4
2.0 8.3 0.2 85.3 5.2
92.7 22.1 80.4 71.7
9.7 94.6
3.2
9.6 6.7 3.0 15.1 1.1
*
8.3 1.6 0.2 10.5 1.1 1.2
30.3 15.4 18.6
1.0 14.7
1.3 9.1
3.3 2.6 15.7
73.0 13.3 26.4 57.6 34.2 28.5 17.8

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

19.6 82.3 2.4 29.0 2.0
8.5 0.2 88.5 4.8
95.2 20.2 84.4 74.8
8.5 97.0 3.1
11.2 9.3 1.9 16.1 1.0 0.3
8.6 1.7 0.4 9.7 1.5 1.2
35.5 15.1 18.3
0.7 15.1
1.3 8.0
2.9 1.6 14.3
73.8 12.0 24.9 56.2 34.8 28.6 18.4

20.3 84.7
2.4 27.1
2.2 9.0 0.2 90.8 5.7
93.0 21.5 80.3 71.3
9.8 95.6
3.7
11.3 7.0 4.3
14.6 0.7 0.4
8.3 1.6 0.2 9.9 1.3 1.6
31.0 15.4 20.1
1.2 16.5
1.8 8.2
2.7 2.0 13.5
70.5 14.3 20.1 54.3 31.0 25.9 14.1

19.9 84.5
2.4 13.4
1.7 7.4 0.2 75.7 5.3
80.4 14.8 67.6 48.3 10.6 91.7
3.1
8.7 5.8 2.9 15.7
* 0.5
6.1 1.3
* 8.3 0.9 1.4
25.6 8.1
21.9 1.2
23.2 2.0 6.7
. . .
73.8 17.8 14.0 39.1 18.1 14.8
.

16.9 72.4
2.1 14.8
1.7 7.1 0.2 82.6 6.5
75.0 20.1 64.7 48.0
8.2 94.7
3.0
12.4 7.7 4.8
11.4 *
0.3
6.3 1.2
* 8.5 1.0 1.7
26.7 8.6
22.7 0.8
23.2 2.4 6.8
0.9 0.6 5.6
75.2 14.0 12.8 48.0 25.0 20.7
1.3

20.7 89.0 2.6 14.3 1.5
6.6 0.2 66.8 3.7
80.4 22.5 68.6 53.1 10.1 91.7 2.1
9.6 5.0 4.6 6.9
* *
6.0 0.8
* 7.7 1.0 1.7
26.3 8.4 19.1 0.4 20.8 1.7 5.9
2.4 2.2 13.4
76.3 13.7 22.7 48.4 21.4 18.0 11.2

19.0 82.4
2.4 14.9
1.3 5.8 0.2 62.8 4.6
69.8 18.2 60.8 46.9
7.4 88.9
2.1
8.6 5.7 2.9 11.4 1.1
*
6.5 0.9
* 8.2 1.2 1.1
27.1 7.1
17.4 0.8
19.2 1.2 7.6
2.6 2.7 12.0
78.1 12.9 28.0 51.0 26.1 21.3 14.1

18.7 81.4 2.4 16.1 1.3
5.8 0.2 64.3 3.6
72.6 19.9 65.0 54.7
6.4 93.8
*
7.3 5.7
* 11.8 0.6 0.2
6.8 1.0
* 8.0 1.6 1.0
31.1 8.0
16.7 0.3 19.7 1.1 6.6
2.3 1.5 10.5
78.8 11.0 22.2 50.7 27.0 21.7 15.0

19.0 82.0
2.4 14.7
1.5 6.5 0.2 70.2 4.7
75.6 19.2 65.3 50.3
8.5 92.1
2.4
9.3 5.9 3.4 11.4 0.5 0.3
6.3 1.0 0.1 8.1 1.1 1.4
27.4 8.0
19.4 0.7
21.2 1.6 6.7
2.1 1.7 10.4
76.5 13.9 20.1 47.5 23.5 19.2 10.7

24.9 100.8
2.7 48.3
3.1 12.6
0.3 101.6 10.6

21.9 88.7
2.4 54.0
4.0 16.3
0.4 142.6
9.3

27.3 110.6
3.0 49.4 4.0 16.2 0.4 119.9 8.3

22.7 92.0
2.5 53.6
3.4 13.9
0.4 123.0
7.1

22.5 91.5 2.6 55.3 3.6 14.5 0.4 127.6 7.7

23.9 96.7
2.6 52.0
3.6 14.7
0.4 122.6
8.6

120.6 20.1 99.7 94.0 13.4 100.0 10.1

124.3 25.7
102.2 92.0 13.9
100.0 9.8

122.3 29.4
112.7 95.0 9.6
100.0 *

139.1 24.7
119.6 96.1 14.8
100.0 5.5

143.0 20.3
126.1 95.1 12.2
100.0 6.1

130.1 24.0
112.4 94.5 12.8
100.0 6.4

13.6 6.4 7.3
23.6 1.1 0.5

22.3 10.7 11.7 20.3
* 0.7

12.6 5.6 7.0 14.6
* 0.7

12.4 9.1 *
21.2 1.5 *

18.7 16.3
* 25.0 1.9 0.5

15.7 9.5 6.3
20.8 1.0 0.5

11.3 1.4 0.4
11.7 1.8 2.9

12.8 3.2 *
14.4 1.4 2.3

12.3 2.4
* 13.1 1.8 1.4

12.0 3.2 0.5
15.2 1.0 1.5

12.4 3.1 0.8 13.2 1.5 1.5

12.2 2.6 0.4
13.5 1.5 1.9

38.5 27.4 22.1
3.2 9.9 2.0 10.0

35.5 31.3 23.9
2.4 9.0 2.7 10.9

36.0 29.5 19.7 2.2 7.8 2.3 10.6

37.0 32.6 21.4
1.3 6.5 1.7 11.5

43.7 29.8 21.7 1.4 6.8 1.5 10.8

38.2 30.1 21.6
2.1 8.0 2.0 10.8

.

1.4

4.4

3.5

3.4

3.2

.

0.8

2.1

2.3

1.8

1.8

.

9.5

16.1

17.8

18.1

15.4

50.8 18.0 14.8 61.1 39.7 33.1
.

56.4 14.1 12.7 72.3 49.1 43.3
4.3

60.8 15.0 18.1 67.2 43.2 36.3 26.2

62.9 14.4 23.5 71.6 51.6 44.0 26.1

63.9

59.0

13.6

15.0

29.7

19.7

68.3

68.0

51.0

46.7

43.6

39.8

25.6

21.1

143

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Health District 10 Unit 0 - Athens

1990
277962 71521
5459
21.4 20.5 22.0
608 169 4548 451 1395 289 45 1405 137
57 36 21 81
7 19
361 72
8 401 46 70
1148 630
1324 87 767 105 213
. . .
3187 636 72
1765 1579 1174
. 2

1991
283240 72420 5499
21.5 20.8 22.0
512 141 4334 402 1443 286
50 1367
96
55 38 17 86
8 20
351 63 10
392 50 68
1115 649 1224
65 670 105 205
79 58 352
3144 621
82 2044 1849 1521 213
12

Total
1992 1993

288463 73308
5539

293732 74200 5578

22.5 20.4 22.0

21.8 20.7 23.0

516 125 4349 396 1441 275
45 1273
106

563 124 4408 437 1541 294
42 1315 108

53

39

31

22

22

17

76

64

8

8

21

23

371

341

78

57

8

1

385

369

54

62

212

210

1028 614
1241 55
582 99
197

1135 645 1180
45 531
79 188

225

224

200

193

850

765

3259 558 86
1995 1990 1603
988 7

3390 487 119 2043 2271 1774 1155
10

1994 5-year
298949 1442346 75090 366539 5618 27692

21.9 20.8 23.0

21.8 20.7 22.0

577 132 4297 446 1448 313
42 1144
108

2776 691
21936 2132 7268 1457 224 6504 555

41

245

26

153

15

92

67

374

7

38

25

108

334

1758

62

332

10

37

353

1900

55

267

70

630

1185 614
1144 34
574 78
165

5611 3152 6113
286 3124
466 968

194

722

200

651

910

2877

3540 537 90
2087 2123 1738 1298
9

16520 2839 449 9934 9812 7810 3654 40

White
1990 1991 1992 1993 1994 5-year

215877 54990 3882

220477 55786 3920

225042 56578 3959

229628 57368 3996

234195 1125219 58159 282881 4035 19792

22.2 20.6 21.0

22.4 21.0 21.0

23.3 20.7 22.0

22.6 20.9 22.0

23.1 21.1 22.0

22.8 20.8 22.0

350 89 3177 255 461 195 27 949 82

261 64
3019 199 487 200
31 919
57

265 46
3076 198 533 202 28 818 57

298 54
3073 230 565 221
22 873
65

299 55
3113 227 593 216 22 772 59

1473 308
15458 1109 2639 1034 130 4331 320

30

31

28

23

23

135

17

23

13

14

18

85

13

8

15

9

5

50

43

52

41

36

41

213

5

3

7

6

4

25

14

13

14

12

17

70

183

184

206

175

201

949

34

25

41

29

45

174

2

3

1

1

8

15

240

221

211

217

228

1117

28

30

36

43

35

172

51

45

129

134

45

404

692

647

646

683

768

3436

208

235

235

221

239

1138

806

748

771

694

722

3741

27

24

24

25

18

118

623

538

484

429

475

2549

64

61

53

46

35

259

118

92

96

90

83

479

.

39

122

134

103

398

.

29

156

130

136

451

.

139

351

348

342

1180

2460 465 54 891 811 569 . 0

2437 465
52 1100 971 789 121
4

2489 417 68
1080 1099
865 587
3

2569 354
81 1072 1215 892 615
5

2693 386 66
1201 1252
979 725
4

12648 2087 321 5344 5348 4094 2048 16

1990
57945 15217
1523

1991
58928 15487
1529

Black
1992 1993

59900 15754
1535

60881 16023
1541

1994 5-year

61852 16291
1547

299506 78772
7676

19.2 19.5 24.0

19.1 19.4 25.0

19.9 19.1 25.0

19.4 19.6 26.0

18.8 19.3 26.0

19.2 19.4 25.0

256 80
1290 196 929 88 18 400 54

250 77
1263 202 952
79 17 392 39

248 79
1203 197 898 62 17 393 47

265 70
1283 207 972
62 20 385 43

276 77
1093 219 849 89 20 336 47

1295 383
6132 1021 4600
380 92
1906 230

27

24

24

16

18

109

19

15

18

8

8

68

8

9

6

8

10

41

38

32

35

28

26

159

2

5

1

2

3

13

5

7

7

11

8

38

175

167

159

162

126

789

37

38

36

28

17

156

6

7

7

0

2

22

159

169

169

148

118

763

17

20

18

19

18

92

18

22

77

72

25

214

445

455

365

436

391

2092

421

414

373

421

371

2000

513

473

464

482

413

2345

60

41

31

20

15

167

142

132

96

101

97

568

40

44

46

33

42

205

94

110

101

97

82

484

.

38

86

79

71

274

.

29

38

55

53

175

.

201

457

390

533

1581

667

666

717

781

768

3599

162

150

130

125

144

711

18

28

18

36

20

120

835

922

892

949

843

4441

749

868

865 1034

841

4357

588

724

724

867

735

3638

.

91

395

540

557

1583

2

8

4

2

4

20

144

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Health District 10 Unit 0 - Athens

1990
16.4 63.6
1.8 31.0
5.1 19.6
0.5 222.7
5.0
111.4 27.8 82.6 68.3 25.1 96.2
6.8
12.5 7.9 4.7
17.6 0.4 0.4
7.9 1.6 0.2 8.9 1.0 1.6
33.8 14.0 30.0
2.0 17.4
2.4 9.0
. . .
71.3 15.7 16.5 39.2 35.1 26.1

1991
15.3 59.8
1.7 33.7
4.8 18.9
0.5 225.8
4.9
93.1 27.5 73.1 70.0 17.5 96.8
4.2
12.7 8.8 4.0
19.6 0.5 0.4
8.1 1.5 0.2 9.2 1.2 1.6
35.1 15.2 29.3
1.5 16.8
2.6 8.8
1.1 0.8 4.9
74.3 16.2 18.8 47.7 43.2 35.5

Total
1992 1993

15.1 59.3 1.7 33.6 4.4 17.4 0.5 213.8 4.5

15.0 59.4
1.7 35.5
4.5 17.7
0.5 216.6
4.7

93.2 24.2 71.5 72.3 19.1 100.0
3.6

100.9 22.0 78.3 75.9 19.4 98.1 4.5

12.2 7.1 5.1
17.3 0.5 0.4

8.8 5.0 3.9 14.4 0.5 0.4

8.5

7.7

1.8

1.3

0.2

*

9.0

8.5

1.3

1.4

4.9

4.8

31.9 14.3 29.3
1.3 16.2 2.8
8.3

33.8 14.8 27.5
1.1 14.6
2.2 7.8

3.1 2.8 11.7

3.0 2.6 10.4

76.6 14.4 20.6 46.4 46.3 37.3

78.6 12.6 25.6 47.0 52.3 40.8

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

14.4 57.2 1.6 34.2 3.8 15.2 0.4 197.0 4.9

15.2 59.8
1.7 33.6
4.5 17.7
0.5 215.4
4.8

102.7 22.9 79.4 76.7 19.2 98.1 6.6

100.2 24.9 77.0 72.7 20.0 97.8
5.1

9.5 6.1 3.5 15.4 0.4 0.5

11.2 7.0 4.2
16.9 0.5 0.4

7.8

8.0

1.4

1.5

0.2

0.2

8.3

8.8

1.3

1.2

1.6

2.9

30.1 14.5 27.3
0.8 13.9 1.9
7.3

32.8 14.6 28.7
1.3 15.8
2.4 8.2

2.6

2.5

2.7

2.2

12.2

9.9

84.3 14.1 20.4 49.2 50.1 41.0

76.9 14.6 20.4 45.9 45.3 36.1

14.7 57.8
1.6 14.7
4.4 17.3
0.5 217.5
4.3

13.7 54.1
1.5 16.3
4.2 16.5
0.4 219.8
4.4

13.7 54.4 1.5 17.5 3.6 14.5 0.4 197.9 4.2

13.4 53.6
1.5 18.6
3.8 15.2
0.4 208.1
4.4

13.3 53.5 1.5 19.3 3.3 13.3 0.4 187.0 4.2

13.7 54.6
1.6 17.3
3.8 15.3
0.4 206.2
4.3

90.2 25.4 65.7 45.5 21.1 95.0
5.4

66.6 24.5 50.8 43.9 14.5 94.6
2.0

66.9 17.4 50.0 46.4 14.4 100.0
3.5

74.6 18.1 57.6 55.7 16.3 96.9
2.3

74.1 18.4 56.3 56.4 14.6 96.6
5.2

74.4 20.9 56.0 49.7 16.2 96.5
3.7

9.4 5.4 4.1 13.4 0.4 0.4

10.3 7.6 2.7
17.0 *
0.4

9.1 4.2 4.9 13.2 0.6 0.4

7.5 4.6 2.9 11.6 0.5 0.3

7.4 5.8 1.6 13.1
* 0.4

8.7 5.5 3.3 13.7 0.4 0.4

5.8

6.1

6.7

5.7

6.5

6.1

1.1

0.8

1.3

0.9

1.4

1.1

*

*

*

*

0.3

0.1

7.6

7.4

6.9

7.2

7.4

7.3

0.9

1.0

1.2

1.4

1.1

1.1

1.6

1.5

4.2

4.4

1.5

2.6

29.0 6.6
26.1 0.9
20.2 2.1 7.4

29.3 7.9
25.5 0.8
19.2 2.2 5.9

27.8 7.7 25.7 0.8 18.8 2.1 5.9

28.9 7.3
23.1 0.8
16.7 1.8 5.5

26.9 7.8
23.7 0.6 16.0 1.2 5.1

28.3 7.4
24.8 0.8
18.2 1.9 5.9

.

0.8

2.4

2.5

1.9

1.9

.

0.6

3.0

2.5

2.5

2.2

.

2.7

6.8

6.6

6.4

5.6

78.5 16.4 17.0 28.3 25.8 18.1

81.7 17.3 17.7 36.8 32.5 26.4

81.9 15.3 21.3 35.5 36.1 28.4

84.6 13.2 23.8 35.4 40.1 29.4

87.8 14.0 20.4 39.0 40.7 31.8

82.9 15.2 20.1 35.0 35.0 26.8

22.3 84.8
2.3 73.0
6.9 26.3
0.7 222.1
7.3

21.4 81.6
2.3 76.7
6.7 25.3
0.7 223.4
6.5

20.1 76.4 2.2 75.8 6.6 24.9 0.7 234.2 5.2

21.1 80.1
2.3 77.0
6.3 24.0
0.7 219.5
5.4

17.7 67.1 1.9 79.0 5.4 20.6 0.6 217.8 7.0

20.5 77.8
2.2 76.2
6.4 24.2
0.7 223.4
6.3

168.1 31.3 128.7 97.9 35.5 98.1
9.8

163.5 30.8
132.1 96.0 25.5
100.0 9.8

161.6 31.9
128.3 98.0 30.6
100.0 3.9

171.9 26.4
134.3 98.1 27.9
100.0 10.4

178.4 27.9
141.5 98.1 30.4
100.0 10.3

168.7 29.6
133.0 97.6 30.0 99.6 8.9

20.9 14.7
6.3 29.1
* 0.4

19.0 11.9
7.2 25.0
1.1 0.5

20.0 15.0 5.1 28.7
* 0.5

12.5 6.2 6.3
21.5 *
0.8

16.5 7.3 9.2 23.4
* 0.5

17.8 11.1
6.8 25.5
0.6 0.5

13.6

13.2

13.2

12.6

11.5

12.9

2.9

3.0

3.0

2.2

1.6

2.5

0.5

0.6

0.6

*

*

0.4

12.5

13.7

14.3

11.7

11.0

12.7

1.3

1.6

1.5

1.5

1.7

1.5

1.4

1.7

6.4

5.6

2.3

3.5

46.5 33.1 41.1
4.8 11.3
3.2 12.8

48.9 33.3 39.4
3.4 11.6
3.9 14.5

42.7 31.5 39.7 2.7 10.1 4.8 14.3

45.8 33.4 38.7
1.6 9.9 3.2 12.8

39.2 34.5 38.8 1.5 9.0 3.9 13.9

44.6 33.1 39.6
2.9 10.5
3.8 13.7

.

1.9

4.3

3.9

3.5

3.4

.

1.5

1.9

2.7

2.6

2.2

.

10.3

23.1

19.5

26.3

19.9

53.0 14.0 15.4 65.6 58.9 46.2

55.5 13.6 20.6 74.2 69.9 58.3

62.2 11.9 19.4 75.3 73.0 61.1

63.6 11.0 29.8 75.2 81.9 68.7

73.6 14.9 18.3 78.4 78.2 68.4

61.2 13.0 20.8 73.6 72.2 60.3

145

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
1990

Population

112561

Women age 15-44

27847

Women age 15-17

2962

Woman's median age at:

Conception of first birth

20.3

Conception of first abortion

19.1

First marriage

22.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

334

Repeat conceptions to women under 18

87

Total Livebirths

2074

Livebirths to women under 18

280

Livebirths to unmarried women

984

Early fetal deaths

199

Fetal deaths 20 weeks or more gestation

17

Total induced abortions

384

Induced abortions to women under 18

53

Infant and child survival

Infant deaths

28

Neonatal deaths

17

Postneonatal deaths

11

Perinatal deaths

35

Deaths of children 1-4 years

5

Deaths of children 5-17 years

5

Infant health

Low birthweight

212

Very low birthweight

42

Under 500 grams

7

Preterm gestation

209

Multiple gestation

31

Born with birth defect

37

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

721

Father not named on birth certificate

534

Maternal education less than high school

670

No prenatal care

7

Maternal smoking during pregnancy

147

Maternal alcohol use during pregnancy

26

Interpregnancy interval less than 6 months

134

Abuse & neglect to persons under age 18 years

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

Prenatal care first trimester

1616

Primary C-section delivery

280

Vaginal birth after previous C-section

5

WIC during pregnancy

1051

Medicaid during pregnancy

1011

WIC and Medicaid during pregnancy

764

Perinatal case management

.

Child fatality investigations

2

Metropolitan Statistical Area 1 - Albany

1991
113463 27961 2971
20.0 19.1 22.0
338 103 1937 281 978 186
32 391
50
26 18
8 51
6 15
200 35 6
202 23 21
679 531 670
8 75
9 130
25 13 120
1563 296
13 1052 1019 795 121
10

Total
1992 1993

114362 28076 2980

115258 28189 2990

19.9 19.3 22.0

20.7 19.3 23.0

352 108 2025 300 1012 118
16 358
49

306 96
1894 239 983 162
27 380
47

21

29

12

19

9

10

28

46

2

5

11

13

214

183

45

50

5

4

216

201

26

21

12

27

674

539

527

521

714

642

15

18

135

221

22

49

142

130

64

42

25

49

264

193

1752 243 12
1162 1186
944 532
2

1509 261
11 1077 1186 891 688
8

1994 5-year

116151 28301 2999

571795 140374
14901

19.9 20.1 23.0

20.2 19.3 22.0

326 84
1846 272 941 162 20 409 41

1656 478
9776 1372 4898
827 112 1922 240

22

126

15

81

7

45

35

195

8

26

18

62

186

995

48

220

7

29

210

1038

23

124

9

106

592

3205

495

2608

611

3307

19

67

179

757

13

119

106

642

88

219

45

132

404

981

1482 234 14
1079 1143
907 821
10

7922 1314
55 5421 5545 4301 2162
32

1990
60041 13771
1323

1991
59997 13638
1326

White
1992 1993

59949 13504
1329

59898 13370
1333

1994 5-year

59852 13236 1336

299737 67519
6646

22.5 19.3 21.0

22.3 19.5 21.0

21.9 19.3 21.0

23.0 18.6 22.0

23.1 20.5 22.0

22.5 19.5 21.0

88

76

89

74

68

395

11

14

22

12

11

70

879

804

834

783

742

4042

65

56

69

53

49

292

160

158

170

160

133

781

94

89

51

66

76

376

6

10

4

6

5

31

162

152

129

142

140

725

22

18

20

18

14

92

7

2

5

2

2

0

12

12

2

3

1

3

4

7

3

5

1

2

7

10

0

1

5

5

6

26

3

18

3

8

8

49

1

7

3

17

59

63

47

45

42

256

9

11

3

9

10

42

3

1

0

0

1

5

63

73

59

59

58

312

15

10

7

9

9

50

11

4

3

10

2

30

266

241

247

179

205

1138

70

73

78

75

56

352

196

183

222

187

143

931

4

3

5

4

4

20

80

47

90

136

124

477

4

2

6

9

0

21

26

31

25

31

24

137

.

6

15

9

37

67

.

7

15

19

17

58

.

7

25

33

66

131

778

718

780

706

678

3660

152

145

105

109

103

614

2

5

5

5

6

23

284

284

342

321

297

1528

219

213

294

292

268

1286

176

174

249

226

226

1051

.

42

129

155

203

529

0

1

0

0

3

4

1990
51522 13806
1607

1991
51754 13799
1600

Black
1992 1993

51988 13793
1593

52218 13786
1586

1994 5-year

52449 13779
1579

259930 68963
7965

19.1 19.0 24.0

18.9 18.6 24.0

18.7 19.4 24.0

19.6 20.1 24.0

18.4 20.0 25.0

18.9 19.2 24.0

245 76
1184 215 823 104 11 218 30

260 89
1126 224 819
96 21 232 31

262 85
1178 230 840 65 12 225 29

231 84
1104 186 822
96 21 236 28

257 73
1090 222 805 84 15 261 27

1255 407
5682 1077 4109
445 80
1172 145

21

24

17

22

16

100

12

16

9

14

12

63

9

8

8

8

4

37

23

38

21

36

27

145

3

3

2

4

7

19

4

12

6

8

15

45

152

136

167

138

144

737

33

24

42

41

38

178

4

5

5

4

6

24

146

128

156

141

151

722

16

13

19

12

13

73

26

17

9

17

7

76

452

434

422

359

381

2048

463

458

448

446

438

2253

472

485

489

454

466

2366

3

5

10

14

15

47

67

28

45

84

54

278

22

7

16

40

13

98

108

98

117

99

81

503

.

14

30

26

41

111

.

1

8

22

20

51

.

63

138

98

249

548

829

838

961

796

794

4218

126

150

135

150

130

691

3

8

7

6

8

32

765

765

818

754

774

3876

792

806

890

891

870

4249

588

621

694

663

677

3243

.

79

403

532

615

1629

2

9

2

8

7

28

148

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates
1990

Perinatal outcome rates

Crude birth rate

18.4

General fertility rate

74.5

Total fertility rate

2.2

% Livebirths to unmarried women

48.3

Crude abortion rate

3.4

General abortion rate

13.8

Total abortion rate

0.4

Abortion ratio

142.3

Fetal Death rate

8.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

112.8

% Repeat conceptions to women under 18

26.0

Livebirths to women under 18

94.5

% Livebirths to unmarried women under 18

91.0

Induced abortions to women under 18

17.9

% Abortions to unmarried women under 18

100.0

Fetal deaths to women under 18

4.7

Infant and child survival rates

Infant mortality

13.5

Neonatal mortality

8.2

Postneonatal mortality

5.3

Perinatal mortality ratio

16.7

Deaths of children 1-4 yrs

0.7

Deaths of children 5-17 yrs

0.2

Infant health rates

% Low birthweight

10.2

% Very low birthweight

2.0

% Under 500 grams

0.3

% Preterm gestation

10.3

% Multiple gestation

1.5

% Birth defect

1.8

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

39.0

% with father not named on birth certificate

26.2

% with maternal education less than high school

32.9

% No prenatal care

0.4

% Maternal smoking during pregnancy

7.2

% Maternal alcohol use during pregnancy

1.3

% Interpregnancy interval less than 6 months

10.9

Child abuse and neglect rates

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

% Prenatal care first trimester

80.2

% Primary C-section delivery

15.0

% Vaginal birth after previous C-section

2.8

% WIC during pregnancy

51.5

% Medicaid during pregnancy

49.6

% Medicaid and WIC during pregnancy

37.5

% Perinatal case management

.

Metropolitan Statistical Area 1 - Albany

1991
17.1 69.3
2.1 51.1
3.4 14.0
0.4 151.3
9.2
113.8 30.5 94.6 90.7 16.8 88.0 6.1
13.4 9.3 4.2
25.9 0.8 0.6
10.3 1.8 0.3
10.6 1.2 1.1
39.4 27.7 35.0
0.4 3.9 0.5 11.2
0.7 0.4 3.5
83.1 17.4
6.2 55.0 53.2 41.5
6.3

Total
1992 1993

17.7 72.1 2.2 50.7 3.1 12.8 0.4 137.4
7.9

16.4 67.2
2.0 52.5
3.3 13.5
0.4 151.5
8.3

118.1 30.7
100.7 88.9 16.4 91.7 4.4

102.4 31.4 79.9 90.8 15.7 95.7 7.0

10.4 5.9 4.5
13.7 *
0.4

15.3 10.0
5.3 23.9
0.6 0.5

10.6 2.2 0.2
10.8 1.3 0.6

9.7 2.6
* 10.7
1.1 1.4

37.6 26.4 35.8
0.8 6.8 1.1 11.6

34.7 27.8 34.3
1.0 11.8
2.6 11.5

1.8

1.2

0.7

1.4

7.5

5.5

88.4 13.8 5.2 58.2 59.4 47.2 26.6

81.3 15.5
5.9 57.5 63.3 47.6 36.7

1994 5-year

15.9 65.2 2.0 51.6 3.5 14.5 0.4 166.9
6.9

17.1 69.6
2.1 50.8
3.4 13.7
0.4 149.6
8.2

108.7 25.8 90.7 90.4 13.7 95.0 5.0

111.1 28.9 92.1 90.3 16.1 94.1
5.4

11.9 8.1 3.8
18.8 1.0 0.7

12.9 8.3 4.6
19.7 0.7 0.5

10.1

10.2

2.6

2.3

0.4

0.3

11.5

10.8

1.3

1.3

0.5

1.1

35.8 27.2 33.6
1.0 9.9 0.7 10.0

37.4 27.0 34.3
0.7 7.9 1.2 11.1

2.5

1.6

1.3

0.9

11.4

7.0

80.8 14.3 7.5 59.2 62.7 49.8 45.1

82.8 15.2
5.5 56.2 57.5 44.6 28.4

White
1990 1991 1992 1993 1994 5-year

14.6 63.8
2.0 18.5
2.7 11.8
0.4 140.9
7.9

13.4 59.0
1.9 19.9
2.5 11.1
0.4 142.2
8.3

13.9 61.8 2.0 20.6 2.2 9.6 0.3 123.1
6.3

13.1 58.6
1.9 20.7
2.4 10.6
0.3 139.9
6.7

12.4 56.1 1.8 18.1 2.3 10.6 0.3 144.8
6.4

13.5 59.9
1.9 19.6
2.4 10.7
0.3 138.1
7.1

66.5 12.5 49.1 67.7 16.6 100.0
*

57.3 18.4 42.2 66.1 13.6 72.2
*

67.0 24.7 51.9 55.1 15.0 78.9
*

55.5 16.2 39.8 63.5 13.5 88.9
*

50.9 16.2 36.7 56.3 10.5 92.9 4.5

59.4 17.7 43.9 61.7 13.8 86.8
2.7

8.0 5.7
* 13.6
* *

* * * 14.7 * *

*

8.9

8.1

6.4

*

6.4

*

4.5

*

*

*

2.0

8.4

12.7

10.7

12.0

*

*

*

0.4

0.4

0.4

*

0.3

6.7

7.8

5.6

5.7

5.7

6.3

1.0

1.4

*

1.1

1.3

1.0

*

*

*

*

*

0.1

7.3

9.2

7.1

7.6

7.9

7.8

1.7

1.3

0.8

1.2

1.2

1.3

1.3

*

*

1.3

*

0.7

32.1 8.1
22.7 *
9.3 *
5.4

31.8 9.2
23.0 *
6.0 *
7.0

31.2 9.4 26.9 0.6 11.0 0.7 5.4

25.9 9.7
24.2 *
17.7 1.2 7.0

29.6 7.6
19.6 *
17.1 *
5.8

30.2 8.8
23.4 0.5
12.0 0.5 6.1

.

0.4

1.0

0.6

2.4

1.1

.

0.5

1.0

1.3

1.1

1.0

.

0.5

1.6

2.2

4.4

2.2

89.4 19.2
* 32.9 25.3 20.4
.

90.5 20.6
5.4 35.7 26.8 21.9
5.3

94.2 14.4 5.1 41.4 35.6 30.1 15.6

91.0 15.8
5.9 41.5 37.8 29.2 20.1

91.7 15.5 8.6 40.5 36.6 30.8 27.7

91.4 17.2
5.5 38.3 32.2 26.3 16.9

Black
1990 1991 1992 1993 1994 5-year

23.0 85.8
2.4 70.7
4.2 15.8
0.4 142.3
9.4

21.8 81.6
2.2 73.7
4.5 16.8
0.5 154.8
10.2

22.7 85.4 2.3 72.5 4.3 16.3 0.4 146.3
9.8

21.1 80.1
2.2 75.3
4.5 17.1
0.5 159.0
10.4

20.8 79.1 2.2 74.8 5.0 18.9 0.5 178.8 7.9

21.9 82.4
2.3 73.3
4.5 17.0
0.5 156.0
9.6

152.5 31.0 133.8 98.1 18.7 100.0
6.8

162.5 34.2
140.0 96.9 19.4 96.8 8.8

164.5 32.4
144.4 99.1 18.2
100.0 7.5

145.6 36.4
117.3 98.4 17.7
100.0 10.7

162.8 28.4
140.6 97.7 17.1 96.2 5.7

157.6 32.4
135.2 98.0 18.2 98.6 7.9

17.7 10.1
7.7 19.2
* *

21.3 14.2
7.2 33.1
* 0.9

14.4 7.6 6.8 17.6
* 0.4

19.9 12.7
7.3 32.0
* 0.6

14.7 11.0
* 24.4 1.6 1.1

17.6 11.1
6.6 25.2
0.9 0.7

12.8 2.8 *
12.5 1.4 2.2

12.1 2.1 0.4
11.5 1.2 1.5

14.2 3.6 0.4 13.5 1.6 0.8

12.5 3.7 *
12.9 1.1 1.5

13.2 3.5 0.6 14.0 1.2 0.6

13.0 3.1 0.4
12.9 1.3 1.3

44.8 39.8 40.6
* 5.8 1.9 14.6

45.3 41.2 43.7
0.5 2.5 0.6 13.8

42.7 38.7 42.2 0.9 3.9 1.4 15.5

41.9 40.8 41.5
1.3 7.7 3.7 14.3

40.1 40.7 43.3 1.4 5.0 1.2 12.5

43.0 40.2 42.3
0.9 5.0 1.8 14.2

.

0.7

1.6

1.4

2.1

1.5

.

*

0.4

1.1

1.0

0.7

.

3.3

7.2

5.1

13.0

7.2

73.0 11.8
* 65.7 68.0 50.5
.

77.5 15.1
6.9 68.8 72.5 55.8
7.1

84.2 13.1 5.3 70.6 76.8 59.9 34.8

74.3 15.1
5.9 69.0 81.5 60.7 48.7

73.5

76.5

13.6

13.7

6.8

5.6

71.9

69.2

80.9

75.8

62.9

57.9

57.2

36.7

149

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
1990

Population

126262

Women age 15-44

36937

Women age 15-17

2162

Woman's median age at:

Conception of first birth

23.0

Conception of first abortion

21.0

First marriage

23.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

219

Repeat conceptions to women under 18

70

Total Livebirths

1865

Livebirths to women under 18

151

Livebirths to unmarried women

562

Early fetal deaths

116

Fetal deaths 20 weeks or more gestation

13

Total induced abortions

872

Induced abortions to women under 18

55

Infant and child survival

Infant deaths

27

Neonatal deaths

16

Postneonatal deaths

11

Perinatal deaths

29

Deaths of children 1-4 years

4

Deaths of children 5-17 years

6

Infant health

Low birthweight

146

Very low birthweight

32

Under 500 grams

2

Preterm gestation

175

Multiple gestation

20

Born with birth defect

38

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

423

Father not named on birth certificate

210

Maternal education less than high school

445

No prenatal care

42

Maternal smoking during pregnancy

237

Maternal alcohol use during pregnancy

56

Interpregnancy interval less than 6 months

97

Abuse & neglect to persons under age 18 years

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

Prenatal care first trimester

1310

Primary C-section delivery

262

Vaginal birth after previous C-section

30

WIC during pregnancy

703

Medicaid during pregnancy

604

WIC and Medicaid during pregnancy

475

Perinatal case management

.

Child fatality investigations

1

Metropolitan Statistical Area 2 - Athens

1991
128677 37452 2171
22.7 21.0 23.0
193 57
1724 146 603 119
21 815
37
15 11
4 32
2 9
140 27 3
137 20 29
453 240 385
31 208
53 82
34 16 224
1270 230
31 792 695 593
50 2

Total
1992 1993

131069 37957 2180

133481 38466 2190

23.7 20.8 23.0

22.3 21.3 23.0

220 61
1780 163 629 111 20 777 52

208 56
1804 159 643 107
20 798
37

24

14

12

10

12

4

32

30

2

1

7

12

146

140

27

25

2

0

154

150

15

31

125

113

462

498

223

245

456

399

26

21

189

134

59

43

88

78

102

101

66

84

447

381

1363 215 31 794 787 625 270 0

1440 198
47 806 895 704 357
0

1994 5-year

135867 38974 2200

655356 189786
10903

22.9 21.3 23.0

22.9 21.1 23.0

215 56
1712 160 607 140 20 687 44

1055 300
8885 779
3044 593 94
3949 225

20

100

16

65

4

35

34

157

5

14

10

44

121

693

22

133

6

13

128

744

22

108

35

340

489

2325

239

1157

386

2071

16

136

176

944

39

250

63

408

88

325

82

248

520

1572

1451 186 35 846 816 686 474 0

6834 1091
174 3941 3797 3083 1151
3

1990
97134 28547
1469

White
1991 1992 1993 1994 5-year

99004 28945
1477

100862 29337
1484

102728 29733 1493

104582 30125 1500

504310 146687
7423

24.0 21.1 22.0

24.0 21.2 23.0

24.3 21.0 23.0

23.6 21.3 23.0

24.3 21.6 23.0

24.0 21.2 23.0

111 30
1236 70 156 67 7 601 32

88 20 1106 65 165 78 10 553 19

95 17 1142 73 193 70
8 493
20

75 16 1145 54 190 70 12 539 18

83 19 1144 62 225 76 10 482 17

452 102 5773 324 929 361
47 2668
106

18

7

9

6

11

51

10

4

3

5

10

32

8

3

6

1

1

19

16

14

11

17

19

77

3

1

1

0

3

8

5

4

4

5

6

24

69

59

64

49

60

301

14

5

9

9

13

50

1

1

0

0

4

6

101

67

68

70

74

380

13

10

10

20

11

64

27

13

69

62

23

194

243

233

239

274

293

1282

66

81

77

72

87

383

243

198

231

178

206

1056

9

6

7

6

9

37

181

145

134

93

129

682

31

21

26

22

18

118

46

24

32

27

25

154

.

11

39

44

27

121

.

4

41

46

37

128

.

64

130

112

135

441

978

936

965

998

1010

4887

182

163

162

139

126

772

23

17

24

23

22

109

313

344

346

344

431

1778

268

298

361

399

425

1751

206

253

273

292

341

1365

.

34

154

181

245

614

0

2

0

0

0

2

1990
26099 7352 663

1991
26568 7556 662

Black
1992 1993

27035 7759 662

27504 7963 661

1994 5-year

27969 8167 661

135175 38797
3309

19.7 20.4 25.0

19.5 19.8 26.0

20.5 19.1 25.0

19.1 20.1 26.0

18.9 19.5 25.5

19.6 19.8 25.0

106

104

123

133

131

597

40

37

44

40

37

198

565

575

582

615

500

2837

81

80

90

105

98

454

404

435

430

450

380

2099

44

36

31

28

57

196

6

9

12

8

10

45

226

216

228

215

176

1061

22

18

30

19

26

115

9

8

14

8

9

48

6

7

9

5

6

33

3

1

5

3

3

15

13

16

21

13

15

78

1

1

1

1

2

6

1

5

3

7

4

20

77

81

77

88

56

379

18

22

17

16

9

82

1

2

2

0

2

7

73

68

81

77

49

348

7

10

5

11

9

42

10

15

51

47

12

135

169

209

211

208

181

978

143

159

143

171

150

766

200

186

223

217

174

1000

33

25

19

15

7

99

54

63

54

41

45

257

24

32

33

21

20

130

50

55

56

50

38

249

.

22

53

53

47

175

.

12

23

34

37

106

.

155

291

253

360

1059

283

299

353

408

378

1721

74

61

46

52

54

287

7

12

7

22

10

58

360

429

429

441

382

2041

321

390

405

475

370

1961

256

334

341

398

328

1657

.

15

113

176

220

524

1

0

0

0

0

1

150

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates
1990

Perinatal outcome rates

Crude birth rate

14.8

General fertility rate

50.5

Total fertility rate

1.4

% Livebirths to unmarried women

30.5

Crude abortion rate

6.9

General abortion rate

23.6

Total abortion rate

0.6

Abortion ratio

303.5

Fetal Death rate

3.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

101.3

% Repeat conceptions to women under 18

32.0

Livebirths to women under 18

69.8

% Livebirths to unmarried women under 18

74.0

Induced abortions to women under 18

25.4

% Abortions to unmarried women under 18

92.3

Fetal deaths to women under 18

8.8

Infant and child survival rates

Infant mortality

14.5

Neonatal mortality

8.6

Postneonatal mortality

5.9

Perinatal mortality ratio

15.4

Deaths of children 1-4 yrs

*

Deaths of children 5-17 yrs

0.3

Infant health rates

% Low birthweight

7.8

% Very low birthweight

1.7

% Under 500 grams

*

% Preterm gestation

9.5

% Multiple gestation

1.1

% Birth defect

2.0

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

33.7

% with father not named on birth certificate

11.4

% with maternal education less than high school

24.5

% No prenatal care

2.3

% Maternal smoking during pregnancy

13.1

% Maternal alcohol use during pregnancy

3.1

% Interpregnancy interval less than 6 months

10.1

Child abuse and neglect rates

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

% Prenatal care first trimester

71.3

% Primary C-section delivery

15.7

% Vaginal birth after previous C-section

17.2

% WIC during pregnancy

38.1

% Medicaid during pregnancy

32.8

% Medicaid and WIC during pregnancy

25.8

% Perinatal case management

.

Metropolitan Statistical Area 2 - Athens

1991
13.4 46.0
1.3 35.4
6.3 21.8
0.6 303.8
3.8
88.9 29.5 67.2 71.2 17.0 100.0
5.5
8.7 6.4
* 18.3
* 0.4
8.1 1.6
* 8.1 1.2 1.7
38.2 14.1 23.3
1.9 13.2
3.4 8.9
1.2 0.6 7.8
75.2 15.1 17.6 46.5 40.8 34.8
2.9

Total
1992 1993

13.6 46.9 1.3 35.7 5.9 20.5 0.5 288.1 3.7

13.5 46.9
1.3 36.2
6.0 20.7
0.5 291.7
3.5

100.9 27.7 74.8 78.3 23.8
100.0 2.8

95.0 26.9 72.6 86.8 16.9 97.3
5.5

13.5 6.7 6.8
17.8 *
0.3

7.8 5.5
* 16.4
* 0.6

8.2

7.8

1.5

1.4

*

*

8.7

8.5

0.8

1.7

7.1

6.3

36.0 12.6 26.1
1.5 13.8
4.3 8.8

36.9 13.8 22.9
1.2 9.7 3.1 7.8

3.5 2.3 15.4

3.4 2.9 13.0

77.4 13.4 19.6 45.0 44.6 35.4 15.3

80.5 12.6 23.6 45.4 50.5 39.7 20.1

1994 5-year

12.6 43.9 1.3 35.9 5.1 17.6 0.5 268.1 4.2

13.6 46.8
1.3 34.7
6.0 20.8
0.5 291.4
3.8

97.7 26.0 72.7 82.9 20.0 97.7
8.2

96.8 28.4 71.4 78.8 20.6 97.3
6.1

11.7 9.3 *
19.6 0.7 0.5

11.3 7.3 4.0
17.5 0.4 0.4

7.1

7.8

1.3

1.5

0.4

0.1

7.6

8.5

1.3

1.2

2.1

3.8

29.8 14.2 23.2
1.0 10.6 2.3
7.1

34.6 13.2 24.0
1.6 12.1
3.2 8.6

3.0 2.8 17.5

2.8 2.1 13.5

86.4 12.4 18.6 50.1 48.3 40.6 28.1

78.1 13.8 19.4 44.9 43.3 35.1 16.6

White
1990 1991 1992 1993 1994 5-year

12.7 43.3
1.3 12.8
6.2 21.1
0.5 313.8
2.7

11.2 38.2
1.1 15.1
5.6 19.1
0.5 316.2
3.1

11.3 38.9 1.2 17.1 4.9 16.8 0.4 286.5 2.9

11.1 38.5
1.1 16.9
5.2 18.1
0.5 304.5
2.9

10.9 38.0 1.1 19.9 4.6 16.0 0.4 281.5 2.9

11.4 39.4
1.2 16.3
5.3 18.2
0.5 300.9
2.9

75.6 27.0 47.7 46.4 21.8 90.3
7.5

59.6 22.7 44.0 43.1 12.9 100.0
*

64.0 17.9 49.2 53.5 13.5 100.0
*

50.2 21.3 36.2 63.0 12.1 94.4
*

55.3 22.9 41.3 58.1 11.3 94.1
4.0

60.9 22.6 43.6 52.3 14.3 95.2
3.6

14.6 8.1 6.5
12.9 *
0.4

6.3 * *
12.5 * *

7.9

5.2

9.6

8.8

*

4.4

8.7

5.5

5.3

*

*

3.3

9.6

14.7

16.5

13.2

*

*

*

0.3

*

0.4

*

0.3

5.6

5.3

5.6

4.3

5.2

5.2

1.1

0.5

0.8

0.8

1.1

0.9

*

*

*

*

*

0.1

8.3

6.1

6.0

6.2

6.5

6.7

1.1

0.9

0.9

1.8

1.0

1.1

2.2

1.2

6.1

5.4

2.0

3.4

27.8 5.4
20.1 0.7
15.0 2.6 7.5

29.8 7.4
18.5 0.6
14.2 2.1 4.4

28.2 6.8 20.6 0.6 14.8 2.9 5.2

30.9 6.4
16.0 0.5
10.3 2.4 4.5

26.7 7.7
18.4 0.8 11.6 1.6 4.2

28.6 6.7
18.8 0.7
13.3 2.3 5.2

.

0.6

2.0

2.2

1.4

1.5

.

*

2.1

2.3

1.9

1.6

.

3.3

6.7

5.7

6.8

5.6

80.2 16.5 19.3 25.6 21.9 16.9
.

86.0 16.6 15.3 31.4 27.2 23.1
3.1

85.0 16.0 20.2 30.6 31.9 24.1 13.6

87.7 14.1 16.4 30.5 35.4 25.9 16.1

90.2 12.5 17.7 38.1 37.5 30.1 21.6

85.7 15.2 17.8 31.1 30.7 23.9 13.7

Black
1990 1991 1992 1993 1994 5-year

21.6 76.8
2.1 72.4
8.7 30.7
0.8 268.1
7.1

21.6 76.1
2.1 77.0
8.1 28.6
0.8 258.1
6.1

21.5 75.0 2.1 74.5 8.4 29.4 0.8 267.0 5.7

22.4 77.2
2.2 74.6
7.8 27.0
0.8 247.4
4.9

17.9 61.2 1.8 77.4 6.3 21.6 0.6 235.9 8.6

21.0 73.1
2.1 75.1
7.8 27.3
0.8 255.7
6.5

159.9 37.7 122.2 97.5 33.2 95.2 10.6

157.0 35.6
120.8 95.0 27.2
100.0 12.1

185.9 35.8
136.0 97.8 45.3
100.0 *

201.1 30.1
158.8 99.0 28.7
100.0 13.6

198.3 28.2
148.4 99.0 39.4
100.0 18.2

180.4 33.2
137.2 97.8 34.8 99.1 11.8

15.9 10.6
* 22.8
* *

13.9 12.2
* 27.4
* 0.8

24.1 15.5 8.7 35.4
* *

13.0 8.1 *
20.9 *
1.1

18.0 12.0
* 29.4
* *

16.9 11.6
5.3 27.1
0.6 0.6

13.6

14.1

13.3

14.3

11.2

13.4

3.2

3.8

2.9

2.6

1.8

2.9

*

*

*

*

*

0.2

13.1

12.1

14.1

12.8

10.0

12.5

1.3

1.8

0.9

1.8

1.8

1.5

1.8

2.6

8.8

7.6

2.4

4.8

49.9 25.6 36.7
6.0 9.9 4.4 15.6

55.4 28.1 34.6
4.5 12.4
6.4 15.1

53.4 24.8 39.2 3.3 12.9 7.9 15.6

48.7 28.4 36.6
2.5 9.4 4.8 13.7

37.7 30.5 35.9 1.4 9.2 4.1 14.3

48.5 27.4 36.6
3.6 10.7
5.4 14.9

.

2.5

6.0

5.9

5.2

4.9

.

1.4

2.6

3.8

4.1

3.0

.

17.7

32.9

28.3

39.9

29.8

51.0 14.7 13.0 64.5 57.5 45.9
.

53.6 12.1 20.3 75.9 69.0 59.1
2.7

61.8 8.5 19.4 74.4 70.2 59.1 19.6

67.2 9.5
40.0 73.1 78.8 66.0 29.2

76.8

61.8

12.4

11.3

17.5

22.2

77.8

73.0

75.4

70.2

66.8

59.3

44.8

23.4

151

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events

Total
1990 1991 1992 1993 1994 5-year

Population

2959950 3039321 3118544 3197946 3277164 15592925

Women age 15-44

790743 800344 809923 819528 829107 4049645

Women age 15-17

59470 60532 61587 62649 63706 307944

Woman's median age at:

Conception of first birth

24.1

24.0

24.3

24.4

24.6

24.3

Conception of first abortion

20.9

21.1

21.2

21.5

21.6

21.3

First marriage

23.0

24.0

24.0

24.0

24.0

24.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

5984

5840

5822

5831

5792 29269

Repeat conceptions to women under 18

1557

1539

1595

1443

1410

7544

Total Livebirths

52510 51957 52205 53337 54130 264139

Livebirths to women under 18

3775

3831

3784

3826

3891 19107

Livebirths to unmarried women

15329 15902 16291 16816 16694 81032

Early fetal deaths

4129

4488

4464

4069

3962 21112

Fetal deaths 20 weeks or more gestation

527

606

558

507

530

2728

Total induced abortions

24539 24276 24089 23820 22775 119499

Induced abortions to women under 18

2015

1808

1842

1833

1727

9225

Infant and child survival

Infant deaths

606

524

451

485

460

2526

Neonatal deaths

422

340

299

323

283

1667

Postneonatal deaths

184

184

152

162

177

859

Perinatal deaths

939

942

853

826

810

4370

Deaths of children 1-4 years

97

99

76

89

95

456

Deaths of children 5-17 years

193

204

193

194

163

947

Infant health

Low birthweight

4296

4284

4231

4465

4326 21602

Very low birthweight

869

873

861

964

854

4421

Under 500 grams

95

101

85

101

99

481

Preterm gestation

5079

5005

5029

5129

5007 25249

Multiple gestation

630

644

668

714

715

3371

Born with birth defect

766

827

773

734

532

3632

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

9834

9135

9846 11057 13260 53132

Father not named on birth certificate

8462

8703

8865

8770

8674 43474

Maternal education less than high school

9796 10006

9939

9873

9608 49222

No prenatal care

1672 1519 1258

920

631

6000

Maternal smoking during pregnancy

7063

6372

5696

5417

5378 29926

Maternal alcohol use during pregnancy

1576 1239 1047

889

1030

5781

Interpregnancy interval less than 6 months

2188 2199 2263 2049 1965 10664

Abuse & neglect to persons under age 18 years

Physical

.

641

1852

1787

1656

5936

Sexual

.

457

1235

1129

903

3724

Neglect

.

2444

7331

6926

6445 23146

Interventions to improve infant & child survival

Prenatal care first trimester

37615 38209 39603 42700 45381 203508

Primary C-section delivery

7032

6940

6762

6711

6627 34072

Vaginal birth after previous C-section

1365

1281

1296

1403

1524

6869

WIC during pregnancy

16822 20294 19419 21440 20851 98826

Medicaid during pregnancy

13332 16429 18344 22100 20759 90964

WIC and Medicaid during pregnancy

10037 13584 14129 16998 16293 71041

Perinatal case management

.

1645

4156

6190

7810 19801

Child fatality investigations

113

218

158

220

221

930

Metropolitan Statistical Area 3 - Atlanta

White
1990 1991 1992 1993 1994 5-year
2134425 2185638 2236760 2287993 2339115 11183931 548243 553075 557891 562724 567540 2789473 40100 40721 41340 41961 42580 206703

25.1 21.1 23.0

25.2 21.3 23.0

25.5 21.5 23.0

25.5 21.9 23.0

25.8 22.1 23.0

25.4 21.5 23.0

2638 512
33565 1571 4351 2541 220
11986 996

2482 444 32799 1572 4599 2712 243 11256 843

2409 444
32742 1566 4749 2699 231
10485 778

2386 458 33218 1554 5062 2520 184 10193 768

2420 421
34224 1591 5268 2437 223 9449 750

12335 2279
166548 7854
24029 12909
1101 53369
4135

275

211

170

201

186

1043

195

139

112

125

111

682

80

72

58

76

75

361

410

385

343

305

338

1781

58

52

46

40

43

239

110

129

99

107

94

539

1915 330 35
2455 386 486

1903 340
34 2391 378 515

1803 282 20
2360 397 496

1945 367
17 2445 418 497

2011 316 29
2508 460 380

9577 1635
135 12159
2039 2374

6066 2101 5615
589 5287
879 956

5469 2232 5667 493 4740 646 958

5895 2290 5574
417 4304
518 926

6457 2278 5395 274 4114 430 828

7357 2389 5330
229 4054
584 885

31244 11290 27581
2002 22499
3057 4553

.

286

683

776

736

2481

.

277

712

711

582

2282

.

940

2335

2562

2528

8365

26529 4510 835 6668 5296 3820 . 51

26394 4478 787 8372 6789 5469 865 80

26956 4251 759 8039 7662 5803 2102 62

28343 4097 883 8995 9606 6965 2627 95

30088 4023 1041 8961 9274 7020 3185 92

138310 21359 4305 41035 38627 29077 8779 380

Black
1990 1991 1992 1993 1994 5-year

747219 220748
17590

759706 221184
17719

772171 221616
17848

784662 222053
17977

797128 3860885 222485 1108085
18105 89240

20.9 20.5 25.0

20.7 20.7 26.0

20.9 20.8 26.0

21.1 20.6 26.0

21.2 20.8 26.0

21.0 20.6 26.0

3282 1029 17827 2182 10867 1376
300 11405
981

3266 1078 17876 2217 11184 1562 348 11744 922

3318 1132 18088 2186 11393 1578
308 12372
1011

3344 968 18572 2230 11546 1344 306 12401 1015

3277 972
18178 2240
11191 1293 285
12288 948

16487 5179
90541 11055 56181
7153 1547 60210 4877

320

306

269

280

264

1439

219

198

176

194

164

951

101

108

93

86

100

488

513

540

484

500

445

2482

37

47

29

48

50

211

79

73

87

83

66

388

2295 521 59
2531 233 270

2285 525
67 2529 253 296

2335 563 65
2574 260 261

2413 577
83 2574 283 220

2200 521 68
2375 244 141

11528 2707 342
12583 1273 1188

3544 6308 3982 1063 1754
688 1192

3417 6397 4098 1006 1609 590 1194

3665 6473 4112
825 1361
520 1283

4234 6344 4177 628 1264 453 1172

5411 6128 4005
380 1301
441 1027

20271 31650 20374
3902 7289 2692 5868

.

277

850

817

799

2743

.

123

324

323

278

1048

.

1301

4107

3799

3510 12717

10337 2384 510 9893 7885 6116 . 60

10918 2312 468
11502 9364 7886 743 132

11617 2350 518
10940 10323
8052 1963
88

13179 2458 492
11832 11897
9578 3382 119

13890 2432 445
11256 10868 8821
4392 119

59941 11936
2433 55423 50337 40453 10480
518
152

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates
1990

Perinatal outcome rates

Crude birth rate

17.7

General fertility rate

66.4

Total fertility rate

2.0

% Livebirths to unmarried women

29.6

Crude abortion rate

8.3

General abortion rate

31.0

Total abortion rate

1.0

Abortion ratio

299.2

Fetal Death rate

6.3

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

100.6

% Repeat conceptions to women under 18

26.0

Livebirths to women under 18

63.5

% Livebirths to unmarried women under 18

79.4

Induced abortions to women under 18

33.9

% Abortions to unmarried women under 18

98.2

Fetal deaths to women under 18

4.7

Infant and child survival rates

Infant mortality

11.5

Neonatal mortality

8.0

Postneonatal mortality

3.5

Perinatal mortality ratio

17.7

Deaths of children 1-4 yrs

0.5

Deaths of children 5-17 yrs

0.4

Infant health rates

% Low birthweight

8.2

% Very low birthweight

1.7

% Under 500 grams

0.2

% Preterm gestation

9.8

% Multiple gestation

1.2

% Birth defect

1.5

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

27.3

% with father not named on birth certificate

16.3

% with maternal education less than high school

19.1

% No prenatal care

3.3

% Maternal smoking during pregnancy

13.8

% Maternal alcohol use during pregnancy

3.1

% Interpregnancy interval less than 6 months

8.0

Child abuse and neglect rates

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

% Prenatal care first trimester

73.1

% Primary C-section delivery

15.1

% Vaginal birth after previous C-section

25.7

% WIC during pregnancy

32.4

% Medicaid during pregnancy

25.7

% Medicaid and WIC during pregnancy

19.4

% Perinatal case management

.

Metropolitan Statistical Area 3 - Atlanta

1991
17.1 64.9
2.0 31.0
8.0 30.3
0.9 297.4
6.7
96.5 26.4 63.3 80.6 29.9 98.2
4.1
10.1 6.5 3.6
17.9 0.5 0.4
8.2 1.7 0.2 9.8 1.3 1.6
26.6 17.0 19.7
3.0 12.6
2.5 8.1
0.8 0.6 3.1
74.7 15.0 25.2 39.6 32.0 26.5
3.2

Total
1992 1993

16.7 64.5 2.0 31.6
7.7 29.7 0.9 295.6 6.4

16.7 65.1
2.0 32.0
7.4 29.1
0.9 290.9
5.8

94.5 27.4 61.4 81.8 29.9 98.3 4.3

93.1 24.7 61.1 83.2 29.3 97.8
3.5

8.6 5.7 2.9 16.2 0.4 0.3

9.1 6.1 3.1 15.3 0.4 0.3

8.1

8.4

1.6

1.8

0.2

0.2

9.8

9.8

1.3

1.4

1.5

1.4

27.3 17.2 19.5
2.5 11.3
2.1 7.9

27.3 16.7 19.0
1.8 10.5
1.7 7.1

2.3

2.1

1.5

1.4

9.0

8.3

76.7 14.5 25.8 37.7 35.6 27.4
8.1

80.8 14.1 28.6 40.8 42.0 32.3 11.8

1994 5-year

16.5 65.3 2.0 31.3
6.9 27.5 0.9 279.1 5.7

16.9 65.2
2.0 31.1
7.7 29.5
0.9 292.4
6.2

90.9 24.3 61.1 83.0 27.1 98.5 3.7

95.0 25.8 62.0 81.6 30.0 98.2
4.1

8.5 5.2 3.3 14.8 0.5 0.3

9.6 6.3 3.3 16.4 0.5 0.3

8.0

8.2

1.6

1.7

0.2

0.2

9.4

9.7

1.3

1.3

1.0

1.4

27.3 16.2 18.2
1.2 10.2
2.0 6.9

27.2 16.7 19.1
2.3 11.6
2.3 7.6

1.9

1.8

1.1

1.1

7.5

7.0

84.8 13.7 30.4 39.0 38.9 30.5 14.6

78.1 14.5 27.1 37.9 34.9 27.2
9.5

White
1990 1991 1992 1993 1994 5-year

15.7 61.2
1.8 13.1
5.6 21.9
0.7 247.2
5.4

15.0 59.3
1.8 14.2
5.1 20.4
0.6 238.5
5.7

14.6 58.7 1.8 14.7
4.7 18.8 0.6 226.6 5.5

14.5 59.0
1.8 15.4
4.5 18.1
0.6 220.6
5.0

14.6 60.3 1.9 15.6
4.0 16.6 0.5 203.4 4.9

14.9 59.7
1.8 14.6
4.8 19.1
0.6 227.5
5.3

65.8 19.4 39.2 54.6 24.8 97.3
2.8

61.0 17.9 38.6 57.0 20.7 97.0
2.4

58.3 18.4 37.9 59.7 18.8 97.1 2.2

56.9 19.2 37.0 62.8 18.3 96.2
1.9

56.8 17.4 37.4 61.9 17.6 97.8 2.4

59.7 18.5 38.0 59.2 20.0 97.1
2.4

8.2

6.4

5.2

6.1

5.4

6.3

5.8

4.2

3.4

3.8

3.2

4.1

2.4

2.2

1.8

2.3

2.2

2.2

12.1

11.7

10.4

9.1

9.8

10.6

0.5

0.4

0.4

0.3

0.3

0.4

0.3

0.3

0.3

0.3

0.2

0.3

5.7

5.8

5.5

5.9

5.9

5.8

1.0

1.0

0.9

1.1

0.9

1.0

0.1

0.1

0.1

0.1

0.1

0.1

7.4

7.4

7.3

7.5

7.4

7.4

1.2

1.2

1.2

1.3

1.4

1.2

1.5

1.6

1.5

1.5

1.1

1.4

24.4 6.3
17.1 1.8
16.1 2.7 5.6

23.4 6.9
17.7 1.5
14.8 2.0 5.7

24.6 7.1 17.4 1.3 13.5 1.6 5.4

24.4 6.9
16.6 0.8
12.7 1.3 4.8

23.9 7.1
16.0 0.7 12.2 1.8 5.0

24.2 6.9
17.0 1.2
13.8 1.9 5.3

.

0.5

1.3

1.4

1.3

1.1

.

0.5

1.3

1.3

1.0

1.0

.

1.8

4.3

4.7

4.5

3.8

80.2 15.2 23.5 20.1 16.0 11.5
.

81.6 15.4 23.7 25.8 20.9 16.9
2.7

83.1 14.6 23.8 24.9 23.7 17.9 6.5

86.2 13.8 27.7 27.4 29.3 21.2
8.0

88.7 13.2 31.5 26.6 27.5 20.8
9.4

84.0 14.4 26.0 25.0 23.5 17.7
6.7

Black
1990 1991 1992 1993 1994 5-year

23.9 80.8
2.4 61.8 15.3 51.7
1.5 368.0
8.0

23.5 80.8
2.4 63.5 15.5 53.1
1.6 371.4
9.0

23.4 81.6 2.4 64.0 16.0 55.8 1.6 381.8 8.8

23.7 83.6
2.5 63.1 15.8 55.8
1.7 379.5
7.7

22.8 81.7 2.4 62.4 15.4 55.2 1.6 382.7 7.4

23.5 81.7
2.4 63.0 15.6 54.3
1.6 376.8
8.2

186.6 31.4 124.0 97.6 55.8 99.3
8.8

184.3 33.0
125.1 97.8 52.0 99.5 8.2

185.9 34.1
122.5 98.1 56.6 99.3 8.9

186.0 28.9
124.0 98.0 56.5 99.1 7.4

181.0 29.7
123.7 98.4 52.4 99.0 7.0

184.8 31.4
123.9 98.0 54.7 99.2 8.0

18.0 12.3
5.7 28.3
0.6 0.5

17.1 11.1
6.1 29.6
0.8 0.4

14.9 9.7 5.2 26.3 0.5 0.5

15.1 10.4
4.7 26.5
0.8 0.5

14.5 9.0 5.6 24.1 0.8 0.4

15.9 10.5
5.4 27.0
0.7 0.5

12.9

12.8

12.9

13.0

12.1

12.7

2.9

2.9

3.1

3.1

2.9

3.0

0.3

0.4

0.4

0.4

0.4

0.4

14.5

14.4

14.5

14.1

13.3

14.1

1.3

1.4

1.5

1.5

1.4

1.4

1.5

1.7

1.4

1.2

0.8

1.3

33.6 35.9 22.8
6.2 10.1
4.0 11.9

33.3 36.3 23.5
5.8 9.3 3.4 11.9

32.6 36.3 23.2 4.7 7.9 3.0 12.0

32.8 34.7 23.0
3.4 7.1 2.5 10.9

33.0 34.2 22.5 2.1 7.3 2.5 10.2

33.0 35.5 23.0
4.4 8.3 3.1 11.4

.

1.2

3.5

3.3

3.2

2.8

.

0.5

1.3

1.3

1.1

1.1

.

5.4

16.9

15.3

13.9

12.9

59.7 15.0 30.6 56.3 44.8 34.8
.

62.2 14.5 28.0 65.2 53.1 44.7
4.2

65.0 14.6 29.8 61.4 57.9 45.2 11.0

71.5 14.7 30.5 64.7 65.0 52.4 18.5

77.5

67.3

14.9

14.7

27.8

29.3

62.8

62.1

60.6

56.4

49.2

45.3

24.5

14.6

153

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
1990

Population

255750

Women age 15-44

64114

Women age 15-17

5438

Woman's median age at:

Conception of first birth

21.6

Conception of first abortion

19.5

First marriage

23.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

659

Repeat conceptions to women under 18

155

Total Livebirths

4829

Livebirths to women under 18

460

Livebirths to unmarried women

1727

Early fetal deaths

415

Fetal deaths 20 weeks or more gestation

57

Total induced abortions

1641

Induced abortions to women under 18

174

Infant and child survival

Infant deaths

68

Neonatal deaths

45

Postneonatal deaths

23

Perinatal deaths

103

Deaths of children 1-4 years

7

Deaths of children 5-17 years

25

Infant health

Low birthweight

442

Very low birthweight

96

Under 500 grams

5

Preterm gestation

523

Multiple gestation

62

Born with birth defect

79

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

1778

Father not named on birth certificate

1002

Maternal education less than high school

1132

No prenatal care

91

Maternal smoking during pregnancy

821

Maternal alcohol use during pregnancy

109

Interpregnancy interval less than 6 months

227

Abuse & neglect to persons under age 18 years

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

Prenatal care first trimester

3561

Primary C-section delivery

665

Vaginal birth after previous C-section

70

WIC during pregnancy

1922

Medicaid during pregnancy

1478

WIC and Medicaid during pregnancy

1150

Perinatal case management

.

Child fatality investigations

13

Metropolitan Statistical Area 4 - Augusta

1991
260440 65025 5536
21.7 19.6 23.0
617 158 4840 453 1833 377
56 1526 147
58 39 19 96 12 21
459 91 13
476 66 70
1815 1044 1171
99 762 116 219
20 11 13
3616 634
82 2307 1889 1618
43 7

Total
1992 1993

265125 65939 5633

269813 66853 5731

21.7 19.7 23.0

21.9 19.7 23.0

605 171 4595 433 1846 429
57 1441
143

581 152 4561 446 1846 416
42 1335 117

56

36

38

22

18

14

93

65

6

8

18

15

420

417

76

77

7

11

432

457

52

50

83

67

1490 1104 1086
75 703
93 261

1454 1055 1002
51 650
85 210

56

135

44

69

183

459

3412 616 91
2131 1992 1569
128 0

3527 658
76 2246 2248 1755 463
4

1994 5-year
274498 1325626 67766 329697 5829 28167

21.6 19.3 23.0

21.7 19.5 23.0

580 119 4373 428 1748 389
39 1298
131

3042 755
23198 2220 9000 2026 251 7241 712

46

264

29

173

17

91

66

423

8

41

21

100

419

2157

93

433

7

43

425

2313

66

296

45

344

1359 1001
941 54
491 83
165

7896 5206 5332
370 3427
486 1082

173

384

50

174

544

1199

3477 656 86
2093 2080 1594
383 0

17593 3229 405
10699 9687 7686 1017 24

White
1990 1991 1992 1993 1994 5-year

161397 38825 3031

163789 39134 3074

166177 39443 3116

168568 39752 3158

170958 40061 3200

830889 197215
15578

22.7 19.7 22.0

23.3 20.2 22.0

23.1 19.5 23.0

23.2 20.4 23.0

23.2 19.7 22.0

23.1 19.8 22.0

287 56 2729 194 464 245 15 782 83

220 47
2647 149 510 208
24 700
62

227 49
2515 156 508 231 24 649 63

218 40
2546 162 526 242
16 613
49

227 40
2434 173 496 207 16 563 46

1179 232
12871 834
2504 1133
95 3307
303

25

25

20

18

18

106

17

15

11

11

11

65

8

10

9

7

7

41

32

39

35

24

26

156

4

5

4

1

3

17

18

11

11

9

13

62

162

172

148

165

176

823

31

23

26

24

34

138

2

1

2

2

2

9

210

198

180

198

187

973

31

39

25

30

39

164

42

31

38

35

23

169

855

841

690

685

681

3752

230

250

255

289

265

1289

538

498

480

453

418

2387

15

22

11

11

14

73

559

523

497

471

352

2402

52

57

47

46

49

251

80

72

95

75

66

388

.

15

31

67

74

187

.

11

33

42

24

110

.

9

59

129

131

328

2243 386 38 727 491 366 . 8

2189 358
36 832 640 527
15 4

2052 366 48 852 726 557 37 0

2123 379
44 881 859 622 169
0

2058 347 52 849 796 597 180 0

10665 1836 218 4141 3512 2669 401 12

1990
86921 23033
2225

1991
88119 23310
2251

Black
1992 1993

89315 23587
2276

90513 23865
2302

1994 5-year

91709 24141
2327

446577 117935
11380

20.1 18.9 24.0

19.7 19.1 24.0

19.9 19.4 25.0

20.0 19.1 24.0

20.0 18.7 25.0

20.0 19.0 24.0

369 99
2020 266
1252 163 42 783 88

395 111 2099 303 1321 160
32 765
84

376 121 1985 277 1332 193
32 733
79

355 108 1936 279 1306 170
26 672
65

348 78
1851 252
1238 170 23 690 84

1843 517
9891 1377 6449
856 155 3643 400

42

33

36

18

26

155

27

24

27

11

17

106

15

9

9

7

9

49

70

57

57

40

40

264

3

7

2

7

5

24

7

9

7

6

8

37

276

279

267

246

240

1308

63

68

49

52

59

291

3

12

5

8

5

33

306

270

246

251

235

1308

30

26

26

20

26

128

36

39

44

31

22

172

900

943

778

754

657

4032

767

790

846

758

726

3887

583

662

589

541

513

2888

76

77

62

40

39

294

255

236

194

168

133

986

57

58

46

36

32

229

142

144

161

129

95

671

.

5

19

61

83

168

.

0

10

21

22

53

.

0

116

314

384

814

1254 267 29
1181 975 776 . 4

1348 260
44 1456 1233 1083
26 3

1281 242 41
1265 1256 1007
91 0

1343 272
30 1340 1368 1121
291 4

1344 294 33
1217 1260
979 199
0

6570 1335
177 6459 6092 4966
607 11
154

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates
1990

Perinatal outcome rates

Crude birth rate

18.9

General fertility rate

75.3

Total fertility rate

2.2

% Livebirths to unmarried women

36.3

Crude abortion rate

6.4

General abortion rate

25.6

Total abortion rate

0.7

Abortion ratio

235.6

Fetal Death rate

7.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

121.2

% Repeat conceptions to women under 18

23.5

Livebirths to women under 18

84.6

% Livebirths to unmarried women under 18

78.3

Induced abortions to women under 18

32.0

% Abortions to unmarried women under 18

97.7

Fetal deaths to women under 18

5.5

Infant and child survival rates

Infant mortality

14.1

Neonatal mortality

9.3

Postneonatal mortality

4.8

Perinatal mortality ratio

21.1

Deaths of children 1-4 yrs

0.4

Deaths of children 5-17 yrs

0.5

Infant health rates

% Low birthweight

9.2

% Very low birthweight

2.0

% Under 500 grams

0.1

% Preterm gestation

11.0

% Multiple gestation

1.3

% Birth defect

1.6

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

38.3

% with father not named on birth certificate

21.0

% with maternal education less than high school

23.8

% No prenatal care

1.9

% Maternal smoking during pregnancy

17.3

% Maternal alcohol use during pregnancy

2.3

% Interpregnancy interval less than 6 months

8.4

Child abuse and neglect rates

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

% Prenatal care first trimester

74.0

% Primary C-section delivery

15.4

% Vaginal birth after previous C-section

15.6

% WIC during pregnancy

40.3

% Medicaid during pregnancy

31.0

% Medicaid and WIC during pregnancy

24.1

% Perinatal case management

.

Metropolitan Statistical Area 4 - Augusta

1991
18.6 74.4
2.2 38.5
5.9 23.5
0.6 223.7
7.0
111.5 25.6 81.8 88.6 26.6 96.6 4.5
12.0 8.1 4.0
19.6 0.7 0.4
9.5 1.9 0.3 10.0 1.4 1.5
39.0 21.9 24.6
2.1 16.2
2.5 8.0
0.3 0.2 0.2
75.0 14.8 16.7 48.4 39.6 33.9
0.9

Total
1992 1993

17.3 69.7 2.1 40.7 5.4 21.9 0.6 220.3 7.6

16.9 68.2
2.1 40.9
4.9 20.0
0.5 209.5
7.1

107.4 28.3 76.9 86.2 25.4 97.9 6.6

101.4 26.2 77.8 87.8 20.4 99.1 3.7

12.2 8.3 3.9
20.0 0.3 0.3

7.9 4.8 3.1 14.1 0.4 0.3

9.1

9.1

1.7

1.7

0.2

0.2

9.5

10.1

1.1

1.1

1.8

1.5

33.3 24.3 24.0 1.7 15.6 2.1
9.7

32.4 23.4 22.3
1.1 14.5
1.9 8.1

0.8

1.8

0.6

0.9

2.5

6.1

74.4 15.2 19.0 46.9 43.9 34.6
2.8

77.4 16.4 15.2 49.8 49.8 38.9 10.3

1994 5-year

15.9 64.5 2.0 40.6 4.7 19.2 0.5 212.3 6.5

17.5 70.4
2.1 39.3
5.5 22.0
0.6 220.7
7.2

99.5 20.5 73.4 86.2 22.5 98.5 4.1

108.0 24.8 78.8 85.4 25.3 97.9
4.9

10.5 6.6 3.9
15.0 0.4 0.4

11.4 7.5 4.0
18.0 0.5 0.4

9.6

9.3

2.1

1.9

0.2

0.2

9.9

10.1

1.5

1.3

1.0

1.5

31.9 23.2 22.0 1.3 11.4 1.9
6.7

35.1 22.7 23.4
1.6 15.1
2.1 8.2

2.2

1.3

0.6

0.6

7.1

4.0

79.7 17.2 17.5 48.6 48.3 37.0 8.9

76.0 15.8 16.8 46.7 42.3 33.6
5.6

White
1990 1991 1992 1993 1994 5-year

16.9 70.3
2.1 17.2
4.8 20.1
0.6 206.8
7.0

16.2 67.6
2.0 19.6
4.3 17.9
0.5 195.0
6.2

15.1 63.8 1.9 20.4 3.9 16.5 0.5 189.3 6.7

15.1 64.0
2.0 20.9
3.6 15.4
0.4 179.1
6.6

14.2 60.8 1.9 20.7 3.3 14.1 0.4 174.6 5.7

15.5 65.3
2.0 19.7
4.0 16.8
0.5 189.6
6.4

94.7 19.5 64.0 50.8 27.4 95.2
4.0

71.6 21.4 48.5 70.3 20.2 95.2
3.6

72.9 21.6 50.1 63.9 20.2 96.8 3.5

69.0 18.3 51.3 70.8 15.5 97.9
2.5

70.9 17.6 54.1 69.2 14.4 100.0 3.4

75.7 19.7 53.5 64.4 19.5 96.7
3.4

9.2 6.2 2.9 11.7
* 0.6

9.4 5.7 3.8 14.6 0.5 0.4

8.0 4.4 3.6 13.8
* 0.4

7.1

7.4

8.2

4.3

4.5

5.1

2.8

2.9

3.2

9.4

10.6

12.0

*

*

0.3

0.3

0.4

0.4

5.9

6.5

5.9

6.5

7.2

6.4

1.1

0.9

1.0

0.9

1.4

1.1

*

*

*

*

*

0.1

7.8

7.6

7.2

7.9

7.8

7.7

1.1

1.5

1.0

1.2

1.6

1.3

1.5

1.2

1.5

1.4

0.9

1.3

32.4 8.5
20.0 0.6
20.9 1.9 5.6

33.1 9.6
19.2 0.8
20.4 2.2 5.1

28.1 10.2 19.3 0.4 20.1 1.9
6.8

27.3 11.5 18.1
0.4 18.8
1.8 5.4

28.7 11.1 17.5 0.6 14.8 2.1
4.9

30.0 10.1 18.9
0.6 19.0
2.0 5.6

.

0.4

0.7

1.6

1.7

1.1

.

0.3

0.8

1.0

0.6

0.7

.

0.2

1.4

3.1

3.1

2.0

82.4 15.9 14.1 27.0 18.2 13.6
.

83.0 15.5 12.4 31.9 24.6 20.2
0.6

81.8 16.6 17.1 34.2 29.2 22.4 1.5

83.4 16.9 15.9 35.0 34.1 24.7
6.7

84.8 16.3 19.3 35.4 33.2 24.9 7.5

83.1 16.2 15.7 32.6 27.6 21.0
4.0

Black
1990 1991 1992 1993 1994 5-year

23.2 87.7
2.5 62.9
9.0 34.0
0.9 259.4
9.4

23.8 90.0
2.6 63.9
8.7 32.8
0.8 249.3
8.8

22.2 84.2 2.5 68.1 8.2 31.1 0.8 248.3 9.9

21.4 81.1
2.4 68.2
7.4 28.2
0.7 238.7
8.7

20.2 76.7 2.3 67.8 7.5 28.6 0.7 251.5 8.4

22.1 83.9
2.5 66.1
8.2 30.9
0.8 249.6
9.0

165.8 26.8 119.6 98.5 39.6 100.0
8.1

175.5 28.1
134.6 98.0 37.3 97.6 6.2

165.2 32.2
121.7 98.9 34.7 98.7 11.0

154.2 30.4
121.2 97.8 28.2
100.0 5.6

149.6 22.4
108.3 98.0 36.1 97.6 5.2

161.9 28.1
121.0 98.2 35.1 98.7 7.2

20.8 13.4
7.5 33.9
* 0.3

15.7 11.4
4.3 26.7
1.0 0.4

18.1 13.6 4.6 28.3
* 0.3

9.3 5.7 3.6 20.4 1.0
*

14.0 9.2 4.9 21.3 0.7 0.4

15.7 10.7
5.0 26.3
0.7 0.3

13.7 3.1 *
15.4 1.5 1.8

13.3 3.2 0.6
13.0 1.3 1.9

13.5 2.5 0.3 12.6 1.3 2.2

12.7 2.7 0.4
13.1 1.0 1.6

13.0 3.2 0.3 12.9 1.4 1.2

13.2 2.9 0.3
13.4 1.3 1.7

46.6 38.6 29.4
3.8 12.9
2.9 11.5

46.6 38.1 32.1
3.7 11.5
2.8 11.2

40.3 43.2 30.2 3.2 10.0 2.4 13.0

39.6 39.6 28.3
2.1 8.8 1.9 11.0

36.4 39.8 28.2 2.1 7.3 1.8 9.0

42.0 39.8 29.7
3.0 10.2
2.4 11.2

.

0.2

0.6

2.0

2.7

1.4

.

*

0.3

0.7

0.7

0.4

.

*

3.9

10.3

12.4

6.7

62.4 14.7 16.9 59.4 49.0 39.0
.

64.4 13.8 22.8 70.3 59.5 52.3
1.3

64.7 13.7 21.2 64.6 64.2 51.5
4.6

69.4 16.0 14.0 70.0 71.4 58.5 15.2

72.6

66.6

18.2

15.2

15.4

18.0

66.7

66.2

69.0

62.4

53.6

50.9

10.9

7.8

155

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events

1990 1991

Population

113951 115331

Women age 15-44

26110 26160

Women age 15-17

2534

2523

Woman's median age at:

Conception of first birth

20.5

20.5

Conception of first abortion

18.5

19.3

First marriage

20.0

20.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

191

216

Repeat conceptions to women under 18

36

29

Total Livebirths

1627

1655

Livebirths to women under 18

181

201

Livebirths to unmarried women

324

406

Early fetal deaths

11

76

Fetal deaths 20 weeks or more gestation

9

11

Total induced abortions

284

260

Induced abortions to women under 18

10

7

Infant and child survival

Infant deaths

24

21

Neonatal deaths

14

11

Postneonatal deaths

10

10

Perinatal deaths

23

21

Deaths of children 1-4 years

2

1

Deaths of children 5-17 years

9

6

Infant health

Low birthweight

140

129

Very low birthweight

33

26

Under 500 grams

5

2

Preterm gestation

151

138

Multiple gestation

18

20

Born with birth defect

20

1

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

506

272

Father not named on birth certificate

169

200

Maternal education less than high school

556

570

No prenatal care

10

13

Maternal smoking during pregnancy

206

218

Maternal alcohol use during pregnancy

6

5

Interpregnancy interval less than 6 months

58

63

Abuse & neglect to persons under age 18 years

Physical

.

23

Sexual

.

14

Neglect

.

70

Interventions to improve infant & child survival

Prenatal care first trimester

1300 1326

Primary C-section delivery

144

96

Vaginal birth after previous C-section

14

6

WIC during pregnancy

628

837

Medicaid during pregnancy

439

598

WIC and Medicaid during pregnancy

331

531

Perinatal case management

.

33

Child fatality investigations

7

5

Metropolitan Statistical Area 5 - Chattanooga

Total
1992 1993

116671 26199
2510

118056 26233 2500

20.5 19.5 20.0

21.0 18.6 20.0

195 33
1546 177 353 81 19 245 14

208 45
1532 173 382 100
16 200
23

9

16

2

7

7

9

21

21

5

4

7

8

121

120

13

25

0

1

136

124

16

17

3

7

76

242

170

165

514

518

7

8

131

199

2

5

72

64

65

59

42

39

119

141

1268 76 3
706 538 444 135
0

1244 70 11
756 611 523 128
1

1994 5-year

119405 26288 2487

583414 130990
12554

20.2 19.2 20.0

20.5 18.8 20.0

240 38
1628 205 466 76 9 187 30

1050 181
7988 937
1931 344 64
1176 84

21

91

11

45

10

46

17

103

4

16

15

45

142

652

22

119

1

9

154

703

15

86

7

38

277

1373

201

905

551

2709

14

52

351

1105

7

25

61

318

48

195

37

132

148

478

1293 120 25 824 646 532 190 4

6431 506 59
3751 2832 2361
486 17

White
1990 1991 1992 1993 1994 5-year

110573 25331
2444

111915 25376 2434

113237 25413
2423

114578 25456 2413

115901 25494 2402

566204 127070
12117

20.5 18.4 20.0

20.6 19.1 20.0

20.6 19.6 20.0

21.0 18.6 20.0

20.3 19.3 20.0

20.6 18.9 20.0

187 35
1577 177 296 11 7 270 10

207 29
1602 192 378
74 11 244
7

188 31
1503 173 327 75 19 231 11

202 43
1489 169 356
98 16 193 22

228 37
1562 194 426 72 8 177 29

1012 175
7733 905
1783 330 61
1115 79

24

20

8

16

21

89

14

11

2

7

11

45

10

9

6

9

10

44

21

21

21

21

16

100

2

1

5

4

4

16

9

6

7

8

15

45

134

124

116

115

130

619

31

26

13

25

20

115

5

2

0

1

1

9

144

134

128

122

142

670

18

20

15

16

15

84

20

1

3

6

7

37

488

262

72

232

266

1320

153

182

156

153

171

815

545

555

507

505

529

2641

9

13

7

4

11

44

200

214

129

197

349

1089

4

5

2

4

6

21

55

62

70

63

58

308

.

18

60

51

48

177

.

11

40

37

35

123

.

66

111

122

113

412

1270 139 13 605 424 318 . 5

1298 93 6
800 573 509
27 5

1239 74 3
682 519 428 125
0

1216 66 11
736 592 508 124
1

1259 117 24 791 620 515 179 4

6282 489 57
3614 2728 2278
455 15

1990
2704 589
72

1991
2729 590
72

Black
1992 1993

2752 590 71

2777 591
71

1994 5-year

2801 592 71

13762 2952 357

19.7 18.7 30.0

18.1 21.7 22.0

18.9 17.1 23.0

21.6 20.4 30.0

19.6 16.8 22.0

19.2 18.7 25.0

4

9

7

4

11

35

1

0

2

2

1

6

44

47

35

33

53

212

4

9

4

3

10

30

27

27

26

24

37

141

0

2

5

2

3

12

2

0

0

0

1

3

10

12

10

3

6

41

0

0

3

0

1

4

0

1

1

0

0

2

0

0

0

0

0

0

0

1

1

0

0

2

2

0

0

0

1

3

0

0

0

0

0

0

0

0

0

0

0

0

5

5

5

4

11

30

2

0

0

0

1

3

0

0

0

0

0

0

5

4

6

1

10

26

0

0

1

1

0

2

0

0

0

1

0

1

17

9

4

9

10

49

16

17

14

10

30

87

10

14

7

8

19

58

1

0

0

3

3

7

6

4

2

2

2

16

2

0

0

1

1

4

3

1

2

1

3

10

.

0

2

2

0

4

.

0

1

0

1

2

.

3

3

16

2

24

25

24

23

21

28

121

5

2

2

3

1

13

0

0

0

0

1

1

22

35

22

16

28

123

14

24

19

16

22

95

13

21

16

12

15

77

.

5

10

3

10

28

2

0

0

0

0

2

156

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

1990 1991

Perinatal outcome rates

Crude birth rate

14.3

General fertility rate

62.3

Total fertility rate

1.9

% Livebirths to unmarried women

20.1

Crude abortion rate

2.5

General abortion rate

10.9

Total abortion rate

0.1

Abortion ratio

146.9

Fetal Death rate

0.8

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

75.4

% Repeat conceptions to women under 18

18.8

Livebirths to women under 18

71.4

% Livebirths to unmarried women under 18

52.2

Induced abortions to women under 18

3.9

% Abortions to unmarried women under 18

100.0

Fetal deaths to women under 18

*

Infant and child survival rates

Infant mortality

14.8

Neonatal mortality

8.6

Postneonatal mortality

6.2

Perinatal mortality ratio

14.1

Deaths of children 1-4 yrs

*

Deaths of children 5-17 yrs

0.4

Infant health rates

% Low birthweight

8.6

% Very low birthweight

2.0

% Under 500 grams

0.3

% Preterm gestation

9.4

% Multiple gestation

1.1

% Birth defect

1.4

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

43.2

% with father not named on birth certificate

10.5

% with maternal education less than high school

34.7

% No prenatal care

0.6

% Maternal smoking during pregnancy

15.0

% Maternal alcohol use during pregnancy

0.4

% Interpregnancy interval less than 6 months

6.7

Child abuse and neglect rates

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

% Prenatal care first trimester

82.1

% Primary C-section delivery

9.5

% Vaginal birth after previous C-section

13.9

% WIC during pregnancy

39.0

% Medicaid during pregnancy

27.2

% Medicaid and WIC during pregnancy

20.5

% Perinatal case management

.

Metropolitan Statistical Area 5 - Chattanooga

14.4 63.3
2.0 24.9
2.3 9.9 0.1 129.2 3.7
85.6 13.4 79.7 56.5
2.8 100.0
3.6
12.7 6.6 6.1
12.6 *
0.3
7.8 1.6
* 8.5 1.2
*
27.1 12.2 35.0
0.8 20.9
0.5 7.6
0.8 0.5 2.4
82.4 6.1
11.5 51.2 36.6 32.5
2.0

Total
1992 1993

13.3 59.0 1.8 23.1 2.1 9.4 0.1 128.7 4.3

13.0 58.4
1.8 25.3
1.7 7.6 0.1 107.9 4.7

77.7 16.9 70.5 56.9
5.6 100.0
2.8

83.2 21.6 69.2 59.5
9.2 100.0
6.0

5.8 *
4.5 13.4 0.8 0.3

10.4 4.6 5.9
13.6 *
0.4

7.8

7.8

0.8

1.6

*

*

8.9

8.2

1.0

1.1

*

0.8

8.3 11.1 33.7 0.5 14.1
* 8.5

26.7 10.9 34.3
0.6 21.7
0.5 7.8

2.2

2.0

1.4

1.3

4.0

4.7

85.6 5.2
* 46.1 35.2 29.0
8.8

85.0 4.8
18.0 50.0 40.4 34.6
8.5

1994 5-year

13.6 61.9 1.9 29.0 1.6
7.1 0.2 98.2 3.4

13.7 61.0
1.9 24.5
2.0 9.0 0.1 122.4 3.4

96.5 15.8 82.4 62.4 12.1 100.0 2.0

83.6 17.2 74.6 57.6
6.7 100.0
3.1

12.9 6.8 6.2 10.4 * 0.7

11.4 5.6 5.8
12.8 0.5 0.4

8.7

8.2

1.4

1.5

*

0.1

9.5

8.9

0.9

1.1

0.7

0.7

27.5 12.5 34.2 0.9 34.1 0.7 7.1

27.4 11.4 34.4
0.7 20.9
0.5 7.5

1.6

1.6

1.2

1.1

4.9

4.0

83.4 7.9 24.5 51.1 40.0 33.0 11.8

83.6 6.7
15.9 47.5 35.8 29.9
7.7

White
1990 1991 1992 1993 1994 5-year

14.3 62.3
1.9 19.0
2.4 10.7
0.1 144.6
0.8

14.3 63.1
2.0 23.9
2.2 9.6 0.1 125.7 3.7

13.3 59.1 1.8 22.0 2.0
9.1 0.1 125.5 4.2

13.0 58.5
1.8 24.2
1.7 7.6 0.1 107.1 4.7

13.5 61.3 1.9 27.6 1.5
6.9 0.2 97.1 3.3

13.7 60.9
1.9 23.3
2.0 8.8 0.1 120.2 3.3

76.5 18.7 72.4 51.1
4.1 100.0
*

85.0 14.0 78.9 54.5
2.9 100.0
3.7

77.6 16.5 71.4 55.9 4.5 100.0 2.9

83.7 21.3 70.0 59.2
9.1 100.0
5.8

94.9 16.2 80.8 60.8 12.1 100.0 2.1

83.5 17.3 74.7 56.3
6.5 100.0
3.1

15.2 8.9 6.4
13.3 *
0.4

12.5 6.9 5.7
13.0 *
0.3

5.3 *
4.0 13.8 0.8 0.3

10.7 4.7 6.1
14.0 *
0.4

13.4 7.0 6.4 10.2 * 0.7

11.5 5.8 5.7
12.8 0.5 0.4

8.5

7.7

7.7

7.7

8.3

8.0

2.0

1.6

0.9

1.7

1.3

1.5

0.3

*

*

*

*

0.1

9.2

8.5

8.6

8.3

9.2

8.8

1.2

1.3

1.0

1.1

1.0

1.1

1.5

*

*

0.7

0.7

0.7

43.1 9.8
35.0 0.6
15.0 *
6.6

27.1 11.5 35.2
0.8 21.3
0.5 7.7

8.1 10.5 34.2 0.5 14.3
* 8.5

26.4 10.4 34.4
* 22.2
* 7.9

27.3 11.0 34.3 0.7 35.1 0.6 7.1

27.3 10.7 34.6
0.6 21.3
0.4 7.5

.

0.6

2.1

1.7

1.6

1.5

.

0.4

1.4

1.3

1.2

1.1

.

2.3

3.8

4.2

3.8

3.5

82.6 9.5
13.3 38.7 27.1 20.4
.

83.0 6.1
12.8 50.6 36.2 32.2
1.7

85.9 5.2
* 45.8 34.9 28.8
8.4

85.4 4.7
19.6 50.0 40.2 34.5
8.4

84.7 8.1 24.5 51.1 40.1 33.3 11.6

84.3 6.7
16.2 47.2 35.7 29.8
7.5

Black
1990 1991 1992 1993 1994 5-year

16.3 74.7
2.3 62.8
3.7 17.0
0.3 178.6
*

17.2 79.7
2.4 57.4
4.4 20.3
* 196.7
*

12.7 59.3 1.8 76.5 3.6 16.9 0.3 200.0 8.5

* 125.5

*

*

* 125.5

* 100.0

*

*

*

*

*

*

98.2 * * * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

11.4

10.6

14.3

*

*

*

*

*

*

11.4

*

17.6

*

*

*

*

*

*

48.6 36.4 23.8
* 16.7
* *

26.5 36.2 29.8
* * * *

* 41.2 20.6
* * * *

.

*

*

.

*

*

.

*

*

62.5 11.9
* 50.0 31.8 29.5
.

58.5 * *
74.5 51.1 44.7 10.6

69.7 * *
64.7 55.9 47.1 29.4

11.9 55.8
1.7 75.0
* * * * *

18.9 89.6 2.6 71.2 2.1 10.1 0.3 95.2
*

15.4 71.8
2.1 67.8
3.0 13.9
0.2 153.0
5.1

* 155.6

*

*

* 141.4

*

90.0

*

*

*

*

*

*

98.1 17.1 84.1 96.7
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

20.8

14.2

*

*

*

*

*

*

*

18.9

12.4

*

*

*

*

*

*

40.9 31.3 25.0
* * * *

38.5 56.6 36.5
* * * *

34.5 41.4 28.0
3.6 10.9
* 8.5

* * 22.3

*

*

*

*

*

8.4

70.0

56.0

62.4

*

*

6.8

*

*

*

50.0

52.8

58.6

50.0

41.5

45.2

37.5

28.3

36.7

*

18.9

16.9

157

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
1990

Population

214000

Women age 15-44

49490

Women age 15-17

4355

Woman's median age at:

Conception of first birth

21.0

Conception of first abortion

18.9

First marriage

22.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

584

Repeat conceptions to women under 18

136

Total Livebirths

4094

Livebirths to women under 18

413

Livebirths to unmarried women

1467

Early fetal deaths

207

Fetal deaths 20 weeks or more gestation

58

Total induced abortions

1149

Induced abortions to women under 18

157

Infant and child survival

Infant deaths

63

Neonatal deaths

40

Postneonatal deaths

23

Perinatal deaths

97

Deaths of children 1-4 years

2

Deaths of children 5-17 years

11

Infant health

Low birthweight

368

Very low birthweight

80

Under 500 grams

9

Preterm gestation

370

Multiple gestation

46

Born with birth defect

43

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

1202

Father not named on birth certificate

972

Maternal education less than high school

971

No prenatal care

110

Maternal smoking during pregnancy

728

Maternal alcohol use during pregnancy

113

Interpregnancy interval less than 6 months

223

Abuse & neglect to persons under age 18 years

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

Prenatal care first trimester

2674

Primary C-section delivery

647

Vaginal birth after previous C-section

46

WIC during pregnancy

1812

Medicaid during pregnancy

1372

WIC and Medicaid during pregnancy

1019

Perinatal case management

.

Child fatality investigations

0

Metropolitan Statistical Area 6 - Columbus

1991
216219 49953 4404
20.9 19.4 22.0
555 141 3940 423 1473 238
42 1107 113
41 26 15 67 10 13
329 60 7
356 41 39
1210 985 1000 118 648
90 209
75 37 355
2391 576
88 2000 1582 1173 285
2

Total
1992 1993

218430 50417 4452

220651 50882 4501

20.9 19.6 22.0

20.7 19.9 22.0

538 140 4228 426 1511 255
55 1092
99

565 151 3779 425 1452 248
28 1119 120

53

46

42

34

11

12

100

59

6

10

17

12

401

338

85

79

13

14

413

358

55

38

53

43

1245 1054 1006
125 635
77 227

1128 945 916
70 554
70 202

222

224

130

108

918

968

2472 538 87
2030 1742 1218
217 0

2328 471 100 1978 1835 1341 451
1

1994 5-year
222857 1092157 51345 252087 4549 22262

20.9 19.6 23.0

20.9 19.4 22.0

539 152 3746 411 1444 163
31 1058
117

2781 720
19787 2098 7347 1111 214 5525 606

48

251

34

176

14

75

64

387

8

36

10

63

357

1793

63

367

8

51

379

1876

49

229

34

212

1305 947 837 75 421 41 197

6090 4903 4730
498 2986
391 1058

224

745

124

399

846

3087

2456 445 74
1943 1666 1236
415 17

12321 2677 395 9763 8197 5987 1368 20

White
1990 1991 1992 1993 1994 5-year

128956 28015 2217

129274 27963 2222

129592 27911 2226

129906 27858 2231

130218 27804 2235

647946 139551
11132

22.2 19.4 22.0

22.7 19.8 21.0

22.7 20.0 22.0

22.2 20.8 22.0

22.2 20.3 22.0

22.4 20.0 22.0

217 37 2175 141 343 78 23 557 72

192 37
2048 140 363
95 18 541 47

164 30
2136 122 304 117 18 498 35

181 41
1979 135 345 105
7 505
41

182 38
1916 137 332 63 11 422 43

936 183 10254 675 1687 458
77 2523
238

23

18

17

14

10

82

16

11

9

8

7

51

7

7

8

6

3

31

38

29

28

14

19

128

1

9

1

4

3

18

7

10

7

8

6

38

125

131

136

106

124

622

21

15

29

22

14

101

1

3

3

2

2

11

138

138

157

147

132

712

12

20

26

16

15

89

21

19

22

17

15

94

559

525

543

489

609

2725

207

219

199

207

197

1029

458

431

411

407

323

2030

26

32

22

17

16

113

506

456

451

388

300

2101

51

35

30

26

15

157

83

64

72

65

59

343

.

25

73

84

74

256

.

18

70

50

60

198

.

137

306

297

260

1000

1629 358 24 708 389 288 . 0

1430 309 41 794 503 367 113 2

1456 310 38 818 525 380 100 0

1369 254 59 805 631 446 190 1

1396 254 42 787 525 389 173 2

7280 1485
204 3912 2573 1870
576 5

1990
77967 19548
1998

1991
78763 19723
2019

Black
1992 1993

79555 19898
2040

80352 20075
2062

1994 5-year

81143 20250
2082

397780 99494 10201

19.4 18.4 23.0

19.2 18.6 22.0

19.2 18.7 24.0

19.1 18.7 24.0

19.3 18.8 24.0

19.2 18.6 23.0

362 99
1851 271
1121 104 34 560 81

361 103 1830 282 1105 126
24 531
65

374 110 2008 304 1198 133
37 573
64

380 109 1725 288 1099 142
21 584
77

351 114 1744 269 1091
94 20 597 73

1828 535
9158 1414 5614
599 136 2845 360

39

23

35

31

37

165

24

15

33

26

26

124

15

8

2

5

11

41

57

38

71

45

45

256

1

1

5

6

5

18

4

3

10

4

4

25

240

195

259

229

225

1148

58

44

54

57

49

262

8

4

10

12

6

40

229

215

249

207

239

1139

32

21

29

21

32

135

21

20

29

25

19

114

629

668

680

612

669

3258

763

764

850

734

736

3847

508

563

590

498

493

2652

84

85

102

53

59

383

217

178

172

159

114

840

60

54

47

44

26

231

137

139

150

134

133

693

.

41

119

116

128

404

.

13

56

45

52

166

.

199

557

595

529

1880

999 276
22 1084
981 729
. 0

916 260
47 1185 1074 803 172
0

964 218
47 1186 1206
831 115
0

916 210
41 1133 1193 887 257
0

1009 184 31
1119 1117
834 236
15

4804 1148
188 5707 5571 4084
780 15
158

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates
1990

Perinatal outcome rates

Crude birth rate

19.1

General fertility rate

82.7

Total fertility rate

2.4

% Livebirths to unmarried women

36.3

Crude abortion rate

5.4

General abortion rate

23.2

Total abortion rate

0.7

Abortion ratio

207.9

Fetal Death rate

5.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

134.1

% Repeat conceptions to women under 18

23.3

Livebirths to women under 18

94.8

% Livebirths to unmarried women under 18

82.8

Induced abortions to women under 18

36.1

% Abortions to unmarried women under 18

99.4

Fetal deaths to women under 18

4.4

Infant and child survival rates

Infant mortality

15.4

Neonatal mortality

9.8

Postneonatal mortality

5.7

Perinatal mortality ratio

23.4

Deaths of children 1-4 yrs

*

Deaths of children 5-17 yrs

0.3

Infant health rates

% Low birthweight

9.0

% Very low birthweight

2.0

% Under 500 grams

0.2

% Preterm gestation

9.2

% Multiple gestation

1.1

% Birth defect

1.1

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

30.4

% with father not named on birth certificate

24.0

% with maternal education less than high school

24.0

% No prenatal care

2.7

% Maternal smoking during pregnancy

18.1

% Maternal alcohol use during pregnancy

2.8

% Interpregnancy interval less than 6 months

9.5

Child abuse and neglect rates

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

% Prenatal care first trimester

65.5

% Primary C-section delivery

17.9

% Vaginal birth after previous C-section

10.8

% WIC during pregnancy

44.8

% Medicaid during pregnancy

33.9

% Medicaid and WIC during pregnancy

25.2

% Perinatal case management

.

Metropolitan Statistical Area 6 - Columbus

1991
18.2 78.9
2.3 37.8
5.1 22.2
0.6 206.8
6.1
126.0 25.4 96.0 83.8 25.7 96.4 5.4
10.4 6.6 3.8
16.8 0.7 0.3
8.4 1.5 0.2 9.1 1.1 1.0
31.7 25.2 25.7
3.0 16.7
2.3 9.1
1.3 0.6 6.1
60.7 16.6 20.4 51.3 40.5 30.1
7.3

Total
1992 1993

19.4 83.9 2.5 36.2 5.0 21.7 0.6 193.5 6.4

17.1 74.3
2.2 38.8
5.1 22.0
0.7 215.6
5.7

120.8 26.0 95.7 84.5 22.2
100.0 4.5

125.5 26.7 94.4 87.4 26.7 98.3 6.0

12.5 9.9 2.6
23.3 0.4 0.4

12.2 9.0 3.2
15.5 0.7 0.3

9.5

8.9

2.0

2.1

0.3

0.4

9.9

9.6

1.3

1.0

1.3

1.1

30.6 25.3 24.1 3.0 15.3 1.9
9.1

31.3 25.3 24.5
1.9 14.9
1.9 9.5

3.7 2.2 15.5

3.7 1.8 16.1

58.6 14.6 17.9 48.7 41.8 29.2
5.2

61.9 14.1 24.6 52.9 49.0 35.8 12.1

1994 5-year

16.8 73.0 2.2 39.1 4.7 20.6 0.6 210.8 4.2

18.1 78.5
2.3 37.6
5.1 21.9
0.6 206.7
5.6

118.5 28.2 90.3 87.4 25.7 97.4 4.0

124.9 25.9 94.2 85.2 27.2 98.3
4.9

12.8 9.1 3.8
16.9 0.5 0.2

12.7 8.9 3.8
19.3 0.5 0.3

9.5

9.1

1.7

1.9

0.2

0.3

10.3

9.6

1.3

1.2

0.9

1.1

36.1 25.6 22.7 2.0 11.5 1.1
9.4

32.0 25.1 24.2
2.6 15.4
2.0 9.3

3.7 2.0 13.9

3.1 1.7 12.9

66.0 13.6 17.7 52.6 45.1 33.4 11.2

62.5 15.4 18.2 49.9 41.9 30.6
8.8

White
1990 1991 1992 1993 1994 5-year

16.9 77.6
2.3 15.9
4.3 19.9
0.6 196.2
3.8

15.8 73.2
2.2 17.9
4.2 19.3
0.6 199.7
4.3

16.5 76.5 2.3 14.4 3.8 17.8 0.5 179.7 4.9

15.2 71.0
2.2 17.6
3.9 18.1
0.6 193.9
4.3

14.7 68.9 2.1 17.5 3.2 15.2 0.5 174.2 3.0

15.8 73.5
2.2 16.6
3.9 18.1
0.5 189.0
4.1

97.9 17.1 63.6 55.4 32.5 100.0
2.7

86.4 19.3 63.0 59.3 21.2 97.8
2.7

73.7 18.3 54.8 50.8 15.7 100.0 4.0

81.1 22.7 60.5 65.2 18.4 97.6
3.6

81.4 20.9 61.3 67.6 19.2 92.9
*

84.1 19.6 60.6 59.8 21.4 97.9
2.9

10.6

8.8

8.0

7.1

5.2

8.0

7.4

5.4

4.2

4.0

3.7

5.0

3.2

3.4

3.8

3.0

*

3.0

17.3

14.0

13.0

7.0

9.9

12.4

*

1.2

*

*

*

0.5

0.3

0.5

0.3

0.4

0.3

0.4

5.7

6.4

6.4

5.4

6.5

6.1

1.0

0.7

1.4

1.1

0.7

1.0

*

*

*

*

*

0.1

6.4

6.8

7.4

7.5

7.0

7.0

0.6

1.0

1.2

0.8

0.8

0.9

1.0

0.9

1.0

0.9

0.8

0.9

26.4 9.6
21.2 1.2
23.6 2.4 7.0

26.4 10.8 21.2
1.6 22.7
1.7 5.8

26.3 9.4
19.5 1.0 21.6 1.4 6.0

25.5 10.5 20.7
0.9 19.9
1.3 6.2

32.8 10.4 17.0 0.8 16.0 0.8
6.0

27.4 10.1 20.0
1.1 20.9
1.6 6.2

.

0.8

2.4

2.8

2.5

2.1

.

0.6

2.3

1.7

2.0

1.7

.

4.6

10.3

9.9

8.6

8.4

75.0 18.6 10.3 32.7 18.0 13.3
.

69.9 17.1 18.4 39.1 24.8 18.1
5.6

68.3 16.7 15.2 38.7 24.9 18.0 4.7

69.4 14.6 26.7 41.0 32.1 22.7
9.7

73.2 15.0 20.8 41.4 27.6 20.5
9.1

71.2 16.4 18.1 38.5 25.3 18.4
7.2

Black
1990 1991 1992 1993 1994 5-year

23.7 94.7
2.7 61.7
7.2 28.6
0.8 219.2
7.4

23.2 92.8
2.7 61.1
6.7 26.9
0.8 210.3
8.3

25.2 100.9
3.0 60.6 7.2 28.8 0.8 207.5 9.0

21.5 85.9
2.5 64.5
7.3 29.1
0.8 235.7
8.4

21.5 86.1 2.6 63.7 7.4 29.5 0.9 242.1 6.2

23.0 92.0
2.7 62.3
7.2 28.6
0.8 222.5
7.9

181.2 27.3 135.6 97.0 40.5 98.8
6.5

178.8 28.5
139.6 96.0 32.2 95.3 8.9

183.3 29.4
149.0 98.0 31.4
100.0 5.4

184.3 28.7
139.7 97.9 37.4 98.6 9.2

168.6 32.5
129.2 97.7 35.1
100.0 7.2

179.2 29.3
138.6 97.3 35.3 98.6 7.5

21.1 13.0
8.2 30.2
* *

12.6 8.2 4.4
20.5 * *

17.4 16.4
* 34.7 0.8
*

18.0 15.1
2.9 25.8
0.9 *

21.2 14.9 6.4 25.5 0.7
*

18.0 13.5
4.5 27.5
0.6 0.3

13.0 3.1 0.4
12.6 1.8 1.1

10.7 2.4 *
11.9 1.2 1.1

12.9 2.7 0.5 12.6 1.5 1.4

13.3 3.3 0.7
12.2 1.2 1.5

12.9 2.8 0.3 14.0 1.9 1.1

12.5 2.9 0.4
12.6 1.5 1.3

35.6 42.0 28.0
4.6 12.0
3.3 12.0

37.9 42.2 31.2
4.7 9.9 3.0 12.0

35.4 43.0 29.9 5.2 8.7 2.4 12.1

37.8 43.1 29.3
3.1 9.5 2.6 13.1

40.0 43.0 28.8 3.5 6.7 1.5 12.7

37.3 42.6 29.4
4.3 9.4 2.6 12.3

.

1.6

4.5

4.3

4.7

3.8

.

0.5

2.1

1.7

1.9

1.5

.

7.6

20.9

22.0

19.3

17.5

54.1 16.9 11.8 59.7 54.0 40.1
.

50.1 16.1 24.1 65.5 59.3 44.4
9.5

48.1 12.5 20.8 60.0 61.0 42.0
5.8

53.4 13.8 23.0 66.5 70.0 52.1 15.1

58.4

52.7

12.2

14.3

14.9

18.9

65.3

63.3

65.2

61.8

48.7

45.3

13.8

10.8

159

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
1990

Population

290909

Women age 15-44

70971

Women age 15-17

6444

Woman's median age at:

Conception of first birth

21.0

Conception of first abortion

19.6

First marriage

22.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

724

Repeat conceptions to women under 18

164

Total Livebirths

4988

Livebirths to women under 18

544

Livebirths to unmarried women

1956

Early fetal deaths

263

Fetal deaths 20 weeks or more gestation

60

Total induced abortions

1317

Induced abortions to women under 18

166

Infant and child survival

Infant deaths

78

Neonatal deaths

46

Postneonatal deaths

32

Perinatal deaths

107

Deaths of children 1-4 years

6

Deaths of children 5-17 years

25

Infant health

Low birthweight

506

Very low birthweight

104

Under 500 grams

17

Preterm gestation

601

Multiple gestation

57

Born with birth defect

32

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

1509

Father not named on birth certificate

1017

Maternal education less than high school

1294

No prenatal care

84

Maternal smoking during pregnancy

712

Maternal alcohol use during pregnancy

94

Interpregnancy interval less than 6 months

242

Abuse & neglect to persons under age 18 years

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

Prenatal care first trimester

3726

Primary C-section delivery

699

Vaginal birth after previous C-section

93

WIC during pregnancy

2176

Medicaid during pregnancy

1957

WIC and Medicaid during pregnancy

1468

Perinatal case management

.

Child fatality investigations

1

Metropolitan Statistical Area 7 - Macon

1991
293331 71055 6456
21.8 20.0 23.0
648 187 4836 503 1943 204
49 1360 138
82 61 21 108
6 33
494 115
20 563
59 29
1461 1012 1244
88 505
79 292
112 104 439
3582 629 114 2281 2146 1645
8 18

Total
1992 1993

295748 71132 6469

298154 71213 6481

20.9 19.9 23.0

21.2 19.9 23.0

701 180 4829 522 2074 185
57 1357
170

644 156 4708 501 2067 178
58 1356 132

73

75

49

56

24

19

105

113

15

11

27

19

466

473

85

108

13

20

477

508

66

61

42

103

1469 1012 1243
104 610
70 264

1489 1046 1210
95 485
60 219

245

200

227

157

806

767

3584 614 152
2242 2272 1682
127 15

3556 598 125 2258 2583 1839 750
60

1994 5-year
300554 1478696 71296 355667 6494 32344

21.2 19.6 23.0

21.2 19.8 23.0

664 146 4761 521 2083 168
41 1314
127

3381 833
24122 2591
10123 998 265
6704 733

77

385

54

266

23

119

93

526

10

48

26

130

468

2407

102

514

18

88

562

2711

52

295

45

251

1438 1032 1129
133 537
62 224

7366 5119 6120
504 2849
365 1241

219

776

188

676

941

2953

3636 662 108
2260 2440 1785
591 14

18084 3202 592
11217 11398
8419 1476
108

White
1990 1991 1992 1993 1994 5-year

185673 42881 3559

186850 42774 3564

188024 42665 3570

189192 42556 3575

190356 42447 3580

940095 213323
17848

23.2 19.7 22.0

23.8 20.6 22.0

23.0 20.3 22.0

23.1 20.1 22.0

24.0 19.9 22.0

23.5 20.1 22.0

283 47 2667 185 426 157 18 725 93

231 53
2543 160 428 131
18 676
67

249 45
2543 171 490 115 15 648 77

222 48
2502 153 478 120
21 609
63

204 36
2527 147 492 105 14 547 47

1189 229
12782 816
2314 628 86
3205 347

22

23

28

23

39

135

15

14

18

16

27

90

7

9

10

7

12

45

34

31

33

38

40

176

2

3

4

6

5

20

17

15

11

9

11

63

181

176

144

178

164

843

34

34

28

35

34

165

5

5

6

4

6

26

224

201

174

187

210

996

32

27

28

36

27

150

7

15

14

34

16

86

725

691

714

720

708

3558

204

194

229

225

217

1069

522

497

476

486

435

2416

13

16

17

16

28

90

511

386

438

379

406

2120

52

44

18

26

28

168

84

116

66

73

68

407

.

56

106

99

97

358

.

61

142

91

111

405

.

132

244

249

310

935

2221 421 45 809 601 480 . 1

2134 394
56 862 665 549
2 5

2124 358 70 820 712 549 54 5

2083 343
69 857 895 625 254
23

2154 370 54 868 799 619 255 4

10716 1886 294 4216 3672 2822 565 38

Black
1990 1991 1992 1993 1994 5-year

101795 27031 2807

102349 26973 2807

102900 26912 2806

103447 26853 2806

103991 26794 2806

514482 134562
14033

19.2 19.4 24.0

19.5 19.5 25.0

19.2 19.2 25.0

19.5 19.5 25.0

18.9 19.4 25.5

19.3 19.4 25.0

437 117 2278 357 1527 105
40 559 71

416 134 2249 343 1512
72 31 652 70

445 132 2232 351 1580
68 42 659 86

419 108 2151 348 1583
54 36 701 66

457 110 2171 372 1585
61 27 735 79

2174 601
11081 1771 7787 360 176 3306 372

55

59

44

52

38

248

30

47

31

40

27

175

25

12

13

12

11

73

70

77

72

74

53

346

4

3

11

5

5

28

8

18

15

10

15

66

320

315

320

290

302

1547

69

79

57

73

67

345

12

15

7

16

12

62

370

359

300

315

346

1690

25

32

38

25

25

145

24

14

28

69

29

164

769

760

741

752

714

3736

812

818

782

819

812

4043

766

742

761

719

686

3674

70

72

86

79

105

412

199

118

170

104

127

718

42

35

52

33

34

196

156

174

194

144

154

822

.

37

115

87

102

341

.

37

59

49

70

215

.

279

478

483

575

1815

1471 273 48
1364 1351
986 . 0

1415 226
56 1410 1473 1091
6 1

1423 250 78
1409 1549 1127
73 10

1435 246
56 1384 1668 1200
495 37

1433 281 53
1371 1622 1152
330 8

7177 1276
291 6938 7663 5556
904 56
160

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Metropolitan Statistical Area 7 - Macon

1990
17.1 70.3
2.1 39.7
4.5 18.6
0.6 198.2
4.8
112.4 22.7 84.4 81.7 25.8 97.5 3.3
15.6 9.2 6.5
21.2 0.3 0.4
10.2 2.1 0.3
12.2 1.2 0.6
34.2 20.6 26.3
1.7 14.5
1.9 8.6
. . .
75.8 15.9 17.5 44.1 39.7 29.8
.

1991
16.5 68.1
2.0 40.7
4.6 19.1
0.6 210.0
4.0
100.4 28.9 77.9 83.8 21.4 99.3 2.8
17.0 12.6
4.4 22.1
0.3 0.6
10.2 2.4 0.4
11.8 1.2 0.6
34.3 21.2 26.1
1.9 10.6
1.7 10.3
1.4 1.3 5.5
76.3 14.7 22.5 47.7 44.9 34.4
0.2

Total
1992 1993

16.3 67.9 2.0 43.6 4.6 19.1 0.6 210.6 3.6

15.8 66.1
2.0 44.6
4.5 19.0
0.6 214.8
3.5

108.4 25.7 80.7 87.8 26.3 98.8 2.6

99.4 24.2 77.3 85.7 20.4 98.5
2.2

15.1 10.1 5.0 21.5 0.8 0.5

15.9 11.9
4.1 23.7
0.6 0.3

9.7 1.8 0.3 10.0 1.4 0.9

10.0 2.3 0.4
11.0 1.3 2.2

34.4 21.2 26.2
2.2 12.8
1.5 9.5

35.1 22.5 26.1
2.1 10.5
1.3 8.0

3.0

2.4

2.8

1.9

9.9

9.4

75.6 14.5 29.1 47.1 47.7 35.3
2.7

76.2 14.4 26.0 48.7 55.7 39.6 16.2

1994 5-year

15.8 66.8 2.0 44.3 4.4 18.4 0.6 208.7 3.1

16.3 67.8
2.0 42.5
4.5 18.8
0.6 208.4
3.8

102.2 22.0 80.2 91.9 19.6 99.2 3.2

104.5 24.6 80.1 86.2 22.7 98.6
2.8

16.2 11.3 4.9 19.4 0.5 0.4

16.0 11.0
5.0 21.6
0.5 0.4

9.8 2.1 0.4 12.0 1.1 0.9

10.0 2.1 0.4
11.4 1.2 1.0

33.1 21.9 24.1
2.8 11.5
1.3 8.1

34.2 21.5 25.8
2.1 12.0
1.5 8.9

2.7

2.4

2.3

2.1

11.4

9.1

77.1 15.7 21.7 48.0 51.9 37.9 12.6

76.2 15.0 23.3 47.1 47.9 35.3
7.8

White
1990 1991 1992 1993 1994 5-year

14.4 62.2
1.9 16.2
3.9 16.9
0.5 202.9
4.2

13.6 59.5
1.8 17.0
3.6 15.8
0.5 200.0
3.8

13.5 59.6 1.8 19.5 3.4 15.2 0.5 194.9 3.1

13.2 58.8
1.8 19.4
3.2 14.3
0.4 186.9
3.5

13.3 59.5 1.8 19.7 2.9 12.9 0.4 171.1 2.9

13.6 59.9
1.8 18.3
3.4 15.0
0.5 191.5
3.5

79.5 16.6 52.0 54.6 26.1 98.9
1.7

64.8 22.9 44.9 56.3 18.8 98.5
2.0

69.8 18.1 47.9 66.7 21.6 97.4
*

62.1 21.6 42.8 57.9 17.6 100.0
2.0

57.0 17.6 41.1 74.1 13.1 97.8 2.8

66.6 19.3 45.7 61.6 19.4 98.5
1.9

8.2 5.6 2.6 12.7
* 0.5

9.0 5.5 3.6 12.1
* 0.5

11.0 7.1 4.0
12.9 *
0.3

9.2 6.4 2.8 15.1 0.6 0.3

15.4 10.7 4.8 15.7 0.5 0.3

10.6 7.0 3.5
13.7 0.4 0.4

6.8

6.9

5.7

7.1

6.5

6.6

1.3

1.3

1.1

1.4

1.3

1.3

0.2

0.2

0.2

*

0.2

0.2

8.5

8.0

6.9

7.6

8.4

7.9

1.2

1.1

1.1

1.5

1.1

1.2

0.3

0.6

0.6

1.4

0.6

0.7

29.1 7.7
19.8 0.5
19.4 2.0 5.9

29.4 7.7
19.8 0.6
15.4 1.8 8.3

30.2 9.1 19.0 0.7 17.5 0.7 4.8

30.6 9.1
19.7 0.7
15.4 1.1 5.2

29.9 8.7
17.5 1.1 16.3 1.1 4.7

29.8 8.5
19.2 0.7
16.8 1.3 5.8

.

1.2

2.3

2.2

2.1

2.0

.

1.4

3.1

2.0

2.4

2.2

.

2.9

5.4

5.5

6.7

5.1

84.3 18.2 13.8 30.7 22.8 18.2
.

85.4 17.7 19.1 34.2 26.4 21.8
*

84.8 16.1 24.2 32.6 28.3 21.8
2.1

83.6 15.8 24.0 34.8 36.3 25.4 10.3

85.9 16.8 18.4 34.8 32.0 24.8 10.2

84.8 16.9 19.7 33.4 29.1 22.3
5.7

Black
1990 1991 1992 1993 1994 5-year

22.4 84.3
2.4 67.8
5.5 20.7
0.6 186.8
5.8

22.0 83.4
2.4 68.2
6.4 24.2
0.7 215.9
4.4

21.7 82.9 2.4 72.0 6.4 24.5 0.7 218.9 4.5

20.8 80.1
2.3 74.7
6.8 26.1
0.7 237.9
3.5

20.9 81.0 2.3 73.9 7.1 27.4 0.8 244.9 3.5

21.5 82.3
2.3 71.3
6.4 24.6
0.7 220.8
4.3

155.7 26.8 127.2 96.0 25.3 95.7
5.3

148.2 32.2
122.2 96.7 24.9
100.0 3.9

158.6 29.7
125.1 98.0 30.6
100.0 4.6

149.3 25.8
124.0 98.0 23.5 96.9 2.5

162.9 24.1
132.6 98.9 28.2
100.0 3.9

154.9 27.6
126.2 97.5 26.5 98.6 4.1

24.1 13.2 11.1 30.2
* 0.3

26.2 20.9
5.4 33.8
* 0.7

19.7 13.9 5.9 31.7 1.4 0.6

24.2 18.6
5.7 33.8
0.6 0.4

17.5 12.4 5.1 24.1 0.6 0.6

22.4 15.8
6.7 30.7
0.7 0.5

14.1 3.0 0.5
16.4 1.1 1.1

14.0 3.5 0.7
16.2 1.4 0.6

14.3 2.6 0.3 13.7 1.7 1.3

13.5 3.4 0.7
14.9 1.2 3.2

13.9 3.1 0.6 16.2 1.2 1.3

14.0 3.1 0.6
15.5 1.3 1.5

40.9 36.1 34.1
3.1 8.9 1.9 11.3

40.7 36.9 33.6
3.3 5.3 1.6 12.3

39.9 35.7 34.8 4.0 7.8 2.4 14.2

40.9 38.6 33.9
3.8 4.9 1.6 11.2

37.2 37.9 32.1 4.9 5.9 1.6 12.0

39.9 37.0 33.7
3.8 6.6 1.8 12.2

.

1.1

3.3

2.5

2.9

2.5

.

1.1

1.7

1.4

2.0

1.6

.

8.1

13.9

13.9

16.5

13.1

65.8 13.3 24.2 60.6 60.0 43.8
.

65.7 11.2 26.9 63.6 66.4 49.2
0.3

65.2 12.7 34.7 64.2 70.6 51.4
3.3

67.6 12.7 29.8 65.3 78.7 56.6 23.3

66.7

66.2

14.4

12.9

26.9

28.6

63.9

63.5

75.6

70.1

53.7

50.8

15.4

10.4

161

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
1990

Population

258060

Women age 15-44

61495

Women age 15-17

5229

Woman's median age at:

Conception of first birth

21.6

Conception of first abortion

19.6

First marriage

22.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

628

Repeat conceptions to women under 18

174

Total Livebirths

4796

Livebirths to women under 18

464

Livebirths to unmarried women

1756

Early fetal deaths

459

Fetal deaths 20 weeks or more gestation

53

Total induced abortions

1375

Induced abortions to women under 18

134

Infant and child survival

Infant deaths

58

Neonatal deaths

38

Postneonatal deaths

20

Perinatal deaths

92

Deaths of children 1-4 years

6

Deaths of children 5-17 years

18

Infant health

Low birthweight

476

Very low birthweight

103

Under 500 grams

16

Preterm gestation

503

Multiple gestation

50

Born with birth defect

45

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

1564

Father not named on birth certificate

1034

Maternal education less than high school

1161

No prenatal care

136

Maternal smoking during pregnancy

788

Maternal alcohol use during pregnancy

78

Interpregnancy interval less than 6 months

261

Abuse & neglect to persons under age 18 years

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

Prenatal care first trimester

3500

Primary C-section delivery

771

Vaginal birth after previous C-section

66

WIC during pregnancy

1766

Medicaid during pregnancy

1799

WIC and Medicaid during pregnancy

1204

Perinatal case management

.

Child fatality investigations

6

Metropolitan Statistical Area 8 - Savannah

1991
262383 62061 5307
21.1 19.4 22.0
641 164 4573 485 1761 470
47 1287 129
66 49 17 95
5 15
482 107
20 547
48 43
1390 1051 1157 110 666
92 270
55 22 174
3440 744
77 2211 2055 1632
14 31

Total
1992 1993

266698 62628 5385

271018 63189 5463

21.4 19.8 23.0

21.5 20.2 23.0

597 160 4680 470 1796 462
38 1287
101

618 164 4679 480 1930 465
50 1242 104

74

64

50

39

24

25

87

87

6

9

19

15

453

486

96

94

15

16

515

570

55

64

48

58

1466 1047 1090
91 690
79 255

1681 1102 1082
88 548
48 248

141

165

100

107

529

608

3509 713 115
2128 2216 1597
144 32

3484 783 154 2509 2532 1998 520
42

1994 5-year
275332 1333491 63756 313129 5540 26924

21.1 19.6 23.0

21.3 19.7 23.0

667 147 4582 527 1901 283
41 1157
116

3151 809
23310 2426 9144 2139 229 6348 584

55

317

39

215

16

102

80

441

6

32

14

81

474

2371

86

486

15

82

505

2640

57

274

36

230

1829 1042 1046
82 457
42 208

7930 5276 5536
507 3149
339 1242

146

507

93

322

586

1897

3391 771 121
2097 2339 1617
556 35

17324 3782 533
10711 10941
8048 1234
146

White
1990 1991 1992 1993 1994 5-year

165531 38283 2922

168569 38681 2978

171608 39079 3034

174641 39475 3090

177679 39873 3146

858028 195391
15170

23.4 20.5 22.0

23.0 19.7 22.0

23.2 20.6 22.0

23.6 20.4 23.0

23.6 20.2 23.0

23.4 20.2 22.0

234 46 2616 165 380 261 19 690 56

239 40
2381 165 364 238
13 616
66

181 43
2459 136 366 241 9 582 41

198 44
2456 151 447 238
15 558
44

207 36
2389 156 421 150 15 503 42

1059 209
12301 773
1978 1128
71 2949
249

23

18

26

21

18

106

13

16

15

14

12

70

10

2

11

7

6

36

33

29

25

26

27

140

2

2

3

1

0

8

12

6

9

7

5

39

174

151

160

174

171

830

28

30

27

27

22

134

4

5

3

3

2

17

186

199

199

221

199

1004

28

18

29

32

31

138

33

22

29

24

20

128

718

603

644

732

771

3468

211

202

210

243

194

1060

533

488

452

420

401

2294

31

19

18

16

15

99

553

463

495

397

336

2244

41

42

34

20

16

153

85

68

82

82

71

388

.

28

47

58

60

193

.

15

61

61

51

188

.

79

207

227

231

744

2186 471 30 588 544 361 . 3

2052 409
31 722 640 486
6 7

2065 401 56 733 715 502 65 10

2042 424
70 850 827 586 151
13

2022 420 68 709 753 466 166 9

10367 2125 255 3602 3479 2401 388 42

1990
88521 22054
2203

1991
89801 22197
2229

Black
1992 1993

91078 22340
2255

92357 22481
2281

1994 5-year

93634 22624
2307

455391 111695
11276

19.4 18.9 24.0

19.3 18.8 24.0

19.1 19.1 25.0

19.0 19.9 25.0

18.9 18.8 24.0

19.1 19.1 24.0

392 126 2149 299 1376 192
34 664 76

395 124 2141 316 1388 220
32 644
61

413 116 2140 331 1414 213
28 683
60

416 120 2154 328 1474 221
34 656
58

458 111 2110 369 1473 129
26 639
74

2074 597
10694 1643 7125 975 154 3286 329

35

47

47

43

37

209

25

33

34

25

27

144

10

14

13

18

10

65

59

64

60

60

53

296

4

3

3

8

6

24

6

9

10

8

9

42

299

329

288

308

299

1523

75

76

67

67

64

349

12

15

12

13

13

65

315

344

309

342

299

1609

22

29

26

32

26

135

11

20

18

33

14

96

835

772

804

927

1021

4359

822

845

829

858

844

4198

626

659

621

651

638

3195

105

89

71

70

66

401

232

198

184

146

118

878

37

50

43

28

24

182

176

201

170

165

135

847

.

26

92

94

77

289

.

5

34

36

41

116

.

84

311

345

329

1069

1292 292 36
1175 1254
843 . 3

1350 325
46 1472 1398 1133
8 24

1377 301 56
1369 1474 1078
76 21

1382 353
83 1636 1678 1396
367 29

1300 340 51
1363 1560 1138
383 25

6701 1611
272 7015 7364 5588
834 102
162

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates
1990

Perinatal outcome rates

Crude birth rate

18.6

General fertility rate

78.0

Total fertility rate

2.3

% Livebirths to unmarried women

37.0

Crude abortion rate

5.3

General abortion rate

22.4

Total abortion rate

0.6

Abortion ratio

204.6

Fetal Death rate

9.0

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

120.1

% Repeat conceptions to women under 18

27.7

Livebirths to women under 18

88.7

% Livebirths to unmarried women under 18

79.0

Induced abortions to women under 18

25.6

% Abortions to unmarried women under 18

97.7

Fetal deaths to women under 18

7.1

Infant and child survival rates

Infant mortality

12.1

Neonatal mortality

7.9

Postneonatal mortality

4.2

Perinatal mortality ratio

19.0

Deaths of children 1-4 yrs

0.4

Deaths of children 5-17 yrs

0.4

Infant health rates

% Low birthweight

9.9

% Very low birthweight

2.1

% Under 500 grams

0.3

% Preterm gestation

10.6

% Multiple gestation

1.1

% Birth defect

0.9

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

34.7

% with father not named on birth certificate

21.8

% with maternal education less than high school

24.6

% No prenatal care

2.9

% Maternal smoking during pregnancy

16.7

% Maternal alcohol use during pregnancy

1.7

% Interpregnancy interval less than 6 months

9.4

Child abuse and neglect rates

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

% Prenatal care first trimester

73.8

% Primary C-section delivery

18.1

% Vaginal birth after previous C-section

13.8

% WIC during pregnancy

37.2

% Medicaid during pregnancy

37.9

% Medicaid and WIC during pregnancy

25.4

% Perinatal case management

.

Metropolitan Statistical Area8 - Savannah

1991
17.4 73.7
2.2 39.0
4.9 20.7
0.6 200.0
9.3
120.8 25.6 91.4 80.3 24.3 96.9 5.8
14.4 10.7
3.8 20.6
0.3 0.3
10.5 2.3 0.4
12.1 1.1 0.9
32.5 23.2 25.8
2.4 14.8
2.1 10.1
0.8 0.3 2.4
75.8 18.5 15.3 48.9 45.5 36.1
0.3

Total
1992 1993

17.5 74.7 2.2 38.8 4.8 20.5 0.6 198.0
8.5

17.3 74.0
2.2 41.9
4.6 19.7
0.5 192.6
8.4

110.9 26.8 87.3 82.1 18.8 97.0 5.2

113.1 26.5 87.9 86.0 19.0 99.0 6.8

15.8 10.7 5.2 18.4 0.3 0.4

13.7 8.3 5.4
18.4 0.5 0.3

9.7 2.1 0.3 11.1 1.2 1.0

10.4 2.0 0.3
12.4 1.4 1.2

32.6 22.6 23.7
2.0 15.0
1.7 9.2

37.6 23.9 23.6
1.9 11.9
1.0 9.0

1.9

2.2

1.4

1.4

7.2

8.1

75.2 17.4 21.3 46.0 47.9 34.5
3.1

74.7 19.4 26.4 54.4 54.9 43.3 11.3

1994 5-year

16.6 71.9 2.2 42.0 4.2 18.1 0.5 190.6
5.2

17.5 74.4
2.2 39.7
4.8 20.3
0.6 197.3
8.1

120.4 22.0 95.1 87.2 20.9 99.1 5.2

117.0 25.7 90.1 83.0 21.7 97.9
6.0

12.0 8.5 3.5 17.3 0.3 0.3

13.6 9.2 4.4
18.7 0.4 0.3

10.3 1.9 0.3 11.2 1.3 0.8

10.2 2.1 0.4
11.5 1.2 1.0

41.5 23.0 23.3
1.8 10.2
0.9 8.1

35.8 22.9 24.2
2.2 13.7
1.5 9.2

1.9

1.7

1.2

1.1

7.7

6.4

74.4 19.3 22.9 46.4 51.7 35.8 12.3

74.8 18.5 20.3 46.5 47.5 35.0
6.8

White
1990 1991 1992 1993 1994 5-year

15.8 68.3
2.1 14.7
4.2 18.0
0.5 191.5
7.8

14.1 61.6
1.9 15.4
3.7 15.9
0.5 187.7
7.4

14.3 62.9 1.9 15.1 3.4 14.9 0.4 176.2
6.7

14.1 62.2
1.9 18.5
3.2 14.1
0.4 170.4
6.6

13.4 59.9 1.8 17.9 2.8 12.6 0.3 164.4
4.2

14.3 63.0
1.9 16.3
3.4 15.1
0.4 178.5
6.5

80.1 19.7 56.5 47.9 19.2 98.2
5.5

80.3 16.7 55.4 49.4 22.2 97.0
3.0

59.7 23.8 44.8 46.7 13.5 95.0
1.6

64.1 22.2 48.9 62.7 14.2 100.0
*

65.8 17.4 49.6 61.7 13.4 97.6
3.5

69.8 19.7 51.0 53.7 16.4 97.6
3.0

8.8 5.0 3.8 12.5
* 0.4

7.6 6.7
* 12.1
* 0.2

10.6 6.1 4.5
10.1 *
0.3

8.6 5.7 2.9 10.5
* 0.2

7.5 5.0 2.5 11.2
* 0.2

8.6 5.7 2.9 11.3 0.2 0.3

6.7

6.3

6.5

7.1

7.2

6.7

1.1

1.3

1.1

1.1

0.9

1.1

*

0.2

*

*

*

0.1

7.2

8.4

8.2

9.1

8.4

8.3

1.1

0.8

1.2

1.3

1.3

1.1

1.3

0.9

1.2

1.0

0.8

1.0

28.7 8.2
20.7 1.2
21.5 1.6 6.3

26.4 8.6
20.8 0.8
19.8 1.8 5.3

27.1 8.6 18.7 0.7 20.5 1.4 6.0

30.9 10.0 17.5
0.7 16.5
0.8 6.1

33.2 8.2
17.1 0.6 14.3 0.7 5.4

29.3 8.7
19.0 0.8
18.6 1.3 5.8

.

0.7

1.1

1.4

1.4

1.2

.

0.4

1.5

1.4

1.2

1.1

.

2.0

5.0

5.4

5.3

4.4

84.1 20.1 12.4 22.7 21.0 14.0
.

86.7 19.4 12.4 30.6 27.1 20.6
0.3

84.1 18.6 20.1 30.2 29.4 20.7 2.7

83.4 20.1 22.9 35.1 34.2 24.2
6.2

84.7 20.4 23.0 30.1 31.9 19.8
7.0

84.6 19.7 18.6 29.6 28.6 19.8
4.1

Black
1990 1991 1992 1993 1994 5-year

24.3 97.4
2.7 64.7
7.5 30.1
0.8 216.9
11.2

23.8 96.5
2.7 65.8
7.2 29.0
0.8 210.3
12.5

23.5 95.8 2.7 66.9 7.5 30.6 0.8 221.5 11.7

23.3 95.8
2.7 69.5
7.1 29.2
0.8 213.6
11.6

22.5 93.3 2.7 70.8 6.8 28.2 0.8 219.7
7.1

23.5 95.7
2.7 67.5
7.2 29.4
0.8 216.4 10.8

177.9 32.1 135.7 96.3 34.5 98.6
9.5

177.2 31.4
141.8 96.5 27.4 96.7 9.4

183.1 28.1
146.8 96.4 26.6 98.3 10.2

182.4 28.8
143.8 96.9 25.4 98.3 14.0

198.5 24.2
159.9 98.1 32.1
100.0 7.8

183.9 28.8
145.7 96.9 29.2 98.5 10.2

16.3 11.6
4.7 27.0
* 0.3

22.0 15.4
6.6 29.5
* 0.4

22.0 15.9 6.2 27.7
* 0.5

20.0 11.6
8.5 27.4
1.1 0.4

17.5 12.8 4.8 24.8 0.8 0.4

19.5 13.5
6.2 27.3
0.7 0.4

13.9 3.5 0.6
14.8 1.0 0.5

15.4 3.5 0.7
16.3 1.4 0.9

13.5 3.1 0.6 14.6 1.2 0.8

14.3 3.1 0.6
16.1 1.5 1.5

14.2 3.0 0.6 14.4 1.2 0.7

14.2 3.3 0.6
15.3 1.3 0.9

42.1 38.6 29.7
5.0 11.0
1.7 12.5

39.6 40.0 31.5
4.2 9.4 2.4 14.7

39.5 39.2 29.6 3.4 8.7 2.0 12.5

45.6 40.5 31.0
3.3 6.9 1.3 12.1

51.1 40.6 30.8 3.2 5.7 1.2 10.9

43.6 39.8 30.5
3.8 8.4 1.7 12.6

.

0.9

3.0

3.0

2.4

2.3

.

0.2

1.1

1.2

1.3

0.9

.

2.8

10.1

11.0

10.3

8.6

61.1 15.4 15.4 55.2 59.0 39.6
.

63.6 17.5 18.4 69.8 66.3 53.7
0.4

64.6 16.2 22.1 64.7 69.7 51.0
3.6

64.5 19.1 30.5 77.1 79.1 65.8 17.3

62.3

63.2

18.3

17.3

22.7

22.0

65.5

66.5

75.0

69.8

54.7

52.9

18.4

9.9

163

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events

Total
1990 1991 1992 1993 1994 5-year

Population

2146773 2171372 2195216 2219841 2243711 10976913

Women age 15-44

488783 491484 494047 496775 499343 2470432

Women age 15-17

48395 48491 48576 48671 48756 242889

Woman's median age at:

Conception of first birth

20.3

20.3

20.5

20.4

20.4

20.4

Conception of first abortion

19.2

19.3

19.4

19.2

19.4

19.3

First marriage

21.0

21.0

21.0

21.0

22.0

21.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

5081

5025

4739

4895

5040 24780

Repeat conceptions to women under 18

1191

1196

1132

1064

1026

5609

Total Livebirths

35824 34809 35206 34195 34207 174241

Livebirths to women under 18

4225

4190

3995

4148

4284 20842

Livebirths to unmarried women

12413 12754 12885 12932 13053 64037

Early fetal deaths

2341 2503 2454 2346 2245 11889

Fetal deaths 20 weeks or more gestation

446

365

336

277

298

1722

Total induced abortions

5419

5288

5043

4902

4631 25283

Induced abortions to women under 18

691

657

571

602

601

3122

Infant and child survival

Infant deaths

444

429

387

390

381

2031

Neonatal deaths

285

280

248

244

245

1302

Postneonatal deaths

159

149

139

146

136

729

Perinatal deaths

735

642

580

521

546

3024

Deaths of children 1-4 years

89

79

66

90

84

408

Deaths of children 5-17 years

189

178

200

186

189

942

Infant health

Low birthweight

3183 2963 3050 3047 3083 15326

Very low birthweight

576

539

565

579

632

2891

Under 500 grams

68

62

60

54

83

327

Preterm gestation

3380 3276 3262 3261 3201 16380

Multiple gestation

388

369

406

370

434

1967

Born with birth defect

570

523

614

1044

489

3240

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

11285 10671 10379 10447 10594 53376

Father not named on birth certificate

6729

6769

6840

6607

6534 33479

Maternal education less than high school

11925 11706 11237 10905 10608 56381

No prenatal care

596

476

471

381

348

2272

Maternal smoking during pregnancy

6253

5558

5425

4960

4637 26833

Maternal alcohol use during pregnancy

784

627

588

470

387

2856

Interpregnancy interval less than 6 months

1826

1800

1815

1590

1511

8542

Abuse & neglect to persons under age 18 years

Physical

.

639

1530

1658

1587

5414

Sexual

.

670

1596

1614

1487

5367

Neglect

.

3799

7468

7944

8536 27747

Interventions to improve infant & child survival

Prenatal care first trimester

24736 24366 25155 25123 26015 125395

Primary C-section delivery

5256

4782

4729

4630

4625 24022

Vaginal birth after previous C-section

406

471

537

575

597

2586

WIC during pregnancy

18513 20677 20140 20830 20192 100352

Medicaid during pregnancy

14310 16381 17763 19696 19028 87178

WIC and Medicaid during pregnancy

11573 14241 14835 16615 15878 73142

Perinatal case management

.

3053

6779

8290

9770 27892

Child fatality investigations

31

101

74

163

191

560

Non Metropolitan Statistical Area

White
1990 1991 1992 1993 1994 5-year
1556418 1573883 1590944 1608417 1625491 7955153 344172 345478 346715 348026 349262 1733653 31776 31805 31830 31858 31882 159150

21.1 19.5 20.0

21.1 19.6 20.0

21.3 19.6 21.0

21.3 19.4 21.0

21.3 19.7 21.0

21.2 19.5 21.0

2605 530
23073 2137 3855 1526 208 3400 400

2487 462 22312 2032 3986 1675 156 3231 367

2413 485
22863 2013 4350 1616 151 2970 312

2502 450 22451 2092 4555 1545 118 2915 337

2529 429
22611 2124 4670 1457 145 2708 324

12536 2356
113310 10398 21416 7819 778 15224 1740

218

190

210

195

181

994

136

123

126

123

109

617

82

67

84

72

72

377

348

282

275

240

253

1398

49

40

33

55

40

217

123

111

129

115

108

586

1536 250 25
1800 228 324

1406 210 21
1758 209 318

1486 258 20
1724 249 425

1533 242 20
1743 223 757

1528 280 22
1752 258 308

7489 1240
108 8777 1167 2132

6105 1996 7164
235 4969
422 813

5561 2052 6924 163 4517 359 777

5652 2187 6834
171 4423
302 861

5790 2144 6731 156 4173 250 818

6019 2202 6510
148 3913
200 750

29127 10581 34163
873 21995
1533 4019

.

340

876

966

919

3101

.

410

1097

1092

980

3579

.

1624

3481

3769

4156 13030

17643 3666 263 9603 6671 5368 . 12

17260 3245 299
11092 7998 6974 1564 31

17822 3166 353
11078 9075 7596 3615 32

17870 3098 383
11578 10513
8646 4236
87

18425 3068 391
11406 10307
8441 5140
96

89020 16243
1689 54757 44564 37025 14555
258

Black
1990 1991 1992 1993 1994 5-year

563817 138067
16079

568836 138656
16110

573614 139198
16136

578636 139792
16166

583429 2868331 140330 696043
16192 80684

18.8 18.6 24.0

18.9 18.5 24.0

19.0 18.8 24.0

18.9 18.6 25.0

18.8 18.7 25.0

18.9 18.6 24.0

2459 658
12561 2080 8540 792 236 1882 282

2522 733 12305 2152 8749 799 208 1917 281

2309 645
12084 1974 8487 827 183 1933 251

2376 609 11500 2044 8326 795 158 1874 260

2495 596
11306 2152 8312 761 152 1840 271

12161 3241
59756 10402 42414
3974 937
9446 1345

226

237

177

194

199

1033

149

156

122

120

135

682

77

81

55

74

64

351

385

358

302

277

291

1613

40

39

33

35

44

191

65

67

70

69

79

350

1628 325 43
1562 158 244

1546 328
41 1511 157
201

1550 306 39
1521 156 186

1491 330
34 1487 143 276

1537 351 60
1427 175 175

7752 1640
217 7508
789 1082

5130 4724 4724
359 1261
362 1004

5062 4703 4743 312 1020 266 1019

4658 4625 4340
298 983 283 948

4602 4432 4117 222 772 220 760

4495 4289 4036
198 703 186 753

23947 22773 21960
1389 4739 1317 4484

.

195

496

552

553

1796

.

175

363

421

416

1375

.

1665

3143

3418

3700 11926

6971 1562
142 8837 7597 6177
. 16

6977 1506 168 9491 8343 7234 1484
57

7155 1535
176 8961 8627 7192 3146
37

7084 1510 188 9135 9093 7902 4018
69

7389 1517
200 8646 8611 7348 4585
86

35576 7630 874
45070 42271 35853 13233
265
164

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Non Metropolitan Statistical Area

1990
16.7 73.3
2.1 35.1
2.5 11.1
0.3 122.5
6.1
105.0 23.4 87.3 69.3 14.3 97.5
4.7
12.4 8.0 4.5
20.3 0.7 0.4
8.9 1.6 0.2 9.6 1.1 1.6
37.8 19.0 33.9
1.7 18.1
2.3 9.0
. . .
70.0 16.4 11.7 52.3 40.4 32.7
.

1991
16.0 70.8
2.1 37.1
2.4 10.8
0.3 122.5
6.2
103.6 23.8 86.4 72.4 13.5 98.5 5.1
12.3 8.0 4.3
18.3 0.6 0.4
8.5 1.5 0.2 9.5 1.1 1.5
37.8 19.7 34.3
1.4 16.7
1.9 9.3
1.1 1.1 6.4
71.5 15.4 13.7 60.0 47.6 41.4
8.9

Total
1992 1993

16.0 71.3 2.1 37.1 2.3 10.2 0.3 116.7 6.0

15.4 68.8
2.0 38.3
2.2 9.9 0.3 117.1 5.5

97.6 23.9 82.2 72.8 11.8 98.2 5.1

100.6 21.7 85.2 74.7 12.4 97.6 4.4

11.0 7.0 4.0
16.3 0.5 0.5

11.4 7.1 4.3
15.1 0.7 0.4

8.7

8.9

1.6

1.7

0.2

0.2

9.4

9.6

1.2

1.1

1.8

3.2

35.7 19.7 32.6
1.4 16.2
1.8 9.1

36.6 19.5 32.5
1.1 15.3
1.5 8.3

2.6 2.7 12.5

2.7 2.7 13.1

72.7 15.2 14.8 57.9 51.1 42.6 19.5

74.5 15.3 16.4 61.6 58.3 49.1 24.5

1994 5-year

15.2 68.5 2.0 38.7 2.1 9.3 0.3 111.6 5.4

15.9 70.5
2.1 37.2
2.3 10.2
0.3 118.2
5.8

103.4 20.4 87.9 75.8 12.3 97.8 4.7

102.0 22.6 85.8 73.0 12.9 97.9
4.8

11.1 7.2 4.0
15.8 0.6 0.4

11.7 7.5 4.2
17.2 0.6 0.4

9.0

8.8

1.8

1.7

0.2

0.2

9.5

9.5

1.3

1.1

1.5

1.9

34.2 19.3 31.8
1.0 14.2
1.2 8.2

36.4 19.4 33.0
1.3 16.1
1.7 8.8

2.6 2.4 14.0

2.2 2.2 11.5

77.1 15.3 17.1 59.8 56.3 47.0 28.9

73.1 15.5 14.8 58.3 50.6 42.5 20.4

White
1990 1991 1992 1993 1994 5-year

14.8 67.0
2.0 16.9
2.2 9.9 0.3 120.1 5.4

14.2 64.6
1.9 18.0
2.1 9.4 0.3 117.6 5.6

14.4 65.9 2.0 19.3 1.9 8.6 0.2 107.2 5.4

14.0 64.5
2.0 20.5
1.8 8.4 0.2 107.5 5.0

13.9 64.7 2.0 20.9 1.7
7.8 0.2 100.3 4.8

14.2 65.4
2.0 19.1
1.9 8.8 0.2 110.6 5.2

82.0 20.3 67.3 42.7 12.6 95.7
3.2

78.2 18.6 63.9 46.6 11.5 97.8
3.8

75.8 20.1 63.2 48.8 9.8 96.8 4.1

78.5 18.0 65.7 52.3 10.6 96.7
3.3

79.3 17.0 66.6 53.5 10.2 96.9 3.6

78.8 18.8 65.3 48.8 10.9 96.7
3.6

9.4 5.9 3.6 14.9 0.6 0.4

8.5 5.5 3.0 12.6 0.5 0.4

9.2 5.5 3.7 11.9 0.4 0.5

8.7 5.5 3.2 10.6 0.6 0.4

8.0 4.8 3.2 11.1 0.4 0.4

8.8 5.4 3.3 12.3 0.5 0.4

6.7

6.3

6.5

6.8

6.8

6.6

1.1

0.9

1.1

1.1

1.2

1.1

0.1

0.1

0.1

0.1

0.1

0.1

7.9

8.0

7.6

7.8

7.8

7.8

1.0

0.9

1.1

1.0

1.2

1.0

1.4

1.5

1.9

3.5

1.4

2.0

32.0 8.7
31.6 1.0
22.4 1.9 6.6

31.2 9.3
31.6 0.7
21.3 1.7 6.6

30.5 9.7 30.6 0.8 20.5 1.4 6.9

31.7 9.7
30.5 0.7
19.8 1.2 6.7

29.5 9.9
29.5 0.7 18.2 0.9 6.3

30.9 9.4
30.8 0.8
20.5 1.4 6.6

.

0.9

2.2

2.5

2.3

2.0

.

1.1

2.8

2.8

2.5

2.3

.

4.2

8.9

9.6

10.4

8.3

77.4 17.8 11.8 42.0 29.2 23.5
.

78.5 16.3 13.4 50.2 36.2 31.6
7.1

79.2 15.6 14.9 49.0 40.1 33.6 16.0

80.6 15.6 16.6 52.1 47.3 38.9 19.1

82.6 15.3 17.1 51.0 46.1 37.8 23.0

79.6 16.1 14.8 48.8 39.7 33.0 16.3

Black
1990 1991 1992 1993 1994 5-year

22.3 91.0
2.5 68.9
3.3 13.6
0.4 120.9
8.2

21.6 88.7
2.5 72.1
3.4 13.8
0.4 125.3
7.8

21.1 86.8 2.4 71.2 3.4 13.9 0.4 128.0 7.8

19.9 82.3
2.3 73.4
3.2 13.4
0.4 130.3
7.2

19.4 80.6 2.3 74.7 3.2 13.1 0.4 130.4 6.9

20.8 85.9
2.4 72.0
3.3 13.6
0.4 126.9
7.6

152.9 26.8 129.4 96.7 17.5 100.0
7.9

156.6 29.1
133.6 96.8 17.4 99.6 7.8

143.1 27.9
122.3 97.3 15.6
100.0 7.3

147.0 25.6
126.4 97.7 16.1 98.8 6.8

154.1 23.9
132.9 98.0 16.7 98.9 6.9

150.7 26.7
128.9 97.3 16.7 99.5 7.3

18.0 11.9
6.2 30.1
0.9 0.5

19.3 12.7
6.7 28.6
0.9 0.5

14.6 10.1 4.6 24.6 0.7 0.5

16.9 10.4
6.5 23.8
0.8 0.5

17.6 11.9 5.7 25.4 0.9 0.5

17.3 11.4
5.9 26.6
0.8 0.5

13.0

12.6

12.8

13.0

13.6

13.0

2.6

2.7

2.5

2.9

3.1

2.7

0.3

0.3

0.3

0.3

0.5

0.4

12.6

12.5

12.8

13.1

12.8

12.8

1.3

1.3

1.3

1.3

1.6

1.3

2.0

1.7

1.6

2.5

1.6

1.8

48.2 38.1 38.4
2.9 10.3
3.0 12.9

49.4 38.7 39.4
2.6 8.6 2.2 13.7

45.0 38.8 36.6 2.5 8.4 2.4 12.8

45.8 39.0 36.4
2.0 7.0 2.0 11.2

43.8 38.5 36.6 1.8 6.4 1.7 11.8

46.5 38.6 37.5
2.4 8.2 2.3 12.5

.

1.0

2.5

2.7

2.7

2.2

.

0.9

1.8

2.1

2.1

1.7

.

8.4

15.7

17.0

18.3

14.9

56.5 14.0 11.8 71.3 61.3 49.8
.

58.6 13.8 13.9 78.1 68.7 59.6 12.2

60.5 14.4 14.1 75.2 72.4 60.3 26.4

62.6 14.8 16.1 80.5 80.1 69.6 35.4

66.2

60.8

15.3

14.4

16.9

14.5

77.7

76.5

77.4

71.7

66.0

60.8

41.2

28.4

165

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events

Total
1990 1991 1992 1993 1994 5-year

Population

3408556 3493579 3578362 3663419 3748169 17892085

Women age 15-44

888768 898369 907919 917512 927077 4539645

Women age 15-17

68762 69766 70761 71766 72761 353816

Woman's median age at:

Conception of first birth

23.5

23.5

23.8

23.9

24.0

23.7

Conception of first abortion

20.9

21.1

21.2

21.3

21.5

21.2

First marriage

23.0

23.0

23.0

24.0

24.0

23.0

Pregnancy and perinatal outcomes

Conceptions to women under 18

6812

6632

6526

6591

6551 33112

Repeat conceptions to women under 18

1706

1666

1731

1564

1511

8178

Total Livebirths

58943 58115 58110 59129 60204 294501

Livebirths to women under 18

4515

4538

4392

4486

4589 22520

Livebirths to unmarried women

16518 17053 17486 17962 18081 87100

Early fetal deaths

4384

4921

4808

4355

4213 22681

Fetal deaths 20 weeks or more gestation

579

643

600

542

554

2918

Total induced abortions

25663 25278 25022 24711 23470 124144

Induced abortions to women under 18

2087

1875

1911

1913

1794

9580

Infant and child survival

Infant deaths

681

577

522

546

517

2843

Neonatal deaths

463

374

345

362

319

1863

Postneonatal deaths

218

203

177

184

198

980

Perinatal deaths

1032 1014

940

896

864

4746

Deaths of children 1-4 years

105

107

85

103

111

511

Deaths of children 5-17 years

222

235

235

246

200

1138

Infant health

Low birthweight

4775

4719

4684

4895

4769 23842

Very low birthweight

952

940

948

1044

939

4823

Under 500 grams

110

108

98

109

106

531

Preterm gestation

5558

5465

5464

5505

5400 27392

Multiple gestation

688

701

725

761

784

3659

Born with birth defect

818

797

761

1091

523

3990

Maternal risk markers for lowered infant survival

Weight gain less than 25 lbs. during pregnancy

11378 10258 10795 12098 14398 58927

Father not named on birth certificate

9129

9402

9494

9343

9434 46802

Maternal education less than high school

12198 12371 12089 12152 11866 60676

No prenatal care

1746 1546 1299

959

691

6241

Maternal smoking during pregnancy

8238

7521

6680

6385

6308 35132

Maternal alcohol use during pregnancy

1732 1352 1153

976

1066

6279

Interpregnancy interval less than 6 months

2419

2414

2495

2259

2156 11743

Abuse & neglect to persons under age 18 years

Physical

.

753

2132

2112

1927

6924

Sexual

.

600

1443

1305

1112

4460

Neglect

.

2956

7938

7748

7308 25950

Interventions to improve infant & child survival

Prenatal care first trimester

42552 43076 44305 47387 50300 227620

Primary C-section delivery

8036

7689

7323

7282

7272 37602

Vaginal birth after previous C-section

1402

1320

1360

1464

1614

7160

WIC during pregnancy

19907 23897 22656 24884 24329 115673

Medicaid during pregnancy

15228 18709 20737 24920 23676 103270

WIC and Medicaid during pregnancy

11628 15717 16229 19501 18806 81881

Perinatal case management

.

2241

4876

6959

8836 22912

Child fatality investigations

128

236

162

232

244

1002

Perinatal region 1 - Atlanta

White
1990 1991 1992 1993 1994 5-year
2578521 2634247 2689858 2745597 2801158 13449381 646445 651056 655642 660253 664834 3278230 49343 49895 50441 50993 51539 252210

24.2 21.0 22.0

24.3 21.1 22.0

24.6 21.4 23.0

24.6 21.8 23.0

24.8 21.9 23.0

24.5 21.4 23.0

3490 681
40200 2334 5661 2829 270
13099 1073

3312 578 39117 2307 5902 3160 283 12218 910

3195 611
38940 2262 6194 3067 276
11386 844

3219 596 39328 2275 6470 2859 220 11105 850

3271 552
40520 2352 6851 2719 261
10224 831

16487 3018
198105 11530 31078 14634 1310 58032 4508

353

263

237

258

244

1355

237

171

151

161

148

868

116

92

86

97

96

487

504

459

427

373

406

2169

69

63

54

54

61

301

139

157

150

151

127

724

2444 425 47
2951 449 550

2366 406
42 2885 441 503

2284 366 28
2817 466 509

2395 450
28 2860 472 829

2459 398 34
2930 534 381

11948 2045 179
14443 2362 2772

7729 2802 8149
668 6466 1017 1199

6730 2967 8126 536 5879 747 1186

6940 3008 7894
463 5303
609 1179

7657 2957 7831 309 5085 513 1086

8643 3176 7774
287 4999
631 1089

37699 14910 39774
2263 27732
3517 5739

.

386

965

1078

1000

3429

.

399

958

902

775

3034

.

1306

3059

3350

3401 11116

31574 5519 884 9880 7362 5556 . 63

31335 5216 838
12083 9187 7683 1426 94

31888 4875 825
11532 10299
8119 2965
68

33223 4716 954
12716 12752
9747 3564 111

35145 4700 1136
12640 12429 9738
4432 110

163165 25026 4637 58851 52029 40843 12387 446

Black
1990 1991 1992 1993 1994 5-year

743069 218699
17488

755149 219021
17604

767207 219339
17719

779292 219663
17834

791349 3836067 219980 1096702
17949 88594

21.0 20.4 25.0

20.8 20.7 26.0

21.0 20.8 26.0

21.2 20.6 26.0

21.3 20.8 26.0

21.0 20.6 26.0

3251 1009 17595 2156 10742 1339
301 11363
972

3223 1070 17691 2188 11027 1544 344 11729 918

3229 1101 17749 2097 11131 1550
304 12352
1008

3262 950 18198 2164 11262 1299 304 12348 1009

3176 942
17887 2173
10966 1256 272
12181 930

16141 5072
89120 10778 55128
6988 1525 59973 4837

317

306

273

284

263

1443

218

200

183

197

163

961

99

106

90

87

100

482

511

537

485

500

432

2465

34

44

30

48

48

204

79

76

78

89

70

392

2242 509 62
2506 228 258

2254 526
66 2496 247 276

2303 565 69
2543 248 236

2389 571
80 2525 278 240

2192 523 70
2341 238 128

11380 2694 347
12411 1239 1138

3414 6271 3842 1058 1748
707 1177

3274 6354 3992 990 1615 601 1179

3556 6374 3926
820 1347
534 1261

4060 6222 3990 632 1261 457 1124

5250 6079 3797
383 1281
430 1011

19554 31300 19547
3883 7252 2729 5752

.

271

845

821

789

2726

.

119

297

317

276

1009

.

1336

3994

3788

3355 12473

10207 2382 497 9755 7705 5967 . 62

10829 2318 454
11375 9237 7797 775 127

11359 2287 515
10665 10062
7825 1818
83

12941 2409 481
11517 11533
9270 3202 114

13708 2388 438
11004 10587
8578 4159
120

59044 11784
2385 54316 49124 39437
9954 506
168

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Perinatal region 1 - Atlanta

17.3 66.3
2.0 28.4
7.5 28.9
0.9 285.5
5.9
99.1 25.0 65.7 72.9 30.4 97.9
4.3
11.6 7.9 3.7
17.3 0.5 0.4
8.1 1.6 0.2 9.6 1.2 1.4
28.3 15.7 21.2
3.0 14.4
3.0 7.9
. . .
73.7 15.3 24.2 34.2 26.1 20.0
.

16.6 64.7
2.0 29.7
7.2 28.1
0.8 283.2
6.5
95.1 25.1 65.0 74.8 26.9 98.3
4.0
9.9 6.4 3.5 17.3 0.5 0.4
8.1 1.6 0.2 9.5 1.2 1.4
27.0 16.4 21.8
2.7 13.5
2.4 8.0
0.8 0.7 3.3
75.4 14.8 24.0 41.6 32.6 27.4
3.9

16.2 64.0 2.0 30.5
7.0 27.6 0.8 281.9 6.2
92.2 26.5 62.1 76.8 27.0 98.2 4.3
9.0 5.9 3.1 16.0 0.4 0.4
8.1 1.6 0.2 9.5 1.3 1.3
27.4 16.6 21.4
2.3 12.0
2.1 7.9
2.3 1.6 8.6
77.3 14.1 24.9 39.5 36.1 28.3
8.5

16.1 64.4
2.0 30.8
6.7 26.9
0.8 277.9
5.5
91.8 23.7 62.5 78.2 26.7 97.9
3.5
9.2 6.1 3.1 15.0 0.5 0.4
8.3 1.8 0.2 9.4 1.3 1.9
27.7 16.0 21.1
1.7 11.3
1.7 7.1
2.2 1.4 8.2
81.1 13.7 27.5 42.6 42.7 33.4 11.9

16.1 64.9 2.0 30.4
6.3 25.3 0.8 264.7 5.4
90.0 23.1 63.1 78.1 24.7 98.5 3.2
8.6 5.3 3.3 14.2 0.5 0.3
7.9 1.6 0.2 9.1 1.3 0.9
26.9 15.9 20.3
1.2 10.9
1.8 6.8
2.0 1.1 7.5
84.7 13.5 29.3 41.0 39.9 31.7 14.9

16.5 64.9
2.0 30.0
6.9 27.3
0.8 278.7
5.9
93.6 24.7 63.6 76.2 27.1 98.2
3.8
9.7 6.3 3.3 16.0 0.5 0.3
8.1 1.6 0.2 9.4 1.3 1.4
27.4 16.1 21.1
2.2 12.4
2.2 7.5
1.9 1.2 6.9
78.5 14.3 25.9 39.8 35.5 28.2
9.9

15.6 62.2
1.9 14.2
5.1 20.3
0.6 231.5
5.1

14.8 60.1
1.8 15.3
4.6 18.8
0.6 222.2
5.6

14.5 59.4 1.8 16.1
4.2 17.4 0.5 211.6 5.3

14.3 59.6
1.8 16.7
4.0 16.8
0.5 207.1
4.8

14.5 60.9 1.9 17.1
3.6 15.4 0.5 189.9 4.7

14.7 60.4
1.9 15.9
4.3 17.7
0.5 212.7
5.1

70.7 19.5 47.3 50.4 21.7 96.7
2.7

66.4 17.5 46.2 53.3 18.2 97.3
2.7

63.3 19.1 44.8 57.5 16.7 97.0 2.6

63.1 18.5 44.6 59.7 16.7 96.5
2.4

63.5 16.9 45.6 59.7 16.1 98.0 2.2

65.4 18.3 45.7 56.1 17.9 97.1
2.5

8.8 5.9 2.9 12.5 0.5 0.3

6.7 4.4 2.4 11.6 0.4 0.3

6.1 3.9 2.2 10.9 0.4 0.3

6.6

6.0

6.8

4.1

3.7

4.4

2.5

2.4

2.5

9.4

10.0

10.9

0.3

0.4

0.4

0.3

0.3

0.3

6.1

6.1

5.9

6.1

6.1

6.0

1.1

1.0

0.9

1.1

1.0

1.0

0.1

0.1

0.1

0.1

0.1

0.1

7.4

7.5

7.3

7.4

7.3

7.4

1.1

1.1

1.2

1.2

1.3

1.2

1.4

1.3

1.3

2.2

1.0

1.4

26.4 7.0
20.7 1.7
16.6 2.6 5.9

24.7 7.7
21.2 1.4
15.7 2.0 6.0

25.1 7.8 20.8 1.2 14.2 1.6 5.8

25.5 7.6
20.4 0.8
13.5 1.4 5.3

24.1 7.9
19.7 0.7 13.0 1.6 5.2

25.1 7.6
20.6 1.2
14.6 1.9 5.6

.

0.6

1.5

1.6

1.5

1.3

.

0.6

1.5

1.4

1.1

1.2

.

2.1

4.7

5.1

5.0

4.3

79.7 15.5 21.7 24.9 18.5 14.0
.

81.3 14.9 22.2 31.2 23.8 19.9
3.7

82.9 14.0 22.6 30.0 26.8 21.1
7.7

85.6 13.4 26.2 32.7 32.8 25.1
9.2

87.9 13.0 29.8 31.6 31.1 24.4 11.1

83.5 14.2 24.5 30.1 26.6 20.9
7.9

23.7 80.5
2.4 61.9 15.3 52.0
1.5 370.5
7.8

23.4 80.8
2.4 63.2 15.5 53.6
1.6 373.7
9.0

23.1 80.9 2.4 63.7 16.1 56.3 1.7 385.9 8.7

23.4 82.8
2.5 62.9 15.8 56.2
1.7 383.5
7.5

22.6 81.3 2.4 62.1 15.4 55.4 1.6 384.7 7.2

23.2 81.3
2.4 62.8 15.6 54.7
1.6 379.7
8.1

185.9 31.0 123.3 97.7 55.6 99.3
8.6

183.1 33.2
124.3 97.9 52.1 99.6 7.7

182.2 34.1
118.4 98.1 56.9 99.3 9.1

182.9 29.1
121.3 98.2 56.6 99.1 7.0

176.9 29.7
121.1 98.2 51.8 99.0 6.1

182.2 31.4
121.7 98.0 54.6 99.2 7.7

18.0 12.4
5.7 28.6
0.6 0.5

17.3 11.3
6.1 29.8
0.8 0.5

15.4 10.3 5.1 26.9 0.5 0.5

15.6 10.8
4.8 27.0
0.8 0.5

14.7 9.1 5.6 23.8 0.8 0.4

16.2 10.8
5.5 27.2
0.7 0.5

12.8

12.7

13.0

13.1

12.3

12.8

2.9

3.0

3.2

3.1

2.9

3.0

0.4

0.4

0.4

0.4

0.4

0.4

14.5

14.4

14.6

14.1

13.3

14.2

1.3

1.4

1.4

1.6

1.3

1.4

1.5

1.6

1.3

1.3

0.7

1.3

33.3 36.1 22.3
6.2 10.3
4.2 12.0

32.7 36.4 23.2
5.8 9.4 3.5 12.0

32.7 36.4 22.6 4.7 8.0 3.2 12.0

32.6 34.7 22.4
3.5 7.2 2.6 10.7

32.8 34.4 21.7 2.2 7.3 2.5 10.3

32.8 35.6 22.4
4.5 8.4 3.2 11.4

.

1.1

3.5

3.3

3.2

2.8

.

0.5

1.2

1.3

1.1

1.0

.

5.7

16.6

15.4

13.4

12.8

59.7 15.2 30.2 56.2 44.4 34.4
.

62.5 14.7 27.8 65.2 52.9 44.7
4.4

64.8 14.5 29.7 61.0 57.5 44.7 10.4

71.7 14.7 30.3 64.3 64.4 51.7 17.9

77.7

67.4

14.9

14.8

27.7

29.1

62.4

61.8

60.0

55.9

48.6

44.9

23.6

14.1

169

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Perinatal region 2 - Augusta

1990
681954 168926 14449
21.2 19.9 22.0
1657 412
11835 1215 4306 833 135 3511 386
159 99 60 235 24 61
1071 222 19
1201 143 190
4260 2293 3328
245 1924
263 589
. . .
8420 1618
162 5066 4202 3244
. 16

1991
692693 170774
14595
21.2 20.2 22.0
1538 394 11682 1188 4495 814 139 3358 308
153 106
47 244
28 54
1088 200
27 1130 146 163
4365 2366 3265 222 1728 264 565
129 107 642
8623 1513 197 5952 5087 4327
315 23

Total
1992 1993

703318 172613 14742

714035 174456
14889

21.7 20.1 22.0

21.4 20.2 23.0

1455 377
11368 1098 4506 828 126 3125 304

1516 352 11328 1188 4579 828 108 3075 286

127

112

80

72

47

40

204

181

18

20

54

55

1041 185 17
1052 134 326

1011 191
19 1090 143 303

3469 2386 3147
184 1571
234 606

3559 2340 2974 124 1424 192 498

376 323 1564

455 335 1808

8399 1487
222 5626 5437 4395 1274
13

8629 1441 233 5794 6082 4852 2058
23

1994 5-year
724638 3516638 176284 863053
15037 73713

21.3 19.8 23.0

21.3 20.1 22.0

1579 344
10895 1210 4316 813 106 2838 315

7745 1879 57108 5899 22202 4116
614 15907
1599

115

666

77

434

38

232

180

1044

21

111

55

279

992 205
23 1012
149 143

5203 1003
105 5485
715 1125

3336 2213 2809
116 1318
191 424

18989 11598 15523
891 7965 1144 2682

460 321 2072

1420 1086 6086

8702 1512
208 5614 5650 4546 2291
16

42773 7571 1022
28052 26458 21364
5938 91

White
1990 1991 1992 1993 1994 5-year

458249 110564
8528

465646 111673
8614

472965 112771
8699

480341 113874
8786

487657 2364858 114967 563849
8872 43498

22.3 20.2 21.0

22.5 20.6 22.0

23.1 20.3 22.0

22.6 20.7 22.0

23.0 20.4 22.0

22.7 20.4 22.0

744 162 6930 527 1074 511 47 1906 191

595 130 6735 430 1173 493
62 1797
146

579 116 6583 417 1197 498
58 1615
142

617 113 6661 473 1294 530
46 1634
132

645 116 6521 486 1272 481
47 1484
134

3180 637
33430 2333 6010 2513 260 8436 745

62

70

54

50

48

284

38

47

28

32

33

178

24

23

26

18

15

106

84

107

86

75

80

432

12

12

13

8

7

52

42

30

33

27

34

166

398

423

420

412

435

2088

72

60

75

63

85

355

5

4

3

5

11

28

528

492

457

489

500

2466

68

75

75

84

83

385

103

88

181

178

83

633

1928 519
1624 54
1381 138 231

1916 570 1539
52 1266 141 198

1636 579
1504 40
1173 116 228

1710 614 1413
42 1088 103 189

1748 582
1388 35
1018 95
170

8938 2864 7468
223 5926
593 1016

.

60

192

221

213

686

.

58

214

194

202

668

.

228

502

613

698

2041

5523 1024
101 1996 1549 1137
. 8

5522 983
99 2409 1961 1628 147
8

5327 952 131
2346 2193 1723
656 5

5535 888 141 2421 2546 1897 901
11

5565 898 128
2504 2487 1934 1070
7

27472 4745 600
11676 10736
8319 2774
39

Black
1990 1991 1992 1993 1994 5-year

211674 54652 5667

214177 55205 5703

216648 55757 5738

219146 56310 5774

221606 1083252 56856 278780 5810 28691

19.5 18.9 24.0

19.3 19.1 25.0

19.7 19.2 25.0

19.5 19.1 25.0

19.2 18.6 25.0

19.4 19.0 25.0

908 250 4738 688 3216 309
88 1471
191

939 264 4797 756 3316 303
75 1439 160

869 260 4612 679 3292 314
67 1386
158

889 234 4530 709 3264 282
62 1329 150

927 227 4192 721 3024 312
59 1272
178

4532 1235 22869 3553 16112 1520
351 6897
837

96

83

72

62

65

378

60

59

52

40

43

254

36

24

20

22

22

124

150

135

117

105

100

607

12

16

5

12

14

59

19

23

21

28

19

110

665

657

609

589

547

3067

147

140

108

127

120

642

14

23

14

13

12

76

664

628

583

588

502

2965

73

70

58

59

63

323

85

74

138

120

60

477

2296 1768 1688
191 534 124 352

2403 1792 1711
170 459 122 361

1792 1797 1619
142 383 118 373

1815 1715 1548
82 324
86 302

1541 1617 1401
79 292
93 250

9847 8689 7967
664 1992
543 1638

.

59

157

211

198

625

.

48

97

126

102

373

.

388

989

1124

1290

3791

2767 571 58
3016 2622 2082
. 6

2977 508
94 3501 3100 2683 165
14

2932 513 87
3241 3206 2651
612 7

2990 538
88 3323 3489 2926 1154
9

2981 592 75
3040 3109 2570 1201
7

14647 2722 402
16121 15526 12912
3132 43
170

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Perinatal region 2 - Augusta

17.4 70.1
2.0 36.9
5.1 20.8
0.6 214.5
6.1
114.7 24.9 84.1 75.8 26.7 97.6
5.6
13.4 8.4 5.1
19.6 0.6 0.5
9.1 1.9 0.2 10.3 1.2 1.6
41.3 19.6 28.8
2.1 16.6
2.3 9.0
. . .
71.9 15.3 14.6 43.3 35.9 27.8
.

16.9 68.4
2.0 39.0
4.8 19.7
0.5 209.3
5.9
105.4 25.6 81.4 81.1 21.1 97.4 4.3
13.1 9.1 4.1
20.6 0.6 0.4
9.3 1.7 0.2 9.8 1.3 1.4
43.0 20.5 28.7
1.9 15.5
2.4 8.6
0.7 0.6 3.4
74.7 14.6 17.0 51.6 44.1 37.5
2.7

16.2 65.9 1.9 40.1 4.4 18.1 0.5 201.8 5.8
98.7 25.9 74.5 81.4 20.6 99.0 4.5
11.2 7.0 4.2
17.7 0.4 0.4
9.2 1.6 0.1 9.4 1.2 2.9
34.8 21.2 28.2
1.6 15.0
2.2 9.4
2.0 1.7 8.2
74.6 14.7 19.6 50.1 48.4 39.1 11.3

15.9 64.9
1.9 41.0
4.3 17.6
0.5 200.0
5.6
101.8 23.2 79.8 83.4 19.2 97.9 3.6
9.9 6.4 3.6 15.8 0.4 0.4
8.9 1.7 0.2 9.8 1.3 2.7
35.4 20.9 26.8
1.1 13.6
1.8 7.8
2.4 1.7 9.3
77.0 14.5 19.1 51.8 54.4 43.4 18.4

15.0 61.8 1.8 40.2 3.9 16.1 0.4 193.3 5.4
105.0 21.8 80.5 83.1 20.9 98.4 5.1
10.6 7.1 3.5
16.4 0.5 0.4
9.1 1.9 0.2 9.4 1.4 1.3
32.5 20.6 26.4
1.1 12.4
1.8 7.1
2.3 1.6 10.6
80.8 15.8 17.9 52.3 52.6 42.3 21.3

16.2 66.2
1.9 39.4
4.5 18.4
0.5 204.1
5.7
105.1 24.3 80.0 80.9 21.7 98.0
4.6
11.7 7.6 4.1
18.1 0.5 0.4
9.1 1.8 0.2 9.7 1.3 2.0
37.4 20.6 27.8
1.6 14.7
2.1 8.4
1.8 1.4 7.9
75.7 15.0 17.7 49.8 46.9 37.9 13.3

15.1 62.7
1.8 15.7
4.2 17.2
0.5 202.2
5.3

14.5 60.3
1.7 17.6
3.9 16.1
0.4 197.1
5.2

13.9 58.4 1.7 18.4 3.4 14.3 0.4 184.1 5.1

13.9 58.5
1.7 19.7
3.4 14.3
0.4 183.9
5.2

13.4 56.7 1.7 19.8 3.0 12.9 0.3 173.7 4.7

14.1 59.3
1.7 18.2
3.6 15.0
0.4 188.5
5.1

87.2 21.8 61.8 46.9 22.4 95.8
4.5

69.1 21.8 49.9 54.0 16.9 95.9
2.8

66.6 20.0 47.9 53.4 16.3 98.6 3.1

70.2 18.3 53.8 61.5 15.0 96.9
2.2

72.7 18.0 54.8 61.0 15.1 97.7 4.3

73.1 20.0 53.6 55.3 17.1 96.9
3.4

8.9 5.5 3.5 12.0 0.5 0.5

10.4 7.0 3.4
15.7 0.5 0.4

8.2 4.3 4.0 12.9 0.5 0.4

7.5 4.8 2.7 11.2 0.3 0.3

7.4 5.1 2.3 12.2 0.3 0.4

8.5 5.3 3.2 12.8 0.4 0.4

5.7

6.3

6.4

6.2

6.7

6.2

1.0

0.9

1.1

0.9

1.3

1.1

0.1

*

*

0.1

0.2

0.1

7.7

7.4

7.0

7.4

7.8

7.5

1.0

1.1

1.2

1.3

1.3

1.2

1.5

1.3

2.8

2.7

1.3

1.9

32.2 7.6
23.9 0.8
20.4 2.0 6.4

33.3 8.6
23.4 0.8
19.7 2.2 5.6

28.8 8.9 23.3 0.6 19.5 1.9 6.4

29.2 9.3
21.6 0.6
17.9 1.7 5.3

28.5 9.0
21.7 0.5 16.1 1.5 4.9

30.4 8.7
22.8 0.7
18.7 1.9 5.7

.

0.5

1.7

1.9

1.8

1.5

.

0.5

1.9

1.7

1.7

1.5

.

2.0

4.4

5.3

6.0

4.5

80.3 16.6 14.5 29.1 22.6 16.6
.

82.6 16.5 14.1 36.2 29.5 24.5
2.2

81.6 16.4 18.6 36.0 33.7 26.5 10.1

83.6 15.2 18.9 36.8 38.7 28.8 13.7

86.1 15.7 17.8 38.9 38.6 30.1 16.6

82.8 16.1 16.8 35.3 32.5 25.2 10.6

22.4 86.7
2.5 68.9
6.9 26.9
0.7 221.9
7.7

22.4 86.9
2.5 70.3
6.7 26.1
0.7 216.9
7.2

21.3 82.7 2.4 72.4 6.4 24.9 0.7 216.6 7.2

20.7 80.4
2.4 73.1
6.1 23.6
0.6 213.6
6.4

18.9 73.7 2.2 73.2 5.7 22.4 0.6 217.3 6.9

21.1 82.0
2.4 71.5
6.4 24.7
0.7 217.3
7.1

160.2 27.5 121.4 97.8 33.7 99.5
7.4

164.7 28.1
132.6 96.9 28.1 98.7 6.8

151.4 29.9
118.3 98.5 27.5 99.4 6.8

154.0 26.3
122.8 98.0 26.0 98.6 6.1

159.6 24.5
124.1 98.2 30.6 98.9 6.5

158.0 27.3
123.8 97.9 29.2 99.0 6.7

20.3 12.7
7.7 31.1
0.7 0.4

17.3 12.3
5.1 27.7
1.0 0.4

15.6 11.3 4.4 25.0 0.3 0.4

13.7 8.8 4.9
22.9 0.7 0.5

15.5 10.3 5.3 23.5 0.8 0.3

16.5 11.1
5.5 26.1
0.7 0.4

14.0 3.1 0.3
14.3 1.6 1.8

13.7 2.9 0.5
13.3 1.5 1.5

13.2 2.3 0.3 12.8 1.3 3.0

13.0 2.8 0.3
13.2 1.3 2.7

13.0 2.9 0.3 12.2 1.5 1.4

13.4 2.8 0.3
13.2 1.4 2.1

54.6 37.9 36.5
4.1 11.5
2.7 12.4

56.4 37.9 36.7
3.6 10.0
2.7 12.4

43.4 39.5 35.8 3.1 8.9 2.8 13.3

44.4 38.4 34.9
1.9 7.7 2.0 11.1

38.8 39.2 34.2 1.9 7.1 2.3 10.6

47.7 38.6 35.7
3.0 9.1 2.5 12.0

.

0.8

2.1

2.8

2.6

2.1

.

0.7

1.3

1.7

1.4

1.3

.

5.3

13.4

15.1

17.1

12.8

59.2 13.4 14.5 64.6 56.2 44.6
.

63.2 11.9 21.4 74.1 65.6 56.8
3.5

64.4 12.4 20.8 71.2 70.5 58.3 13.5

67.1 13.4 19.3 74.4 78.1 65.5 25.8

72.2

65.0

16.0

13.3

17.6

18.8

73.6

71.5

75.3

68.9

62.2

57.3

29.1

17.5

171

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Perinatal region 3 - Macon

1990
632632 147656 14273
20.6 19.6 22.0
1545 365
10370 1221 4206 597 136 2329 294
163 102 61 242 18 52
1040 199 33
1173 114 115
3273 2277 3073
158 1586
194 561
. . .
7387 1536
163 5195 4494 3533
. 4

1991
637788 148024
14308
20.8 19.6 22.0
1519 393 10290 1194 4327 513 116 2336 285
151 108
43 223
19 63
994 212
35 1113 111 101
3076 2291 3068 169 1264 148 623
216 201 1225
7172 1421 184 5616 4978 4057
738 31

Total
1992 1993

642790 148368 14341

647922 148730
14374

20.5 19.7 22.0

20.7 19.4 22.0

1490 380
10100 1181 4413 472 113 2290 278

1448 326 9888 1152 4454 453
91 2302 267

148

156

92

105

56

51

203

195

24

23

55

45

966 178
22 1033
131 125

966 203
25 1050 119 200

3209 2243 2933
182 1400
149 595

3218 2214 2849 166 1141 109 484

518 488 2168

477 434 2075

7203 1334
238 5395 5280 4176 1332
38

7232 1334 209 5561 5899 4615 2182
97

1994 5-year
652936 3214068 149073 741851
14405 71702

20.6 19.5 23.0

20.6 19.6 22.0

1526 327
10139 1235 4518 469 94 2192 258

7528 1791 50787 5983 21918 2504
550 11449
1382

161

779

103

510

58

269

199

1062

25

109

66

281

1029 228 37
1148 126 144

4995 1020
152 5517
601 685

3162 2235 2812
202 1243
121 459

15938 11260 14735
877 6634
721 2722

486 433 2508

1697 1556 7976

7579 1434
202 5516 5708 4469 2349
52

36573 7059 996
27283 26359 20850
6601 222

White
1990 1991 1992 1993 1994 5-year

404294 89464 7906

407164 89433 7921

409935 89386 7935

412796 89352 7948

415586 2049775 89308 446943 7960 39670

22.1 19.6 21.0

22.7 20.0 21.0

22.2 20.0 21.0

22.3 19.8 21.0

22.9 19.9 22.0

22.4 19.9 21.0

623 116 5534 457 906 337 47 1259 155

568 109 5392 408 931 285
39 1166
139

540 105 5311 409 1018 253
29 1103
120

517 103 5220 382 1028 259
30 1067
124

515 84
5412 400
1073 278 28 940 98

2763 517
26869 2056 4956 1412 173 5535 636

49

44

61

49

73

276

34

26

34

34

43

171

15

18

27

15

30

105

84

66

62

64

71

347

8

7

4

13

8

40

30

30

25

22

29

136

375

345

329

333

363

1745

64

59

57

59

73

312

12

6

8

4

9

39

461

413

401

395

464

2134

59

55

58

57

59

288

51

40

60

75

65

291

1524 441
1363 24
1125 82 194

1415 450 1322
33 946
66 210

1469 483
1275 33
1007 47
187

1489 458 1265
28 877
40 171

1477 480
1213 54
950 51
156

7374 2312 6438
172 4905
286 918

.

96

218

236

230

780

.

105

303

261

244

913

.

356

732

776

911

2775

4489 913 83
1998 1536 1217
. 2

4362 846
94 2197 1732 1442 307
10

4305 755 110
2109 1884 1515
579 11

4269 750 115 2207 2218 1677 825
34

4523 800 99
2249 2123 1679 1008
15

21948 4064 501
10760 9493 7530 2719 72

Black
1990 1991 1992 1993 1994 5-year

222250 56519 6223

223738 56561 6235

225169 56592 6245

226645 56632 6256

228080 1125882 56662 282967 6266 31224

19.1 19.5 24.0

19.3 19.1 25.0

19.0 19.0 25.0

19.2 19.0 25.0

18.8 19.0 25.0

19.1 19.1 25.0

914 249 4773 762 3295 257
87 1016
133

947 284 4833 785 3391 226
77 1118
143

943 272 4710 772 3387 216
84 1126
151

927 223 4589 770 3415 190
60 1170 139

1006 243
4620 831
3434 186 66
1210 159

4737 1271 23525 3920 16922 1075
374 5640
725

113

107

86

107

88

501

67

82

58

71

60

338

46

25

28

36

28

163

155

157

141

130

128

711

10

12

20

10

17

69

22

33

29

23

37

144

658

646

633

626

661

3224

134

151

121

144

154

704

21

29

14

21

28

113

704

696

628

647

675

3350

55

56

73

61

67

312

62

61

65

125

79

392

1728 1833 1701
133 459 112 365

1648 1840 1739
136 316
82 411

1714 1757 1649
148 390 102 403

1706 1752 1575
138 261
68 309

1658 1750 1584
148 287
70 300

8454 8932 8248
703 1713
434 1788

.

79

241

209

226

755

.

72

142

142

167

523

.

703

1186

1178

1412

4479

2853 614 79
3187 2945 2308
. 2

2765 563
88 3402 3234 2607 430
9

2839 569 124
3264 3377 2649
752 27

2908 570
93 3326 3648 2915 1349
62

2977 619 101
3225 3548 2760 1325
34

14342 2935 485
16404 16752 13239
3856 134
172

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Perinatal region 3 - Macon

16.4 70.2
2.1 41.0
3.7 15.8
0.5 172.7
5.3
108.2 23.6 85.5 78.5 20.6 97.9
3.4
15.7 9.8 5.9
23.0 0.5 0.4
10.0 1.9 0.3
11.4 1.1 1.1
36.6 22.2 30.1
1.6 15.5
1.9 9.4
. . .
72.4 16.8 14.5 50.7 43.8 34.5
.

16.1 69.5
2.1 42.5
3.7 15.8
0.5 175.6
4.6
106.2 25.9 83.4 81.3 19.9 99.3 4.3
14.7 10.5
4.2 21.4
0.5 0.5
9.7 2.1 0.3 11.0 1.1 1.0
36.2 22.5 30.3
1.7 12.5
1.5 10.4
1.2 1.1 7.0
71.8 15.7 16.3 55.2 48.9 39.9
7.3

15.7 68.1 2.0 44.3 3.6 15.4 0.5 176.1 4.2
103.9 25.5 82.4 82.8 19.4 98.5 3.4
14.7 9.1 5.6 19.9 0.6 0.4
9.6 1.8 0.2 10.4 1.3 1.2
37.0 22.5 29.5
1.8 14.1
1.5 10.1
2.9 2.8 12.3
72.6 15.1 20.7 54.1 53.0 41.9 13.4

15.3 66.5
2.0 45.6
3.6 15.5
0.5 180.4
3.8
100.7 22.5 80.1 83.2 18.6 98.5 3.1
15.8 10.6
5.2 19.5
0.6 0.3
9.8 2.1 0.3 10.8 1.2 2.0
36.9 22.7 29.2
1.7 11.7
1.1 8.5
2.7 2.4 11.7
73.8 15.4 18.7 57.0 60.4 47.3 22.4

15.5 68.0 2.0 45.1 3.4 14.7 0.4 169.6 4.0
105.9 21.4 85.7 85.7 17.9 98.0 4.2
15.9 10.2 5.8 19.4 0.6 0.5
10.1 2.2 0.4 11.5 1.3 1.4
35.0 22.3 28.2
2.0 12.5
1.2 8.0
2.7 2.4 14.0
75.6 16.1 18.5 55.1 57.0 44.6 23.5

15.8 68.5
2.0 43.7
3.6 15.4
0.5 174.9
4.4
105.0 23.8 83.4 82.3 19.3 98.5
3.7
15.3 10.0
5.4 20.7
0.6 0.4
9.8 2.0 0.3 11.0 1.2 1.4
36.3 22.4 29.5
1.8 13.3
1.4 9.3
2.4 2.2 11.3
73.2 15.8 17.8 54.4 52.5 41.6 16.5

13.7 61.9
1.9 16.6
3.1 14.1
0.4 174.9
4.5

13.2 60.3
1.8 17.5
2.9 13.0
0.4 168.8
3.9

13.0 59.4 1.8 19.4 2.7 12.3 0.4 164.5 3.3

12.6 58.4
1.8 19.9
2.6 11.9
0.4 161.9
3.4

13.0 60.6 1.9 20.0 2.3 10.5 0.3 140.9 3.6

13.1 60.1
1.8 18.7
2.7 12.4
0.4 162.5
3.7

78.8 18.6 57.8 48.4 19.6 98.0
2.0

71.7 19.2 51.5 51.0 17.5 99.3
3.5

68.1 19.4 51.5 54.2 15.1 96.7 2.1

65.1 19.9 48.1 52.8 15.6 98.4
1.9

64.7 16.3 50.2 60.1 12.3 96.9 3.3

69.7 18.7 51.8 53.1 16.0 97.9
2.6

8.9 6.1 2.7 15.1 0.4 0.4

8.2 4.8 3.4 12.2 0.3 0.4

11.5 6.4 5.1 11.6 * 0.4

9.4 6.5 2.9 12.2 0.6 0.3

13.5 7.9 5.6
13.1 0.4 0.4

10.3 6.4 3.9
12.8 0.4 0.4

6.8

6.4

6.2

6.4

6.7

6.5

1.2

1.1

1.1

1.1

1.3

1.2

0.2

0.1

0.2

*

0.2

0.1

8.4

7.7

7.6

7.7

8.7

8.0

1.1

1.0

1.1

1.1

1.1

1.1

0.9

0.7

1.1

1.4

1.2

1.1

30.6 8.1
25.0 0.4
20.6 1.5 6.4

30.3 8.4
24.8 0.6
17.8 1.2 7.1

31.0 9.2 24.3 0.6 19.3 0.9 6.4

31.4 8.9
24.6 0.5
17.0 0.8 5.8

30.0 9.0
22.7 1.0 17.8 1.0 5.1

30.7 8.7
24.3 0.7
18.5 1.1 6.2

.

1.0

2.2

2.4

2.3

2.0

.

1.1

3.1

2.6

2.5

2.3

.

3.7

7.5

7.9

9.2

7.1

82.1 19.0 12.5 36.5 28.1 22.2
.

82.2 18.0 14.6 41.2 32.5 27.0
5.8

82.3 16.3 17.4 40.1 35.9 28.8 11.0

82.3 16.6 17.7 42.8 43.0 32.5 16.0

84.3 16.9 15.7 42.0 39.7 31.4 18.8

82.6 17.4 15.5 40.5 35.7 28.3 12.9

21.5 84.4
2.4 69.9
4.6 18.0
0.5 164.9
6.6

21.6 85.4
2.4 71.0
5.0 19.8
0.6 178.1
5.8

20.9 83.2 2.4 73.1 5.0 19.9 0.6 182.9 5.7

20.2 81.0
2.3 75.5
5.2 20.7
0.6 194.4
4.6

20.3 81.5 2.3 75.5 5.3 21.4 0.6 198.4 4.8

20.9 83.1
2.3 72.9
5.0 19.9
0.6 183.6
5.5

146.9 27.2 122.4 96.7 21.4 97.7
5.1

151.9 30.0
125.9 97.0 22.9 99.3 5.3

151.0 28.8
123.6 98.0 24.2
100.0 5.1

148.2 24.1
123.1 98.3 22.2 98.5 4.8

160.6 24.2
132.6 98.2 25.4 98.7 5.6

151.7 26.8
125.5 97.7 23.2 98.9 5.2

23.7 14.0
9.8 31.9
0.6 0.4

22.1 17.0
5.3 32.0
0.7 0.6

18.3 12.3 6.0 29.4 1.2 0.5

23.3 15.5
8.0 28.0
0.6 0.4

19.0 13.0 6.1 27.3 1.0 0.7

21.3 14.4
7.0 29.8
0.8 0.5

13.8 2.8 0.4
14.9 1.2 1.3

13.4 3.1 0.6
14.6 1.2 1.3

13.4 2.6 0.3 13.6 1.6 1.4

13.6 3.1 0.5
14.3 1.3 2.7

14.3 3.3 0.6 14.9 1.5 1.7

13.7 3.0 0.5
14.5 1.3 1.7

44.0 38.9 36.2
2.8 9.8 2.4 12.5

43.6 38.5 36.6
2.9 6.6 1.7 13.7

44.4 37.9 35.7 3.2 8.4 2.2 13.8

43.6 38.7 34.9
3.1 5.8 1.5 11.3

41.3 38.5 34.9 3.3 6.3 1.5 11.2

43.4 38.5 35.7
3.1 7.4 1.9 12.6

.

1.0

3.2

2.7

2.9

2.5

.

0.9

1.9

1.9

2.2

1.7

.

9.3

15.5

15.4

18.3

14.6

60.9 14.4 17.8 67.6 62.4 48.9
.

59.9 13.1 18.3 71.2 67.7 54.6
9.0

61.7 13.8 24.4 70.4 72.8 57.1 16.2

64.2 14.0 20.3 73.5 80.7 64.4 29.8

65.3

62.4

15.1

14.1

22.2

20.7

70.9

70.7

78.0

72.2

60.6

57.1

29.1

20.9

173

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Perinatal region 4 - Columbus

1990
606681 141872 13546
20.6 19.1 21.0
1610 388
10856 1196 3984 707 140 2690 361
138 95 43 234 21 51
996 185 15 990 134 209
3063 2310 3196
252 1974
235 571
. . .
7297 1443
148 5067 3970 3075
. 0

1991
614008 142925
13629
20.6 19.2 21.0
1589 395 10596 1189 4066 697 101 2595 338
125 79 46
179 25 44
929 179
18 1002
116 281
3053 2298 3134 271 1835 198 546
182 150 976
7031 1428 215 5747 4559 3776
504 14

Total
1992 1993

621152 143947 13703

628492 145011
13787

20.8 19.3 22.0

20.7 19.6 22.0

1605 390
10889 1259 4079 813 131 2566 296

1555 377 10455 1207 4156 808
87 2488 290

110

111

83

70

27

41

215

154

20

22

52

30

968 184
21 1016
127 300

974 211
23 1028 127 361

3123 2400 3126
245 1734
189 558

3144 2353 2946 164 1601 158 520

463 454 2454

486 422 2399

7173 1508
187 5597 5083 3941 1057
13

7207 1410 234 5805 5649 4531 1421
19

1994 5-year
635650 3105983 146037 719792
13861 68526

20.7 19.3 22.0

20.7 19.3 22.0

1573 370
10125 1193 4056 668 107 2460 311

7932 1920 52921 6044 20341 3693
566 12799
1596

115

599

74

401

41

198

180

962

21

109

43

220

938 174
22 1023
132 212

4805 933 99
5059 636
1363

3368 2244 2706
151 1341
130 506

15751 11605 15108
1083 8485
910 2701

513 391 2544

1644 1417 8373

7344 1235
205 5386 5148 4077 1489
52

36052 7024 989
27602 24409 19400
4471 98

White
1990 1991 1992 1993 1994 5-year

399840 89319 7964

404242 89759 7999

408557 90177 8029

412957 90620 8064

417277 2042873 91038 450913 8093 40149

22.0 19.4 21.0

22.1 19.5 21.0

22.0 19.6 21.0

22.1 20.0 21.0

22.1 19.7 22.0

22.1 19.6 21.0

687 138 6198 481 975 388 54 1480 186

655 130 6073 467 1065 398
39 1410
164

646 111 6231 477 1019 472
57 1335
142

622 120 6112 469 1184 453
32 1248
137

631 114 5896 466 1124 385
41 1200
140

3241 613
30510 2360 5367 2096 223 6673 769

56

49

41

45

36

227

41

29

27

22

20

139

15

20

14

23

16

88

94

68

83

53

62

360

13

19

9

11

9

61

34

29

22

21

30

136

383

378

367

408

407

1943

57

58

62

76

65

318

4

7

4

4

5

24

425

440

438

491

465

2259

66

53

66

62

58

305

120

183

216

243

154

916

1466 512
1651 71
1484 92 214

1397 540 1578
65 1380
80 191

1479 549
1544 62
1327 81
209

1508 604 1500
43 1271
66 201

1680 548
1297 33
1076 53
208

7530 2753 7570
274 6538
372 1023

.

83

218

233

228

762

.

93

262

269

248

872

.

455

1005

975

1111

3546

4745 876 83
2119 1437 1105
. 0

4624 859 118 2496 1802 1493 197
5

4668 928 105
2520 2058 1618
446 4

4724 853 136 2599 2410 1848 606
12

4750 736 127
2430 2182 1687
626 26

23511 4252 569
12164 9889 7751 1875 47

Black
1990 1991 1992 1993 1994 5-year

197241 49890 5378

199271 50156 5404

201228 50407 5426

203260 50676 5452

205224 1006223 50929 252058 5474 27133

19.1 18.4 24.0

19.0 18.6 23.0

19.1 18.5 25.0

19.0 19.1 25.0

19.1 18.5 24.0

19.0 18.6 24.0

917 250 4567 714 3004 290
85 1144
170

930 264 4435 721 2996 272
62 1124 171

958 279 4542 782 3047 334
74 1165
153

929 256 4234 736 2960 345
55 1183 151

935 256 4098 721 2899 273
64 1199
170

4669 1305 21876 3674 14906 1514
340 5815
815

81

76

68

64

78

367

54

50

56

47

53

260

27

26

12

17

25

107

138

111

131

101

116

597

8

6

11

11

12

48

17

15

30

9

13

84

608

546

595

558

519

2826

127

120

120

135

109

611

11

11

17

19

17

75

562

556

570

529

544

2761

66

62

61

62

72

323

87

97

81

116

57

438

1576 1795 1535
180 483 140 354

1630 1756 1548
205 441 117 349

1615 1845 1570
181 393 108 343

1601 1743 1429
120 319
92 315

1647 1676 1376
117 257
77 292

8069 8815 7458
803 1893
534 1653

.

75

173

208

243

699

.

46

136

99

119

400

.

459

1165

1184

1296

4104

2494 550 65
2922 2525 1963
. 0

2343 560
96 3222 2749 2277 307
7

2427 568 80
3040 3004 2308
606 9

2414 547
98 3154 3217 2666 807
7

2508 485 76
2906 2930 2367
854 26

12186 2710 415
15244 14425 11581
2574 49
174

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Perinatal region 4 - Columbus

17.9 76.5
2.2 37.2
4.4 19.0
0.6 186.1
6.4
118.9 24.1 88.3 77.8 26.6 98.9
5.2
12.7 8.8 4.0
21.3 0.5 0.4
9.2 1.7 0.1 9.2 1.3 1.9
32.6 21.6 30.0
2.4 18.7
2.2 9.1
. . .
67.7 14.9 14.0 47.3 37.1 28.7
.

17.3 74.1
2.2 38.8
4.2 18.2
0.5 184.4
6.2
116.6 24.9 87.2 79.9 24.8 97.3 5.4
11.8 7.5 4.4
16.7 0.6 0.4
8.8 1.7 0.2 9.6 1.1 2.7
32.4 21.9 30.0
2.6 17.7
1.9 9.1
1.1 0.9 5.8
66.8 15.2 19.4 54.8 43.5 36.0
4.8

17.5 75.6 2.2 37.9 4.1 17.8 0.5 177.6 6.9
117.1 24.3 91.9 79.5 21.6 99.0 4.7
10.1 7.6 2.5
19.5 0.5 0.4
8.9 1.7 0.2 9.4 1.2 2.8
31.7 22.3 29.1
2.3 16.2
1.8 9.0
2.7 2.6 14.3
66.1 15.6 16.9 52.0 47.2 36.6
9.8

16.6 72.1
2.2 40.3
4.0 17.2
0.5 179.2
6.5
112.8 24.2 87.5 83.0 21.0 98.6 5.1
10.6 6.7 3.9
14.6 0.5 0.2
9.3 2.0 0.2 10.0 1.2 3.5
32.8 22.8 28.6
1.6 15.7
1.5 8.9
2.8 2.4 13.8
69.2 15.1 23.4 56.2 54.7 43.9 13.8

15.9 69.3 2.1 40.6 3.9 16.8 0.5 183.4 5.7
113.5 23.5 86.1 84.0 22.4 97.4 6.2
11.4 7.3 4.1
17.6 0.5 0.3
9.3 1.7 0.2 10.2 1.3 2.1
34.9 22.5 27.1
1.5 13.5
1.3 9.1
2.9 2.2 14.5
73.0 13.8 19.5 53.9 51.5 40.8 14.9

17.0 73.5
2.2 38.9
4.1 17.8
0.5 182.1
6.3
115.8 24.2 88.2 80.8 23.3 98.2
5.3
11.3 7.6 3.8
18.0 0.5 0.4
9.1 1.8 0.2 9.7 1.2 2.6
32.9 22.2 29.0
2.1 16.4
1.8 9.0
2.4 2.1 12.1
68.5 15.0 18.6 52.8 46.7 37.1 10.8

15.5 69.4
2.1 15.9
3.7 16.6
0.5 181.7
5.2

15.0 67.7
2.0 17.7
3.5 15.7
0.5 177.0
5.4

15.3 69.1 2.1 16.5 3.3 14.8 0.4 164.5 6.1

14.8 67.4
2.0 19.6
3.0 13.8
0.4 158.5
5.7

14.1 64.8 2.0 19.3 2.9 13.2 0.4 158.9 5.0

14.9 67.7
2.0 17.8
3.3 14.8
0.4 168.3
5.5

86.3 20.1 60.4 48.4 23.4 98.4
3.3

81.9 19.8 58.4 53.7 20.5 96.9
3.5

80.5 17.2 59.4 50.8 17.7 97.9 4.1

77.1 19.3 58.2 59.8 17.0 97.8
2.7

78.0 18.1 57.6 61.3 17.3 94.8 3.7

80.7 18.9 58.8 54.8 19.2 97.2
3.5

9.0 6.6 2.4 15.0 0.6 0.5

8.1 4.8 3.3 11.1 0.8 0.4

6.6 4.3 2.3 13.2 0.4 0.3

7.4

6.1

7.4

3.6

3.4

4.6

3.8

2.7

2.9

8.6

10.4

11.7

0.5

0.4

0.5

0.3

0.4

0.4

6.2

6.2

5.9

6.7

6.9

6.4

0.9

1.0

1.0

1.2

1.1

1.0

*

0.1

*

*

0.1

0.1

6.9

7.3

7.1

8.1

8.0

7.5

1.1

0.9

1.1

1.0

1.0

1.0

2.0

3.0

3.5

4.0

2.6

3.0

27.2 8.4
27.0 1.2
24.6 1.5 6.3

25.9 9.0
26.3 1.1
23.2 1.3 5.9

26.2 8.9 25.1 1.0 21.7 1.3 6.1

26.9 10.0 24.9
0.7 21.2
1.1 6.1

29.8 9.4
22.3 0.6 18.6 0.9 6.7

27.2 9.1
25.1 0.9
21.9 1.2 6.2

.

0.8

2.2

2.3

2.2

1.9

.

0.9

2.6

2.7

2.4

2.2

.

4.6

10.1

9.7

10.9

8.8

77.0 15.9 13.3 34.6 23.4 18.0
.

76.6 15.9 18.9 41.5 29.9 24.8
3.3

75.1 16.9 15.9 40.9 33.4 26.2 7.2

77.5 15.7 22.5 43.0 39.8 30.6 10.0

81.1 14.1 21.1 41.7 37.4 28.9 10.7

77.4 15.7 18.3 40.3 32.8 25.7
7.8

23.2 91.5
2.6 66.8
5.8 22.9
0.6 187.0
8.1

22.3 88.4
2.5 68.5
5.6 22.4
0.6 189.7
7.3

22.6 90.1 2.6 68.0 5.8 23.1 0.6 189.6 8.7

20.8 83.6
2.4 71.0
5.8 23.3
0.7 202.7
8.2

20.0 80.5 2.3 72.0 5.8 23.5 0.7 211.9 7.1

21.7 86.8
2.5 69.2
5.8 23.1
0.7 195.9
7.9

170.5 27.3 132.8 97.5 31.6 99.4
8.2

172.1 28.4
133.4 96.9 31.6 97.6 8.3

176.6 29.1
144.1 97.0 28.2
100.0 5.7

170.4 27.6
135.0 97.8 27.7 99.3 9.0

170.8 27.4
131.7 98.9 31.1 99.4 10.2

172.1 28.0
135.4 97.6 30.0 99.1 8.3

17.7 11.8
6.0 29.7
0.5 0.4

17.1 11.3
5.9 24.7
0.4 0.3

15.0 12.3 2.7 28.4 0.7 0.6

15.1 11.1
4.1 23.5
0.7 0.2

19.0 12.9 6.2 27.9 0.7 0.3

16.8 11.9
5.0 26.9
0.6 0.3

13.3

12.3

13.1

13.2

12.7

12.9

2.8

2.7

2.6

3.2

2.7

2.8

0.2

0.2

0.4

0.4

0.4

0.3

12.5

12.7

12.7

12.7

13.5

12.8

1.5

1.4

1.4

1.5

1.8

1.5

1.9

2.2

1.8

2.8

1.4

2.0

40.1 39.9 34.3
4.0 10.9
3.1 12.5

41.5 40.1 35.5
4.7 10.2
2.7 12.8

39.4 41.2 35.1 4.1 8.8 2.4 12.6

41.4 41.8 34.3
2.9 7.7 2.2 12.7

42.3 41.6 34.3 2.9 6.4 1.9 12.5

40.9 40.9 34.7
3.7 8.9 2.5 12.6

.

1.1

2.5

3.0

3.5

2.5

.

0.7

2.0

1.4

1.7

1.5

.

6.8

17.1

17.1

18.6

14.9

55.0 13.5 15.2 65.0 56.1 43.7
.

53.3 14.3 20.6 73.6 62.8 52.0
7.0

53.7 14.0 18.5 67.9 67.1 51.5 13.5

57.3 14.5 25.4 75.7 77.2 63.9 19.4

61.6

56.1

13.5

14.0

17.3

19.3

72.1

70.7

72.7

66.9

58.8

53.7

21.2

15.1

175

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Perinatal region 5 - Savannah

1990
689726 162828 14748
20.8 19.5 21.0
1591 385
12649 1279 4140 1008 152 2182 239
138 83 55 237 27 57
1121 216 29
1351 132 163
3948 2368 3440
257 2269
300 648
. . .
8731 1999
157 5884 4576 3506
. 12

1991
700444 164508
14875
20.4 19.7 21.0
1584 374 11898 1324 4168 1082 120 2132 201
166 109
57 228
18 51
1056 219
31 1303 130 141
3527 2376 3365 192 1880 257 644
195 188 1175
8402 1793 173 6730 5252 4447
680 53

Total
1992 1993

711026 166161 15001

721772 167854
15128

20.9 19.8 22.0

20.6 19.9 22.0

1527 396
12973 1287 4425 1051 107 2103 177

1603 386 12334 1345 4472 998 110 1972 185

155

140

98

87

57

53

203

199

21

35

62

43

1152 222 24
1333 163 149

1122 217
29 1343 135 136

3801 2541 3307
177 1972
221 667

3877 2461 3154 161 1695 165 605

467 504 2421

523 524 2641

9232 1880
243 6944 5785 4598 2283
40

8951 1922 279 7279 6399 5275 2773
82

1994 5-year
732367 3555335 169519 830870
15256 75009

20.5 19.7 22.0

20.6 19.7 22.0

1171 238
9198 1036 2961
615 72
1049 101

7476 1779 59052 6271 20166 4754
561 9438
903

99

698

72

449

27

249

145

1012

28

129

41

254

775

5226

148

1022

26

139

874

6204

118

678

102

691

3083 1536 2340
75 1280
99 420

18236 11282 15606
862 9096 1042 2984

487 419 2506

1672 1635 8743

6832 1405
183 5165 4416 3602 2556
82

42148 8999 1035
32002 26428 21428
8292 269

White
1990 1991 1992 1993 1994 5-year

478360 110566
9303

485573 111504
9376

492703 112426
9451

499943 113372
9525

507089 2463668 114299 562167
9599 47253

21.5 19.8 20.0

21.2 20.1 21.0

21.6 20.1 21.0

21.7 20.0 21.0

21.3 19.7 21.0

21.5 20.0 21.0

744 137 7732 594 1201 593 66 1168 119

765 139 7197 636 1231 647
41 1120 108

672 150 7839 571 1305 621
36 1021
82

726 146 7593 611 1442 575
42 970
89

642 128 6364 559 1198 384
41 580
63

3549 700
36725 2971 6377 2820 226 4859 461

68

68

70

70

51

327

39

49

41

43

35

207

29

19

29

27

16

120

107

90

79

84

76

436

10

9

13

18

11

61

39

29

30

25

22

145

508

429

491

505

427

2360

92

74

84

79

67

396

9

10

7

6

6

38

691

640

645

651

517

3144

73

63

92

82

83

393

96

80

94

71

63

404

2109 670
1954 78
1741 167 260

1822 661 1875
60 1460 150 249

2000 698
1859 46
1536 103 282

2042 712 1755
55 1362
77 262

1920 559
1496 33
1092 57
233

9893 3300 8939
272 7191
554 1286

.

104

221

258

239

822

.

107

328

339

262

1036

.

569

1204

1174

1183

4130

5967 1307
87 2876 1928 1520
. 3

5604 1102
89 3310 2336 1969 321
13

6116 1170
138 3486 2611 2099 1165
15

6006 1191 151 3693 3023 2415 1416
38

5065 965 124
3146 2581 2051 1471
32

28758 5735 589
16511 12479 10054
4373 101

Black
1990 1991 1992 1993 1994 5-year

199207 48893 5177

202146 49369 5223

205053 49839 5268

208000 50319 5313

210910 1025315 50792 249212 5359 26339

19.1 18.8 24.0

19.2 18.9 24.0

19.3 19.5 24.0

19.0 19.7 24.0

19.0 19.6 24.0

19.1 19.3 24.0

844 245 4808 684 2935 402
86 976 118

807 235 4568 680 2917 416
77 960
91

848 244 4938 710 3086 418
69 1038
95

867 237 4573 727 3009 415
67 958
94

525 109 2719 474 1743 220
31 449
37

3891 1070 21606 3275 13690 1871
330 4381
435

70

97

84

70

44

60

56

44

26

37

28

26

130

135

121

112

17

9

8

17

18

22

31

18

47

368

36

240

11

128

68

566

17

68

19

108

603

620

651

603

341

2818

124

143

136

134

80

617

20

21

17

23

19

100

653

655

674

671

348

3001

58

64

70

51

35

278

66

59

53

62

36

276

1807 1696 1474
178 506 133 383

1672 1705 1468
129 402 106 393

1759 1827 1409
129 412 114 381

1795 1738 1373
101 320
88 333

1123 968 826 42 175 41 184

8156 7934 6550
579 1815
482 1674

.

79

216

218

209

722

.

55

134

148

137

474

.

507

1014

1236

1117

3874

2690 670 70
2973 2637 1982
. 9

2703 663
84 3356 2882 2451 358
39

2973 686 97
3382 3133 2470 1107
23

2821 715 125 3514 3329 2829 1345
42

1685 418 58
1973 1801 1532 1072
48

12872 3152 434
15198 13782 11264
3882 161
176

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Perinatal region 5 - Savannah

18.3 77.7
2.2 33.1
3.2 13.4
0.4 135.8
7.6
107.9 24.2 86.7 72.5 16.2 97.4 6.6
10.9 6.6 4.4
18.5 0.6 0.4
8.9 1.7 0.2 10.8 1.1 1.3
33.8 18.9 27.6
2.1 18.5
2.4 8.8
. . .
69.9 17.8 12.0 47.0 36.6 28.0
.

17.0 72.3
2.1 35.4
3.0 13.0
0.4 139.1
7.9
106.5 23.6 89.0 72.6 13.5 97.5 5.6
14.0 9.2 4.8
19.0 0.4 0.4
8.9 1.8 0.3 11.1 1.1 1.2
33.0 20.2 28.8
1.6 16.7
2.3 9.5
1.0 1.0 6.1
71.4 17.1 13.6 57.2 44.6 37.8
5.8

18.2 78.1 2.3 34.6 3.0 12.7 0.3 129.1
7.3
101.8 25.9 85.8 75.5 11.8 97.2 6.0
11.9 7.6 4.4
15.5 0.4 0.4
8.9 1.7 0.2 10.4 1.3 1.2
32.6 19.8 26.0
1.4 16.2
1.8 8.8
2.4 2.6 12.3
72.1 16.6 16.4 54.2 45.2 35.9 17.8

17.1 73.5
2.2 36.7
2.7 11.7
0.3 127.7
6.8
106.0 24.1 88.9 76.2 12.2 97.8 6.1
11.4 7.1 4.3
16.0 0.7 0.3
9.1 1.8 0.2 11.0 1.1 1.2
35.3 20.2 26.0
1.3 14.7
1.4 8.6
2.6 2.6 13.2
73.4 17.8 19.9 59.7 52.5 43.3 22.7

12.6 54.3 1.6 32.6 1.4 6.2 0.2 95.7
4.2

16.6 71.1
2.1 34.6
2.7 11.4
0.3 127.4
6.7

76.8 20.3 67.9 71.5 6.6 98.0
3.2

99.7 23.8 83.6 73.8 12.0 97.5
5.5

10.8 7.8 3.0
15.6 0.6 0.3

11.8 7.6 4.2
17.0 0.6 0.4

8.4

8.9

1.6

1.7

0.3

0.2

9.6

10.6

1.3

1.2

1.2

1.2

37.0 16.9 26.0
0.8 14.8
1.1 8.4

34.2 19.3 26.9
1.5 16.3
1.9 8.8

2.4 2.1 12.3

2.1 2.1 11.0

75.2 17.5 17.4 56.9 48.6 39.7 28.2

72.2 17.4 15.9 54.8 45.3 36.7 18.1

16.2 69.9
2.0 15.7
2.4 10.6
0.3 121.8
6.2

14.8 64.5
1.9 17.3
2.3 10.0
0.3 123.7
6.6

15.9 69.7 2.1 16.9 2.1 9.1 0.3 107.0
6.0

15.2 67.0
2.0 19.2
1.9 8.6 0.2 105.5 5.6

80.0 18.4 63.9 45.5 12.8 96.6
4.6

81.6 18.2 67.8 48.6 11.5 97.2
3.6

71.1 22.3 60.4 49.6 8.7 95.1
3.6

76.2 20.1 64.2 52.2
9.3 96.6
3.8

8.8 5.0 3.8 13.7 0.4 0.5

9.4 6.8 2.7 12.4 0.3 0.3

8.9 5.2 3.7 10.0 0.5 0.3

9.2 5.7 3.6 11.0 0.6 0.3

6.6

6.0

6.3

6.7

1.2

1.0

1.1

1.0

0.1

0.1

0.1

0.1

9.0

9.0

8.3

8.7

1.0

0.9

1.2

1.1

1.3

1.2

1.3

1.0

29.2 8.7
25.6 1.0
23.2 2.2 6.3

28.0 9.3
26.4 0.8
21.6 2.2 6.4

28.4 9.0 24.1 0.6 21.0 1.4 6.5

30.5 9.5
23.5 0.7
19.5 1.1 6.3

.

0.9

1.8

2.1

.

0.9

2.7

2.7

.

4.7

9.8

9.4

77.9 18.9 11.6 37.6 25.2 19.8
.

78.7 17.2 12.1 46.4 32.7 27.6
4.5

78.9 17.0 15.8 45.0 33.7 27.1 15.0

79.9 17.9 17.8 49.2 40.3 32.2 18.9

12.6 55.7 1.7 19.1 1.1
5.1 0.1 78.6 3.8

14.9 65.3
1.9 17.6
2.0 8.6 0.2 108.6 5.7

66.9 19.9 58.2 50.5
6.6 96.8
2.9

75.1 19.7 62.9 49.3
9.8 96.5
3.7

8.0 5.5 2.5 11.9 0.4 0.2

8.9 5.6 3.3 11.8 0.4 0.3

6.7

6.4

1.1

1.1

0.1

0.1

8.2

8.7

1.3

1.1

1.1

1.2

33.5 8.9
24.0 0.5 18.4 1.0 6.8

29.8 9.1
24.7 0.8
20.9 1.6 6.5

1.9

1.7

2.1

2.1

9.4

8.4

80.5 17.3 17.5 50.1 41.1 32.6 23.4

79.1 17.7 15.0 45.5 34.4 27.7 15.3

24.1 98.3
2.7 61.8
4.9 20.0
0.5 154.6
10.8

22.6 92.5
2.6 64.8
4.7 19.4
0.5 158.3
10.8

24.1 99.1 2.8 63.4 5.1 20.8 0.6 159.8 10.4

22.0 90.9
2.5 66.6
4.6 19.0
0.5 159.0
9.8

12.9 53.5 1.5 65.0 2.1
8.8 0.2 130.9 5.1

21.1 86.7
2.4 64.2
4.3 17.6
0.5 154.7
9.4

163.0 29.0 132.1 96.2 22.8 99.1 10.6

154.5 29.1
130.2 95.1 17.4 97.8 9.2

161.0 28.8
134.8 96.2 18.0 98.9 10.4

163.2 27.3
136.8 96.7 17.7 98.9 10.4

98.0 20.8 88.4 96.4
6.9 100.0
3.9

147.7 27.5 124.3 96.1 16.5 98.8
8.9

14.6 9.2 5.5
26.6 1.0 0.4

21.2 13.1
8.2 29.1
0.5 0.4

17.0 11.3 5.7 24.2 0.5 0.6

15.3 9.6 5.7
24.1 1.0 0.4

17.3 13.2 4.1 24.7 1.0 0.4

17.0 11.1
6.0 25.8
0.8 0.4

12.5 2.6 0.4
13.8 1.2 1.4

13.6 3.1 0.5
14.6 1.4 1.3

13.2 2.8 0.3 13.9 1.4 1.1

13.2 2.9 0.5
14.8 1.1 1.4

12.5 2.9 0.7 13.0 1.3 1.4

13.0 2.9 0.5
14.1 1.3 1.3

41.5 35.7 31.3
3.8 10.8
2.8 12.3

41.0 37.9 32.9
2.9 9.2 2.4 13.8

39.6 37.5 29.1 2.7 8.7 2.4 12.3

43.3 38.4 30.6
2.3 7.3 2.0 11.9

45.1 36.1 31.1 1.6 6.7 1.6 12.0

41.8 37.2 31.0
2.7 8.7 2.3 12.5

.

1.1

3.1

3.0

2.9

2.5

.

0.8

1.9

2.1

1.9

1.7

.

7.3

14.4

17.3

15.4

13.6

56.9 16.0 12.7 62.6 55.5 41.7
.

59.8 16.7 15.9 74.5 64.0 54.4
8.0

61.1 16.0 16.6 69.5 64.4 50.8 22.7

62.4 18.0 23.1 77.7 73.6 62.6 29.8

62.9

60.4

17.8

16.8

17.4

17.1

73.6

71.3

67.2

64.6

57.1

52.8

40.0

23.4

177

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Perinatal region 6 - Albany

1990
458667 106440 11211
19.9 19.0 21.0
1189 314
7954 1067 3364
611 98 605 88
117 81 36 180 23 38
766 161 18 718 91 135
2900 1752 2715
90 964 118 468
. . .
5651 1124
63 4274 3832 3035
. 14

1991
462025 106895
11218
19.8 19.2 21.0
1211 352 7690 1080 3544 634 110 611
79
90 59 31 166 23 47
694 123
15 687
86 99
2807 1802 2706
62 784
91 472
149 98
664
5459 1083
74 4509 4209 3488 774
37

Total
1992 1993

465215 107310 11225

468578 107765
11231

19.9 19.2 21.0

20.0 19.4 22.0

1166 306
7654 1053 3488
587 79
583 75

1143 322 7355 1019 3428 649
87 604
74

86

90

54

58

32

32

134

143

16

24

41

55

691

701

136

135

18

16

736

742

79

81

92

105

2710 1778 2683
85 857
91 466

2639 1745 2472
78 922 119 424

321 253 1520

318 336 1716

5806 974 74
4534 4518 3704 1666
15

5505 991
83 4577 4737 3890 2444
46

1994 5-year
471779 2326264 108186 536596
11239 56123

20.0 19.9 22.0

19.9 19.3 22.0

1663 388
10424 1436 5005
810 96
1507 155

6372 1682 41077 5655 18829 3291
470 3910
471

124

507

82

334

42

173

177

800

23

109

61

242

1073 228 30
1114 124 108

3925 783 97
3997 461 539

3796 2503 3184
137 1137
97 535

14852 9580
13760 452
4664 516
2365

356 333 2032

1144 1020 5932

7825 1468
172 6175 6319 5028 3489
46

30246 5640 466
24069 23615 19145
8373 158

White
1990 1991 1992 1993 1994 5-year

280884 61710 5797

282047 61639 5797

283135 61556 5798

284287 61479 5797

285385 1415738 61396 307780 5798 28986

21.6 19.0 20.0

21.4 19.4 21.0

21.3 19.3 21.0

21.5 19.6 21.0

21.9 20.4 21.0

21.5 19.7 21.0

362 70 3923 312 614 322 39 261 40

327 60
3728 283 649 317 39 258 29

383 73
3833 343 724 304 23 225 27

357 74
3655 313 701 328 25 243 28

444 73
4836 370 945 396 29 563 46

1873 350
19975 1621 3633 1667 155 1550 170

47

20

29

29

39

164

32

13

18

22

23

108

15

7

11

7

16

56

71

52

41

46

51

261

11

6

4

8

6

35

18

20

22

27

19

106

247

244

213

257

315

1276

38

37

31

33

55

194

4

4

4

2

4

18

265

289

291

306

386

1537

48

44

29

43

48

212

51

44

39

46

48

228

1269 294
1073 36 649 40
130

1146 297
1001 21
560 27
138

1172 364
1111 31
615 27
144

1152 341 998 27 665 34 153

1441 433
1127 32
828 29
150

6180 1729 5310
147 3317
157 715

.

56

116

128

162

462

.

52

146

184

166

548

.

144

396

612

626

1778

3179 646 35
1436 1091
848 . 4

2964 588
40 1607 1301 1093 270
7

3155 513 47
1717 1544 1263
570 6

2993 511
50 1731 1665 1332 775
14

4042 729 86
2130 1965 1525 1119
20

16333 2987 258 8621 7566 6061 2734 51

Black
1990 1991 1992 1993 1994 5-year

173124 43575 5311

174142 43675 5302

175104 43758 5292

176122 43857 5283

177083 43942 5273

875574 218807
26461

18.7 19.0 24.0

18.5 18.7 23.0

18.6 19.0 24.0

18.8 19.3 24.0

18.6 19.2 24.0

18.6 19.0 24.0

822 242 3998 751 2745 283
58 337
47

882 292 3924 796 2893 312
70 343
49

780 231 3781 707 2757 281
56 349
48

784 248 3666 705 2720 321
62 354
45

1216 315
5487 1064 4046
405 67
921 109

4484 1328 20856 4023 15161 1602
313 2304
298

70

69

57

61

85

342

49

45

36

36

59

225

21

24

21

25

26

117

108

113

93

97

126

537

12

17

12

16

17

74

19

27

19

28

42

135

516

448

477

442

754

2637

123

86

105

102

173

589

14

11

14

14

26

79

448

397

444

435

721

2445

43

42

50

37

75

247

84

55

53

56

59

307

1624 1455 1631
54 315
78 337

1647 1504 1694
41 221
64 332

1527 1410 1559
53 240
64 320

1480 1402 1467
51 255
85 271

2320 2063 2046
103 305
66 382

8598 7834 8397
302 1336
357 1642

.

54

144

141

165

504

.

26

72

119

136

353

.

356

796

811

1168

3131

2450 472 28
2828 2736 2182
. 9

2468 490
33 2889 2903 2391 503
30

2624 456 27
2807 2967 2435 1095
9

2490 475
33 2837 3063 2551 1664
32

3706 731 84
4008 4325 3485 2359
25

13738 2624 205
15369 15994 13044
5621 105
178

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Perinatal region 6 - Albany

17.3 74.7
2.2 42.8
1.3 5.7 0.2 64.6 7.5
106.1 26.4 95.2 81.6
7.8 100.0
5.4
14.7 10.2
4.6 22.4
0.8 0.4
9.6 2.0 0.2 9.2 1.2 1.7
40.9 22.3 34.7
1.2 12.5
1.5 10.1
. . .
72.7 15.7
8.9 54.4 48.8 38.6
.

16.6 71.9
2.1 46.6
1.3 5.7 0.2 66.9 7.7
108.0 29.1 96.3 85.1 7.0 91.1 7.0
11.7 7.7 4.1
21.3 0.8 0.5
9.0 1.6 0.2 9.1 1.1 1.3
41.5 23.7 35.7
0.8 10.6
1.2 10.4
1.1 0.7 4.9
73.6 15.8 10.1 59.3 55.4 45.9 10.2

16.5 71.3 2.1 46.1 1.3
5.4 0.2 64.4 7.5
103.9 26.2 93.8 81.0 6.7 94.6 6.1
11.2 7.1 4.2 17.3 0.5 0.4
9.0 1.8 0.2 9.7 1.0 1.2
39.2 23.5 35.5
1.1 11.6
1.2 10.4
2.4 1.9 11.2
77.4 14.4 9.4 59.9 59.7 48.9 22.0

15.7 68.3
2.0 47.2
1.3 5.6 0.2 68.7 7.7
101.8 28.2 90.7 84.6 6.6 93.2 6.0
12.2 7.9 4.4
19.2 0.8 0.6
9.5 1.8 0.2 10.2 1.1 1.5
39.9 24.0 34.0
1.1 13.0
1.7 9.8
2.3 2.5 12.6
75.8 15.2 11.0 62.9 65.1 53.5 33.6

22.1 96.4 2.8 48.6 3.2 13.9 0.4 116.8
8.9
148.0 23.3
127.8 87.7 13.8 98.1 7.9
11.9 7.9 4.1
16.8 0.7 0.6
10.3 2.2 0.3 10.8 1.2 1.1
38.8 24.3 31.0
1.3 11.2
1.0 9.0
2.6 2.4 14.8
75.4 15.9 16.4 60.0 61.4 48.8 33.9

17.7 76.6
2.2 46.4
1.7 7.3 0.2 79.4 7.9
113.5 26.4 100.8 84.2
8.4 95.9
6.5
12.3 8.1 4.2
19.3 0.7 0.5
9.6 1.9 0.2 9.9 1.1 1.3
40.0 23.6 34.0
1.1 11.7
1.3 9.9
2.1 1.9 10.9
75.0 15.4 11.6 59.3 58.2 47.2 25.6

14.0 63.6
1.9 15.8
0.9 4.2 0.1 56.9 6.5
62.4 19.3 53.8 46.6
6.9 100.0
3.1
12.0 8.2 3.9
17.9 0.7 0.4
6.3 1.0
* 6.9 1.2 1.3
35.4 7.6
27.8 0.9
17.1 1.1 6.0
. . .
82.3 18.3
9.9 37.0 28.1 21.9
.

13.2 60.5
1.8 17.6
0.9 4.2 0.1 59.0 6.3
56.4 18.3 48.8 50.4
5.0 79.3
3.8
5.4 3.5 1.9 13.8 0.4 0.4
6.5 1.0
* 7.9 1.2 1.2
34.6 8.1
27.3 0.6
15.9 0.8 6.7
0.8 0.7 2.1
81.4 17.8 10.6 43.6 35.3 29.7
7.3

13.5 62.3 1.9 19.0 0.8 3.7 0.1 50.6
6.3
66.1 19.1 59.2 45.7 4.7 84.6
4.1
7.6 4.7 2.9 10.6
* 0.4
5.6 0.8
* 7.7 0.8 1.1
33.2 9.6 29.3 0.8 16.8 0.7 6.9
1.7 2.1 5.7
83.5 15.1 11.7 45.1 40.6 33.2 15.0

12.9 59.5
1.8 19.4
0.9 4.0 0.1 56.6 6.4
61.6 20.7 54.0 55.2
4.8 85.7
3.3
7.9 6.0 1.9 12.5 0.5 0.5
7.0 0.9
* 8.5 1.2 1.3
34.3 9.4
27.7 0.8
19.0 1.0 7.4
1.8 2.6 8.8
82.5 15.8 13.2 48.0 46.1 36.9 21.5

16.9 78.8 2.4 19.7 2.0
9.2 0.3 96.2 7.4
76.6 16.4 63.8 56.9
7.9 95.7
5.7
8.1 4.8 3.3 10.5 0.4 0.4
6.5 1.1
* 8.1 1.0 1.0
31.4 9.0
23.6 0.7 17.8 0.6 5.6
2.3 2.4 9.0
83.8 16.9 18.3 44.5 41.0 31.9 23.4

14.1 64.9
2.0 18.4
1.1 5.0 0.1 65.8 6.6
64.6 18.7 55.9 51.1
5.9 90.5
4.0
8.2 5.4 2.8 13.0 0.5 0.4
6.4 1.0 0.1 7.8 1.1 1.2
33.6 8.7
26.9 0.7
17.3 0.8 6.5
1.7 2.0 6.4
82.8 16.8 13.0 43.6 38.3 30.7 17.2

23.1 91.7
2.5 69.6
1.9 7.7 0.2 71.3 9.0

22.5 89.8
2.4 74.6
2.0 7.9 0.2 73.0 9.9

21.6 86.4 2.4 73.9 2.0
8.0 0.2 76.7 9.6

20.8 83.6
2.3 75.0
2.0 8.1 0.2 79.4 10.1

31.0 124.9
3.4 74.9 5.2 21.0 0.6 133.3 11.4

23.8 95.3
2.6 73.6
2.6 10.5
0.3 90.9 10.0

154.8 29.4 141.4 96.1
8.8 100.0
7.9

166.4 33.1
150.1 97.4 9.2 98.0 10.6

147.4 29.6
133.6 98.3 9.1
100.0 8.3

148.4 31.6
133.4 97.6 8.5 97.8 9.1

230.6 25.9
201.8 98.4 20.7 99.1 10.4

169.5 29.6
152.0 97.6 11.3 99.0 9.3

17.5 12.3
5.3 26.6
0.8 0.4

17.6 11.5
6.2 28.3
1.2 0.6

15.1 9.5 5.6
24.2 0.8 0.4

16.6 9.8 6.9
26.0 1.1 0.6

15.5 10.8 4.8 22.7 1.1 0.9

16.4 10.8
5.7 25.4
1.0 0.6

12.9 3.1 0.4
11.4 1.1 2.1

11.4 2.2 0.3
10.3 1.1 1.4

12.6 2.8 0.4 11.9 1.3 1.4

12.1 2.8 0.4
12.0 1.0 1.5

13.7 3.2 0.5 13.3 1.4 1.1

12.6 2.8 0.4
11.9 1.2 1.5

46.6 36.9 41.5
1.4 8.1 2.0 13.6

48.2 38.8 43.9
1.1 5.8 1.7 13.5

45.7 37.8 41.9 1.4 6.5 1.7 13.4

46.0 38.6 40.4
1.4 7.1 2.4 12.1

45.5 38.1 38.0 1.9 5.7 1.2 11.8

46.3 38.0 40.9
1.5 6.6 1.8 12.8

.

0.8

2.2

2.2

2.6

2.0

.

0.4

1.1

1.9

2.1

1.4

.

5.6

12.4

12.6

18.1

12.2

63.1 13.1
8.1 71.7 69.3 55.3
.

66.0 13.9
9.2 74.5 74.8 61.6 13.0

71.2 13.6 7.0 75.3 79.5 65.3 29.4

69.1 14.6
8.9 78.2 84.4 70.3 45.8

68.0

67.5

15.1

14.1

14.8

10.1

74.1

74.6

80.0

77.7

64.4

63.3

43.6

33.8

179

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Appling County - 001

1990
15744 3625 430
19.6 18.6 20.0
33 4
258 31 88 12
2 15
2
1 1 0 3 0 1
19 4 0
22 1 1
94 51 94
3 60
2 9
. . .
185 44
1 145 119 94
. 0

1991
15880 3646 428
19.4 17.0 19.0
47 12 244 41 83 13
2 15
6
2 1 1 3 0 2
10 0 0
16 0 5
74 50 78
1 48
2 16
8 4 39
167 35 4
144 126 105
3 0

Total
1992 1993

16010 3666 426

16142 3686 423

20.1 19.0 21.0

20.0 18.8 20.0

37

36

6

8

254

237

34

32

99

97

21

19

4

2

8

9

0

2

4

3

4

1

0

2

8

3

1

2

1

2

20

21

7

3

0

0

23

16

2

2

5

3

74

82

54

55

72

86

3

1

43

47

3

7

16

12

13

21

19

12

65

51

182

175

40

45

2

0

148

151

148

163

126

128

96

95

2

0

1994 5-year

16273 3706 421

80049 18329
2128

19.4 18.0 20.5

19.7 18.3 20.0

41

194

8

38

235

1228

36

174

83

450

4

69

1

11

14

61

4

14

5

15

4

11

1

4

5

22

1

4

2

8

15

85

5

19

1

1

18

95

3

8

6

20

83

407

40

250

84

414

2

10

40

238

1

15

12

65

8

50

13

48

76

231

174

883

51

215

1

8

160

748

156

712

136

589

92

286

3

5

1990
12356 2792 299

1991
12445 2801 297

White
1992 1993

12532 2810 295

12621 2817 293

1994 5-year

12706 2825 291

62660 14045
1476

20.1 13.8 19.0

19.7 17.3 19.0

21.4 22.4 20.0

21.1 18.8 20.0

19.8 17.4 20.0

20.2 17.6 19.0

17

32

20

23

29

121

1

5

3

4

4

17

174

172

173

162

172

853

16

27

19

21

26

109

36

38

38

40

45

197

8

11

21

16

4

60

1

1

1

2

1

6

7

11

6

5

10

39

1

5

0

1

2

9

1

1

1

2

3

8

1

1

1

0

2

5

0

0

0

2

1

3

2

2

2

2

3

11

0

0

0

2

0

2

0

1

1

1

0

3

12

7

12

11

8

50

4

0

3

1

3

11

0

0

0

0

1

1

13

14

15

11

12

65

0

0

2

2

1

5

1

4

1

1

4

11

57

48

50

48

58

261

18

20

19

17

22

96

60

53

48

59

63

283

2

1

2

0

0

5

48

39

37

39

36

199

1

1

2

2

0

6

6

6

12

8

6

38

.

5

9

14

6

34

.

3

14

6

7

30

.

14

55

28

53

150

138

124

128

127

135

652

35

23

25

29

39

151

1

3

2

0

1

7

87

90

83

89

109

458

64

75

86

99

105

429

55

66

71

74

93

359

.

2

52

48

59

161

0

0

1

0

0

1

1990
3268 813 128

1991
3296 817 127

Black
1992 1993

3323 821 127

3351 824 126

1994 5-year

3378 828 125

16616 4103 634

17.4 20.2 25.0

19.2 16.8 23.5

19.6 19.0 24.0

18.9 21.0 21.0

18.1 18.2 26.5

18.8 18.5 24.0

16

14

17

13

12

72

3

7

3

4

4

21

84

71

81

75

61

372

15

13

15

11

10

64

52

44

61

57

37

251

3

2

0

3

0

8

1

1

3

0

0

5

8

4

2

4

4

22

1

1

0

1

2

5

0

1

3

1

2

7

0

0

3

1

2

6

0

1

0

0

0

1

1

1

6

1

2

11

0

0

1

0

1

2

1

1

0

1

2

5

7

3

8

10

5

33

0

0

4

2

2

8

0

0

0

0

0

0

9

2

8

5

5

29

1

0

0

0

2

3

0

1

4

2

2

9

37

25

24

34

24

144

33

29

35

38

18

153

34

24

24

27

20

129

1

0

1

1

2

5

12

9

6

8

4

39

1

1

1

5

1

9

3

10

4

4

6

27

.

3

.

1

.

24

4

5

2

14

5

5

6

17

9

19

18

70

47

43

54

48

37

229

9

12

15

16

10

62

0

1

0

0

0

1

58

53

65

62

50

288

55

50

62

64

50

281

39

38

55

54

42

228

.

1

44

47

33

125

0

0

1

0

3

4

182

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

16.4

15.4

15.9

14.7

14.4

15.3

General fertility rate

71.2

66.9

69.3

64.3

63.4

67.0

Total fertility rate

2.2

2.0

2.1

1.9

1.9

2.0

% Livebirths to unmarried women

34.2

34.2

39.4

41.3

35.9

37.0

Crude abortion rate

1.0

0.9

0.5

0.6

0.9

0.8

General abortion rate

4.1

4.1

2.2

2.4

3.8

3.3

Total abortion rate

0.1

0.1

0.1

0.1

0.1

0.1

Abortion ratio

52.3

54.2

27.9

33.7

54.9

44.4

Fetal Death rate

3.9

4.9

6.8

5.7

1.6

4.6

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

76.7 109.8

86.9

85.1

97.3

91.2

% Repeat conceptions to women under 18

*

25.5

16.2

22.2

19.5

19.6

Livebirths to women under 18

72.1

95.8

79.9

75.6

85.4

81.8

% Livebirths to unmarried women under 18

77.4

61.0

63.6

59.4

47.2

61.3

Induced abortions to women under 18

*

14.0

*

*

*

6.6

% Abortions to unmarried women under 18

* 100.0

*

*

* 100.0

Fetal deaths to women under 18

*

*

*

*

*

3.8

Infant and child survival rates

Infant mortality

*

*

*

*

21.3

12.2

Neonatal mortality

*

*

*

*

*

9.0

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

31.0

*

21.2

17.8

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

0.5

Infant health rates

% Low birthweight

7.4

4.1

7.9

8.9

6.4

6.9

% Very low birthweight

*

*

2.8

*

2.1

1.5

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

8.6

6.6

9.2

6.8

7.8

7.8

% Multiple gestation

*

*

*

*

*

0.7

% Birth defect

*

2.0

2.0

*

2.6

1.6

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

38.2

31.8

31.2

36.6

37.4

35.0

% with father not named on birth certificate

19.8

20.5

21.5

23.4

17.2

20.5

% with maternal education less than high school

36.7

32.1

28.8

36.8

36.4

34.1

% No prenatal care

*

*

*

*

*

0.8

% Maternal smoking during pregnancy

23.3

19.8

17.1

20.0

17.5

19.6

% Maternal alcohol use during pregnancy

*

*

*

3.0

*

1.2

% Interpregnancy interval less than 6 months

6.4

12.4

11.0

9.4

9.5

9.7

Child abuse and neglect rates

Physical

.

1.7

2.9

4.6

1.8

2.7

Sexual

.

*

4.2

2.6

2.9

2.6

Neglect

.

8.5

14.3

11.2

16.8

12.7

Interventions to improve infant & child survival

% Prenatal care first trimester

72.3

70.5

73.1

74.2

74.7

72.9

% Primary C-section delivery

18.6

16.7

17.9

21.5

24.8

19.8

% Vaginal birth after previous C-section

*

*

*

*

*

6.0

% WIC during pregnancy

56.4

59.0

59.0

64.3

69.0

61.4

% Medicaid during pregnancy

46.3

51.6

59.0

69.4

67.2

58.4

% Medicaid and WIC during pregnancy

36.6

43.0

50.2

54.5

58.6

48.3

% Perinatal case management

.

*

38.2

40.4

39.7

29.7

Appling County - 001

14.1 62.3
1.9 20.7
0.6 2.5 0.1 36.8 3.2

13.8 61.4
1.9 22.1
0.9 3.9 0.1 55.8 5.0

56.9 *
53.5 56.3
* * *

107.7 15.6 90.8 44.4 16.8
100.0 *

*

*

*

*

*

*

*

*

*

*

*

*

6.9

4.1

*

*

*

*

7.5

8.1

*

*

*

*

34.1 10.3 34.5
* 27.6
* 6.8

29.3 11.6 30.8
* 22.7
* 7.3

.

1.6

.

*

.

4.3

79.8 21.9
* 50.0 36.8 31.6
.

74.7 15.6
* 52.3 43.6 38.4
*

13.8 61.6 1.9 22.2 0.5 2.1 0.1 29.9 7.8
67.7 *
64.3 36.8
* * *
* * * * * *
7.0 * *
8.8 * *
31.4 11.1 28.2
* 21.6
* 11.9
2.8 4.4 17.1
75.7 16.6
* 48.5 50.3 41.5 30.4

12.8 57.5
1.8 25.0
0.4 1.8 0.1 27.0 6.4
78.5 *
71.7 38.1
* * *
* * * * * *
6.8 * *
6.9 * *
31.8 10.6 37.1
* 24.4
* 9.1
4.4 1.9 8.7
78.9 20.0
* 55.6 61.9 46.3 30.0

13.5 60.9 1.9 26.5 0.8 3.5 0.1 53.2 2.1

13.6 60.7
1.9 23.3
0.6 2.8 0.1 40.6 4.9

99.6 *
89.3 34.6
* * *

82.0 14.0 73.9 41.3
6.1 100.0
*

*

9.4

*

5.9

*

*

*

12.8

*

*

*

*

4.7

5.9

*

1.3

*

*

7.0

7.7

*

0.6

*

1.3

34.7 12.9 37.1
* 21.4
* 7.0

32.3 11.3 33.5
0.6 23.6
0.7 8.5

1.9 2.2 16.6

2.6 2.3 11.7

78.9 25.3
* 63.7 61.4 54.4 34.5

77.6 19.9
7.7 54.0 50.6 42.3 23.9

25.7 103.3
3.1 62.7
2.4 9.8 0.3 83.3
*

21.5 86.9
2.6 62.9
* * * * *

24.4 98.7 3.0 76.3
* * * * *

22.4 91.0
2.6 76.0
* * * * *

125.0 *
117.2 100.0
* * *

109.9 50.0
102.0 92.3 * * *

134.2 *
118.4 100.0
* * *

103.2 *
87.3 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

71.4

*

*

*

*

*

*

*

*

*

8.3 * *
10.8 * *

*

9.9

13.3

*

*

*

*

*

*

*

10.0

6.7

*

*

*

*

*

*

46.8 39.8 41.5
* 14.5
* *

36.8 40.8 34.3
* 12.9
* 21.3

30.8 43.8 30.0
* 7.5
* *

46.6 50.7 36.0
* 10.7
6.7 *

.

*

.

*

.

18.4

*

3.9

3.8

3.9

6.9

14.6

56.6 11.8
* 69.9 66.3 47.0
.

61.4 19.4
* 74.6 70.4 53.5
*

67.5 20.5
* 81.3 77.5 68.8 55.0

64.0 25.0
* 82.7 85.3 72.0 62.7

18.1 73.7 2.2 62.7
* * * * *

22.4 90.7
2.7 68.4
1.3 5.4 0.1 53.9 3.4

95.7 *
79.7 80.0
* * *

113.7 29.2 101.0 95.2
7.9 100.0
*

*

18.8

*

16.1

*

*

*

29.2

*

*

*

1.0

8.2

8.9

*

2.2

*

*

8.5

7.9

*

*

*

2.4

44.4 30.5 33.9
* * * 15.8

40.9 41.6 35.2
1.4 10.6
2.5 12.2

* 4.6 13.9

2.7 3.3 13.5

61.7

62.2

20.0

19.1

*

*

84.7

78.3

84.7

76.4

71.2

62.0

55.9

43.9

183

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Atkinson County - 002

1990
6213 1392
148
18.2 .
19.0
23 5
120 22 42
6 0 3 0
1 0 1 0 1 0
14 1 0
21 1 2
49 23 59
1 24
0 9
. . .
77 20
1 84 71 60
. 0

1991
6171 1379 147
20.4 .
20.0
15 6
117 15 34 4 0 2 0
4 4 0 3 0 1
10 3 1
23 1 2
42 12 51
2 22
0 6
4 2 22
91 25
0 86 63 55
4 0

Total
1992 1993

6119 1364
147

6081 1354 147

19.5 .
19.0

20.3 .
20.0

17

17

4

2

125

128

17

17

47

44

6

4

0

0

1

1

0

0

3

3

2

3

1

0

2

3

0

0

1

0

15

17

4

4

0

1

19

19

2

1

0

1

49

54

18

21

58

54

1

0

22

18

0

0

7

7

4

9

12

5

39

34

94

98

20

31

0

1

87

99

77

84

65

78

44

55

0

1

1994 5-year

6030 1340
146

30614 6829 735

20.9 15.6 21.0

19.7 15.6 20.0

23

95

6

23

124

614

20

91

45

212

18

38

1

1

2

9

1

1

2

13

2

11

0

2

3

11

1

2

1

3

14

70

2

14

2

4

14

96

2

7

0

5

59

253

19

93

45

267

0

4

13

99

0

0

6

35

4

21

14

33

47

142

88

448

20

116

2

4

82

438

81

376

71

329

55

158

0

1

1990
4427 972 92

1991
4394 960
91

White
1992 1993

4351 946 91

4322 937
91

1994 5-year

4282 924 90

21776 4739 455

18.2 .
19.0

20.6 .
20.0

19.7 .
19.0

20.8 .
20.0

20.7 15.6 20.5

20.1 15.6 19.0

15

10

12

12

18

67

3

3

3

1

5

15

82

89

89

106

101

467

14

10

11

12

15

62

16

16

20

30

28

110

4

3

2

2

13

24

0

0

0

0

1

1

2

0

0

0

1

3

0

0

0

0

1

1

1

2

3

1

0

7

0

2

2

1

0

5

1

0

1

0

0

2

0

1

2

1

1

5

0

0

0

0

1

1

0

1

0

0

0

1

8

5

6

10

10

39

1

2

2

1

0

6

0

0

0

0

0

0

14

16

10

10

10

60

1

0

1

1

2

5

1

2

0

1

0

4

32

28

31

42

47

180

10

4

3

13

9

39

44

38

44

43

38

207

1

1

1

0

0

3

21

22

22

18

13

96

0

0

0

0

0

0

6

3

3

3

5

20

.

4

4

4

0

12

.

2

10

4

10

26

.

18

29

15

29

91

57

70

67

85

71

350

14

17

12

26

14

83

0

0

0

1

1

2

54

62

62

82

66

326

49

46

53

66

67

281

40

41

46

63

59

249

.

4

30

42

43

119

0

0

0

0

0

0

1990
1658 393 51

1991
1647 389
51

Black
1992 1993

1633 384 51

1623 381
51

1994 5-year

1609 377 50

8170 1925
253

18.2 .
22.0

19.2 .
23.5

18.0 .
26.5

18.3 .
21.0

21.3 .
28.0

18.3 .
25.0

8

5

5

5

5

28

2

3

1

1

1

8

38

26

36

22

23

145

8

5

6

5

5

29

26

17

27

14

17

101

2

1

4

2

5

14

0

0

0

0

0

0

1

2

1

1

1

6

0

0

0

0

0

0

0

2

0

2

2

6

0

2

0

2

2

6

0

0

0

0

0

0

0

2

0

2

2

6

1

0

0

0

0

1

0

0

1

0

1

2

6

5

9

7

4

31

0

1

2

3

2

8

0

1

0

1

2

4

7

7

9

9

4

36

0

1

1

0

0

2

1

0

0

0

0

1

17

14

18

12

12

73

13

8

15

8

10

54

15

11

14

11

7

58

0

0

0

0

0

0

3

0

0

0

0

3

0

0

0

0

0

0

3

3

4

4

1

15

.

0

0

5

4

9

.

0

1

1

2

4

.

3

7

8

16

34

20

20

27

13

17

97

6

8

8

5

6

33

1

0

0

0

1

2

30

22

25

17

16

110

22

15

24

18

14

93

20

12

19

15

12

78

.

0

14

13

12

39

0

0

0

1

0

1

184

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Atkinson County - 002

19.3 86.2
2.4 35.3
* * * * 4.3
155.4 21.7 148.6 68.2
* * *
* * * * * *
11.7 * *
17.6 * *
45.0 19.3 50.0
* 20.3
* 13.6
. . .
66.4 19.2
* 70.6 59.7 50.4
.

19.0 84.8
2.4 29.3
* * * * *
101.8 40.0
101.8 73.3 * * *
* * * * * *
8.6 * *
19.8 * *
40.4 10.3 44.3
* 19.0
* 8.6
* * 11.9
77.8 23.6
* 74.1 54.3 47.4
*

20.4 91.6 2.7 38.2
* * * * 4.4
115.8 *
115.8 50.0 * * *
* * * * * *
12.0 * *
15.4 * *
45.0 14.6 47.2
* 18.2
* 9.0
* 6.6 21.4
75.8 18.5
* 70.7 62.6 52.8 35.8

21.0 94.5
2.8 34.6
* * * * *
115.8 *
115.8 70.6 * * *
* * * * * *
13.3 * *
15.0 * *
46.2 16.5 42.9
* 14.2
* 10.0
5.0 2.8 18.8
76.6 29.5
* 78.0 66.1 61.4 43.3

20.6 92.5 2.7 36.9
* * * * 14.2
157.3 26.1
136.8 50.0 * * *
* * * * * *
11.3 * *
11.5 * *
51.3 15.6 37.5
* 10.7
* 8.8
* 7.8 26.3
72.7 18.5
* 67.2 66.4 58.2 45.1

20.1 89.9
2.6 34.9
0.3 1.3 0.0 13.6 5.7
129.2 24.2 123.8 62.2
* * *
21.2 17.9
* 17.9
* *
11.4 2.3 *
15.8 1.2 0.8
45.7 15.3 44.4
* 16.4
* 9.9
2.9 4.5 19.6
73.9 21.8
* 72.2 61.9 54.2 32.4

18.5 84.4
2.5 19.8
* * * * *

20.3 92.7
2.7 18.0
* * * * *

20.5 94.1 2.8 22.7
* * * * *

24.5 113.1
3.4 28.6
* * * * *

23.6 109.3
3.3 28.3
* * * * 15.2

21.4 98.5
2.9 23.8
* * * * 5.3

163.0 *
152.2 50.0
* * *

109.4 *
109.4 60.0 * * *

132.2 *
121.1 * * * *

132.2 *
132.2 58.3 * * *

199.3 27.8
166.1 33.3 * * *

147.2 22.4 136.2 45.2
* * *

*

*

*

*

*

15.0

*

*

*

*

*

10.7

*

*

*

*

*

*

*

*

*

*

*

10.7

*

*

*

*

*

*

*

*

*

*

*

*

9.8 * *
17.3 * *

5.7 * *
18.0 * *

6.7 * *
11.4 * *

9.4

9.9

8.4

*

*

1.3

*

*

*

9.5

10.1

13.0

*

*

1.1

*

*

*

41.6 12.3 54.3
* 25.9
* 13.3

34.6 *
43.2 *
24.7 * *

39.7 *
50.0 *
25.6 * *

42.4 12.4 41.3
* 17.1
* *

50.0 9.1
39.2 *
13.1 *
8.6

42.0 8.4
45.2 *
20.9 *
7.6

.

*

*

*

*

2.5

.

*

8.4

*

8.6

5.5

.

15.0

24.5

12.8

25.0

19.3

71.3 20.0
* 66.7 60.5 49.4
.

78.7 21.0
* 69.7 51.7 46.1
*

76.1 15.6
* 70.5 60.2 52.3 34.1

80.2 29.2
* 78.1 62.9 60.0 40.0

72.4 15.9
* 66.7 67.7 59.6 43.4

75.9 20.5
* 70.6 60.8 53.9 31.2

22.9 96.7
2.6 68.4
* * * * *

15.8 66.8
1.8 68.0
* * * * *

22.0 93.7 2.6 77.1
* * * * *

13.6 57.7
1.6 63.6
* * * * *

14.3 61.0 1.8 73.9
* * * * 13.3

17.7 75.3
2.1 70.6
0.7 3.1 0.1 36.4 7.3

156.9 *
156.9 100.0
* * *

98.4 *
98.4 100.0
* * *

98.8 *
118.6 100.0
* * *

98.8 *
98.8 100.0
* * *

99.2 *
99.2 100.0
* * *

110.5 28.6 114.4 100.0
* * *

*

*

*

*

*

41.4

*

*

*

*

*

41.4

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

*

*

15.8 * *
18.4 * *

19.2 * *
28.0 * *

25.0 * *
25.7 * *

31.8 * *
40.9 * *

*

21.4

*

5.5

*

*

*

25.2

*

*

*

*

53.1 34.2 40.5
* * * *

63.6 32.0 44.0
* * * *

58.1 42.9 40.0
* * * *

66.7 36.4 50.0
* * * *

57.1 43.5 30.4
* * * *

58.9 37.8 40.8
* * * 17.2

.

*

*

8.5

*

3.8

.

*

*

*

*

*

.

*

11.7

13.5

27.4

14.3

55.6 17.6
* 78.9 57.9 52.6
.

76.9 34.8
* 88.0 60.0 48.0
*

75.0 25.8
* 71.4 68.6 54.3 40.0

59.1 31.3
* 77.3 81.8 68.2 59.1

73.9

67.8

30.0

26.6

*

*

69.6

76.9

60.9

65.0

52.2

54.5

52.2

37.1

185

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Bacon County - 003

1990
9566 2185
259
18.8 19.8 20.0
28 6
153 23 55 15
0 8 2
3 0 3 0 2 3
12 5 1
37 1 1
49 30 45
1 32
3 4
. . .
125 18
1 85 72 58
. 0

1991
9596 2182 255
19.0 21.5 20.0
23 2
127 22 54 14 4 4 0
2 2 0 6 0 0
11 2 0
18 2 1
34 38 44
0 24
0 5
2 4 6
105 22 1 86 73 60 5 0

Total
1992 1993

9626 2179
251

9659 2177 247

19.3 21.4 21.0

18.3 .
20.0

25

30

7

5

135

115

20

26

48

55

24

14

4

1

2

0

0

0

0

1

0

1

0

0

4

2

2

1

0

0

10

4

1

2

0

0

13

10

2

1

3

2

27

32

23

29

44

41

1

0

15

15

0

0

7

3

6

6

6

16

37

53

116

93

23

15

2

2

83

68

84

76

68

63

46

37

0

0

1994 5-year

9689 2176
243

48136 10899
1254

19.4 .
21.0

19.1 21.5 20.0

33

139

5

25

144

674

31

122

61

273

5

72

2

11

1

15

0

2

0

6

0

3

0

3

2

14

0

5

2

5

8

45

1

11

0

1

14

92

1

7

2

9

51

193

29

149

45

219

0

2

20

106

1

4

2

21

4

18

12

38

51

147

118

557

31

109

0

6

101

423

83

388

71

320

44

132

0

0

1990
8030 1798
205

1991
8040 1791
201

White
1992 1993

8054 1783
197

8067 1777
193

1994 5-year

8081 1771
189

40272 8920 984

20.1 21.7 20.0

19.6 21.5 20.0

19.9 .
20.0

19.6 .
20.0

20.6 .
21.0

20.2 21.6 20.0

17

13

12

13

15

70

4

1

3

0

1

9

111

95

100

81

100

487

14

13

11

11

15

64

23

27

21

27

23

121

12

12

16

7

2

49

0

2

3

0

0

5

5

4

1

0

1

11

1

0

0

0

0

1

2

0

0

1

0

3

0

0

0

1

0

1

2

0

0

0

0

2

0

2

3

1

0

6

0

0

0

0

0

0

0

0

0

0

2

2

5

6

6

2

4

23

1

0

1

2

0

4

0

0

0

0

0

0

21

11

9

5

9

55

1

2

1

1

1

6

1

0

3

2

1

7

31

23

20

21

32

127

14

18

6

14

12

64

29

29

25

27

24

134

0

0

1

0

0

1

27

23

14

10

18

92

1

0

0

0

0

1

1

3

3

1

0

8

.

1

5

5

2

13

.

4

2

9

6

21

.

5

18

8

22

53

97

82

91

70

84

424

17

16

17

14

24

88

0

1

1

1

0

3

54

59

52

41

61

267

41

47

52

47

46

233

33

37

39

37

37

183

.

1

24

18

23

66

0

0

0

0

0

0

1990
1480 376 53

1991
1485 376
52

Black
1992 1993

1489 375 51

1494 375
51

1994 5-year

1499 374 50

7447 1875
257

17.3 17.9 23.5

16.4 .
23.0

18.5 21.4 25.0

17.1 .
27.0

16.2 .
28.0

17.0 19.7 24.5

11

10

13

17

18

69

2

1

4

5

4

16

42

31

35

34

44

186

9

9

9

15

16

58

32

27

27

28

38

152

3

2

8

7

3

23

0

2

1

1

2

6

3

0

1

0

0

4

1

0

0

0

0

1

1

2

0

0

0

3

0

2

0

0

0

2

1

0

0

0

0

1

0

4

1

1

2

8

2

0

2

1

0

5

3

0

0

0

0

3

7

5

4

2

4

22

4

2

0

0

1

7

1

0

0

0

0

1

16

7

4

5

5

37

0

0

1

0

0

1

0

1

0

0

1

2

18

10

7

11

19

65

16

20

17

15

17

85

16

15

19

14

21

85

1

0

0

0

0

1

5

1

1

5

2

14

2

0

0

0

1

3

3

2

4

2

2

13

.

1

1

1

1

4

.

0

4

7

6

17

.

0

12

40

25

77

28

22

25

23

34

132

1

6

6

1

7

21

1

0

1

1

0

3

31

27

31

27

40

156

31

25

32

29

37

154

25

23

29

26

34

137

.

4

22

19

21

66

0

0

0

0

0

0

186

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

16.0

13.2

14.0

11.9

14.9

14.0

General fertility rate

70.0

58.2

62.0

52.8

66.2

61.8

Total fertility rate

2.0

1.7

1.8

1.6

1.9

1.8

% Livebirths to unmarried women

36.2

43.2

36.1

48.2

42.7

40.9

Crude abortion rate

0.8

*

*

*

*

0.3

General abortion rate

3.7

*

*

*

*

1.4

Total abortion rate

0.1

*

*

*

*

0.0

Abortion ratio

45.2

*

*

*

*

19.4

Fetal Death rate

7.3

8.2

12.8

6.9

3.2

7.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

108.1

90.4

99.7 121.6 135.8 110.8

% Repeat conceptions to women under 18

21.4

*

28.0

16.7

15.2

18.0

Livebirths to women under 18

88.8

86.4

79.8 105.3 127.6

97.3

% Livebirths to unmarried women under 18

65.2

63.6

70.0

88.5

74.2

73.0

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

23.9

*

*

13.6

Infant and child survival rates

Infant mortality

*

*

*

*

*

8.9

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

45.8

*

*

*

20.4

Deaths of children 1-4 yrs

*

*

*

*

*

1.7

Deaths of children 5-17 yrs

*

*

*

*

*

0.5

Infant health rates

% Low birthweight

7.8

8.7

7.4

*

5.6

6.7

% Very low birthweight

3.3

*

*

*

*

1.6

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

24.5

14.4

9.8

8.8

9.9

13.8

% Multiple gestation

*

*

*

*

*

1.0

% Birth defect

*

*

*

*

*

1.3

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

33.3

29.6

21.8

28.8

37.5

30.5

% with father not named on birth certificate

19.7

30.4

17.3

25.4

20.3

22.3

% with maternal education less than high school

29.6

36.1

33.1

36.6

32.1

33.2

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

21.2

19.4

11.4

13.3

14.1

16.0

% Maternal alcohol use during pregnancy

*

*

*

*

*

*

% Interpregnancy interval less than 6 months

*

7.6

9.3

*

*

5.9

Child abuse and neglect rates

Physical

.

*

2.1

2.1

*

1.6

Sexual

.

*

2.1

5.7

4.3

3.4

Neglect

.

2.1

13.1

18.9

18.3

13.1

Interventions to improve infant & child survival

% Prenatal care first trimester

83.3

84.0

86.6

80.9

83.1

83.6

% Primary C-section delivery

13.6

19.3

19.2

14.6

24.6

18.3

% Vaginal birth after previous C-section

*

*

*

*

*

8.3

% WIC during pregnancy

55.9

68.8

62.4

59.6

70.6

63.4

% Medicaid during pregnancy

47.4

58.4

63.2

66.7

58.0

58.2

% Medicaid and WIC during pregnancy

38.2

48.0

51.1

55.3

49.7

48.0

% Perinatal case management

.

4.0

34.6

32.5

30.8

25.6

Bacon County - 003

13.8 61.7
1.9 20.9
0.6 2.8 0.1 38.8 7.2
82.9 *
68.3 42.9
* * *
* * * * * *
4.5 * *
19.1 * *
29.2 12.7 26.4
* 24.8
* *
. . .
88.2 17.7
* 49.1 37.3 30.0
.

11.8 53.0
1.6 29.0
* * * * 7.8
64.8 *
64.8 38.5
* * *
* * * * * *
6.3 * *
11.8 * *
26.4 19.4 31.5
* 25.0
* *
* * 2.3
86.3 18.6
* 63.4 50.5 39.8
*

12.4 56.1 1.7 21.2
* * * * 10.7
60.9 *
55.9 54.5
* * *
* * * * * *
6.0 * *
9.1 * *
21.1 6.1 25.3
* 14.3
* *
2.3 *
8.4
91.9 18.9
* 52.5 52.5 39.4 24.2

10.0 45.6
1.4 33.8
* * * * 3.9
67.5 *
57.1 72.7
* * *
* * * * * *
* * * 6.3 * *
26.6 17.5 34.6
* 12.5
* *
2.4 4.3 3.8
86.4 19.2
* 51.3 58.8 46.3 22.5

12.4 56.5 1.7 23.2
* * * * *
79.4 *
79.4 46.7
* * *
* * * * * *
* * * 9.1 * *
33.7 12.1 24.5
* 18.4
* *
* 2.9 10.5
84.0 27.6
* 61.6 46.5 37.4 23.2

12.1 54.6
1.6 25.2
0.3 1.2 0.0 19.9 6.2
71.2 12.9 65.1 50.0
* * 7.1
* * * 12.2 * *
4.7 * *
11.4 1.2 1.4
27.5 13.3 28.1
* 19.3
* 3.3
1.5 2.5 6.2
87.4 20.4
* 55.5 48.4 38.0 17.8

28.4 111.7
2.9 76.2
* * * * *

20.9 82.6
2.1 87.1
* * * * *

23.5 93.4 2.4 79.4
* * * * 24.0

22.8 90.8
2.4 82.4
* * * * 21.4

29.4 117.5
3.1 86.4
* * * * 13.4

25.0 99.2
2.6 82.2
* * * * 15.5

207.5 *
169.8 100.0
* * *

191.9 *
172.7 100.0
* * *

253.4 *
175.4 88.9 * * *

336.6 29.4
297.0 100.0
* * *

362.2 *
321.9 100.0
* * *

268.9 23.2
226.0 98.3 * * 39.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

41.7

*

*

*

*

*

6.4

*

*

*

*

*

*

16.7 * *
39.0 * *

16.1 * *
22.6 * *

*

*

*

11.8

*

*

*

3.8

*

*

*

*

*

14.7

11.6

20.2

*

*

*

*

*

*

*

*

43.9 38.1 38.1
* 11.9
* *

37.0 64.5 51.7
* * * *

24.1 50.0 55.9
* * * *

34.4 44.1 41.2
* 15.2
* *

46.3 38.6 50.0
* * * *

38.2 45.9 47.0
* 7.6
* 11.7

.

*

*

*

*

*

.

*

*

11.0

9.5

6.7

.

*

18.8

63.1

39.7

30.2

70.0 * *
73.8 73.8 59.5
.

75.9 22.2
* 87.1 80.6 74.2
*

71.4 20.0
* 91.2 94.1 85.3 64.7

67.6 * *
79.4 85.3 76.5 55.9

81.0

73.3

17.9

13.0

*

*

90.9

84.3

84.1

83.2

77.3

74.1

47.7

46.2

187

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Baker County - 004

1990
3615 820 95
19.3 .
20.0
12 2
67 12 29
3 0 3 0
0 0 0 0 0 1
5 1 0 6 0 2
24 13 34
0 5 0 3
. . .
50 9 0
44 38 30
. 0

1991
3618 820
94
20.4 .
22.0
7 0 49 7 19 7 0 2 0
1 0 1 0 1 0
3 0 0 4 0 1
20 10 16
0 5 0 2
1 0 11
39 13
0 33 30 27
1 2

Total
1992 1993

3617 817 93

3613 815
93

20.2 14.5 22.0

19.1 21.3 20.5

4

9

1

3

26

47

3

9

9

19

1

3

0

0

5

3

1

0

1

1

1

0

0

1

1

0

0

0

1

0

2

3

1

2

1

0

2

5

0

1

1

3

12

19

3

13

9

19

0

0

1

4

1

0

1

0

8

0

1

3

10

23

23

42

1

6

0

0

19

34

19

37

17

33

0

7

1

1

1994 5-year

3609 813 91

18072 4085 466

20.7 12.3 22.5

19.4 20.8 21.5

5

37

0

6

44

233

4

35

21

97

4

18

1

1

4

17

1

2

2

5

2

3

0

2

2

3

0

1

1

3

8

21

2

6

1

2

4

21

2

3

0

7

12

87

10

49

13

91

0

0

5

20

0

1

1

7

0

9

0

4

11

55

34

188

5

34

0

0

27

157

29

153

24

131

8

16

0

4

1990
1747 372 35

1991
1743 371 35

White
1992 1993

1743 370 35

1736 368 35

1994 5-year

1730 366 35

8699 1847
175

19.4 .
19.0

21.1 .
21.0

18.5 14.5 19.0

19.2 27.4 20.0

25.9 .
20.0

20.8 20.8 20.0

5

2

3

3

0

13

1

0

1

0

0

2

34

23

13

20

17

107

5

2

2

3

0

12

3

1

0

2

3

9

0

2

1

0

3

6

0

0

0

0

1

1

1

2

1

2

1

7

0

0

1

0

0

1

0

0

0

1

0

1

0

0

0

0

0

0

0

0

0

1

0

1

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

0

0

3

2

0

1

0

6

0

0

0

1

0

1

0

0

0

0

0

0

2

1

0

3

0

6

0

0

0

0

0

0

1

0

0

0

0

1

11

9

5

8

2

35

3

1

0

1

2

7

14

8

3

8

4

37

0

0

0

0

0

0

4

4

1

3

4

16

0

0

0

0

0

0

1

1

1

0

0

3

.

0

3

0

0

3

.

0

0

0

0

0

.

8

2

13

1

24

30

22

12

19

16

99

5

5

0

4

2

16

0

0

0

0

0

0

19

11

7

11

8

56

13

9

8

13

8

51

11

7

7

11

6

42

.

0

0

7

3

10

0

0

0

1

0

1

1990
1861 447 59

1991
1863 447 59

Black
1992 1993

1862 445 58

1860 444
58

1994 5-year

1858 443 57

9303 2227
290

19.3 .
20.5

18.7 .
30.0

20.2 .
32.5

19.0 21.3 23.0

18.7 12.3 25.0

19.0 16.8 25.0

7

5

1

6

5

24

1

0

0

3

0

4

33

26

13

27

27

126

7

5

1

6

4

23

26

18

9

17

18

88

3

5

0

3

1

12

0

0

0

0

0

0

2

0

4

1

2

9

0

0

0

0

1

1

0

1

1

0

2

4

0

0

1

0

2

3

0

1

0

0

0

1

0

0

1

0

1

2

0

1

0

0

0

1

1

0

1

0

1

3

2

1

2

2

8

15

1

0

1

1

2

5

0

0

1

0

1

2

4

3

2

2

4

15

0

0

0

1

2

3

1

1

1

3

0

6

13

11

10

9

20

8

0

0

1

1

0

0

2

1

7

11

10

52

3

12

8

42

6

11

9

54

0

0

0

0

0

1

1

4

1

0

0

1

0

0

1

4

.

1

3

0

0

4

.

0

0

1

0

1

.

3

1

8

6

18

20

17

11

23

18

89

4

8

1

2

3

18

0

0

0

0

0

0

25

22

12

23

19

101

25

21

11

24

21

102

19

20

10

22

18

89

.

1

0

0

5

6

0

2

1

0

0

3

188

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

18.5

13.5

7.2

13.0

12.2

12.9

General fertility rate

81.7

59.8

31.8

57.7

54.1

57.0

Total fertility rate

2.3

1.7

0.9

1.7

1.6

1.6

% Livebirths to unmarried women

43.3

38.8

34.6

41.3

50.0

42.2

Crude abortion rate

*

*

1.4

*

*

0.9

General abortion rate

*

*

6.1

*

*

4.2

Total abortion rate

*

*

0.2

*

*

0.1

Abortion ratio

*

* 151.5

*

*

61.8

Fetal Death rate

6.1

8.5

*

7.4

6.2

6.1

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

126.3

74.2

*

97.3

54.8

79.3

% Repeat conceptions to women under 18

*

*

*

*

*

16.2

Livebirths to women under 18

126.3

74.2

*

97.3

*

75.0

% Livebirths to unmarried women under 18

66.7

85.7

*

87.5

*

76.5

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

21.5

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

*

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

7.5

*

*

*

18.2

9.0

% Very low birthweight

*

*

*

*

*

2.6

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

9.0

*

*

10.9

*

9.1

% Multiple gestation

*

*

*

*

*

*

% Birth defect

*

*

*

*

*

3.0

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

38.7

43.5

57.1

47.5

29.3

41.4

% with father not named on birth certificate

19.4

20.4

*

28.3

23.8

21.3

% with maternal education less than high school

50.7

32.7

34.6

41.3

31.0

39.6

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

7.5

10.2

*

*

11.9

8.7

% Maternal alcohol use during pregnancy

*

*

*

*

*

*

% Interpregnancy interval less than 6 months

*

*

*

*

*

5.2

Child abuse and neglect rates

Physical

.

*

7.5

*

*

2.1

Sexual

.

*

*

*

*

*

Neglect

.

10.3

9.4

21.7

10.5

13.0

Interventions to improve infant & child survival

% Prenatal care first trimester

79.4

81.3

88.5

91.3

77.3

82.8

% Primary C-section delivery

14.5

28.9

*

15.0

13.2

16.3

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

65.7

67.3

73.1

73.9

64.3

68.3

% Medicaid during pregnancy

56.7

61.2

73.1

80.4

69.0

66.5

% Medicaid and WIC during pregnancy

44.8

55.1

65.4

71.7

57.1

57.0

% Perinatal case management

.

*

*

15.2

19.0

9.8

Baker County - 004

19.5 91.4
2.7 * * * * * *
142.9 *
142.9 * * * *
* * * * * *
* * * * * *
32.4 *
41.2 * * * *
. . .
90.9 15.6
* 55.9 38.2 32.4
.

13.2 62.0
1.8 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
39.1 *
34.8 * * * *
* * 19.0
95.7 23.8
* 47.8 39.1 30.4
*

7.5 35.1 1.0
* * * * * *
* * * * * * *
* * * * * *
* * * * * *
45.5 * * * * * *
* * *
92.3 * *
53.8 61.5 53.8
*

11.5 54.3
1.6 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
47.1 *
40.0 * * * *
* * 30.9
95.0 * *
55.0 65.0 55.0 35.0

9.8 46.4 1.4
* * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* * *
94.1 * *
47.1 47.1 35.3
*

12.3 57.9
1.7 8.4 0.8 3.8 0.1 57.4 4.3
74.3 *
68.6 * * * *
* * * * * *
5.6 * *
5.6 * *
34.3 6.5
34.6 *
15.1 * *
* * 14.2
93.4 16.7
* 52.3 47.7 39.3 13.7

17.7 73.8
2.0 78.8
* * * * 11.2

14.0 58.2
1.6 69.2
* * * * 11.2

118.6 *
118.6 100.0
* * *

85.3 *
85.3 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

46.4 30.3 60.6
* * * *

47.8 34.6 30.8
* * * *

.

*

.

*

.

*

66.7 * *
75.8 75.8 57.6
.

68.0 33.3
* 84.6 80.8 76.9
*

7.0 29.2 0.8 69.2
* * * * *

14.5 60.8
1.7 65.4
* * * * 13.5

* 104.3

*

*

* 104.3

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

70.0 *
46.2 * * * *

47.8 46.2 42.3
* * * *

*

*

*

*

*

12.4

84.6 * *
92.3 84.6 76.9
*

88.5 * *
88.5 92.3 84.6
*

14.5 60.9 1.7 72.0
* * * * *

13.5 56.6
1.6 71.5
1.0 4.0 0.1 59.2 7.6

88.2 * * * * * *

82.8 *
79.4 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

29.6 * * * * *

11.9 4.0 *
12.2 *
4.8

41.7 32.0 36.0
* * * *

48.1 34.1 43.9
* * * *

*

*

*

*

9.4

7.0

66.7

73.6

*

16.1

*

*

76.0

82.1

84.0

82.9

72.0

72.4

20.0

6.7

189

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Baldwin County - 005

1990
39530 9500 688
21.0 20.4 23.0
80 22 545 54 246 61 10 232 24
11 8 3
18 1 1
53 9 4
62 8 7
203 122 161
4 79
5 33
. . .
355 78 11 247 210 162
. 0

1991
39849 9520 690
21.7 20.1 23.0
82 12 606 51 275 45
1 225
26
7 5 2 6 1 2
65 10
0 65
8 10
151 137 164
9 55
5 28
10 12 83
342 110
3 296 250 208
1 0

Total
1992 1993

40161 9537 693

40483 9558 695

21.9 20.1 23.0

22.1 19.6 23.0

77

86

19

16

620

592

57

58

321

318

41

57

10

5

223

245

20

27

8

9

4

4

4

5

14

9

1

0

1

6

77

52

14

13

2

0

95

62

4

2

5

4

252

236

163

157

181

154

21

9

99

61

8

4

37

27

13

23

22

3

113

116

363

384

80

98

13

12

310

329

289

325

229

258

12

45

15

6

1994 5-year

40794 9576 697

200817 47691 3463

20.9 20.0 23.0

21.6 20.1 23.0

93

418

19

88

568

2931

65

285

303

1463

47

251

7

33

219

1144

27

124

11

46

6

27

5

19

14

61

1

4

6

16

68

315

15

61

2

8

70

354

11

33

6

32

192

1034

140

719

160

820

10

53

95

389

3

25

17

142

18

64

16

53

99

411

392

1836

79

445

15

54

310

1492

293

1367

232

1089

48

106

7

28

1990
22451 5109 317

1991
22491 5085 317

White
1992 1993

22528 5059 317

22572 5036 318

1994 5-year

22609 5011 318

112651 25300 1587

22.4 20.1 22.0

23.7 20.7 22.0

23.9 20.8 22.0

23.6 20.1 22.0

23.2 20.7 22.0

23.5 20.5 22.0

25

25

16

21

25

112

3

3

5

0

4

15

260

275

248

256

240

1279

15

19

13

13

21

81

51

38

57

60

60

266

26

24

21

26

25

122

3

0

1

2

1

7

111

94

95

111

84

495

9

4

3

8

4

28

1

2

2

1

3

9

1

2

0

0

1

4

0

0

2

1

2

5

4

2

1

2

2

11

1

0

0

0

1

2

0

2

1

4

3

10

17

16

20

10

17

80

1

2

2

0

2

7

1

0

1

0

0

2

26

23

25

17

21

112

3

3

1

1

1

9

3

4

2

1

3

13

81

60

82

81

72

376

23

19

26

31

28

127

60

56

61

52

58

287

0

3

5

1

3

12

49

28

56

37

64

234

1

3

3

0

1

8

11

8

7

6

6

38

.

5

9

10

7

31

.

8

10

2

7

27

.

27

33

24

17

101

195

214

181

207

192

989

52

63

36

44

35

230

3

1

6

4

4

18

71

87

75

99

95

427

65

74

66

100

85

390

47

59

51

73

68

298

.

1

4

17

16

38

0

0

5

2

1

8

1990
16706 4286 366

1991
16841 4296 367

Black
1992 1993

16973 4304 369

17109 4314 370

1994 5-year

17240 4323 371

84869 21522
1842

20.3 21.2 24.0

20.5 18.4 26.0

19.9 19.4 26.0

20.4 18.5 24.0

20.3 17.9 25.0

20.3 18.7 25.0

55

56

61

65

68

305

19

9

14

16

15

73

280

325

364

331

321

1621

39

31

44

45

44

203

194

235

263

255

243

1190

33

21

19

31

20

124

7

1

9

3

6

26

113

124

123

127

133

620

15

22

17

19

23

96

10

5

6

8

8

37

7

3

4

4

5

23

3

2

2

4

3

14

14

4

13

7

12

50

0

1

1

0

0

2

1

0

0

2

3

6

35

49

56

41

51

232

8

8

12

13

13

54

3

0

1

0

2

6

36

42

69

44

49

240

5

5

3

1

10

24

4

6

3

3

3

19

120

90

165

155

118

648

98

117

136

126

112

589

101

108

119

101

102

531

4

6

16

8

7

41

30

27

43

24

31

155

4

2

5

4

2

17

22

20

29

21

11

103

.

4

3

13

11

31

.

4

11

0

9

24

.

55

78

89

80

302

158

125

175

174

193

825

26

45

44

52

43

210

8

2

7

8

11

36

175

208

232

225

214

1054

144

176

222

221

208

971

114

149

177

181

164

785

.

0

8

26

32

66

0

0

10

4

5

19

190

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Baldwin County - 005

13.8 57.4
1.6 45.8
5.9 24.4
0.7 270.7
8.4
116.3 27.5 78.5 84.9 34.9 100.0
*
20.2 14.7
* 32.4
* *
9.7 1.7
* 11.5
1.5 1.3
41.7 22.7 30.1
* 14.7
0.9 10.3
. . .
66.5 16.6 16.7 46.0 39.1 30.2
.

15.2 63.7
1.8 46.1
5.6 23.6
0.7 254.8
5.5
118.8 14.6 73.9 76.5 37.7
100.0 8.7
11.6 8.3 * 9.9 * *
10.7 1.7 *
11.1 1.3 1.7
41.4 22.9 27.7
1.6 9.2 0.8 8.5
1.1 1.3 9.0
63.0 20.5
* 49.5 41.8 34.8
*

15.4 65.0 1.9 52.1 5.6 23.4 0.7 248.9 5.6
111.2 24.7 82.3 87.7 28.9
100.0 *
12.9 * *
22.2 * *
12.4 2.3
* 15.4
* 0.8
49.9 26.5 29.4 3.5 16.1 1.3 10.2
1.4 2.4 12.3
60.4 14.6 19.1 50.3 46.9 37.2
1.9

14.6 61.9
1.8 53.9
6.1 25.6
0.7 272.2
6.6
123.7 18.6 83.5 89.7 38.8
100.0 *
15.2 *
8.5 15.1
* 0.9
8.8 2.2
* 10.5
* *
42.7 26.6 26.2
1.5 10.4
* 7.8
2.5 *
12.6
65.8 19.3 14.6 55.8 55.1 43.7
7.6

13.9 59.3 1.7 54.4 5.4 22.9 0.7 259.8 5.8
133.4 20.4 93.3 84.6 38.7 92.6 *
19.4 10.6 8.9 24.3
* 0.9
12.0 2.6
* 12.6
2.0 1.1
36.4 25.1 28.8 1.8 17.1
* 5.3
2.0 1.7 10.7
69.5 16.4 20.0 55.7 52.6 41.7
8.6

14.6 61.5
1.8 50.5
5.7 24.0
0.7 261.2
6.4
120.7 21.1 82.3 84.9 35.8 98.3
5.5
15.7 9.2 6.5
20.6 *
0.5
10.7 2.1 0.3
12.3 1.1 1.1
42.4 24.8 28.4
1.9 13.5
0.9 8.5
1.7 1.4 11.2
65.0 17.5 15.3 51.5 47.2 37.6
4.5

11.6 50.9
1.5 19.8
4.9 21.7
0.6 275.4
6.3

12.2 54.1
1.5 14.0
4.2 18.5
0.5 236.8
5.5

11.0 49.0 1.4 23.1 4.2 18.8 0.5 259.6 4.5

11.3 50.8
1.5 23.5
4.9 22.0
0.6 281.0
5.6

10.6 47.9 1.4 25.1 3.7 16.8 0.5 239.3 5.4

11.4 50.6
1.5 20.9
4.4 19.6
0.5 258.9
5.5

78.9 *
47.3 60.0 28.4 100.0
*

78.8 *
59.9 42.1
* * *

50.4 31.3 41.0 53.8
* * *

66.1 *
40.9 53.8 25.2 100.0
*

78.7 *
66.1 57.1
* * *

70.6 13.4 51.0 53.1 17.6 96.4
3.1

*

*

*

*

*

7.0

*

*

*

*

*

*

*

*

*

*

*

3.9

*

*

*

*

*

8.6

*

*

*

*

*

*

*

*

*

*

*

0.6

6.5

5.8

8.1

3.9

7.1

6.3

*

*

*

*

*

0.5

*

*

*

*

*

*

10.1

8.5

10.1

6.7

8.9

8.8

*

*

*

*

*

0.7

*

*

*

*

*

1.0

33.3 8.9
23.3 *
19.1 *
7.9

31.1 7.0
20.6 *
10.4 *
5.7

37.4 10.5 24.7 2.1 22.8
* 5.0

32.8 12.2 20.6
* 14.5
* 4.2

30.9 11.7 24.3
* 26.9
* 4.6

33.1 10.0 22.6
1.0 18.5
0.6 5.5

.

1.1

2.1

2.3

1.6

1.8

.

1.8

2.3

*

1.6

1.6

.

6.2

7.6

5.6

4.0

5.9

75.6 23.3
* 27.6 25.3 18.3
.

82.0 26.6
* 32.0 27.2 21.7
*

74.8 16.9 17.6 30.4 26.7 20.6
*

81.5 20.9
* 38.8 39.2 28.6
6.7

80.7 16.8
* 39.7 35.6 28.5
6.7

78.9 21.1 10.1 33.6 30.7 23.5
3.8

16.8 65.3
1.9 70.5
6.8 26.4
0.7 257.4 10.7

19.3 75.7
2.1 73.7
7.4 28.9
0.8 262.2
5.6

21.4 84.6 2.4 72.9 7.2 28.6 0.8 238.4 6.7

19.3 76.7
2.2 77.3
7.4 29.4
0.8 257.6
8.1

18.6 74.3 2.2 78.1 7.7 30.8 0.9 276.5 6.2

19.1 75.3
2.2 74.6
7.3 28.8
0.8 258.1
7.5

150.3 34.5 106.6 94.7 41.0 100.0
*

152.5 16.1 84.4 96.8 59.9
100.0 *

165.5 23.0
119.4 97.7 46.1
100.0 *

175.8 24.6
121.7 100.0
51.4 100.0
*

183.4 22.1
118.7 97.7 62.0 95.7 *

165.6 23.9 110.2 97.5 52.1 98.9 7.6

35.7 25.0
* 48.8
* *

15.4 * * * * *

16.5 * *
34.9 * *

24.2 * *
21.0 * *

24.9 15.6
* 36.7
* *

22.8 14.2
8.8 30.4
* 0.3

12.5 2.9 *
13.1 1.8 *

15.1 2.5 *
13.5 1.6 1.8

15.4 3.3
* 19.2
* *

12.4 3.9 *
13.3 * *

15.9 4.0
* 15.8
3.2 *

14.3 3.3 0.4
15.1 1.5 1.2

50.0 35.6 37.0
* 10.9
* 12.4

53.6 36.6 34.3
2.0 8.4
* 10.8

59.1 37.7 33.0 4.6 11.9 1.4 13.2

51.3 38.2 30.7
2.5 7.3
* 10.7

41.0 36.0 32.9 2.3 10.0
* 6.0

50.7 36.9 33.4
2.7 9.7 1.1 10.7

.

*

*

2.8

2.3

1.6

.

*

2.3

*

1.9

1.3

.

11.7

16.6

18.9

17.0

16.0

58.3 10.7 25.8 63.6 52.4 41.5
.

45.3 15.3
* 65.0 55.0 46.6
*

49.9 13.5 20.6 64.3 61.5 49.0
2.2

53.5 17.7 21.6 68.2 67.0 54.8
7.9

60.5

53.5

16.1

14.7

25.0

20.9

68.8

66.0

66.9

60.8

52.7

49.2

10.3

5.0

191

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Banks County - 006

1990
10308 2332 220
21.6 19.1 20.0
13 2
112 11 20
5 2 18 2
2 1 1 3 0 0
11 4 0 9 2 4
19 6
35 0
14 2 3
. . .
83 20
1 50 33 26
. 0

1991
10527 2361 220
19.8 18.8 20.0
11 2
101 9
18 7 0
16 2
3 3 0 5 0 0
15 3 2
12 1 3
23 10 37
0 19
3 1
0 6 16
82 16
0 62 43 42 19
1

Total
1992 1993

10745 2388 219

10966 2418 220

22.6 18.9 19.0

20.3 19.1 20.0

15

18

5

2

150

142

11

16

36

24

12

9

1

2

19

30

3

2

0

2

0

2

0

0

2

4

0

0

0

3

11

7

0

2

0

0

13

8

1

1

7

4

25

27

16

12

37

47

0

0

25

27

1

1

4

6

5

12

10

14

14

35

127

117

17

13

2

1

69

81

65

70

56

63

32

16

2

1

1994 5-year

11176 2444 219

53722 11943
1099

21.3 22.2 20.0

21.1 19.0 20.0

18

75

2

13

141

646

16

63

23

121

5

38

3

8

18

101

2

11

1

8

1

7

0

1

4

18

0

0

1

4

13

57

0

9

0

2

15

57

4

9

2

20

28

122

9

53

37

193

1

1

12

97

0

7

3

17

8

25

13

43

33

98

124

533

21

87

6

10

70

332

57

268

52

239

17

84

0

4

1990
9874 2223
207

1991
10089 2253 208

White
1992 1993

10301 2281 208

10516 2311 208

1994 5-year

10724 2339 208

51504 11407
1038

21.5 19.1 20.0

19.8 17.8 20.0

22.6 18.4 19.0

20.3 19.1 20.0

21.3 22.3 19.5

21.1 19.0 20.0

12

9

12

16

16

65

2

1

3

1

1

8

102

97

140

135

139

613

10

7

8

14

16

55

13

16

29

20

22

100

5

7

12

8

5

37

2

0

1

2

3

8

18

11

16

29

14

88

2

2

3

2

0

9

2

3

0

2

1

8

1

3

0

2

1

7

1

0

0

0

0

1

3

5

2

4

4

18

0

0

0

0

0

0

0

0

0

3

1

4

9

12

10

4

2

0

0

2

0

8

10

12

1

1

1

4

3

7

6

13

50

2

0

8

0

0

2

7

14

51

1

4

8

3

2

19

17

20

24

26

28

115

4

9

15

10

8

46

31

34

32

44

37

178

0

0

0

0

1

1

12

19

25

26

11

93

1

2

1

1

0

5

3

1

4

4

3

15

.

0

4

11

8

23

.

2

10

14

13

39

.

3

14

32

33

82

77

79

119

113

122

510

16

14

16

13

20

79

0

0

2

1

6

9

45

59

61

74

68

307

27

41

59

64

56

247

21

40

50

57

51

219

.

18

32

14

16

80

0

0

1

1

0

2

1990
364 91 10

1991
372 92 10

Black
1992 1993

379

387

93

95

10

10

1994 5-year

395

1897

96

467

10

50

24.6 .
26.0

19.0 .
21.0

21.2 21.4
.

16.6 .
30.0

22.0 .
21.0

22.1 21.4 25.5

1

2

3

2

1

9

0

1

2

1

1

5

10

4

9

6

2

31

1

2

3

2

0

8

7

2

7

4

1

21

0

0

0

1

0

1

0

0

0

0

0

0

0

2

3

1

3

9

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

2

3

1

1

0

7

0

1

0

0

0

1

0

0

0

0

0

0

1

2

0

1

1

5

1

0

0

0

0

1

0

0

0

1

0

1

2

3

1

1

0

7

2

1

1

2

1

7

4

3

4

3

0

14

0

0

0

0

0

0

2

0

0

1

1

4

1

1

0

0

0

2

0

0

0

2

0

2

.

0

0

1

0

1

.

0

0

0

0

0

.

0

0

3

0

3

6

3

7

4

2

22

4

2

1

0

1

8

1

0

0

0

0

1

5

3

8

6

2

24

6

2

6

5

1

20

5

2

6

5

1

19

.

1

0

2

1

4

0

0

0

0

0

0

192

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Banks County - 006

10.9 48.0
1.5 18.2
1.7 7.7 0.2 129.5 3.9
59.1 *
50.0 45.5
* * *
* * * * * *
9.9 * *
8.2 * *
30.6 5.5
32.4 *
12.7 * *
. . .
74.8 19.4
* 45.5 30.0 23.6
.

9.6 42.8
1.3 18.2
1.5 6.8 0.2 128.0 3.4
50.0 *
40.9 55.6
* * *
* * * . * *
14.9 * *
12.0 * *
34.3 10.0 37.4
* 19.2
* *
* 2.2 5.8
81.2 17.0
* 62.0 43.0 42.0 19.0

14.0 62.8 2.0 24.2 1.8
8.0 0.2 104.4 5.4
68.4 33.3 50.1 63.6
* * *
* * * * * *
7.3 * *
8.7 *
4.7
27.2 10.7 25.2
* 17.2
* *
1.8 3.5 5.0
85.8 12.6
* 46.3 43.6 37.6 21.5

12.9 58.7
1.8 17.0
2.7 12.4
0.4 163.0
5.0
81.8 *
72.7 56.3
* * *
* * * * * *
4.9 * *
5.7 * *
34.6 8.5
34.1 *
19.6 *
8.6
4.2 4.9 12.3
83.0 10.0
* 57.4 49.6 44.7 11.3

12.6 57.7 1.8 16.8 1.6 7.4 0.2 107.1 3.7
82.0 *
72.9 62.5
* * *
* * * * * *
9.2 * *
10.9 * *
21.5 6.6 28.0
* 8.9
* *
2.8 4.5 11.4
88.6 17.2 40.0 51.1 41.6 38.0 12.4

12.0 54.1
1.7 19.0
1.9 8.5 0.3 126.6 4.3
68.3 17.3 57.3 57.1 10.0 100.0
*
12.4 10.8
* 27.5
* *
8.8 1.4
* 8.9 1.4 3.1
28.4 8.3
30.9 *
15.5 1.1 5.6
2.2 3.8 8.6
83.2 14.9 18.9 52.1 42.1 37.5 15.9

10.3 45.9
1.4 12.9
1.8 8.1 0.2 139.5 4.0
58.0 *
48.3 * * * *
* * * * * *
8.8 * *
7.9 * *
30.4 *
31.3 *
11.9 * *
. . .
76.2 16.8
* 44.6 26.7 20.8
.

9.6 43.1
1.3 16.8
1.1 4.9 0.1 94.8 3.6
43.4 *
33.7 * * * *
* * * . * *
12.4 * *
10.4 * *
31.7 9.4
35.8 *
20.0 * *
* * *
81.4 15.4
* 61.5 42.7 41.7 18.8

13.6 61.4 1.9 20.9 1.6 7.0 0.2 94.7 5.7

12.8 58.4
1.8 14.9
2.8 12.5
0.4 165.7
4.8

57.8 *
38.5 * * * *

76.9 *
67.3 50.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

7.1

4.4

*

*

*

*

8.6

5.2

*

*

5.0

*

28.2 10.8 23.4
* 18.4
* *

36.1 7.5
33.6 *
19.7 * *

*

4.0

3.7

5.1

5.2

11.8

85.6 12.5
* 43.9 42.4 36.0 23.0

83.7 10.5
* 55.2 47.8 42.5 10.4

13.0 59.4 1.9 16.3 1.3 6.0 0.2 86.4 3.8

11.9 53.7
1.7 16.6
1.7 7.7 0.2 117.2 4.4

76.9 *
76.9 62.5
* * *

62.6 12.3 53.0 50.9
8.7 100.0
*

*

13.1

*

11.4

*

*

*

29.0

*

*

*

*

9.4

8.2

*

1.3

*

*

10.4

8.4

*

1.3

*

3.1

21.9 5.9 28.5
* 8.3
* *

28.5 7.6
30.1 *
15.6 0.8 5.2

2.9

2.1

4.7

3.6

12.0

7.6

88.4 16.7 40.0 50.4 41.5 37.8 11.9

83.6 14.2 19.1 50.7 40.8 36.2 15.9

27.5 109.9
4.3 77.8
* * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
. . .
60.0 * *
55.6 66.7 55.6
.

*

23.7

15.5

*

96.5

63.4

*

2.8

2.0

*

77.8

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

87.5

*

*

*

*

*

*

*

*

88.9 100.0

*

66.7

83.3

*

66.7

83.3

*

*

*

*

16.3

*

66.4

*

2.2

*

70.0

*

4.7

*

19.3

*

0.5

* 219.5

*

*

* 180.0

*

55.6

* 160.0

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

23.3

*

*

*

*

*

16.7

*

*

*

*

*

30.4

*

23.3

*

46.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

75.9

*

33.3

*

*

*

80.0

*

66.7

*

63.3

*

*

193

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Barrow County - 007

1990
29721 7124 630
21.2 20.6 21.0
62 20 578 50 138 47
3 107 11
4 3 1 6 0 1
33 6 1
43 3 7
152 71 175
5 134 11 20
. . .
421 88 16 183 196 128
. 0

1991
30594 7259 640
22.1 19.6 22.0
52 12 577 41 150 44
5 115
11
5 4 1 10 0 2
35 9 1
47 6 7
120 73
171 12
117 20 29
9 9 35
428 80 15
238 231 179
14 0

Total
1992 1993

31457 7395 650

32335 7529 658

23.4 18.7 21.0

23.0 18.6 22.0

47

52

10

6

581

605

33

41

147

163

49

65

6

3

90

87

11

10

5

6

3

3

2

3

9

6

4

1

3

3

42

38

8

7

1

0

49

53

7

9

18

15

128

137

75

72

155

155

3

7

119

108

10

8

21

17

25

32

49

36

106

79

426

477

83

68

16

25

214

221

219

253

175

186

131

126

6

1

1994 5-year

33200 7662 668

157307 36969 3245

22.1 19.3 22.0

22.4 19.4 21.0

65

278

11

59

589

2930

49

214

151

749

48

253

0

17

91

490

14

57

6

26

5

18

1

8

5

36

0

5

2

11

39

187

13

43

2

5

49

241

5

30

4

51

182

719

64

355

169

825

2

29

104

582

8

57

16

103

45

111

35

129

71

291

506

2258

74

393

16

88

249

1105

264

1163

206

874

146

417

1

8

1990
25962 6174 527

1991
26820 6318 539

White
1992 1993

27672 6462 551

28534 6606 562

1994 5-year

29389 6749 573

138377 32309 2751

21.7 20.5 21.0

22.8 19.7 22.0

23.6 19.6 21.0

23.5 18.5 22.0

22.5 19.0 21.0

22.8 19.4 21.0

48

35

30

41

52

206

14

9

6

5

10

44

492

499

506

522

521

2540

38

25

21

33

40

157

80

89

95

97

106

467

41

39

43

57

40

220

2

4

4

1

0

11

88

85

67

70

65

375

9

10

7

8

10

44

3

3

2

6

5

19

2

3

1

3

4

13

1

0

1

3

1

6

4

8

5

4

5

26

0

0

4

1

0

5

0

2

1

3

2

8

22

30

33

34

33

152

3

6

6

6

12

33

1

0

0

0

2

3

32

38

41

41

42

194

3

5

6

9

4

27

6

6

12

11

4

39

123

95

108

107

157

590

39

41

45

40

48

213

141

140

130

124

143

678

3

10

3

7

1

24

127

112

111

101

99

550

11

14

10

6

5

46

18

22

16

16

13

85

.

7

16

25

39

87

.

6

44

32

33

115

.

33

73

72

55

233

373

391

383

421

457

2025

74

69

66

60

68

337

15

12

16

22

14

79

130

183

164

162

198

837

139

175

169

188

215

886

83

133

134

130

161

641

.

9

98

88

111

306

0

0

3

1

0

4

1990
3354 858 89

1991
3453 875
90

Black
1992 1993

3550 892 92

3649 908
93

1994 5-year

3747 925 94

17752 4458 459

20.1 20.8 26.0

19.1 18.9 23.0

19.9 18.2 24.5

19.1 18.6 25.5

19.0 21.8 28.0

19.3 19.6 25.0

14

17

16

11

12

70

6

3

4

1

1

15

78

74

69

78

58

357

12

16

11

8

9

56

56

61

49

65

44

275

6

5

6

6

7

30

1

1

2

2

0

6

16

26

23

13

22

100

2

1

4

2

3

12

1

2

3

0

1

7

1

1

2

0

1

5

0

1

1

0

0

2

2

2

4

2

0

10

0

0

0

0

0

0

1

0

2

0

0

3

10

5

9

3

5

32

2

3

2

1

1

9

0

1

1

0

0

2

10

9

8

11

6

44

0

1

1

0

1

3

1

1

6

4

0

12

29

24

18

30

19

120

32

32

29

32

16

141

33

30

24

31

24

142

2

2

0

0

0

4

7

5

8

7

5

32

0

6

0

2

3

11

2

7

5

1

3

18

.

2

8

5

3

18

.

3

3

2

1

9

.

0

24

5

12

41

44

34

40

53

46

217

12

11

16

7

6

52

1

3

0

3

2

9

49

54

48

58

46

255

54

55

48

64

45

266

42

45

39

55

42

223

.

5

31

38

32

106

0

0

3

0

0

3

194

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Barrow County - 007

19.4 81.1
2.4 24.0
3.6 15.0
0.4 145.4
7.2
98.4 32.3 79.4 58.0 17.5 100.0
7.9
* * * 10.3 * *
5.7 1.0
* 7.5
* 1.2
32.5 12.3 31.7
0.9 23.6
1.9 7.3
. . .
73.9 17.0 28.6 31.8 34.1 22.3
.

18.9 79.5
2.3 26.3
3.8 15.8
0.5 154.6
7.2
81.3 23.1 64.1 78.0 17.2 90.9
*
8.7 * *
17.2 * *
6.1 1.6
* 8.2 1.1 1.2
28.2 12.8 30.8
2.1 21.9
3.8 9.4
1.0 1.0 4.1
74.8 16.0 21.4 41.7 40.5 31.3
2.5

18.5 78.6 2.3 25.6 2.9 12.2 0.4 124.0 7.4
72.4 21.3 50.8 72.7 16.9 100.0
7.7
8.6 * *
15.3 * *
7.2 1.4
* 8.5 1.2 3.1
28.4 13.0 27.5
* 23.3
2.0 6.5
2.8 5.5 11.9
74.3 16.3 24.6 37.2 38.1 30.4 22.8

18.7 80.4
2.4 27.3
2.7 11.6
0.3 114.5
9.0
79.0 11.5 62.3 67.5 15.2 100.0
7.6
9.9 * *
9.9 * *
6.3 1.2
* 8.9 1.5 2.5
28.9 12.1 26.5
1.2 20.6
1.5 5.4
3.5 3.9 8.6
80.2 13.0 33.8 37.1 42.4 31.2 21.1

17.7 76.9 2.3 25.9 2.7 11.9 0.4 124.5 6.7
97.3 16.9 73.4 71.4 21.0 100.0 10.5
10.2 8.5
* . * *
6.6 2.2
* 8.4 0.9
*
33.3 11.0 29.1
* 18.2
1.4 5.1
4.7 3.7 7.5
86.5 14.1 26.2 42.6 45.2 35.3 25.0

18.6 79.3
2.4 25.8
3.1 13.3
0.4 132.5
7.5
85.7 21.2 65.9 69.0 17.6 98.2
7.4
8.9 6.1 2.7 12.2 0.5 0.4
6.4 1.5 0.2 8.3 1.0 1.7
30.4 12.2 29.1
1.0 21.5
2.1 6.7
3.1 3.6 8.0
78.0 15.3 27.0 38.1 40.1 30.1 17.9

19.0 79.7
2.3 16.4
3.4 14.3
0.4 141.0
7.1

18.6 79.0
2.3 18.0
3.2 13.5
0.4 134.9
7.3

18.3 78.3 2.3 19.0 2.4 10.4 0.3 108.1 7.3

18.3 79.0
2.4 18.9
2.5 10.6
0.3 107.7
8.8

17.7 77.2 2.3 20.5 2.2 9.6 0.3 103.3 6.4

18.4 78.6
2.3 18.6
2.7 11.6
0.3 118.9
7.4

91.1 29.2 72.1 44.7 17.1 100.0
*

65.0 25.7 46.4 68.0 18.6 90.0
*

54.5 20.0 38.1 61.9 12.7 100.0
*

73.0 12.2 58.7 59.4 14.2 100.0
*

90.7 19.2 69.8 65.0 17.4 100.0 12.2

74.9 21.4 57.1 59.0 16.0 97.7
6.9

*

*

*

*

*

*

*

15.9

*

*

*

*

*

11.5

*

*

*

*

9.8

*

*

*

*

*

9.6

7.5

*

5.1

*

2.4

.

10.2

*

0.5

*

*

4.5

6.0

6.5

6.5

6.3

6.0

*

1.2

1.2

1.1

2.3

1.3

*

*

*

*

*

*

6.5

7.7

8.2

8.0

8.1

7.7

*

1.0

1.2

1.8

*

1.1

1.2

1.2

2.4

2.1

*

1.5

31.2 8.0
29.8 *
26.2 2.3 7.5

26.2 8.3
29.0 2.0
24.1 3.0 8.0

27.3 9.0 26.4
* 24.7
2.2 5.7

26.4 7.8
24.4 1.4
22.3 1.3 5.9

32.6 9.3
27.8 *
19.6 1.0 4.6

28.9 8.5
27.4 1.0
23.4 2.0 6.3

.

1.0

2.1

3.1

4.7

2.8

.

0.8

5.8

4.0

4.0

3.7

.

4.5

9.6

9.1

6.7

7.5

76.6 16.9 30.0 26.6 28.4 17.0
.

78.8 15.8 20.7 37.0 35.4 26.9
1.8

76.6 15.0 26.7 32.7 33.7 26.7 19.6

81.9 13.4 34.4 31.6 36.6 25.3 17.2

88.2 14.7 25.5 38.3 41.6 31.1 21.5

80.5 15.1 27.5 33.3 35.2 25.5 15.1

23.3 90.9
2.5 71.8
4.8 18.6
0.5 158.4
8.2

21.4 84.6
2.3 83.6
7.5 29.7
0.9 245.3
6.9

19.4 77.4 2.2 72.1 6.5 25.8 0.7 230.0 9.0

21.4 85.9
2.5 83.3
3.6 14.3
0.4 131.3
8.8

15.5 62.7 1.9 77.2 5.9 23.8 0.7 252.9 7.6

20.1 80.1
2.3 77.7
5.6 22.4
0.6 202.8
8.1

157.3 42.9 134.8 100.0
* * *

188.3 *
177.2 93.8 * * *

174.3 *
119.8 90.9 * * *

118.3 *
86.0 100.0
* * *

127.1 *
95.3 100.0
* * *

152.7 21.4 122.1 96.4 26.2 100.0 10.9

*

*

*

*

*

19.6

*

*

*

*

*

14.0

*

*

*

*

*

*

*

*

*

*

*

27.5

*

*

*

*

*

*

*

*

*

*

*

*

12.8 * *
12.8 * *

6.8 * *
12.3 * *

13.0 * *
11.8 *
8.7

* * * 14.1 * *

8.6 * *
10.5 * *

9.0 2.5
* 12.4
* 3.4

41.4 41.0 45.8
* 9.0
* *

40.0 43.8 42.9
* 7.6 9.1 22.6

34.6 42.6 36.4
* 14.3
* 13.2

46.9 41.0 41.9
* 10.4
* *

34.5 28.1 42.1
* 8.8
* *

39.9 39.8 41.9
* 9.9 3.4 10.2

.

*

6.7

4.1

*

3.7

.

*

*

*

*

1.9

.

*

20.2

4.1

9.5

8.5

57.9 16.4
* 62.8 69.2 53.8
.

47.2 18.0
* 74.0 75.3 61.6
6.8

58.8 25.4
* 70.6 70.6 57.4 45.6

68.8 10.3
* 74.4 82.1 70.5 48.7

79.3

61.8

11.8

16.5

*

23.7

80.7

72.0

78.9

75.1

73.7

63.0

56.1

38.4

195

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Bartow County - 008

1990
55911 13384
1212
20.7 19.6 21.0
140 32 1041 111 234 45
7 253 29
14 10
4 16
3 5
62 13
0 86
7 17
274 101 361 54 264 24 47
. . .
654 148 21 397 319 236
. 0

1991
57446 13592
1224
20.5 19.4 21.0
142 28
1019 115 255
64 10 207 25
2 2 0 12 3 5
70 8 0
88 9
20
283 115 375
39 224
10 37
12 17 40
678 131
17 507 407 351
29 0

Total
1992 1993

58970 13800
1237

60509 14008
1249

21.0 20.2 21.0

21.2 19.6 21.0

123

131

32

34

968

979

104

106

258

257

64

53

11

12

194

186

16

15

7

7

6

5

1

2

17

17

1

2

1

5

63

81

9

14

2

0

82

85

13

9

22

44

288

364

113

119

354

334

27

7

177

225

5

8

38

28

13

27

36

47

75

124

638

729

156

116

25

19

430

521

440

480

337

390

70

29

0

4

1994 5-year

62033 14216
1262

294869 69000
6184

21.3 18.7 21.0

21.0 19.5 21.0

137 30
1063 97
282 59 9
194 31

673 156 5070 533 1286 285
49 1034
116

7

37

5

28

2

9

14

76

0

9

3

19

71

347

12

56

2

4

89

430

12

50

13

116

396

1605

96

544

305

1729

5

132

212

1102

8

55

29

179

32

84

54

154

129

368

852

3551

147

698

24

106

510

2365

492

2138

402

1716

105

233

2

6

1990
50413 12025
1078

1991
51925 12245
1092

White
1992 1993

53430 12464
1107

54944 12684
1120

1994 5-year

56448 12903
1135

267160 62321
5532

20.7 19.7 20.0

20.8 19.0 20.0

21.4 20.4 21.0

21.4 19.1 21.0

21.4 17.9 21.0

21.2 19.5 21.0

125

121

104

107

120

577

27

23

26

26

23

125

917

905

857

882

934

4495

104

96

92

87

84

463

160

187

189

200

193

929

35

57

56

43

47

238

6

9

7

5

7

34

216

177

161

152

160

866

21

22

10

13

27

93

11

2

5

6

4

28

7

2

5

4

2

20

4

0

0

2

2

8

11

11

12

9

9

52

3

2

1

2

0

8

4

4

1

4

1

14

52

55

45

66

55

273

7

8

6

10

8

39

0

0

1

0

0

1

72

77

69

68

77

363

7

8

12

9

9

45

13

20

22

39

11

105

234

245

247

327

331

1384

78

87

75

92

70

402

325

331

326

308

266

1556

42

30

23

4

3

102

251

213

175

220

200

1059

20

10

4

8

8

50

40

31

31

23

24

149

.

3

10

21

29

63

.

8

34

46

50

138

.

23

56

96

113

288

595

622

584

668

765

3234

126

115

137

105

129

612

19

17

20

16

20

92

337

424

365

455

423

2004

272

344

373

418

408

1815

200

298

285

337

333

1453

.

25

61

27

95

208

0

0

0

4

2

6

1990
5026 1241
128

1991
5164 1259
129

Black
1992 1993

5301 1277
131

5439 1294
132

1994 5-year

5576 1312
133

26507 6382 653

20.2 16.7 22.0

19.7 19.7 25.0

19.6 18.8 25.5

19.5 22.5 23.0

20.2 19.1 23.0

19.9 19.1 23.0

15

21

18

5

5

6

116

111

104

7

19

12

72

68

69

5

3

7

1

1

4

30

28

29

8

3

5

23

16

93

7

6

29

91

125

547

19

12

69

57

88

354

6

8

29

5

2

13

27

32

146

2

4

22

3

0

2

1

3

9

3

0

1

1

3

8

0

0

1

0

0

1

4

1

5

6

5

21

0

1

0

0

0

1

1

1

0

1

2

5

9

14

17

14

16

70

6

0

2

4

4

16

0

0

1

0

2

3

13

11

12

16

11

63

0

1

1

0

3

5

3

0

0

4

2

9

38

38

40

32

61

209

23

28

38

27

26

142

34

42

26

25

38

165

10

8

4

3

2

27

12

11

2

3

12

40

4

0

1

0

0

5

7

6

7

5

5

30

.

0

3

6

3

12

.

1

1

1

3

6

.

4

16

23

13

56

54

55

49

56

85

299

20

16

18

10

18

82

2

0

5

3

4

14

58

81

62

61

84

346

45

61

64

59

81

310

34

51

49

50

66

250

.

4

9

2

9

24

0

0

0

0

0

0

196

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Bartow County - 008

18.6 77.8
2.3 22.6
4.5 18.9
0.5 187.4
4.2
115.5 22.9 91.6 46.4 23.9 93.1
*
13.4 9.6 *
15.3 *
0.5
6.0 1.2
* 8.3 0.7 1.6
31.1 9.8
35.4 5.3
25.6 2.3 8.0
. . .
64.1 16.2 17.6 38.4 30.9 22.8
.

17.7 75.0
2.3 25.3
3.6 15.2
0.4 159.1
5.5
116.0 19.7 93.9 53.5 20.4 92.0 *
* * * 11.7 * 0.4
6.9 0.8
* 8.7 0.9 2.0
31.9 11.4 37.3
3.9 22.3
1.0 6.6
0.8 1.1 2.5
69.5 14.6 14.9 50.2 40.3 34.8
2.9

16.4 70.1 2.1 27.0 3.3 14.1 0.4 156.6 5.6
99.5 26.0 84.1 59.6 12.9 100.0
*
7.2 6.2
* 17.4
* *
6.5 0.9
* 8.6 1.4 2.3
33.0 11.8 37.5 2.9 18.7 0.5
6.9
0.8 2.2 4.6
68.0 18.4 23.6 45.1 46.1 35.3
7.3

16.2 69.9
2.1 26.5
3.1 13.3
0.4 151.1
4.7
104.9 26.0 84.9 63.2 12.0
100.0 8.0
7.2 5.1
* 17.2
* 0.4
8.3 1.4
* 8.8 0.9 4.5
40.0 12.3 34.6
0.7 23.2
0.8 5.0
1.6 2.8 7.4
77.6 13.5 17.1 53.7 49.4 40.2
3.0

17.1 74.8 2.3 26.9 3.1 13.6 0.4 146.2 4.9
108.6 21.9 76.9 60.4 24.6
100.0 7.9
6.6 4.7
* 13.1
* *
6.7 1.1
* 8.5 1.1 1.2
39.8 9.2 29.3 0.5 20.3 0.8 4.9
1.9 3.2 7.5
83.0 15.5 24.0 48.6 46.9 38.3 10.0

17.2 73.5
2.2 25.6
3.5 15.0
0.4 160.4
5.0
108.8 23.2 86.2 56.4 18.8 96.6
4.7
7.3 5.5 1.8 14.8 0.5 0.3
6.8 1.1
* 8.6 1.0 2.3
35.3 10.8 34.7
2.7 22.1
1.1 6.3
1.3 2.3 5.6
72.5 15.6 19.3 47.1 42.6 34.2
5.8

18.2 76.3
2.3 17.6
4.3 18.0
0.5 183.5
3.7

17.4 73.9
2.2 20.9
3.4 14.5
0.4 154.0
5.5

16.0 68.8 2.1 22.4 3.0 12.9 0.4 148.8 5.1

16.1 69.5
2.1 22.9
2.8 12.0
0.4 140.5
3.8

16.5 72.4 2.2 20.9 2.8 12.4 0.4 139.1 4.3

16.8 72.1
2.2 20.9
3.2 13.9
0.4 153.5
4.5

116.0 21.6 96.5 42.7 19.5 90.5
*

110.8 19.0 87.9 45.8 20.1 90.9 *

94.0 25.0 83.1 54.3
9.0 100.0
*

95.5 24.3 77.7 56.3 11.6 100.0
6.2

105.8 19.2 74.0 55.4 23.8
100.0 8.8

104.3 21.7 83.7 50.5 16.8 95.7
4.5

12.0 7.6 *
11.9 * *

* * * 12.0 * *

5.8 5.8
* 13.9
* *

6.8 * *
10.1 * *

*

6.2

*

4.4

*

1.8

9.6

11.5

*

0.4

*

0.3

5.7

6.1

5.3

7.5

5.9

6.1

0.8

0.9

0.7

1.1

0.9

0.9

*

*

*

*

*

*

7.9

8.6

8.2

7.8

8.3

8.2

0.8

0.9

1.4

1.0

1.0

1.0

1.4

2.2

2.6

4.4

1.2

2.3

30.1 8.6
36.2 4.7
27.6 2.2 7.7

31.0 9.7
37.1 3.4
23.9 1.1 6.3

32.0 8.9 39.0 2.8 20.9
* 6.3

39.8 10.5 35.4
* 25.2
0.9 4.6

37.6 7.6 29.1
* 21.8 0.9
4.6

34.2 9.0
35.3 2.3
23.9 1.1 5.9

.

*

0.7

1.4

1.9

1.1

.

0.6

2.3

3.1

3.2

2.3

.

1.6

3.8

6.4

7.3

4.9

66.1 15.6 19.0 37.0 29.9 22.0
.

71.6 14.4 17.3 47.3 38.4 33.2
2.8

70.1 18.1 22.5 43.2 44.1 33.7 7.2

79.0 13.5 16.3 52.1 47.8 38.6
3.1

84.8 15.4 23.3 45.8 44.2 36.1 10.3

74.3 15.4 19.5 45.0 40.8 32.7
5.9

23.1 93.5
2.5 62.1
6.0 24.2
0.7 197.4
4.8

21.5 88.2
2.4 61.8
5.4 22.2
0.6 195.8
*

19.6 81.5 2.2 67.6 5.5 22.7 0.6 200.0 9.4

16.7 70.3
2.0 62.6
5.0 20.9
0.6 209.3
8.5

22.4 95.3 2.7 72.1 5.7 24.4 0.7 191.6 7.6

20.6 85.7
2.4 65.4
5.5 22.9
0.6 198.4
6.7

117.2 33.3 54.7 100.0 62.5 100.0
*

162.4 23.8
146.9 94.4 * * *

137.8 33.3 91.9
100.0 38.3
100.0 *

174.4 30.4
144.0 94.7 * * *

120.1 37.5 90.1 91.7 * * *

142.4 31.2 105.7 95.6 33.7 100.0
*

*

*

*

*

*

16.5

*

*

*

*

*

14.6

*

*

*

*

*

*

*

*

46.3

62.5

39.4

37.5

*

*

*

*

*

*

*

*

*

*

*

0.9

7.8 5.2
* 11.2
* *

12.6 * *
10.0 * *

16.3 * *
11.8 * *

15.6 * *
17.6 * *

12.8 * *
9.0 * *

12.8 2.9 *
11.6 0.9 1.6

40.0 19.8 29.6
8.8 10.3
* 10.6

39.6 25.5 38.2
7.5 10.0
* 9.7

42.1 37.3 25.5
* * * 13.0

38.6 29.7 27.8
* * * 9.8

55.0 21.3 31.4
* 9.8
* 7.5

43.5 26.2 30.7
5.1 7.4 0.9 10.0

.

*

*

3.6

*

1.8

.

*

*

*

*

0.9

.

*

9.9

13.9

7.7

8.6

48.2 20.6
* 50.0 38.8 29.3
.

53.4 17.0
* 73.6 55.5 46.4
*

50.0 21.2 29.4 60.8 62.7 48.0 8.8

63.6 12.7
* 67.0 64.8 54.9
*

70.2

57.3

16.7

17.7

*

17.9

68.9

64.0

66.4

57.3

54.1

46.2

7.4

5.6

197

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Ben Hill County - 009

1990
16245 3690 440
19.4 18.6 21.0
51 16 292 46 132 19
3 20
4
8 5 3 8 1 3
19 5 1
31 1
17
99 66 119
1 68
8 23
. . .
219 37
3 186 146 126
. 1

1991
16401 3711 443
19.0 19.7 21.0
62 21 267 58 122 19
1 27
1
3 0 3 1 1 2
34 4 0
31 4
15
80 73 133
3 48
1 20
6 7 20
206 36 5
169 161 135
54 0

Total
1992 1993

16559 3734 445

16710 3755 448

18.9 19.8 21.5

19.2 18.5 21.0

50

52

16

15

268

252

49

44

116

114

15

15

3

1

18

27

0

6

2

9

2

5

0

4

6

6

0

2

2

2

32

25

8

7

0

0

32

28

8

3

11

16

76

91

63

64

110

107

1

2

53

54

4

2

18

12

31

6

23

15

76

24

214

200

41

33

3

2

180

166

177

184

146

146

90

80

0

6

1994 5-year

16862 3776 450

82777 18666
2225

18.2 17.5 21.0

18.8 19.3 21.0

69

284

19

87

270

1349

63

260

121

605

20

88

1

9

28

120

3

14

5

27

3

15

2

12

4

25

0

4

0

9

26

136

7

31

1

2

26

148

0

16

15

74

100

446

63

329

115

584

0

7

55

278

7

22

14

87

12

55

13

58

128

248

213

1052

38

185

5

18

185

886

194

862

161

714

123

347

0

7

1990
11098 2430 257

1991
11168 2429 256

White
1992 1993

11237 2430 254

11304 2428 253

1994 5-year

11371 2428 251

56178 12145
1270

20.0 18.6 20.0

20.9 21.0 19.0

19.3 19.8 20.0

19.4 18.9 19.0

18.3 21.1 20.0

19.4 19.9 20.0

24

21

24

24

32

125

10

4

8

5

9

36

161

135

157

138

153

744

21

20

23

19

30

113

37

28

31

27

28

151

11

9

5

8

12

45

1

1

1

0

0

3

17

17

13

13

11

71

3

0

0

3

0

6

3

2

0

4

3

12

2

0

0

3

2

7

1

2

0

1

1

5

2

1

2

3

2

10

1

0

0

1

0

2

2

1

0

2

0

5

7

15

12

12

12

58

0

1

3

5

3

12

0

0

0

0

1

1

17

15

20

13

13

78

0

4

5

2

0

11

12

6

6

5

8

37

50

38

32

43

39

202

13

15

16

13

15

72

71

65

65

62

63

326

1

0

1

1

0

3

54

39

45

46

40

224

3

0

2

0

4

9

12

3

12

4

5

36

.

5

15

5

6

31

.

5

12

11

5

33

.

10

33

18

68

129

135

111

129

117

132

624

18

18

24

22

23

105

0

3

2

2

4

11

90

67

90

75

96

418

64

67

90

86

99

406

55

55

70

62

81

323

.

26

50

37

63

176

0

0

0

3

0

3

1990
5088 1242
183

1991
5137 1248 184

Black
1992 1993

5186 1254
185

5234 1259 186

1994 5-year

5281 1265
187

25926 6268 925

18.6 17.8 24.0

17.5 19.0 24.0

17.6 19.1 25.5

18.7 19.3 26.0

17.1 15.5 26.5

18.0 17.7 25.0

27

41

26

27

37

158

6

17

8

10

10

51

130

131

110

114

116

601

25

38

26

25

33

147

95

94

85

87

93

454

8

10

10

7

8

43

2

0

2

1

1

6

3

9

5

13

17

47

1

1

0

2

3

7

5

1

2

5

2

15

3

0

2

2

1

8

2

1

0

3

1

7

6

0

4

3

2

15

0

1

0

1

0

2

1

1

2

0

0

4

12

19

20

13

14

78

5

3

5

2

4

19

1

0

0

0

0

1

14

16

12

15

13

70

1

0

3

1

0

5

5

9

5

11

7

37

49

42

44

48

61

244

53

58

47

51

48

257

48

68

45

45

52

258

0

3

0

1

0

4

14

9

8

8

14

53

5

1

2

2

3

13

11

17

6

8

9

51

.

0

13

.

1

9

.

10

32

1

4

18

4

8

22

6

57

105

83

94

84

83

80

424

19

18

17

11

14

79

3

2

1

0

1

7

96

102

89

91

89

467

82

94

86

98

95

455

71

80

75

84

80

390

.

28

40

43

60

171

1

0

0

3

0

4

198

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Ben Hill County - 009

18.0 79.1
2.4 45.4
1.2 5.4 0.2 59.2 7.0
115.9 31.4 104.5 69.6
* * *
27.4 17.1
* 27.1
* *
6.5 1.7
* 10.7
* 5.8
36.7 22.7 41.5
* 23.4
2.7 12.9
. . .
76.3 14.8
* 63.9 50.2 43.3
.

16.3 71.9
2.2 46.4
1.6 7.3 0.2 85.7 5.7
140.1 33.9
131.0 81.0 * * *
* * * * * *
12.7 * *
11.8 *
5.6
32.4 27.8 50.8
* 18.3
* 13.2
1.2 1.4 4.0
78.0 15.5 16.7 64.3 61.2 51.3 20.5

16.2 71.8 2.2 44.6 1.1
4.8 0.1 58.6 5.6
112.5 32.0
110.2 67.3 * * *
* * * 22.1 * *
11.9 3.0 *
12.3 3.1 4.1
31.3 24.2 42.8
* 20.4
* 11.8
6.1 4.5 15.0
79.9 17.9
* 69.2 68.1 56.2 34.6

15.1 67.1
2.0 45.8
1.6 7.2 0.2 91.2 4.5
116.1 28.8 98.3 77.3 13.4
100.0 *
35.7 19.8
* 23.7
* *
9.9 2.8
* 11.2
* 6.3
38.9 25.7 43.5
* 21.7
* 8.1
1.2 2.9 4.7
79.4 15.0
* 66.7 73.9 58.6 32.1

16.0 71.5 2.1 44.8 1.7
7.4 0.2 87.2 6.1
153.4 27.5
140.1 66.7 * * *
18.5 * * * * *
9.6 2.6
* 9.6
* 5.6
38.9 23.3 42.8
* 20.4
2.6 9.5
2.3 2.5 24.9
79.8 16.4 13.2 68.5 71.9 59.6 45.6

16.3 72.3
2.2 45.4
1.4 6.4 0.2 76.1 5.8
127.7 30.6 116.9 72.3
6.3 100.0
5.8
20.0 11.1
9.0 18.4
* 0.5
10.1 2.3 *
11.1 1.2 5.5
35.7 24.7 44.2
0.5 20.9
1.7 11.2
2.7 2.9 12.2
78.6 15.9 10.7 66.5 64.7 53.6 33.3

14.5 66.3
2.1 23.0
1.5 7.0 0.2 88.5 5.8

12.1 55.6
1.8 21.4
1.5 7.0 0.2 104.3 4.5

93.4 41.7 81.7 33.3
* * *

82.1 *
78.2 55.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

4.3 * *
10.6 *
7.5

11.1 * *
11.5 *
4.4

32.3 8.1
44.7 *
33.5 *
12.1

30.4 11.5 49.6
* 29.8
* *

.

1.7

.

1.7

.

3.4

84.9 12.6
* 55.9 39.8 34.2
.

82.2 15.8
* 51.1 51.1 42.0 19.8

14.0 64.6 2.0 20.4 1.2
5.3 0.2 73.9 2.5
94.5 33.3 90.6 30.4
* * *
* * * * * *
7.6 * *
13.2 3.3 3.8
21.8 10.5 43.3
* 29.6
* 14.5
5.1 4.1 11.2
82.2 17.9
* 59.2 59.2 46.1 32.9

12.2 56.8
1.8 20.0
1.2 5.4 0.2 81.8 3.3

13.5 63.0 1.9 18.3 1.0
4.5 0.1 62.1 5.4

13.2 61.3
1.9 20.6
1.3 5.8 0.2 81.9 4.3

95.0 20.8 75.2 47.4
* * *

127.6 28.1
119.6 33.3 * * *

98.4 28.8 89.0 38.9
4.7 100.0
6.3

*

*

16.1

*

*

9.4

*

*

6.8

*

*

13.4

*

*

*

*

*

0.5

8.7

7.8

7.8

3.6

*

1.6

*

*

*

9.6

8.5

10.7

*

*

1.5

3.6

5.2

5.0

32.8 9.6
46.3 *
34.1 * *

26.5 9.8 41.4
* 26.1
* 6.0

28.7 9.8
44.9 *
30.6 1.2 8.7

1.7

2.0

2.6

3.7

1.7

2.8

6.1

23.0

10.9

84.8 18.3
* 55.6 63.7 45.9 27.4

86.8 18.0
* 62.7 64.7 52.9 41.2

84.2 16.4 11.8 57.1 55.5 44.1 30.8

25.6 104.7
3.0 73.6
* * * * 9.7

25.5 105.0
2.9 71.8
1.8 7.2 0.2 60.0 8.0

21.2 87.7 2.5 79.4 1.0
4.0 0.1 38.5 12.0

21.8 90.5
2.5 76.3
2.5 10.3
0.3 95.6
7.1

22.0 91.7 2.5 80.2 3.2 13.4 0.4 118.9 7.9

23.2 95.9
2.7 76.0
1.8 7.5 0.2 66.8 8.9

147.5 22.2 136.6 100.0
* * *

222.7 41.5
206.4 94.7 * * *

140.6 30.8
140.6 100.0
* * *

144.9 37.0
134.2 100.0
* * *

197.8 27.0
176.4 97.0 * * *

170.7 32.3
158.9 98.0 7.6 100.0 5.4

38.5

*

*

43.9

*

25.0

*

*

*

*

*

13.3

*

*

*

*

*

11.8

45.5

*

*

*

*

24.7

*

*

*

*

*

*

*

*

*

*

*

*

9.2 3.8
* 10.9
* 3.8

14.5 * *
12.2 *
6.9

18.2 4.5
* 11.2
* 4.5

11.4 * *
13.2 *
9.6

12.1 * *
11.2 *
6.0

13.0 3.2 *
11.7 0.8 6.2

43.0 41.1 37.8
* 10.9
3.9 14.1

34.7 44.3 52.3
* 6.9
* 21.0

46.3 43.9 42.5
* 7.5
* 8.7

46.6 44.7 40.2
* 7.0
* 11.4

56.0 41.4 44.8
* 12.1
* 13.8

45.0 43.0 43.7
* 8.9 2.2 14.0

.

*

6.4

*

*

2.2

.

*

4.4

*

3.9

2.7

.

4.9

15.7

2.9

27.5

12.8

65.4 17.8
* 74.4 63.6 55.0
.

73.4 15.3
* 77.9 71.8 61.1 21.4

76.4 18.1
* 83.2 80.4 70.1 37.4

72.8 11.0
* 79.8 86.0 73.7 37.7

70.2

71.5

13.6

15.1

*

9.3

76.7

78.2

81.9

76.2

69.0

65.3

51.7

36.5

199

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Berrien County - 010

1990
14153 3139 305
19.6 19.1 19.0
29 5
227 28 47 15
4 7 0
5 5 0 9 1 2
27 8 0
29 2 2
85 37 89
5 54
4 14
. . .
156 32
1 93 78 60
. 0

1991
14218 3125 302
19.7 22.0 21.0
33 6
209 31 64 13 4 8 1
1 1 0 5 0 0
21 2 0
29 2 0
76 33 88
1 45
2 10
3 3 13
146 28 1
118 99 81 5 0

Total
1992 1993

14275 3111 301

14340 3098 298

20.4 .
20.0

20.4 .
21.0

35

27

6

5

228

216

32

25

62

60

17

10

1

0

2

3

0

0

1

2

0

1

1

1

1

1

0

0

0

2

19

11

5

1

0

0

22

19

1

1

1

3

73

76

30

37

85

82

0

1

56

54

5

0

13

12

6

18

16

22

18

104

178

155

24

23

8

5

133

132

122

141

100

113

52

80

0

0

1994 5-year

14397 3085 296

71383 15558
1502

19.5 19.8 20.0

19.8 19.6 20.0

37

161

11

33

225

1105

34

150

60

293

13

68

3

12

9

29

1

2

1

10

0

7

1

3

4

20

0

1

1

5

17

95

4

20

0

0

14

113

1

7

5

11

84

394

23

160

81

425

1

8

44

253

1

12

13

62

10

37

15

56

85

220

176

811

25

132

4

19

144

620

134

574

108

462

87

224

0

0

1990
12407 2725 254

1991
12464 2714 251

White
1992 1993

12516 2702 249

12573 2691 246

1994 5-year

12627 2680 244

62587 13512
1245

19.7 19.9 19.0

20.1 22.0 20.0

20.4 .
20.0

21.0 .
21.0

19.7 19.8 20.0

20.0 20.2 20.0

21

22

28

23

29

123

2

5

5

5

9

26

185

167

185

180

185

902

20

20

27

21

26

114

20

37

31

37

37

162

14

11

16

9

13

63

2

4

0

0

2

8

4

7

2

3

6

22

0

1

0

0

0

1

3

0

1

2

1

7

3

0

0

1

0

4

0

0

1

1

1

3

5

4

0

1

3

13

1

0

0

0

0

1

2

0

0

2

0

4

16

13

14

9

5

0

4

1

0

0

0

0

21

23

19

14

2

0

0

1

1

0

1

2

9

61

3

13

0

0

9

86

0

3

4

8

67

55

61

60

66

309

13

17

14

20

12

76

67

66

62

68

64

327

2

0

0

0

1

3

48

42

50

50

39

229

2

2

3

0

0

7

9

6

8

10

11

44

.

3

5

13

7

28

.

3

14

21

13

51

.

8

9

72

52

141

132

120

149

135

150

686

29

22

19

21

20

111

0

1

7

5

3

16

66

88

98

104

114

470

51

70

87

108

107

423

40

57

70

87

87

341

.

4

40

59

72

175

0

0

0

0

0

0

1990
1648 394 48

1991
1656 392 48

Black
1992 1993

1662 390 47

1670 388 47

1994 5-year

1676 386 47

8312 1950
236

19.4 18.7 24.0

16.7 .
23.0

19.8 .
28.0

18.5 .
30.5

18.6 .
25.0

18.5 18.7 25.0

8

11

7

4

8

38

3

1

1

0

2

7

42

42

43

35

38

200

8

11

5

4

8

36

27

27

31

23

23

131

0

2

1

1

0

4

2

0

1

0

1

4

2

1

0

0

3

6

0

0

0

0

1

1

2

1

0

0

0

3

2

1

0

0

0

3

0

0

0

0

0

0

4

1

1

0

1

7

0

0

0

0

0

0

0

0

0

0

1

1

11

8

5

2

8

34

3

2

1

0

1

7

0

0

0

0

0

0

8

6

3

5

5

27

0

2

1

0

1

4

1

0

0

1

1

3

18

21

12

16

18

85

24

16

16

17

11

84

22

22

23

14

16

97

3

1

0

1

0

5

6

3

6

4

5

24

2

0

2

0

1

5

5

4

5

2

2

18

.

0

0

3

2

5

.

0

0

1

1

2

.

5

8

26

20

59

24

26

29

20

24

123

3

6

5

2

5

21

1

0

1

0

1

3

27

30

35

28

29

149

27

29

35

33

26

150

20

24

30

26

21

121

.

1

12

21

14

48

0

0

0

0

0

0

200

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Berrien County - 010

16.0 72.3
2.1 20.8
0.5 2.2 0.1 27.7 6.1

14.7 66.9
2.0 30.9
0.6 2.6 0.1 34.0 5.8

16.0 73.3 2.2 27.3
* * * * 6.1

95.1 17.2 91.8 35.7
* * *

109.2 18.2
102.6 58.1 * * *

116.4 17.1
106.5 53.1 * * *

22.0

*

*

22.0

*

*

*

*

*

39.0

23.5

*

*

*

*

*

*

*

11.9

10.0

8.3

3.5

*

2.2

*

*

*

12.9

14.0

9.7

*

*

*

*

*

*

40.9 16.4 39.7
2.3 24.2
* 10.6

41.3 15.9 42.7
* 22.2
* 8.7

33.8 13.2 37.4
* 24.7 2.2 10.7

.

*

1.5

.

*

4.1

.

3.3

4.6

70.6 15.8
* 41.2 34.5 26.5
.

72.3 14.6
* 57.0 47.8 39.1
2.4

79.1 11.8 34.8 58.6 53.7 44.1 22.9

15.1 69.7
2.1 27.9
* * * * 3.2

15.6 72.9 2.2 26.8 0.6 2.9 0.1 35.9 5.5

15.5 71.0
2.1 26.7
0.4 1.9 0.1 23.8 5.3

90.7 18.5 83.9 60.0
* * *

124.9 29.7
114.8 51.5 * * *

107.2 20.5 99.9 51.7
* * 6.7

*

*

9.0

*

*

6.3

*

*

*

*

*

17.9

*

*

*

*

*

0.4

5.1

7.6

8.6

*

*

1.8

*

*

*

8.8

6.3

10.3

*

*

0.6

*

2.3

1.0

36.4 17.2 38.3
* 25.5
* 9.6

38.0 10.3 36.2
* 19.9
* 9.9

38.0 14.6 38.8
0.7 23.3
1.1 9.9

4.6 5.6 26.4

2.5 3.8 21.5

2.4 3.6 14.0

72.8 11.9 22.7 61.4 65.6 52.6 37.2

78.6 12.0
* 64.3 59.8 48.2 38.8

74.7 13.2 19.4 56.4 52.2 42.0 25.7

14.9 67.9
2.0 10.9
* * * * 5.9
82.7 *
78.7 * * * *
* * * 26.7 * *
8.6 2.7
* 11.5
* *
39.9 7.1
36.8 *
26.5 *
8.7
. . .
73.7 17.3
* 35.9 27.7 21.7
.

13.4 61.5
1.9 22.2
0.6 2.6 0.1 36.8 5.9

14.8 68.5 2.1 16.8
* * * * 6.3

87.5 22.7 79.6 35.0
* * *

112.4 17.9
108.4 44.4 * * *

*

*

*

*

*

*

*

*

*

*

*

*

7.8 * *
13.8 * *

7.6 * *
10.3 * *

37.2 10.2 39.8
* 25.6
* 6.7

34.5 7.6 33.5
* 27.0
* 8.4

*

1.5

*

4.3

2.5

2.8

74.5 14.4
* 52.7 41.9 34.1
*

81.9 11.5 35.0 53.0 47.0 37.8 21.6

14.3 66.9
2.1 20.7
* * * * 3.3

14.7 69.0 2.1 20.0 0.5 2.2 0.1 29.0 6.0

93.3 21.7 85.2 52.4
* * *

118.8 31.0
106.5 38.5 * * *

*

*

*

*

*

*

*

*

*

*

*

*

5.0

4.9

*

*

*

*

7.8

4.9

*

*

*

*

34.3 11.2 38.2
* 28.4
* 9.5

36.3 6.5 34.6
* 21.4
* 10.3

4.0 6.4 22.0

2.1 4.0 15.8

75.4 13.2 25.0 58.1 60.3 48.6 33.0

81.5 11.6
* 61.6 57.8 47.0 38.9

14.4 66.8
2.0 18.0
0.4 1.6 0.1 22.0 5.5
98.8 21.1 91.6 38.6
* * 6.4
7.8 * *
14.3 * *
6.8 1.4
* 9.6
* 0.9
36.4 8.4
36.5 *
25.8 0.8 8.8
2.1 3.9 10.8
77.5 13.6 19.5 52.2 47.0 37.9 24.4

25.5 106.6
3.0 64.3
* * * * *

25.4 107.1
3.0 67.5
* * * * *

25.9 110.3
3.3 73.8
* * * * *

166.7 *
166.7 75.0
* * *

231.1 *
231.1 100.0
* * *

148.0 *
105.7 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

26.2 * *
19.0 * *

19.0 * *
15.0 * *

11.6 * * * * *

45.0 57.1 52.4
* 14.3
* 17.2

58.3 40.0 55.0
* * * *

30.8 38.1 54.8
* 14.3
* 18.5

.

*

*

.

*

*

.

7.8

12.5

57.1 * *
64.3 64.3 47.6
.

63.4 15.4
* 75.0 72.5 60.0
*

67.4 12.8
* 83.3 83.3 71.4 28.6

21.0 90.2
2.6 65.7
* * * * *

22.7 98.4 2.9 62.2
* * * * *

24.1 102.6
3.0 66.8
0.7 3.1 0.1 28.0 4.1

* 171.7 160.7

*

*

18.4

* 171.7 152.3

* 100.0

94.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

34.3

*

*

*

*

*

*

*

21.1

17.0

*

*

3.5

*

*

*

14.3

13.5

13.8

*

*

*

*

*

*

48.5 48.6 40.0
* * * *

48.6 29.7 43.2
* 13.5
* *

45.9 42.9 49.5
2.6 12.3
2.6 14.4

* * 40.4

* * 31.0

1.9 *
22.9

60.6

63.2

62.4

*

14.7

11.7

*

*

*

80.0

78.4

76.0

94.3

70.3

76.5

74.3

56.8

61.7

60.0

37.8

31.2

201

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Bibb County - 011

1990
149967 36359
3314
20.6 20.0 23.0
407 102 2672 314 1212 105 29 746 88
44 29 15 59
4 9
317 73 15 389 29 12
814 626 731 60 328 34 155
. . .
2033 345 55
1210 1214
869 . 0

1991
149676 35993 3288
21.4 20.3 23.0
391 123 2539 311 1188
91 32 779 74
50 39 11 69
3 22
297 66 15
351 26 16
769 638 734
55 186
29 161
48 48 262
1898 282
64 1211 1269 929
3 11

Total
1992 1993

149383 35626 3260

149088 35259 3234

20.4 19.8 23.0

20.8 20.0 23.0

420 124 2546 317 1309
83 32 789 98

387 107 2542 306 1304
56 36 819 75

49

51

32

35

17

16

63

71

10

6

18

13

279

267

50

56

8

14

302

295

35

33

25

60

749

788

624

680

744

722

75

71

299

181

41

24

175

147

104

80

78

56

494

448

1953 297 82
1252 1359
998 32 7

1944 302
67 1263 1548 1075 575
51

1994 5-year

148790 34892 3207

746904 178129
16303

20.8 19.7 24.0

20.8 20.0 23.0

411 92
2547 320
1318 47 23
774 83

2016 548
12846 1568 6331 382 152 3907 418

43

237

32

167

11

70

52

314

5

28

17

79

268

1428

56

301

12

64

350

1687

23

146

22

135

769

3889

671

3239

670

3601

98

359

232

1226

29

157

140

778

73

305

49

231

516

1720

1948 323 60
1207 1459 1001
247 6

9776 1549
328 6143 6849 4872
857 75

1990
86252 19590
1549

1991
85469 19200
1526

White
1992 1993

84682 18808
1503

83895 18417
1480

1994 5-year

83108 18026 1458

423406 94041
7516

23.7 20.3 22.0

24.7 21.1 22.0

23.7 20.7 22.0

24.8 20.1 23.0

24.4 20.8 23.0

24.2 20.5 22.0

121 22 1183 78 183 62 10 390 42

111 28
1087 76
184 58 10
360 32

104 25
1055 74
219 46 4
343 32

91 23 1082 60 209 31 12 328 30

86 14 1055 61 221 29
8 281
21

513 112 5462 349 1016 226
44 1702
157

9

16

13

16

20

74

8

11

7

11

14

51

1

5

6

5

6

23

20

20

11

23

21

95

2

1

3

4

3

13

6

5

8

6

6

31

97

90

49

73

63

372

19

21

10

14

14

78

4

5

2

4

4

19

112

98

75

72

103

460

18

7

9

16

8

58

1

7

7

18

3

36

305

286

278

287

288

1444

91

88

93

101

99

472

234

226

209

211

186

1066

9

5

8

8

17

47

200

117

169

119

139

744

12

9

4

4

7

36

40

53

27

32

28

180

.

23

31

25

15

94

.

23

40

28

14

105

.

61

97

95

65

318

1023

956

948

947

932

4806

171

150

141

149

149

760

20

25

24

24

21

114

343

339

313

343

314

1652

287

289

297

389

330

1592

217

234

231

260

242

1184

.

1

8

154

74

237

0

0

1

18

2

21

1990
62526 16415
1743

1991
62405 16244
1729

Black
1992 1993

62283 16072
1715

62160 15901
1701

1994 5-year

62035 15729
1687

311408 80361
8575

19.0 19.4 24.5

19.2 19.2 25.0

18.6 18.6 26.0

19.1 19.8 25.0

18.8 18.9 26.0

19.0 19.0 25.0

285 80
1468 235
1026 43 17
342 46

280 95
1436 235 1003 33 22 402 42

313 97
1474 243
1090 36 28
421 63

294 84
1432 246 1093
22 24 471 43

323 78
1469 258
1096 17 15
477 61

1495 434
7279 1217 5308
151 106 2113 255

34

34

35

35

23

161

20

28

25

24

18

115

14

6

10

11

5

46

36

49

52

48

31

216

2

2

7

2

2

15

3

17

10

7

11

48

219

207

228

193

204

1051

53

45

40

42

42

222

11

10

6

10

8

45

273

253

227

220

246

1219

11

19

26

17

15

88

10

9

18

42

19

98

503

479

468

491

476

2417

534

550

531

579

571

2765

495

508

535

511

483

2532

50

50

66

63

81

310

128

69

130

62

92

481

22

20

37

20

22

121

114

107

147

115

111

594

.

24

67

49

52

192

.

25

33

26

33

117

.

200

358

335

430

1323

993

928

992

972

995

4880

172

132

153

148

170

775

35

37

56

43

39

210

864

871

936

915

885

4471

923

977

1056

1151

1122

5229

650

694

765

811

755

3675

.

2

24

420

171

617

0

0

6

33

3

42

202

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Bibb County - 011

17.8 73.5
2.2 45.8
5.0 20.5
0.6 209.8
3.8
122.8 25.1 94.7 86.3 26.6 97.6
1.8
16.5 10.9
5.7 21.8
* 0.3
11.9 2.7 0.6
14.7 1.1 0.4
34.9 23.7 27.7
2.3 12.4
1.3 10.0
. . .
76.9 14.5 20.9 45.8 45.9 32.9
.

17.0 70.5
2.1 47.3
5.2 21.6
0.6 226.0
3.6
118.9 31.5 94.6 85.7 22.5
100.0 3.3
19.7 15.4
4.4 26.8
* 0.8
11.7 2.6 0.6
14.0 1.0 0.6
34.9 25.4 29.3
2.2 7.4 1.2 10.5
1.2 1.2 6.6
76.5 12.5 25.7 48.2 50.5 37.0
*

17.0 71.5 2.1 52.2 5.3 22.1 0.7 228.5 3.3
128.8 29.5 97.2 92.1 30.1 99.0 2.5
19.2 12.6
6.8 24.4 1.1 0.6
11.0 2.0 0.3
12.0 1.4 1.0
34.0 24.9 29.7
3.0 11.9 1.6 11.6
2.6 2.0 12.4
77.7 13.3 29.6 49.9 54.1 39.7
1.3

17.1 72.1
2.2 52.1
5.5 23.2
0.7 237.0
2.7
119.7 27.6 94.6 90.2 23.2
100.0 2.2
20.1 13.8
6.4 27.5
0.6 0.5
10.5 2.2 0.6
11.8 1.3 2.4
34.8 27.2 28.9
2.9 7.3 1.0 9.7
2.0 1.4 11.2
77.3 13.3 27.9 50.4 61.8 42.9 23.0

17.1 73.0 2.2 52.2 5.2 22.2 0.7 228.0 2.1
128.1 22.4 99.8 94.7 25.9
100.0 3.4
16.9 12.6
4.4 20.2 0.5 0.6
10.5 2.2 0.5
13.9 0.9 0.9
33.0 26.6 26.7
3.9 9.2 1.2 9.4
1.8 1.2 12.9
77.0 14.2 24.2 47.8 57.8 39.7 9.8

17.2 72.1
2.1 49.9
5.2 21.9
0.7 225.8
3.1
123.7 27.2 96.2 89.8 25.6 99.3
2.6
18.4 13.0
5.5 24.2
0.6 0.6
11.1 2.3 0.5
13.3 1.2 1.1
34.3 25.5 28.4
2.9 9.7 1.2 10.3
1.9 1.4 10.8
77.1 13.6 25.7 48.4 54.0 38.4
8.5

13.7 60.4
1.8 15.7
4.5 19.9
0.6 237.1
3.7

12.7 56.6
1.7 17.0
4.2 18.7
0.6 237.5
3.6

12.5 56.1 1.7 20.9 4.1 18.2 0.6 236.9 2.7

12.9 58.8
1.8 19.6
3.9 17.8
0.5 225.7
2.3

12.7 58.5 1.8 21.1 3.4 15.6 0.5 204.5 2.1

12.9 58.1
1.7 18.8
4.0 18.1
0.5 228.9
2.9

78.1 18.2 50.4 56.4 27.1 100.0
*

72.7 25.2 49.8 53.3 21.0 100.0
*

69.2 24.0 49.2 69.4 21.3 96.9
*

61.5 25.3 40.5 56.7 20.3 100.0
*

59.0 16.3 41.8 75.4 14.4 100.0
*

68.3 21.8 46.4 61.8 20.9 99.4
1.3

7.6 6.8
* 16.8
* 0.4

14.7 10.1
4.6 18.2
* 0.4

12.3 6.6 5.7 10.4
* 0.6

14.8 10.2
4.7 21.0
* *

19.0 13.3
5.8 19.8
* 0.5

13.5 9.3 4.3
17.3 0.6 0.5

8.2

8.3

4.6

6.7

6.0

6.8

1.6

1.9

0.9

1.3

1.3

1.4

*

0.5

*

*

*

0.3

9.6

9.1

7.2

6.8

9.8

8.5

1.5

0.6

0.9

1.5

0.8

1.1

*

0.6

0.7

1.7

*

0.7

27.9 7.8
20.1 0.8
17.2 1.0 6.3

28.8 8.1
20.9 0.5
10.9 0.8 8.9

28.4 8.9 20.0 0.8 16.2
* 4.7

28.1 9.5
19.8 0.8
11.2 *
5.2

28.5 9.5
17.8 1.6 13.3 0.7 4.7

28.3 8.7
19.8 0.9
13.8 0.7 6.0

.

1.2

1.7

1.4

0.8

1.3

.

1.2

2.2

1.5

0.8

1.4

.

3.3

5.3

5.2

3.6

4.3

87.2 16.6 14.7 29.4 24.6 18.6
.

88.9 15.7 20.0 31.4 26.8 21.7
*

91.0 15.3 18.9 29.9 28.4 22.1
0.8

87.8 15.8 19.8 32.2 36.5 24.4 14.4

88.9 16.1 17.4 30.0 31.5 23.1 7.1

88.7 15.9 18.1 30.6 29.4 21.9
5.6

23.5 89.4
2.6 70.4
5.5 20.8
0.6 182.6
3.8

23.0 88.4
2.6 70.8
6.4 24.7
0.7 211.8
3.7

23.7 91.7 2.7 75.3 6.8 26.2 0.8 214.6 4.2

23.0 90.1
2.6 77.5
7.6 29.6
0.9 241.4
3.0

23.7 93.4 2.7 75.4 7.7 30.3 0.9 240.9 2.2

23.4 90.6
2.6 73.9
6.8 26.3
0.8 218.6
3.4

163.5 28.1 134.8 96.2 26.4 95.6
2.9

161.9 33.9
135.9 96.1 24.3
100.0 4.0

182.5 31.0
141.7 98.8 36.7
100.0 4.7

172.8 28.6
144.6 98.4 25.3
100.0 3.5

191.5 24.1
152.9 99.2 36.2
100.0 4.1

174.4 29.0
141.9 97.8 29.7 99.2 3.8

23.2 13.6
9.7 24.2
* *

23.7 19.5
4.3 33.6
* 1.1

23.7 17.0
6.9 34.6 1.5 0.7

24.4 16.8
7.8 33.0
* 0.5

15.7 12.3
3.4 20.9
* 0.7

22.1 15.8
6.4 29.2
0.6 0.6

14.9 3.6 0.7
18.7 0.8 0.7

14.4 3.1 0.7
17.9 1.3 0.6

15.5 2.7 0.4 15.7 1.8 1.2

13.5 2.9 0.7
15.6 1.2 2.9

13.9 2.9 0.5 17.0 1.0 1.3

14.4 3.1 0.6
17.0 1.2 1.3

41.0 36.7 34.0
3.5 8.8 1.5 12.7

40.1 38.8 35.9
3.6 4.9 1.4 11.5

38.6 36.7 37.1 4.6 9.0 2.6 15.9

40.3 41.1 36.2
4.5 4.4 1.4 13.1

36.7 39.3 33.4 5.6 6.3 1.5 12.5

39.3 38.5 35.3
4.4 6.7 1.7 13.2

.

1.2

3.2

2.4

2.5

2.3

.

1.2

1.6

1.2

1.6

1.4

.

9.6

17.2

16.1

20.6

15.9

68.5 12.9 28.2 59.3 63.3 44.6
.

66.7 10.2 30.8 61.5 68.9 49.0
*

68.1 11.8 37.8 64.7 73.0 52.9
1.7

68.9 11.5 36.1 64.9 81.6 57.5 29.8

68.2

68.1

12.8

11.8

31.2

33.0

60.9

62.2

77.2

72.8

52.0

51.2

11.8

10.8

203

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Bleckley County - 012

1990
10430 2370 242
21.1 19.9 21.0
16 0
163 12 55
5 0 21 3
1 1 0 1 1 2
18 5 0
17 2 1
44 36 41
4 25
1 9
. . .
108 37
2 78 54 43
. 0

1991
10535 2387 245
21.2 19.2 22.0
24 4
161 18 46 7 2 26 6
0 0 0 2 0 3
9 1 0 15 0 2
46 27 38
6 28
1 11
2 2 23
106 13 1 77 64 53 29 0

Total
1992 1993

10627 2400 248

10735 2419 251

20.7 20.0 22.0

20.6 20.7 21.0

21

23

6

9

158

172

17

20

62

70

10

5

2

1

23

30

4

2

0

1

0

1

0

0

2

2

0

2

2

0

10

19

1

4

0

0

11

19

0

3

1

2

50

56

34

34

45

40

3

2

24

15

1

1

11

9

6

4

4

8

30

38

91

116

20

25

0

3

87

97

86

99

68

77

54

70

1

3

1994 5-year

10828 2432 254

53155 12008
1240

20.2 18.5 21.0

20.7 19.9 21.0

27

111

2

21

166

820

20

87

74

307

6

33

0

5

25

125

7

22

2

4

1

3

1

1

1

8

0

3

2

9

18

74

0

11

0

0

26

88

2

7

1

7

48

244

45

176

42

206

3

18

17

109

4

8

7

47

6

18

7

21

28

119

113

534

26

121

3

9

97

436

94

397

80

321

69

222

1

5

1990
8000 1743
178

1991
8070 1750
179

White
1992 1993

8133 1755
180

8206 1762
181

1994 5-year

8268 1766
181

40677 8776 898

22.0 19.8 21.0

23.1 19.7 22.0

22.3 20.0 22.0

21.5 20.7 20.0

22.2 19.1 21.0

22.3 19.8 21.0

12

9

10

10

10

51

0

2

3

3

0

8

105

113

104

99

92

513

9

5

7

7

6

34

13

8

19

11

14

65

2

4

6

5

5

22

0

2

1

1

0

4

17

20

20

24

17

98

3

4

3

2

4

16

0

0

0

1

1

2

0

0

0

1

0

1

0

0

0

0

1

1

0

2

1

2

0

5

0

0

0

0

0

0

2

2

2

0

0

6

8

6

6

6

8

34

2

1

1

1

0

5

0

0

0

0

0

0

8

5

9

7

15

44

2

0

0

1

1

4

0

1

0

2

0

3

25

34

25

25

23

132

6

6

10

2

8

32

26

16

30

16

16

104

0

0

1

0

1

2

16

23

19

10

12

80

0

1

0

0

0

1

3

4

6

3

2

18

.

2

.

2

.

11

0

2

4

5

9

10

4

8

2

13

8

38

83

94

78

82

76

413

29

10

15

22

18

94

1

1

0

3

3

8

40

43

46

44

40

213

23

31

40

37

33

164

20

25

33

29

28

135

.

12

24

28

21

85

0

0

1

1

1

3

1990
2332 601 60

1991
2356 605 61

Black
1992 1993

2376 608 61

2400 612
62

1994 5-year

2421 615 63

11885 3041 307

20.0 26.0 27.5

18.0 14.0 24.0

19.3 20 .2 27.0

18.8 20.6 31.0

18.6 17.1 21.0

19.0 20.3 26.5

4

15

11

13

16

59

0

2

3

6

2

13

55

47

54

71

71

298

3

13

10

13

13

52

41

38

43

59

60

241

3

3

4

0

1

11

0

0

1

0

0

1

4

5

3

5

8

25

0

2

1

0

3

6

1

0

0

0

1

2

1

0

0

0

1

2

0

0

0

0

0

0

1

0

1

0

1

3

1

0

0

2

0

3

0

1

0

0

2

3

10

3

4

13

10

40

3

0

0

3

0

6

0

0

0

0

0

0

9

9

2

12

11

43

0

0

0

2

1

3

1

1

1

0

1

4

19

12

25

29

23

108

29

21

24

32

37

143

14

21

15

23

26

99

4

6

2

2

2

16

9

4

5

5

5

28

1

0

1

1

4

7

6

7

5

5

5

28

.

0

1

0

2

3

.

0

0

1

5

6

.

10

21

28

18

77

23

11

13

32

36

115

7

3

5

3

8

26

1

0

0

0

0

1

37

34

41

52

55

219

29

33

46

60

59

227

22

28

35

47

50

182

.

17

30

41

46

134

0

0

0

2

0

2

204

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Bleckley County - 012

15.6 68.8
2.0 34.4
2.0 8.9 0.3 111.1 2.1
66.1 *
49.6 54.5
* * *
* * * * * *
11.0 3.1 *
10.6 * *
33.3 22.4 25.8
* 15.6
* 9.6
. . .
70.1 25.7
* 48.4 33.5 26.7
.

15.3 67.4
2.0 28.6
2.5 10.9
0.3 132.7
3.8
97.9 *
73.4 77.8 24.5 100.0
*
* * * * * *
5.6 * *
9.3 * *
35.1 16.8 23.6
3.8 17.5
* 11.8
* * 8.2
67.5 9.5 *
47.8 39.8 32.9 18.0

14.9 65.8 1.9 39.2 2.2 9.6 0.3 119.2 5.0
84.8 28.6 68.7 82.4
* * *
* * * * * *
6.4 * *
7.0 * *
38.2 21.5 28.7
* 15.2
* 11.6
2.1 *
10.6
59.9 13.9
* 55.1 54.4 43.0 34.2

16.0 71.1
2.1 41.4
2.8 12.4
0.4 143.5
2.9
91.6 39.1 79.6 68.4
* * *
* * * * * *
11.1 * *
11.2 * *
37.8 20.1 23.7
* 8.9
* 8.7
* 2.8 13.1
69.0 16.8
* 57.4 58.6 45.6 41.4

15.3 68.3 2.0 45.1 2.3 10.3 0.3 126.9 2.5
106.4 *
78.8 75.0 27.6 100.0
*
* * * * * *
10.8 * *
15.9 * *
32.4 27.4 25.9
* 10.5
* 8.2
2.0 2.4 9.5
70.6 17.4
* 59.1 57.3 48.8 42.1

15.4 68.3
2.0 37.8
2.4 10.4
0.3 127.0
3.2
89.5 18.9 70.2 72.9 17.7 100.0
*
* * * 9.7 * 0.9
9.1 1.3
* 10.8
0.9 0.9
35.4 21.6 25.5
2.3 13.5
1.0 10.0
1.6 1.8 10.4
67.5 16.7 10.0 53.6 48.8 39.5 34.0

13.1 60.2
1.8 12.7
2.1 9.8 0.3 137.1
*

14.0 64.6
2.0 7.1 2.5 11.4 0.3 143.9 3.4

12.8 59.3 1.8 18.3 2.5 11.4 0.3 152.7 4.0

12.1 56.2
1.7 11.2
2.9 13.6
0.4 186.0
3.4

11.1 52.1 1.6 15.4 2.1 9.6 0.3 149.1 2.8

12.6 58.5
1.8 12.8
2.4 11.2
0.3 153.8
3.0

67.4 *
50.6 * * * *

50.3 *
27.9 * * * *

55.7 *
39.0 * * * *

55.4 *
38.8 * * * *

55.2 *
33.1 * * * *

56.8 15.7 37.8 31.3 17.8 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

9.7

*

*

*

*

*

*

*

*

*

*

*

*

7.6

5.3

5.8

6.1

8.7

6.7

*

*

*

*

*

1.0

*

*

*

*

*

*

7.8

4.4

8.7

7.1

16.5

8.6

*

*

*

*

*

*

*

*

*

*

*

*

27.2 5.8
25.2 *
15.7 * *

34.3 5.3
14.2 *
20.4 * *

28.4 9.6 29.1
* 18.3
* 9.8

28.7 *
16.3 *
10.2 * *

28.0 8.8
17.8 *
13.2 * *

29.5 6.3
20.5 *
15.7 *
6.4

.

*

*

*

*

1.0

.

*

*

2.5

*

1.7

.

5.8

4.6

5.0

4.0

4.8

82.2 31.9
* 38.8 22.3 19.4
.

83.2 10.9
* 38.1 27.4 22.1 10.6

76.5 16.3
* 44.2 38.5 31.7 23.1

83.7 25.6
* 44.9 37.8 29.6 28.6

83.5 22.2
* 44.0 36.3 30.8 23.1

81.8 21.3 11.9 41.8 32.2 26.5 20.9

23.6 91.5
2.5 74.5
* * * * *

20.0 77.7
2.0 80.9
2.1 8.3 0.2 90.9
*

22.7 88.8 2.4 79.6
* * * * 8.2

29.6 116.0
3.0 85.5
2.1 8.2 0.2 64.9
*

29.3 115.5
3.1 85.7 3.3 13.0 0.3 100.0
*

25.1 98.0
2.6 81.7
2.1 8.2 0.2 74.4 4.3

* 246.7 179.2 208.7 254.4 191.9

*

*

*

46.2

*

22.0

* 213.8 162.9 208.7 206.7 169.2

* 100.0 100.0 100.0 100.0 100.0

*

*

*

*

*

19.5

*

*

*

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

18.2 * *
16.4 * *

* * * 19.1 * *

*

18.3

14.1

13.5

*

*

*

2.0

*

*

*

*

*

17.4

15.7

14.6

*

*

*

*

*

*

*

*

47.5 52.7 25.9
* 16.4
* 14.6

38.7 44.7 44.7 14.0
* * 28.0

58.1 44.4 27.8
* 9.3
* 14.7

49.2 46.4 33.3
* 7.2
* 10.2

36.5 52.9 37.7
* 7.4
* 13.9

45.8 48.5 33.8
5.7 9.6 2.4 15.1

.

*

*

*

*

*

.

*

*

*

5.6

1.7

.

11.8

24.3

31.9

20.2

22.1

45.1 14.0
* 67.3 52.7 40.0
.

25.6 * *
72.3 70.2 59.6 36.2

26.0 9.6
* 75.9 85.2 64.8 55.6

47.1 * *
75.4 87.0 68.1 59.4

54.5

41.4

12.3

9.5

*

*

78.6

74.2

84.3

76.9

71.4

61.7

65.7

55.8

205

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Brantley County - 013

1990
11077 2619 277
19.8 19.3 19.5
16 2
151 15 37
4 2 2 0
0 0 0 2 0 1
11 2 0
12 0 0
51 22 51
4 45
5 3
. . .
98 18
0 94 76 65
. 0

1991
11459 2664 279
18.6 .
19.0
24 2
177 26 38 9 0 1 0
2 1 1 1 1 1
16 2 0
20 3 3
48 19 61
3 41
5 5
1 0 12
107 22 1
133 82 72 22 0

Total
1992 1993

11832 2709 281

12215 2754 282

20.8 .
20.0

19.9 .
20.0

14

22

5

5

177

181

14

22

34

38

8

4

0

1

0

0

0

0

0

2

0

2

0

0

0

3

2

0

0

2

17

21

1

2

0

0

22

21

3

4

0

0

50

57

17

20

61

68

0

2

47

46

1

2

10

7

4

3

6

12

20

30

124

132

34

32

2

1

124

123

99

120

87

103

55

68

0

2

1994 5-year

12591 2800 284

59174 13546
1402

21.1 .
20.0

19.9 19.3 20.0

22

98

6

20

164

850

22

99

33

180

5

30

0

3

3

6

0

0

0

4

0

3

0

1

0

6

0

3

1

5

9

74

1

8

0

0

11

86

0

10

8

11

59

265

17

95

45

286

1

10

33

212

1

14

9

34

1

9

6

24

23

85

131

592

25

131

1

5

107

581

98

475

82

409

75

220

0

2

1990
10438 2457 256

1991
10811 2501 258

White
1992 1993

11177 2546 260

11552 2591 261

1994 5-year

11918 2635 263

55896 12730
1298

19.8 19.3 19.0

18.6 .
19.0

20.6 .
20.0

19.8 .
19.0

20.4 .
20.0

19.8 19.3 19.0

14

23

14

22

21

94

2

2

5

5

6

20

139

167

164

173

154

797

13

25

14

22

21

95

31

35

27

32

30

155

4

8

8

4

5

29

2

0

0

1

0

3

2

1

0

0

3

6

0

0

0

0

0

0

0

2

0

1

0

3

0

1

0

1

0

2

0

1

0

0

0

1

2

1

0

2

0

5

0

1

2

0

0

3

1

1

0

2

1

5

10

13

14

20

9

66

1

1

1

1

1

5

0

0

0

0

0

0

11

18

19

20

11

79

0

3

3

4

0

10

0

2

0

0

7

9

48

42

44

53

55

242

17

15

14

16

15

77

46

58

59

66

45

274

2

3

0

2

1

8

45

39

46

46

33

209

5

5

1

2

1

14

3

4

10

7

9

33

.

1

4

1

1

7

.

0

6

3

5

14

.

10

17

12

23

62

95

102

117

130

124

568

17

21

34

30

25

127

0

1

2

1

1

5

86

127

113

115

98

539

68

75

91

112

90

436

59

67

79

95

74

374

.

20

50

62

70

202

0

0

0

2

0

2

1990
596 150 17

1991
617 152
17

Black
1992 1993

637

657

155

157

17

17

1994 5-year

678 3184

159

773

17

86

17.9 .
22.5

19.6 .
20.0

21.2 .
26.0

37.5 .
25.0

24.9 .
23.0

21.1 .
24.0

2

0

0

0

1

3

0

0

0

0

0

0

10

9

13

8

10

50

2

0

0

0

1

3

6

3

7

6

3

25

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

1

0

0

0

1

0

1

0

0

0

0

0

0

0

0

0

1

0

1

0

0

0

0

0

0

0

0

0

0

0

0

1

3

3

1

0

8

1

1

0

1

0

3

0

0

0

0

0

0

1

2

3

1

0

7

0

0

0

0

0

0

0

1

0

0

1

2

2

5

6

4

4

21

5

4

3

4

2

18

3

2

2

2

0

9

2

0

0

0

0

2

0

1

1

0

0

2

0

0

0

0

0

0

0

1

0

0

0

1

.

0

0

2

0

2

.

0

0

8

1

9

.

0

2

17

0

19

2

4

7

2

7

22

1

1

0

2

0

4

0

0

0

0

0

0

7

6

11

8

9

41

6

6

8

8

8

36

5

5

8

8

8

34

.

2

5

6

5

18

0

0

0

0

0

0

206

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

13.6

15.4

15.0

14.8

13.0

14.4

General fertility rate

57.7

66.4

65.3

65.7

58.6

62.7

Total fertility rate

1.8

2.0

2.1

2.1

1.8

2.0

% Livebirths to unmarried women

24.5

21.8

19.4

21.5

20.1

21.4

Crude abortion rate

*

*

*

*

*

0.1

General abortion rate

*

*

*

*

*

0.4

Total abortion rate

*

*

*

*

*

0.0

Abortion ratio

*

*

*

*

*

6.7

Fetal Death rate

2.3

3.8

3.3

1.8

1.8

2.6

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

57.8

86.1

49.9

78.1

77.6

69.9

% Repeat conceptions to women under 18

*

*

35.7

22.7

27.3

20.4

Livebirths to women under 18

54.2

93.3

49.9

78.1

77.6

70.6

% Livebirths to unmarried women under 18

33.3

54.2

35.7

50.0

40.9

44.3

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

*

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

7.0

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

0.4

Infant health rates

% Low birthweight

7.3

9.0

9.6

11.6

5.5

8.7

% Very low birthweight

*

*

*

*

*

0.9

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

7.9

11.5

12.6

11.9

6.7

10.2

% Multiple gestation

*

*

*

*

*

1.2

% Birth defect

*

*

*

*

5.0

1.3

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

35.7

28.4

30.1

34.1

38.3

33.2

% with father not named on birth certificate

14.6

10.9

9.7

11.3

10.4

11.3

% with maternal education less than high school

34.0

35.3

34.9

38.9

27.6

34.2

% No prenatal care

*

*

*

*

*

1.2

% Maternal smoking during pregnancy

30.0

23.6

27.2

26.6

20.5

25.5

% Maternal alcohol use during pregnancy

3.4

2.9

*

*

*

1.7

% Interpregnancy interval less than 6 months

*

4.7

8.8

7.0

10.1

7.0

Child abuse and neglect rates

Physical

.

*

*

*

*

0.6

Sexual

.

*

1.7

3.3

1.6

1.7

Neglect

.

3.5

5.6

8.2

6.2

5.9

Interventions to improve infant & child survival

% Prenatal care first trimester

65.8

61.5

70.5

73.3

80.9

70.4

% Primary C-section delivery

13.3

13.8

21.9

20.3

16.6

17.3

% Vaginal birth after previous C-section

*

*

*

*

*

6.1

% WIC during pregnancy

62.3

76.4

70.9

69.5

65.2

69.1

% Medicaid during pregnancy

50.3

47.1

56.6

67.8

59.8

56.5

% Medicaid and WIC during pregnancy

43.0

41.4

49.7

58.2

50.0

48.6

% Perinatal case management

.

12.6

31.4

38.4

45.7

31.9

Brantley County - 013

13.3 56.6
1.7 22.3
* * * * 2.4
54.7 *
50.8 * * * *
* * * * * *
7.2 * *
7.9 * *
35.6 12.2 33.3
* 32.4
3.6 *
. . .
69.3 13.7
* 61.9 48.9 42.4
.

15.4 66.8
2.1 21.3
* * * * 3.6
89.2 *
97.0 56.5
* * *
* * * * * *
7.8 * *
11.0 * *
26.4 9.1
35.6 *
23.8 3.1 *
* * 3.1
62.2 13.8
* 77.4 45.7 40.9 12.2

14.7 64.4 2.0 16.7
* * * * 3.1
53.9 35.7 53.9 35.7
* * *
* * * * * *
8.5 * *
11.7 * *
28.6 8.6 36.4
* 28.6
* 9.6
* 1.8 5.1
71.8 23.8
* 69.8 56.2 48.8 30.9

15.0 66.8
2.1 18.9
* * * * 1.9
84.2 22.7 84.2 50.0
* * *
* * * * * *
11.6 * *
11.8 * *
33.3 9.5
39.5 *
27.9 *
7.4
* * 3.5
75.6 20.0
* 68.0 66.3 56.2 36.7

12.9 58.4 1.9 19.5
* * * * 1.9
79.8 28.6 79.8 38.1
* * *
* * * * * *
5.8 * *
7.1 *
4.6
38.2 9.7 29.4
* 21.9
* 10.7
* 1.4 6.6
81.6 17.6
* 63.6 58.4 48.1 45.5

14.3 62.6
2.0 19.7
0.1 0.5 0.0 7.2 2.6
72.4 21.3 73.2 43.0
* * *
* * * 6.3 * 0.4
8.3 0.6
* 10.0
1.3 1.1
32.2 9.8
35.0 1.0
26.8 1.8 7.3
0.5 1.0 4.6
72.1 17.9
6.5 68.4 55.3 47.5 31.1

16.8 66.7
2.1 60.0
* * * * *
* * * * * * *
* * * * * *
* * * * * *
* 50.0
* * * * *
. . .
* * * 70.0 60.0 50.0 .

14.6 59.1
1.4 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
55.6 * * * * * *
* * *
* * * 66.7 66.7 55.6 *

20.4 84.1 2.4 53.8
* * * * *

12.2 51.1
1.6 75.0
* * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

50.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

34.0

*

72.3

53.8 * *
84.6 61.5 61.5 38.5

* * * 100.0 100.0 100.0 75.0

14.8 62.9 2.5
* * * * * *

15.7 64.7
2.0 50.0
* * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

16.0

*

*

*

*

*

14.0

*

*

*

*

*

46.7

*

36.0

*

18.0

*

*

*

*

*

*

*

*

*

*

*

9.7

*

20.5

70.0

44.0

*

*

*

*

90.0

82.0

80.0

72.0

80.0

68.0

50.0

45.0

207

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Brooks County - 014

1990
15398 3367 377
19.5 18.8 21.0
38 14 245 39 120 14
0 2 0
4 3 1 4 0 1
26 3 0
30 2 6
102 65 96
4 26
3 13
. . .
137 17
3 142 112 95
. 0

1991
15510 3375 376
18.6 23.5 21.0
47 14 268 45 142 12
4 5 2
7 5 2 8 1 6
27 7 2
24 2 3
101 86 98 0 21 0 16
4 2 78
148 29 5
188 162 140
83 1

Total
1992 1993

15621 3384 374

15734 3392 373

19.3 .
22.0

19.5 20.3 21.0

33

38

8

10

212

230

31

38

112

119

19

20

2

5

3

3

0

0

2

0

1

0

1

0

3

5

2

1

0

0

13

18

2

4

1

0

20

20

0

2

1

1

77

103

72

69

88

88

4

3

23

17

1

2

8

9

2

13

8

4

100

140

139

162

20

26

3

2

132

154

138

157

116

136

94

109

0

0

1994 5-year

15846 3400 371

78109 16918
1871

19.5 19.4 22.0

19.2 19.4 21.0

33

189

9

55

222

1177

32

185

124

617

12

77

3

14

2

15

0

2

2

15

2

11

0

4

5

25

0

4

1

8

30

114

8

24

0

3

30

124

4

10

4

15

92

475

71

363

86

456

4

15

25

112

1

7

15

61

21

40

7

21

81

399

156

742

29

121

5

18

149

765

158

727

132

619

140

426

0

1

1990
8893 1779
157

1991
8981 1789
159

White
1992 1993

9067 1799
160

9155 1809
162

1994 5-year

9241 1818
163

45337 8994 801

22.5 18.8 20.0

19.7 17.2 21.0

21.2 .
21.0

21.7 20.3 20.0

24.3 .
21.0

22.1 18.8 21.0

9

10

12

6

7

44

2

1

2

2

3

10

103

95

95

94

86

473

10

9

11

6

6

42

16

14

22

13

16

81

6

10

10

8

7

41

0

1

0

3

1

5

1

1

0

2

0

4

0

1

0

0

0

1

3

2

0

0

0

5

2

1

0

0

0

3

1

1

0

0

0

2

2

2

0

3

1

8

0

1

0

1

0

2

0

4

0

0

1

5

8

6

6

3

9

32

0

1

0

1

4

6

0

0

0

0

0

0

7

5

6

4

8

30

1

1

0

0

2

4

1

3

0

0

2

6

35

31

36

29

29

160

8

5

13

5

5

36

35

30

33

27

27

152

1

0

0

0

1

2

16

13

19

13

17

78

0

0

0

0

0

0

2

3

1

3

6

15

.

0

0

1

12

13

.

0

3

2

4

9

.

15

30

36

22

103

79

66

77

79

67

368

12

10

12

13

17

64

2

2

1

0

2

7

37

48

41

39

39

204

25

39

38

38

39

179

22

34

31

28

30

145

.

20

25

23

32

100

0

0

0

0

0

0

1990
6390 1560
214

1991
6437 1563 213

Black
1992 1993

6483 1566
212

6529 1568 212

1994 5-year

6576 1571
211

32414 7827 1062

18.7 .
21.0

18.2 29.9 21.0

18.6 .
23.0

17.6 .
22.0

18.7 19.4 23.0

18.3 24.6 22.0

28

37

21

32

26

144

11

13

6

8

6

44

140

173

117

135

136

701

28

36

20

32

26

142

102

128

90

105

108

533

8

2

9

12

5

36

0

3

2

2

2

9

1

4

3

1

2

11

0

1

0

0

0

1

1

5

2

0

2

10

1

4

1

0

2

8

0

1

1

0

0

2

2

6

3

2

4

17

0

0

2

0

0

2

1

2

0

0

0

3

17

21

7

15

21

81

3

6

2

3

4

18

0

2

1

0

0

3

21

19

14

16

22

92

1

1

0

2

2

6

5

0

1

1

2

9

66

70

41

73

63

313

56

81

59

63

66

325

59

68

55

60

59

301

3

0

4

3

3

13

10

8

4

4

8

34

3

0

1

2

1

7

11

13

7

6

9

46

.

4

1

10

9

24

.

2

5

2

3

12

.

63

62

87

57

269

58

82

62

83

89

374

5

19

8

13

12

57

1

3

2

2

3

11

104

140

91

115

110

560

87

123

100

119

119

548

73

106

85

108

102

474

.

63

69

86

108

326

0

1

0

0

0

1

208

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

15.9

17.3

General fertility rate

72.8

79.4

Total fertility rate

2.1

2.3

% Livebirths to unmarried women

49.6

53.4

Crude abortion rate

*

0.3

General abortion rate

*

1.5

Total abortion rate

*

*

Abortion ratio

*

17.3

Fetal Death rate

5.3

4.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

100.8 125.1

% Repeat conceptions to women under 18

36.8

29.8

Livebirths to women under 18

103.4 119.7

% Livebirths to unmarried women under 18

84.2

77.8

Induced abortions to women under 18

*

*

% Abortions to unmarried women under 18

*

*

Fetal deaths to women under 18

*

*

Infant and child survival rates

Infant mortality

*

26.1

Neonatal mortality

*

18.7

Postneonatal mortality

*

*

Perinatal mortality ratio

*

29.4

Deaths of children 1-4 yrs

*

*

Deaths of children 5-17 yrs

*

1.8

Infant health rates

% Low birthweight

10.7

10.1

% Very low birthweight

*

2.6

% Under 500 grams

*

*

% Preterm gestation

12.4

9.0

% Multiple gestation

*

*

% Birth defect

2.5

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

45.9

43.5

% with father not named on birth certificate

26.7

32.3

% with maternal education less than high school

39.8

37.1

% No prenatal care

*

*

% Maternal smoking during pregnancy

10.9

8.1

% Maternal alcohol use during pregnancy

*

*

% Interpregnancy interval less than 6 months

8.6

9.7

Child abuse and neglect rates

Physical

.

*

Sexual

.

*

Neglect

.

16.9

Interventions to improve infant & child survival

% Prenatal care first trimester

57.6

58.5

% Primary C-section delivery

7.7

11.7

% Vaginal birth after previous C-section

*

27.8

% WIC during pregnancy

58.4

70.7

% Medicaid during pregnancy

46.1

60.9

% Medicaid and WIC during pregnancy

39.1

52.6

% Perinatal case management

.

31.2

Brooks County - 014

13.6 62.6 1.9 53.1
* * * * 6.5

14.6 67.8
2.0 52.2
* * * * 8.3

88.2 24.2 82.9 87.1
* * *

101.9 26.3
101.9 97.4 * * *

*

*

*

*

*

*

*

21.3

*

*

*

*

6.1

7.8

*

*

*

*

9.5

8.8

*

*

*

*

38.9 34.1 41.9
* 11.0
* 6.8

46.8 30.3 38.6
* 7.5
* 6.6

* 1.7 21.5

2.8 *
30.0

67.5 10.1
* 62.6 65.4 55.0 44.5

70.7 12.4
* 67.5 68.9 59.6 47.8

14.0 65.3 2.0 56.9
* * * * 5.0

15.1 69.6
2.1 53.0
0.2 0.9 0.0 11.6 6.0

89.0 27.3 86.3 90.6
* * *

101.0 29.1 98.9 87.0
* * 3.2

* * * 22.2 * *

12.7 9.3 *
21.0 *
0.5

13.5 3.6
* 13.8
* *

9.7 2.0
* 10.6
0.9 1.3

43.4 32.6 39.6
* 11.6
* 11.7

43.8 31.1 39.3
1.3 9.8 0.6 8.7

4.5 1.5 17.3

2.1 1.1 21.4

70.6 14.1 38.5 68.3 72.5 60.6 64.2

64.7 11.2 21.2 65.6 62.3 53.1 46.2

11.6 57.9
1.7 15.8
* * * * 4.5
57.3 *
63.7 66.7
* * *
* * * * * *
7.8 * *
6.9 * *
37.2 7.8
35.0 *
16.0 * *
. . .
76.7 13.2
* 36.3 24.5 21.6
.

10.6 53.1
1.6 14.9
* * * * 6.1
62.9 *
56.6 * * * *
* * * * * *
6.3 * *
5.3 * *
37.3 5.3
31.9 *
14.1 * *
* * 7.1
73.3 11.6
* 51.1 41.5 36.2 21.3

10.5 52.8 1.6 23.2
* * * * 5.6
75.0 *
68.7 72.7
* * *
* * * * * *
6.3 * *
6.3 * *
38.7 13.7 34.7
* 20.0
* *
* * 14.1
82.8 13.3
* 43.2 40.0 32.6 26.3

10.3 52.0
1.6 13.8
* * * * 7.2
37.0 *
37.0 83.3
* * *
* * * * * *
* * * * * *
31.9 5.3
28.7 *
14.0 * *
* * 16.7
84.9 14.1
* 41.5 40.4 29.8 24.5

9.3 47.3 1.5 19.0
* * * * 5.5
42.9 *
36.8 * * * *
* * * * * *
10.5 * *
9.5 * *
35.4 6.0
32.1 *
20.5 *
11.8
5.5 *
10.1
78.8 21.0
* 46.4 46.4 35.7 38.1

10.4 52.6
1.6 17.3
* * * * 5.8
54.9 22.7 52.4 56.1
* * *
10.6 * *
16.7 *
0.7
6.8 1.3
* 6.4
* 1.3
36.1 7.7
32.5 *
16.8 *
5.6
1.5 1.1 12.0
79.3 14.5 24.1 43.5 38.2 30.9 27.2

21.9 89.7
2.4 73.4
* * * * 6.4

26.9 110.7
3.0 74.4
* * * * 3.2

130.8 39.3 130.8 89.3
* * *

173.5 35.1
168.8 94.4 * * *

*

28.9

*

*

*

*

*

34.1

*

*

*

*

12.2 * *
15.1 *
3.6

12.1 3.5 *
11.0 * *

52.4 40.3 42.4
* 7.3
* 12.4

47.0 47.1 40.0
* 4.8
* 11.5

.

*

.

*

.

25.4

43.0 3.9 *
74.8 62.6 52.5
.

50.3 11.7
* 81.4 71.5 61.6 36.6

18.0 74.7 2.0 77.6
* * * * 7.7

20.7 86.1
2.4 78.9
* * * * 9.6

20.7 86.6 2.4 80.6
* * * * 4.5

21.6 89.6
2.4 76.8
0.3 1.4 0.0 14.5 6.3

98.9 28.6 94.2 95.0
* * *

151.2 25.0
151.2 100.0
* * *

123.5 23.1
123.5 100.0
* * *

135.6 30.6 133.7 95.8
* * *

*

*

*

14.3

*

*

*

11.4

*

*

*

*

*

*

*

23.9

*

*

*

*

*

*

*

*

6.0 * *
12.1 * *

11.1 * *
12.0 * *

15.4 * *
16.4 * *

11.6 2.6 *
13.3 0.9 1.3

39.0 50.9 47.8
* * * 10.6

57.0 47.4 45.1
* * * 7.2

48.5 49.3 44.4
* 6.1
* 11.7

49.1 46.8 43.6
1.9 5.0 1.0 10.7

* 2.0 24.9

4.0 *
34.7

3.6 *
22.6

2.4 1.2 26.9

54.9

61.5

65.4

54.8

7.4

11.0

9.7

8.9

*

*

*

20.0

78.4

86.5

82.1

80.7

86.2

89.5

88.8

79.0

73.3

81.2

76.1

68.3

59.5

64.7

80.6

58.7

209

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Bryan County - 015

1990
15438 3866 393
22.1 18.8 20.0
32 6
286 27 63 19
3 43
5
3 3 0 6 0 1
29 6 1
24 5 1
91 32 80
7 46
7 16
. . .
217 46
2 98 93 68
. 1

1991
15962 3965 411
20.7 18.5 20.0
35 6
281 28 70 28 1 32 6
6 5 1 6 0 1
24 4 1
25 4 5
73 46 89
4 59
7 12
4 2 15
216 44 1
137 112
99 4 0

Total
1992 1993

16480 4061 428

17006 4161 446

21.5 18.7 21.0

20.8 20.1 21.5

37

29

10

4

312

315

27

27

80

72

12

24

1

3

38

46

9

1

4

3

2

2

2

1

3

4

0

1

2

1

21

26

4

1

0

0

26

30

4

5

3

2

104

100

46

38

74

69

4

4

56

46

4

1

14

19

7

8

15

10

47

89

244

243

47

56

11

10

144

153

138

140

111

122

74

82

0

1

1994 5-year

17526 4258 463

82412 20311
2141

21.3 19.7 20.0

21.3 19.1 20.0

41

174

5

31

320

1514

35

144

87

372

20

103

3

11

41

200

4

25

1

17

1

13

0

4

4

23

0

1

1

6

30

130

5

20

1

3

32

137

6

24

0

11

113

481

51

213

86

398

2

21

39

246

6

25

14

75

10

29

14

41

110

261

242

1162

41

234

9

33

148

680

149

632

117

517

95

255

0

2

1990
13018 3276 335

1991
13567 3381 353

White
1992 1993

14114 3484 370

14665 3590 388

1994 5-year

15212 3693 405

70576 17424
1852

22.6 18.8 20.0

20.2 18.0 20.0

22.4 20.2 20.0

21.7 20.0 20.0

22.0 19.1 20.0

21.9 19.0 20.0

25

27

23

20

29

124

4

2

7

2

5

20

228

215

251

259

242

1195

20

21

15

19

24

99

36

30

43

40

43

192

15

23

10

19

16

83

1

0

0

2

0

3

41

26

27

32

30

156

5

6

7

1

3

22

3

4

3

3

0

13

3

3

2

2

0

10

0

1

1

1

0

3

4

3

2

3

0

12

0

0

0

1

0

1

0

1

1

1

0

3

25

13

13

21

18

90

5

2

2

1

2

12

1

0

0

0

0

1

18

14

16

23

20

91

5

2

2

5

4

18

1

5

3

2

0

11

63

53

74

84

74

348

19

18

27

18

20

102

56

65

52

52

59

284

5

1

2

1

0

9

41

52

52

42

34

221

5

7

3

1

3

19

11

5

7

13

10

46

.

4

6

6

7

23

.

2

11

7

10

30

.

11

39

57

70

177

185

184

210

209

201

989

40

31

39

44

27

181

2

1

8

8

7

26

66

89

111

111

94

471

61

76

98

100

93

428

42

67

83

84

70

346

.

2

51

59

57

169

1

0

0

1

0

2

1990
2293 548 52

1991
2371 561 54

Black
1992 1993

2448 574 57

2526 588 59

1994 5-year

2603 601 61

12241 2873 283

18.3 .
19.0

21.5 22.8 27.0

17.0 17.9 25.0

17.7 23.1 28.0

18.4 22.1 22.0

18.8 19.4 26.0

7

8

13

9

12

49

2

4

3

2

0

11

56

64

57

53

73

303

7

7

11

8

11

44

27

40

36

32

44

179

4

5

2

5

4

20

2

1

1

0

3

7

2

5

11

13

10

41

0

0

2

0

1

3

0

2

1

0

1

4

0

2

0

0

1

3

0

0

1

0

0

1

2

3

1

0

4

10

0

0

0

0

0

0

1

0

1

0

1

3

4

11

8

1

2

2

0

1

0

6

11

10

0

2

2

0

0

0

5

11

39

0

3

8

0

1

2

7

10

44

0

2

6

0

0

0

28

19

29

14

37

127

13

28

19

20

31

111

24

23

20

17

25

109

2

3

2

3

2

12

5

6

3

4

5

23

2

0

1

0

3

6

5

7

7

6

4

29

.

0

1

2

2

5

.

0

3

3

4

10

.

3

6

27

31

67

31

31

32

32

36

162

6

13

6

11

12

48

0

0

2

2

2

6

32

47

31

40

52

202

32

36

38

38

53

197

26

32

26

36

46

166

.

2

21

23

36

82

0

0

0

0

0

0

210

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Bryan County - 015

18.5 74.0
2.3 22.4
2.8 11.1
0.3 122.5
5.7
81.4 18.8 68.7 65.4 12.7 100.0
*
* * * 20.8 * *
10.1 2.1 * 8.5 1.8 *
33.0 11.4 28.5
2.5 16.4
2.5 10.5
. . .
75.9 18.0
* 34.9 33.1 24.2
.

17.6 70.9
2.3 25.5
2.0 8.1 0.3 92.2 8.6
85.1 17.1 68.1 51.9 14.6 100.0
*
21.4 17.8
* 21.3
* *
8.5 * *
9.1 *
1.8
27.9 16.7 32.5
* 21.5
2.6 7.5
* * 2.9
77.7 17.7
* 49.8 40.7 36.0
*

18.9 76.8 2.4 26.0 2.3 9.4 0.3 103.3
4.4
86.5 27.0 63.1 59.3 21.0 88.9
*
* * * * * *
6.7 * *
8.5 * *
34.9 14.9 24.2
* 18.2
* 7.3
1.3 2.9 8.9
78.2 17.7 25.6 46.8 44.8 36.0 24.0

18.5 75.7
2.4 23.2
2.7 11.1
0.3 117.9
7.0
65.0 *
60.6 59.3
* * *
* * * * * *
8.3 * *
9.7 1.6
*
33.8 12.3 22.3
* 14.9
* 10.2
1.5 1.9 16.5
77.6 20.8 24.4 49.4 45.2 39.4 26.5

18.3 75.2 2.4 27.9 2.3 9.6 0.3 106.5
5.6
88.6 12.2 75.6 68.6
* * *
* * * * * *
9.4 1.6
* 10.3 1.9
*
37.5 16.3 27.7
* 12.6
1.9 7.9
1.8 2.5 19.9
76.8 14.7 26.5 47.4 47.8 37.5 30.4

18.4 74.5
2.4 25.0
2.4 9.8 0.3 108.6 6.3
81.3 17.8 67.3 61.3 11.7 96.0
3.3
11.2 8.6 *
15.1 *
0.3
8.6 1.3
* 9.2 1.6 0.7
33.6 14.3 26.9
1.4 16.6
1.7 8.6
1.4 1.9 12.3
77.3 17.8 19.3 45.8 42.5 34.8 21.2

17.5 69.6
2.2 16.1
3.1 12.5
0.4 143.9
4.9

15.8 63.6
2.1 14.2
1.9 7.7 0.3 97.0 8.0

74.6 *
59.7 52.6 14.9 100.0
*

76.5 *
59.5 35.0 17.0 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

11.0

6.0

2.2

*

*

*

8.1

6.6

2.2

*

*

2.3

28.8 8.5
25.1 2.2
18.5 2.3
10.3

25.9 8.5
30.8 *
24.6 3.3 4.0

.

*

.

*

.

2.6

81.1 19.9
* 29.6 27.4 18.8
.

86.4 16.3
* 42.0 35.8 31.6
*

17.8 72.0 2.3 17.3 1.9 7.7 0.2 93.4
3.2

17.7 72.1
2.3 15.7
2.2 8.9 0.3 101.9 6.4

15.9 65.5 2.1 18.1 2.0 8.1 0.2 103.8
4.6

16.9 68.6
2.2 16.3
2.2 9.0 0.3 108.0 5.4

62.1 30.4 40.5 33.3 18.9 85.7
*

51.5 *
49.0 42.1
* * *

71.6 17.2 59.2 54.2
* * *

67.0 16.1 53.5 44.3 11.9 95.5
2.7

*

*

*

10.9

*

*

*

8.4

*

*

*

*

*

*

*

10.0

*

*

*

*

*

*

*

*

5.2

8.1

7.4

7.5

*

*

*

1.0

*

*

*

*

6.4

9.1

8.4

7.7

*

2.0

*

1.5

*

*

*

0.9

30.3 10.8 21.0
* 20.9
* 4.5

34.3 7.1
20.5 *
16.6 *
8.8

31.9 8.4
25.0 *
14.5 *
7.4

30.4 8.7
24.2 0.8
18.9 1.6 6.9

1.4

1.3

1.5

1.3

2.5

1.5

2.1

1.7

8.9

12.6

15.0

9.9

83.7 18.1 23.5 44.6 39.4 33.3 20.5

81.0 19.7 25.8 43.7 39.4 33.1 23.2

83.1 12.8 26.9 39.7 39.2 29.5 24.1

83.0 17.4 19.3 40.1 36.4 29.4 17.8

24.4 102.2
2.9 48.2
* * * * 10.9

27.0 114.0
3.2 65.6
2.1 8.9 0.3 65.8 12.5

23.3 99.3 2.7 65.5 4.5 19.2 0.5 146.7 12.2

21.0 90.2
2.5 60.4
5.1 22.1
0.6 183.1
8.5

28.0 121.5
3.4 62.9 3.8 16.6 0.5 111.1 11.6

24.8 105.5
2.9 60.7
3.3 14.3
0.4 109.0
11.1

134.6 *
134.6 100.0
* * *

147.1 *
128.7 100.0
* * *

229.7 *
194.3 90.9 * * *

152.5 *
135.6 100.0
* * *

196.1 *
179.7 100.0
* * *

173.0 22.4
155.4 97.7 * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

32.3

*

*

*

*

*

*

*

*

*

*

*

*

* * * 10.7 * *

17.2 * *
18.0 * *

14.0 * *
18.5 * *

9.4 * *
13.2 * *

15.1 * *
14.3 * *

12.9 2.6 *
15.0 2.0 *

50.9 23.2 42.9
* 8.9
* 11.4

34.5 45.9 37.7
* 9.8
* 20.6

58.0 34.5 37.0
* * * 18.9

29.2 37.7 32.1
* * * 15.8

57.8 44.3 35.7
* 7.2
* *

46.7 37.6 37.1
4.1 7.8 2.0 15.2

.

*

*

*

*

1.4

.

*

*

*

*

2.8

.

*

6.7

29.6

33.2

18.6

55.4 11.5
* 57.1 57.1 46.4
.

49.2 23.2
* 77.0 59.0 52.5
*

56.1 12.5
* 56.4 69.1 47.3 38.2

61.5 25.6
* 75.5 71.7 67.9 43.4

52.9

54.7

19.0

18.3

*

18.2

74.3

68.5

75.7

66.8

65.7

56.3

51.4

34.3

211

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Bulloch County - 016

1990
43125 12072
771
21.5 19.7 22.0
80 27 625 55 224 67 13 233 18
4 3 1 16 5 5
51 9 0
49 9 4
178 125 174
9 113 63 48
. . .
439 93 10 318 244 193
. 0

1991
43847 12276
768
20.9 20.5 22.0
71 14 624 58 236 71
5 246
10
4 2 2 8 2 3
39 7 0
46 7 3
175 129 167
3 113
42 37
8 19 36
434 110
10 345 284 238
55 0

Total
1992 1993

44558 12480
766

45278 12684
763

21.2 20.2 22.0

21.6 20.6 22.0

84

68

29

21

622

574

61

55

237

212

75

54

5

4

241

206

16

11

11

2

10

2

1

0

15

6

0

1

4

3

56

42

15

9

3

0

57

41

10

2

5

3

173

159

138

125

176

166

8

6

94

126

38

34

37

23

11

19

21

18

90

145

430

432

109

111

14

9

311

332

306

327

244

272

119

146

0

0

1994 5-year

45991 12887
760

222799 62399
3828

21.2 20.5 22.5

21.2 20.3 22.0

93

396

24

115

588

3033

78

307

226

1135

62

329

8

35

232

1158

10

65

7

28

6

23

1

5

15

60

0

8

4

19

51

239

15

55

3

6

49

242

8

36

2

17

155

840

126

643

167

850

8

34

82

528

21

198

21

166

17

55

24

82

129

400

407

2142

148

571

11

54

324

1630

340

1501

275

1222

170

490

1

1

1990
31464 8858 479

1991
32098 9040 477

White
1992 1993

32729 9222 475

33361 9404 474

1994 5-year

33993 9585
472

163645 46109
2377

23.1 19.9 21.0

21.5 20.6 22.0

23.1 20.3 22.0

22.9 20.7 22.0

23.0 20.5 22.0

22.8 20.4 22.0

31

34

28

27

39

159

10

4

10

6

10

40

364

382

371

359

369

1845

17

28

22

21

29

117

47

63

52

62

69

293

39

39

42

25

43

188

5

1

3

1

5

15

154

191

154

141

145

785

11

6

4

5

8

34

1

3

5

2

3

14

1

2

4

2

2

11

0

1

1

0

1

3

6

3

7

3

8

27

3

1

0

1

0

5

4

2

3

1

2

12

21

16

24

22

25

108

6

2

4

4

6

22

0

0

1

0

0

1

24

24

29

26

29

132

5

2

7

1

6

21

3

2

2

2

1

10

93

86

91

92

87

449

20

26

28

30

25

129

62

79

70

87

75

373

3

2

3

2

3

13

79

83

63

95

69

389

31

30

20

14

13

108

17

14

11

9

7

58

.

2

7

8

8

25

.

9

18

15

15

57

.

9

49

53

44

155

293

305

311

299

298

1506

57

68

71

55

92

343

7

7

10

7

10

41

136

149

128

158

156

727

82

112

119

154

163

630

70

93

98

126

125

512

.

22

42

72

79

215

0

0

0

0

0

0

1990
11226 3086 284

1991
11414 3150 283

Black
1992 1993

11599 3215 282

11787 3279 281

1994 5-year

11972 3343 280

57998 16072
1410

18.9 19.4 25.0

19.6 19.1 25.0

18.9 19.8 23.0

19.6 20.4 25.0

18.9 20.5 25.0

19.1 19.8 25.0

49

37

56

41

54

237

17

10

19

15

14

75

259

240

247

210

215

1171

38

30

39

34

49

190

177

173

185

149

156

840

28

32

32

29

18

139

8

4

2

3

3

20

75

52

85

63

85

360

7

4

12

6

2

31

3

1

6

0

4

14

2

0

6

0

4

12

1

1

0

0

0

2

10

5

8

3

7

33

2

1

0

0

0

3

1

1

1

2

2

7

30

23

32

18

26

129

3

5

11

4

9

32

0

0

2

0

3

5

25

22

28

14

20

109

4

5

3

1

2

15

1

1

3

1

1

7

84

89

81

105

103

110

111

88

105

6

1

5

33

30

31

32

12

17

31

23

26

66

67

387

94

101

513

79

91

474

4

5

21

31

13

138

20

8

89

14

14

108

.

6

4

9

8

27

.

9

3

2

7

21

.

26

41

86

78

231

145

128

118

130

105

626

36

42

36

54

56

224

3

3

4

2

1

13

182

196

181

170

167

896

161

171

186

172

176

866

123

145

145

145

149

707

.

33

77

73

90

273

0

0

0

0

1

1

212

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Bulloch County - 016

14.5 51.8
1.5 36.4
5.4 19.3
0.4 246.6
7.2
103.8 33.8 71.3 81.8 23.3 100.0
9.1
* * * 25.1 2.2 0.7
8.2 1.4
* 8.0 1.5
*
31.3 20.3 28.2
1.5 18.4 10.3 12.2
. . .
70.4 16.8 16.1 51.6 39.6 31.3
.

14.2 50.8
1.4 38.3
5.6 20.0
0.4 258.9
6.5
92.4 19.7 75.5 84.5 13.0 100.0
*
* * * 12.7 * *
6.3 1.1
* 7.5 1.1
*
30.1 20.9 27.2
* 18.4
6.9 10.7
0.8 1.9 3.6
70.1 20.6 12.0 55.9 46.0 38.6
8.9

14.0 49.8 1.4 38.8 5.4 19.3 0.5 254.8
6.7
109.7 34.5 79.7 82.0 20.9
100.0 9.1
17.7 16.1
* 23.9
* *
9.0 2.4
* 9.3 1.6 0.8
30.8 22.6 28.9
1.3 15.4 6.3 10.4
1.1 2.1 9.0
70.4 20.5 17.5 50.9 50.1 39.9 19.5

12.7 45.3
1.3 37.1
4.5 16.2
0.4 245.2
4.7
89.1 30.9 72.1 76.4 14.4 90.9
*
* * * 10.4 * *
7.3 1.6
* 7.2
* *
31.0 21.9 29.2
1.1 22.1
6.0 7.0
1.9 1.8 14.3
78.5 22.5 11.4 58.0 57.2 47.6 25.5

12.8 45.6 1.2 39.0 5.0 18.0 0.4 259.5
5.7
122.3 25.8
102.6 80.5 13.2 90.0 7.9
11.9 10.2
* 25.2
* *
8.7 2.6
* 8.4 1.4
*
30.5 21.7 28.8
1.4 14.2 3.6 7.8
1.7 2.4 12.6
72.2 29.5 13.9 55.9 58.6 47.4 29.3

13.6 48.6
1.4 37.9
5.2 18.6
0.4 253.1
6.2
103.4 29.0 80.2 81.0 17.0 96.9
6.8
9.2 7.6 1.7 19.6 0.7 0.5
7.9 1.8 0.2 8.1 1.2 0.6
30.7 21.5 28.5
1.1 17.7
6.6 9.8
1.4 2.0 9.9
72.2 21.9 14.1 54.4 50.1 40.8 20.6

11.6 41.1
1.4 13.1
4.9 17.4
0.4 272.6
5.3

11.9 42.3
1.3 16.6
6.0 21.1
0.5 311.1
4.5

11.3 40.2 1.2 14.3 4.7 16.7 0.4 269.2
5.1

10.8 38.2
1.1 17.3
4.2 15.0
0.3 267.6
2.9

10.9 38.5 1.1 19.0 4.3 15.1 0.4 256.6
5.3

11.3 40.0
1.2 16.1
4.8 17.0
0.4 276.1
4.6

64.7 32.3 35.5 47.1 23.0 100.0
*

71.2 *
58.7 67.9 12.6 100.0
*

58.9 35.7 46.3 54.5
* * *

57.0 22.2 44.3 42.9 10.6
* *

82.7 25.6 61.5 50.0 17.0 87.5
*

66.9 25.2 49.2 53.4 14.3 94.1
3.8

* * * 16.3 * *

*

13.5

*

*

*

*

*

18.7

*

*

*

*

*

*

7.6

*

*

6.0

*

*

*

*

21.4

14.5

*

*

0.7

*

*

0.5

5.8

4.2

6.5

6.1

6.8

5.9

1.6

*

*

*

1.6

1.2

*

*

*

*

*

*

6.7

6.3

8.0

7.3

8.0

7.2

1.4

*

1.9

*

1.7

1.2

*

*

*

*

*

0.5

28.0 5.6
17.3 *
22.1 8.7 8.0

23.8 6.8
20.8 *
22.0 8.0 7.2

26.8 7.7 19.3
* 17.4 5.5
5.6

28.5 8.4
24.4 *
26.7 3.9 4.7

27.3 6.9
20.7 *
19.2 3.6 4.2

26.8 7.1
20.5 0.7
21.5 6.0 6.0

.

*

1.1

1.3

1.3

1.0

.

1.5

2.9

2.4

2.4

2.3

.

1.5

7.9

8.4

6.9

6.2

80.7 17.4 22.6 37.9 22.8 19.5
.

80.3 20.5 14.6 39.2 29.5 24.5
5.8

85.0 22.4 21.7 35.3 32.8 27.0 11.6

86.9 18.4 11.9 44.1 43.0 35.2 20.1

84.4 29.4 20.0 43.0 44.9 34.4 21.8

83.4 21.6 17.5 39.9 34.6 28.1 14.7

23.1 83.9
2.2 69.4
6.7 24.3
0.6 200.5
13.0

21.0 76.2
1.9 73.6
4.6 16.5
0.4 157.1
12.4

21.3 76.8 2.0 75.8 7.3 26.4 0.6 231.6 10.9

17.8 64.0
1.7 71.3
5.3 19.2
0.5 205.9
10.1

18.0 64.3 1.7 73.2 7.1 25.4 0.6 264.0
6.6

20.2 72.9
1.9 72.7
6.2 22.4
0.5 211.8 10.5

172.5 34.7 133.8 97.4 24.6 100.0
*

130.7 27.0
106.0 100.0
* * *

198.6 33.9
138.3 97.4 42.6
100.0 17.7

145.9 36.6
121.0 97.1 21.3
100.0 *

192.8 25.9
174.9 98.0 * * *

168.1 31.6
134.7 97.9 22.0 100.0 12.1

* * * 37.5 * *

* * * 20.5 * *

24.3 24.3
* 32.1
* *

*

*

12.0

*

*

10.2

*

*

*

*

32.1

27.7

*

*

*

*

*

0.5

11.6 * *
9.8 * *

9.6

13.0

2.1

4.5

*

*

9.4

11.5

2.1

*

*

*

8.6

12.1

11.0

*

4.2

2.7

*

*

0.4

6.7

9.4

9.4

*

*

1.3

*

*

0.6

35.7 41.2 43.5
2.4 12.9 12.5 17.3

41.0 43.8 37.9
* 12.8
5.1 15.3

37.0 45.1 43.4 2.1 12.8 7.1 16.5

35.7 45.0 38.2
* 14.8
9.6 10.6

36.0 47.4 42.9 2.4 6.1 3.8 13.9

37.1 44.4 41.3
1.8 12.0
7.7 15.0

.

1.6

*

2.4

2.1

1.8

.

2.4

*

*

1.8

1.4

.

7.0

10.9

22.6

20.3

15.2

56.0 16.1
* 71.4 63.1 48.2
.

54.0 21.0
* 83.4 72.8 61.7 14.0

49.0 17.1
* 74.2 76.2 59.4 31.6

64.7 28.6
* 81.3 82.3 69.4 34.9

50.7

54.7

30.3

22.2

*

8.8

78.4

77.5

82.6

74.9

70.0

61.2

42.3

30.3

213

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Burke County - 017

1990
20579 4788 516
19.3 19.3 21.0
56 13 382 47 209 10
5 69
8
10 7 3
11 0 0
58 19
2 59
8 10
245 121 134 17 55
3 37
. . .
256 40
6 229 214 169
. 0

1991
20620 4784 517
19.8 19.2 23.0
59 16 391 48 205 18
5 80
9
6 5 1 10 3 2
51 9 1
47 3 4
242 119 139
12 40
6 18
4 5 62
299 40 11
263 224 197
9 1

Total
1992 1993

20663 4783 517

20699 4777 517

20.6 18.3 22.5

19.2 18.3 23.0

51

66

12

13

392

381

40

54

199

213

16

11

4

4

63

62

7

9

2

7

1

5

1

2

5

9

1

1

2

1

45

50

7

14

0

1

44

56

4

5

7

0

162

150

117

119

134

150

10

5

47

45

8

5

19

24

15

12

26

12

72

80

287

264

46

40

11

4

242

237

247

270

209

214

50

49

1

0

1994 5-year

20740 4774 518

103301 23906 2584

19.9 17.7 22.0

19.8 18.3 22.0

66

298

9

63

387

1933

53

242

209

1035

7

62

1

19

52

326

12

45

5

30

5

23

0

7

6

41

1

6

2

7

52

256

14

63

0

4

48

254

5

25

4

25

171

970

118

594

113

670

10

54

29

216

2

24

21

119

12

43

12

55

61

275

286

1392

45

211

6

38

259

1230

267

1222

220

1009

80

188

0

2

1990
9762 2135
203

1991
9792 2132 203

White
1992 1993

9823 2130
202

9848 2125 202

1994 5-year

9878 2122
202

49103 10644
1013

20.4 19.5 20.0

22.1 18.9 21.0

21.9 18.4 19.5

20.7 18.6 20.0

21.9 17.2 22.0

21.2 18.6 20.0

15

16

14

14

11

70

3

2

5

3

1

14

135

155

157

155

135

737

11

10

12

11

8

52

25

28

22

36

26

137

5

9

8

8

5

35

1

1

1

0

0

3

30

33

23

20

18

124

4

6

2

2

3

17

2

2

1

1

0

6

1

1

1

1

0

4

1

1

0

0

0

2

2

2

2

1

0

7

0

3

0

1

0

4

0

1

0

0

1

2

8

7

9

12

9

45

0

1

2

2

2

7

0

0

0

0

0

0

11

8

12

11

13

55

2

1

3

4

1

11

2

1

5

0

2

10

60

65

55

44

57

281

10

10

14

23

15

72

37

45

42

52

31

207

2

2

0

0

1

5

31

26

28

33

23

141

1

3

2

2

0

8

12

5

6

5

3

31

.

2

12

7

4

25

.

2

15

6

9

32

.

37

12

24

14

87

101

128

125

115

111

580

17

31

31

20

22

121

3

2

4

2

3

14

54

70

64

74

65

327

40

56

62

78

63

299

32

47

48

62

51

240

.

0

7

23

18

48

0

0

0

0

0

0

1990
10756 2633 310

1991
10777 2628 310

Black
1992 1993

10800 2625 310

10819 2619 311

1994 5-year

10840 2615 311

53992 13120
1553

19.0 18.9 25.0

19.3 19.9 24.5

19.8 17.8 30.0

18.2 18.3 26.0

18.2 17.7 27.0

18.9 17.8 26.5

41

43

37

51

55

227

10

14

7

10

8

49

247

236

234

225

252

1194

36

38

28

43

45

190

184

177

177

176

183

897

5

9

8

3

2

27

4

4

3

4

1

16

39

47

40

41

34

201

4

3

5

6

9

27

8

4

1

6

5

24

6

4

0

4

5

19

2

0

1

2

0

5

9

8

3

8

6

34

0

0

1

0

1

2

0

1

2

1

1

5

50

44

36

38

43

211

19

8

5

12

12

56

2

1

0

1

0

4

48

39

32

45

35

199

6

2

1

1

4

14

8

3

2

0

2

15

185

177

106

106

114

688

111

109

103

96

103

522

97

94

92

98

82

463

15

10

10

5

9

49

24

14

19

12

6

75

2

3

6

3

2

16

25

13

13

19

18

88

.

1

3

5

7

16

.

3

11

6

3

23

.

25

60

56

45

186

155

171

161

148

175

810

23

9

15

20

23

90

3

9

7

2

3

24

175

193

178

162

194

902

174

168

185

191

204

922

137

150

161

151

169

768

.

9

43

26

62

140

0

1

1

0

0

2

214

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Burke County - 017

18.6 79.8
2.3 55.9
3.4 14.4
0.4 147.4
3.6
108.5 23.2 91.1 85.1 15.5 100.0
*
26.2 18.3
* 28.4
* *
15.2 5.0 *
15.8 2.1 2.6
68.8 32.4 36.2
4.6 14.8
* 15.5
. . .
67.4 12.2 13.3 61.2 57.2 45.2
.

19.0 81.7
2.4 53.0
3.9 16.7
0.5 161.9
4.8
114.2 27.1 92.9 85.4 17.4
100.0 *
15.3 12.8
* 25.3
* *
13.0 2.3 *
12.1 * *
64.2 30.7 36.3
3.1 10.4
1.6 7.4
* 0.7 9.1
76.7 11.6 26.8 68.0 57.9 50.9
2.3

19.0 82.0 2.4 51.2 3.0 13.2 0.4 132.6 4.2
98.7 23.5 77.4 82.5 13.6 100.0
*
* * * 12.6 * *
11.5 1.8 *
11.3 *
1.8
42.3 30.1 34.6
2.6 12.2
2.1 7.8
2.2 3.8 10.5
73.2 13.8 20.0 62.2 63.5 53.7 12.9

18.4 79.8
2.4 56.6
3.0 13.0
0.4 135.4
3.1
127.6 19.7
104.4 92.6 17.4
100.0 *
18.4 13.1
* 23.4
* *
13.1 3.7 *
14.9 1.3 *
40.3 31.6 40.3
1.3 12.0
1.3 10.6
1.8 1.8 11.7
69.8 11.9
* 63.0 71.8 56.9 13.0

18.7 81.1 2.4 54.7 2.5 10.9 0.3 116.3 1.7
127.4 13.6
102.3 94.3 23.2
100.0 *
12.9 12.9
* 15.5
* *
13.4 3.6 *
12.6 1.3 *
45.6 30.9 30.7
2.6 7.6
* 9.3
1.8 1.8 8.9
74.5 13.2 14.3 67.8 69.9 57.6 20.9

18.7 80.9
2.4 54.2
3.2 13.6
0.4 139.2
3.5
115.3 21.1 93.6 88.4 17.4 100.0
4.3
15.5 11.9
3.7 21.0
0.8 0.3
13.2 3.3 *
13.3 1.3 1.3
52.1 31.1 35.6
2.8 11.4
1.3 10.1
1.6 2.0 10.1
72.3 12.5 17.1 64.5 64.0 52.9 12.3

13.8 63.2
2.0 18.8
3.1 14.1
0.4 174.4
3.3

15.8 72.7
2.3 18.3
3.4 15.5
0.5 166.7
4.7

16.0 73.7 2.3 14.2 2.3 10.8 0.3 121.7 4.2

15.7 72.9
2.3 23.8
2.0 9.4 0.3 109.3 3.8

13.7 63.6 2.0 19.4 1.8
8.5 0.3 113.9 2.4

15.0 69.2
2.2 18.9
2.5 11.6
0.3 137.8
3.7

73.9 *
54.2 54.5
* * *

78.8 *
49.3 50.0 29.6 100.0
*

69.2 35.7 59.3 50.0
* * *

69.2 *
54.3 63.6
* * *

54.3 *
39.5 62.5
* * *

69.1 20.0 51.3 55.8 16.8 100.0
*

*

*

*

*

*

8.1

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

9.5

*

*

*

*

*

*

*

*

*

*

*

*

5.9

4.5

5.7

7.7

6.7

6.1

*

*

*

*

*

0.9

*

*

*

*

*

*

8.3

5.2

7.7

7.3

9.8

7.6

*

*

*

*

*

1.5

*

*

3.2

*

*

1.4

46.5 7.5
28.2 *
23.5 *
14.6

43.3 6.5
29.4 *
17.1 *
5.5

36.2 9.0 27.1
* 18.3
* 7.1

29.5 15.2 34.4
* 21.9
* 5.6

43.2 11.2 23.7
* 17.3
* *

39.5 9.9
28.7 0.7
19.6 1.1 7.4

.

*

4.6

2.7

*

2.4

.

*

5.8

2.3

3.5

3.1

.

14.2

4.6

9.2

5.4

8.4

74.8 15.3
* 40.6 30.1 24.1
.

83.1 22.0
* 45.8 36.6 30.7
*

79.6 23.7
* 41.3 40.0 31.0 4.5

74.2 15.2
* 49.0 51.7 41.1 15.2

82.8 18.8
* 48.5 47.0 38.1 13.4

78.9 19.1 14.9 45.0 41.2 33.1
8.1

23.0 93.8
2.6 76.3
3.6 14.8
0.4 131.8
3.8

21.9 89.8
2.5 75.6
4.4 17.9
0.5 158.8
4.9

21.7 89.1 2.5 76.0 3.7 15.2 0.4 140.4 4.2

20.8 85.9
2.4 78.6
3.8 15.7
0.4 150.2
2.7

23.2 96.4 2.8 73.8 3.1 13.0 0.3 117.6
*

22.1 91.0
2.6 76.0
3.7 15.3
0.4 139.7
3.4

132.3 24.4 116.1 94.4
* * *

138.5 32.6
122.4 94.7 * * *

119.2 18.9 90.2 96.4 16.1
100.0 *

164.1 19.6
138.4 100.0
19.3 100.0
*

176.8 14.5
144.6 100.0
28.9 100.0
*

146.2 21.6 122.4 97.4 17.4 100.0 6.4

32.4 24.3
* 35.9
* *

* * * 33.3 * *

*

26.7

19.8

20.1

*

*

19.8

15.9

*

*

*

4.3

*

34.9

23.7

28.1

*

*

*

*

*

*

*

0.3

20.2 7.7 *
20.0 2.5 3.2

18.6 3.4 *
16.7 * *

15.4 2.1
* 13.7
* *

16.9 5.3 *
20.1 * *

17.1 4.8
* 14.1
* *

17.7 4.7 *
16.9 1.2 1.3

81.5 46.1 40.6
6.3 10.0
* 16.0

78.0 46.6 40.9
4.3 6.1
* 8.6

46.1 44.2 39.8 4.3 8.2 2.6
8.3

47.7 42.9 44.5
2.2 5.4
* 13.9

46.9 41.5 34.6
3.7 2.4
* 11.5

59.9 44.2 40.0
4.2 6.4 1.4 11.6

.

*

*

1.2

1.7

1.0

.

*

2.6

1.4

*

1.4

.

5.9

14.3

13.3

10.7

11.0

63.3 10.6
* 72.6 72.2 56.8
.

72.5 4.4
31.0 82.5 71.8 64.1
3.8

68.8 7.4 22.6 76.4 79.4 69.1 18.5

66.7 9.8 *
72.3 85.3 67.4 11.6

70.0

68.2

10.3

8.6

*

18.8

78.2

76.4

82.3

78.1

68.1

65.1

25.0

14.9

215

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Butts County - 018

1990
15326 3108 310
19.3 19.9 21.0
44 13 224 34 90 20
1 66
8
2 1 1 3 1 2
19 4 0
20 2 2
61 40 72
9 45
6 14
. . .
143 50
4 131 107 86
. 0

1991
15473 3108 313
19.6 17.4 22.0
41 7
207 26 87 21 4 65 13
2 1 1 5 0 0
17 3 0
17 4 4
54 34 64
6 32
3 9
1 0 5
136 34 7
109 99 80 1 1

Total
1992 1993

15610 3106 316

15760 3106 319

19.4 20.0 22.5

20.0 18.0 22.0

34

36

10

5

199

229

26

26

88

105

29

20

1

1

61

64

2

9

3

2

2

2

1

0

3

3

1

0

1

2

15

15

5

3

1

0

18

24

2

0

2

1

53

63

29

47

59

66

8

2

34

26

1

2

5

15

6

9

6

6

40

33

130

161

27

36

2

2

113

152

104

144

83

121

4

9

0

0

1994 5-year

15901 3105 322

78070 15533
1579

19.9 18.4 22.0

19.6 18.6 22.0

37

192

6

41

203

1062

27

139

88

458

20

110

2

9

50

306

8

40

3

12

1

7

2

5

3

17

0

2

4

9

15

81

2

17

1

2

17

96

3

11

1

10

28

259

42

192

61

322

4

29

20

157

2

14

11

54

17

33

9

21

58

136

145

715

31

178

11

26

117

622

111

565

97

467

8

22

5

6

1990
9770 1949
185

1991
9940 1959
189

White
1992 1993

10104 1967 193

10274 1976 198

1994 5-year

10439 1985 202

50527 9836 967

19.4 19.9 20.5

20.7 17.0 21.0

19.8 20.5 20.0

20.1 17.8 21.0

20.6 18.0 21.0

20.2 18.6 21.0

21

18

17

19

18

93

5

1

5

3

1

15

142

115

107

130

125

619

16

9

11

12

12

60

33

26

28

38

31

156

16

11

18

12

11

68

0

1

1

0

2

4

37

41

34

27

26

165

3

9

1

6

6

25

2

2

0

1

2

7

1

1

0

1

0

3

1

1

0

0

2

4

2

2

2

1

2

9

1

0

0

0

0

1

2

0

1

1

2

6

8

7

6

6

6

33

3

1

2

1

1

8

0

0

0

0

0

0

8

8

5

14

10

45

2

2

1

0

1

6

2

2

0

0

1

5

33

27

26

33

15

134

11

10

7

16

14

58

44

29

29

40

34

176

3

2

1

1

2

9

35

22

29

21

20

127

2

1

1

1

1

6

8

2

5

9

4

28

.

0

1

6

12

19

.

0

5

3

4

12

.

0

13

29

24

66

104

90

77

99

103

473

30

15

16

22

17

100

4

6

1

0

6

17

69

46

53

72

57

297

59

49

49

73

56

286

47

35

41

57

45

225

.

1

3

7

5

16

0

0

0

0

3

3

1990
5438 1132
122

1991
5490 1131 123

Black
1992 1993

5539 1129
124

5592 1128 126

1994 5-year

5642 1127
127

27701 5647 622

18.7 19.9 24.0

19.4 17.9 23.0

18.8 19.0 26.0

20.0 19.2 26.0

19.1 19.1 27.5

19.1 19.0 25.0

23

23

17

17

19

99

8

6

5

2

5

26

82

91

92

98

76

439

18

17

15

14

15

79

57

61

60

67

56

301

4

10

11

8

9

42

1

3

0

1

0

5

26

24

27

37

24

138

5

4

1

3

2

15

0

0

3

1

1

5

0

0

2

1

1

4

0

0

1

0

0

1

1

3

1

2

1

8

0

0

1

0

0

1

0

0

0

1

2

3

11

10

9

9

1

2

3

2

0

0

1

0

12

9

13

10

0

2

1

0

0

2

2

1

9

48

1

9

1

2

7

51

2

5

0

5

28

27

27

29

13

124

29

24

22

31

27

133

28

35

30

26

26

145

6

4

7

1

2

20

10

10

5

5

0

30

4

2

0

1

1

8

6

7

0

6

7

26

.

0

3

3

5

11

.

0

1

3

4

8

.

0

25

4

31

60

39

46

53

62

42

242

20

19

11

14

14

78

0

1

1

2

5

9

62

62

60

80

58

322

48

49

55

70

53

275

39

44

42

64

50

239

.

0

1

2

3

6

0

1

0

0

2

3

216

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Butts County - 018

14.6 72.1
2.2 40.5
4.3 21.2
0.7 211.5
7.1
141.9 29.5 109.7 79.4 25.8 100.0
*
* * * * * *
8.5 * *
9.0 * *
32.4 18.0 32.7
4.1 20.4
2.7 11.4
. . .
65.3 25.3
* 59.0 48.2 38.7
.

13.4 66.6
2.0 42.9
4.2 20.9
0.6 218.9
8.0
131.0 17.1 83.1 65.4 41.5
100.0 *
* * * 23.7 * *
8.3 * *
8.4 * *
32.5 16.7 31.8
3.0 15.8
* 7.9
* * 1.3
66.0 18.9 30.4 53.7 48.8 39.4
*

12.7 64.1 2.0 44.7 3.9 19.6 0.6 210.3 9.7
107.6 29.4 82.3 88.5 * * 19.0
* * * * * *
7.5 2.5
* 9.1
* *
31.9 14.7 29.9
4.1 17.3
* 4.3
1.5 1.5 10.0
66.0 15.6
* 57.4 52.8 42.1
*

14.5 73.7
2.3 45.9
4.1 20.6
0.6 203.8
6.8
112.9 13.9 81.6 73.1 28.2 88.9 *
* * * * * *
6.6 * *
10.5 * *
31.0 20.5 28.8
* 11.4
* 11.7
2.2 1.5 8.2
70.3 17.2
* 66.4 62.9 52.8
3.9

12.8 65.4 2.1 44.0 3.1 16.1 0.5 181.8 7.1
115.0 16.2 83.9 73.1 24.9
100.0 *
* * * * * *
7.4 * *
8.5 * *
16.0 21.0 30.7
* 10.0
* 10.2
4.2 2.2 14.2
72.1 17.6 45.8 58.5 55.5 48.5 4.0

13.6 68.4
2.1 43.6
3.9 19.7
0.6 205.6
7.7
121.6 21.4 88.0 76.1 25.3 97.5
9.5
11.3 6.6 4.7
15.9 *
0.6
7.6 1.6
* 9.2 1.0 0.9
28.8 18.3 30.8
2.8 15.0
1.3 9.2
2.0 1.3 8.4
68.0 19.0 22.6 59.2 53.8 44.4
2.7

14.5 72.9
2.3 23.6
3.8 19.0
0.6 189.7
8.2

11.6 58.7
1.8 23.0
4.1 20.9
0.6 244.0
6.1

10.6 54.4 1.7 26.4 3.4 17.3 0.5 212.5 9.7

12.7 65.8
2.1 29.2
2.6 13.7
0.4 159.8
6.1

12.0 63.0 2.0 25.0 2.5 13.1 0.4 158.5 6.5

12.3 62.9
2.0 25.4
3.3 16.8
0.5 192.8
7.3

113.5 23.8 86.5 56.3
* * *

95.1 *
47.6 *
47.6 100.0
*

87.9 29.4 56.9 72.7
* * 25.9

96.2 *
60.8 50.0 30.4 83.3
*

89.2 *
59.5 41.7 29.7 100.0
*

96.2 16.1 62.1 48.3 25.9 96.0
9.3

*

*

*

*

*

11.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

14.4

*

*

*

*

*

*

*

*

*

*

*

0.7

5.6

6.1

5.6

4.6

4.8

5.3

*

*

*

*

*

1.3

*

*

*

*

*

*

5.7

7.1

4.7

10.8

8.1

7.4

*

*

*

*

*

1.0

*

*

*

*

*

0.8

28.0 7.9
31.7 *
25.2 *
9.6

27.3 8.8
25.9 *
19.6 * *

28.0 6.6 27.4
* 27.6
* 8.2

28.2 12.3 30.8
* 16.2
* 11.8

14.0 11.3 27.6
* 16.1
* *

25.1 9.5
28.9 1.5
20.8 1.0 8.0

.

*

*

2.4

4.6

1.9

.

*

2.0

*

*

1.2

.

*

5.3

11.5

9.3

6.6

74.8 24.6
* 49.3 42.1 33.6
.

78.3 15.3 40.0 40.7 43.4 31.0
*

72.0 17.6
* 50.0 46.2 38.7
*

76.2 18.6
* 55.4 56.2 43.8
5.4

83.7 15.6 40.0 46.0 45.2 36.3 4.0

77.0 18.6 22.7 48.5 46.7 36.7
3.4

15.1 72.4
2.1 69.5
4.8 23.0
0.7 228.1
5.3

16.6 80.5
2.3 68.5
4.4 21.2
0.6 187.5
11.5

16.6 81.5 2.4 65.9 4.9 23.9 0.7 207.7 9.7

17.5 86.9
2.6 68.4
6.6 32.8
1.0 256.9
8.0

13.5 67.5 2.0 75.7 4.3 21.3 0.6 220.2 8.0

15.8 77.7
2.3 69.4
5.0 24.4
0.7 220.8
8.5

188.5 34.8 147.5 100.0 41.0 100.0
*

186.7 26.1
138.0 94.1 * * *

136.8 29.4
120.7 100.0
* * *

135.5 *
111.6 92.9 * * *

150.1 26.3
118.5 100.0
* * *

159.3 26.3
127.1 97.4 24.1 100.0 9.7

*

*

*

*

*

11.4

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

18.0

*

*

*

*

*

*

*

*

*

*

*

*

13.4

11.0

9.8

9.2

11.8

10.9

*

*

*

*

*

2.1

*

*

*

*

*

*

14.8

10.1

14.3

10.2

9.5

11.8

*

*

*

*

*

1.2

*

*

*

*

*

1.1

40.0 35.4 34.6
7.4 12.2
* 15.0

40.9 27.0 39.8
* 11.2
* 14.9

37.0 24.2 33.0 7.7 5.5
* *

34.1 31.6 26.5
* 5.1
* 11.5

19.7 36.5 35.1
* * * 16.3

34.4 30.6 33.6
4.6 6.9 1.8 10.9

.

*

*

*

3.1

1.7

.

*

*

*

*

1.3

.

*

15.9

*

19.3

9.5

48.8 26.3
* 75.6 58.5 47.6
.

51.1 23.5
* 69.7 55.1 49.4
*

58.9 13.4
* 65.9 60.4 46.2
*

63.3 15.6
* 81.6 71.4 65.3
*

55.3

55.8

21.5

19.8

55.6

22.5

78.4

74.2

71.6

63.4

67.6

55.1

*

1.7

217

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Calhoun County - 019

1990
5013 1077
119
18.3 18.4 20.0
11 0
53 7
28 4 2
16 4
0 0 0 2 0 0
2 0 0 1 0 0
11 18 17
0 6 0 1
. . .
40 6 0
37 33 27
. 0

1991
4986 1075 118
21.3 20.1 22.5
9 2 68 8 35 7 0 7 1
0 0 0 0 0 0
6 1 0 9 0 2
25 16 20
1 5 0 6
3 2 3
50 9 0
43 37 31
1 0

Total
1992 1993

4956 1075
117

4932 1074 117

20.0 16.9 22.0

18.6 22.1 22.0

8

9

2

1

69

67

6

9

37

37

5

7

3

0

5

16

2

0

0

1

0

0

0

1

3

0

0

0

1

1

12

9

2

1

0

0

7

7

2

0

0

0

20

33

15

23

14

17

0

0

4

5

0

0

3

2

3

3

3

3

6

6

53

51

10

8

0

1

52

53

48

49

46

45

2

21

0

0

1994 5-year

4898 1070
116

24785 5371 587

20.0 20.3 22.0

19.9 18.4 22.0

17

54

6

11

91

348

13

43

56

193

5

28

0

5

11

55

3

10

0

1

0

0

0

1

0

5

1

1

2

4

11

40

2

6

0

0

11

35

0

2

3

5

32

121

31

103

30

98

0

1

7

27

1

1

8

20

4

13

0

8

28

43

70

264

9

42

2

3

61

246

63

230

55

204

44

68

0

0

1990
2047 379 34

1991
2027 373
33

White
1992 1993

2008 370 33

1989 364
32

1994 5-year

1967 358 31

10038 1844 162

18.3 17.4 18.5

24.3 .
22.0

20.9 .
22.0

28.5 22.1 21.0

22.8 23.3 21.5

22.5 18.6 21.0

4

0

1

0

0

5

0

0

0

0

0

0

16

21

24

18

30

109

2

0

1

0

0

3

4

0

3

2

3

12

2

1

3

1

1

8

1

0

0

0

0

1

5

2

1

5

4

17

2

0

0

0

0

2

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

0

1

0

0

0

0

0

0

0

0

0

1

0

1

0

1

1

1

0

3

0

1

0

0

0

1

0

0

0

0

0

0

0

3

0

0

0

3

0

0

0

0

0

0

0

2

0

0

2

4

2

6

7

6

5

26

3

0

1

1

2

7

4

3

6

4

4

21

0

0

0

0

0

0

2

1

2

2

3

10

0

0

0

0

1

1

0

1

2

0

1

4

.

2

1

0

0

3

.

0

0

2

0

2

.

0

0

0

4

4

14

20

23

16

26

99

3

5

3

5

2

18

0

0

0

1

2

3

7

12

11

10

8

48

6

4

9

7

9

35

4

4

8

7

7

30

.

0

0

2

5

7

0

0

0

0

0

0

1990
2953 695 85

1991
2937 693
84

Black
1992 1993

2919 692 84

2905 691
83

1994 5-year

2885 688 83

14600 3459 419

19.2 18.5 23.5

19.0 20.1 23.0

19.9 16.9 22.0

18.5 20.4 22.0

19.2 15.5 28.5

19.1 18.3 24.0

7

9

7

9

17

49

0

2

2

1

6

11

37

46

45

49

61

238

5

8

5

9

13

40

24

35

34

35

53

181

2

6

2

6

4

20

1

0

3

0

0

4

11

5

4

11

7

38

2

1

2

0

3

8

0

0

0

1

0

1

0

0

0

0

0

0

0

0

0

1

0

1

1

0

3

0

0

4

0

0

0

0

1

1

0

0

1

0

2

3

2

5

11

8

11

37

0

0

2

1

2

5

0

0

0

0

0

0

1

6

7

7

11

32

0

0

2

0

0

2

0

0

0

0

1

1

9

19

13

27

27

95

15

16

14

22

29

96

13

17

8

13

26

77

0

1

0

0

0

1

4

4

2

3

4

17

0

0

0

0

0

0

1

5

1

2

7

16

.

1

2

3

3

9

.

2

3

1

0

6

.

2

6

6

23

37

26

29

30

35

44

164

3

3

7

3

7

23

0

0

0

0

0

0

30

31

41

43

53

198

27

33

39

42

54

195

23

27

38

38

48

174

.

1

2

19

39

61

0

0

0

0

0

0

218

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

10.6

13.6

General fertility rate

49.2

63.3

Total fertility rate

1.5

1.8

% Livebirths to unmarried women

52.8

51.5

Crude abortion rate

3.2

1.4

General abortion rate

14.9

6.5

Total abortion rate

0.4

0.2

Abortion ratio

207.8

84.3

Fetal Death rate

7.4

7.4

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

92.4

76.3

% Repeat conceptions to women under 18

*

*

Livebirths to women under 18

58.8

67.9

% Livebirths to unmarried women under 18

100.0 100.0

Induced abortions to women under 18

*

*

% Abortions to unmarried women under 18

*

*

Fetal deaths to women under 18

*

*

Infant and child survival rates

Infant mortality

*

*

Neonatal mortality

*

*

Postneonatal mortality

*

*

Perinatal mortality ratio

*

*

Deaths of children 1-4 yrs

*

*

Deaths of children 5-17 yrs

*

*

Infant health rates

% Low birthweight

*

8.8

% Very low birthweight

*

*

% Under 500 grams

*

*

% Preterm gestation

*

13.4

% Multiple gestation

*

*

% Birth defect

*

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

27.5

42.4

% with father not named on birth certificate

34.0

23.5

% with maternal education less than high school

32.1

29.4

% No prenatal care

*

*

% Maternal smoking during pregnancy

11.3

7.4

% Maternal alcohol use during pregnancy

*

*

% Interpregnancy interval less than 6 months

*

14.6

Child abuse and neglect rates

Physical

.

*

Sexual

.

*

Neglect

.

*

Interventions to improve infant & child survival

% Prenatal care first trimester

78.4

78.1

% Primary C-section delivery

13.0

14.1

% Vaginal birth after previous C-section

*

*

% WIC during pregnancy

69.8

63.2

% Medicaid during pregnancy

62.3

54.4

% Medicaid and WIC during pregnancy

50.9

45.6

% Perinatal case management

.

*

Calhoun County - 019

13.9 64.2 1.9 55.2 1.0
4.7 0.1 61.0 7.4

13.6 62.4
1.8 56.1
3.2 14.9
0.5 173.9
8.4

18.6 85.0 2.5 61.5 2.2 10.3 0.3 101.9
5.6

14.0 64.8
1.9 55.9
2.2 10.2
0.3 124.4
7.3

68.2 *
51.2 83.3
* * *

77.1 *
77.1 75.0
* * *

147.1 35.3
112.5 100.0
* * *

92.1 20.4 73.3 92.9 17.0 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

14.2

*

*

*

*

*

*

*

*

17.4 * *
10.4 * *

13.4 * *
10.4 * *

12.1 * *
12.1 * *

11.5 1.7 *
10.1 *
1.5

34.5 22.4 20.9
* * * *

55.9 34.3 25.8
* 7.7
* *

39.0 34.1 33.0
* 8.0
* 18.6

40.6 29.8 28.4
* 7.9
* 10.0

*

*

*

2.3

*

*

*

1.4

4.3

4.3

20.7

7.7

77.9 16.1
* 77.6 71.6 68.7
*

78.5 13.1
* 79.1 73.1 67.2 31.3

76.9 10.5
* 67.0 69.2 60.4 48.4

77.9 13.2
* 71.1 66.5 59.0 23.2

7.8 42.2
1.3 *
2.4 13.2
0.4 208.3
*
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
. . .
93.3 * *
43.8 37.5
* .

10.4 56.3
1.8 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
28.6 * * * * * *
* * *
95.2 25.0
* 57.1
* * *

12.0 64.9 2.1
* * * * * *

9.0 49.5
1.6 *
2.5 13.7
0.5 208.3
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

30.4 *
25.0 * * * *

37.5 * * * * * *

*

*

*

*

*

*

95.8 * *
45.8 37.5 33.3
*

94.1 33.3
* 55.6 38.9 38.9
*

15.3 83.8 2.7
* * * * * *

10.9 59.1
1.9 11.0
1.7 9.2 0.3 125.0 5.4

*

30.9

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

18.5 * * * * * *

25.2 6.4
19.4 *
9.5 * *

*

*

*

*

*

*

86.7 * *
26.7 30.0 23.3 16.7

92.5 19.4
* 44.0 32.1 27.5
7.5

12.5 53.2
1.6 64.9
3.7 15.8
0.4 207.5
7.2

15.7 66.4
1.8 76.1
1.7 7.2 0.2 86.2 10.1

15.4 65.0 1.9 79.1
* * * * 7.2

16.9 70.9
2.0 72.9
3.8 15.9
0.5 161.8
11.6

21.1 88.7 2.5 86.9 2.4 10.2 0.3 97.2
*

16.3 68.8
2.0 77.0
2.6 11.0
0.3 124.6
8.4

82.4 *
58.8 100.0
* * *

106.9 *
95.0 100.0
* * *

83.5 *
59.7 100.0
* * *

107.9 *
107.9 75.0 * * *

205.8 35.3
157.4 100.0
* * *

116.9 22.4 95.5 94.9 19.1 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

10.9

24.4

16.3

18.0

15.5

*

*

*

*

*

2.1

*

*

*

*

*

*

*

13.3

16.3

14.3

18.0

13.6

*

*

*

*

*

*

*

*

*

*

*

*

37.5 40.5 35.1
* * * *

51.4 34.8 37.0
* * * 16.7

37.1 32.6 18.6
* * * *

62.8 44.9 26.5
* * * *

49.1 47.5 42.6
* * * 25.9

49.0 40.7 32.6
* 7.2
* 11.9

.

*

*

*

*

2.3

.

*

*

*

*

1.5

.

*

6.1

6.2

24.4

9.5

72.2 * *
81.1 73.0 62.2
.

69.0 * *
67.4 71.7 58.7
*

68.2 . *
95.3 90.7 88.4
*

72.9 * *
87.8 85.7 77.6 38.8

72.1

71.0

11.9

10.2

*

*

86.9

83.9

88.5

82.6

78.7

73.7

63.9

30.7

219

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Camden County - 020

1990
30167 7538 596
21.4 17.0 21.0
45 12 656 41 123 35
7 8 1
3 2 1 9 1 0
42 3 0
54 8
14
137 73 119
9 92
6 27
. . .
435 77
4 220 109 84
. 1

1991
31349 7747 628
20.8 19.3 21.0
42 8
724 42
137 28 0 7 0
9 6 3 6 0 3
53 12
2 64
7 6
88 93 130
3 56
9 26
17 1
60
532 52 6
314 138 108
3 0

Total
1992 1993

32533 7953 661

33714 8164 693

21.3 17.6 21.0

21.6 .
21.0

49

22

10

5

817

732

48

22

156

133

8

2

2

1

7

2

3

0

4

6

2

5

2

1

4

7

0

2

3

2

67

36

8

9

0

1

65

57

16

2

10

2

96

68

109

73

142

97

4

5

63

24

5

1

36

41

22

23

9

21

101

155

642

625

53

26

5

8

374

278

69

69

57

52

15

31

0

2

1994 5-year

34894 8371 725

162657 39773 3303

21.7 .
21.0

21.3 18.6 21.0

37

195

9

44

747

3676

37

190

134

683

2

75

2

12

2

26

0

4

7

29

5

20

2

9

6

32

5

8

3

11

49

247

7

39

1

4

65

305

11

44

8

40

165

554

85

433

80

568

1

22

67

302

11

32

29

159

24

86

5

36

93

409

611

2845

46

254

4

27

354

1540

167

552

139

440

98

147

7

10

1990
23284 5709 423

1991
24260 5877 452

White
1992 1993

25234 6044 481

26212 6213 510

1994 5-year

27184 6380 539

126174 30223 2404

21.7 17.0 20.0

21.5 19.1 20.0

21.8 17.6 21.0

21.6 .
20.0

21.9 .
20.0

21.7 18.1 20.0

28

29

31

12

26

126

6

5

4

1

6

22

490

554

618

551

597

2810

25

29

30

12

26

122

52

59

66

67

70

314

23

21

5

1

2

52

5

0

0

1

2

8

5

2

4

2

2

15

1

0

2

0

0

3

2

4

3

5

4

18

1

2

1

4

3

11

1

2

2

1

1

7

6

2

2

6

4

20

0

0

0

2

2

4

0

1

3

2

1

7

23

35

40

17

36

151

2

6

4

3

2

17

0

0

0

0

0

0

35

44

43

34

47

203

3

5

10

2

11

31

8

1

9

1

2

21

99

57

71

43

121

391

38

42

50

31

47

208

90

97

100

74

63

424

5

0

1

4

0

10

87

50

57

20

60

274

6

7

5

1

8

27

19

19

23

29

22

112

.

12

11

15

18

56

.

1

9

17

4

31

.

34

59

99

47

239

350

435

508

486

502

2281

52

42

41

18

34

187

2

5

3

7

4

21

146

210

258

197

273

1084

60

78

39

39

113

329

47

58

34

31

96

266

.

2

6

18

68

94

0

0

0

1

2

3

1990
6079 1577
151

1991
6317 1621 159

Black
1992 1993

6556 1664
167

6794 1709 176

1994 5-year

7032 1752
184

32777 8324 837

21.0 .
23.0

19.7 20.1 22.0

20.3 18.3 23.0

21.0 .
22.0

20.4 .
22.5

20.5 20.1 22.5

16

13

18

10

10

67

5

3

6

4

3

21

158

158

183

160

130

789

15

13

18

10

10

66

71

78

87

65

61

362

12

7

3

1

0

23

2

0

2

0

0

4

3

4

3

0

0

10

0

0

1

0

0

1

1

5

1

1

3

11

1

4

1

1

2

9

0

1

0

0

1

2

3

4

2

1

2

12

1

0

0

0

3

4

0

2

0

0

2

4

18

18

26

19

13

94

1

6

4

6

5

22

0

2

0

1

1

4

18

20

21

22

17

98

5

1

6

0

0

12

6

5

1

1

5

18

36

28

25

20

40

149

35

51

59

41

36

222

28

32

39

22

14

135

4

3

3

1

1

12

4

6

6

3

5

24

0

2

0

0

2

4

8

6

12

11

7

44

.

4

10

4

4

22

.

0

0

2

1

3

.

24

30

42

36

132

79

88

122

123

24

9

11

8

2

1

1

1

70

102

110

74

48

60

30

28

36

50

23

20

.

1

9

12

1

0

0

1

97

509

10

62

0

5

72

428

49

215

39

168

28

50

5

7

220

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

21.7

23.1

25.1

21.7

21.4

22.6

General fertility rate

87.0

93.5 102.7

89.7

89.2

92.4

Total fertility rate

2.3

2.5

2.8

2.5

2.4

2.5

% Livebirths to unmarried women

19.0

19.2

19.5

18.3

18.3

18.9

Crude abortion rate

0.3

0.2

0.2

*

*

0.2

General abortion rate

1.1

0.9

0.9

*

*

0.7

Total abortion rate

0.0

0.0

0.0

*

*

0.0

Abortion ratio

11.3

9.2

8.4

*

*

6.9

Fetal Death rate

5.7

3.6

1.3

*

*

2.2

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

75.5

66.8

74.2

31.8

51.0

59.0

% Repeat conceptions to women under 18

26.7

19.0

20.4

22.7

24.3

22.6

Livebirths to women under 18

68.8

66.8

72.7

31.8

51.0

57.5

% Livebirths to unmarried women under 18

51.2

61.9

69.6

63.6

64.9

62.2

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

1.5

Infant and child survival rates

Infant mortality

*

12.4

*

8.2

9.4

7.9

Neonatal mortality

*

8.3

*

6.8

6.7

5.4

Postneonatal mortality

*

*

*

*

*

2.5

Perinatal mortality ratio

13.6

.

*

9.5

8.0

8.7

Deaths of children 1-4 yrs

*

*

*

*

1.6

0.6

Deaths of children 5-17 yrs

*

*

*

*

*

0.3

Infant health rates

% Low birthweight

6.4

7.3

8.2

4.9

6.6

6.7

% Very low birthweight

*

1.7

1.0

1.2

0.9

1.1

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

8.3

9.0

8.1

7.8

8.8

8.4

% Multiple gestation

1.2

1.0

2.0

*

1.5

1.2

% Birth defect

2.7

1.6

2.8

*

1.9

2.1

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

27.8

24.9

28.5

33.5

40.1

30.8

% with father not named on birth certificate

11.3

13.0

13.6

10.0

11.5

11.9

% with maternal education less than high school

18.4

18.3

17.8

13.4

11.2

15.8

% No prenatal care

1.4

*

*

0.7

*

0.6

% Maternal smoking during pregnancy

18.0

15.3

18.2

11.5

16.1

16.4

% Maternal alcohol use during pregnancy

1.2

2.5

1.4

*

2.7

1.7

% Interpregnancy interval less than 6 months

7.5

6.5

7.6

9.2

6.5

7.5

Child abuse and neglect rates

Physical

.

1.7

2.1

2.1

2.0

2.0

Sexual

.

*

0.9

1.9

0.4

0.8

Neglect

.

6.1

9.7

14.0

7.9

9.5

Interventions to improve infant & child survival

% Prenatal care first trimester

67.0

73.8

79.2

86.3

82.9

78.1

% Primary C-section delivery

13.1

7.8

6.9

3.7

6.7

7.4

% Vaginal birth after previous C-section

*

13.0

14.3

28.6

*

12.3

% WIC during pregnancy

34.0

43.9

46.7

38.1

48.0

42.4

% Medicaid during pregnancy

16.8

19.3

8.6

9.5

22.7

15.2

% Medicaid and WIC during pregnancy

13.0

15.1

7.1

7.1

18.9

12.1

% Perinatal case management

.

*

1.9

4.2

13.3

4.9

Camden County - 020

21.0 85.8
2.3 10.7
0.2 0.9
* 9.5 5.1
66.2 21.4 59.1 32.0
* * *
* * * 12.1 * *
4.7 * *
7.2 *
2.1
26.5 7.8
18.5 1.0
22.7 1.6 6.9
. . .
72.3 11.8
* 30.0 12.3
9.7 .

22.8 94.3
2.6 10.8
* * * * 3.6

24.5 102.3
2.8 10.9
* * * * 0.8

64.2 17.2 64.2 48.3
* * *

64.5 *
62.4 55.2
* * *

*

*

*

*

*

*

*

*

*

*

*

*

6.3

6.5

1.1

*

*

*

8.0

7.1

0.9

1.6

*

3.3

21.5 7.7
17.8 *
18.1 2.5 6.2

27.6 8.2 16.5
* 21.5
1.9 6.6

1.6

1.4

*

1.1

4.6

7.4

78.7 8.2
14.7 38.3 14.2 10.6
*

82.6 7.0
* 42.4 6.4
5.6 1.0

21.0 88.7
2.4 12.2
* * * * *
23.5 *
23.5 41.7
* * *
9.1 * *
10.9 * *
3.1 * *
6.2 * *
30.3 5.6
13.5 *
13.8 *
8.9
1.8 2.0 11.7
89.0 3.4
31.8 35.9
7.1 5.6 3.3

22.0 93.6 2.6 12.0
* * * * *
48.3 23.1 48.3 53.8
* * *
* * * * * *
6.0 * *
8.0 1.9
*
38.4 8.0
11.0 *
18.9 2.5 6.2
2.0 *
5.2
85.4 6.2
* 46.5 19.3 16.4 11.6

22.3 93.0
2.5 11.3
0.1 0.5 0.0 5.2 2.0
52.4 17.5 50.7 47.1
* * *
6.4 3.9 2.5 7.1
* *
5.4 0.6
* 7.3 1.1 1.5
28.9 7.5
15.4 0.4
19.8 1.9 7.0
1.7 0.9 7.3
81.9 7.2
12.8 39.0 11.8
9.6 4.1

26.0 100.2
2.6 46.4
* * * * 8.9
106.0 31.3 99.3 86.7 * * *
* * * * * *
11.4 * *
11.8 3.3 4.8
32.1 22.9 18.5
* * * 9.8
. . .
50.3 17.1
* 45.8 31.4 23.5
.

25.0 97.5
2.5 49.7
* * * * 4.3

27.9 109.9
2.8 49.2
* * * * 3.0

81.7 *
81.7 92.3
* * *

107.6 33.3
107.6 94.1 * * *

31.6

*

*

*

*

*

*

*

*

*

*

*

11.4

14.3

3.8

*

*

*

12.7

11.9

*

3.4

6.1

*

34.6 32.5 20.4
* 7.3
* 6.7

34.2 33.3 22.2
* 8.1
* 10.7

* * 11.1

4.3 *
13.0

56.4 6.2 *
65.0 38.2 31.8
*

67.8 6.6
* 62.1 16.9 13.0
5.1

23.6 93.6
2.5 40.9
* * * * *
57.0 *
57.0 90.0
* * *
* * * * * *
11.9 3.8 *
13.8 * *
37.7 25.6 13.9
* * * 10.4
* * 17.2
78.3 5.2 *
46.3 17.5 12.5
7.5

18.5 74.2 1.9 47.3
* * * * *

24.1 94.8
2.4 46.7
0.3 1.2 0.0 12.1 3.2

54.4 *
54.4 90.0
* * *

80.1 31.3 78.9 90.8
* * *

*

13.9

*

11.4

*

*

*

15.1

*

*

*

*

10.0 3.8
* 13.1
* 6.0

11.9 2.8 *
12.6 1.5 4.2

48.8 27.7 11.6
* 6.0
* 9.0

37.2 28.6 17.7
1.6 5.8
* 9.4

* * 13.9

2.3 *
13.9

75.2

65.3

8.4

8.5

*

10.0

55.4

55.1

37.7

27.7

30.0

21.6

21.5

8.0

221

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Candler County - 021

1990
7744 1673
207
20.1 17.8 21.0
25 9
134 20 53 12
2 13
4
0 0 0 2 0 1
9 1 0 9 0 0
49 30 57
2 21 16
9
. . .
85 23
1 89 57 49
. 0

1991
7791 1666 203
20.6 18.8 20.0
21 8
136 19 57 9 1 13 2
1 0 1 1 0 1
6 0 0 4 2 2
35 38 62
1 25 13 10
1 1 16
78 22
3 106
88 79 25
0

Total
1992 1993

7828 1659
199

7878 1651 195

19.9 18.3 22.0

20.8 18.5 21.5

25

18

8

4

120

133

20

15

49

47

17

12

2

1

14

21

3

3

0

1

0

1

0

0

2

2

0

0

1

1

5

13

0

1

0

1

12

9

0

2

0

0

39

48

29

32

45

44

1

0

23

11

5

5

4

4

7

4

7

7

34

28

92

86

28

21

2

4

92

91

69

99

65

82

49

54

0

0

1994 5-year

7915 1645
192

39156 8294 997

20.4 17.5 22.0

20.5 18.4 21.0

23

112

4

33

137

660

18

92

54

260

12

62

2

8

18

79

4

16

1

3

1

2

0

1

3

10

0

0

1

5

10

43

3

5

1

2

14

48

2

6

2

4

40

211

37

166

55

263

2

6

20

100

5

44

7

34

10

22

12

27

46

124

83

424

36

130

1

11

94

472

95

408

82

357

61

189

1

1

1990
5238 1093
131

1991
5260 1088 129

White
1992 1993

5280 1083
126

5304 1077 123

1994 5-year

5323 1073
121

26405 5414 629

23.5 18.8 21.0

20.9 18.1 20.0

20.8 18.3 21.0

22.9 20.0 20.0

20.9 20.6 21.0

21.4 18.8 21.0

14

11

7

10

12

54

6

4

0

3

2

15

81

77

71

76

82

387

12

10

6

8

9

45

19

17

12

13

18

79

7

4

12

9

9

41

1

1

1

0

0

3

8

6

10

13

10

47

2

1

1

1

2

7

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

1

0

0

3

0

0

0

0

0

0

1

0

0

1

1

3

3

1

1

4

6

15

0

0

0

0

1

1

0

0

0

0

0

0

3

3

6

6

8

26

0

0

0

1

0

1

0

1

0

0

0

1

30

10

20

24

19

103

11

13

5

6

10

45

32

33

22

25

34

146

0

0

0

0

1

1

16

18

16

9

15

74

6

10

1

3

2

22

6

3

2

2

3

16

.

1

4

2

7

14

.

0

2

2

7

11

.

2

13

6

27

48

56

52

63

62

52

285

16

11

16

11

20

74

1

1

2

3

0

7

53

59

49

42

51

254

26

40

34

47

50

197

26

38

33

37

41

175

.

5

24

25

31

85

0

0

0

0

1

1

1990
2405 557 73

1991
2420 555
72

Black
1992 1993

2431 552 70

2447 550
69

1994 5-year

2458 547 68

12160 2761 351

18.0 16.8 22.5

18.9 19.0 20.0

18.1 .
23.5

19.5 17.4 24.0

19.9 15.8 27.0

18.7 17.2 24.0

11

10

18

8

11

58

3

4

8

1

2

18

53

59

48

57

53

270

8

9

14

7

9

47

34

40

37

34

35

180

5

5

5

3

3

21

1

0

1

1

2

5

5

7

4

8

8

32

2

1

2

2

2

9

0

1

0

1

1

3

0

0

0

1

1

2

0

1

0

0

0

1

1

0

1

2

3

7

0

0

0

0

0

0

0

1

1

0

0

2

6

5

4

9

4

28

1

0

0

1

2

4

0

0

0

1

1

2

6

1

6

3

6

22

0

2

0

1

2

5

0

1

0

0

2

3

19

25

19

24

21

108

19

25

24

26

26

120

25

29

23

19

20

116

2

1

1

0

1

5

5

7

7

2

4

25

10

3

4

2

3

22

3

7

2

2

4

18

.

0

3

2

3

8

.

0

2

3

5

10

.

13

19

22

17

71

29

26

28

24

31

138

7

11

12

10

16

56

0

2

0

1

1

4

36

47

43

49

42

217

31

48

35

52

43

209

23

41

32

45

40

181

.

20

25

29

29

103

0

0

0

0

0

0

222

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Candler County - 021

17.3 80.1
2.4 39.6
1.7 7.8 0.2 80.2 9.0
120.8 36.0 96.6 70.0 * * *
* * * * * *
6.7 * *
6.7 * *
39.8 22.4 42.9
* 15.7 11.9 11.0
. . .
63.9 19.0
* 66.4 42.5 36.6
.

17.5 81.6
2.5 42.5
1.7 7.8 0.2 81.8 6.0
103.3 38.1 93.5 52.6 * * *
* * * * * *
4.4 * * * * *
27.8 28.4 46.3
* 18.7
9.7 12.5
* * 7.5
58.6 19.1
* 79.1 65.7 59.0 18.7

15.3 72.3 2.2 40.8 1.8
8.4 0.3 90.3 12.7
125.6 32.0
100.5 85.0 * * *
* * * * * *
4.2 * *
10.0 * *
35.5 24.2 37.5
* 19.2
4.2 *
3.2 3.2 15.8
76.7 25.5
* 76.7 57.5 54.2 40.8

16.9 80.6
2.5 35.9
2.7 12.7
0.4 125.7
7.9
92.1 *
76.8 71.4
* * *
* * * * * *
9.8 * *
6.9 * *
41.4 24.4 33.6
* 8.5 3.8
*
* 3.2 12.8
65.6 18.4
* 69.5 75.6 62.6 41.2

17.3 83.3 2.6 40.0 2.3 10.9 0.3 105.9
9.1
119.9 *
93.8 77.8
* * *
* * * * * *
7.3 * *
10.4 * *
34.2 27.4 41.7
* 14.9
3.7 10.9
4.5 5.4 20.8
66.4 29.5
* 69.6 70.4 60.7 45.2

16.9 79.6
2.4 39.8
2.0 9.5 0.3 97.2 8.9
112.4 29.5 92.3 71.4 16.1 100.0
5.0
* * * 15.0 * 0.6
6.5 0.8
* 7.4 0.9
*
35.6 25.4 40.5
0.9 15.3
6.7 9.4
2.5 3.1 14.3
66.0 22.3 15.3 72.2 62.4 54.6 36.3

15.5 74.1
2.3 23.5
1.5 7.3 0.2 82.5 7.3
106.9 42.9 91.6 58.3
* * *
* * * * * *
* * * * * *
39.0 13.6 39.5
* 19.8
7.4 13.3
. . .
69.1 21.6
* 65.4 32.1 32.1
.

14.6 70.8
2.3 22.1
1.1 5.5 0.2 68.2 4.6

13.4 65.6 2.1 16.9 1.9
9.2 0.3 106.4 12.0

14.3 70.6
2.2 17.3
2.5 12.1
0.4 132.7
8.4

85.5 *
77.8 * * * *

55.7 *
47.8 * * * *

81.1 *
64.9 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

8.5

8.0

*

*

*

*

*

*

13.9 16.9 42.9
* 23.4 13.0
*

30.8 7.0 31.0
* 22.5
* *

36.9 8.0
33.3 *
12.2 * *

*

*

*

*

*

*

*

10.4

4.7

70.3 16.4
* 76.6 51.9 49.4
6.5

88.7 26.2
* 69.0 47.9 46.5 33.8

82.7 17.7
* 56.0 62.7 49.3 33.3

15.4 76.4 2.4 22.0 1.9 9.3 0.3 99.0
8.4

14.7 71.5
2.3 20.5
1.8 8.7 0.3 98.3 8.1

99.3 *
74.4 55.6
* * *

85.8 27.8 71.5 53.3 11.1 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

7.3

3.9

*

*

*

*

9.8

6.7

*

*

*

*

26.8 12.2 42.5
* 18.3
* *

29.4 11.7 38.0
* 19.2
5.7 7.8

5.5

2.8

5.5

2.2

21.1

9.5

68.4 27.0
* 62.2 61.0 50.0 37.8

75.6 21.9 14.6 65.8 51.0 45.3 27.9

22.0 95.2
2.7 64.2
2.1 9.0 0.3 76.9 12.6

24.4 106.4
3.0 70.2
2.9 12.6
0.4 98.6
9.0

19.7 86.9 2.5 77.1
* * * * 14.5

23.3 103.7
3.1 60.7
3.3 14.6
0.4 115.9
*

21.6 96.8 2.9 68.6 3.3 14.6 0.4 119.4 11.0

22.2 97.8
2.8 67.9
2.6 11.6
0.3 96.4 10.9

150.7 *
109.6 87.5
* * *

139.5 *
125.5 66.7 * * *

256.4 44.4
199.4 92.9 * * *

116.1 *
101.6 100.0
* * *

162.7 *
133.1 100.0
* * *

165.1 31.0
133.8 89.1 25.6 100.0 *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

25.5

*

*

*

*

*

*

*

*

*

*

*

*

11.3 * *
11.3 * *

8.5

*

15.8

*

10.4

*

*

*

*

*

*

*

*

*

*

*

12.5

*

11.8

8.3

*

*

*

*

1.9

*

*

*

*

*

41.3 35.8 48.1
* 9.4 18.9
*

46.3 43.9 50.9
* 12.3
* 18.9

43.2 50.0 47.9
* 14.6
* *

47.1 46.4 33.9
* * * *

47.7 51.0 40.0
* * * *

45.2 45.3 44.1
1.9 9.5 8.3 11.3

.

*

*

*

*

2.3

.

*

*

*

5.7

2.9

.

15.2

22.0

25.2

19.2

20.4

55.8 14.9
* 67.9 58.5 43.4
.

44.1 22.9
* 82.5 84.2 71.9 35.1

58.3 . *
89.6 72.9 66.7 52.1

42.9 19.2
* 87.5 92.9 80.4 51.8

66.0

52.7

34.8

23.2

*

*

82.4

81.9

84.3

78.9

78.4

68.3

56.9

48.6

223

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Carroll County - 022

1990
71422 18108
1624
20.7 19.6 21.0
179 45 1194 132 316 120 10 320 38
8 6 2 16 3 4
97 15
1 93 21 85
321 153 350 25 301 15 66
. . .
860 146 31 526 414 331
. 0

1991
72882 18362
1637
20.7 20.1 21.0
155 36
1187 122 344 123
12 274
25
17 9 8
20 3 9
81 13
0 82
8 154
306 151 367
18 266
6 55
19 18 53
873 132
22 591 491 423
34 1

Total
1992 1993

74334 18615
1650

75793 18868
1663

20.5 19.3 21.0

20.3 20.1 21.0

182 33
1168 136 345 122 16 293 37

152 29
1132 121 345 140
13 292
24

5

4

3

2

2

2

19

15

1

1

6

2

72

100

14

18

0

1

80

101

8

12

188

229

307

324

153

176

358

354

11

21

244

219

9

8

67

50

48

57

80

63

239

239

887

871

152

128

21

32

586

588

556

595

450

486

159

143

0

3

1994 5-year

77245 19122
1677

371676 93075
8251

21.0 20.2 22.0

20.7 19.9 21.0

167 33
1203 124 372 111 12 280 29

835 176 5884 635 1722 616 63 1459 153

10

44

8

28

2

16

20

90

3

11

6

27

101

451

13

73

1

3

88

444

13

62

130

786

345

1603

159

792

330

1759

12

87

224

1254

15

53

59

297

50

174

47

208

263

794

950

4441

131

689

17

123

592

2883

624

2680

486

2176

177

513

10

14

1990
59646 14668
1314

1991
60978 14909
1326

White
1992 1993

62307 15149
1337

63639 15390
1349

1994 5-year

64968 15630
1361

311538 75746
6686

21.3 19.5 20.0

21.4 20.2 21.0

21.2 19.7 21.0

21.1 20.2 21.0

21.4 20.0 22.0

21.3 19.9 21.0

123

114

126

109

119

591

28

27

20

22

20

117

938

938

930

873

948

4627

87

87

89

87

88

438

149

178

179

176

188

870

90

103

99

106

99

497

7

9

11

9

9

45

232

210

221

188

185

1036

31

20

29

17

20

117

4

13

4

3

5

3

1

8

1

11

13

14

3

3

1

4

8

3

2

5

28

0

3

14

2

2

14

9

12

59

1

1

9

1

6

22

64

52

49

63

67

295

9

8

9

14

3

43

0

0

0

0

0

0

66

57

58

70

59

310

17

5

6

6

11

45

60

120

154

170

108

612

231

228

235

232

247

1173

68

77

82

88

87

402

266

301

272

271

247

1357

11

7

6

8

3

35

277

241

225

201

204

1148

10

4

7

7

11

39

42

35

51

37

43

208

.

8

38

39

38

123

.

13

56

52

34

155

.

33

122

133

174

462

727

731

727

705

776

3666

120

111

118

92

101

542

23

16

16

22

15

92

345

411

410

392

408

1966

279

342

389

407

434

1851

223

299

307

322

331

1482

.

22

92

83

100

297

0

0

0

1

8

9

1990
11231 3269 295

1991
11461 3309 297

Black
1992 1993

11689 3349 300

11918 3389 302

1994 5-year

12147 3430
305

58446 16747
1499

19.6 20.6 24.0

19.1 19.0 23.0

18.8 18.9 25.0

18.9 19.3 25.5

19.6 20.7 25.0

19.1 19.4 25.0

55

41

55

43

48

242

17

9

13

7

13

59

253

242

235

255

248

1233

45

35

47

34

36

197

167

166

165

169

183

850

29

20

23

30

11

113

3

3

5

4

3

18

76

54

62

96

83

371

6

5

7

7

9

34

4

4

1

1

5

15

3

4

0

1

5

13

1

0

1

0

0

2

5

7

5

6

8

31

0

0

0

0

2

2

0

1

3

1

0

5

33

29

23

37

34

156

6

5

5

4

10

30

1

0

0

1

1

3

27

25

22

31

29

134

4

2

2

6

2

16

24

33

33

58

22

170

90

76

72

91

96

425

85

74

71

88

71

389

83

66

85

83

82

399

14

11

5

13

9

52

24

25

19

18

20

106

5

2

2

1

4

14

24

20

16

13

16

89

.

6

9

18

12

45

.

1

21

7

11

40

.

13

103

85

80

281

132

139

157

162

168

758

25

20

34

36

30

145

8

6

5

10

2

31

180

179

174

194

183

910

134

148

166

186

188

822

107

123

142

162

154

688

.

12

66

59

77

214

0

0

0

2

2

4

224

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Carroll County - 022

16.7 65.9
1.8 27.0
4.5 17.7
0.5 193.2
7.8
110.2 25.1 81.3 59.8 23.4 97.4
8.6
6.7 5.0
* 13.3
* *
8.1 1.3
* 7.9 1.8 7.1
30.0 13.1 30.0
2.1 25.8
1.3 9.9
. . .
72.7 14.4 19.6 44.9 35.3 28.2
.

16.3 64.6
1.8 29.2
3.8 14.9
0.4 170.1
8.2
94.7 23.2 74.5 59.2 15.3 100.0
6.1
14.3 7.6 6.8
16.7 *
0.6
6.8 1.1
* 7.0 0.7 13.1
29.1 12.8 31.4
1.5 22.8
0.5 8.3
1.0 0.9 2.7
73.9 12.3 20.8 50.1 41.6 35.9
2.9

15.7 62.7 1.8 29.8 3.9 15.7 0.4 182.7
7.7
110.3 18.1 82.4 62.2 22.4
100.0 6.7
4.3 * *
16.0 *
0.4
6.2 1.2
* 6.9 0.7 16.1
29.7 13.2 31.0
1.0 21.1
0.8 10.6
2.4 4.0 12.0
76.4 14.3 21.6 50.6 48.0 38.8 13.7

14.9 60.0
1.7 30.8
3.9 15.5
0.4 184.6
8.4
91.4 19.1 72.7 63.6 14.4 95.5
4.2
* * * 13.1 * *
8.8 1.6
* 9.0 1.1 20.3
31.5 15.7 31.7
1.9 19.6
0.7 7.9
2.8 3.1 11.8
77.1 12.7 28.3 52.5 53.2 43.4 12.8

15.6 62.9 1.8 31.2 3.6 14.6 0.4 172.8
7.2
99.6 19.8 74.0 63.7 17.3 92.9 8.4
8.3 6.7
* 16.5
* 0.4
8.4 1.1
* 7.4 1.1 10.8
30.6 13.4 27.8
1.0 18.8
1.3 9.4
2.4 2.3 12.8
80.9 12.1 16.3 49.7 52.4 40.8 14.9

15.8 63.2
1.8 29.6
3.9 15.7
0.4 180.7
7.8
101.2 21.1 77.0 61.7 18.5 97.3
6.8
7.5 4.8 2.7 15.1 0.5 0.4
7.7 1.2
* 7.6 1.1 13.4
30.2 13.6 30.4
1.5 21.6
0.9 9.2
2.2 2.6 9.9
76.2 13.1 21.3 49.5 46.0 37.4 11.0

15.7 63.9
1.8 16.2
3.9 15.8
0.4 181.8
7.2

15.4 62.9
1.8 19.1
3.4 14.1
0.4 165.1
8.3

14.9 61.4 1.8 19.4 3.5 14.6 0.4 174.7
7.5

13.7 56.7
1.7 20.3
3.0 12.2
0.4 159.2
7.8

14.6 60.7 1.8 20.0 2.8 11.8 0.3 147.8
7.6

14.9 61.1
1.8 19.0
3.3 13.7
0.4 165.9
7.7

93.6 22.8 66.2 39.8 23.6 96.8
6.8

86.0 23.7 65.6 44.7 15.1 100.0
6.8

94.2 15.9 66.6 44.3 21.7 100.0 7.5

80.8 20.2 64.5 52.9 12.6 93.8
3.7

87.5 16.8 64.7 48.9 14.7 90.0 8.1

88.4 19.8 65.5 46.2 17.5 96.6
6.6

* * * 11.6 * *

13.9 5.3 8.6
13.7 *
0.7

* * * 14.9 * *

* * * 10.2 * *

5.3 * *
12.5 *
0.5

6.1 3.0 3.0 12.6 0.5 0.4

6.8

5.5

5.3

7.2

7.1

6.4

1.0

0.9

1.0

1.6

*

0.9

*

*

*

*

*

*

7.2

6.1

6.3

8.1

6.3

6.8

1.8

0.5

0.7

0.7

1.2

1.0

6.4

12.9

16.6

19.5

11.4

13.3

27.3 7.4
29.1 1.2
30.2 1.1 8.2

26.8 8.3
32.4 0.8
26.0 *
6.9

27.9 8.9 29.6 0.7 24.4 0.8 9.9

28.8 10.1 31.4
0.9 23.3
0.8 7.7

27.6 9.3
26.4 *
21.8 1.2 8.6

27.7 8.8
29.7 0.8
25.2 0.9 8.3

.

0.5

2.4

2.4

2.3

1.9

.

0.8

3.5

3.2

2.0

2.4

.

2.1

7.6

8.1

10.5

7.1

78.2 15.1 18.7 37.5 30.3 24.2
.

78.2 13.1 18.4 44.1 36.7 32.0
2.4

78.6 14.0 19.8 44.4 42.1 33.3 10.0

81.0 11.9 23.9 45.2 46.9 37.1
9.6

83.6 11.9 17.0 43.5 46.3 35.3 10.7

79.9 13.2 19.5 42.9 40.4 32.4
8.1

22.5 77.4
1.9 67.1
6.8 23.2
0.6 208.8 10.7

21.1 73.1
1.9 69.2
4.7 16.3
0.4 167.7
7.9

20.1 70.2 1.8 70.8 5.3 18.5 0.5 190.2
8.7

21.4 75.2
1.9 68.1
8.1 28.3
0.7 249.4
10.0

20.4 72.3 1.9 74.4 6.8 24.2 0.6 238.5 5.0

21.1 73.6
1.9 69.9
6.3 22.2
0.6 212.6
8.4

186.4 30.9 152.5 97.7 20.3 100.0 16.9

137.9 22.0
117.7 94.3 16.8
100.0 *

183.5 23.6
156.8 95.7 23.4
100.0 *

142.3 16.3
112.5 91.2 23.2
100.0 *

157.6 27.1
118.2 100.0
29.5 100.0
*

161.5 24.4
131.4 95.9 22.7
100.0 8.0

* * * 19.5 * *

* * * 28.6 * *

* * * 20.8 * *

* * * 23.2 * *

20.2 20.2
* 31.9
* *

12.2 10.5
* 24.8
* 0.4

13.0

12.0

9.8

14.5

13.7

12.7

2.4

2.1

2.1

*

4.0

2.4

*

*

*

*

*

*

10.8

10.4

9.4

12.5

11.8

11.0

*

*

*

2.4

*

1.3

9.5

13.7

14.1

22.7

8.9

13.8

40.5 34.1 33.6
5.6 9.7 2.0 15.5

39.0 30.8 28.0
4.6 10.5
* 13.7

38.1 30.5 36.5 2.2 8.2
* 13.7

41.4 35.5 33.6
5.2 7.3
* 9.0

41.9 28.9 33.7 3.7 8.2
* 13.1

40.3 32.0 33.1
4.3 8.8 1.2 13.0

.

1.6

2.4

4.7

3.1

3.0

.

*

5.6

1.8

2.8

2.6

.

3.5

27.4

22.2

20.6

18.5

52.6 11.7 22.9 72.3 53.8 43.0
.

58.2 9.0
31.6 74.6 61.7 51.3
5.0

67.4 15.5 35.7 74.7 71.2 60.9 28.3

63.5 15.9 47.6 78.2 75.0 65.3 23.8

69.7

62.2

13.0

13.1

*

29.5

74.4

74.8

76.4

67.6

62.6

56.6

31.3

22.1

225

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Catoosa County - 023

1990
42464 10010
961
21.4 18.4 20.0
67 10 600 61 103
5 3 117 6
7 2 5 5 0 4
52 11
1 60
7 11
171 56 186
3 68
1 27
. . .
480 54
4 203 148 99
. 7

1991
43301 10049
956
21.4 18.8 20.0
75 12 611 69 128 22
3 100
3
7 2 5 5 0 2
50 5 0
55 6 0
90 71 186
3 74
2 25
12 5
38
501 34 1
274 212 185
2 3

Total
1992 1993

44124 10086
951

44964 10111
946

21.0 18.0 20.5

21.8 18.9 20.0

72

65

11

13

595

559

62

54

136

120

33

32

5

6

101

82

8

8

4

5

1

4

3

1

6

9

1

4

0

1

43

44

3

11

0

0

62

42

7

11

2

2

26

72

65

46

187

163

3

3

40

66

2

2

26

22

32

26

25

24

51

71

488

453

21

24

1

3

271

254

200

191

167

161

8

12

0

1

1994 5-year

45791 10162
941

220644 50418
4756

22.0 19.3 21.0

21.4 18.9 20.0

76

355

11

57

594

2959

68

314

150

637

25

117

2

19

83

483

7

32

8

31

3

12

5

19

4

29

0

5

5

12

42

231

12

42

1

2

51

270

2

33

3

18

73

432

60

298

173

895

3

15

116

364

1

8

16

116

30

100

24

78

70

230

490

2412

42

175

5

14

308

1310

210

961

177

789

12

34

4

15

1990
41822 9826 944

1991
42629 9860 939

White
1992 1993

43430 9893 934

44237 9926 929

1994 5-year

45039 9958 924

217157 49463 4671

21.4 18.1 20.0

21.4 18.8 20.0

21.0 18.4 20.0

21.7 18.9 20.0

22.0 19.4 21.0

21.4 19.0 20.0

67

74

71

63

73

348

10

12

11

12

11

56

591

605

589

547

577

2909

61

68

62

53

66

310

101

126

134

116

140

617

5

22

29

32

24

112

3

3

5

6

2

19

114

93

97

80

80

464

6

3

7

7

6

29

7

6

4

5

8

30

2

2

1

4

3

12

5

4

3

1

5

18

5

5

6

9

4

29

0

0

1

4

0

5

4

2

0

1

5

12

50

48

43

43

37

221

11

5

3

11

11

41

1

0

0

0

1

2

57

54

61

42

48

262

7

6

7

11

2

33

11

0

2

2

3

18

170

90

25

69

72

426

55

68

63

44

53

283

185

184

187

159

169

884

3

3

3

2

1

12

68

74

40

66

116

364

1

2

2

2

1

8

27

25

26

22

15

115

.

11

31

23

30

95

.

4

24

22

22

72

.

35

48

60

63

206

472

498

482

444

484

2380

54

33

21

24

41

173

4

1

1

3

5

14

201

270

268

248

297

1284

148

208

199

186

206

947

99

182

166

157

174

778

.

2

8

11

12

33

5

3

0

1

4

13

1990
357 94 10

1991
364 94 10

Black
1992 1993

371

378

95

95

10

10

1994 5-year

385 1855

96

474

10

50

26.7 19.4 58.0

16.1 .
26.0

19.9 17.1
.

19.9 .
30.0

19.7 16.8 45.0

19.9 17.7 38.0

0

1

1

1

3

6

0

0

0

1

0

1

5

6

3

6

9

29

0

1

0

1

2

4

2

2

2

4

8

18

0

0

3

0

1

4

0

0

0

0

0

0

3

5

3

1

2

14

0

0

1

0

1

2

0

1

0

0

0

1

0

0

0

0

0

0

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

2

0

1

4

8

0

0

0

0

0

0

0

0

0

0

0

0

1

1

0

0

2

4

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

2

1

4

1

3

2

2

7

15

1

2

0

2

3

8

0

0

0

1

2

3

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

.

0

0

0

0

0

.

0

0

0

1

1

.

3

0

10

1

14

4

3

3

4

2

16

0

1

0

0

0

1

0

0

0

0

0

0

1

4

2

2

6

15

0

4

1

2

2

9

0

3

1

1

1

6

.

0

0

0

0

0

2

0

0

0

0

2

226

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Catoosa County - 023

14.1 59.9
1.9 17.3
2.8 11.7
0.1 161.4
0.8
69.7 14.9 63.5 49.2
6.2 100.0
*
11.7 *
8.4 8.3
* *
8.7 1.8
* 10.1
1.2 2.2
42.2 9.4
31.4 *
13.8 *
8.5
. . .
82.8 9.5 *
34.1 24.8 16.6
.

14.1 60.8
1.9 21.2
2.3 10.0
0.1 135.3
2.8
78.4 16.0 72.2 58.0
* * *
11.5 *
8.2 8.1
* *
8.2 0.8
* 9.1 1.0
*
26.6 11.7 30.8
* 20.9
* 7.9
1.1 0.4 3.4
84.1 5.8 *
45.3 35.0 30.6
*

13.5 59.0 1.9 23.1 2.3 10.0 0.1 137.2 4.0
75.7 15.3 65.2 52.5 8.4 100.0
*
* * * 10.0 * *
7.2 * *
10.5 1.2 *
7.8 11.0 32.0
* 11.8
* 8.2
2.8 2.2 4.5
85.6 3.7
* 46.0 34.0 28.4
1.4

12.4 55.3
1.8 21.9
1.8 8.1 0.2 120.2 4.1
68.7 20.0 57.1 61.1
8.5 100.0
5.3
8.9 * *
15.9 * *
7.9 2.0
* 7.7 2.0
*
24.7 8.4
29.8 *
22.2 *
7.2
2.3 2.1 6.2
84.5 4.5 *
46.4 34.9 29.4
2.2

13.0 58.5 1.8 25.4 1.8 8.2 0.2 117.9 2.7
80.8 14.5 72.3 60.3 7.4 100.0
*
13.5 *
8.5 * *
0.6
7.1 2.0
* 8.6
* *
23.0 10.1 29.3
* 35.5
* 5.1
2.6 2.1 6.0
87.3 7.5 15.2 52.0 35.5 29.9 2.0

13.4 58.7
1.9 21.8
2.2 9.6 0.1 134.7 2.9
74.6 16.1 66.0 56.3
6.7 100.0
2.9
10.5 4.1 6.4 9.7 0.4 0.3
7.8 1.4
* 9.2 1.1 1.0
25.6 10.2 30.7
0.5 20.1
0.4 7.4
2.2 1.7 5.0
84.8 6.2
11.5 44.7 32.8 26.9
1.5

14.1 60.1
1.9 17.2
2.7 11.6
0.1 159.9
0.8

14.2 61.4
1.9 21.1
2.2 9.4 0.1 128.1 2.8

13.6 59.5 1.9 23.0 2.2 9.8 0.1 134.3 3.6

12.4 55.1
1.7 21.6
1.8 8.1 0.2 119.8 4.1

12.8 57.9 1.8 24.4 1.8
8.0 0.2 117.1 2.6

13.4 58.8
1.9 21.5
2.1 9.4 0.1 132.1 2.8

71.0 14.9 64.6 49.2
6.4 100.0
*

78.8 16.2 72.4 57.4
* * *

76.0 15.5 66.4 52.5 7.5 100.0
*

67.8 19.0 57.0 60.4
7.5 100.0
5.4

79.0 15.1 71.4 59.1 6.5 100.0
*

74.5 16.1 66.4 55.7
6.2 100.0
3.0

11.8 *
8.5 8.4
* *

9.9

*

9.1

13.9

10.3

*

*

*

*

4.1

*

*

*

8.7

6.2

8.2

10.1

16.3

*

9.9

*

*

*

*

0.4

*

*

*

0.6

0.3

8.5

7.9

7.3

7.9

6.4

7.6

1.9

0.8

*

2.0

1.9

1.4

*

*

*

*

*

*

9.7

9.0

10.5

7.8

8.3

9.1

1.2

1.0

1.2

2.1

*

1.1

2.2

*

*

*

*

1.0

42.5 9.4
31.7 *
14.0 *
8.6

26.9 11.4 30.8
* 21.1
* 8.0

7.5 10.8 32.3
* 11.8
* 8.3

24.4 8.2
29.7 *
22.9 *
7.4

23.0 9.2 29.5
* 36.0
* 4.9

25.6 9.8
30.8 0.4
20.4 0.4 7.5

.

1.0

2.8

2.0

2.6

2.1

.

*

2.2

1.9

1.9

1.6

.

3.2

4.3

5.3

5.5

4.6

82.7 9.7 *
34.2 25.2 16.9
.

84.3 5.7 *
45.1 34.7 30.4
*

85.5 3.8
* 46.0 34.1 28.5 1.4

84.7 4.6 *
46.3 34.7 29.3
2.1

88.6 7.6 15.2 51.7 35.8 30.3 2.1

85.1 6.3
11.6 44.6 32.9 27.0
1.4

14.0 53.2
1.6 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
. . .
* * * * * * .

16.5 63.6
1.9 *
13.7 53.0
* . *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* * *
* * * * * * *

*

15.9

23.4

15.6

*

63.2

94.1

61.2

*

2.1

3.1

2.0

*

*

88.9

62.1

*

*

*

7.5

*

*

*

29.5

*

*

*

0.4

*

*

* 297.9

*

*

*

*

*

*

* 121.2

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

27.6

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

77.8

51.7

*

*

*

27.6

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

97.0

*

*

*

*

*

34.2

*

*

*

61.5

*

*

*

*

*

*

*

*

*

*

66.7

51.7

*

*

*

31.0

*

*

*

20.7

*

*

*

*

227

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Charlton County - 024

1990
8496 1911
202
19.3 18.5 22.0
20 3
150 20 54 12
1 1 0
1 0 1 1 0 0
14 0 0
12 2 3
46 26 57
2 24
2 12
. . .
89 13
0 93 64 56
. 0

1991
8590 1912 203
19.5 .
21.0
13 2
148 13 63 7 0 0 0
1 1 0 1 0 1
7 2 0 15 2 3
47 35 57
4 19
2 15
2 10 17
74 7 1
95 71 62 12
0

Total
1992 1993

8675 1911
204

8768 1913 206

20.1 .
20.0

19.2 .
21.0

12

23

5

2

154

142

12

23

58

55

7

4

1

0

0

0

0

0

1

1

0

0

1

1

1

0

0

0

4

0

6

7

0

2

0

0

7

10

1

0

0

0

40

25

40

32

55

45

1

3

22

21

0

3

7

7

3

8

13

18

13

40

108

112

11

14

1

1

99

85

76

72

65

63

45

51

0

0

1994 5-year

8857 1912
207

43386 9559 1021

20.4 18.5 21.0

19.5 18.5 21.0

12

80

2

14

131

725

12

80

49

279

5

35

0

2

1

2

0

0

2

6

0

1

2

5

0

3

0

0

1

6

11

45

3

7

0

0

15

59

2

7

7

13

26

184

39

172

41

255

1

11

19

105

1

8

4

45

6

19

3

44

36

106

100

483

19

64

1

4

88

460

70

353

58

304

58

166

1

1

1990
6094 1330
127

1991
6173 1334 130

White
1992 1993

6246 1336
133

6326 1341 137

1994 5-year

6402 1343
140

31241 6684 666

19.5 18.5 19.0

19.8 .
20.0

21.2 .
19.0

19.4 .
20.0

20.8 18.5 20.0

20.0 18.5 20.0

11

5

4

15

5

40

1

2

1

0

2

6

100

90

95

105

89

479

11

5

4

15

5

40

19

19

15

27

16

96

6

6

4

2

1

19

0

0

1

0

0

1

1

0

0

0

1

2

0

0

0

0

0

0

1

1

1

0

2

5

0

1

0

0

0

1

1

0

1

0

2

4

0

1

1

0

0

2

0

0

0

0

0

0

0

1

3

0

0

4

8

4

4

5

9

30

0

1

0

0

3

4

0

0

0

0

0

0

9

6

5

6

12

38

1

1

0

0

2

4

2

2

0

0

6

10

26

24

21

16

9

96

11

11

9

16

16

63

33

28

31

28

25

145

2

1

0

0

1

4

22

18

16

20

17

93

2

1

0

2

0

5

6

8

2

4

3

23

.

1

1

5

3

10

.

9

8

9

3

29

.

2

3

18

28

51

63

54

77

88

70

352

10

5

8

13

11

47

0

1

1

1

1

4

50

49

52

54

52

257

30

33

34

43

38

178

24

29

29

36

28

146

.

5

19

32

31

87

0

0

0

0

1

1

1990
2355 569 75

1991
2381 568
75

Black
1992 1993

2405 567 76

2430 567
76

1994 5-year

2455 566 77

12026 2838 379

18.6 .
27.0

18.8 .
23.5

18.8 .
25.0

18.9 .
27.0

19.0 .
27.0

18.9 .
26.5

9

8

8

8

7

40

2

0

4

2

0

8

50

58

57

36

41

242

9

8

8

8

7

40

35

44

43

28

33

183

6

1

3

2

4

16

1

0

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

1

0

0

0

0

0

0

0

0

0

1

0

1

1

0

0

0

0

1

0

0

0

0

0

0

0

0

0

0

1

1

6

3

2

2

2

15

0

1

0

2

0

3

0

0

0

0

0

0

3

9

2

4

3

21

1

1

1

0

0

3

1

1

0

0

1

3

20

23

18

9

17

87

15

24

31

16

23

109

24

29

24

17

16

110

0

3

1

2

0

6

2

1

6

1

2

12

0

1

0

1

1

3

6

7

5

2

1

21

.

1

0

3

3

7

.

1

3

9

0

13

.

7

1

21

8

37

26

20

29

24

29

128

3

2

3

1

8

17

0

0

0

0

0

0

43

46

47

30

35

201

34

38

42

28

32

174

32

33

36

26

30

157

.

7

26

18

27

78

0

0

0

0

0

0

228

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

17.7

17.2

17.8

16.2

14.8

16.7

General fertility rate

78.5

77.4

80.6

74.2

68.5

75.8

Total fertility rate

2.3

2.3

2.4

2.3

2.1

2.3

% Livebirths to unmarried women

36.5

43.2

38.2

38.7

38.0

38.9

Crude abortion rate

*

*

*

*

*

*

General abortion rate

*

*

*

*

*

*

Total abortion rate

*

*

*

*

*

*

Abortion ratio

*

*

*

*

*

*

Fetal Death rate

6.8

3.7

4.2

3.1

2.6

4.1

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

99.0

64.0

58.9 111.9

58.1

78.3

% Repeat conceptions to women under 18

*

*

41.7

*

*

17.5

Livebirths to women under 18

99.0

64.0

58.9 111.9

58.1

78.3

% Livebirths to unmarried women under 18

60.0

76.9

83.3

78.3

83.3

75.0

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

8.3

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

6.9

Perinatal mortality ratio

*

*

*

*

*

*

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

0.6

Infant health rates

% Low birthweight

9.3

4.7

3.9

4.9

8.4

6.2

% Very low birthweight

*

*

*

*

*

1.0

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

8.1

10.3

4.6

7.0

11.6

8.2

% Multiple gestation

*

*

*

*

*

1.0

% Birth defect

*

*

*

*

7.7

2.4

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

36.8

43.5

38.1

28.1

29.9

35.8

% with father not named on birth certificate

17.6

24.0

26.1

22.5

30.2

24.0

% with maternal education less than high school

38.8

39.3

36.4

32.1

33.1

36.1

% No prenatal care

*

*

*

*

*

1.5

% Maternal smoking during pregnancy

18.6

17.3

20.0

22.6

20.9

19.7

% Maternal alcohol use during pregnancy

*

*

*

*

*

1.5

% Interpregnancy interval less than 6 months

13.0

15.6

6.6

10.0

*

10.5

Child abuse and neglect rates

Physical

.

*

*

2.9

2.2

1.8

Sexual

.

3.7

4.8

6.6

*

4.1

Neglect

.

6.4

4.8

14.7

13.1

9.8

Interventions to improve infant & child survival

% Prenatal care first trimester

60.5

51.0

71.5

80.6

76.9

67.8

% Primary C-section delivery

9.8

5.1

8.1

10.3

15.7

9.7

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

62.8

65.1

64.7

59.9

68.2

64.1

% Medicaid during pregnancy

43.2

48.6

49.7

50.7

54.3

49.2

% Medicaid and WIC during pregnancy

37.8

42.5

42.5

44.4

45.0

42.3

% Perinatal case management

.

8.2

29.4

35.9

45.0

29.1

Charlton County - 024

16.4 75.2
2.3 19.2
* * * * 4.5
86.6 *
86.6 * * * *
* * * * * *
8.0 * *
9.1 * *
32.9 11.1 33.7
* 27.2
* 10.0
. . .
63.6 11.1
* 50.5 30.3 24.2
.

14.6 67.5
2.1 21.3
* * * * 4.5
38.5 *
38.5 * * * *
* * * * * *
* * * 6.7 * *
42.1 12.4 31.5
* 30.5
* 13.3
* 5.0
*
61.4 6.0 *
55.1 37.1 32.6
5.6

15.2 71.1 2.2 16.0
* * * * 3.7

16.6 78.3
2.4 25.7
* * * * *

* 109.8

*

*

* 109.8

*

66.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

4.8

*

*

*

*

5.3

5.7

*

*

*

*

36.8 9.5 33.0
* 27.6
* *

27.6 15.2 26.9
* 33.3
* *

*

2.7

4.4

4.9

*

9.8

81.9 9.8 *
54.7 35.8 30.5 20.0

85.4 12.9
* 51.4 41.0 34.3 30.5

13.9 66.3 2.1 18.4
* * * * *
35.8 *
35.8 * * * *
* * * * * *
10.1 * *
13.8 *
11.3
18.0 18.4 29.1
* 32.1
* *
* * 15.1
79.5 13.6
* 59.8 43.7 32.2 35.6

15.3 71.7
2.2 20.3
* * * * 3.0
60.0 15.0 60.0 50.0
* * *
10.4 * * * * *
6.3 * *
8.0 *
3.2
31.9 13.3 30.8
* 29.9
1.6 8.2
1.4 4.0 7.0
74.6 10.8
* 54.1 37.5 30.7 23.1

21.2 87.9
2.3 71.4
* * * * 12.3

24.4 102.0
2.8 77.2
* * * * *

23.7 100.5
2.8 76.8
* * * * *

14.8 63.5
1.7 77.8
* * * * *

16.7 72.4 2.0 80.5
* * * * *

20.1 85.3
2.3 76.6
* * * * 6.7

120.0 *
120.0 100.0
* * *

106.1 *
106.1 100.0
* * *

105.8 *
105.8 100.0
* * *

104.8 *
104.8 100.0
* * *

91.3 *
91.3 100.0
* * *

105.5 20.0 105.5 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

12.0

*

*

*

*

6.2

*

*

*

*

*

*

*

*

*

*

*

*

*

15.8

*

*

*

8.8

*

*

*

*

*

*

*

*

*

*

*

*

43.5 30.6 49.0
* * * 18.8

45.1 42.1 51.8
* * * 19.4

39.1 55.4 43.6
* 12.0
* 12.2

30.0 44.4 48.6
* * * *

45.9 56.1 43.2
* * * *

41.4 45.6 47.4
2.5 5.5
* 14.5

.

*

.

*

.

7.9

*

*

*

10.0

*

23.3

*

2.0

*

3.6

8.8

10.3

54.2 * *
87.8 69.4 65.3
.

35.1 * *
80.7 66.7 57.9 12.3

52.7 * *
83.9 75.0 64.3 46.4

68.6 * *
83.3 77.8 72.2 50.0

70.7

54.2

20.5

7.7

*

*

85.4

84.1

78.0

72.8

73.2

65.7

65.9

41.1

229

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Chatham County - 025

1990
216935 51448
4212
21.7 19.8 23.0
548 157 4116 402 1617 409 49 1264 117
49 33 16 83
5 14
415 95 15 441 40 36
1348 964 963 122 648 64 231
. . .
2987 668 60
1557 1570 1055
. 5

1991
219713 51700 4254
21.2 19.4 23.0
559 151 3844 419 1567 414
42 1192 116
56 42 14 83
4 13
421 95 18
483 39 34
1190 927 942 103 529
77 240
48 15 137
2875 624
69 1914 1775 1425
9 28

Total
1992 1993

222488 51955 4296

225263 52204 4338

21.4 19.9 23.0

21.5 20.3 23.0

523 142 3966 414 1618 420
34 1181
85

545 152 3937 417 1751 408
43 1138
94

66

55

45

34

21

21

78

76

6

6

17

11

405

425

88

87

14

15

451

496

46

52

42

53

1237 948 910 82 558 71 222

1427 1003 916
79 439
42 220

126

147

65

64

405

429

2953 616 95
1846 1906 1382
65 32

2897 661 131 2212 2200 1755 421
36

1994 5-year
228037 1112436 52460 259767 4380 21479

20.9 19.6 24.0

21.3 19.8 23.0

573 132 3847 452 1705 236
32 1060
102

2748 734
19710 2104 8258 1887 200 5835 514

48

274

35

189

13

85

68

388

5

26

13

68

405

2071

79

444

13

75

429

2300

44

221

29

194

1553 929 866 73 368 35 181

6755 4771 4597
459 2542
289 1094

114

435

55

199

396

1367

2821 657 106
1829 2003 1404
444 30

14533 3226 461 9358 9454 7021 939 131

White
1990 1991 1992 1993 1994 5-year

130607 29734 2088

132092 29807 2107

133579 29883 2125

135062 29954 2144

136549 30030 2162

667889 149408
10625

23.9 20.6 22.0

23.5 20.1 22.0

23.7 20.8 22.0

24.2 20.6 23.0

24.0 20.3 23.0

23.8 20.5 23.0

168 32 2056 114 298 223 17 603 42

177 31
1827 116 272 190 11 539 55

131 30
1885 100 275 207 8 505 28

143 37
1851 105 347 193 9 477 34

138 22
1824 103 325 113 9 435 31

757 152 9443 538 1517 926
54 2559
190

15

12

20

13

15

75

9

12

11

9

10

51

6

0

9

4

5

24

27

23

20

16

20

106

1

1

3

0

0

5

9

4

8

4

5

30

119

123

131

130

129

632

21

25

23

22

19

110

3

5

3

2

1

14

138

162

158

167

152

777

18

15

23

23

20

99

24

15

24

19

18

100

559

465

474

532

587

2617

174

152

162

197

150

835

379

335

324

297

281

1616

21

16

12

13

12

74

423

341

372

297

261

1694

33

29

29

15

13

119

63

51

65

66

53

298

.

22

36

47

38

143

.

9

33

30

17

89

.

56

110

113

116

395

1741 380 24 444 387 265 . 2

1587 322 24 540 463 361 3 5

1594 324 41 529 503 353 11 10

1537 320 51 644 597 421 84 9

1543 338 57 536 538 334 100 7

8002 1684
197 2693 2488 1734
198 33

1990
82608 20641
2031

1991
83666 20740
2051

Black
1992 1993

84723 20841
2071

85779 20939
2092

1994 5-year

86836 21039
2112

423611 104199
10357

19.4 18.9 24.0

19.3 18.8 24.0

19.2 19.3 25.0

19.0 19.9 25.0

19.0 18.8 24.0

19.2 19.1 24.0

378 123 2031 288 1319 180
32 641 73

376 120 1969 299 1286 212
29 628
60

390 111 2006 312 1328 206
25 655
57

398 115 2021 311 1395 210
34 634
58

433 110 1948 347 1373 119
23 613
71

1975 579
9975 1557 6701
927 143 3171 319

34

43

45

42

33

197

24

30

33

25

25

137

10

13

12

17

8

60

56

58

56

60

48

278

4

3

3

6

5

21

5

9

9

7

8

38

293

296

269

291

274

1423

74

69

63

65

60

331

12

13

11

13

12

61

301

317

286

322

274

1500

22

23

23

29

24

121

11

18

17

33

10

89

778

711

746

876

934

4045

789

771

778

805

775

3918

582

598

572

608

580

2940

101

85

68

64

60

378

222

184

176

137

104

823

31

48

40

27

20

166

168

188

155

153

126

790

.

25

88

89

68

270

.

4

29

31

37

101

.

72

287

293

273

925

1225 280 36
1110 1182
790 . 3

1252 292
45 1358 1296 1051
6 23

1296 283 52
1293 1379 1014
53 21

1303 336
79 1548 1579 1321 335
27

1217 311 47
1270 1443 1058
339 22

6293 1502
259 6579 6879 5234
733 96
230

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Chatham County - 025

19.0 80.0
2.4 39.7
5.8 24.6
0.7 215.1
9.6
130.1 28.6 95.4 83.2 27.8 97.3
8.1
11.9 8.0 3.9
19.9 0.4 0.3
10.1 2.3 0.4
10.8 1.0 0.9
34.9 23.7 23.8
3.0 16.0
1.6 9.6
. . .
73.4 18.2 14.5 38.2 38.5 25.9
.

17.5 74.4
2.2 41.2
5.4 23.1
0.6 215.2
9.7
131.4 27.0 98.5 84.7 27.3 96.5 6.3
14.6 10.9
3.7 21.4
* 0.3
11.0 2.5 0.5
12.7 1.0 0.9
33.2 24.4 25.0
2.7 14.0
2.0 10.7
0.8 0.3 2.3
75.3 18.5 15.8 50.3 46.7 37.5
0.2

17.8 76.3 2.3 41.3 5.3 22.7 0.6 209.9
9.2
121.8 27.2 96.4 85.2 19.8 97.6 5.8
16.6 11.3 5.4 19.5
0.4 0.4
10.2 2.2 0.4
11.5 1.2 1.1
32.5 24.2 23.4
2.1 14.3
1.8 9.5
2.1 1.1 6.8
74.7 17.7 21.3 47.1 48.6 35.3
1.7

17.5 75.4
2.3 45.1
5.1 21.8
0.6 205.6
8.8
125.6 27.9 96.1 88.7 21.7 98.9 8.3
14.0 8.6 5.4
19.1 0.4 0.3
10.8 2.2 0.4
12.8 1.3 1.4
38.0 25.9 23.8
2.0 11.4
1.1 9.5
2.4 1.1 7.1
73.8 19.5 26.6 57.0 56.7 45.2 10.9

16.9 73.3 2.2 44.9 4.6 20.2 0.6 204.6
5.2
130.8 23.0
103.2 89.9 23.3 99.0 5.5
12.5 9.1 3.4 17.5 0.3 0.3
10.5 2.1 0.3
11.3 1.2 0.8
41.9 24.4 22.9
1.9 9.7 0.9 8.3
1.9 0.9 6.4
73.6 19.6 23.9 48.1 52.7 36.9 11.7

17.7 75.9
2.3 42.4
5.2 22.5
0.6 210.2
8.5
127.9 26.7 98.0 86.4 23.9 97.8
6.8
13.9 9.6 4.4
19.5 0.4 0.3
10.5 2.3 0.4
11.8 1.1 1.0
36.1 24.5 23.8
2.4 13.1
1.5 9.5
1.8 0.8 5.7
74.2 18.7 20.7 48.0 48.5 36.0
6.1

15.7 69.1
2.1 14.6
4.6 20.3
0.6 206.9
8.6

13.8 61.3
1.8 15.0
4.1 18.1
0.5 208.0
7.5

14.1 63.1 1.9 14.8 3.8 16.9 0.5 193.1
7.5

13.7 61.8
1.9 19.0
3.5 15.9
0.4 188.2
6.9

13.4 60.7 1.9 18.0 3.2 14.5 0.4 182.6
4.1

14.1 63.2
1.9 16.3
3.8 17.1
0.5 196.3
6.9

80.5 19.0 54.6 50.9 20.1 97.6
6.2

84.0 17.5 55.1 52.6 26.1 96.4
2.8

61.6 22.9 47.1 49.5 13.2 96.3
*

66.7 25.9 49.0 64.8 15.9 100.0
*

63.8 15.9 47.6 63.4 14.3 96.8
2.8

71.2 20.1 50.6 56.1 17.9 97.3
3.1

7.3 4.4 2.9 13.0
* 0.4

6.6 6.6
* 12.5
* *

10.6 5.8 4.8
10.6 *
0.4

7.0

8.2

7.9

4.9

5.5

5.4

*

2.8

2.6

8.6

10.9

11.2

*

*

0.1

*

0.2

0.3

5.8

6.7

6.9

7.0

7.1

6.7

1.0

1.4

1.2

1.2

1.0

1.2

*

0.3

*

*

*

0.1

6.8

8.9

8.5

9.2

8.4

8.3

0.9

0.8

1.2

1.3

1.1

1.1

1.2

0.8

1.3

1.0

1.0

1.1

28.4 8.5
18.7 1.0
20.8 1.6 5.9

26.6 8.4
18.7 0.9
19.0 1.6 5.3

26.0 8.7 17.5 0.6 20.1 1.6 6.4

29.8 10.8 16.4
0.7 16.4
0.8 6.6

33.0 8.3
15.7 0.7 14.5 0.7 5.4

28.7 8.9
17.4 0.8
18.2 1.3 5.9

.

0.8

1.2

1.5

1.2

1.2

.

0.3

1.1

1.0

0.6

0.7

.

1.9

3.7

3.7

3.8

3.3

85.3 20.6 12.7 21.8 19.0 13.0
.

87.4 19.9 12.2 29.8 25.6 19.9
*

84.7 19.6 19.7 28.4 27.0 19.0 0.6

83.3 20.2 21.5 35.3 32.7 23.1
4.6

84.6 21.5 24.4 29.7 29.8 18.5 5.5

85.1 20.4 18.5 28.8 26.6 18.6
2.7

24.6 98.4
2.8 65.7
7.8 31.1
0.8 220.6
11.3

23.5 94.9
2.7 66.1
7.5 30.3
0.8 219.5
12.7

23.7 96.3 2.7 67.0 7.7 31.4 0.9 225.3 11.8

23.6 96.5
2.8 70.1
7.4 30.3
0.8 218.3
11.9

22.4 92.6 2.6 71.5 7.1 29.1 0.8 226.5
6.9

23.5 95.7
2.7 68.1
7.5 30.4
0.8 222.0 10.9

186.1 32.5 141.8 96.1 35.9 98.6 10.3

183.3 31.9
145.8 97.3 29.2 96.6 9.7

188.3 28.5
150.6 96.5 27.5 98.2 10.1

190.3 28.9
148.7 97.1 27.7 98.3 14.8

205.0 25.4
164.3 98.0 33.6
100.0 8.5

190.7 29.3
150.3 97.0 30.8 98.4 10.7

16.7 11.8
5.0 27.1
* 0.3

21.8 15.2
6.7 29.0
* 0.5

22.4 16.5 6.1 27.6
* 0.4

20.8 12.4
8.5 29.2
0.9 0.3

16.9 12.8 4.2 24.4 0.7 0.4

19.7 13.7
6.1 27.5
0.6 0.4

14.4 3.6 0.6
15.0 1.1 0.5

15.0 3.5 0.7
16.3 1.2 0.9

13.4 3.1 0.5 14.4 1.2 0.9

14.4 3.2 0.6
16.2 1.5 1.6

14.1 3.1 0.6 14.3 1.2 0.5

14.3 3.3 0.6
15.2 1.2 0.9

41.7 39.3 29.3
5.1 11.1
1.6 12.7

39.6 39.6 31.0
4.4 9.5 2.5 14.8

39.0 39.2 29.1 3.4 8.9 2.0 12.2

45.9 40.4 30.8
3.2 6.9 1.4 12.0

50.4 40.3 30.3 3.1 5.4 1.0 11.0

43.3 39.8 30.1
3.9 8.4 1.7 12.6

.

0.9

3.1

3.1

2.3

2.4

.

*

1.0

1.1

1.3

0.9

.

2.6

10.1

10.1

9.3

8.1

61.3 15.7 16.1 55.3 58.8 39.3
.

64.1 17.1 19.0 69.8 66.6 54.0
0.3

64.8 16.2 22.3 65.2 69.5 51.1
2.7

64.8 19.3 31.6 77.7 79.3 66.3 16.8

62.9

63.6

18.1

17.3

23.0

22.6

66.1

66.8

75.1

69.8

55.0

53.1

17.6

9.3

231

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Chattahoochee County - 026

1990
16934 3199 265
23.5 18.3 20.5
19 1
248 11 33 18
0 86
8
3 3 0 2 0 0
13 3 0
15 3 5
75 20 28
1 28
9 6
. . .
186 33
5 92 22 19
. 0

1991
17069 3242 277
24.4 19.3 22.0
26 4
246 14 38 19 2
127 11
3 0 3 2 0 3
17 4 0
25 3 5
68 25 45
6 29
7 12
5 1 8
170 25 10
104 35 27 0 0

Total
1992 1993

17208 3287 288

17342 3328 300

21.5 19.8 22.0

21.4 20.0 21.0

26

17

3

4

269

223

17

15

33

26

16

10

1

1

94

79

9

2

7

3

7

3

0

0

8

3

1

1

0

1

22

20

6

3

2

1

29

19

2

5

5

0

65

61

23

18

42

33

1

0

37

33

1

1

13

12

16

17

1

6

19

18

183

157

36

21

4

10

129

108

36

34

31

27

1

2

0

0

1994 5-year

17477 3372 311

86030 16428
1441

22.1 21.9 21.0

22.3 20.0 21.0

13

101

3

15

264

1250

8

65

37

167

16

79

2

6

77

463

5

35

3

19

2

15

1

4

4

19

2

4

1

5

16

88

1

17

0

3

19

107

5

18

4

19

84

353

23

109

29

177

1

9

33

160

0

18

10

53

15

53

12

20

35

80

185

881

36

151

7

36

115

548

26

153

17

121

3

6

0

0

1990
10091 1761 141

1991
10114 1769 147

White
1992 1993

10142 1779 153

10162 1786 158

1994 5-year

10186 1795 164

50695 8890 762

24.4 18.3 20.0

26.0 19.3 21.5

22.7 20.3 22.0

21.8 20.5 20.0

23.0 22.3 21.0

23.8 20.4 21.0

9

10

10

8

6

43

0

1

1

3

2

7

167

155

161

148

184

815

5

4

5

6

4

24

6

15

10

11

14

56

5

12

12

5

10

44

0

1

0

0

2

3

38

59

42

29

35

203

4

4

4

1

2

15

2

2

2

1

1

8

2

0

2

1

0

5

0

2

0

0

1

3

2

1

2

0

2

7

0

0

1

0

0

1

0

1

0

0

1

2

5

9

12

2

0

2

0

0

1

6

14

13

2

1

1

4

3

2

7

8

41

0

0

4

0

0

1

9

12

54

1

2

7

0

1

10

44

40

39

41

59

223

5

8

6

6

10

35

19

26

26

20

22

113

0

2

0

0

1

3

22

23

30

28

31

134

6

6

1

1

0

14

4

6

6

6

6

28

.

0

3

5

4

12

.

1

0

2

6

9

.

2

10

6

10

28

136

109

117

103

137

602

18

14

23

12

25

92

2

8

2

9

6

27

47

49

71

65

68

300

7

14

20

23

12

76

5

12

17

17

6

57

.

0

0

1

2

3

0

0

0

0

0

0

1990
5235 1089
99

1991
5277 1103
104

Black
1992 1993

5320 1117
108

5361 1131 112

1994 5-year

5403 1145
116

26595 5584 538

19.9 18.6 21.0

21.4 17.1 21.5

19.4 18.2 23.5

19.9 19.8 23.0

19.3 21.9 21.0

19.9 19.5 22.0

10

16

16

9

5

56

1

3

2

1

1

8

71

80

94

63

72

380

6

10

12

9

3

40

27

22

23

14

21

107

6

4

4

5

6

25

0

1

1

1

0

3

43

62

49

47

36

237

4

7

5

1

2

19

1

1

5

2

1

10

1

0

5

2

1

9

0

1

0

0

0

1

0

1

6

3

2

12

0

0

0

1

2

3

0

2

0

1

0

3

8

7

10

13

8

46

1

3

4

3

1

12

0

0

1

1

0

2

9

9

15

10

7

50

1

2

1

4

3

11

1

2

3

0

3

9

28

27

22

14

23

114

15

17

17

11

11

71

9

18

15

11

5

58

1

3

1

0

0

5

5

3

4

3

2

17

3

1

0

0

0

4

2

4

6

4

4

20

.

5

9

11

10

35

.

0

1

2

2

5

.

5

8

9

18

40

43

54

58

46

42

243

14

11

10

8

10

53

3

2

2

1

1

9

42

51

55

35

43

226

15

20

16

10

14

75

14

14

14

9

11

62

.

0

1

0

1

2

0

0

0

0

0

0

232

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Chattahoochee County - 026

14.6 77.5
2.1 13.5
5.1 26.9
0.8 241.6
6.9
71.7 *
41.5 72.7 30.2 100.0
*
* * * * * *
5.2 * *
6.1 *
2.0
31.3 8.2
11.4 *
11.6 3.7 3.9
. . .
75.0 15.1 18.5 37.6
9.0 7.8
.

14.4 75.9
2.1 15.8
7.4 39.2
1.1 319.1
7.7
93.9 *
50.6 84.6 39.7 100.0
*
* * * * * *
6.9 * *
10.3 *
2.1
28.7 10.3 18.5
2.5 12.2
2.9 7.2
1.1 *
1.7
69.7 11.7 34.5 42.8 14.4 11.1
*

15.6 81.8 2.3 12.4 5.5 28.6 0.8 246.7 5.5
90.2 *
59.0 81.3 31.2 100.0
*
26.0 26.0
* 29.6
* *
8.2 2.2
* 10.9
* 1.9
24.8 8.6 15.7
* 14.1
* 7.0
3.3 *
4.0
68.3 14.8
* 48.3 13.5 11.6
*

12.9 67.0
1.9 11.9
4.6 23.7
0.7 250.0
4.2
56.7 *
50.1 85.7
* * *
* * * * * *
9.0 * *
8.7 2.3
*
28.8 8.3
15.1 *
15.3 *
8.2
3.5 1.2 3.7
71.0 11.2 32.3 49.5 15.6 12.4
*

15.1 78.3 2.2 14.2 4.4 22.8 0.6 211.0 7.1
41.8 *
25.7 87.5 16.1 100.0
*
* * * * * *
6.1 * *
7.3 1.9
*
32.9 8.8
11.2 *
12.9 *
5.7
3.1 2.5 7.2
70.1 15.7 22.6 44.2 10.0 6.5
*

14.5 76.1
2.1 13.6
5.4 28.2
0.8 255.0
6.3
70.1 14.9 45.1 82.3 24.3 100.0
*
15.2 12.0
* 15.1
* 0.3
7.0 1.4
* 8.7 1.5 1.5
29.3 8.8
14.4 0.7
13.2 1.5 6.4
2.8 1.0 4.2
70.8 13.8 25.4 44.4 12.4
9.8 0.6

16.5 94.8
2.6 3.6 3.8 21.6 0.6 180.1 3.4

15.3 87.6
2.4 9.8 5.8 33.4 1.0 256.5 9.0

15.9 90.5 2.6 6.3 4.1 23.6 0.7 195.3 6.7

14.6 82.9
2.4 7.5 2.9 16.2 0.5 157.6 3.9

18.1 102.5
2.9 7.7 3.4 19.5 0.5 150.2 7.8

16.1 91.7
2.6 6.9 4.0 22.8 0.7 189.2 6.2

63.8 *
35.5 * * * *

68.1 * * * * * *

65.5 *
32.8 * * * *

50.7 *
38.0 * * * *

36.7 * * * * * *

56.4 16.3 31.5 62.5 19.7 100.0
*

*

*

*

*

*

9.8

*

*

*

*

*

6.1

*

*

*

*

*

*

*

*

*

*

*

8.6

*

*

*

*

*

*

*

*

*

*

*

*

3.0

5.8

7.5

4.7

4.3

5.0

*

*

*

*

*

*

*

*

*

*

*

*

3.6

9.1

8.1

6.1

6.6

6.7

*

*

*

*

*

0.9

*

*

*

*

*

1.2

27.3 3.0
11.5 *
13.7 3.7 *

26.5 5.2
16.9 *
15.2 4.0 5.9

24.7 3.8
16.2 *
19.0 *
5.7

28.3 4.1
13.6 *
19.2 *
5.8

33.1 5.5
12.0 *
17.4 *
5.0

28.1 4.3
14.0 *
16.9 1.8 5.3

.

*

*

2.0

*

1.2

.

*

*

*

2.4

0.9

.

*

3.9

2.4

3.9

2.7

81.4 12.2
* 28.5
4.2 3.0
.

70.8 10.5 38.1 31.8
9.1 7.8
*

72.7 15.9
* 44.4 12.5 10.6
*

70.1 9.6
40.9 44.2 15.6 11.6
*

74.5 15.3 30.0 37.2 6.6 3.3
*

74.0 12.9 28.1 37.1
9.4 7.0
*

13.6 65.2
1.7 38.6
8.2 39.5
1.1 355.4
6.4

15.2 72.5
1.9 28.9 11.7 56.2
1.5 418.9
5.4

17.7 84.1 2.3 24.7 9.2 43.9 1.2 328.9 5.4

11.8 55.7
1.5 23.7
8.8 41.6
1.1 401.7
6.2

13.3 62.9 1.7 30.4 6.7 31.5 0.8 307.7 7.9

14.3 68.1
1.9 29.2
8.9 42.4
1.1 363.5
6.3

101.0 *
60.6 100.0
* * *

154.6 *
96.6 88.9 67.6 100.0
*

148.6 *
111.4 90.9 46.4
100.0 *

80.4 *
80.4 100.0
* * *

43.0 * * * * * *

104.0 14.3 74.3 94.6 35.3 100.0
*

*

*

53.2

*

*

26.3

*

*

53.2

*

*

23.7

*

*

*

*

*

*

*

*

63.2

*

*

31.3

*

*

*

*

*

*

*

*

*

*

*

*

11.3 * *
12.9 * *

8.8 * *
11.5 * *

10.8 * *
16.1 * *

20.6 * *
16.9 * *

11.1 * *
10.1 * *

12.1 3.2 *
13.6 3.0 2.4

40.6 21.4 12.9
* 7.1
* *

36.0 21.8 23.1
* * * *

24.4 18.3 16.1
* * * 8.8

25.0 18.6 18.6
* * * *

33.3 15.9
7.2 * * * *

31.8 19.2 15.7
1.4 4.7
* 7.9

.

3.0

5.3

6.5

5.9

5.2

.

*

*

*

*

0.7

.

3.0

4.8

5.3

10.6

5.9

60.6 22.2
* 60.0 21.4 20.0
.

68.4 15.3
* 65.4 25.6 17.9
*

62.4 11.9
* 59.1 17.2 15.1
*

74.2 15.7
* 59.3 16.9 15.3
*

58.3

64.5

17.2

16.2

*

22.0

62.3

61.2

20.3

20.3

15.9

16.8

*

*

233

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Chattooga County - 027

1990
22242 4794 509
21.0 18.5 20.0
43 18 326 36 85
9 4 62 5
4 2 2 6 0 3
23 3 0
31 3
11
101 54 150
5 81
7 17
. . .
240 55
2 160 99 88
. 1

1991
22259 4753 499
20.3 18.5 19.0
29 3
284 26 75 18 5 55 3
1 0 1 5 2 0
15 4 0
17 4 6
65 45 114
5 66
3 23
2 6 28
202 43 1
179 118 107
0 0

Total
1992 1993

22267 4711 490

22289 4675 481

19.7 17.4 21.0

20.7 20.1 20.0

41

45

4

8

284

280

35

40

105

86

18

16

4

3

48

46

4

4

4

3

1

2

3

1

5

5

2

1

2

6

22

26

3

5

0

1

31

18

1

1

7

53

67

69

51

47

119

102

5

3

61

61

3

2

16

13

13

21

20

9

86

115

219

223

37

43

3

4

164

168

132

142

112

119

10

4

5

0

1994 5-year

22296 4634 472

111353 23567 2451

20.6 20.1 20.0

20.5 18.5 20.0

45

203

8

41

298

1472

39

176

103

454

10

71

3

19

45

256

5

21

5

17

3

8

2

9

6

27

1

6

1

12

31

117

6

21

2

3

40

137

5

14

9

86

74

376

59

256

99

584

8

26

69

338

5

20

10

79

29

65

15

50

131

360

238

1122

45

223

12

22

174

845

144

635

120

546

4

18

1

7

1990
20220 4305 453

1991
20226 4270 445

White
1992 1993

20231 4237 437

20241 4205 430

1994 5-year

20245 4172 422

101163 21189 2188

21.4 18.8 20.0

20.3 19.0 19.0

19.8 18.0 21.0

20.8 21.8 20.0

21.0 17.7 20.0

20.7 18.5 20.0

36

26

35

42

41

180

17

3

4

8

8

40

300

248

250

254

261

1313

33

24

31

37

35

160

67

48

79

69

75

338

8

16

15

15

10

64

2

4

4

3

3

16

47

39

34

31

29

180

3

2

2

4

5

16

3

1

3

2

5

14

2

0

0

1

3

6

1

1

3

1

2

8

4

4

4

4

6

22

0

2

0

1

1

4

1

0

2

5

1

9

20

12

17

23

24

96

3

4

1

4

6

18

0

0

0

0

2

2

31

15

27

17

32

122

3

4

1

1

4

13

10

5

6

48

8

77

92

48

51

59

63

313

42

31

37

36

44

190

137

106

107

94

92

536

4

3

3

3

6

19

76

61

55

58

64

314

6

2

3

2

4

17

15

22

13

12

10

72

.

1

11

20

24

56

.

4

16

7

13

40

.

15

71

88

104

278

226

182

196

209

211

1024

49

35

31

39

38

192

2

1

3

4

10

20

143

153

140

148

147

731

87

98

109

122

120

536

79

89

92

102

99

461

.

0

6

3

3

12

1

0

3

0

1

5

1990
1941 470 56

1991
1943 466
55

Black
1992 1993

1943 462 54

1945 458
53

1994 5-year

1946 454 52

9718 2309
270

18.4 18.1 25.5

20.0 17.7 23.5

18.1 17.4 24.5

20.5 18.3 24.0

19.8 22.2 26.0

19.9 18.2 24.5

7

3

6

2

4

22

1

0

0

0

0

1

26

36

32

24

35

153

3

2

4

2

4

15

18

27

25

16

28

114

1

2

3

1

0

7

2

1

0

0

0

3

14

16

13

14

15

72

2

1

2

0

0

5

1

0

1

1

0

3

0

0

1

1

0

2

1

0

0

0

0

1

2

1

1

1

0

5

0

0

2

0

0

2

2

0

0

1

0

3

3

3

5

3

7

21

0

0

2

1

0

3

0

0

0

1

0

1

0

2

4

1

8

15

0

0

0

0

1

1

1

1

1

5

1

9

9

17

15

10

10

61

12

14

14

11

15

66

13

8

11

7

7

46

1

2

2

0

2

7

5

5

6

3

5

24

1

1

0

0

1

3

2

1

3

1

0

7

.

0

2

1

2

5

.

1

1

1

1

4

.

8

7

13

10

38

14

20

23

13

25

95

6

8

6

4

7

31

0

0

0

0

2

2

17

26

23

19

26

111

12

20

22

19

23

96

9

18

20

17

20

84

.

0

4

1

1

6

0

0

2

0

0

2

234

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Chattooga County - 027

14.7 68.0
2.0 26.4
2.8 12.9
0.2 154.6
2.7
84.5 41.9 70.7 50.0
9.8 100.0
*
* * * 18.2 * *
7.1 * *
9.6 *
3.5
35.8 16.8 47.0
1.6 26.0
2.3 9.2
. . .
74.8 18.5
* 49.7 30.7 27.3
.

12.8 59.8
1.8 26.6
2.5 11.6
0.2 151.9
4.8
58.1 *
52.1 56.0
* * *
* * * 17.3 * *
5.3 * *
6.0 *
2.2
25.8 16.0 40.4
1.8 24.6
* 14.0
* 1.1 4.9
72.1 16.5
* 63.5 41.8 37.9
*

12.8 60.3 1.8 37.2 2.2 10.2 0.1 135.2 4.9
83.7 *
71.5 51.4
* * *
* * * 17.4 * *
7.7 * *
11.0 *
2.7
26.9 18.0 42.8 1.9 23.2
* 10.6
2.3 3.5 15.1
81.1 14.2
* 58.0 46.6 39.6
3.5

12.6 59.9
1.8 30.8
2.1 9.8 0.2 133.3 4.1
93.5 17.8 83.1 65.0
* * *
* * * 17.7 * 1.4
9.3 1.8
* 6.5
* 20.0
26.7 16.8 36.7
* 23.1
* 9.4
3.7 1.6 20.3
81.4 17.3
* 60.2 50.9 42.7
*

13.4 64.3 2.0 35.0 2.0 9.7 0.3 126.1 3.0
95.4 17.8 82.7 59.0 10.6 100.0
*
16.8 * *
19.9 * *
10.4 2.0
* 13.6 1.7 3.3
27.4 20.1 35.0 2.8 25.4 1.8 7.1
5.1 2.6 23.1
82.1 17.2 36.4 59.2 49.0 40.8
*

13.2 62.5
1.9 31.1
2.3 10.9
0.2 140.7
3.9
82.8 20.2 71.8 56.6
8.6 100.0
3.3
11.5 5.4 6.1
18.1 0.9 0.6
7.9 1.4
* 9.4 1.0 6.2
28.7 17.5 40.6
1.8 24.5
1.5 10.1
2.9 2.2 15.9
78.2 16.8 16.7 57.9 43.5 37.4
1.6

14.8 69.7
2.1 22.6
2.3 10.9
0.1 131.7
2.3

12.3 58.1
1.8 19.5
1.9 9.1 0.1 127.0 4.7

12.4 59.0 1.8 31.9 1.7 8.0 0.1 111.8 4.7

12.5 60.4
1.9 27.3
1.5 7.4 0.2 102.3 4.3

12.9 62.6 1.9 29.1 1.4 7.0 0.2 95.4 3.4

13.0 62.0
1.9 26.0
1.8 8.5 0.1 114.3 3.9

79.5 47.2 72.8 45.5
* * *

58.4 *
53.9 52.2
* * *

80.0 *
70.9 45.2
* * *

97.7 19.0 86.0 62.2
* * *

97.1 19.5 82.9 54.3 11.8 100.0
*

82.3 22.2 73.1 52.2
7.3 100.0
2.7

*

*

*

*

19.2

10.7

*

*

*

*

*

4.6

*

*

*

*

*

6.1

*

*

*

*

22.7

16.6

*

*

*

*

*

*

*

*

*

1.4

*

0.5

6.7

4.8

6.8

9.1

9.2

7.3

*

*

*

*

2.3

1.4

*

*

*

*

*

*

10.5

6.1

10.9

6.7

12.4

9.4

*

*

*

*

*

1.0

3.4

2.1

2.6

19.9

3.3

6.2

35.5 14.2 46.6
* 26.7
2.1 9.0

22.1 12.6 43.1
* 26.3
* 14.8

23.2 14.9 43.5
* 23.8
* 9.8

25.1 14.2 37.2
* 24.2
* 9.6

26.6 17.1 36.9 2.4 26.9
* 7.9

26.8 14.6 41.6
1.5 25.6
1.4 10.3

.

*

2.2

4.0

4.8

2.8

.

*

3.2

1.4

2.6

2.0

.

3.0

14.1

17.5

20.7

13.8

76.6 17.8
* 48.3 29.4 26.7
.

74.6 15.6
* 62.2 39.8 36.2
*

82.0 13.4
* 56.2 43.8 36.9
2.4

83.6 17.4
* 58.5 48.2 40.3
*

83.1 16.5 35.7 57.0 46.5 38.4
*

79.9 16.2 17.4 56.1 41.2 35.4
1.2

13.4 55.3
1.5 69.2
7.2 29.8
0.3 325.6
*

18.5 77.3
2.2 75.0
8.2 34.3
0.5 290.9
*

16.5 69.3 1.9 78.1 6.7 28.2 0.4 270.8
*

12.3 52.4
1.5 66.7
7.2 30.6
0.7 359.0
*

125.0

* 111.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

15.6

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

21.7

39.1 46.2 52.0
* 19.2
* *

48.6 38.9 22.2
* 13.9
* *

53.6 43.8 36.7
* 19.4
* *

45.5 45.8 30.4
* * * *

.

*

*

*

.

*

*

*

.

13.3

11.6

21.6

53.8 27.3
* 65.4 46.2 34.6
.

55.6 22.9
* 72.2 55.6 50.0
*

76.7 22.2
* 71.9 68.8 62.5
*

56.5 * *
79.2 79.2 70.8
*

18.0 77.2 2.2 82.4 7.7 33.1 0.9
. *

15.7 66.3
1.9 75.0
7.4 31.2
0.6 306.4
4.3

*

81.6

*

*

*

55.6

* 100.0

*

18.5

* 100.0

*

*

*

*

*

*

*

*

*

32.1

*

*

*

*

20.0 * *
23.5 * *

13.7 * *
9.9 *
6.0

32.3 44.1 21.9
* 15.6
* *

43.9 43.4 31.5
4.7 16.2
* 9.1

* * 16.6

2.1 *
15.8

73.5

63.8

24.1

23.0

*

*

76.5

73.0

67.6

63.2

58.8

55.3

*

4.8

235

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Cherokee County - 028

1990
90204 23589
1746
24.8 20.7 21.0
104 18 1827 73 186 128
5 394 29
15 10
5 16
0 4
107 15
0 134 11 22
396 100 297 18 322 43 52
. . .
1491 248 39 384 307 243 . 0

1991
94253 24171
1804
24.7 20.3 21.0
118 23
1807 85
218 153
11 393
31
15 9 6
20 0 9
113 24 3
124 19 28
356 119 306
16 249
40 43
40 34 93
1435 236
43 461 380 324 107
1

Total
1992 1993 1994 5-year

98295 24752
1861

102341 25332 1918

106379 25913 1975

491472 123757
9302

26.0 19.3 21.5

25.5 20.6 22.0

26.1 19.1 23.0

25.5 19.9 22.0

131 26
1747 76
219 141
9 359
48

113 21
1861 85
254 130
10 351
23

136 19
1808 88
248 154
15 336
42

602 107 9050 407 1125 706
50 1833
173

13

3

8

54

10

2

5

36

3

1

3

18

18

12

20

86

3

2

1

6

8

9

5

35

91

124

93

528

20

16

23

98

2

1

2

8

124

136

121

639

12

25

22

89

19

14

13

96

387

422

455

2016

122

110

107

558

276

283

258

1420

13

16

11

74

196

239

235

1241

28

26

30

167

41

33

42

211

59

53

66

218

88

86

78

286

154

243

182

672

1472 230 41 401 376 301 174 0

1588 246
42 491 528 388 192
0

1636 217 64 445 454 358 226 1

7622 1177
229 2182 2045 1614
699 2

1990
87690 22915
1693

1991
91586 23468
1749

White
1992 1993 1994 5-year

95482 24021
1804

99378 24573
1859

103270 25126 1914

477406 120103
9018

24.9 20.4 21.0

24.8 20.3 21.0

26.0 19.3 21.0

25.5 20.7 22.0

26.3 19.1 22.5

25.5 19.9 22.0

99 18 1786 70 174 110
5 364
28

110 22
1765 82
202 128
8 365
28

123 24
1708 74
199 123
9 337
45

102 19
1802 80
232 109
10 331
19

126 17
1754 81
229 132
15 315
39

560 100 8815 387 1036 602
47 1712
159

15

15

13

3

8

54

10

9

10

2

5

36

5

6

3

1

3

18

16

17

18

12

20

83

0

0

3

1

1

5

4

9

7

9

4

33

103

109

86

114

88

500

15

24

18

15

21

93

0

3

2

0

2

7

128

119

119

126

115

607

10

19

12

23

22

86

22

27

19

12

12

92

385

346

380

411

438

1960

93

106

110

97

95

501

292

296

270

272

250

1380

18

12

12

15

11

68

319

246

191

233

233

1222

43

37

26

25

27

158

52

42

39

32

41

206

.

31

44

46

55

176

.

32

72

81

75

260

.

80

148

212

161

601

1462 240 39 370 295 233 . 0

1414 231
42 436 359 305 101
0

1443 225 40 385 361 289 166 0

1547 232
41 462 501 363 177
0

1589 209 61 413 428 333 216 1

7455 1137
223 2066 1944 1523
660 1

1990
1693 443 38

1991
1769 454
39

Black
1992 1993

1845 464 41

1921 475
42

1994 5-year

1997 485 43

9224 2321
203

23.0 20.8 27.5

20.7 20.2 27.5

25.2 17.1 26.0

21.2 16.6 25.0

20.0 25.6 29.0

21.8 20.1 26.0

3

5

4

8

6

26

0

1

2

2

1

6

34

36

29

39

40

178

3

3

2

5

5

18

12

16

18

18

18

82

2

4

2

3

2

13

0

0

0

0

0

0

14

19

11

16

14

74

0

2

2

3

1

8

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

1

0

0

1

0

1

2

3

4

4

9

3

23

0

0

2

1

1

4

0

0

0

1

0

1

5

5

5

7

4

26

1

0

0

2

0

3

0

1

0

1

1

3

9

8

7

10

11

45

7

13

11

11

12

54

4

9

6

8

7

34

0

3

1

1

0

5

3

3

4

2

1

13

0

3

2

1

3

9

0

1

2

1

1

5

.

1

2

1

6

10

.

1

2

1

2

6

.

0

0

11

10

21

24

18

21

26

34

123

6

3

5

9

6

29

0

1

1

1

3

6

13

23

15

20

27

98

12

19

14

19

22

86

10

18

11

18

21

78

.

6

8

10

8

32

0

0

0

0

0

0

236

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Cherokee County - 028

20.3 77.5
2.3 10.3
4.4 16.7
0.5 166.2
6.4
59.6 17.3 41.8 42.5 16.6 92.9
4.0
8.2 5.5 2.8 8.7
* *
5.9 0.8
* 7.4 0.6 1.2
27.8 5.5
16.4 1.0
17.8 2.4 5.3
. . .
82.1 15.4 19.3 21.1 16.9 13.4
.

19.2 74.8
2.3 12.2
4.2 16.3
0.5 165.6
7.2
65.4 19.5 47.1 56.0 17.2 96.8
*
8.3 5.0 3.3 11.0
* 0.5
6.3 1.3
* 6.9 1.1 1.6
25.8 6.7
17.2 0.9
14.0 2.2 4.5
1.5 1.3 3.5
80.3 14.9 21.5 25.8 21.3 18.1
6.0

17.8 70.6 2.1 12.6 3.7 14.5 0.5 158.4 6.5
70.4 19.8 40.8 60.5 25.8 95.8 4.8
7.4 5.7
* 10.3
* 0.4
5.2 1.1
* 7.2 0.7 1.1
28.3 7.0
16.0 0.8 11.3 1.6 4.3
2.1 3.2 5.6
85.0 15.0 20.6 23.1 21.7 17.4 10.0

18.2 73.5
2.2 13.8
3.4 13.9
0.4 148.5
6.0
58.9 18.6 44.3 56.5 12.0 100.0
2.6
* * * 6.4 * 0.5
6.7 0.9
* 7.4 1.4 0.8
27.1 6.0
15.6 0.9
13.1 1.4 3.2
1.8 3.0 8.4
86.4 15.2 19.0 26.8 28.8 21.1 10.5

17.0 69.8 2.1 13.9 3.2 13.0 0.4 144.5 7.0
68.9 14.0 44.6 68.2 21.3 97.6 3.0
4.4 2.8
* 11.0
* *
5.1 1.3
* 6.8 1.2 0.7
27.1 6.0
14.6 0.6 13.2 1.7 4.3
2.2 2.6 6.1
91.3 13.6 32.7 24.9 25.4 20.0 12.7

18.4 73.1
2.2 12.6
3.7 14.8
0.5 156.7
6.6
64.7 17.8 43.8 57.1 18.6 96.5
3.2
6.0 4.0 2.0 9.5 0.2 0.4
5.8 1.1 0.1 7.1 1.0 1.1
27.2 6.2
16.0 0.8
13.9 1.9 4.3
1.9 2.5 5.9
85.0 14.8 22.5 24.4 22.8 18.0
9.8

20.4 77.9
2.3 9.8 4.2 15.9 0.5 159.8 5.6

19.3 75.2
2.3 11.6
4.0 15.6
0.5 160.4
6.2

17.9 71.1 2.1 11.7 3.5 14.0 0.5 154.2 5.8

18.1 73.3
2.2 13.1
3.3 13.5
0.4 146.3
5.3

17.0 69.8 2.1 13.2 3.1 12.5 0.4 141.5 6.2

18.5 73.4
2.2 11.9
3.6 14.3
0.5 152.5
5.8

58.5 18.2 41.3 40.0 16.5 96.3
*

62.9 20.0 46.9 54.3 16.0 96.4
*

68.2 19.5 41.0 59.5 25.0 95.6 3.3

54.9 18.6 43.0 53.8 10.2 100.0
*

65.8 13.5 42.3 69.1 20.4 97.4 3.1

62.1 17.9 42.9 55.7 17.6 96.8
2.1

8.4

8.5

7.6

*

4.6

6.1

5.6

5.1

5.9

*

2.9

4.1

2.8

3.4

*

*

*

2.1

8.9

9.6

10.5

6.6

11.3

9.4

*

*

*

*

*

0.1

*

0.5

0.4

0.5

*

0.4

5.8

6.2

5.0

6.3

5.0

5.7

0.8

1.4

1.1

0.8

1.2

1.1

*

*

*

*

*

0.1

7.2

6.8

7.0

7.1

6.6

7.0

0.6

1.1

0.7

1.3

1.3

1.0

1.2

1.5

1.1

0.7

0.7

1.0

27.5 5.2
16.5 1.0
18.0 2.4 5.4

25.6 6.1
17.1 0.7
14.2 2.1 4.5

28.4 6.5
16.0 0.7 11.3 1.5 4.2

27.2 5.5
15.4 0.8
13.2 1.4 3.2

26.9 5.5
14.6 0.6 13.5 1.6 4.3

27.1 5.7
15.9 0.8
14.1 1.8 4.3

.

1.2

1.6

1.6

1.9

1.6

.

1.2

2.7

2.9

2.6

2.4

.

3.1

5.5

7.6

5.5

5.5

82.3 15.2 19.5 20.8 16.6 13.1
.

80.8 14.9 21.5 25.0 20.6 17.5
5.8

85.1 15.0 20.5 22.7 21.3 17.1
9.8

86.8 14.8 19.2 26.0 28.2 20.4 10.0

91.4 13.6 32.1 23.8 24.7 19.2 12.5

85.3 14.7 22.5 23.7 22.3 17.5
9.5

20.1 76.7
2.3 36.4
8.3 31.6
0.9 274.5
*

20.4 79.4
2.3 44.4 10.7 41.9
1.3 322.0
*

15.7 62.5 1.9 62.1 6.0 23.7 0.7 261.9
*

20.3 82.1
2.5 47.4
8.3 33.7
1.0 275.9
*

20.0 82.4 2.5 45.0 7.0 28.8 0.9 250.0
*

19.3 76.7
2.3 46.6
8.0 31.9
1.0 278.2
6.0

* 127.2

*

*

*

*

*

*

*

*

*

*

*

*

* 191.8 139.5 128.4

*

*

*

23.1

* 119.9 116.3

88.9

* 100.0

*

94.4

*

*

*

39.5

*

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

23.1

*

*

*

*

*

*

*

*

15.2

13.9

17.2

18.9

*

*

*

*

*

*

*

*

*

12.9

*

*

*

*

*

14.9

*

*

*

*

39.1 21.2
* * * * *

38.1 36.1 25.0
* * * *

36.8 37.9 21.4
* * * *

31.3 28.9 21.1
* * * *

29.7 30.0 17.5
* * * *

34.1 30.7 19.5
2.9 7.4 5.1 5.1

.

*

*

*

10.4

4.6

.

*

*

*

*

2.8

.

*

*

19.8

17.3

9.6

72.7 19.4
* 39.4 36.4 30.3
.

54.5 * *
63.9 52.8 50.0 16.7

75.0 19.2
* 51.7 48.3 37.9 27.6

66.7 29.0
* 52.6 50.0 47.4 26.3

85.0

71.1

17.1

18.7

*

28.6

67.5

55.7

55.0

48.9

52.5

44.3

20.0

22.4

237

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Clarke County - 029

1990
87594 27638
1324
23.8 21.1 23.0
142 50 1200 93 439 80 11 736 42
17 10
7 21
2 2
94 24
2 108 14 25
264 156 269 33 107 39 62
. . .
800 163 21 484 422 332
. 1

1991
89115 28059
1319
23.3 21.0 24.0
128 41
1157 93
498 88 16
688 27
12 10
2 26
2 5
106 25 3
100 12 22
343 190 245
26 123
48 74
31 14 192
798 145
28 571 493 427
13 1

Total
1992 1993

90631 28476
1314

92153 28897
1309

23.9 20.8 24.0

22.3 21.3 24.0

159 51
1177 114 497 75 13 647 41

156 46
1220 120 531
79 17 687 26

16

8

8

5

8

3

21

22

1

1

6

6

101

108

20

18

2

0

109

105

10

17

89

72

315

351

170

195

307

279

20

18

120

87

47

36

73

61

90

78

42

59

371

316

855

940

123

134

21

32

577

607

564

661

457

532

136

228

0

0

1994 5-year

93666 29315
1304

453159 142385
6571

23.0 21.4 24.0

23.2 21.1 24.0

155 39
1133 111 466 107 13 589 36

740 227 5887 531 2431 429 70 3347 172

14

67

11

44

3

23

22

112

5

11

7

26

91

500

16

103

3

10

88

510

17

70

22

230

327

1600

186

897

256

1356

8

105

98

535

33

203

51

321

67

266

59

174

467

1346

948

4341

125

690

28

130

592

2831

576

2716

478

2226

332

709

0

2

1990
61929 20092
731

1991
62910 20388
724

White
1992 1993

63884 20681
718

64867 20978
711

1994 5-year

65842 21271
704

319432 103410
3588

25.3 21.1 23.0

24.8 21.2 23.0

25.4 21.1 23.0

24.4 21.3 24.0

24.8 21.6 24.0

24.9 21.2 23.0

48

33

43

33

41

198

15

8

9

8

10

50

643

597

592

613

624

3069

20

21

28

22

26

117

78

96

99

111

125

509

41

50

41

45

51

228

6

7

4

9

4

30

488

441

393

453

405

2180

23

10

13

9

12

67

9

4

4

0

6

23

5

3

1

0

6

15

4

1

3

0

0

8

10

10

5

9

9

43

1

1

0

0

3

5

1

0

3

2

3

9

33

31

26

22

35

147

8

4

5

2

8

27

1

1

0

0

2

4

46

36

28

26

40

176

7

3

6

6

6

28

14

6

39

25

11

95

105

142

104

142

158

651

34

50

39

38

49

210

92

76

95

82

96

441

4

3

4

4

2

17

62

65

68

49

55

299

17

17

16

16

13

79

18

16

19

10

14

77

.

8

28

25

15

76

.

3

18

27

19

67

.

32

63

74

107

276

504

495

487

535

552

2573

98

84

82

81

70

415

15

14

15

9

15

68

136

160

163

179

218

856

119

132

172

203

224

850

91

113

131

149

167

651

.

4

42

72

124

242

0

1

0

0

0

1

1990
22935 6582 568

1991
23333 6779 566

Black
1992 1993

23730 6974 564

24129 7171 562

1994 5-year

24525 7367 559

118652 34872
2819

19.7 20.5 25.0

19.5 19.8 26.0

20.1 19.1 25.0

19.5 20.3 26.0

19.1 19.5 25.0

19.6 19.8 25.0

93

94

114

123

113

537

35

33

42

38

29

177

500

520

533

565

446

2564

73

71

86

98

85

413

360

399

393

417

339

1908

35

33

26

26

49

169

5

7

9

8

9

38

207

201

204

194

157

963

18

17

26

17

23

101

8

8

11

8

8

43

5

7

7

5

5

29

3

1

4

3

3

14

11

14

16

13

13

67

1

1

1

1

2

6

1

5

3

4

4

17

61

75

70

84

51

341

16

21

14

16

8

75

1

2

2

0

1

6

62

62

77

76

43

320

7

9

4

11

9

40

10

15

46

43

11

125

148

191

201

193

157

890

121

140

128

155

135

679

177

168

212

195

155

907

29

23

16

14

6

88

44

58

52

38

41

233

21

31

31

20

19

122

43

55

54

50

37

239

.

22

53

51

40

166

.

11

22

32

36

101

.

155

282

234

343

1014

253

270

324

371

337

1555

59

56

35

47

49

246

6

12

6

21

10

55

319

393

396

408

341

1857

289

355

374

438

332

1788

229

309

316

370

294

1518

.

9

93

156

199

457

1

0

0

0

0

1

238

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Clarke County - 029

13.7 43.4
1.3 37.0
8.4 26.6
0.7 362.2
3.5
107.3 35.2 70.2 90.3 31.7 95.0
9.1
14.2 8.3 5.9
17.3 * *
7.8 2.0
* 9.1 1.2 2.1
34.7 13.2 23.0
2.8 9.1 3.3 9.9
. . .
67.7 15.1 20.2 40.8 35.6 28.0
.

13.0 41.2
1.2 43.6
7.7 24.5
0.6 352.5
3.8
97.0 32.0 70.5 83.9 20.5 100.0
7.6
10.4 8.6 *
22.2 *
0.4
9.2 2.2
* 8.7 1.0 1.9
43.8 16.6 22.2
2.3 11.8
4.6 11.8
1.8 0.8 10.8
70.6 14.1 23.7 49.9 43.1 37.3
1.1

13.0 41.3 1.2 42.6 7.1 22.7 0.6 337.2 3.3
121.0 32.1 86.8 87.7 31.2
100.0 *
13.6 6.8 6.8
17.6 *
0.5
8.6 1.7
* 9.3 0.9 7.6
36.8 14.6 26.7
1.7 13.2 5.2 11.0
5.0 2.4 20.8
73.7 11.4 24.1 49.4 48.3 39.2 11.7

13.2 42.2
1.2 44.2
7.5 23.8
0.6 342.1
3.5
119.1 29.5 91.7 91.7 19.9 96.2 7.6
6.6 4.1
* 17.8
* 0.5
8.9 1.5
* 8.7 1.4 5.9
37.9 16.2 23.6
1.5 9.2 3.8 9.1
4.3 3.3 17.5
77.8 12.4 27.1 50.5 55.0 44.3 19.0

12.1 38.6 1.1 41.8 6.3 20.1 0.5 319.2 4.2
118.9 25.2 85.1 89.0 27.6 97.2 11.5
12.4 9.7 *
19.2 1.1 0.6
8.0 1.4
* 7.9 1.5 1.9
30.1 16.7 23.3
0.7 8.9 3.0 8.9
3.7 3.2 25.7
84.9 12.7 22.0 53.1 51.7 42.9 29.8

13.0 41.3
1.2 41.8
7.4 23.5
0.6 343.1
3.7
112.6 30.7 80.8 88.7 26.2 97.6
7.8
11.4 7.5 3.9
18.8 0.5 0.4
8.5 1.8 0.2 8.8 1.2 3.9
36.3 15.4 23.8
1.8 10.3
3.9 10.2
3.7 2.4 18.7
74.9 13.1 23.5 48.7 46.7 38.3 15.3

10.4 32.0
1.1 12.3
7.9 24.3
0.6 413.6
2.4

9.5 29.3
1.0 16.2
7.0 21.6
0.5 402.0
2.9

9.3 28.6 0.9 16.9 6.2 19.0 0.4 379.3 2.5

9.5 29.2
0.9 18.3
7.0 21.6
0.5 403.7
2.7

9.5 29.3 0.9 20.3 6.2 19.0 0.5 373.6 2.6

9.6 29.7
1.0 16.8
6.8 21.1
0.5 395.0
2.6

65.7 31.3 27.4 65.0 31.5 91.3
8.2

45.6 24.2 29.0 52.4 13.8 100.0
*

59.9 20.9 39.0 57.1 18.1 100.0
*

46.4 24.2 30.9 59.1 12.7 88.9
*

58.2 24.4 36.9 57.7 17.0 91.7
7.1

55.2 25.3 32.6 58.1 18.7 93.9
4.7

14.0 7.8 *
15.4 * *

* * * 16.6 * *

*

*

9.6

7.5

*

*

9.6

4.9

*

*

*

2.6

8.4

14.5

14.3

13.9

*

*

*

0.4

*

*

*

0.3

5.1

5.2

4.4

3.6

5.6

4.8

1.2

*

0.8

*

1.3

0.9

*

*

*

*

*

*

7.2

6.1

4.8

4.3

6.5

5.8

1.1

*

1.0

1.0

1.0

0.9

2.2

1.0

6.6

4.1

1.8

3.1

24.1 5.3
14.6 *
9.8 2.7 5.7

34.1 8.4
13.1 *
11.8 3.1 5.6

23.2 6.7 16.4
* 14.3 3.4
6.1

28.9 6.3
13.7 *
9.8 3.2 3.2

26.3 7.9
15.8 *
9.0 2.1 4.6

27.2 6.9
14.7 0.6
10.8 2.9 5.0

.

0.9

3.0

2.7

1.6

2.0

.

*

1.9

2.9

2.0

1.8

.

3.4

6.7

7.9

11.4

7.3

79.5 17.0 25.4 21.4 18.7 14.3
.

84.2 15.7 23.7 26.9 22.2 19.0
*

83.1 15.4 27.3 27.8 29.4 22.4 7.2

88.0 14.9 14.5 29.5 33.4 24.5 11.9

90.0 12.8 21.7 35.3 36.3 27.1 20.1

84.9 15.2 22.4 28.2 28.0 21.4 10.1

21.8 76.0
2.0 73.0
9.0 31.4
0.9 276.4
6.4

22.3 76.7
2.1 78.1
8.6 29.7
0.8 264.1
5.9

22.5 76.4 2.2 74.3 8.6 29.3 0.8 263.9 5.2

23.4 78.8
2.3 75.4
8.0 27.1
0.8 243.7
5.2

18.2 60.5 1.8 77.6 6.4 21.3 0.6 236.4 8.3

21.6 73.5
2.1 75.6
8.1 27.6
0.8 257.3
6.2

163.7 37.6 128.5 97.3 31.7 100.0 10.6

166.1 35.1
125.4 94.4 30.0
100.0 14.1

202.2 36.8
152.6 97.7 46.1
100.0 *

219.0 30.9
174.5 99.0 30.3
100.0 14.2

202.0 25.7
151.9 98.8 41.1
100.0 17.9

190.5 33.0
146.5 97.6 35.8
100.0 12.1

16.0 10.0
* 21.8
* *

15.4 13.5
* 26.6
* 0.9

20.6 13.1
* 29.5
* *

14.2 8.8 *
22.7 * *

17.9 11.2
* 28.6
* *

16.8 11.3
5.5 25.7
0.7 0.6

12.2

14.4

13.2

14.9

11.4

13.3

3.2

4.0

2.6

2.8

1.8

2.9

*

*

*

*

*

0.2

12.6

12.2

14.6

13.8

9.8

12.7

1.4

1.8

*

2.0

2.1

1.6

2.0

2.9

8.7

7.6

2.5

4.9

51.6 24.5 36.9
5.9 9.1 4.4 14.8

56.2 27.4 34.7
4.6 12.6
6.8 16.7

55.1 24.2 40.7 3.0 13.4 8.0 16.1

48.4 28.0 35.9
2.6 9.3 4.9 14.8

36.9 30.9 36.0 1.4 9.4 4.3 15.4

49.0 26.9 36.9
3.5 10.7
5.6 15.6

.

2.9

6.8

6.5

5.1

5.3

.

1.4

2.8

4.1

4.5

3.2

.

20.1

36.3

29.8

43.3

32.4

51.4 13.2 13.3 64.7 58.6 46.5
.

53.6 12.3 22.2 76.9 69.5 60.5
1.8

62.1 7.0 20.7 74.9 70.7 59.7 17.6

66.5 9.4
40.4 73.8 79.2 66.9 28.2

76.6

61.8

12.7

10.7

19.2

23.7

78.0

73.6

76.0

70.9

67.3

60.2

45.5

22.5

239

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Clay County - 030

1990
3364 703 76
20.4 18.9 24.0
6 1 58 4 31 2 0 9 2
2 2 0 1 0 1
9 3 0 8 1 1
15 23 12
2 9 1 5
. . .
39 7 1
38 37 29
. 0

1991
3364 703
77
18.5 18.8 20.0
9 2 49 8 34 3 2 8 0
1 0 1 2 0 1
3 1 0 3 0 0
14 22 17
1 7 1 2
2 2 15
34 7 0
39 38 33
0 0

Total
1992 1993

3364 702 77

3357 700
77

17.4 .
23.5

20.5 17.2 27.0

14

11

4

5

56

51

14

8

33

37

3

5

1

0

4

6

0

2

1

1

1

1

0

0

1

0

0

0

0

2

7

4

0

0

0

0

4

3

1

0

1

1

20

16

21

25

24

15

0

1

7

5

0

0

5

1

12

1

1

3

28

15

44

41

2

2

0

0

39

38

41

36

34

31

1

2

0

0

1994 5-year

3354 699 78

16803 3507 385

20.6 .
21.5

20.1 18.7 23.0

8

48

4

16

38

252

8

42

30

165

6

19

0

3

7

34

0

4

1

6

1

5

0

1

1

5

0

0

2

6

6

29

2

6

0

0

6

24

1

3

1

4

16

81

17

108

7

75

1

5

2

30

1

3

2

15

3

18

5

11

26

84

27

185

4

22

0

1

27

181

30

182

26

153

5

8

0

0

1990
1310 240 21

1991
1312 240
21

White
1992 1993

1316 239 21

1313 238
20

1994 5-year

1316 238 20

6567 1195
104

23.0 20.3 23.0

18.1 18.8 19.0

23.6 .
23.0

24.1 20.1 21.0

22.1 .
19.0

23.3 20.2 21.0

1

0

2

1

2

6

0

0

0

0

0

0

16

8

15

13

6

58

1

0

2

1

2

6

2

2

1

4

1

10

1

0

1

1

2

5

0

0

1

0

0

1

6

2

0

3

2

13

0

0

0

0

0

0

0

0

1

0

0

1

0

0

1

0

0

1

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

2

1

3

0

0

1

3

0

4

0

0

0

0

0

0

0

0

0

0

0

0

1

0

1

0

1

3

1

0

0

0

0

1

1

0

0

0

0

1

2

2

2

1

1

8

1

0

1

4

1

7

2

3

6

1

0

12

0

0

0

1

0

1

3

0

2

1

0

6

0

0

0

0

0

0

1

1

1

0

0

3

.

1

1

0

1

3

.

0

1

1

2

4

.

0

3

2

0

5

13

6

13

12

5

49

4

1

1

1

0

7

1

0

0

0

0

1

8

6

5

5

1

25

2

4

5

5

2

18

2

4

4

4

1

15

.

0

0

1

0

1

0

0

0

0

0

0

1990
2044 462 55

1991
2044 462
55

Black
1992 1993

2044 461 56

2040 460
56

1994 5-year

2038 459 56

10210 2303 279

19.8 16.0 24.0

18.8 18.7 26.0

16.1 .
26.0

20.2 16.4 29.5

20.6 .
22.0

19.5 17.2 25.0

5

9

12

10

6

42

1

2

4

5

4

16

42

40

41

37

32

192

3

8

12

7

6

36

29

32

32

33

29

155

0

3

2

4

4

13

0

2

0

0

0

2

3

6

4

3

5

21

2

0

0

2

0

4

2

1

0

1

1

5

2

0

0

1

1

4

0

1

0

0

0

1

1

2

0

0

1

4

0

0

0

0

0

0

1

1

0

0

1

3

9

3

6

1

6

25

3

1

0

0

2

6

0

0

0

0

0

0

7

3

3

3

5

21

0

0

1

0

1

2

0

0

1

1

1

3

13

12

18

15

15

73

22

22

20

21

16

101

10

14

18

14

7

63

2

1

0

0

1

4

6

6

5

3

2

22

1

1

0

0

1

3

4

1

4

1

2

12

.

0

3

1

2

6

.

0

0

0

3

3

.

0

12

10

23

45

26

27

31

29

22

135

3

6

1

1

4

15

0

0

0

0

0

0

30

33

34

33

26

156

35

33

36

30

28

162

27

29

30

27

25

138

.

0

1

1

5

7

0

0

0

0

0

0

240

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Clay County - 030

17.2 82.5
2.5 54.4
2.7 12.8
0.4 130.4
*
78.9 * * * * * *
* * * * * *
15.5 * *
14.0 * *
41.7 40.4 21.4
* 17.3
* 14.7
. . .
73.6 14.0
* 66.7 64.9 50.9
.

14.6 69.7
2.1 69.4
2.4 11.4
0.3 127.0
8.5
117.5 *
104.4 100.0
* * *
* * * * * *
* * * * * *
43.8 44.9 34.7
* 15.6
* *
* * 15.2
75.6 15.2
* 79.6 77.6 67.3
*

16.6 79.8 2.4 60.0
* * * * *
181.3 *
181.3 85.7 * * *
* * * * * *
12.5 * * * * *
42.6 38.2 43.6
* 13.5
* 15.6
12.2 *
28.4
81.5 * *
70.9 74.5 61.8
*

15.2 72.9
2.2 72.5
1.8 8.6 0.3 96.8 7.1
142.5 45.5
103.6 87.5 * * *
* * * * * *
* * * * * *
42.1 49.0 29.4
* 12.5
* *
* * 15.3
80.4 * *
74.5 70.6 60.8
*

11.3 54.4 1.6 81.1 2.1 10.0 0.3 134.6 10.0
102.7 *
102.7 75.0 * * *
* * * * * *
15.8 * *
16.2 * *
47.1 45.9 18.9
* * * *
* 5.1 26.4
71.1 * *
73.0 81.1 70.3 13.5

15.0 71.9
2.2 66.3
2.0 9.7 0.3 109.7 6.8
124.7 33.3 109.1 85.7
* * *
23.8 19.8
* 19.6
* 1.6
11.5 2.4 * 9.7 * *
43.3 43.4 30.2
2.1 13.5
* 10.0
4.6 2.8 21.3
76.8 9.6 *
72.7 73.1 61.4
4.2

12.2 66.7
2.1 *
4.6 25.0
0.7 260.9
*
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
. . .
81.3 * *
53.3 * * .

6.1 33.3
1.1 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* * *
85.7 * *
75.0 * * *

11.4 62.8 2.0
* * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * 40.0 * * * *
* * *
86.7 * *
33.3 33.3
* *

9.9 54.6
1.7 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* * *
92.3 * *
38.5 38.5
* *

4.6 25.2 0.8
* * * * * *

8.8 48.5
1.6 17.5
2.0 10.9
0.3 168.8
5.0

*

57.8

*

*

*

57.8

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

21.1

*

12.3

*

21.1

*

*

*

15.4

*

*

*

*

*

*

*

*

*

4.7

83.3 * * * * * *

86.0 14.6
* 43.9 31.6 26.3
*

20.5 90.9
2.7 69.0
* * * * *

19.6 86.6
2.5 80.0
2.9 13.0
0.4 115.4
13.0

20.1 88.9 2.5 80.0
* * * * *

18.1 80.5
2.3 89.2
* * * * *

15.7 69.8 2.0 93.5 2.5 10.9
* 119.0
10.9

18.8 83.4
2.4 81.6
2.1 9.1 0.2 91.3 7.4

90.9 * * * * * *

162.5 *
144.4 100.0
* * *

214.7 *
214.7 91.7 * * *

178.9 50.0
125.2 85.7 * * *

106.6 *
106.6 83.3 * * *

150.8 38.1 129.3 91.7
* * *

*

*

*

*

*

26.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

21.4 * *
16.7 * *

*

14.6

*

*

*

*

*

*

*

*

*

*

*

18.8

13.0

*

*

3.1

*

*

*

*

16.1

11.1

*

*

*

*

*

*

52.0 52.4 24.4
* 15.0
* *

46.2 55.0 35.0
* 15.4
* *

51.4 50.0 45.0
* 12.5
* *

48.4 56.8 37.8
* * * *

50.0 51.6 22.6
* * * *

49.7 53.2 33.3
* 12.1
* 10.1

.

*

*

*

*

2.1

.

*

*

*

*

*

.

*

16.8

14.0

32.2

15.8

70.3 * *
71.4 83.3 64.3
.

73.0 15.4
* 82.5 82.5 72.5
*

79.5 * *
85.0 90.0 75.0
*

78.4 * *
89.2 81.1 73.0
*

68.8

74.2

*

8.4

*

*

83.9

82.1

90.3

85.3

80.6

72.6

16.1

4.7

241

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Clayton County - 031

1990
182052 50075
4079
23.0 20.0 22.0
357 71 3440 207 957 305 34 1622 136
49 38 11 72
4 8
266 65 12 318 39 64
607 468 668 109 612 107 139
. . .
2144 494 96
1099 817 562 . 9

1991
185850 50531 4127
22.2 20.2 22.0
436 73
3394 274 1056 290
40 1721 147
39 25 14 64
6 9
261 54 9
306 35 51
533 525 679
97 461
58 107
49 25 118
2267 483
79 1473 1195 974 289
14

Total
1992 1993

189641 50984 4174

193440 51441 4221

22.3 21.0 23.0

22.3 20.6 23.0

354 64
3288 227
1057 240 32
1620 114

441 83
3368 295 1251 203
23 1648 137

32

31

19

16

13

15

51

39

6

5

8

18

275

300

62

62

9

6

315

330

52

37

35

26

489

557

569

589

649

695

72

56

361

335

37

30

126

136

112

128

71

87

480

472

2268 474 71
1400 1337
973 371
18

2467 462
91 1704 1662 1287 465
27

1994 5-year

197233 51896 4268

948216 254927
20868

22.5 21.1 23.0

22.5 20.6 23.0

365 77
3462 243
1357 203 20
1500 115

1953 368
16952 1246 5678 1241 149 8111 649

33

184

19

117

14

67

37

263

2

23

16

59

290

1392

47

290

2

38

339

1608

41

204

28

204

703

2889

695

2846

678

3369

43

377

287

2056

28

260

133

641

172

461

57

240

501

1571

2724 392 110
1732 1710 1330
552 24

11870 2305 447 7408 6721 5126 1677 92

White
1990 1991 1992 1993 1994 5-year

131729 33634 2949

132164 33305 2907

132595 32976 2865

133031 32648 2823

133462 32319 2781

662981 164882
14325

22.5 19.5 21.0

22.1 19.8 21.0

22.2 20.1 22.0

21.6 19.9 22.0

22.2 20.5 22.0

22.1 19.9 21.0

220 36
2202 126 450 177 17 809 82

259 39
2086 165 468 158 16 825 86

208 32
1950 138 440 133 14 686 64

238 39
1873 169 526 114 10 681 61

193 32
1826 140 559 101 7 531 49

1118 178
9937 738
2443 683 64
3532 342

26

12

14

13

13

78

20

9

5

4

5

43

6

3

9

9

8

35

37

26

19

13

11

106

1

5

2

1

1

10

7

4

7

11

10

39

141

137

129

131

114

652

30

28

24

24

14

120

7

4

2

1

0

14

178

178

141

145

154

796

25

21

34

20

21

121

44

30

15

16

17

122

378

317

291

318

318

1622

204

231

213

228

247

1123

500

477

460

484

448

2369

58

44

31

24

14

171

528

391

318

292

234

1763

71

45

24

18

11

169

77

59

65

68

70

339

.

25

64

53

74

216

.

17

47

62

37

163

.

54

272

262

276

864

1434 309 59 590 484 324 . 7

1457 307 48 763 685 541 165 3

1391 281 45 709 754 544 230 8

1401 241 63 814 844 639 219 16

1485 212 73 809 854 651 256 14

7168 1350
288 3685 3621 2699
870 48

1990
43403 14479
939

1991
44309 14581
950

Black
1992 1993

45212 14683
961

46118 14786
972

1994 5-year

47022 14888
983

226064 73418
4804

23.6 21.2 25.0

21.7 21.5 26.0

22.4 22.3 26.0

23.6 20.8 26.0

22.9 21.5 26.0

23.0 21.5 26.0

125 31
1115 73 490 112 17 729 50

169 32
1175 105 571 125 24 822 57

136 31
1203 84
599 98 18
843 45

190 42
1363 119 701
81 11 873 70

158 43
1466 93
753 97 13
900 62

778 179 6322 474 3114 513
83 4167
284

22

26

18

18

19

103

17

15

14

12

13

71

5

11

4

6

6

32

34

37

32

24

25

152

2

1

3

4

1

11

1

4

1

6

5

17

116

120

140

156

161

693

33

25

38

37

32

165

5

5

7

5

2

24

129

124

163

175

171

762

12

14

17

17

19

79

19

20

19

10

11

79

201

189

178

219

348

1135

254

285

343

345

414

1641

132

157

146

172

183

790

49

50

40

31

26

196

81

66

41

40

52

280

35

13

13

12

17

90

55

38

54

63

58

268

.

23

41

64

89

217

.

6

22

19

18

65

.

52

187

188

183

610

651

727

791

978

1120

4267

171

162

176

210

170

889

33

30

25

27

34

149

469

650

638

818

842

3417

309

470

536

761

776

2852

219

400

395

602

621

2237

.

115

128

223

271

737

2

10

9

9

10

40

242

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Clayton County - 031

18.9 68.7
2.0 28.1
8.9 32.4
1.0 299.4
7.1
87.5 19.9 50.7 75.1 33.3 97.8
4.2
14.2 11.0
3.2 20.7
* 0.2
7.7 1.9 0.3 9.4 1.1 1.9
26.2 13.8 20.1
3.3 18.3
3.2 8.3
. . .
65.3 16.2 27.9 32.3 24.0 16.5
.

18.3 67.2
2.0 31.4
9.3 34.1
1.0 315.3
6.8
105.7 16.7 66.4 73.9 35.6 97.9 4.1
11.5 7.4 4.2
18.6 0.5 *
7.7 1.6 0.3 9.1 1.0 1.5
25.2 15.6 20.7
3.0 13.9
1.7 6.4
0.9 0.5 2.3
69.4 16.1 22.3 43.8 35.6 29.0
8.6

17.3 64.5 1.9 32.7
8.5 31.8 0.9 312.1 5.6
84.8 18.1 54.4 74.9 27.3 98.2 3.4
9.7 5.8 4.0 15.4 0.5 0.2
8.4 1.9 0.3 9.7 1.6 1.1
25.9 17.6 20.7 2.3 11.2 1.2 7.2
2.1 1.3 9.1
70.7 16.2 23.4 43.3 41.3 30.1 11.5

17.4 65.5
2.0 37.6
8.5 32.0
1.0 313.8
4.6
104.5 18.8 69.9 82.7 32.5 97.0 2.1
9.2 4.8 4.5 11.5 0.4 0.5
8.9 1.8 0.2 9.9 1.1 0.8
26.5 17.7 21.5
1.7 10.1
0.9 7.5
2.4 1.6 8.7
74.4 15.4 27.7 51.1 49.9 38.6 14.0

17.6 66.7 2.0 39.7
7.6 28.9 0.9 289.1 4.4
85.5 21.1 56.9 83.5 26.9 99.1 2.1
9.5 5.5 4.1 10.6
* 0.4
8.4 1.4
* 9.9 1.2 0.8
25.2 20.3 20.1 1.3 8.4 0.8 7.2
3.1 1.0 9.1
79.6 12.8 31.3 50.6 50.0 38.9 16.1

17.9 66.5
2.0 33.9
8.6 31.8
1.0 306.0
5.7
93.6 18.8 59.7 78.2 31.1 98.0
3.2
10.9 6.9 4.0
15.4 0.4 0.3
8.2 1.7 0.2 9.6 1.2 1.2
25.8 17.0 20.6
2.3 12.4
1.6 7.3
2.2 1.1 7.3
71.9 15.3 26.6 44.2 40.1 30.6 12.6

16.7 65.5
1.9 20.7
6.1 24.1
0.7 251.5
6.1

15.8 62.6
1.9 22.7
6.2 24.8
0.7 266.8
5.4

14.7 59.1 1.8 23.0
5.2 20.8 0.6 246.0 4.6

14.1 57.4
1.7 28.4
5.1 20.9
0.6 254.1
3.9

13.7 56.5 1.7 31.0
4.0 16.4 0.5 215.2 3.4

15.0 60.3
1.8 24.9
5.3 21.4
0.6 247.9
4.7

74.6 16.4 42.7 64.5 27.8 97.5
4.7

89.1 15.1 56.8 58.9 29.6 96.4
3.4

72.6 15.4 48.2 61.6 22.3 98.4 2.4

84.3 16.4 59.9 73.4 21.6 93.3
2.8

69.4 16.6 50.3 72.7 17.6 100.0 1.8

78.0 15.9 51.5 66.3 23.9 97.0
3.1

11.8

5.8

7.2

6.9

7.1

7.8

9.1

4.3

2.6

*

2.7

4.3

2.7

*

4.6

4.8

4.4

3.5

16.7

12.4

9.7

6.9

6.0

10.6

*

0.6

*

*

*

0.2

0.3

*

0.3

0.5

0.4

0.3

6.4

6.6

6.6

7.0

6.2

6.6

1.4

1.3

1.2

1.3

0.8

1.2

0.3

*

*

*

*

0.1

8.2

8.6

7.4

7.8

8.5

8.1

1.1

1.0

1.8

1.1

1.2

1.2

2.0

1.4

0.8

0.9

0.9

1.2

23.9 9.4
23.4 2.7
24.6 3.3 7.2

22.7 11.2 23.5
2.2 19.0
2.2 5.9

24.3 11.1 24.6 1.6 16.7 1.3 6.3

25.4 12.3 26.8
1.3 15.8
1.0 6.9

21.7 13.7 25.2 0.8 13.0 0.6 7.4

23.5 11.4 24.6
1.8 18.1
1.7 6.7

.

0.7

1.9

1.6

2.2

1.6

.

0.5

1.4

1.8

1.1

1.2

.

1.6

8.0

7.7

8.1

6.3

67.9 15.8 26.2 27.1 22.2 14.9
.

71.8 16.6 22.6 36.9 33.2 26.2
8.0

72.6 16.2 25.0 37.0 39.4 28.4 12.0

76.1 14.6 31.0 43.9 45.5 34.5 11.8

82.3 13.2 36.0 44.8 47.3 36.0 14.2

73.9 15.4 28.2 37.5 36.9 27.5 11.4

25.7 77.0
2.3 44.5 16.8 50.3
1.5 368.9
9.1

26.5 80.6
2.4 49.1 18.6 56.4
1.7 382.1
10.6

26.6 81.9 2.5 50.5 18.6 57.4 1.7 389.0 8.2

29.6 92.2
2.8 52.0 18.9 59.0
1.8 373.9
6.7

31.2 98.5 3.0 52.0 19.1 60.5 1.9 363.2 7.5

28.0 86.1
2.6 49.9 18.4 56.8
1.7 375.2
8.4

133.1 24.8 77.7 95.9 53.2 100.0
*

177.9 18.9
110.5 97.1 60.0
100.0 7.4

141.5 22.8 87.4 97.6 46.8
100.0 7.3

195.6 22.1
122.5 99.2 72.0
100.0 *

160.8 27.2 94.7 98.9 63.1 98.4 *

162.0 23.0 98.7 97.9 59.1 99.6 4.6

19.7 15.2
4.6 30.0
* *

22.1 12.8
9.5 30.9
* *

15.0 11.6
* 26.2
* *

13.2 8.8 4.4
17.5 *
0.6

13.0 8.9 4.1
16.9 *
0.5

16.3 11.2
5.1 23.7
0.5 0.3

10.4

10.2

11.6

11.4

11.0

11.0

3.0

2.1

3.2

2.7

2.2

2.6

0.4

0.4

0.6

0.4

*

0.4

11.7

10.7

13.7

13.0

11.8

12.2

1.1

1.2

1.4

1.3

1.3

1.3

1.7

1.7

1.6

0.7

0.8

1.3

30.5 23.0 12.2
4.6 7.5 3.2 9.8

29.1 24.5 13.9
4.5 5.8 1.1 6.1

28.4 28.9 12.7 3.5 3.5 1.1 8.4

28.0 25.6 13.1
2.3 3.0 0.9 8.4

29.1 28.6 12.7 1.8 3.6 1.2 7.2

29.0 26.3 12.9
3.2 4.5 1.5 7.9

.

1.5

2.7

4.1

5.6

3.5

.

0.4

1.4

1.2

1.1

1.1

.

3.5

12.3

12.1

11.6

9.9

61.1 17.2 30.0 42.6 28.0 19.9
.

65.3 15.7 22.6 55.9 40.4 34.4
9.9

68.0 16.4 21.6 53.7 45.2 33.3 10.8

72.7 17.1 22.1 60.7 56.5 44.7 16.6

77.1

69.5

13.0

15.8

24.1

24.0

58.1

54.7

53.6

45.7

42.9

35.8

18.7

14.3

243

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Clinch County - 032

1990
6160 1409
173
19.1 21.8 20.0
22 7
109 21 45 10
1 2 0
2 2 0 3 0 1
6 1 0 8 1 2
46 24 54
0 15
1 3
. . .
59 15
0 58 54 45
. 0

1991
6145 1398 170
19.0 .
22.0
12 1
90 11 37
2 0 1 0
3 2 1 2 0 1
9 0 0 12 4 2
32 16 36
0 13
1 3
4 1 12
50 11
0 60 57 49 24
1

Total
1992 1993

6127 1387
166

6115 1377 162

20.8 .
21.0

19.4 .
21.0

10

13

2

3

103

103

10

13

44

43

6

7

0

1

1

5

0

0

0

0

0

0

0

0

0

1

0

0

0

1

11

7

2

0

0

0

12

12

3

0

1

3

38

43

20

18

32

36

1

0

9

19

1

3

3

5

10

6

7

5

25

29

62

77

8

10

0

1

67

63

62

70

55

54

40

45

0

0

1994 5-year

6093 1366
159

30640 6937 830

20.1 24.2 22.0

19.7 22.7 21.0

14

71

2

15

135

540

14

69

52

221

11

36

1

3

2

11

0

0

2

7

2

6

0

1

3

9

0

0

1

4

18

51

7

10

1

1

19

63

3

11

4

12

52

211

24

102

48

206

3

4

14

70

1

7

6

20

5

25

8

21

31

97

97

345

18

62

2

3

81

329

95

338

73

276

73

182

1

2

1990
4456 1009
127

1991
4453 1002 125

White
1992 1993

4445 994 121

4446 988 119

1994 5-year

4437 980 116

22237 4973 607

20.4 22.7 19.5

20.2 .
21.0

20.7 .
20.0

20.3 .
20.0

20.8 .
20.0

20.5 22.7 20.0

5

6

6

9

8

34

1

0

1

3

2

7

60

58

66

66

82

332

5

5

6

9

8

33

7

12

13

12

12

56

6

1

6

5

4

22

0

0

0

1

0

1

1

0

0

4

1

6

0

0

0

0

0

0

0

0

0

0

2

2

0

0

0

0

2

2

0

0

0

0

0

0

0

0

0

1

2

3

0

0

0

0

0

0

1

1

0

0

1

3

4

4

5

6

11

30

0

0

2

0

5

7

0

0

0

0

1

1

6

8

9

7

13

43

1

2

2

0

2

7

0

1

1

1

3

6

23

16

23

19

31

112

4

5

4

6

3

22

26

21

21

24

27

119

0

0

1

0

1

2

11

12

7

13

11

54

1

0

1

0

0

2

1

1

1

2

1

6

.

4

9

5

4

22

.

1

7

4

4

16

.

4

6

6

23

39

43

40

42

53

68

246

9

6

6

8

13

42

0

0

0

0

1

1

22

32

34

34

40

162

21

34

32

38

51

176

16

27

26

28

37

134

.

14

20

27

37

98

0

0

0

0

1

1

1990
1682 394 46

1991
1678 391
45

Black
1992 1993

1673 388 44

1670 386
43

1994 5-year

1664 383 42

8366 1941
221

17.9 20.9 26.0

17.6 .
27.0

20.8 .
23.0

18.8 .
29.0

18.6 24.2 25.0

18.4 22.5 27.0

17

6

4

4

6

37

6

1

1

0

0

8

49

31

37

37

53

207

16

6

4

4

6

36

38

25

31

31

40

165

4

1

0

2

7

14

1

0

0

0

1

2

1

1

0

1

1

4

0

0

0

0

0

0

2

3

0

0

0

5

2

2

0

0

0

4

0

1

0

0

0

1

3

2

0

0

1

6

0

0

0

0

0

0

0

0

0

1

0

1

2

5

6

1

7

21

1

0

0

0

2

3

0

0

0

0

0

0

2

4

3

5

6

20

0

2

1

0

1

4

2

1

0

2

1

6

23

16

15

24

21

99

20

11

16

12

21

80

28

15

11

12

21

87

0

0

0

0

2

2

4

1

2

6

3

16

0

1

0

3

1

5

2

2

2

3

5

14

.

0

1

1

1

3

.

0

0

1

4

5

.

7

19

23

8

57

16

9

20

24

29

98

6

4

2

2

5

19

0

0

0

1

1

2

36

27

33

29

41

166

33

22

30

32

44

161

29

21

29

26

36

141

.

10

20

18

36

84

0

1

0

0

0

1

244

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

17.7

14.6

16.8

16.8

22.2

17.6

General fertility rate

77.4

64.4

74.3

74.8

98.8

77.8

Total fertility rate

2.2

1.9

2.2

2.2

2.9

2.3

% Livebirths to unmarried women

41.7

43.0

44.4

41.7

39.4

41.9

Crude abortion rate

*

*

*

0.8

*

0.4

General abortion rate

*

*

*

3.6

*

1.6

Total abortion rate

*

*

*

*

*

0.0

Abortion ratio

*

*

*

43.1

*

18.5

Fetal Death rate

8.5

*

5.0

5.8

10.2

6.2

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

127.2

70.6

60.2

80.0

88.2

85.5

% Repeat conceptions to women under 18

31.8

*

*

*

*

21.1

Livebirths to women under 18

121.4

64.7

60.2

80.0

88.2

83.1

% Livebirths to unmarried women under 18

90.5

81.8

60.0

46.2

53.8

69.1

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

13.0

Neonatal mortality

*

*

*

*

*

11.1

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

16.6

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

5.5

10.0

10.7

6.8

13.3

9.4

% Very low birthweight

*

*

*

*

5.2

1.9

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

7.5

14.0

12.1

11.7

14.5

12.0

% Multiple gestation

*

*

*

*

*

2.1

% Birth defect

*

*

*

*

*

2.3

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

50.5

43.8

45.2

46.2

40.9

45.1

% with father not named on birth certificate

22.2

18.6

20.2

17.5

18.2

19.3

% with maternal education less than high school

50.9

43.4

32.3

35.3

36.6

39.5

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

14.0

15.3

9.4

19.0

10.6

13.5

% Maternal alcohol use during pregnancy

*

*

*

*

*

1.3

% Interpregnancy interval less than 6 months

*

*

*

8.1

8.7

7.0

Child abuse and neglect rates

Physical

.

*

5.5

3.4

2.8

3.5

Sexual

.

*

3.9

2.8

4.5

2.9

Neglect

.

6.6

13.8

16.2

17.5

13.5

Interventions to improve infant & child survival

% Prenatal care first trimester

59.0

60.2

61.4

75.5

72.9

66.5

% Primary C-section delivery

15.3

13.6

9.1

10.8

15.1

12.9

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

53.7

69.8

67.7

61.2

61.4

62.3

% Medicaid during pregnancy

50.0

66.3

62.6

68.0

72.0

64.0

% Medicaid and WIC during pregnancy

41.7

57.0

55.6

52.4

55.3

52.3

% Perinatal case management

.

27.9

40.4

43.7

55.3

43.3

Clinch County - 032

13.5 59.5
1.8 11.9
* * * * 6.9
39.4 *
39.4 * * * *
* * * * * *
* * * 10.2 * *
46.9 *
44.8 *
18.6 * *
. . .
78.2 17.3
* 37.3 35.6 27.1
.

13.0 57.9
1.7 21.4
* * * * *
48.2 *
40.2 * * * *
* * * * * *
* * * 14.3 * *
31.4 8.9
37.5 *
21.8 * *
* * *
74.1 11.1
* 57.1 60.7 48.2 25.0

14.8 66.4 2.0 20.6
* * * * 7.0
49.5 *
49.5 * * * *
* * * * * *
7.6 * *
14.3 * *
41.1 *
33.3 *
11.5 * *
7.7 6.0 5.2
65.6 11.1
* 54.0 50.8 41.3 31.7

14.8 66.8
2.0 18.2
* * * * 6.1
75.8 *
75.8 * * * *
* * * * * *
9.1 * *
10.6 * *
31.7 9.1
36.4 *
20.6 * *
4.3 *
5.2
81.5 13.8
* 51.5 57.6 42.4 40.9

18.5 83.7 2.5 15.0
* * * * 6.1
69.2 *
69.2 * * * *
* * * * * *
13.4 6.1
* 16.2
* *
39.7 *
34.2 *
13.8 * *
* * 20.2
84.0 18.1
* 50.0 63.8 46.3 46.3

14.9 66.8
2.0 17.3
0.3 1.2
* 16.4
5.4
56.0 20.6 54.4 36.4
* * *
* * * * * *
9.0 2.1
* 13.3
2.2 1.8
38.1 6.8
37.0 *
17.0 *
3.8
4.7 3.4 8.4
77.1 14.5
* 50.0 54.3 41.4 37.0

29.1 124.4
3.4 77.6
* * * * 12.7

18.5 79.3
2.3 86.2
* * * * *

369.6 35.3 347.8 100.0
* * *

132.7 *
132.7 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

16.1

*

*

*

*

*

*

*

*

*

*

54.8 40.8 58.3
* * * *

76.2 37.9 55.6
* * * *

.

*

.

*

.

11.0

35.6 13.0
* 73.5 67.3 59.2
.

32.1 * *
93.1 75.9 72.4 34.5

22.1 95.3 2.8 86.1
* * * * *
* * * * * * *
* * * * * *
16.2 * * * * *
53.6 44.4 30.6
* * * *
* * 30.1
54.1 * *
91.7 83.3 80.6 55.6

22.2 96.0
2.8 83.8
* * * * *

31.9 138.5
3.9 76.9
* * * * 20.9

24.7 106.6
3.0 81.3
* * * * 8.2

* 142.2 167.6

*

*

21.6

* 142.2 163.0

* 100.0 100.0

*

*

*

*

*

*

*

*

*

*

*

24.2

*

*

*

*

*

*

*

*

28.7

*

*

*

*

*

*

* * * 13.5 * *

13.2 * *
11.8 * *

10.1 * *
10.0 *
2.9

72.7 32.4 33.3
* 16.2
* *

42.9 40.4 40.4
* * * 14.3

57.2 39.4 43.7
* 8.0 2.5 11.1

* * 36.8

* * 12.9

* 2.0 22.7

64.9

55.8

49.2

*

10.6

10.1

*

*

*

78.4

78.8

81.8

86.5

84.6

79.3

70.3

69.2

69.5

48.6

69.2

54.5

245

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Cobb County - 033

1990
447745 124331
8597
25.7 21.6 24.0
580 123 7716 317 1241 698 61 3495 248
73 54 19 113 12 30
513 104
9 610 95 78
1431 630 947 183
1002 223 249
. . .
6161 1092
175 1544 1239
877 .
14

1991
463750 126703
8846
26.1 21.9 24.0
539 90
7503 308 1329 753
56 3431 212
44 33 11 90
8 19
490 87 13
554 97 58
1229 685 962 151 879 169 258
102 75
288
6091 1017 145 1912 1560 1226 130
24

Total
1992 1993

479750 129075
9095

495756 131448
9345

25.9 21.9 24.0

26.1 22.4 24.0

546 117 7425 328 1451 688
66 3366
198

602 128 7713 354 1526 663
43 3387 230

46

54

33

38

13

16

99

80

7

10

23

30

492

540

98

104

9

9

585

582

87

109

48

51

1262 742 947 115 799 113 222

1445 739 982
79 781 106 226

258

250

128

83

554

548

6338 962 132
1821 1846 1320
595 19

6672 959 196 2213 2355 1714 934
18

1994 5-year
511758 2398759 133819 645376
9594 45476

26.4 22.5 24.0

26.0 22.1 24.0

594 112 7996 382 1731 691
63 3211
197

2861 570
38353 1689 7278 3493 289
16890 1085

54

271

33

191

21

80

95

477

11

48

19

121

532

2567

95

488

14

54

575

2906

127

515

45

280

1679 856 971 67 792 127 213

7046 3652 4809
595 4253
738 1168

252

862

96

382

707

2097

7070 980 239
2242 2368 1746 1151
29

32332 5010 887 9732 9368 6883 2810 104

White
1990 1991 1992 1993 1994 5-year

391959 106347
7508

400986 106839
7632

410007 107330
7757

419036 107824
7882

428060 2050048 108315 536655
8006 38784

25.9 21.0 24.0

26.4 21.4 23.0

26.1 21.8 24.0

26.5 22.3 24.0

26.6 22.5 24.0

26.3 21.8 24.0

454 91
6305 236 728 521 36
2436 207

391 55
6059 223 764 535
33 2306 159

383 74
5910 241 828 506 38
2153 134

404 86
5956 234 828 453
25 2087 162

369 61
6184 231 947 458 33
1827 128

2001 367
30414 1165 4095 2473 165
10809 790

49

32

26

26

29

162

36

22

18

17

17

110

13

10

8

9

12

52

72

56

56

40

50

274

11

7

5

8

6

37

25

17

18

26

17

103

361

334

331

342

330

1698

66

52

56

59

49

282

4

8

2

3

4

21

452

402

411

386

388

2039

82

72

64

79

94

391

62

42

37

33

38

212

1127

957

974

1069

1237

5364

368

388

423

373

457

2009

785

783

784

753

752

3857

119

102

80

48

42

391

905

789

732

687

698

3811

184

146

100

87

108

625

176

183

149

143

141

792

.

55

131

149

120

455

.

56

94

63

71

284

.

157

302

296

357

1112

5172 890 140 980 842 574 . 12

5080 811 122 1209 1038 792
77 21

5170 749 92
1136 1236
856 377
11

5285 729 149 1300 1495 1021 562
13

5571 730 186
1339 1516 1074
696 15

26278 3909 689 5964 6127 4317 1712 72

1990
44154 14673
804

1991
45732 14895
827

Black
1992 1993

47310 15118
851

48889 15340
874

1994 5-year

50467 15563
897

236552 75589
4253

24.4 23.7 25.0

24.5 23.6 26.0

24.7 22.1 26.0

24.3 22.4 27.0

24.4 22.2 26.0

24.5 22.7 26.0

120 30
1261 81 501 102 25 880 35

133 35
1283 80
546 129
21 926
47

146 38
1321 81
599 115
25 1058
58

179 39
1514 115 665 137
16 1124
58

211 51
1595 145 761 124 21
1232 65

789 193 6974 502 3072 607 108 5220 263

23

12

19

28

22

104

18

11

14

21

14

78

5

1

5

7

8

26

41

32

39

37

35

184

1

1

2

2

4

10

5

2

3

4

2

16

142

142

150

177

189

800

36

35

39

44

42

196

5

5

7

6

10

33

148

144

165

177

174

808

13

21

20

27

32

113

16

15

10

18

7

66

278

248

257

322

396

1501

254

284

304

343

380

1565

142

159

139

192

208

840

64

47

35

29

24

199

96

89

62

86

90

423

38

23

13

17

19

110

71

66

65

71

68

341

.

32

95

85

113

325

.

10

23

16

20

69

.

108

178

220

294

800

869

886

1007

1186

1307

5255

186

181

190

211

228

996

31

22

37

41

49

180

537

655

637

834

840

3503

380

487

566

769

784

2986

292

401

436

627

621

2377

.

50

202

340

421

1013

2

3

6

5

11

27

246

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Cobb County - 033

17.2 62.1
1.9 16.3
7.8 28.1
0.9 289.9
6.8
67.5 21.2 36.9 67.9 28.8 97.6
3.4
9.5 7.0 2.5 14.5 0.4 0.4
6.7 1.3 0.1 8.0 1.2 1.0
25.2 8.3
12.5 2.4
13.2 2.9 6.3
. . .
80.5 16.0 22.2 20.3 16.3 11.5
.

16.2 59.2
1.8 18.0
7.4 27.1
0.9 290.6
6.9
60.9 16.7 34.8 73.9 24.0 97.2
2.5
5.9 4.4 1.5 11.9 0.3 0.2
6.5 1.2 0.2 7.5 1.3 0.8
23.6 9.2
13.1 2.1
11.9 2.3 6.5
0.9 0.6 2.4
81.9 15.3 18.7 25.8 21.1 16.6
1.8

15.5 57.5 1.7 19.8
7.0 26.1 0.8 290.6
6.1
60.0 21.4 36.1 72.8 21.8 99.5
2.9
6.2 4.4 1.8 13.2 0.2 0.3
6.6 1.3 0.1 8.0 1.2 0.6
23.6 10.1 13.0 1.6 10.9 1.5 5.6
2.1 1.0 4.5
85.9 14.4 19.5 24.8 25.2 18.0
8.1

15.6 58.7
1.8 20.1
6.8 25.8
0.8 285.6
5.8
64.4 21.3 37.9 77.7 24.6 97.4
2.5
7.0 4.9 2.1 10.3 0.3 0.3
7.0 1.3 0.1 7.7 1.4 0.7
23.9 9.7
13.0 1.0
10.3 1.4 5.5
2.0 0.7 4.3
86.9 13.9 27.1 29.1 31.0 22.6 12.3

15.6 59.8 1.8 22.0
6.3 24.0 0.8 266.8
6.2
61.9 18.9 39.8 79.6 20.5 99.0 2.0
6.8 4.1 2.6 11.8 0.4 0.2
6.7 1.2 0.2 7.3 1.6 0.6
23.3 10.9 12.5 0.9 10.1 1.6 5.0
1.9 0.7 5.4
88.9 13.9 28.9 28.5 30.1 22.2 14.6

16.0 59.4
1.8 19.2
7.0 26.2
0.8 284.6
6.3
62.9 19.9 37.1 74.7 23.9 98.0
2.6
7.1 5.0 2.1 12.3 0.3 0.3
6.7 1.3 0.1 7.7 1.4 0.7
23.9 9.7
12.8 1.6
11.3 2.0 5.8
1.7 0.8 4.2
84.9 14.7 23.4 25.7 24.8 18.2
9.3

16.1 59.3
1.8 11.7
6.2 22.9
0.8 260.8
5.6

15.1 56.7
1.7 12.8
5.8 21.6
0.7 257.0
5.7

14.4 55.1 1.7 14.2
5.3 20.1 0.7 249.4
5.3

14.2 55.2
1.7 14.1
5.0 19.4
0.6 243.9
4.8

14.4 57.1 1.8 15.6
4.3 16.9 0.6 213.9
4.9

14.8 56.7
1.7 13.6
5.3 20.1
0.7 245.4
5.3

60.5 20.0 31.4 60.0 27.6 97.1
2.5

51.2 14.1 29.2 67.0 20.8 96.9
1.6

49.4 19.3 31.1 65.4 17.3 99.2 1.5

51.3 21.3 29.7 69.3 20.6 96.9
1.4

46.1 16.5 28.9 69.1 16.0 98.4 1.4

51.6 18.3 30.0 66.1 20.4 97.6
1.7

7.8

5.3

4.4

4.4

4.7

5.3

5.7

3.6

3.0

2.9

2.7

3.6

2.1

1.7

1.4

1.5

1.9

1.7

11.4

9.2

9.4

6.7

8.0

9.0

0.5

0.3

0.2

0.3

0.3

0.3

0.4

0.2

0.3

0.4

0.2

0.3

5.7

5.5

5.6

5.7

5.3

5.6

1.0

0.9

0.9

1.0

0.8

0.9

*

0.1

*

*

*

0.1

7.3

6.7

7.0

6.6

6.4

6.8

1.3

1.2

1.1

1.3

1.5

1.3

1.0

0.7

0.6

0.6

0.6

0.7

23.9 5.9
12.7 1.9
14.6 3.0 5.5

22.3 6.5
13.2 1.7
13.3 2.5 5.7

22.5 7.2
13.5 1.4 12.6 1.7 4.8

22.6 6.4
12.9 0.8
11.7 1.5 4.5

22.0 7.5
12.5 0.7 11.5 1.8 4.3

22.7 6.7
12.9 1.3
12.7 2.1 5.0

.

0.6

1.3

1.5

1.1

1.1

.

0.6

0.9

0.6

0.7

0.7

.

1.6

3.0

2.9

3.4

2.7

82.6 15.9 22.0 15.7 13.5
9.2 .

84.7 15.2 19.2 20.2 17.3 13.2
1.3

87.9 14.1 16.9 19.4 21.1 14.6
6.4

89.1 13.7 26.0 22.1 25.5 17.4
9.6

90.6 13.4 28.7 22.0 24.9 17.6 11.4

86.9 14.5 22.7 19.9 20.4 14.4
7.2

28.6 85.9
2.4 40.2 19.9 60.0
1.7 385.1
9.8

28.1 86.1
2.5 43.2 20.2 62.2
1.8 391.0
10.7

27.9 87.4 2.5 46.2 22.4 70.0 2.0 418.7
9.8

31.0 98.7
2.9 44.8 23.0 73.3
2.0 401.7
10.4

31.6 102.5
3.0 48.7 24.4 79.2 2.2 413.1 10.0

29.5 92.3
2.7 44.8 22.1 69.1
1.9 402.8 10.1

149.3 25.0 100.7 91.3 43.5 100.0
7.5

160.8 26.3 96.7 93.8 56.8
100.0 7.3

171.6 26.0 95.2 95.1 68.2
100.0 9.4

204.8 21.8
131.6 96.5 66.4 98.3 9.2

235.2 24.2
161.6 96.5 72.4
100.0 *

185.5 24.5 118.0 95.0 61.8 99.6 7.5

18.2 14.3
4.0 31.9
* 0.6

9.4 8.6
* 24.5
* *

14.4 10.6 3.8 29.0
* *

18.5 13.9
4.7 24.2
* *

13.8 8.8 5.1 21.7
* *

14.9 11.2
3.8 26.0
0.5 0.3

11.3

11.1

11.4

11.7

11.8

11.5

2.9

2.7

3.0

2.9

2.6

2.8

0.4

0.4

0.5

0.4

0.6

0.5

11.9

11.4

12.7

11.9

11.1

11.8

1.0

1.7

1.5

1.8

2.0

1.6

1.3

1.2

0.8

1.2

0.4

0.9

31.3 20.4 11.5
5.2 7.8 3.1 10.5

29.3 22.5 12.7
3.7 7.1 1.8 9.4

28.9 23.4 10.8 2.7 4.8 1.0 9.0

28.1 23.1 13.0
2.0 5.8 1.2 8.5

28.3 24.3 13.4 1.5 5.8 1.2 8.1

29 .0 22.8 12.3
2.9 6.2 1.6 9.1

.

2.3

6.6

5.7

7.3

5.5

.

0.7

1.6

1.1

1.3

1.2

.

7.7

12.3

14.7

18.9

13.6

70.0 16.8 22.3 43.1 30.5 23.4
.

69.3 16.0 16.7 51.8 38.5 31.7
4.0

77.0 16.1 31.4 49.0 43.5 33.5 15.5

78.8 15.6 30.6 56.2 51.8 42.2 22.9

82.4

76.0

16.3

16.1

30.2

26.3

53.7

51.1

50.2

43.5

39.7

34.7

26.9

18.1

247

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Coffee County - 034

1990
29592 7076 739
19.9 17.0 21.0
89 15 587 82 212 64
8 8 5
12 9 3
16 1 2
62 15
3 112
5 6
207 106 226
3 144
8 28
. . .
431 103
2 372 234 202
. 0

1991
30075 7152 740
19.5 22.5 21.0
84 17 561 76 214 60
6 12
3
5 4 1 11 0 0
54 12
0 95
6 6
175 106 224
4 103
3 28
14 10 53
459 122
2 410 291 275
91 0

Total
1992 1993

30538 7222 741

31022 7299 743

19.9 18.0 20.0

19.8 19.1 21.0

92

103

20

27

568

543

80

92

240

219

59

56

7

1

12

13

4

3

4

5

3

5

1

0

10

6

2

2

5

1

61

50

12

11

2

2

92

79

6

6

8

6

188

203

117

101

203

213

6

5

114

99

6

1

40

31

19

29

44

40

92

122

452

391

101

131

2

1

381

403

330

371

278

327

191

219

1

9

1994 5-year

31493 7371 744

152720 36120 3706

19.7 18.0 21.0

19.7 17.8 21.0

96

464

15

94

590

2849

90

420

243

1128

69

308

4

26

10

55

2

17

7

33

6

27

1

6

10

53

2

7

5

13

50

277

11

61

3

10

79

457

6

29

2

28

277

1050

117

547

236

1102

3

21

81

541

2

20

40

167

26

88

32

126

122

389

446

2179

113

570

5

12

393

1959

385

1611

324

1406

233

734

11

21

1990
21558 5012 490

1991
21857 5051 491

White
1992 1993

22144 5087 491

22445 5127 491

1994 5-year

22735 5164 492

110739 25441 2454

20.5 17.2 20.0

20.1 16.3 20.0

20.6 18.0 19.0

20.1 17.9 20.0

20.2 30.7 21.0

20.3 17.8 20.0

49

51

48

60

54

262

5

11

10

13

9

48

386

358

373

374

399

1890

46

44

41

52

52

235

79

72

99

94

100

444

36

50

39

41

41

207

5

3

3

1

2

14

4

6

9

5

6

30

3

2

3

2

0

10

8

2

4

5

2

21

6

1

3

5

2

17

2

1

1

0

0

4

10

5

6

6

4

31

1

0

2

2

0

5

2

0

1

1

2

6

30

22

28

27

21

128

8

3

7

9

4

31

2

0

2

2

0

6

67

54

50

45

39

255

3

3

2

6

2

16

4

4

6

4

1

19

119

96

118

128

174

635

44

40

47

50

40

221

150

135

137

148

160

730

2

3

4

2

2

13

116

80

89

85

71

441

7

2

1

0

0

10

12

15

22

11

20

80

.

10

13

18

12

53

.

8

35

25

19

87

.

35

54

67

59

215

295

313

316

283

327

1534

69

76

62

88

78

373

2

2

2

0

5

11

227

241

224

249

247

1188

141

165

190

228

234

958

125

155

158

194

197

829

.

46

102

127

132

407

0

0

0

8

5

13

1990
7504 1958
232

1991
7627 1977 232

Black
1992 1993

7744 1994
233

7867 2014 233

1994 5-year

7986 2031
234

38727 9974 1164

18.1 16.3 26.0

18.7 28.8 27.0

18.5 .
23.0

18.7 20.2 26.0

18.0 15.9 25.0

18.5 17.4 25.0

40

33

44

42

42

201

10

6

10

14

6

46

199

203

193

164

190

949

36

32

39

39

38

184

133

142

141

124

143

683

28

10

20

15

27

100

3

3

4

0

2

12

4

6

3

8

4

25

2

1

1

1

2

7

4

3

0

0

5

12

3

3

0

0

4

10

1

0

0

0

1

2

6

6

4

0

6

22

0

0

0

0

2

2

0

0

4

0

3

7

32

32

33

23

29

149

7

9

5

2

7

30

1

0

0

0

3

4

45

41

42

33

40

201

2

3

4

0

4

13

2

2

2

2

1

9

86

79

70

71

103

409

62

66

70

50

77

325

76

89

66

62

76

369

1

1

2

2

1

7

28

23

25

14

10

100

1

1

5

1

2

10

16

13

18

19

20

86

.

4

5

11

11

31

.

2

9

12

13

36

.

15

35

50

53

153

134

146

135

106

118

639

34

46

39

41

35

195

0

0

0

1

0

1

145

169

156

151

146

767

93

126

139

140

150

648

77

120

119

132

127

575

.

45

88

91

101

325

0

0

1

1

6

8

248

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Coffee County - 034

19.8 83.0
2.4 36.5
0.3 1.1 0.0 12.0 10.5
120.4 16.9 111.0 69.1 6.8 * 6.8
20.4 15.3
* 26.9
* *
10.6 2.6 *
19.2 0.9 1.0
37.8 18.2 39.0
* 24.8
1.4 8.1
. . .
75.7 20.0
* 63.9 40.2 34.7
.

18.7 78.4
2.3 38.6
0.4 1.7 0.0 18.7 9.8
113.5 20.2
102.7 65.8 * * 9.5
8.9 * *
19.4 * *
9.6 2.1
* 17.1
1.1 1.1
34.3 19.1 40.6
* 18.6
* 8.6
1.6 1.1 5.9
82.4 25.0
* 73.9 52.4 49.5 16.4

18.6 78.6 2.3 42.7 0.4 1.7 0.0 18.6 9.1
124.2 21.7
108.0 71.3 * * 13.5
* * * 17.4 * 0.8
10.7 2.1
* 16.4 1.1 1.4
36.1 20.8 36.3 1.1 20.3 1.1 12.0
2.1 4.8 10.1
80.7 20.7
* 67.8 58.7 49.5 34.0

17.5 74.4
2.2 40.9
0.4 1.8 0.1 21.2 7.8
138.7 26.2
123.9 68.5 * * 10.8
9.2 9.2
* 11.0
* *
9.2 2.0
* 14.7
1.1 1.1
40.0 18.8 39.7
0.9 18.5
* 10.6
3.1 4.3 13.1
72.8 27.9
* 75.2 69.2 61.0 40.9

18.7 80.0 2.4 41.7 0.3 1.4 0.0 14.8 10.0
129.1 15.6
121.0 67.4 * * 6.7
11.9 10.2
* 16.8
* *
8.5 1.9
* 13.6 1.0
*
49.5 20.1 40.5
* 13.9
* 11.8
2.8 3.4 12.9
75.9 23.4 5.0 67.4 66.0 55.6 40.0

18.7 78.9
2.3 40.0
0.4 1.5 0.0 16.9 9.4
125.2 20.3 113.3 68.4
4.6 100.0
9.4
11.6 9.5 2.1
18.4 0.7 0.4
9.7 2.1 0.4 16.2 1.0 1.0
39.7 19.4 39.2
0.7 19.2
0.7 10.2
2.4 3.4 10.6
77.5 23.3
3.2 69.5 57.2 49.9 32.8

17.9 77.0
2.3 20.6
* * * * 8.4

16.4 70.9
2.2 20.3
0.3 1.2
* 14.3 10.9

100.0 10.2 93.9 46.7
* * *

104.0 21.6 89.7 45.5 * * 12.2

20.7 15.5
* 25.6
* *

* * * 13.9 * *

7.8 2.1
* 17.5
* *

6.1 * *
15.2 * *

32.5 11.5 39.4
* 30.4
1.8 5.5

28.9 11.3 38.2
* 22.7
* 7.4

.

1.7

.

1.3

.

5.9

77.4 20.1
* 59.3 36.8 32.6
.

88.4 24.6
* 67.9 46.5 43.7 13.0

16.8 73.3 2.2 26.7 0.4 1.8 0.0 21.2 8.3

16.7 72.9
2.3 25.6
0.2 1.0 0.0 11.9 8.2

17.6 77.3 2.4 25.2 0.3 1.2 0.0 13.4 8.5

17.1 74.3
2.3 23.7
0.3 1.2 0.0 14.0 8.8

97.8 20.8 83.6 48.8
* * 12.2

122.1 21.7
105.9 48.1 * * 12.2

109.8 16.7
105.7 48.1 * * *

106.8 18.3 95.8 47.4
4.1 100.0
8.6

* * * 16.0 * *

13.4 13.4
* 16.0
* *

*

11.1

*

9.0

*

*

*

16.3

*

0.8

*

0.3

7.5 1.9
* 13.5
* 1.6

7.2 2.4
* 12.3
1.6 *

5.3

6.8

*

1.6

*

0.3

9.8

13.6

*

0.9

*

1.0

33.5 12.7 37.1
* 24.1
* 10.0

37.2 13.6 40.3
* 23.2
* 5.4

46.3 10.1 40.4
* 17.9
* 9.1

35.9 11.8 39.1
0.7 23.6
0.5 7.5

2.2

2.9

1.9

2.2

5.8

4.1

3.1

3.6

9.0

11.0

9.5

8.9

85.6 19.3
* 60.4 51.2 42.6 27.5

76.9 27.5
* 67.8 62.1 52.9 34.6

82.4 23.3 8.1 62.2 58.9 49.6 33.2

82.1 22.9
4.5 63.4 51.1 44.3 27.3

26.5 101.6
2.8 67.9
* * * * 16.3

26.6 102.7
2.8 71.0
0.8 3.0 0.1 26.8 7.6

24.9 96.8 2.7 74.6
* * * * 12.0

20.8 81.4
2.2 75.6
1.0 4.0 0.1 42.8 7.4

23.8 93.5 2.6 77.3
* * * * 14.3

24.5 95.1
2.6 73.1
0.6 2.5 0.1 23.0 11.5

172.4 25.0 155.2 97.2
* * *

142.0 18.2
137.7 93.8 * * *

189.2 22.7
167.7 94.9 * * *

180.2 33.3
167.3 97.4 * * *

179.9 14.3
162.7 94.6 * * *

172.7 22.9 158.1 95.6
6.0 100.0 12.0

*

*

*

*

26.3

12.6

*

*

*

*

*

10.5

*

*

*

*

*

*

29.7

29.1

*

*

31.3

22.9

*

*

*

*

*

*

*

*

*

*

*

0.7

16.1 3.5 *
22.8 * *

15.8 4.4 *
20.5 * *

17.1 2.6
* 22.2
* *

14.0 * *
20.1 * *

15.3 3.7
* 21.6
* *

15.7 3.2 *
21.5 1.4 0.9

47.8 31.5 38.8
* 14.3
* 12.6

44.4 33.0 44.7
* 11.5
* 10.8

41.9 37.0 34.9
* 13.2 2.6 16.2

44.9 30.5 37.8
* 8.5
* 21.8

56.3 41.6 41.1
* 5.4
* 16.8

47.2 34.8 39.5
0.8 10.7
1.1 15.2

.

*

1.7

3.7

3.7

2.6

.

*

3.1

4.1

4.3

3.1

.

5.2

12.0

16.9

17.6

13.0

72.0 19.9
* 73.6 47.2 39.1
.

71.9 25.7
* 84.5 63.0 60.0 22.5

71.4 23.9
* 82.5 73.5 63.0 46.6

64.6 27.9
* 92.1 85.4 80.5 55.5

62.1

68.6

23.8

24.2

*

*

78.9

82.0

81.1

69.3

68.6

61.5

54.6

44.0

249

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Colquitt County - 035

1990
36645 7886 828
19.6 15.9 20.0
95 29 579 90 230 52
8 16
3
8 7 1 14 2 4
58 9 1
47 12 16
220 119 239 13 114
7 26
. . .
360 122
1 320 294 236
. 1

1991
36818 7894 835
19.1 19.1 20.0
109 32
559 103 243
47 4
11 2
9 6 3 9 1 4
45 13
1 38
4 20
239 107 229
6 108
9 32
4 5 69
367 104
3 345 330 291
46 0

Total
1992 1993

36983 7901 841

37157 7910 848

19.3 20.0 21.0

19.4 21.0 21.0

92

112

24

33

572

604

92

107

262

267

31

48

4

3

7

17

0

2

6

6

4

5

2

1

8

8

3

2

4

5

40

77

8

16

2

2

44

58

3

6

21

8

228

178

140

133

233

254

12

9

82

108

7

5

39

32

38

33

21

44

178

198

370

373

126

127

2

1

346

407

357

409

286

356

35

143

0

1

1994 5-year

37323 7918 855

184926 39509 4206

19.2 19.1 21.0

19.3 19.8 21.0

101

509

22

140

590

2904

94

486

256

1258

62

240

0

19

18

69

1

8

6

35

3

25

3

10

3

42

2

10

2

19

69

289

17

63

1

7

63

250

10

35

9

74

152

1017

104

603

231

1186

3

43

85

497

5

33

34

163

19

94

44

114

275

720

433

1903

146

625

1

8

332

1750

342

1732

259

1428

186

410

5

7

1990
27047 5627 562

1991
27082 5610 565

White
1992 1993

27112 5594 568

27148 5577 571

1994 5-year

27177 5560 574

135566 27968 2840

20.6 15.9 20.0

20.1 17.9 19.5

20.0 20.0 21.0

19.9 20.0 20.0

21.0 18.1 21.0

20.2 18.9 20.0

45

42

47

57

39

230

12

9

10

13

6

50

371

359

378

405

399

1912

40

39

47

53

34

213

73

85

99

104

105

466

32

27

22

35

39

155

5

1

4

1

0

11

12

7

6

12

10

47

3

2

0

2

1

8

4

4

5

4

3

20

4

3

3

4

1

15

0

1

2

0

2

5

9

4

7

5

1

26

1

0

1

0

1

3

2

1

3

2

0

8

26

19

17

44

31

137

5

7

5

7

4

28

0

1

2

1

0

4

28

18

24

35

34

139

9

4

3

3

5

24

12

13

13

6

5

49

134

126

135

111

90

596

37

34

52

50

41

214

133

134

149

161

138

715

10

5

9

7

2

33

83

85

64

86

76

394

6

4

3

2

4

19

12

10

28

16

19

85

.

0

19

19

10

48

.

2

14

23

24

63

.

23

65

112

121

321

269

255

256

269

310

1359

86

75

89

87

101

438

1

2

2

0

1

6

171

177

189

233

192

962

134

167

198

234

190

923

109

141

148

196

136

730

.

21

22

71

87

201

0

0

0

0

1

1

1990
8861 2121
253

1991
8903 2123 255

Black
1992 1993

8943 2125
257

8985 2128 259

1994 5-year

9025 2130
261

44716 10627
1285

18.0 .
24.0

17.1 20.5 24.0

18.1 .
25.0

18.3 24.2 24.0

17.4 23.4 26.0

17.7 21.3 25.0

49

67

45

54

62

277

17

23

14

20

16

90

206

198

194

198

191

987

49

64

45

53

60

271

156

158

163

162

151

790

20

20

9

13

23

85

3

3

0

2

0

8

3

4

1

5

8

21

0

0

0

0

0

0

4

4

1

2

3

14

3

2

1

1

2

9

1

2

0

1

1

5

5

5

1

3

2

16

1

1

2

2

1

7

2

3

1

3

2

11

32

26

23

33

38

152

4

6

3

9

13

35

1

0

0

1

1

3

19

20

20

23

29

111

3

0

0

3

5

11

4

7

8

2

4

25

86

112

93

67

62

420

82

73

88

82

63

388

104

94

84

92

93

467

3

1

3

2

1

10

31

23

18

22

9

103

1

5

4

3

1

14

14

22

11

16

15

78

.

4

15

14

9

42

.

3

5

17

13

38

.

35

85

68

135

323

91

112

114

104

123

544

36

29

37

40

45

187

0

1

0

1

0

2

148

167

157

173

140

785

159

162

159

174

152

806

126

149

138

159

123

695

.

25

13

72

99

209

1

0

0

1

4

6

250

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Colquitt County - 035

15.8 73.4
2.2 40.6
0.4 2.0 0.1 24.2 8.4
114.7 30.5 108.7 70.8
* * *
13.8 12.1
* 23.9
* *
10.0 1.6 * 8.3 2.1 2.8
40.0 21.0 42.2
2.3 20.2
1.2 8.2
. . .
62.7 24.4
* 56.4 51.9 41.6
.

15.2 70.8
2.1 43.8
0.3 1.4 0.0 17.7 6.7
130.6 29.4
123.4 82.4 * * 9.6
16.1 10.7
* 16.0
* *
8.1 2.3
* 6.8
* 3.6
44.3 19.3 41.3
1.1 19.5
1.6 9.7
* 0.5 6.6
65.9 21.2
* 62.2 59.5 52.4
8.3

15.5 72.4 2.1 46.0 0.2 0.9 0.0 11.3
5.2
109.4 26.1
109.4 68.1 * * *
10.5 * *
13.9 * *
7.0 1.4
* 7.7
* 3.7
41.1 24.6 41.1 2.1 14.5 1.2 11.7
3.6 2.0 17.1
66.8 25.5
* 60.7 62.6 50.2
6.1

16.3 76.4
2.2 44.7
0.5 2.1 0.1 25.3 6.4
132.1 29.5
126.2 81.9 * * 5.9
9.9 8.3
* 13.2
* 0.7
12.7 2.6 * 9.7 1.0 1.3
30.6 22.3 42.7
1.5 18.3
0.8 9.0
3.2 4.2 18.9
62.2 24.6
* 68.2 68.5 59.6 24.0

15.8 74.5 2.2 44.2 0.5 2.3 0.1 26.8
8.1
118.2 21.8
110.0 82.8 * * 9.4
10.2 * * * * *
11.7 2.9
* 10.9 1.7 1.5
26.9 18.0 40.0
* 14.9 0.9 10.1
1.8 4.2 26.3
73.9 28.9
* 57.3 59.1 44.7 32.1

15.7 73.5
2.2 43.9
0.4 1.7 0.1 21.2 7.0
121.0 27.5 115.5 77.5
1.9 87.5
6.2
12.1 8.6 3.5
14.4 0.9 0.5
10.0 2.2 0.2 8.7 1.2 2.6
36.4 21.0 41.5
1.5 17.5
1.2 9.8
2.3 2.7 17.2
66.3 24.9
2.2 61.0 60.4 49.8 17.8

13.7 65.9
2.0 20.1
0.4 2.1 0.1 28.3 7.3
80.1 26.7 71.2 40.0
* * *
* * * 23.9 * *
7.0 1.3
* 7.7 2.5 3.2
38.0 10.2 36.7
2.8 23.0
1.7 6.3
. . .
73.1 26.5
* 47.1 36.9 30.0
.

13.3 64.0
2.0 23.9
0.3 1.2 0.0 17.7 5.2
74.3 21.4 69.0 52.6
* * *
* * * * * *
5.3 1.9
* 5.1
* 3.6
36.5 9.6
37.7 1.4
23.9 *
5.0
* * 3.4
71.2 23.9
* 49.9 47.0 39.7
5.9

13.9 67.6 2.1 26.3 0.2 1.1 0.0 14.5
5.5
82.7 21.3 82.7 39.1
* * *
13.2 * *
18.3 * *
4.5 1.3
* 6.4
* 3.4
36.6 13.8 39.8 2.4 17.1
* 13.4
2.9 2.1 9.8
69.4 27.4
* 50.3 52.7 39.4
5.9

14.9 72.6
2.2 25.9
0.4 2.2 0.1 26.5 6.5
99.8 22.8 92.8 63.5
* * *
* * * 12.3 * *
10.9 1.7 * 8.8 * 1.5
28.2 12.5 40.4
1.8 21.7
* 6.9
2.9 3.5 16.9
66.9 25.2
* 58.1 58.4 48.9 17.7

14.7 71.8 2.2 26.6 0.4 1.8 0.1 22.3
7.2
67.9 15.4 59.2 55.9
* * *
* * * * * *
7.8 * *
8.6 1.3 1.3
23.4 10.4 35.1
* 19.5
* 8.2
1.5 3.6 18.3
78.3 29.9
* 48.7 48.2 34.5 22.1

14.1 68.4
2.1 24.7
0.3 1.7 0.1 22.0 6.3
81.0 21.7 75.0 50.5
2.8 87.5
4.9
10.5 7.8 2.6
13.5 *
0.3
7.2 1.5
* 7.4 1.3 2.6
32.3 11.3 38.0
1.8 21.0
1.0 8.0
1.8 2.4 12.1
71.8 26.6
2.5 50.9 48.9 38.6 13.2

23.2 97.1
2.6 77.6
* * * * 11.8

22.2 93.3
2.5 79.8
* * * * 11.3

21.7 91.3 2.5 84.0
* * * * 4.7

22.0 93.1
2.5 83.1
0.6 2.4 0.1 22.9 7.1

21.2 89.7 2.4 81.6 0.9 3.8 0.1 36.0 10.8

22.1 92.9
2.5 81.2
0.5 2.0 0.1 19.0 9.1

193.7 34.7 193.7 95.8
* * *

262.7 34.3
251.0 100.0
* * 19.6

175.0 31.1
175.0 97.8 * * *

208.4 37.0
204.6 100.0
* * *

237.5 25.8
229.8 98.3 * * *

215.5 32.5
210.8 98.5 * * 9.3

*

*

*

*

*

14.2

*

*

*

*

*

9.1

*

*

*

*

*

5.1

23.9

24.9

*

*

*

16.1

*

*

*

*

*

1.7

*

*

*

*

*

0.9

15.5 * *
9.4 * *

13.1 3.0 *
10.1 *
3.5

11.9 * *
10.3 *
4.2

16.7 4.5 *
11.8 * *

19.9 6.8 * 15.7 2.7 *

15.4 3.5 *
11.4 1.1 2.6

44.1 40.6 51.5
* 15.4
* 11.3

58.0 36.9 47.5
* 11.6
2.5 17.5

50.0 45.4 43.5
* 9.5
* 8.9

35.8 42.1 47.2
* 11.4
* 13.0

34.3 34.1 50.5
* 4.9
* 14.7

44.6 39.8 48.0
1.0 10.7
1.5 13.0

.

*

4.3

4.0

2.6

3.0

.

*

1.4

4.9

3.7

2.7

.

10.1

24.4

19.5

38.6

23.1

44.6 20.6
* 73.3 78.7 62.4
.

56.9 16.6
* 84.3 81.8 75.3 12.6

61.6 21.8
* 80.9 82.0 71.1
6.7

52.8 23.4
* 88.7 89.2 81.5 36.9

64.7

55.9

26.8

21.8

*

*

75.7

80.6

82.2

82.8

66.5

71.4

53.5

27.1

251

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Columbia County - 036

1990
66031 16951
1541
24.2 18.6 22.0
119 18 1132 72 181 94
8 287 42
11 7 4
17 0 5
67 15
2 88 15 17
364 92 191
9 164 16 33
. . .
937 162 18 253 151 124
. 0

1991
68523 17338
1602
24.3 19.2 22.0
89 18 1132 57 185 81
7 252
31
6 5 1 13 2 6
69 11
0 81 17 17
384 104 146
9 143
20 24
20 11 13
933 163
16 287 215 180
7 0

Total
1992 1993

71011 17728
1664

73499 18115
1725

24.1 19.2 22.0

24.4 19.1 22.0

76 13 1059 49 185 93 10 250 23

84 16 1099 50 201 106
6 229
32

7

5

4

2

3

3

14

8

1

0

1

7

73

66

11

11

1

0

75

81

12

15

15

9

287

306

109

111

143

144

6

2

148

165

12

25

28

24

36

29

32

28

49

45

877

929

162

146

24

21

278

297

237

318

184

230

31

111

0

0

1994 5-year

75989 18505
1787

355053 88637
8320

24.6 19.2 22.0

24.3 19.0 22.0

90 12 1130 64 206 84
8 237
22

458 77 5552 292 958 458 39 1255 150

5

34

3

21

2

13

10

62

2

5

4

23

67

342

11

59

0

3

87

412

13

72

5

63

314

1655

119

535

136

760

5

31

118

738

19

92

27

136

36

121

11

82

51

158

981

4657

177

810

20

99

321

1436

298

1219

232

950

129

278

0

0

1990
56785 14596
1324

1991
59184 14979
1381

White
1992 1993

61581 15363
1438

63978 15745
1495

1994 5-year

66376 16129
1551

307904 76812
7189

24.3 18.8 22.0

24.5 18.4 21.0

24.5 19.0 22.0

24.5 18.8 22.0

25.2 19.2 22.0

24.5 18.9 22.0

99

72

60

65

72

368

13

12

9

11

9

54

975

970

897

964

979

4785

63

41

38

41

53

236

110

121

115

141

140

627

82

72

84

100

71

409

6

6

8

5

6

31

215

205

194

171

171

956

34

30

19

22

15

120

10

6

7

5

5

33

6

5

4

2

3

20

4

1

3

3

2

13

12

12

12

7

8

51

0

2

0

0

2

4

5

4

1

5

3

18

54

53

52

53

57

269

10

8

9

8

8

43

2

0

1

0

0

3

71

63

58

70

74

336

14

14

9

13

13

63

15

14

14

8

4

55

281

307

231

253

267

1339

57

60

63

77

73

330

150

117

109

122

115

613

5

5

3

1

4

18

150

134

135

149

112

680

16

19

11

22

18

86

24

17

17

20

20

98

.

15

27

20

29

91

.

11

29

21

8

69

.

9

33

34

33

109

826

820

762

831

856

4095

145

141

139

129

150

704

17

12

20

19

19

87

182

208

203

231

241

1065

101

158

171

253

227

910

83

133

127

179

173

695

.

4

10

79

94

187

0

0

0

0

0

0

1990
7282 1811
159

1991
7557 1853
165

Black
1992 1993

7831 1896
172

8106 1938
178

1994 5-year

8380 1980
184

39156 9478 858

21.9 18.0 23.5

22.3 21.4 26.0

22.6 20.2 23.0

22.7 19.6 27.0

21.6 18.8 24.5

22.1 19.6 25.0

19

17

16

19

17

88

5

6

4

5

3

23

135

134

137

120

126

652

9

16

11

9

11

56

69

64

69

59

65

326

10

5

8

5

9

37

2

1

2

1

2

8

53

40

49

49

53

244

7

1

4

10

6

28

1

0

0

0

0

1

1

0

0

0

0

1

0

0

0

0

0

0

5

1

2

1

2

11

0

0

1

0

0

1

0

1

0

2

1

4

13

14

19

13

10

69

5

3

2

3

3

16

0

0

0

0

0

0

17

16

16

11

12

72

1

3

3

2

0

9

2

3

1

1

1

8

76

70

49

53

43

291

35

43

45

33

44

200

36

27

29

21

20

133

4

4

3

1

0

12

12

9

10

15

4

50

0

1

1

2

1

5

8

6

10

3

5

32

.

5

5

5

5

20

.

0

3

3

3

9

.

0

15

8

17

40

92

90

92

86

102

462

11

18

20

17

23

89

0

2

3

1

1

7

69

79

73

65

77

363

47

55

65

62

69

298

39

47

57

51

57

251

.

3

21

31

34

89

0

0

0

0

0

0

252

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Columbia County - 036

17.1 66.8
2.2 16.2
4.3 16.9
0.5 188.2
6.3
77.2 15.1 46.7 63.9 27.3 100.0
3.9
9.7 6.2
* 14.9
* *
5.9 1.3
* 7.9 1.3 1.5
33.4 8.3
17.2 0.8
14.8 1.4 5.3
. . .
83.1 16.5 13.6 22.7 13.5 11.1
.

16.5 65.3
2.1 16.6
3.7 14.5
0.4 171.2
5.1
55.5 20.2 35.6 75.0 19.3 100.0
*
5.3 4.4
* 11.4
* *
6.1 1.0
* 7.3 1.5 1.5
35.6 9.3
13.2 0.8
13.1 1.8 3.8
1.0 0.5 0.6
82.7 16.6 12.0 25.8 19.3 16.2
0.6

14.9 59.7 1.9 17.7 3.5 14.1 0.4 176.6 6.0
45.7 17.1 29.4 77.6 13.8 100.0
3.0
6.6 * *
13.1 * *
6.9 1.0
* 7.2 1.1 1.4
27.8 10.4 13.7 0.6 14.2 1.2 4.6
1.7 1.5 2.3
83.1 17.9 16.9 26.6 22.6 17.6
3.0

15.0 60.7
1.9 18.5
3.1 12.6
0.4 158.9
6.2
48.7 19.0 29.0 72.0 18.5 96.8
*
4.5 * *
7.2 * *
6.0 1.0
* 7.5 1.4 0.8
28.3 10.2 13.3
* 15.2
2.3 3.7
1.3 1.3 2.0
84.5 15.7 13.7 27.4 29.3 21.2 10.2

14.9 61.1 1.9 18.5 3.1 12.8 0.3 161.9 5.2
50.4 13.3 35.8 79.7 12.3 100.0
*
4.4 * *
8.8 * *
5.9 1.0
* 7.8 1.2 0.4
28.4 10.7 12.2 0.4 10.6 1.7
4.3
1.6 0.5 2.3
87.0 17.9 15.5 28.7 26.7 20.8 11.5

15.6 62.6
2.0 17.5
3.5 14.2
0.4 171.5
5.8
55.0 16.8 35.1 73.2 18.0 99.3
2.3
6.1 3.8 2.4 11.1 0.2 0.3
6.2 1.1
* 7.5 1.3 1.1
30.7 9.8
13.9 0.6
13.6 1.7 4.3
1.4 0.9 1.8
84.1 16.9 14.4 26.2 22.3 17.3
6.4

17.2 66.8
2.2 11.5
3.8 14.7
0.4 167.7
6.3

16.4 64.8
2.1 12.7
3.5 13.7
0.4 163.6
5.2

14.6 58.4 1.9 13.0 3.2 12.6 0.4 163.6 6.2

15.1 61.2
1.9 14.8
2.7 10.9
0.3 137.9
6.7

14.7 60.7 1.9 14.5 2.6 10.6 0.3 139.3 4.8

15.5 62.3
2.0 13.3
3.1 12.4
0.4 154.5
5.8

74.8 13.1 47.6 60.3 25.7 100.0
*

52.1 16.7 29.7 70.7 21.7 100.0
*

41.7 15.0 26.4 71.1 13.2 100.0
*

43.5 16.9 27.4 68.3 14.7 95.2
*

46.4 12.5 34.2 75.5 9.7 100.0
*

51.2 14.7 32.8 68.6 16.7 99.2
1.9

10.3

6.2

7.8

5.2

5.1

6.9

6.2

5.2

*

*

*

4.2

*

*

*

*

*

2.7

12.2

12.3

13.3

7.2

8.1

10.6

*

*

*

*

*

*

*

*

*

*

*

0.3

5.5

5.5

5.8

5.5

5.8

5.6

1.0

0.8

1.0

0.8

0.8

0.9

*

*

*

*

*

*

7.4

6.6

6.5

7.4

7.7

7.1

1.5

1.5

1.0

1.4

1.3

1.3

1.5

1.5

1.6

0.8

*

1.2

29.9 5.9
15.7 0.5
15.7 1.7 4.4

33.2 6.3
12.3 0.5
14.3 2.0 3.2

26.4 7.1
12.3 *
15.3 1.2 3.3

26.7 8.1
12.9 *
15.7 2.3 3.6

27.9 7.6
12.0 *
11.6 1.9 3.6

28.8 7.0
13.0 0.4
14.5 1.8 3.6

.

0.8

1.5

1.0

1.5

1.2

.

0.6

1.6

1.1

0.4

0.9

.

0.5

1.8

1.8

1.7

1.4

85.0 17.2 14.8 19.0 10.5
8.7 .

84.8 16.7 10.7 21.8 16.6 13.9
*

85.3 18.1 16.7 22.9 19.3 14.3
1.1

86.2 15.7 14.5 24.3 26.6 18.8
8.3

87.6 17.6 16.8 24.9 23.5 17.9
9.7

85.8 17.1 14.7 22.6 19.3 14.7
5.0

18.5 74.5
2.3 51.5
7.3 29.3
0.8 265.0
6.6

17.7 72.3
2.2 48.9
5.3 21.6
0.6 222.2
3.2

17.5 72.3 2.2 51.5 6.3 25.8 0.6 248.7 5.8

14.8 61.9
1.8 50.0
6.0 25.3
0.6 280.0
3.1

15.0 63.6 1.9 51.6 6.3 26.8 0.7 273.2 7.6

16.7 68.8
2.1 50.7
6.2 25.7
0.7 257.9
5.3

119.5 26.3 56.6 88.9 44.0 100.0
*

102.8 35.3 96.8 86.7 * * *

93.2 *
64.1 100.0
* * *

106.7 26.3 50.6 88.9 56.2
100.0 *

92.2 *
59.7 100.0
32.5 100.0
*

102.5 26.1 65.2 92.7 32.6 100.0
5.8

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

36.5

*

*

*

*

16.7

*

*

*

*

*

*

*

*

*

*

*

*

9.6 3.7
* 12.7
* *

10.4 * *
12.2 * *

13.9 * *
11.9 * *

10.8 * *
9.3 * *

7.9

10.6

*

2.5

*

*

9.5

11.2

*

1.4

*

1.2

58.9 26.1 27.1
* 9.0
* 10.5

55.1 32.8 20.6
* 7.0
* 7.4

36.8 33.6 21.8
* 7.5
* 13.5

44.9 28.0 17.8
* 12.7
* *

34.7 34.9 15.9
* * * 8.5

46.1 31.1 20.7
1.9 7.8 0.8 8.7

.

2.3

2.2

2.1

2.1

2.2

.

*

*

*

*

1.0

.

*

6.6

3.4

7.1

4.4

68.7 9.2 *
51.5 35.1 29.1
.

67.2 15.7
* 60.3 42.0 35.9
*

67.2 17.4
* 54.5 48.5 42.5 15.7

71.7 16.8
* 55.1 52.5 43.2 26.3

81.0

71.0

20.4

15.8

*

8.9

61.1

56.5

54.8

46.3

45.2

39.0

27.0

17.5

253

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Cook County - 037

1990
13456 2868 321
19.7 22.4 21.0
38 12 227 34 85 20
3 5 1
3 2 1 5 0 1
12 4 0
13 1 2
90 32 98
2 44
3 9
. . .
176 36
2 148 113 102
. 0

1991
13539 2868 319
19.5 23.3 20.0
33 11 227 31 75 21
3 4 0
1 1 0 4 0 1
19 4 0
15 5 1
81 24 97
1 41
3 14
1 2 0
175 20 2
152 124 112
48 0

Total
1992 1993

13615 2862 315

13701 2863 312

19.6 .
20.0

20.2 17.6 21.0

33

20

9

3

214

194

32

18

73

79

14

22

2

1

0

2

0

1

3

1

2

0

1

1

4

1

0

4

0

2

18

13

3

1

1

0

9

13

1

2

2

1

84

80

30

33

93

73

2

1

47

40

3

1

12

12

15

19

7

19

85

84

173

157

27

24

2

1

146

136

129

129

118

112

81

77

0

0

1994 5-year

13781 2860 309

68092 14321
1576

19.1 21.8 21.0

19.7 21.9 20.5

43

167

7

42

244

1106

42

157

103

415

15

92

1

10

8

19

0

2

2

10

2

7

0

3

2

16

2

6

2

6

27

89

3

15

0

1

22

72

5

14

4

10

82

417

42

161

98

459

2

8

47

219

1

11

10

57

13

48

25

53

74

243

202

883

28

135

5

12

170

752

162

657

143

587

111

317

2

2

1990
9311 1882
196

1991
9347 1876
194

White
1992 1993

9380 1868
192

9419 1863
190

1994 5-year

9455 1855
187

46912 9344 959

20.4 19.4 20.0

20.4 22.4 19.0

19.8 .
19.0

20.9 17.6 19.0

20.4 21.5 21.0

20.4 21.5 20.0

13

12

18

6

10

59

2

2

4

2

1

11

121

131

129

117

132

630

9

12

17

4

10

52

15

14

16

24

21

90

12

14

8

11

8

53

2

0

1

1

0

4

3

2

0

2

5

12

1

0

0

1

0

2

2

1

2

0

1

6

2

1

2

0

1

6

0

0

0

0

0

0

4

1

3

1

0

9

0

0

0

1

0

1

0

1

0

0

1

2

3

4

9

7

14

37

1

1

2

0

2

6

0

0

1

0

0

1

7

3

6

9

13

38

0

1

1

2

3

7

1

1

2

0

2

6

44

40

44

48

37

213

7

4

5

11

12

39

44

48

54

38

45

229

0

1

1

0

1

3

31

30

32

32

36

161

1

1

1

0

0

3

3

5

6

8

5

27

.

0

8

9

4

21

.

0

5

13

18

36

.

0

24

37

26

87

104

105

109

18

14

17

1

1

2

58

74

81

45

58

69

37

51

66

.

20

45

0

0

0

96

111

525

14

15

78

1

3

8

70

71

354

68

66

306

58

53

265

43

50

158

0

1

1

1990
4031 972 123

1991
4056 972 122

Black
1992 1993

4079 969 121

4104 969 120

1994 5-year

4128 967 118

20398 4848 604

19.0 22.5 23.0

18.2 24.3 21.0

18.7 .
27.0

19.0 .
25.0

17.6 21.7 22.0

18.3 22.5 23.0

25

21

15

14

33

108

10

9

5

1

6

31

106

94

85

77

112

474

25

19

15

14

32

105

70

61

57

55

82

325

8

7

6

11

7

39

1

3

1

0

1

6

2

2

0

0

2

6

0

0

0

0

0

0

1

0

1

1

1

4

0

0

0

0

1

1

1

0

1

1

0

3

1

3

1

0

2

7

0

0

0

3

2

5

1

0

0

2

1

4

9

15

9

6

13

52

3

3

1

1

1

9

0

0

0

0

0

0

6

12

3

4

9

34

1

4

0

0

2

7

1

0

0

1

2

4

46

41

40

32

45

204

25

20

25

22

30

122

54

49

39

35

53

230

2

0

1

1

1

5

13

11

15

8

11

58

2

2

2

1

1

8

6

9

6

4

5

30

.

0

7

6

9

22

.

2

2

5

6

15

.

0

51

37

46

134

72

68

64

61

91

356

18

6

10

10

13

57

1

1

0

0

2

4

90

77

65

66

99

397

68

65

60

61

96

350

65

60

52

54

90

321

.

27

36

34

61

158

0

0

0

0

1

1

254

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Cook County - 037

16.9 79.1
2.3 37.6
0.4 1.7 0.0 19.6 8.0
118.4 31.6 105.9 66.7
* * *
* * * 21.7 * *
5.3 * *
5.8 * *
42.5 14.2 43.8
* 19.6
* 6.6
. . .
78.6 17.1
* 65.5 50.0 45.1
.

16.8 79.1
2.3 33.8
* * * * 8.7
103.6 33.3 97.3 63.3 * * *
* * * * * *
8.4 * *
6.8 2.3
*
39.7 10.8 43.7
* 18.6
* 9.7
* * *
78.1 9.9 *
68.5 55.9 50.5 21.6

15.7 74.8 2.1 34.3
* * * * 5.6
104.8 27.3
101.6 62.5 * * *
* * * * * *
8.4 * *
4.2 * *
41.6 14.1 43.7
* 22.3
* 9.2
3.9 1.8 21.9
80.8 14.4
* 68.5 60.6 55.4 38.0

14.2 67.8
1.9 41.1
* * * * 8.0

17.7 85.3 2.5 43.1
0.6 2.8 0.1 29.7 5.9

16.2 77.2
2.2 38.0
0.3 1.3 0.0 15.5 7.3

64.0 *
57.6 72.2
* * *

139.2 16.3
136.0 85.7 * * *

106.0 25.1 99.6 71.0
* * 6.3

*

*

9.0

*

*

6.3

*

*

*

*

*

14.3

*

*

1.4

*

*

0.4

6.7

11.1

8.1

*

*

1.4

*

*

*

6.8

9.2

6.6

*

2.1

1.3

*

*

0.9

43.0 17.2 38.0
* 20.8
* 11.2

34.9 17.6 41.0
* 19.8
* 7.8

40.1 14.7 42.1
0.7 20.2
1.0 8.8

4.9 4.9 21.6

3.3 6.4 19.0

3.1 3.4 15.6

82.6 13.7
* 70.8 67.2 58.3 40.1

83.1 12.9 22.7 71.1 67.8 59.8 46.4

80.6 13.6 12.1 68.9 60.2 53.8 36.6

13.0 64.3
1.9 12.4
* * * * 7.4
66.3 *
45.9 * * * *
* * * * * *
* * * 5.8 * *
38.6 5.8
36.7 *
25.8 * *
. . .
87.4 15.9
* 47.9 37.2 30.6
.

14.0 69.8
2.1 10.8
* * * * 8.0
61.8 *
61.8 * * * *
* * * * * *
* * * * * *
33.9 *
36.9 *
23.4 *
6.0
* * *
82.0 12.2
* 56.9 44.6 39.2 15.4

13.8 69.1 2.1 12.5
* * * * 4.8
93.9 *
88.7 29.4
* * *
* * * * * *
7.0 * *
4.7 * *
35.8 3.9 42.2
* 25.2
* 8.3
3.5 2.2 10.5
84.5 15.0
* 63.3 53.9 51.6 35.2

12.4 62.8
1.9 20.9
* * * * 6.4
31.6 * * * * * *
* * * * * *
6.0 * *
7.8 * *
42.1 9.6
33.0 *
27.8 *
11.9
3.9 5.7 16.2
83.5 13.5
* 60.9 59.1 50.4 37.4

14.0 71.2 2.1 16.3 0.5 2.7 0.1 34.2
4.9
53.4 *
53.4 50.0
* * *
* * * * * *
10.6 * *
10.1 * *
29.1 9.3
34.9 *
28.3 *
6.8
* 7.9 11.4
84.1 12.8
* 55.0 51.2 41.1 38.8

13.4 67.4
2.0 14.4
0.3 1.3 0.0 17.1 6.3
61.5 18.6 54.2 21.6
* * 6.3
9.5 9.5
* 14.2
* *
5.9 1.0
* 6.1 1.1 1.0
35.7 6.3
36.8 *
26.1 *
7.4
2.3 3.9 9.5
84.3 13.9 13.1 56.8 49.1 42.5 31.5

26.3 109.1
2.8 66.7
* * * * 9.3

23.2 96.8
2.6 67.8
* * * * 10.3

20.8 87.7 2.3 67.1
* * * * 7.2

18.8 79.5
2.1 71.4
* * * * 11.4

27.1 115.8
3.1 74.5
* * * * 8.3

23.2 97.8
2.6 69.6
0.3 1.2 0.0 11.4 9.3

203.3 40.0 203.3 91.7
* * *

172.0 42.9
155.6 94.7 * * *

124.3 33.3
124.3 100.0
* * *

117.0 *
117.0 92.9 * * *

279.0 18.2
270.5 96.9 * * *

178.9 28.7
173.9 95.2 * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

14.6

*

*

*

*

*

2.8

*

*

*

*

*

*

8.5

16.0

10.6

*

*

*

*

*

*

5.7

13.3

*

*

*

*

*

*

*

7.8

11.6

11.0

*

*

1.9

*

*

*

*

8.2

7.3

*

*

1.5

*

*

*

46.9 23.8 51.9
* 12.4
* 9.2

48.8 22.2 54.4
* 12.2
* 15.0

50.6 29.4 45.9
* 17.9
* 10.3

44.4 28.6 45.5
* 10.4
* *

41.7 27.3 48.2
* 10.0
* 8.9

46.3 26.1 49.4
1.1 12.4
1.7 10.8

.

*

4.6

3.9

5.9

3.6

.

*

*

3.3

3.9

2.5

.

*

33.6

24.3

30.1

22.0

68.6 18.4
* 85.7 64.8 61.9
.

72.3 7.1 *
85.6 72.2 66.7 30.0

75.3 13.3
* 76.5 70.6 61.2 42.4

81.3 14.1
* 85.7 79.2 70.1 44.2

82.0

75.7

13.0

13.3

*

*

90.0

85.0

87.3

74.9

81.8

68.7

55.5

43.6

255

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Coweta County - 038

1990
53853 12869
1212
21.1 19.2 22.0
135 35 986 99 306 68
9 220 33
15 8 7
18 2 9
104 23
1 103 17 19
261 156 275 23 189 14 49
. . .
688 108 18 397 286 246
. 0

1991
55307 13092
1236
21.2 18.8 21.5
162 39
1013 119 314 55 5 219 40
7 5 2 11 4 3
75 16
2 106
11 21
242 135 288
24 187
16 45
1 0 3
736 116
30 437 321 281
24 0

Total
1992 1993

56750 13317
1261

58210 13543
1284

22.6 19.1 22.0

23.4 19.5 22.0

141 32
1055 94
316 91 19
235 39

114 32
1151 80
350 82 5
193 31

8

9

5

8

3

1

24

13

3

2

7

1

61

93

8

20

1

3

82

97

12

19

17

20

225

300

183

180

271

267

16

9

197

183

16

18

46

46

36

30

39

48

181

282

796

897

120

152

30

34

419

470

388

479

319

373

122

136

0

2

1994 5-year

59658 13767
1308

283778 66588
6301

23.0 18.3 23.0

22.4 18.8 22.0

140 31
1144 109 336 61 13 210 30

692 169 5349 501 1622 357
51 1077
173

5

44

4

30

1

14

17

83

3

14

6

26

74

407

8

75

1

8

112

500

11

70

21

98

305

1333

162

816

258

1359

12

84

176

932

21

85

38

224

31

98

38

125

259

725

940

4057

111

607

41

153

405

2128

417

1891

319

1538

109

391

4

6

1990
41322 9682 873

1991
42739 9919 896

White
1992 1993

44147 10156
919

45567 10394
941

1994 5-year

46978 10630
964

220753 50781
4592

22.8 19.4 21.0

22.8 19.3 21.0

23.9 19.3 21.0

24.0 21.2 21.0

24.5 18.5 22.0

23.7 19.3 21.0

73

95

75

63

68

374

17

21

13

17

13

81

680

735

782

865

850

3912

47

64

43

45

51

250

106

116

117

152

126

617

50

43

57

54

44

248

6

2

10

2

6

26

158

153

162

123

138

734

23

29

27

18

17

114

5

4

4

5

4

22

4

3

3

4

3

17

1

1

1

1

1

5

10

6

13

6

9

44

1

1

2

1

0

5

6

2

4

1

6

19

48

34

29

51

47

209

6

8

4

6

4

28

1

2

0

0

1

4

55

69

46

60

74

304

12

8

7

12

7

46

13

14

13

16

17

73

153

152

143

195

210

853

54

44

64

64

47

273

162

172

169

157

140

800

10

7

7

3

4

31

160

158

169

159

150

796

7

8

8

9

9

41

24

28

18

21

18

109

.

1

3

16

24

44

.

0

4

16

30

50

.

1

44

138

145

328

527

596

638

725

745

3231

83

87

92

122

83

467

12

23

25

23

32

115

196

230

231

251

205

1113

131

178

218

272

217

1016

112

149

171

192

155

779

.

9

56

70

50

185

0

0

0

0

3

3

1990
12194 3087 335

1991
12523 3138 342

Black
1992 1993

12850 3190 348

13181 3242 355

1994 5-year

13508 3294 362

64256 15952
1741

18.4 18.0 23.0

18.7 17.8 24.0

18.9 18.4 25.0

19.4 16.3 25.0

18.7 17.0 26.0

18.8 17.6 24.0

62

67

66

51

72

318

18

18

19

15

18

88

300

272

266

279

284

1401

52

55

51

35

58

251

199

198

198

196

210

1001

17

11

34

25

17

104

3

3

9

3

7

25

59

64

65

66

69

323

10

11

12

13

13

59

10

3

4

4

1

22

4

2

2

4

1

13

6

1

2

0

0

9

8

5

11

7

8

39

1

3

1

1

3

9

3

1

3

0

0

7

56

41

32

40

27

196

17

8

4

14

4

47

0

0

1

3

0

4

48

35

36

36

37

192

5

3

5

6

4

23

6

7

4

4

4

25

106

88

82

104

94

474

101

91

119

115

115

541

110

114

100

107

117

548

12

17

8

5

8

50

27

29

26

22

26

130

6

8

8

9

12

43

25

17

28

24

20

114

.

0

2

5

5

12

.

0

2

2

6

10

.

0

24

63

110

197

156

136

153

168

185

798

25

29

27

29

27

137

6

6

5

11

8

36

200

204

187

218

199

1008

154

143

168

205

199

869

134

132

147

180

163

756

.

15

66

66

58

205

0

0

0

2

1

3

256

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Coweta County - 038

18.3 76.6
2.3 31.6
4.1 17.1
0.5 169.9
6.9
111.4 25.9 81.7 75.5 27.2
100.0 4.1
15.2 8.1 7.2
18.1 *
0.8
10.5 2.3 *
10.6 1.8 1.9
30.9 16.1 28.6
2.4 19.8
1.5 8.9
. . .
70.7 12.3 19.8 41.0 29.5 25.4
.

18.3 77.4
2.4 31.4
4.0 16.7
0.5 168.5
5.2
131.1 24.1 96.3 71.2 32.4 97.4 4.0
6.9 4.9
* 10.8
* *
7.4 1.6
* 10.6
1.1 2.1
28.5 13.5 28.9
2.4 18.9
1.6 8.1
* * *
73.3 12.6 38.0 43.6 32.0 28.0
2.4

18.6 79.2 2.4 30.3 4.1 17.6 0.5 167.4 8.6
111.9 22.7 74.6 79.8 30.9
100.0 7.9
7.6 4.7
* 22.3
* 0.6
5.8 0.8
* 7.9 1.2 1.6
24.9 17.5 26.1
1.5 19.0
1.5 7.6
2.2 2.4 11.2
75.6 12.9 26.5 40.2 37.2 30.6 11.7

19.8 85.0
2.6 30.9
3.3 14.3
0.4 134.4
6.8
88.8 28.1 62.3 76.3 24.1 96.8
*
7.8 7.0
* 11.2
* *
8.1 1.7
* 8.6 1.7 1.7
30.0 15.9 23.8
0.8 16.2
1.6 7.2
1.8 2.9 17.0
78.1 14.6 36.6 41.5 42.3 33.0 12.0

19.2 83.1 2.6 29.7 3.5 15.3 0.5 146.4 5.8
107.0 22.1 83.3 86.8 22.9 96.4 *
4.4 * *
14.7 *
0.5
6.5 0.7
* 9.9 1.0 1.8
28.2 14.3 22.8
1.1 15.5
1.9 6.0
1.8 2.2 15.2
82.4 10.9 36.9 35.7 36.8 28.1 9.6

18.8 80.3
2.5 30.7
3.8 16.2
0.5 156.8
6.7
109.8 24.4 79.5 77.8 27.5 98.2
4.3
8.2 5.6 2.6 15.4 0.7 0.5
7.6 1.4 0.1 9.5 1.3 1.8
28.5 15.5 25.9
1.6 17.8
1.6 7.5
1.5 1.9 11.1
76.3 12.7 31.4 40.3 35.8 29.1
9.1

16.5 70.2
2.2 15.9
3.8 16.3
0.5 175.9
6.2

17.2 74.1
2.3 16.0
3.6 15.4
0.5 163.3
4.9

17.7 77.0 2.4 15.1 3.7 16.0 0.5 159.9 6.8

19.0 83.2
2.6 17.8
2.7 11.8
0.4 117.6
5.6

18.1 80.0 2.5 15.0 2.9 13.0 0.4 132.4 5.1

17.7 77.0
2.4 16.0
3.3 14.5
0.5 148.7
5.7

83.6 23.3 53.8 53.2 26.3 100.0
*

106.1 22.1 71.5 49.2 32.4
100.0 *

81.7 17.3 46.8 55.8 29.4 100.0 7.6

67.0 27.0 47.8 57.8 19.1 94.4
*

70.6 19.1 52.9 73.5 17.6 93.3
*

81.5 21.7 54.4 57.5 24.8 98.2
3.3

7.4 * *
14.6 *
0.8

*

*

*

*

*

*

8.1

16.4

*

*

*

*

5.8

*

5.6

*

*

4.3

*

*

1.3

6.9

10.5

11.2

*

*

0.4

*

0.7

0.5

7.1

4.6

3.7

5.9

5.5

5.3

0.9

1.1

*

0.7

*

0.7

*

*

*

*

*

*

8.2

9.5

5.9

7.0

8.8

7.9

1.8

1.1

0.9

1.4

0.8

1.2

1.9

1.9

1.7

1.9

2.0

1.9

26.6 8.1
24.5 1.5
24.4 1.1 6.7

24.6 6.1
23.8 1.0
22.1 1.1 7.0

21.7 8.3 21.9 0.9 21.9 1.0 4.1

26.1 7.5
18.6 *
18.8 1.1 4.6

26.2 5.6
16.6 *
17.8 1.1 3.8

25.1 7.1
20.8 0.8
20.8 1.1 5.2

.

*

*

1.3

1.9

0.9

.

*

*

1.3

2.4

1.0

.

*

3.7

11.3

11.5

6.8

78.4 13.7 19.4 29.3 19.6 16.8
.

81.8 13.0 40.4 31.6 24.5 20.5
1.2

81.8 13.5 26.3 29.8 28.1 22.1 7.2

84.0 15.5 35.4 29.4 31.9 22.5
8.2

87.9 11.0 36.4 24.3 25.7 18.4
5.9

83.0 13.3 31.3 28.8 26.3 20.2
5.8

24.6 97.2
2.8 67.7
4.8 19.1
0.5 152.5
9.1

21.7 86.7
2.5 73.6
5.1 20.4
0.6 180.8
5.7

20.7 83.4 2.4 75.9 5.1 20.4 0.6 172.9 14.1

21.2 86.1
2.5 71.8
5.0 20.4
0.6 175.5
9.6

21.0 86.2 2.5 74.7 5.1 20.9 0.6 182.1 7.9

21.8 87.8
2.5 72.6
5.0 20.2
0.6 172.5
9.3

185.1 29.0 155.2 96.1 29.9 100.0
*

196.2 26.9
161.1 96.4 32.2 90.9 *

189.4 28.8
146.4 100.0
34.4 100.0
*

143.7 29.4 98.6
100.0 36.6
100.0 *

199.1 25.0
160.4 98.2 36.0
100.0 *

182.6 27.7 144.1 98.0 33.9 98.3 6.9

33.3 *
20.3 26.4
* *

* * * 18.2 * *

* * * 40.0 * *

* * * 24.8 * *

* * * 27.5 * *

15.7 9.3 6.5
27.3 1.7 0.4

18.7 5.7 *
16.3 1.7 2.0

15.1 2.9 *
13.1 *
2.6

12.0 * *
13.8 1.9
*

14.3 5.0 *
13.2 2.2 *

9.5 * *
13.2 * *

14.0 3.4 *
14.0 1.7 1.8

40.2 34.2 37.5
4.1 9.3 2.1 12.9

39.1 33.8 42.9
6.4 10.8
3.0 11.0

34.0 45.6 38.5 3.1 10.1 3.1 16.8

41.8 42.1 39.3
1.8 8.1 3.3 12.8

34.6 40.9 41.8 2.9 9.3 4.3 13.1

37.9 39.2 40.0
3.6 9.5 3.1 13.3

.

*

*

1.1

1.1

0.7

.

*

*

*

1.3

0.6

.

*

5.4

13.8

23.5

10.9

52.9 9.4
20.7 67.8 52.2 45.4
.

50.6 11.7 28.6 75.8 53.2 49.1
5.6

57.5 11.1 27.8 71.6 64.4 56.3 25.3

60.2 11.8 39.3 79.9 75.1 65.9 24.2

65.4

57.3

10.4

10.9

38.1

30.8

70.8

73.1

70.8

63.0

58.0

54.8

20.6

18.9

257

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Crawford County - 039

1990
8991 2142
223
20.3 20.1 22.0
12 3
127 12 41
9 1 27 0
2 2 0 4 0 0
18 5 2
23 3 0
43 26 34
1 21
2 6
. . .
97 14
1 70 54 49
. 0

1991
9087 2143 221
23.1 16.4 21.0
13 0
107 8
33 8 0
26 5
2 1 1 1 0 1
14 4 1
14 2 1
29 19 31
3 15
0 6
3 3 14
72 17
4 63 55 48
0 0

Total
1992 1993

9177 2146
219

9269 2143 215

19.1 19.4 23.0

20.0 18.8 20.0

22

17

5

2

130

128

20

14

58

48

3

2

2

2

31

20

2

2

3

1

1

1

2

0

3

3

0

0

0

0

15

8

2

1

0

0

12

14

3

1

1

1

39

44

31

23

38

42

0

1

16

12

1

0

3

6

5

3

6

3

12

21

87

96

17

20

2

4

66

84

66

77

56

65

10

24

0

0

1994 5-year

9363 2146
213

45887 10720
1091

19.4 21.0 21.0

19.8 19.4 21.0

23

87

1

11

147

639

20

74

61

241

1

23

0

5

35

139

3

12

4

12

3

8

1

4

3

14

0

0

1

2

18

73

2

14

0

3

17

80

2

11

1

4

56

211

33

132

42

187

3

8

24

88

0

3

6

27

3

14

5

17

23

70

108

460

23

91

2

13

81

364

91

343

63

281

22

56

0

0

1990
6090 1431
151

1991
6232 1451
152

White
1992 1993

6368 1472
152

6510 1491
152

1994 5-year

6650 1512
153

31850 7357 760

20.7 .
19.0

23.6 16.0 20.0

20.4 19.4 21.0

21.7 18.4 19.0

19.4 19.4 20.5

20.4 19.1 20.0

7

9

10

7

16

49

2

0

2

2

1

7

87

70

94

83

101

435

7

5

9

6

14

41

14

9

31

15

25

94

6

5

0

2

0

13

0

0

0

0

0

0

14

13

17

12

18

74

0

4

1

1

2

8

1

0

1

0

3

5

1

0

0

0

2

3

0

0

1

0

1

2

2

0

0

0

2

4

0

0

0

0

0

0

0

0

0

0

0

0

11

7

10

5

11

44

4

2

0

1

1

8

1

0

0

0

0

1

13

9

7

8

12

49

2

1

2

1

2

8

0

0

0

1

1

2

29

18

25

29

33

134

7

6

13

6

12

44

18

21

25

25

31

120

0

1

0

0

2

3

19

12

12

12

18

73

2

0

0

0

0

2

3

4

0

2

2

11

.

1

3

3

2

9

.

0

6

3

2

11

.

0

5

16

13

34

73

53

71

69

78

344

9

11

10

11

17

58

0

3

2

3

1

9

39

34

41

50

50

214

24

26

42

41

51

184

23

24

34

36

34

151

.

0

6

7

12

25

0

0

0

0

0

0

1990
2757 689 71

1991
2786 689
70

Black
1992 1993

2814 690 70

2842 690
69

1994 5-year

2871 691 68

14071 3449 347

18.7 20.1 26.5

21.6 23.1 25.5

18.1 20.4 25.0

18.5 19.2 26.0

19.1 26.9 20.0

18.9 20.1 26.0

5

4

12

10

7

38

1

0

3

0

0

4

40

36

36

45

45

202

5

3

11

8

6

33

27

24

27

33

36

147

3

3

3

0

1

10

1

0

2

2

0

5

12

13

14

8

17

64

0

1

1

1

1

4

1

2

2

1

1

7

1

1

1

1

1

5

0

1

1

0

0

2

2

1

3

3

1

10

0

0

0

0

0

0

0

1

0

0

1

2

7

7

5

3

7

29

1

2

2

0

1

6

1

1

0

0

0

2

10

5

5

6

5

31

1

1

1

0

0

3

0

1

1

0

0

2

14

11

14

15

23

77

19

13

18

17

21

88

16

10

13

17

11

67

1

2

0

1

1

5

2

3

4

0

6

15

0

0

1

0

0

1

3

2

3

4

3

15

.

0

2

0

1

3

.

0

0

0

1

1

.

1

7

5

9

22

24

19

16

27

29

115

5

6

7

9

6

33

1

1

0

1

0

3

31

28

25

34

31

149

30

29

24

36

40

159

26

24

22

29

29

130

.

0

4

17

10

31

0

0

0

0

0

0

258

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Crawford County - 039

14.1 59.3
1.8 32.8
3.0 12.6
0.4 164.6
4.7
53.8 *
53.8 66.7
* * *
* * * * * *
14.2 3.9 *
18.4 * *
40.2 20.8 27.2
* 16.8
* 7.7
. . .
77.0 12.5
* 56.0 43.2 39.2
.

11.8 49.9
1.5 31.1
2.9 12.1
0.4 184.4
3.7
59.0 *
36.3 100.0
22.7 100.0
*
* * * * * *
13.1 * *
13.2 * *
30.2 17.9 29.2
* 14.2
* 8.7
* * 5.5
68.6 17.9
* 59.4 51.9 45.3
*

14.2 60.6 1.9 45.7 3.4 14.4 0.4 186.7 2.3
100.7 22.7 91.5 89.5 * * *
* * * * * *
11.5 * *
9.4 * *
33.6 24.4 30.2
* 12.6
* *
1.9 2.3 4.6
68.0 14.9
* 52.0 52.0 44.1
7.9

13.8 59.7
1.8 37.8
2.2 9.3 0.3 131.6
*
78.9 *
65.0 78.6
* * *
* * * * * *
6.3 * *
11.0 * *
36.1 18.1 33.1
* 9.5
* 8.2
* * 8.1
76.2 18.3
* 66.1 60.6 51.2 18.9

15.7 68.5 2.1 42.1 3.7 16.3 0.5 190.2
*
107.8 *
93.7 60.0
* * *
* * * * * *
12.2 * *
11.8 * *
40.3 22.8 29.0
* 16.6
* 7.9
* 1.9 8.8
74.5 17.4
* 55.9 62.8 43.4 15.2

13.9 59.6
1.8 38.3
3.0 13.0
0.4 172.2
2.7
79.8 12.6 67.8 76.7 11.0 100.0
*
18.8 12.5
* 21.7
* *
11.4 2.2 *
12.7 1.7 *
36.4 21.0 29.7
1.3 14.0
* 7.4
1.4 1.6 6.8
73.0 16.2 19.1 57.8 54.4 44.6 11.1

14.3 60.8
1.9 16.5
2.3 9.8 0.3 130.8 4.2

11.2 48.2
1.5 13.0
2.1 9.0 0.3 147.7 3.4

46.4 *
46.4 * * * *

59.3 *
33.0 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

12.6 * *
15.3 * *

10.0 * *
13.0 * *

37.2 8.2
21.2 *
22.4 * *

27.3 8.7
30.4 *
17.4 * *

.

*

.

*

.

*

84.9 11.7
* 45.9 28.2 27.1
.

75.7 18.0
* 49.3 37.7 34.8
*

14.8 63.9 2.0 33.7 2.7 11.5 0.4
. *

12.7 55.7
1.7 18.3
1.8 8.0 0.2 123.7
*

15.2 66.8 2.1 25.3 2.7 11.9 0.4
. *

13.7 59.1
1.8 22.0
2.3 10.1
0.3 141.8
1.8

65.7 *
59.1 77.8
* * *

46.0 *
39.4 * * * *

104.6 *
91.5 42.9
* * *

64.4 14.3 53.9 61.0 10.5 100.0
*

*

*

*

11.5

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

10.6 * *
7.6 * *

6.0

10.9

10.1

*

*

1.8

*

*

*

9.8

12.1

11.5

*

*

1.9

*

*

*

29.1 14.1 27.2
* 13.0
* *

36.3 7.3
30.5 *
14.8 * *

34.4 12.1 31.3
* 18.2
* *

33.0 10.3 28.1
* 17.1
* 4.4

*

*

*

1.3

3.4

*

*

1.6

2.9

9.0

7.1

4.8

75.5 12.2
* 44.6 45.7 37.0 6.5

84.1 16.2
* 61.0 50.0 43.9
8.5

78.0 18.5
* 50.5 51.5 34.3 12.1

79.6 15.3 19.1 50.1 43.1 35.4
7.3

14.5 58.1
1.7 67.5
4.4 17.4
0.5 214.3
*

12.9 52.2
1.6 66.7
4.7 18.9
0.6 250.0
*

12.8 52.1 1.6 77.1 5.0 20.3 0.6 254.5 7.2

15.8 65.3
2.0 73.3
2.8 11.6
0.4 145.5
*

15.7 65.2 1.9 80.0 5.9 24.6 0.7 265.6
*

14.4 58.6
1.8 73.1
4.5 18.6
0.6 227.0
4.6

70.4 *
70.4 * * * *

* 172.4 145.8 102.9 109.4

*

*

*

*

*

* 158.0 116.6

88.2

95.0

* 100.0 100.0 100.0

96.9

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

34.7

*

*

*

*

*

24.8

*

*

*

*

*

*

*

*

*

*

*

48.3

*

*

*

*

*

*

*

*

*

*

*

*

17.5 * *
25.0 * *

19.4 * *
13.9 * *

13.9 * *
14.3 * *

* * * 13.3 * *

15.6 * *
11.4 * *

14.4 3.0 *
15.5 * *

48.3 47.5 40.0
* * * *

37.9 36.1 27.8
* * * *

46.7 51.4 38.2
* * * *

35.7 37.8 37.8
* * * *

54.8 46.7 24.4
* 13.3
* *

44.8 43.8 33.5
2.5 7.5
* 13.3

.

*

*

*

*

*

.

*

*

*

*

*

.

*

8.1

5.7

10.2

6.3

60.0 14.3
* 77.5 75.0 65.0
.

55.9 18.2
* 77.8 80.6 66.7
*

47.1 21.9
* 71.4 68.6 62.9
*

61.4 22.0
* 75.6 80.0 64.4 37.8

65.9

58.7

15.0

18.2

*

*

68.9

74.1

88.9

79.1

64.4

64.7

22.2

19.3

259

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Crisp County - 040

1990
20011 4522 511
19.7 17.6 21.5
73 21 380 63 212 23
2 52
9
4 3 1 5 1 2
45 4 2
38 3 6
149 132 153 10 58 15 19
. . .
193 65 13 253 229 196
. 0

1991
20183 4536 513
19.0 16.7 22.0
79 21 362 63 213 26
4 56 14
6 4 2 8 2 2
30 8 3
43 1 3
155 118 150
4 54
8 37
13 19 144
206 45 9
267 222 196
53 2

Total
1992 1993

20349 4548 515

20526 4563 517

18.7 17.1 21.5

18.3 18.3 22.0

83

81

23

27

351

331

74

70

213

182

32

25

6

3

39

53

10

8

6

6

5

5

1

1

11

8

0

0

1

1

42

42

9

9

0

1

49

40

4

9

4

5

144

146

110

79

139

138

6

6

45

29

9

4

23

25

25

20

27

26

221

183

233

214

50

48

10

12

260

259

257

245

224

230

88

98

2

3

1994 5-year

20696 4575 519

101765 22744 2576

19.5 17.5 22.0

19.0 17.3 22.0

68

384

20

112

376

1800

60

330

187

1007

36

142

2

17

41

241

7

48

8

30

4

21

4

9

6

38

3

6

2

8

44

203

5

35

3

9

59

229

4

21

4

22

144

738

78

517

126

706

7

33

36

222

2

38

20

124

28

86

12

84

175

723

251

1097

66

274

10

54

260

1299

269

1222

234

1080

138

377

5

12

1990
11783 2485 259

1991
11827 2477 259

White
1992 1993

11867 2468 260

11913 2460 260

1994 5-year

11957 2451 260

59347 12341
1297

21.9 16.5 21.0

19.9 18.5 21.0

21.3 17.1 21.0

19.8 20.5 21.0

24.2 17.3 21.0

21.6 18.0 21.0

20

18

18

22

13

91

5

1

2

10

4

22

144

142

131

132

163

712

16

12

13

16

9

66

25

30

24

24

23

126

11

8

14

13

21

67

1

2

1

0

1

5

28

26

18

22

19

113

4

6

5

5

3

23

4

0

2

3

1

10

3

0

2

2

0

7

1

0

0

1

1

3

4

2

3

2

1

12

1

1

0

0

0

2

2

2

0

1

1

6

11

8

13

15

12

59

2

1

5

2

0

10

2

0

0

0

0

2

8

12

16

11

23

70

1

1

2

3

1

8

4

0

2

2

2

10

57

41

35

48

44

225

14

13

12

7

9

55

45

40

32

40

42

199

1

0

3

1

1

6

28

34

26

17

26

131

1

3

2

1

1

8

3

5

5

7

5

25

.

3

12

7

11

33

.

8

15

7

6

36

.

50

79

73

66

268

103

110

100

30

24

20

4

3

2

66

80

70

51

54

66

44

48

56

.

19

32

0

0

0

95

128

536

23

28

125

3

4

16

75

82

373

70

87

328

61

70

279

41

58

150

0

1

1

1990
8153 2025
252

1991
8223 2032 253

Black
1992 1993

8291 2037
254

8363 2044 255

1994 5-year

8432 2050
256

41462 10188
1270

18.0 18.0 23.0

17.7 15.7 26.0

17.3 17.0 23.0

17.4 15.5 29.0

17.5 19.0 24.5

17.6 16.8 24.5

52

61

65

59

55

292

16

20

21

17

16

90

233

219

219

198

209

1078

47

51

61

54

51

264

187

183

189

158

164

881

12

18

18

12

15

75

1

2

5

3

1

12

22

30

21

29

21

123

4

8

5

3

4

24

0

6

4

3

7

20

0

4

3

3

4

14

0

2

1

0

3

6

1

6

8

6

5

26

0

1

0

0

3

4

0

0

1

0

1

2

33

22

28

27

31

141

2

7

4

7

5

25

0

3

0

1

3

7

30

31

33

28

35

157

2

0

2

6

3

13

2

3

2

3

2

12

91

114

108

98

99

510

118

105

98

72

69

462

108

110

107

98

84

507

9

4

3

5

6

27

30

20

19

12

10

91

14

5

7

3

1

30

16

32

18

18

15

99

.

10

13

13

17

53

.

10

11

19

6

46

.

90

131

108

99

428

88

95

132

118

121

554

35

20

29

25

37

146

8

6

8

9

6

37

185

187

189

184

176

921

177

168

190

175

180

890

151

148

167

169

162

797

.

34

56

57

79

226

0

2

2

3

4

11

260

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Crisp County - 040

19.0 84.0
2.6 56.5
2.6 11.5
0.3 113.8
5.5
142.9 28.8 123.3 82.5 17.6 100.0
9.8
* * * 13.1 * *
11.9 * *
10.1 *
1.6
42.0 35.2 41.0
2.7 15.5
4.0 7.9
. . .
51.3 19.8 28.3 67.5 61.1 52.3
.

17.9 79.8
2.4 59.0
2.8 12.3
0.4 124.7
6.8
154.0 26.6
122.8 90.5 27.3
100.0 *
16.6 * *
21.9 * *
8.3 2.2
* 11.9
* *
46.4 32.7 41.7
* 15.0
2.2 17.1
2.2 3.2 24.0
57.7 14.2 20.5 74.0 61.5 54.3 14.7

17.2 77.2 2.3 61.4 1.9 8.6 0.2 90.5
9.0
161.0 27.7
143.6 93.2 19.4
100.0 *
17.1 14.2
* 30.8
* *
12.0 2.6
* 14.2
* *
45.3 31.7 40.5
1.7 13.0
2.6 11.2
4.2 4.5 36.7
67.0 16.1 27.8 74.9 74.1 64.6 25.4

16.1 72.5
2.2 56.3
2.6 11.6
0.4 128.3
6.4
156.6 33.3
135.3 88.4 15.5 85.7 11.6
18.1 15.1
* 24.0
* *
12.7 2.7 *
12.4 2.8 1.5
47.6 24.5 42.7
1.9 9.0
* 12.7
3.3 4.3 30.4
64.8 16.8 31.6 80.2 75.9 71.2 30.3

18.2 82.2 2.4 50.5 2.0 9.0 0.3 89.9 8.5
131.0 29.4
115.6 89.8 13.5
100.0 *
21.3 * *
15.9 * *
11.7 1.3
* 16.0
* *
40.9 21.1 34.1
1.9 9.8
* 9.7
4.6 2.0 29.0
67.1 20.1 24.4 70.3 72.7 63.2 37.3

17.7 79.1
2.4 56.7
2.4 10.6
0.3 109.2
7.3
149.1 29.2 128.1 89.0 18.6 97.9
7.8
16.7 11.7
5.1 20.9
0.9 0.4
11.3 1.9 0.5
12.9 1.2 1.2
44.3 29.1 39.9
1.9 12.5
2.1 11.6
3.6 3.5 30.0
61.5 17.4 26.3 73.1 68.8 60.8 26.9

12.2 57.9
1.9 17.6
2.4 11.3
0.4 152.2
4.8

12.0 57.3
1.8 21.3
2.2 10.5
0.3 145.3
4.4

11.0 53.1 1.7 18.6 1.5 7.3 0.2 108.4 6.9

11.1 53.7
1.7 18.6
1.8 8.9 0.3 131.0 5.7

77.2 25.0 61.8 37.5
* * *

69.5 *
46.3 50.0 23.2 100.0
*

69.3 *
50.1 61.5 19.3 100.0
*

84.7 45.5 61.6 50.0 19.3
* *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

7.7

5.6

9.9

11.4

*

*

3.8

*

*

*

*

*

5.6

8.5

12.4

8.5

*

*

*

*

*

*

*

*

41.6 9.9
32.1 *
19.7 * *

30.1 9.2
28.4 *
24.1 *
7.0

29.9 9.3 25.0
* 20.3
* 7.6

37.5 5.4
31.0 *
13.2 *
9.7

.

*

4.5

2.6

.

2.9

5.6

2.6

.

18.4

29.3

27.3

72.5 24.2
* 46.5 35.9 31.0
.

77.5 19.4
* 56.7 38.3 34.0 13.5

76.3 16.7
* 54.3 51.2 43.4 24.8

72.0 20.2
* 58.1 54.3 47.3 31.8

13.6 66.5 2.1 14.2 1.6
7.8 0.2 93.1 9.0

12.0 57.7
1.8 17.9
1.9 9.2 0.3 125.4 6.2

50.1 *
34.7 * * * *

70.2 24.2 50.9 47.0 17.7 95.7
4.6

*

14.0

*

9.8

*

*

*

16.7

*

*

*

0.6

7.4 * *
14.2 * *

8.3 1.4
* 10.0
1.1 1.4

28.4 5.6
25.9 *
16.1 *
5.7

33.4 7.8
28.4 0.9
18.7 1.1 6.7

4.2 2.3 24.9

3.1 3.4 25.0

79.0 19.3
* 50.6 53.7 43.2 35.8

75.6 19.9 21.1 53.1 46.7 39.7 26.7

28.6 115.1
3.2 81.3
2.7 10.9
0.3 82.1
6.4

26.6 107.8
3.0 83.6
3.6 14.8
0.4 111.5
9.8

26.4 107.5
2.9 87.1 2.5 10.3 0.3 79.5 11.8

23.7 96.9
2.6 81.9
3.5 14.2
0.4 119.8
7.3

24.8 102.0
2.8 80.4 2.5 10.2 0.3 85.0 8.3

26.0 105.8
2.9 82.9
3.0 12.1
0.3 95.3
8.7

206.3 30.8 186.5 97.9
* * *

241.2 32.8
201.7 100.0
31.6 100.0
*

255.7 32.3
240.0 100.0
19.7 100.0
*

231.3 28.8
211.7 100.0
* * 19.6

214.8 29.1
199.2 100.0
* * *

229.9 30.8
207.8 99.6 18.9 100.0 11.0

*

27.4

*

*

33.5

18.6

*

*

*

*

*

13.0

*

*

*

*

*

5.6

*

27.1

35.7

29.9

23.8

23.9

*

*

*

*

*

*

*

*

*

*

*

*

14.2 * *
13.0 * *

10.1 3.2 *
14.2 * *

12.8 * *
15.3 * *

13.6 3.5 *
14.5 3.1 *

14.8 2.4
* 17.3
* *

13.1 2.3 0.6
14.8 1.2 1.1

42.3 51.3 47.0
3.9 13.0
6.1 10.0

57.9 47.9 50.5
* 9.2 2.3 22.2

54.0 45.2 50.0
* 8.8 3.2 12.9

55.1 37.3 50.8
2.6 6.2
* 14.5

51.3 33.8 41.4 3.0 4.9
* 12.6

51.9 43.5 47.9
2.5 8.6 2.8 14.4

.

3.1

4.0

4.0

5.2

4.1

.

3.1

3.4

5.8

1.8

3.5

.

27.8

40.4

33.2

30.4

32.9

38.1 17.2 29.6 80.4 77.0 65.7
.

44.4 10.4 22.2 85.4 76.7 67.6 15.5

61.1 15.3 29.6 87.1 87.6 77.0 25.8

59.9 14.7 39.1 95.3 90.7 87.6 29.5

58.2

52.0

20.4

15.6

26.1

29.1

86.3

86.6

88.2

83.7

79.4

75.0

38.7

27.1

261

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Dade County - 041

1990
13147 3168 284
20.0 .
20.0
19 1
186 19 33
0 0 24 0
1 1 0 1 1 0
16 8 1
13 2 2
50 25 63
3 18
0 4
. . .
150 18
0 65 59 41
. 0

1991
13260 3162 283
20.7 26.9 20.0
20 1
193 20 41 5 1 21 0
1 1 0 2 0 0
10 2 0
10 1 0
23 22 68
2 18
0 4
0 3 12
158 10 0 98 68 62 1 0

Total
1992 1993

13362 3154 282

13472 3145 281

20.8 17.2 19.5

22.1 17.3 20.0

23

20

5

2

194

201

22

16

32

32

3

7

1

0

22

17

1

4

0

2

0

1

0

1

1

0

1

0

1

1

15

17

4

2

0

0

19

19

1

1

0

1

6

30

13

14

53

54

1

1

16

22

0

0

11

12

1

2

4

5

14

11

158

161

9

7

0

0

77

89

60

73

45

57

2

2

0

0

1994 5-year

13579 3138 280

66820 15767
1410

19.7 17.4 19.0

20.3 17.3 20.0

31

113

6

15

202

976

28

105

57

195

9

24

0

2

11

95

3

8

2

6

1

4

1

2

1

5

1

3

4

6

20

78

3

19

0

1

23

84

1

6

1

4

24

133

33

107

61

299

3

10

32

106

1

1

6

37

1

4

1

13

12

49

159

786

10

54

3

3

67

396

68

328

39

244

3

8

0

0

1990
12972 3126 277

1991
13082 3119 276

White
1992 1993

13186 3110 274

13293 3102 273

1994 5-year

13399 3094 271

65932 15551
1371

20.1 .
20.0

20.8 26.9 20.0

20.8 17.2 20.0

22.1 17.3 20.0

19.7 17.4 19.0

20.4 17.3 20.0

19

19

23

20

31

112

1

1

5

2

6

15

185

191

194

197

196

963

19

19

22

16

28

104

33

40

32

30

55

190

0

5

3

7

9

24

0

1

1

0

0

2

24

19

22

16

11

92

0

0

1

4

3

8

1

1

0

2

2

6

1

1

0

1

1

4

0

0

0

1

1

2

1

2

1

0

1

5

1

0

1

0

1

3

0

0

1

1

4

6

16

10

15

16

20

77

8

2

4

2

3

19

1

0

0

0

0

1

13

10

19

18

23

83

2

1

1

1

1

6

2

0

0

1

1

4

50

23

6

30

24

133

25

21

13

13

29

101

63

67

53

52

60

295

3

2

1

0

3

9

18

17

16

22

32

105

0

0

0

0

1

1

4

4

11

12

6

37

.

0

1

2

1

4

.

1

4

5

1

11

.

12

14

11

10

47

149

156

158

159

154

776

18

10

9

7

10

54

0

0

0

0

3

3

65

96

77

89

65

392

59

66

60

73

67

325

41

60

45

57

38

241

.

1

2

2

3

8

0

0

0

0

0

0

1990
101 17 4

1991
102 17 4

Black
1992 1993

103

104

17

17

4

4

1994 5-year

104

513

17

85

4

20

19.7 . .

17.8 .
30.0

.

18.4

19.6

19.6

.

.

.

.

.

.

21.5

26.5

0

1

0

0

0

1

0

0

0

0

0

0

1

2

0

2

5

10

0

1

0

0

0

1

0

1

0

1

2

4

0

0

0

0

0

0

0

0

0

0

0

0

0

2

0

0

0

2

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

4

5

0

1

0

1

1

3

0

0

0

0

0

0

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

1

2

0

1

4

8

0

0

0

0

0

0

0

0

0

0

0

0

0

2

0

0

2

4

0

2

0

0

1

3

0

2

0

0

1

3

.

0

0

0

0

0

0

0

0

0

0

0

262

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

14.1

14.6

14.5

14.9

14.9

14.6

General fertility rate

58.7

61.0

61.5

63.9

64.4

61.9

Total fertility rate

1.7

1.8

1.8

1.9

1.9

1.8

% Livebirths to unmarried women

18.0

21.4

16.7

16.2

28.4

20.2

Crude abortion rate

1.8

1.6

1.6

1.3

0.8

1.4

General abortion rate

7.6

6.6

7.0

5.4

3.5

6.0

Total abortion rate

*

*

*

0.1

0.1

0.1

Abortion ratio

.

95.5

99.5

75.6

49.3

86.4

Fetal Death rate

*

1.9

1.6

2.2

3.2

1.8

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

66.9

70.7

81.5

71.1 110.7

80.1

% Repeat conceptions to women under 18

*

*

21.7

*

19.4

13.3

Livebirths to women under 18

66.9

70.7

78.0

56.9 100.0

74.5

% Livebirths to unmarried women under 18

31.6

40.0

50.0

37.5

46.4

41.9

Induced abortions to women under 18

*

*

*

*

*

5.7

% Abortions to unmarried women under 18

*

*

*

*

* 100.0

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

6.1

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

5.1

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

8.6

5.2

7.7

8.5

9.9

8.0

% Very low birthweight

4.3

*

*

*

*

1.9

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

7.1

5.2

9.9

9.5

11.4

8.7

% Multiple gestation

*

*

*

*

*

0.6

% Birth defect

*

*

*

*

*

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

40.3

22.3

5.9

30.6

22.2

24.9

% with father not named on birth certificate

13.6

11.5

6.8

7.0

16.4

11.1

% with maternal education less than high school

34.2

35.4

27.6

27.1

30.5

30.9

% No prenatal care

*

*

*

*

*

1.1

% Maternal smoking during pregnancy

12.3

16.4

15.7

22.0

29.4

18.7

% Maternal alcohol use during pregnancy

*

*

*

*

*

*

% Interpregnancy interval less than 6 months

*

*

10.1

11.2

5.6

7.4

Child abuse and neglect rates

Physical

.

*

*

*

*

*

Sexual

.

*

*

1.5

*

0.9

Neglect

.

3.5

4.1

3.2

3.5

3.6

Interventions to improve infant & child survival

% Prenatal care first trimester

82.0

83.6

83.2

85.6

82.4

83.4

% Primary C-section delivery

10.5

5.3

4.8

3.6

5.2

5.8

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

35.3

51.0

40.1

44.7

33.3

40.9

% Medicaid during pregnancy

32.1

35.4

31.3

36.7

33.8

33.9

% Medicaid and WIC during pregnancy

22.3

32.3

23.4

28.6

19.4

25.2

% Perinatal case management

.

*

*

*

*

1.0

Dade County - 041

14.3 59.2
1.8 18.0
1.9 7.7
* . *
68.6 *
68.6 31.6
* * *
* * * * * *
8.6 4.3
* 7.1
* *
40.3 13.7 34.4
* 12.3
* *
. . .
81.9 10.5
* 35.5 32.2 22.4
.

14.6 61.2
1.8 21.1
1.5 6.1
* 88.0
1.9
68.9 *
68.9 36.8
* * *
* * * * * *
5.2 * *
5.3 * *
22.8 11.1 35.3
* 15.7
* *
* * 3.5
83.4 5.3 *
50.5 34.7 31.6
*

14.7 62.4 1.9 16.7 1.7 7.1
* 99.5 1.6
83.9 21.7 80.3 50.0
* * *
* * * * * *
7.7 * *
9.9 * *
5.9 6.8 27.6
* 15.7
* 10.1
* * 4.1
83.2 4.8
* 40.1 31.3 23.4
*

14.8 63.5
1.9 15.5
1.2 5.2 0.1 72.7 2.3

14.6 63.3 1.9 28.2 0.8 3.6 0.1 50.7 3.2

14.6 61.9
1.8 19.9
1.4 5.9 0.1 84.9 1.8

73.3 *
58.7 37.5
* * *

114.3 19.4
103.2 46.4 * * *

81.7 13.4 75.9 41.3
5.8 100.0
*

*

*

6.2

*

*

*

*

*

*

*

*

5.2

*

*

*

*

*

*

8.1

10.2

8.0

*

*

2.0

*

*

*

9.2

11.8

8.7

*

*

0.6

*

*

*

30.9 6.7
26.7 *
22.2 *
11.4

22.9 14.9 30.8
* 30.2
* 5.8

25.2 10.6 30.9
1.0 18.7
* 7.4

*

*

*

1.5

*

0.8

3.2

2.9

3.5

85.9 3.6 *
45.6 37.4 29.2
*

82.4 5.4
* 33.3 34.4 19.5
*

83.4 5.8 *
41.0 34.0 25.2
1.0

*

*

*

*

47.9

19.5

*

*

*

* 294.1 117.6

*

*

*

*

13.1

4.6

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

50.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

88.9

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

263

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Dawson County - 042

1990
9429 2209
206
22.6 20.6 21.0
11 1
168 10 31 13
0 29
1
1 0 1 1 0 0
11 1 1
10 0 3
30 15 54
0 33
2 3
. . .
134 29
3 78 54 47
. 0

1991
9735 2258 211
22.1 20.1 20.5
9 3 156 9 31 12 0 22 0
1 0 1 0 1 0
7 0 0 18 1 3
21 13 46
0 27
3 6
6 7 10
132 26 5 98 50 50 9 0

Total
1992 1993

10031 2304 215

10339 2353 221

22.8 19.0 20.0

24.0 20.1 20.0

13

19

3

6

139

166

10

17

18

27

11

7

4

1

30

34

2

2

1

4

1

2

0

2

5

3

0

1

1

0

9

19

1

7

0

0

10

22

0

2

3

2

26

23

6

9

31

33

0

1

20

20

1

1

1

2

20

11

20

9

35

46

117

148

21

21

1

9

62

79

49

58

43

49

13

24

1

2

1994 5-year

10637 2399 225

50171 11523
1078

21.5 21.2 21.0

22.9 19.9 21.0

19

71

2

15

165

794

16

62

44

151

10

53

1

6

30

145

3

8

1

8

0

3

1

5

1

10

0

2

0

1

9

55

3

12

0

1

10

70

3

6

0

11

28

128

19

62

43

207

1

2

34

134

1

8

1

13

12

49

12

48

62

153

142

673

16

113

2

20

80

397

70

281

67

256

54

100

1

4

1990
9328 2183
202

1991
9621 2227 207

White
1992 1993

9910 2271
211

10203 2315 216

1994 5-year

10490 2358
221

49552 11354
1058

22.6 19.9 21.0

22.1 20.1 20.5

22.8 19.0 20.0

24.0 20.1 20.0

22.3 21.2 21.0

22.9 19.8 21.0

11

9

13

19

19

71

1

3

3

6

2

15

167

153

139

166

164

789

10

9

10

17

16

62

31

30

18

27

44

150

13

12

11

7

9

52

0

0

4

1

1

6

26

20

30

32

29

137

1

0

2

2

3

8

1

1

1

4

1

8

0

0

1

2

0

3

1

1

0

2

1

5

1

0

5

3

1

10

0

1

0

1

0

2

0

0

1

0

0

1

11

7

9

19

9

55

1

0

1

7

3

12

1

0

0

0

0

1

10

17

10

22

10

69

0

1

0

2

3

6

3

3

3

2

0

11

29

20

26

23

28

126

14

13

6

9

19

61

54

46

31

33

43

207

0

0

0

1

1

2

33

27

20

20

34

134

2

3

1

1

1

8

3

6

1

2

1

13

.

6

20

10

12

48

.

6

20

8

11

45

.

9

34

45

51

139

134

131

117

148

141

671

29

24

21

21

15

110

3

5

1

9

2

20

77

95

62

79

79

392

53

49

49

58

69

278

46

49

43

49

66

253

.

9

13

24

53

99

0

0

1

2

1

4

1990
4 0 0

1991
4 0 0

Black
1992 1993

4

4

0

0

0

0

1994 5-year

5

21

0

0

0

0

.

19.0

.

.

.

19.0

.

.

.

.

.

.

22.5

.

.

.

.

22.5

0

0

0

0

0

0

0

0

0

0

0

0

1

2

0

0

0

3

0

0

0

0

0

0

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

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0

0

0

0

0

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0

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0

0

0

0

0

0

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0

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0

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0

0

0

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0

0

0

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0

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0

0

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0

0

0

0

0

0

0

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0

0

0

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0

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0

0

0

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0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

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.

0

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0

0

0

.

0

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0

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0

.

0

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0

0

2

1

1

0

0

0

2

.

0

0

0

0

0

0

0

0

0

0

0

264

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Dawson County - 042

17.8 76.1
2.3 18.5
3.1 13.1
0.4 136.2
7.2
53.4 *
48.5 50.0
* * *
* * * * * *
6.5 * *
6.0 * *
28.3 8.9
32.7 *
19.6 * *
. . .
82.2 19.3
* 46.4 32.1 28.0
.

16.0 69.1
2.1 20.0
2.3 9.7 0.3 114.6 6.2
42.7 *
42.7 66.7
* * *
* * * * * *
4.5 * *
11.6 * *
21.9 8.4
29.9 *
17.9 *
7.4
2.2 2.6 3.7
86.3 18.2 41.7 63.2 32.3 32.3
5.8

13.9 60.3 1.9 12.9 3.0 13.0 0.4 162.2 6.9
60.4 *
46.4 * * * *
* * * 35.0 * *
6.5 * *
7.2 * *
34.2 4.3
23.5 *
14.5 * *
7.2 7.2 12.7
86.0 16.3
* 44.6 35.3 30.9
9.4

16.1 70.5
2.2 16.5
3.3 14.4
0.5 162.7
3.8
86.2 31.6 77.1 41.2
* * *
* * * * * *
11.4 4.2 *
13.4 * *
25.3 5.5
20.8 *
12.3 * *
3.9 3.2 16.2
89.2 14.4 50.0 48.2 35.4 29.9 14.6

15.5 68.8 2.1 27.2 2.8 12.5 0.4 145.6 4.6
84.5 *
71.1 68.8
* * *
* * * * * *
5.5 * *
6.2 * *
18.2 11.7 28.1
* 21.4
* *
4.1 4.1 21.2
86.6 11.0
* 49.4 43.2 41.4 33.3

15.8 68.9
2.1 19.2
2.9 12.6
0.4 144.3
5.7
65.9 21.1 57.5 51.6
7.4 100.0
*
10.1 *
6.3 12.5
* *
6.9 1.5
* 8.9 0.8 1.4
24.5 7.9
27.1 *
17.2 1.0 3.2
4.4 4.3 13.6
86.1 15.8 27.0 50.4 35.7 32.5 16.1

17.9 76.5
2.3 18.6
2.8 11.9
0.3 124.4
7.3

15.9 68.7
2.1 19.7
2.1 9.0 0.3 107.0 6.3

14.0 61.2 1.9 12.9 3.0 13.2 0.4 162.2 7.0

16.3 71.7
2.2 16.5
3.1 13.8
0.4 154.6
3.9

15.6 69.6 2.2 27.3 2.8 12.3 0.4 142.9 4.2

15.9 69.5
2.1 19.2
2.8 12.1
0.4 138.2
5.7

54.5 *
49.5 50.0
* * *

43.5 *
43.5 66.7
* * *

61.5 *
47.3 * * * *

87.8 31.6 78.6 41.2
* * *

86.1 *
72.5 68.8
* * *

67.1 21.1 58.6 51.6
7.6 100.0
*

*

*

*

*

*

10.1

*

*

*

*

*

*

*

*

*

*

*

6.4

*

*

35.0

*

*

12.6

*

*

*

*

*

*

*

*

*

*

*

*

6.6

4.6

6.5

11.4

5.5

7.0

*

*

*

4.2

*

1.5

*

*

*

*

*

*

6.0

11.2

7.2

13.4

6.2

8.8

*

*

*

*

*

0.8

*

*

*

*

*

1.4

27.6 8.4
32.9 *
19.8 * *

21.5 8.6
30.5 *
18.2 *
7.5

34.2 4.3 23.5
* 14.5
* *

25.3 5.5
20.8 *
12.3 * *

18.3 11.8 28.3
* 21.5
* *

24.3 7.8
27.3 *
17.3 1.0 3.2

.

2.3

7.4

3.6

4.2

4.4

.

2.3

7.4

2.9

3.8

4.1

.

3.4

12.5

16.1

17.8

12.6

82.7 19.3
* 46.1 31.7 27.5
.

86.8 17.1 41.7 62.5 32.2 32.2
5.9

86.0 16.3
* 44.6 35.3 30.9 9.4

89.2 14.4 50.0 48.2 35.4 29.9 14.6

86.5 10.3
* 49.1 42.9 41.0 32.9

86.2 15.5 27.4 50.1 35.5 32.3 16.1

*

*

*

*

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265

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Decatur County - 043

1990
25511 5788 655
19.1 19.0 21.0
79 20 444 71 195 16
9 24
4
6 5 1 14 2 2
49 12
1 32
7 4
147 87 183
3 65 12 33
. . .
309 83
0 246 225 176
. 0

1991
25638 5814 652
19.8 19.1 21.0
81 28 464 76 228 27
7 19
2
5 4 1 11 1 1
48 8 0
30 5 5
174 118 194
9 68
9 37
33 20 74
331 77 2
269 282 227
97 0

Total
1992 1993

25755 5840 650

25883 5868 647

20.4 18.0 21.0

19.0 22.5 22.5

61

81

20

21

397

422

52

76

195

208

31

40

7

3

14

8

1

0

10

4

5

3

5

1

12

6

2

0

2

1

34

44

9

5

1

1

33

40

7

7

7

4

106

131

91

95

165

166

5

3

56

34

11

4

25

26

30

24

30

28

98

128

286

308

65

74

3

5

240

274

237

285

194

244

193

204

4

2

1994 5-year

25998 5893 645

128785 29203 3248

19.0 21.4 22.0

19.4 19.5 22.0

67

369

16

105

396

2123

64

339

192

1018

49

163

3

29

11

76

0

7

6

31

1

18

5

13

4

47

0

5

1

7

34

209

3

37

0

3

30

165

1

27

3

23

138

696

81

472

157

865

3

23

62

285

1

37

23

144

35

122

22

100

147

447

300

1534

63

362

10

20

270

1299

258

1287

224

1065

210

704

2

8

1990
15228 3291 333

1991
15259 3294 332

White
1992 1993

15280 3297 332

15315 3301 332

1994 5-year

15336 3303 332

76418 16486
1661

21.5 18.3 20.0

21.2 18.4 20.0

22.9 19.9 21.0

20.9 22.5 20.0

20.7 .
21.0

21.4 19.1 20.0

23

19

13

22

22

99

5

5

1

4

1

16

206

226

191

184

194

1001

22

17

10

21

22

92

30

40

46

27

35

178

5

13

15

21

21

75

2

5

2

0

0

9

9

9

5

4

4

31

1

1

0

0

0

2

3

1

2

2

2

10

3

0

1

2

1

7

0

1

1

0

1

3

5

5

3

2

1

16

1

0

0

0

0

1

1

0

2

1

0

4

23

18

8

12

10

71

4

1

1

1

0

7

1

0

0

0

0

1

20

18

12

11

12

73

4

3

4

3

0

14

0

1

2

3

0

6

55

68

44

43

56

266

12

20

25

15

14

86

68

64

64

59

54

309

3

4

1

2

2

12

45

50

43

21

50

209

7

2

4

2

1

16

10

14

12

9

4

49

.

16

9

7

20

52

.

8

16

10

9

43

.

16

28

48

53

145

158

184

150

151

159

802

41

34

29

29

32

165

0

1

1

2

6

10

75

103

79

86

105

448

65

100

70

88

88

411

45

80

54

73

77

329

.

37

56

56

71

220

0

0

1

0

1

2

1990
10070 2448 316

1991
10120 2458 315

Black
1992 1993

10166 2468 313

10217 2479 312

1994 5-year

10262 2489 311

50835 12341
1567

17.7 19.5 24.0

17.4 19.9 23.0

18.4 15.9 23.0

17.9 .
24.5

18.2 21.4 24.0

17.9 19.5 24.0

56

62

48

59

45

270

15

23

19

17

15

89

236

237

205

237

202

1117

49

59

42

55

42

247

165

188

149

180

157

839

11

14

16

19

28

88

7

2

5

3

3

20

15

10

9

4

7

45

3

1

1

0

0

5

3

4

8

2

4

21

2

4

4

1

0

11

1

0

4

1

4

10

9

6

9

4

3

31

1

1

2

0

0

4

1

1

0

0

1

3

26

30

26

32

24

138

8

7

8

4

3

30

0

0

1

1

0

2

11

12

21

29

18

91

3

2

3

4

1

13

4

4

5

1

3

17

91

105

62

87

82

427

75

98

66

80

67

386

115

130

101

106

103

555

0

5

4

1

1

11

20

18

13

13

12

76

5

7

7

2

0

21

23

22

13

17

19

94

.

6

20

12

15

53

.

6

12

18

12

48

.

42

70

59

79

250

149

147

135

157

141

729

42

43

36

45

31

197

0

1

2

3

4

10

170

166

160

187

165

848

159

182

166

196

170

873

130

147

139

170

147

733

.

60

136

147

139

482

0

0

3

2

1

6

266

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

17.4

18.1

General fertility rate

76.7

79.8

Total fertility rate

2.2

2.3

% Livebirths to unmarried women

44.5

49.7

Crude abortion rate

0.9

0.7

General abortion rate

4.1

3.3

Total abortion rate

0.1

0.1

Abortion ratio

48.7

36.5

Fetal Death rate

4.3

6.4

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

120.6 124.2

% Repeat conceptions to women under 18

25.3

34.6

Livebirths to women under 18

108.4 116.6

% Livebirths to unmarried women under 18

78.9

82.9

Induced abortions to women under 18

*

*

% Abortions to unmarried women under 18

*

*

Fetal deaths to women under 18

7.6

*

Infant and child survival rates

Infant mortality

13.5

10.8

Neonatal mortality

11.3

*

Postneonatal mortality

*

*

Perinatal mortality ratio

30.9

23.4

Deaths of children 1-4 yrs

*

*

Deaths of children 5-17 yrs

*

*

Infant health rates

% Low birthweight

11.0

10.3

% Very low birthweight

2.7

1.7

% Under 500 grams

*

*

% Preterm gestation

7.3

6.5

% Multiple gestation

1.6

1.1

% Birth defect

*

1.2

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

36.2

41.3

% with father not named on birth certificate

19.9

25.7

% with maternal education less than high school

41.8

42.3

% No prenatal care

*

2.0

% Maternal smoking during pregnancy

15.9

16.0

% Maternal alcohol use during pregnancy

2.9

2.1

% Interpregnancy interval less than 6 months

12.3

13.1

Child abuse and neglect rates

Physical

.

4.3

Sexual

.

2.6

Neglect

.

9.7

Interventions to improve infant & child survival

% Prenatal care first trimester

69.6

71.8

% Primary C-section delivery

21.8

19.9

% Vaginal birth after previous C-section

*

*

% WIC during pregnancy

56.2

58.6

% Medicaid during pregnancy

51.4

61.4

% Medicaid and WIC during pregnancy

40.2

49.5

% Perinatal case management

.

21.1

Decatur County - 043

15.4 68.0 2.0 50.0 0.5 2.4 0.1 31.0 6.8

16.3 71.9
2.1 50.2
0.3 1.4 0.0 16.9 7.3

15.2 67.2 2.0 48.6 0.4 1.9 0.1 24.0 8.8

16.5 72.7
2.1 48.6
0.6 2.6 0.1 31.7 6.7

93.9 32.8 80.1 94.2
* * 12.3

125.2 25.9
117.4 78.9 * * 7.7

103.9 23.9 99.3 85.9 * * *

113.6 28.5 104.4 83.5
2.2 100.0
7.4

25.2 12.6 12.8 29.7
* *

* * * 14.1 * *

15.2 *
12.7 * * *

14.6 8.5 6.2
21.8 0.6 0.2

8.6

10.4

8.6

9.8

2.3

1.2

*

1.7

*

*

*

*

8.5

9.7

7.6

7.9

1.8

1.7

*

1.3

1.9

*

*

1.2

29.9 23.3 42.3
1.3 15.7
3.1 10.2

34.1 22.9 40.1
* 8.8
* 10.8

37.6 20.5 39.8
* 16.9
* 9.9

36.0 22.5 41.3
1.1 14.7
1.9 11.3

3.9 3.9 12.9

3.1 3.7 16.8

4.6 2.9 19.3

4.0 3.3 14.7

72.4 19.8
* 61.5 60.8 49.7 49.5

73.0 21.8
6.7 66.2 68.8 58.9 49.3

75.9 19.1 15.4 68.4 65.3 56.7 53.2

72.5 20.5
6.0 62.0 61.4 50.8 42.5

13.5 62.6
1.9 14.8
0.6 2.7 0.1 40.5 2.1
69.1 21.7 66.1 36.4
* * *
* * * 24.0 * *
11.2 * *
9.9 * *
31.1 5.9
33.5 *
25.1 3.9 8.6
. . .
76.7 22.5
* 36.9 32.0 22.2
.

14.8 68.6
2.1 17.9
0.6 2.7 0.1 35.3 6.1
57.2 26.3 51.1 35.3
* * *
* * * 21.6 * *
8.0 * *
8.1 * *
35.6 9.0
28.7 *
25.8 *
11.0
4.2 2.1 4.2
81.8 17.3
* 46.2 44.8 35.9 16.6

12.5 57.9 1.7 24.6 0.3 1.5
* 23.3 5.8
39.1 *
30.1 70.0
* * *
* * * * * *
4.2 * *
6.4 * *
27.3 13.4 34.2
* 26.5
* 11.0
2.4 4.2 7.4
78.9 17.4
* 42.2 37.4 28.9 29.9

12.0 55.7
1.7 15.0
* * * * 6.4
66.3 *
63.3 33.3
* * *
* * * * * *
6.5 * *
6.1 * *
27.0 8.3
32.8 *
13.2 *
9.4
1.8 2.6 12.6
82.1 18.4
* 47.8 48.9 40.6 31.1

12.6 58.7 1.8 18.0
* * * * 6.4
66.3 *
66.3 59.1
* * *
* * * * * *
5.2 * *
6.2 * *
32.6 7.2
28.0 *
29.1 * *
5.3 2.4 14.0
82.0 19.4 20.7 54.1 45.4 39.7 36.6

13.1 60.7
1.8 18.0
0.4 1.9 0.1 27.7 5.3
59.6 16.2 55.4 44.6
* * 3.0
10.0 7.0 *
15.8 * *
7.1 0.7
* 7.4 1.4 0.7
30.9 8.7
31.3 1.2
24.1 1.8 8.9
3.4 2.8 9.5
80.3 19.0
8.5 45.4 41.6 33.3 28.1

23.4 96.4
2.7 70.8
1.5 6.1 0.2 55.8 7.4

23.4 96.4
2.7 80.0
1.0 4.1 0.1 37.9 6.9

20.2 83.1 2.3 73.8 0.9 3.6 0.1 38.3 8.5

23.2 95.6
2.7 77.3
* * * * 8.9

19.7 81.2 2.3 78.1 0.7 2.8 0.1 29.2 12.5

22.0 90.5
2.5 76.0
0.9 3.6 0.1 35.4 8.8

177.2 26.8 155.1 98.0
* * 15.8

197.1 37.1
187.6 96.6 * * *

153.2 39.6
134.0 100.0
* * 16.0

189.0 28.8
176.2 96.4 * * *

144.7 33.3
135.0 100.0
* * *

172.3 33.0
157.6 98.0 3.2 100.0 12.1

*

*

39.0

*

*

18.8

*

*

*

*

*

9.8

*

*

*

*

*

9.0

37.0

25.1

42.9

*

*

27.3

*

*

*

*

*

*

*

*

*

*

*

*

11.0 3.4 * 4.7 * *

12.7 3.0 * 5.1 * *

12.7 3.9
* 10.4
* 2.6

13.5 * *
12.4 * *

11.9 * *
9.0 * *

12.4 2.7 * 8.2 1.2 1.6

40.1 32.2 49.4
* 8.7 2.2 15.0

45.9 41.7 55.3
2.1 7.9 3.1 14.2

32.3 32.7 50.0
* 6.7 3.6 9.6

38.8 34.3 45.5
* 5.8
* 11.8

42.1 33.3 51.2
* 6.2
* 15.0

40.0 35.0 50.3
1.0 7.1 2.0 13.2

.

1.6

5.4

3.2

4.0

3.6

.

1.6

3.2

4.9

3.2

3.2

.

11.4

18.9

15.9

21.3

16.9

63.1 21.4
* 73.0 68.2 55.8
.

62.6 22.9
* 70.6 77.4 62.6 25.5

66.2 22.5
* 79.2 82.2 68.8 67.3

66.2 24.9
* 80.3 84.1 73.0 63.1

70.1

65.5

18.8

22.1

*

4.7

82.1

76.8

84.6

79.1

73.1

66.4

69.2

55.3

267

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
DeKalb County - 044

1990
545837 150136 10280
24.6 21.2 25.0
1199 295
9275 683
3386 620 104
5894 479
120 86 34 187 16 35
884 184 29 1058 112 112
1442 1837 1337
317 716 259 388
. . .
6430 1234
249 3463 2210 1738
. 35

1991
553523 149707
10343
24.9 21.4 25.0
1133 351 9151 700 3498 767 122 5936 404
112 74 38
195 17 32
890 219
26 1050 128 123
1429 1875 1401 321 644 203 413
106 54
329
6526 1211 247 4032 2915 2406 153
62

Total
1992 1993

561204 149277 10405

568890 148848
10467

24.7 21.3 26.0

25.0 21.4 26.0

1136 327
9308 673
3648 716 114
5835 430

1052 280 8944 586 3443 642 123 5899 449

113

114

75

83

38

31

187

204

14

13

28

32

874

851

221

194

23

34

1048

971

120

136

105

59

1618 1949 1457
221 584 200 477

1848 1794 1330 147 439 137 336

404

296

132

119

738

598

6883 1219
271 4132 3417 2708
593 43

7202 1163 226 3962 3933 3019 1222
46

1994 5-year
576569 2806023 148417 746385
10529 52023

25.1 21.8 26.0

24.8 21.4 26.0

1072 288
9273 666
3447 623 111
5779 381

5592 1541 45951 3308 17422 3368
574 29343
2143

95

554

62

380

33

174

177

950

19

79

35

162

897 217
31 1001
115 52

4396 1035
143 5128
611 451

2504 1830 1391
116 523 153 332

8841 9285 6916 1122 2906
952 1946

227

1033

116

421

616

2281

7861 1241
231 4298 3793 3138 1731
46

34902 6068 1224
19887 16268 13009
3699 232

White
1990 1991 1992 1993 1994 5-year

292310 71962 4111

292449 70635 4086

292584 69309 4062

292723 67982 4037

292858 1462924 66656 346544 4012 20308

27.4 22.0 25.0

27.6 22.0 25.0

27.7 22.6 25.0

27.9 23.1 26.0

28.1 23.2 26.0

27.7 22.5 25.0

240 42 3670 108 498 227 24 1817 128

195 41
3386 106 442 258
19 1627
86

169 31
3286 96
444 256
27 1367
72

157 34
3075 80
416 248
19 1295
70

160 36
3233 93
440 218
14 1280
63

921 184 16650 483 2240 1207 103 7386 419

35

17

22

21

11

106

25

11

15

12

8

71

10

6

7

9

3

35

48

32

42

32

24

178

7

6

3

3

10

29

12

9

4

8

6

39

219

213

164

162

214

972

40

43

29

24

30

166

9

2

4

2

5

22

296

274

257

217

249

1293

44

49

42

45

47

227

40

42

38

16

23

159

511

467

486

539

692

2695

214

218

196

210

233

1071

435

439

474

407

480

2235

69

66

42

32

31

240

364

291

247

192

228

1322

118

79

61

51

74

383

103

106

109

76

95

489

.

10

25

21

15

71

.

17

19

13

18

67

.

61

68

55

78

262

2940 456 104 619 331 232 . 10

2754 458
95 679 476 371
30 16

2712 411 94 712 560 423 92 7

2661 371
91 652 733 506 170
8

2844 380 100 814 748 594 279 5

13911 2076 484 3476 2848 2126 571 46

Black
1990 1991 1992 1993 1994 5-year

230425 71814 5606

233670 71578 5640

236912 71341 5674

240157 71104 5708

243399 1184562 70867 356704 5742 28370

21.6 20.4 25.0

21.9 20.7 26.0

21.8 20.6 26.0

22.6 20.4 27.0

22.5 20.7 26.0

22.1 20.6 26.0

941 251 5279 568 2854 369 77 3757 341

909 301 5405 573 3019 479
98 3909 310

936 291 5626 564 3160 433
81 4122
340

861 240 5452 486 2953 367
99 4246 366

883 243 5547 554 2939 379
93 4176
309

4530 1326 27309 2745 14925 2027
448 20210
1666

79

93

86

92

83

433

57

63

56

70

53

299

22

30

30

22

30

134

133

158

134

166

148

739

9

11

11

9

9

49

22

22

22

23

27

116

636

645

680

670

644

3275

138

172

184

165

180

839

19

24

19

32

24

118

736

741

753

729

712

3671

63

77

75

90

65

370

70

76

63

38

25

272

846 1607
845 240 347 137 266

883 1634 889 247 345 123 298

1043 1724
886 173 334 138 352

1188 1533 811 110 242
84 247

1635 1548
803 78
291 79
219

5595 8046 4234
848 1559
561 1382

.

79

215

197

192

683

.

33

53

82

89

257

.

240

416

394

487

1537

3284 737 142
2760 1843 1481
. 25

3525 716 145 3227 2359 1973 120
43

3877 772 169
3271 2740 2189
487 33

4220 745 128 3134 3020 2377 998
35

4616 803 121
3259 2836 2383 1368
39

19522 3773 705
15651 12798 10403
2973 175
268

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
DeKalb County - 044

17.0 61.8
1.8 37.0 10.8 39.3
1.2 370.0
5.1
116.6 24.6 66.4 91.8 46.6 98.7
4.1
12.9 9.3 3.7
19.9 0.5 0.4
9.5 2.0 0.3 11.6 1.2 1.2
26.3 20.1 14.8
3.5 7.9 2.9 8.2
. . .
71.2 14.9 28.9 37.8 24.1 19.0
.

16.5 61.1
1.8 38.8 10.7 39.7
1.2 370.7
6.2
109.5 31.0 67.7 89.5 39.1 99.0 3.2
12.2 8.1 4.2
21.0 0.5 0.3
9.7 2.4 0.3 11.7 1.4 1.3
27.6 20.8 15.7
3.6 7.2 2.3 8.9
0.8 0.4 2.5
72.4 14.8 30.3 44.7 32.3 26.7
1.7

16.6 62.4 1.9 39.8 10.4 39.1 1.2 364.8 5.7
109.2 28.8 64.7 91.9 41.3 99.3 4.7
12.1 8.1 4.1
19.8 0.4 0.3
9.4 2.4 0.2 11.4 1.3 1.1
27.7 21.2 15.9
2.4 6.5 2.2 9.5
3.0 1.0 5.5
74.5 14.7 31.4 45.0 37.2 29.5
6.5

15.7 60.1
1.8 39.1 10.4 39.6
1.2 377.5
5.3
100.5 26.6 56.0 92.9 42.9 97.9 2.8
12.7 9.3 3.5
22.5 0.4 0.3
9.5 2.2 0.4 11.0 1.5 0.7
28.3 20.4 15.2
1.7 5.0 1.6 7.2
2.2 0.9 4.4
81.0 14.3 32.9 45.0 44.7 34.3 13.9

16.1 62.5 1.9 37.7 10.0 38.9 1.2 365.6 5.1
101.8 26.9 63.3 92.1 36.2 98.9 3.7
10.2 6.7 3.6
18.9 0.6 0.4
9.7 2.3 0.3 11.0 1.3 0.6
29.2 20.0 15.4
1.3 5.8 1.7 7.0
1.6 0.8 4.4
85.7 14.8 30.8 47.0 41.4 34.3 18.9

16.4 61.6
1.9 38.5 10.5 39.3
1.2 369.7
5.5
107.5 27.6 63.6 91.6 41.2 98.8
3.7
12.1 8.3 3.8
20.4 0.5 0.3
9.6 2.3 0.3 11.3 1.3 1.0
28.0 20.5 15.4
2.5 6.5 2.1 8.2
1.9 0.8 4.2
77.0 14.7 30.8 43.9 35.9 28.7 10.2

12.6 51.0
1.5 13.7
6.2 25.2
0.8 315.8
3.7

11.6 47.9
1.4 13.3
5.6 23.0
0.7 307.0
4.0

11.2 47.4 1.4 13.7 4.7 19.7 0.6 276.4 4.2

10.5 45.2
1.3 13.8
4.4 19.0
0.6 278.9
4.0

11.0 48.5 1.5 13.8
4.4 19.2 0.6 269.5 3.6

11.4 48.0
1.4 13.7
5.0 21.3
0.7 290.9
3.9

58.4 17.5 26.3 62.0 31.1 96.1
1.2

47.7 21.0 25.9 55.7 21.0 97.6
*

41.6 18.3 23.6 66.0 17.7 98.6
*

38.9 21.7 19.8 67.1 17.3 93.9
2.0

39.9 22.5 23.2 54.4 15.7 98.4 1.7

45.4 20.0 23.8 60.8 20.6 96.8
1.3

9.5 6.8 2.7 13.0 0.6 0.3

5.0

6.7

6.8

3.2

4.6

3.9

1.8

2.1

2.9

9.4

12.7

10.3

0.5

*

*

0.3

*

0.2

3.4

6.4

2.5

4.3

*

2.1

7.4

10.6

0.8

0.5

0.2

0.2

6.0

6.3

5.0

5.3

6.6

5.8

1.1

1.3

0.9

0.8

0.9

1.0

0.2

*

*

*

0.2

0.1

8.2

8.2

7.9

7.2

7.8

7.9

1.2

1.5

1.3

1.5

1.5

1.4

1.1

1.2

1.2

0.5

0.7

1.0

21.1 5.9
12.1 1.9
10.1 3.3 5.8

22.1 6.5
13.3 2.0 8.8 2.4 6.5

22.1 6.0 14.7 1.3 7.8 1.9 6.5

23.0 6.9
13.6 1.1 6.4 1.7 5.1

23.7 7.3
15.3 1.0 7.3 2.4 5.9

22.5 6.5
13.8 1.5 8.2 2.4 6.0

.

0.2

0.5

0.4

0.3

0.3

.

0.3

0.4

0.3

0.3

0.3

.

1.2

1.3

1.1

1.5

1.3

81.8 14.0 28.2 17.1
9.1 6.4
.

82.4 15.2 30.4 20.4 14.3 11.1
0.9

83.0 14.0 31.5 21.9 17.3 13.0 2.8

87.2 13.3 37.6 21.5 24.2 16.7
5.6

89.3 13.0 37.5 25.6 23.5 18.7 8.8

84.6 13.9 32.5 21.2 17.4 13.0
4.5

22.9 73.5
2.2 54.8 16.3 52.3
1.6 395.6
6.4

23.1 75.5
2.3 56.7 16.7 54.6
1.7 394.1
8.5

23.7 78.9 2.4 57.0 17.4 57.8 1.8 401.2 7.4

22.7 76.7
2.3 55.1 17.7 59.7
1.8 417.3
6.7

22.8 78.3 2.4 53.6 17.2 58.9 1.8 409.0 6.9

23.1 76.6
2.3 55.4 17.1 56.7
1.7 403.6
7.2

167.9 26.7 101.3 98.1 60.8 99.7
6.4

161.2 33.1
101.6 97.5 55.0 99.7 5.3

165.0 31.1 99.4 97.7 59.9 99.4 8.1

150.8 27.9 85.1 98.3 64.1 98.9 3.5

153.8 27.5 96.5 99.1 53.8 99.0 5.4

159.7 29.3 96.8 98.1 58.7 99.3 5.7

15.0 10.8
4.2 24.8
0.5 0.4

17.2 11.7
5.6 28.7
0.6 0.4

15.3 10.0 5.4 23.5 0.6 0.4

16.9 12.8
4.1 29.9
0.5 0.4

15.0 9.6 5.5 26.2 0.5 0.5

15.9 10.9
5.0 26.6
0.5 0.4

12.1 2.6 0.4
14.2 1.2 1.3

11.9 3.2 0.4
13.9 1.4 1.4

12.1 3.3 0.3 13.6 1.4 1.1

12.3 3.0 0.6
13.6 1.7 0.7

11.6 3.2 0.4 13.0 1.2 0.5

12.0 3.1 0.4
13.7 1.4 1.0

29.6 30.8 16.3
4.7 6.8 2.7 9.4

31.0 30.7 16.8
4.7 6.6 2.3 10.5

30.8 31.1 16.0 3.1 6.2 2.6 11.1

30.9 28.6 15.2
2.1 4.6 1.6 8.3

31.5 28.2 14.7 1.4 5.3 1.4 7.5

30.9 29.9 15.8
3.2 5.9 2.1 9.4

.

1.1

2.8

2.6

2.5

2.2

.

0.4

0.7

1.1

1.1

0.8

.

3.2

5.5

5.1

6.2

5.0

63.9 15.6 29.8 53.0 35.4 28.4
.

66.2 14.8 30.1 60.5 44.3 37.0
2.3

69.4 15.4 31.0 59.0 49.4 39.5
8.8

77.8 15.1 30.1 58.4 56.3 44.3 18.6

83.9

72.4

16.0

15.4

26.3

29.5

59.4

58.1

51.7

47.5

43.5

38.6

24.9

13.7

269

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Dodge County - 045

1990
17607 3684 413
19.5 19.9 20.0
53 14 285 48 109 18
2 35
5
8 4 4 6 0 1
38 8 0
31 3 5
102 65 101
2 50
4 12
. . .
157 48
2 190 148 122
. 0

1991
17628 3656 406
20.3 20.5 21.0
37 15 261 34 110 13
3 32
3
1 1 0 6 2 0
22 2 0
20 1 1
78 58 89
2 31
1 14
1 1 21
164 36 4
178 139 122
76 0

Total
1992 1993

17642 3629 398

17661 3601 390

19.9 18.7 21.0

19.5 18.1 21.0

27

36

4

4

253

233

25

28

96

105

12

17

1

1

36

31

2

7

8

5

6

2

2

3

5

3

0

1

1

4

24

18

3

5

0

0

21

15

0

2

4

2

93

75

63

46

77

69

1

1

36

38

4

3

12

17

16

14

12

11

32

66

163

166

35

24

3

3

158

168

147

154

124

140

110

102

0

1

1994 5-year

17670 3572 383

88208 18142
1991

20.4 20.1 23.0

20.0 19.9 21.0

28

181

5

42

221

1253

22

157

88

508

20

80

3

10

27

161

5

22

4

26

1

14

3

12

4

24

1

4

2

8

16

118

3

21

0

0

20

107

1

7

2

14

82

430

37

269

51

387

0

6

27

182

4

16

8

63

12

43

18

42

48

167

155

805

30

173

5

17

140

834

123

711

103

611

81

369

0

1

1990
12620 2566 267

1991
12623 2542 263

White
1992 1993

12625 2520 259

12625 2495 254

1994 5-year

12624 2471 250

63117 12594
1293

20.0 19.9 20.0

20.8 20.3 20.0

20.1 18.9 20.0

21.2 17.8 20.0

22.1 18.1 22.0

20.6 19.3 20.0

22

17

8

18

12

77

3

6

1

0

0

10

169

159

145

149

130

752

19

15

8

12

7

61

27

36

27

40

21

151

6

6

9

7

14

42

1

3

0

0

0

4

25

17

19

17

17

95

4

2

0

6

4

16

3

0

6

0

1

10

1

0

5

0

0

6

2

0

1

0

1

4

2

5

3

0

0

10

0

0

0

0

0

0

0

0

0

1

2

3

18

9

9

7

4

47

3

1

0

1

0

5

0

0

0

0

0

0

17

9

10

6

6

48

2

1

0

0

0

3

5

1

4

1

0

11

44

42

42

36

44

208

18

17

16

15

6

72

57

52

39

39

26

213

0

0

0

0

0

0

43

27

28

35

21

154

2

0

3

1

3

9

3

3

5

12

3

26

.

1

10

8

5

24

.

1

10

4

14

29

.

8

15

30

30

83

115

121

111

122

110

579

31

25

23

20

19

118

2

2

3

2

4

13

94

94

76

98

66

428

70

71

67

85

54

347

56

60

56

79

43

294

.

36

49

54

35

174

0

0

0

0

0

0

1990
4864 1094
141

1991
4870 1085 139

Black
1992 1993

4874 1075
136

4879 1066 133

1994 5-year

4881 1056
131

24368 5375 680

18.9 21.9 21.0

19.4 22.8 23.0

18.3 17.7 25.0

18.3 21.5 25.0

19.1 21.8 24.0

18.9 21.6 24.0

31

20

19

18

16

104

11

9

3

4

5

32

116

102

107

83

91

499

29

19

17

16

15

96

82

74

69

65

67

357

12

7

3

10

5

37

1

0

1

1

3

6

10

15

17

14

10

66

1

1

2

1

1

6

5

1

2

5

3

16

3

1

1

2

1

8

2

0

1

3

2

8

4

1

2

3

4

14

0

2

0

1

1

4

1

0

1

3

0

5

20

13

15

11

12

71

5

1

3

4

3

16

0

0

0

0

0

0

14

11

11

9

14

59

1

0

0

2

1

4

0

0

0

1

2

3

58

36

51

39

38

222

47

41

47

31

31

197

44

37

38

30

25

174

2

2

1

1

0

6

7

4

8

3

6

28

2

1

1

2

1

7

9

11

7

4

5

36

.

0

6

6

6

18

.

0

2

7

3

12

.

13

14

34

13

74

42

43

51

43

45

224

17

11

12

4

11

55

0

2

0

1

1

4

96

84

82

70

74

406

78

68

80

69

69

364

66

62

68

61

60

317

.

40

61

48

46

195

0

0

0

1

0

1

270

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Dodge County - 045

16.2 77.4
2.2 38.7
2.0 9.5 0.3 102.3 6.0
128.3 26.4 116.2 80.9 12.1
* *
28.1 * *
20.9 * *
13.3 2.8 *
11.0 *
1.8
40.3 23.0 35.9
* 17.7
* 8.3
. . .
58.4 18.3
* 67.4 52.5 43.3
.

14.8 71.4
2.1 42.3
1.8 8.8 0.3 103.6 4.4
91.2 40.5 83.8 79.4
* * *
* * * 22.7 * *
8.4 * *
7.7 * *
38.2 22.3 34.8
* 12.0
* 9.0
* * 4.6
64.1 15.8
* 68.5 53.5 46.9 29.2

14.3 69.7 2.1 37.9 2.0
9.9 0.3 119.2 3.6
67.8 *
62.8 80.0
* * *
31.6 23.7
* 19.7
* *
9.5 * *
8.3 * *
45.6 24.9 30.7
* 14.4
* 8.0
3.5 2.6 7.0
66.3 15.8
* 62.5 58.1 49.0 43.5

13.2 64.7
1.9 45.3
1.8 8.6 0.3 109.9 5.0
92.2 *
71.7 85.7 17.9 100.0
*
21.5 * * * * *
7.8 2.2
* 6.5
* *
37.1 19.8 29.9
* 16.4
* 11.6
3.1 2.4 14.4
73.8 12.4
* 72.4 66.4 60.3 44.0

12.5 61.9 1.8 40.2 1.5
7.6 0.2 98.2 7.6
73.0 17.9 57.4 81.8 13.0 100.0
*
* * * * * *
7.2 * *
9.2 * *
42.5 16.9 23.4
* 12.3
* 6.0
2.6 3.9 10.4
72.1 15.6 18.5 63.9 56.2 47.0 37.0

14.2 69.1
2.0 40.8
1.8 8.9 0.3 106.6 5.3
90.9 23.2 78.9 81.4 11.1 95.5
3.0
20.8 11.2
9.7 19.0
* *
9.4 1.7
* 8.6 0.6 1.1
40.7 21.6 31.3
0.5 14.7
1.3 8.6
2.3 2.3 9.1
66.5 15.8 11.5 66.9 57.1 49.0 38.3

13.4 65.9
2.0 16.2
2.0 9.7 0.3 123.8 3.1
82.4 *
71.2 55.6
* * *
* * * * * *
10.7 * *
10.2 *
3.0
30.3 10.8 34.3
* 25.7
* *
. . .
71.9 20.3
* 56.3 41.9 33.5
.

12.6 62.5
1.9 22.8
1.3 6.7 0.2 91.9 3.5

11.5 57.5 1.8 18.6 1.5
7.5 0.2 109.8 3.6

11.8 59.7
1.8 26.8
1.3 6.8 0.2 98.3 2.8

10.3 52.6 1.6 16.2 1.3
6.9 0.2 104.9 6.1

11.9 59.7
1.8 20.2
1.5 7.5 0.2 106.1 3.8

64.7 35.3 57.1 53.3
* * *

30.9 *
30.9 * * * *

70.9 *
47.2 66.7 23.6 100.0
*

48.0 *
28.0 * * * *

59.6 13.0 47.2 53.3 12.4 93.8
*

*

41.4

*

*

13.3

*

34.5

*

*

8.0

*

*

*

*

*

30.9

*

*

*

13.2

*

*

*

*

*

*

*

*

*

*

5.7

6.2

4.7

*

6.3

*

*

*

*

0.7

*

*

*

*

*

5.7

6.9

4.0

4.6

6.4

*

*

*

*

*

*

*

*

*

1.5

34.1 10.8 33.1
* 17.2
* *

37.2 11.0 26.9
* 19.6
* 6.0

28.3 10.1 26.4
* 23.5
* 12.9

37.9 4.6 20.0
* 16.2
* *

33.3 9.6
28.6 *
20.6 1.2 6.0

*

3.3

2.7

1.7

2.0

*

3.3

*

4.6

2.4

2.7

5.0

10.0

10.0

6.9

77.1 18.1
* 59.5 44.9 38.0 22.8

79.3 18.5
* 52.4 46.2 38.6 33.8

85.3 16.4
* 65.8 57.0 53.0 36.2

85.3 17.6
* 50.8 41.5 33.1 26.9

79.4 18.3 12.5 57.1 46.3 39.3 29.9

23.8 106.0
2.8 71.3
2.1 9.1 0.3 71.4 12.8

20.9 94.1
2.4 72.5
3.1 13.8
0.4 121.0
6.5

22.0 99.5 2.6 64.5 3.5 15.8 0.4 132.8
*

17.0 77.9
2.1 79.3
2.9 13.1
0.3 129.6
10.3

18.6 86.2 2.3 75.3 2.0 9.5 0.3 89.3 10.4

20.5 92.8
2.4 72.1
2.7 12.3
0.3 107.8
8.7

219.9 35.5 205.7 96.6
* * *

144.3 45.0
137.1 100.0
* * *

139.8 *
125.1 100.0
* * *

135.0 *
120.0 100.0
* * *

122.2 31.3
114.6 100.0
* * *

153.0 30.8
141.2 99.0 8.8 100.0 7.4

43.1

*

*

60.2

*

32.1

*

*

*

*

*

16.0

*

*

*

*

*

16.3

*

*

*

*

*

27.7

*

*

*

*

*

*

*

*

*

*

*

*

17.2 4.3 *
12.2 * *

12.7 * *
10.8 * *

14.0 * *
10.3 * *

13.3 * *
11.0 * *

13.2 * *
15.9 * *

14.2 3.2 *
11.9 * *

53.7 40.9 38.3
* 6.1
* 14.1

44.4 40.2 37.4
* * * 19.3

56.7 43.9 36.2
* 7.5
* 10.4

52.7 37.8 36.6
* * * *

49.4 34.8 28.4
* 6.7
* 9.3

51.6 39.8 35.6
1.2 5.7 1.4 12.2

.

*

3.9

3.9

3.9

2.9

.

*

*

4.6

*

2.0

.

8.5

9.1

22.1

8.4

12.1

38.5 15.6
* 83.5 67.8 57.4
.

43.4 12.2
* 82.4 66.7 60.8 39.2

48.6 12.4
* 76.6 74.8 63.6 57.0

53.1 * *
85.4 84.1 74.4 58.5

52.3

46.7

13.1

12.2

*

*

83.1

82.0

77.5

73.5

67.4

64.0

51.7

51.3

271

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Dooly County - 046

1990
9901 2187
238
20.6 18.4 21.0
30 11 143 23 80
9 2 24 7
2 1 1 3 0 1
15 4 0
19 3 2
60 51 52
2 23
2 13
. . .
88 15
1 99 87 82
. 1

1991
9924 2200 239
20.0 18.4 24.0
27 6
164 25 95 8 2 22 2
1 1 0 3 0 0
17 3 0
20 1 3
70 55 61
3 22
1 13
3 2 30
100 30 3
124 99 95 3 0

Total
1992 1993

9942 2211
240

9964 2221 240

20.2 18.2 22.0

22.3 20.2 23.0

28

23

10

5

172

140

23

18

87

80

11

9

3

1

18

29

3

2

3

3

2

0

1

3

5

1

0

0

0

1

17

19

1

3

1

0

18

22

2

0

1

2

68

51

50

40

67

55

2

1

20

20

4

3

14

4

10

14

10

5

99

87

106

87

22

25

4

4

124

109

109

104

96

96

6

7

1

4

1994 5-year

9985 2232
241

49716 11051
1198

19.8 18.8 25.0

20.5 19.0 23.0

26

134

3

35

170

789

24

113

99

441

8

45

4

12

26

119

2

16

3

12

2

6

1

6

7

19

0

0

0

2

29

97

10

21

0

1

27

106

3

9

4

12

73

322

49

245

58

293

4

12

20

105

3

13

7

51

15

42

14

31

72

288

117

498

26

118

5

17

119

575

119

518

104

473

20

36

1

7

1990
4991 991 95

1991
4992 990
94

White
1992 1993

4987 988 94

4986 985
93

1994 5-year

4986 984 92

24942 4938 468

23.3 20.1 20.0

22.1 18.3 22.0

21.7 .
21.0

24.1 20.3 22.0

21.8 20.7 22.5

22.7 20.1 21.0

7

5

8

5

5

30

4

0

3

3

0

10

53

53

61

47

63

277

5

4

8

4

5

26

13

11

12

7

11

54

6

2

1

2

3

14

0

0

0

0

0

0

7

11

2

18

12

50

2

1

0

1

0

4

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

0

0

1

0

0

0

0

1

1

3

1

4

6

15

0

0

0

0

3

3

0

0

0

0

0

0

4

2

3

6

9

24

0

1

0

0

1

2

1

1

1

0

1

4

17

17

21

12

19

86

4

5

6

3

6

24

12

12

24

16

15

79

0

1

0

0

0

1

13

13

10

14

11

61

0

1

3

0

0

4

1

2

4

0

1

8

.

1

4

5

7

17

.

0

6

4

6

16

.

8

25

35

27

95

37

40

47

37

54

215

7

12

12

7

8

46

1

1

0

1

1

4

22

25

29

28

32

136

17

17

22

27

26

109

15

17

19

23

23

97

.

1

2

2

6

11

0

0

0

0

0

0

1990
4852 1179
140

1991
4863 1186
141

Black
1992 1993

4872 1192
141

4883 1198
141

1994 5-year

4893 1204
142

24364 5959 705

18.9 17.6 24.0

19.0 21.4 25.5

19.1 18.2 26.0

20.0 20.1 27.0

18.8 16.2 26.0

19.2 18.0 25.0

23

22

20

7

6

7

90

110

108

18

21

15

67

84

75

3

6

10

2

2

3

17

11

16

5

1

3

18

21

104

2

3

25

93

105

506

14

19

87

73

88

387

7

5

31

1

4

12

11

14

69

1

2

12

2

1

3

3

3

12

1

1

2

0

2

6

1

0

1

3

1

6

3

3

5

1

6

18

0

0

0

0

0

0

0

0

0

1

0

1

14

14

16

15

23

82

4

3

1

3

7

18

0

0

1

0

0

1

15

18

15

16

18

82

3

0

2

0

2

7

1

2

0

2

3

8

43

52

44

39

53

231

47

50

44

37

43

221

40

49

43

39

42

213

2

2

2

1

4

11

10

9

10

6

9

44

2

0

1

3

3

9

12

11

10

4

6

43

.

2

5

7

8

22

.

2

3

1

6

12

.

16

72

48

41

177

51

60

56

50

61

278

8

18

9

18

18

71

0

2

4

3

4

13

77

98

92

81

85

433

70

82

85

77

92

406

67

78

75

73

80

373

.

2

3

5

14

24

1

0

1

4

1

7

272

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Dooly County - 046

14.4 65.4
1.9 57.6
2.4 11.0
0.3 132.6
6.4
126.1 36.7 96.6 91.3 29.4 100.0
*
* * * * * *
10.5 * *
13.7 * *
44.8 36.7 37.7
* 16.7
* 15.1
. . .
62.0 12.0
* 71.2 62.6 59.0
.

16.5 74.5
2.2 58.3
2.2 10.0
0.3 111.7
5.0
112.9 22.2
104.5 100.0
* * *
* * * * * *
10.4 * *
12.3 * *
45.2 33.7 37.4
* 13.5
* 12.7
* * 10.1
64.1 20.8
* 76.1 60.7 58.3
*

17.3 77.8 2.3 51.2 1.8 8.1 0.2 87.8 6.8
116.8 35.7 95.9 82.6 * * *
* * * 28.6 * *
9.9 * *
10.6 * *
43.3 29.4 39.9
* 11.8
* 13.1
3.4 3.4 33.5
63.1 14.5
* 72.9 64.1 56.5
3.5

14.1 63.0
1.9 57.1
2.9 13.1
0.4 162.0
4.5
95.7 21.7 74.9 83.3
* * *
* * * * * *
13.6 * *
15.7 * *
40.5 28.6 39.3
* 14.3
* *
4.8 1.7 29.6
64.4 20.0
* 77.9 74.3 68.6
5.0

17.0 76.2 2.2 59.3 2.6 11.6 0.3 125.0 5.4
107.9 *
99.6 100.0
* * *
* * * 40.2 * *
17.1 5.9 * 16.2 * *
50.0 29.3 34.7
* 12.3
* 7.6
5.1 4.8 24.6
72.2 17.6 26.3 71.3 71.3 62.3 12.0

15.9 71.4
2.1 56.6
2.4 10.8
0.3 122.7
5.6
111.8 26.1 94.3 92.0 13.4 100.0
5.8
15.2 7.6 7.7
23.7 * *
12.3 2.7 *
13.6 1.2 1.5
44.8 31.5 37.8
1.6 13.6
1.7 10.9
3.6 2.6 24.4
65.3 17.0 20.0 73.8 66.5 60.7
5.6

10.6 53.5
1.7 24.5
1.4 7.1 0.2 102.9 8.1

10.6 53.5
1.7 21.2
2.2 11.1
0.3 166.7
*

73.7 *
52.6 * * * *

53.0 * * * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

33.3 *
23.1 *
24.5 * *

33.3 9.6
23.1 *
25.0 * *

.

*

.

*

.

7.1

69.8 14.9
* 41.5 32.1 28.3
.

78.4 27.3
* 48.1 32.7 32.7
*

12.2 61.7 1.9 19.7
* * * * *

9.4 47.7
1.5 14.9
3.6 18.3
0.6 268.7
*

12.6 64.0 1.9 17.7 2.4 12.2 0.4 153.8
*

11.1 56.1
1.7 19.6
2.0 10.1
0.3 145.8
3.2

85.3 *
85.3 62.5
* * *

54.0 * * * * * *

54.3 *
54.3 100.0
* * *

64.1 33.3 55.6 69.2
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

9.5

5.4

*

*

*

*

*

*

*

*

*

12.8

14.5

8.7

*

*

*

*

*

*

*

*

35.6 9.8 39.3
* 16.4
* *

26.7 *
34.0 *
29.8 * *

34.5 9.7 24.2
* 19.0
* *

33.0 8.7
28.8 *
22.5 *
5.1

* 5.4 22.3

4.5 *
31.4

6.3 5.4 24.4

3.8 3.6 21.2

78.3 21.1
* 47.5 36.1 31.1
*

78.7 17.1
* 59.6 57.4 48.9
*

87.1 15.1
* 51.6 41.9 37.1 9.7

78.8 19.0
* 49.5 39.6 35.3
5.0

18.5 76.3
2.1 77.9
3.5 14.4
0.4 150.4
5.1

22.6 92.7
2.6 76.4
2.3 9.3 0.3 84.6 7.6

22.2 90.6 2.5 70.8 3.3 13.4 0.4 115.9 11.7

19.0 77.6
2.2 78.5
2.3 9.2 0.3 98.2 6.7

21.5 87.2 2.4 85.4 2.9 11.6 0.3 109.4 7.5

20.8 84.9
2.4 77.7
2.8 11.6
0.3 111.1
7.7

164.3 30.4 128.6 100.0 35.7 100.0
*

156.4 27.3
149.3 100.0
* * *

141.7 35.0
106.3 93.3 * * *

127.3 *
99.0 100.0
* * *

148.1 *
134.0 100.0
* * *

147.5 24.0 123.4 98.9 17.0 100.0 9.9

*

*

*

*

*

23.7

*

*

*

*

*

11.9

*

*

*

*

*

12.0

*

*

45.0

*

55.0

34.7

*

*

*

*

*

*

*

*

*

*

*

*

15.6 * *
17.4 * *

12.7 * *
16.4 * *

14.8 * *
14.2 * *

16.1 * *
17.2 * *

21.9 6.7 * 17.5 * *

16.2 3.6 *
16.5 1.4 1.6

51.8 54.7 46.5
* 11.8
* 21.8

50.5 45.5 44.5
* 8.2
* 15.7

46.3 41.5 41.3
* 9.4
* 13.7

48.1 39.8 41.9
* 6.5
* *

59.6 41.7 40.8
* 8.8
* 10.5

51.2 44.4 42.9
2.3 8.9 1.8 14.0

.

*

2.8

3.9

4.5

3.0

.

*

*

*

3.3

1.7

.

8.8

39.7

26.6

22.9

24.5

57.3 10.3
* 89.5 81.4 77.9
.

57.7 18.2
* 89.1 74.5 70.9
*

53.3 9.8
* 86.8 80.2 70.8
*

56.8 21.4
* 87.1 82.8 78.5
5.4

62.2

57.4

19.4

15.9

*

25.0

82.5

86.9

89.3

81.5

77.7

74.9

13.6

5.8

273

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Dougherty County - 047

1990
96311 23808
2524
20.2 19.2 22.0
309 85 1833 262 922 182 16 348 46
23 14
9 31
5 4
194 39
5 181 25 35
637 509 613
4 124 24 128
. . .
1416 236 5 966 944 711 . 2

1991
96498 23752
2503
19.7 19.0 23.0
309 99
1710 258 909 168
31 348
44
23 15
8 47
5 13
178 30 4
180 20 18
605 493 611
7 63
9 118
25 13 118
1369 255
12 958 945 734 120
10

Total
1992 1993

96693 23698
2482

96879 23643
2461

19.8 19.7 23.0

20.6 19.6 23.0

320 100 1786 279 943 108
16 323
39

279 91
1681 219 916 149
26 347
41

20

27

11

19

9

8

27

45

2

4

11

11

199

170

45

48

5

4

201

182

24

20

11

26

599

487

490

485

660

589

15

18

109

189

22

47

132

120

58

40

19

40

261

184

1541 216 11
1060 1087
861 517
2

1319 232
10 987 1096 820 656
8

1994 5-year

97067 23587
2441

483448 118488
12410

19.7 20.2 23.0

20.0 19.5 23.0

304 77
1643 254 892 136 20 379 39

1521 452
8653 1272 4582
743 109 1745 209

20

113

13

72

7

41

33

183

6

22

18

57

169

910

44

206

6

24

192

936

19

108

7

97

521

2849

471

2448

570

3043

15

59

154

639

13

115

102

600

79

202

40

112

376

939

1312 210 10 989
1054 832 753 10

6957 1149
48 4960 5126 3958 2046
32

1990
47034 10407
971

1991
46312 10109
943

White
1992 1993

45590 9810 915

44866 9513 887

1994 5-year

44144 9214 859

227946 49053 4575

22.5 19.5 21.0

22.5 19.8 22.0

21.7 19.7 22.0

23.4 18.9 22.0

23.1 20.6 22.0

22.5 19.7 22.0

71

59

67

55

53

305

11

13

17

11

7

59

693

631

646

616

579

3165

54

44

54

39

38

229

132

131

137

125

114

639

80

75

44

56

55

310

6

9

4

5

5

29

136

125

106

115

118

600

16

13

13

14

12

68

3

1

3

6

6

19

2

1

2

5

3

13

1

0

1

1

3

6

9

10

6

9

8

42

2

3

0

0

0

5

1

2

5

3

3

14

48

44

37

36

33

198

7

8

3

8

9

35

1

0

0

0

1

2

44

56

47

48

49

244

9

7

6

9

5

36

9

3

2

9

0

23

205

188

196

140

149

878

59

59

60

57

48

283

157

144

180

146

115

742

1

2

5

4

2

14

61

38

68

108

99

374

3

2

6

8

0

19

24

24

20

24

21

113

.

6

10

9

34

59

.

7

9

11

15

42

.

7

22

24

54

107

614

565

603

548

533

2863

115

112

84

88

86

485

2

4

4

4

3

17

233

230

277

265

235

1240

184

173

230

236

209

1032

148

141

196

185

174

844

.

41

123

135

158

457

0

1

0

0

3

4

1990
48387 13159
1525

1991
48481 13124
1512

Black
1992 1993

48579 13090
1500

48672 13055
1487

1994 5-year

48767 13020 1475

242886 65447
7498

19.0 19.0 24.0

18.9 18.5 24.0

18.7 19.7 24.0

19.5 20.1 24.0

18.4 19.9 25.0

18.8 19.2 24.0

238 74
1129 208 789 101 10 209 30

248 86
1072 213 777
92 21 217 30

252 82
1128 224 804 62 12 214 26

223 80
1059 180 791
93 21 230 26

251 70
1052 216 777 79 15 253 27

1212 392
5440 1041 3938
427 79
1123 139

20

22

17

21

14

94

12

14

9

14

10

59

8

8

8

7

4

35

22

36

21

36

25

140

3

2

2

4

6

17

3

11

6

8

15

43

145

133

162

134

136

710

32

22

42

40

35

171

4

4

5

4

5

22

137

123

153

134

142

689

16

13

18

11

13

71

26

15

9

17

7

74

429

413

399

346

367

1954

449

434

429

428

423

2163

454

465

477

442

454

2292

3

5

10

14

13

45

63

25

41

81

54

264

21

7

16

39

13

96

104

93

112

96

80

485

.

14

30

26

35

105

.

1

8

21

17

47

.

61

138

98

233

530

793

797

928

765

771

4054

119

142

130

142

124

657

3

8

7

6

7

31

731

725

781

721

748

3706

760

772

855

858

841

4086

563

593

664

634

655

3109

.

79

394

520

593

1586

2

9

2

8

7

28

274

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Dougherty County - 047

19.0 77.0
2.2 51.1
3.6 14.6
0.4 144.8
9.4
122.4 27.5 103.8 91.9 18.2 100.0
5.2
12.5 7.6 4.9
16.8 0.8 *
10.6 2.1 0.3
10.0 1.4 1.9
39.2 28.2 34.0
* 6.9 1.3 11.8
. . .
79.7 14.4
3.1 53.5 52.3 39.4
.

17.7 72.0
2.1 53.8
3.6 14.7
0.4 152.0
9.8
123.5 32.0
103.1 91.5 17.6 86.4 6.8
13.5 8.8 4.7
27.0 0.7 0.6
10.4 1.8 *
10.7 1.2 1.1
40.0 29.2 36.2
0.4 3.7 0.5 11.4
0.9 0.4 4.0
82.6 17.0
6.3 56.7 55.9 43.4
7.1

18.5 75.4 2.2 53.5 3.3 13.6 0.4 139.7
8.6
128.9 31.3
112.4 90.2 15.7 92.1 4.8
11.2 6.2 5.1
15.0 *
0.5
11.1 2.5 0.3
11.4 1.4 0.6
38.0 27.8 37.5
0.9 6.2 1.3 12.2
2.0 0.6 8.9
88.3 13.9 5.4 60.2 61.7 48.9 29.4

17.4 71.1
2.1 55.2
3.6 14.7
0.4 154.4
9.3
113.4 32.6 89.0 91.7 16.7 97.5 8.1
16.1 11.3
4.8 26.4
* 0.5
10.1 2.9 *
11.0 1.2 1.6
35.7 29.2 35.5
1.1 11.4
2.8 11.8
1.4 1.4 6.3
80.2 15.4
6.3 59.4 66.0 49.4 39.5

16.9 69.7 2.0 55.0 3.9 16.1 0.5 173.1
7.1
124.6 25.3
104.1 91.7 16.0 94.7 5.3
12.2 7.9 4.3
19.8 0.9 0.9
10.3 2.7 0.4
11.8 1.2 0.4
35.6 29.0 35.2
0.9 9.6 0.8 10.8
2.7 1.4 12.8
80.4 14.4 6.1 60.9 64.9 51.3 46.4

17.9 73.0
2.1 53.7
3.6 14.7
0.4 152.5
8.8
122.6 29.7 102.5 91.4 16.8 94.2
6.0
13.1 8.3 4.8
20.9 0.7 0.5
10.5 2.4 0.3
11.0 1.3 1.1
37.8 28.7 35.7
0.7 7.5 1.4 11.6
1.7 1.0 8.0
82.3 15.0
5.5 58.1 60.0 46.4 30.4

14.7 66.6
2.1 19.3
2.9 13.1
0.4 147.2
9.1

13.6 62.4
2.0 21.0
2.7 12.4
0.4 147.1
9.3

14.2 65.9 2.1 21.4 2.3 10.8 0.3 128.5
7.4

13.7 64.8
2.0 20.6
2.6 12.1
0.4 142.2
8.2

13.1 62.8 2.0 19.9 2.7 12.8 0.4 155.3
6.8

13.9 64.5
2.0 20.4
2.6 12.2
0.4 144.0
8.2

73.1 15.5 55.6 68.5 16.5 100.0
*

62.6 22.0 46.7 65.9 13.8 61.5
*

73.2 25.4 59.0 53.7 14.2 75.0
*

62.0 20.0 44.0 60.5 15.8 92.9
*

61.7 13.2 44.2 56.8 14.0 91.7
*

66.7 19.3 50.1 61.2 14.9 85.1
3.1

* * * 12.9 * *

* * * 15.6 * *

*

9.7

10.4

6.0

*

8.1

*

4.1

*

*

*

1.9

9.2

14.5

13.7

13.1

*

*

*

0.4

0.7

*

*

0.4

6.9

7.0

5.7

5.8

5.7

6.3

1.0

1.3

*

1.3

1.6

1.1

*

*

*

*

*

*

6.4

9.0

7.4

7.9

8.5

7.8

1.3

1.1

0.9

1.5

0.9

1.2

1.3

*

*

1.5

*

0.7

31.4 8.6
23.0 *
8.9 *
6.5

31.8 9.4
23.1 *
6.1 *
6.9

31.8 9.4 28.2 0.8 10.7 0.9 5.6

25.9 9.4
24.1 *
17.9 1.3 7.0

27.7 8.4
20.1 *
17.4 *
6.7

29.9 9.0
23.8 0.5
12.0 0.6 6.5

.

0.6

1.0

0.9

3.4

1.4

.

0.7

0.9

1.1

1.5

1.0

.

0.7

2.1

2.3

5.4

2.6

89.8 18.5
* 34.1 26.9 21.6
.

91.0 20.3
* 36.8 27.7 22.6
6.6

94.1 14.9
* 43.3 36.0 30.7 19.2

89.8 16.2
* 43.7 38.9 30.5 22.3

92.4 16.5
* 40.9 36.4 30.3 27.5

91.4 17.3
5.2 39.6 33.0 27.0 18.7

23.3 85.8
2.3 71.1
4.3 15.9
0.4 142.8
9.6

22.1 81.7
2.2 73.4
4.5 16.5
0.5 152.3
10.4

23.2 86.2 2.3 72.4 4.4 16.3 0.4 145.6
9.8

21.8 81.1
2.2 75.5
4.7 17.6
0.5 160.8
10.8

21.6 80.8 2.2 74.9 5.2 19.4 0.5 179.7 7.9

22.4 83.1
2.3 73.4
4.6 17.2
0.5 156.0
9.7

156.1 31.1 136.4 98.0 19.7 100.0
6.6

164.0 34.7
140.9 96.7 19.8 96.7 9.3

168.0 32.5
149.4 99.1 17.3
100.0 7.3

150.0 35.9
121.0 98.3 17.5
100.0 11.4

170.2 27.9
146.5 97.7 18.3 96.2 6.1

161.6 32.3
138.8 98.0 18.5 98.6 8.1

17.7 10.6
7.2 19.3
* *

20.5 13.1
7.6 32.9
* 0.8

15.1 8.0 7.1 18.4 * 0.5

19.8 13.2
6.7 33.3
* 0.6

13.3 9.5 * 23.4 1.4 1.2

17.3 10.8
6.5 25.4
0.8 0.7

12.8 2.8 *
12.4 1.4 2.3

12.4 2.1 *
11.6 1.2 1.4

14.4 3.7 0.4 13.8 1.6 0.8

12.7 3.8 *
12.8 1.0 1.6

12.9 3.3 0.5 13.7 1.3 0.7

13.1 3.1 0.4
12.8 1.3 1.4

44.5 40.5 41.0
* 5.7 1.9 14.6

45.3 41.0 44.0
0.5 2.4 0.7 13.6

42.0 38.6 43.0 0.9 3.7 1.4 15.5

42.1 40.8 42.1
1.4 7.7 3.7 14.3

40.1 40.8 43.8 1.3 5.2 1.3 12.8

42.8 40.3 42.8
0.9 4.9 1.8 14.2

.

0.8

1.7

1.4

1.9

1.5

.

*

0.4

1.2

0.9

0.7

.

3.4

7.6

5.4

12.9

7.3

73.4 11.7
* 65.9 68.5 50.8
.

77.4 15.0
7.0 68.5 73.0 56.0
7.5

85.0 13.2 5.6 70.4 77.0 59.8 35.5

74.3 14.9
6.3 68.7 81.8 60.4 49.6

73.9

76.9

13.4

13.6

6.3

5.7

72.1

69.1

81.0

76.2

63.1

58.0

57.1

37.3

275

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Douglas County - 048

1990
71120 18390
1618
22.7 19.5 21.0
131 21 1270 85 229 103
9 382 42
12 7 5
16 3 6
91 17
1 104 16 29
299 109 279 43 286 31 41
. . .
904 202 31 323 262 182
. 0

1991
73144 18682
1631
22.4 19.8 21.0
148 24
1151 95
242 121
10 381
43
13 5 8
15 3
10
71 13
2 100
10 13
264 117 266
46 223
22 34
24 19 98
826 196
23 429 316 264
33 6

Total
1992 1993

75157 18973
1644

77184 19265
1657

22.7 19.1 21.0

23.1 19.5 22.0

149 30
1210 97
262 128
8 385
46

128 27
1269 79
282 110
12 380
47

7

8

3

4

4

4

11

16

3

1

4

4

79

80

14

13

0

0

93

108

12

14

13

20

287

305

141

124

248

242

31

12

222

230

14

12

44

44

36

24

47

19

192

95

914

1053

175

172

23

37

436

503

393

504

302

387

173

236

0

12

1994 5-year

79200 19554
1670

375805 94864
8220

22.1 19.2 22.0

22.5 19.5 21.0

137 21
1216 97
310 85 16
374 38

693 123 6116 453 1325 547
55 1902
216

7

47

6

25

1

22

22

80

2

12

7

31

89

410

17

74

4

7

103

508

16

68

21

96

302

1457

146

637

240

1275

9

141

216

1177

15

94

36

199

22

106

17

102

110

495

1052 165 28 471 493 386 274 6

4749 910 142
2162 1968 1521
716 24

1990
64734 16587
1461

1991
66085 16707
1459

White
1992 1993

67437 16829
1457

68790 16948
1456

1994 5-year

70139 17068
1454

337185 84139
7287

22.6 19.3 21.0

22.4 19.8 21.0

22.6 18.8 21.0

23.0 19.3 21.0

21.7 18.6 22.0

22.5 19.3 21.0

114 16
1144 73
163 90
8 323
38

119 16
1004 75
178 106
7 321
36

128 22
1043 86
193 119
6 298
36

109 22
1117 68
215 89 6
300 39

107 14
1027 74
230 68 13
260 32

577 90
5335 376 979 472 40
1502 181

10

12

4

7

6

39

6

4

1

3

5

19

4

8

3

4

1

20

14

11

7

9

17

58

3

2

3

1

2

11

6

10

4

4

7

31

73

57

59

61

63

313

12

11

9

11

12

55

1

1

0

0

2

4

87

87

73

90

71

408

15

9

9

13

11

57

26

13

10

20

16

85

265

230

245

261

244

1245

69

82

114

88

103

456

251

231

222

224

205

1133

34

31

25

6

6

102

273

216

211

220

208

1128

29

19

11

11

13

83

29

27

38

34

26

154

.

18

29

22

13

82

.

18

35

19

14

86

.

61

158

73

95

387

840

743

798

947

905

4233

173

172

149

150

137

781

28

22

15

36

22

123

264

348

348

423

387

1770

215

261

326

424

414

1640

144

215

248

325

322

1254

.

29

147

206

232

614

0

5

0

12

5

22

1990
5597 1570
140

1991
5756 1594
141

Black
1992 1993

5915 1619
142

6074 1643
143

1994 5-year

6233 1667
145

29575 8092 711

23.1 19.8 25.5

23.4 21.3 28.0

23.9 21.1 26.0

24.3 20.5 26.5

22.2 20.7 26.0

23.2 20.8 26.0

16

26

20

19

28

109

5

8

8

5

7

33

118

137

150

138

168

711

11

19

11

11

21

73

65

63

67

65

76

336

9

13

9

19

16

66

1

2

2

6

3

14

48

50

77

72

107

354

4

5

9

8

6

32

2

1

3

1

1

8

1

1

2

1

1

6

1

0

1

0

0

2

2

3

4

7

4

20

0

1

0

0

0

1

0

0

0

0

0

0

18

12

19

18

25

92

5

2

5

2

5

19

0

1

0

0

2

3

17

13

19

16

30

95

1

1

3

1

5

11

3

0

3

0

4

10

33

32

36

40

52

193

40

35

26

36

41

178

27

33

26

17

32

135

8

15

6

6

3

38

11

7

10

6

8

42

2

3

3

1

2

11

12

7

5

10

8

42

.

2

5

1

9

17

.

1

5

0

3

9

.

24

21

19

14

78

59

74

104

96

130

463

26

24

24

22

25

121

3

1

7

1

5

17

57

79

83

74

78

371

46

54

64

72

71

307

37

48

51

57

58

251

.

3

23

25

40

91

0

1

0

0

1

2

276

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Douglas County - 048

17.9 69.1
2.1 18.3
5.4 20.8
0.7 215.6
6.5
81.0 16.0 52.5 63.1 26.0 100.0
4.9
9.4 5.5 4.0 12.5
* 0.4
7.2 1.3
* 8.3 1.3 2.3
26.9 8.7
22.3 3.4
22.8 2.5 5.8
. . .
71.5 18.3 20.9 25.8 20.9 14.5
.

15.7 61.6
1.9 21.2
5.2 20.4
0.6 228.3
7.3
90.7 16.2 58.2 68.8 26.4 100.0
8.6
11.3 4.3 7.0
12.9 *
0.7
6.2 1.1
* 8.8 0.9 1.1
26.4 10.3 23.4
4.0 19.7
1.9 5.7
1.2 0.9 4.7
72.1 18.8 22.8 37.6 27.7 23.1
2.9

16.1 63.8 2.0 21.9
5.1 20.3 0.6 222.2
7.3
90.6 20.1 59.0 65.3 28.0 97.8
6.1
5.8 * *
9.0 * *
6.5 1.2
* 7.8 1.0 1.1
28.2 11.8 20.8 2.6 18.6 1.2 6.6
1.7 2.2 9.1
75.9 16.4 18.1 36.5 32.9 25.3 14.5

16.4 65.9
2.1 22.5
4.9 19.7
0.6 214.4
6.4
77.2 21.1 47.7 65.8 28.4 95.7
3.0
6.3 * *
12.5 * *
6.3 1.0
* 8.6 1.1 1.6
26.9 9.9
19.3 1.0
18.4 1.0 6.3
1.1 0.9 4.4
83.2 15.8 22.4 40.1 40.2 30.8 18.8

15.4 62.2 1.9 25.8
4.7 19.1 0.6 220.8
5.3
82.1 15.3 58.1 72.9 22.8 97.3
3.6
5.8 4.9
* 17.9
* 0.4
7.3 1.4
* 8.6 1.3 1.7
25.8 12.2 20.0 0.8 18.1 1.3 5.5
1.0 0.8 4.9
87.0 15.4 22.0 39.3 41.1 32.2 22.8

16.3 64.5
2.0 21.9
5.1 20.0
0.6 220.1
6.6
84.3 17.7 55.1 67.3 26.3 98.1
5.2
7.7 4.1 3.6 13.0 0.5 0.4
6.7 1.2 0.1 8.4 1.1 1.6
26.8 10.5 21.1
2.3 19.5
1.6 6.0
1.2 1.2 5.8
78.0 16.9 21.3 35.8 32.6 25.2 14.9

17.7 69.0
2.1 14.5
5.0 19.5
0.6 205.7
6.2

15.2 60.1
1.9 17.9
4.9 19.2
0.6 222.3
7.1

15.5 62.0 1.9 18.7
4.4 17.7 0.6 203.1
7.5

16.2 65.9
2.1 19.5
4.4 17.7
0.6 198.3
5.7

14.6 60.2 1.9 22.6
3.7 15.2 0.5 189.8
4.9

15.8 63.4
2.0 18.6
4.5 17.9
0.6 204.0
6.3

78.0 14.0 50.0 58.3 26.0 100.0
4.8

81.6 13.4 51.4 64.4 24.7 100.0
7.5

87.8 17.2 59.0 60.7 24.7 97.2
6.9

74.9 20.2 46.7 60.3 26.8 94.9
*

73.6 13.1 50.9 64.9 22.0 96.8
*

79.2 15.6 51.6 61.7 24.8 97.8
4.7

8.7

12.0

*

6.3

5.8

7.3

5.2

*

*

*

4.9

3.6

*

8.0

*

*

*

3.8

12.2

10.9

6.7

8.0

16.3

10.8

*

*

*

*

*

0.5

0.5

0.8

*

*

0.5

0.5

6.4

5.7

5.7

5.5

6.1

5.9

1.0

1.1

0.9

1.0

1.2

1.0

*

*

*

*

*

*

7.7

8.7

7.1

8.2

7.0

7.7

1.3

0.9

0.9

1.2

1.1

1.1

2.3

1.3

1.0

1.8

1.6

1.6

26.2 6.1
22.3 3.0
24.2 2.6 4.6

25.8 8.2
23.3 3.1
21.9 1.9 5.2

27.4 11.0 21.6 2.4 20.5 1.1 6.8

25.8 8.0
20.3 0.5
20.0 1.0 5.5

24.4 10.1 20.2 0.6 20.6 1.3 4.6

25.9 8.6
21.5 1.9
21.5 1.6 5.3

.

1.0

1.6

1.2

0.7

1.1

.

1.0

1.9

1.0

0.7

1.2

.

3.3

8.5

3.9

5.0

5.2

73.7 17.4 20.9 23.4 19.1 12.8
.

74.2 19.0 24.7 35.0 26.2 21.6
2.9

77.0 16.0 15.3 33.7 31.6 24.0 14.2

84.9 15.7 24.0 38.3 38.4 29.4 18.7

88.5 15.0 21.0 38.1 40.7 31.7 22.8

79.6 16.6 21.4 33.6 31.1 23.8 14.8

21.1 75.2
2.2 55.6
8.6 30.6
0.9 268.2
8.3

23.8 85.9
2.5 46.3
8.7 31.4
0.9 247.5
9.4

25.4 92.7 2.6 45.6 13.0 47.6 1.5 323.5
6.8

22.7 84.0
2.4 47.4 11.9 43.8
1.3 306.4
15.2

27.0 100.8
2.9 46.6 17.2 64.2 1.9 362.7 12.0

24.0 87.9
2.5 48.0 12.0 43.7
1.3 308.1 10.4

114.3 31.3 78.6 100.0
* * *

184.3 30.8
134.7 84.2 35.4
100.0 *

140.6 40.0 77.4
100.0 63.3
100.0 *

132.5 26.3 76.7
100.0 55.8
100.0 *

193.8 25.0
145.3 100.0
41.5 100.0
*

153.3 30.3 102.6 95.8 45.0 100.0 12.7

*

*

*

*

*

11.3

*

*

*

*

*

8.4

*

*

*

*

*

*

*

*

*

48.6

*

27.6

*

*

*

*

*

*

*

*

*

*

*

*

15.3

8.8

12.7

13.0

14.9

12.9

4.2

*

3.3

*

3.0

2.7

*

*

*

*

*

*

14.5

9.6

12.9

11.7

18.5

13.6

*

*

*

*

3.1

1.6

*

*

*

*

*

1.4

35.9 34.2 23.1
6.8 9.4
* 17.9

32.3 25.7 24.6 11.3
5.2 *
9.9

33.3 17.7 17.7 4.1 6.8
* 5.3

37.4 26.3 12.4
4.4 4.4
* 13.3

34.4 25.2 19.6
* 4.9
* 9.9

34.6 25.4 19.3
5.5 6.0 1.6 10.8

.

*

2.5

*

4.2

2.1

.

*

2.5

*

*

1.1

.

12.1

10.3

9.1

6.6

9.5

50.4 24.8
* 48.7 39.3 31.6
.

55.2 19.2
* 58.1 39.7 35.3
*

69.3 19.8 26.9 56.5 43.5 34.7 15.6

70.1 17.7
* 54.0 52.6 41.6 18.2

78.3

65.8

17.5

19.6

25.0

20.7

47.9

53.0

43.6

43.9

35.6

35.9

24.5

15.6

277

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Early County - 049

1990
11854 2515 310
19.7 16.9 21.0
31 13 208 27 108 11
2 10
2
3 2 1 4 2 2
31 7 0
14 2 5
66 66 76
0 24
5 13
. . .
159 25
1 128 120 97
. 1

1991
11846 2511 308
19.7 20.8 22.0
37 14 194 32 120 13
3 14
1
5 4 1 7 0 1
21 4 0
13 2 4
53 72 79
0 22
6 15
5 1 31
138 13 0
137 130 105
1 3

Total
1992 1993

11838 2503 306

11833 2498 304

18.9 18.2 22.0

19.3 17.6 23.0

37

36

9

9

220

200

35

32

137

129

12

7

1

2

19

12

0

4

3

3

1

2

2

1

2

4

0

1

1

2

15

23

2

4

0

0

17

28

2

1

4

4

86

81

72

71

84

74

3

1

27

18

4

2

14

10

6

3

2

2

44

27

167

142

17

18

0

2

169

157

154

151

139

140

11

69

2

5

1994 5-year

11821 2490 302

59192 12517
1529

19.1 16.6 23.5

19.5 18.0 22.0

35

176

10

55

176

998

31

157

110

604

12

55

3

11

12

67

1

8

3

17

2

11

1

6

5

22

0

3

0

6

18

108

2

19

0

0

20

92

3

10

4

21

66

352

51

332

55

368

1

5

19

110

1

18

12

64

4

18

8

13

25

127

120

726

10

83

0

3

137

728

125

680

113

594

96

177

2

13

1990
6579 1263
141

1991
6550 1255
140

White
1992 1993

6518 1245
139

6492 1236
137

1994 5-year

6460 1226
136

32599 6225 692

23.5 16.8 20.0

21.9 20.8 20.0

21.1 18.2 20.0

22.0 18.8 20.0

24.5 .
20.0

22.1 18.5 20.0

7

6

6

5

2

26

2

2

1

2

1

8

87

73

79

62

53

354

6

5

6

5

2

24

12

18

17

12

11

70

6

4

3

2

6

21

0

2

0

0

0

2

4

5

12

5

3

29

1

0

0

0

0

1

2

1

1

0

0

4

1

1

0

0

0

2

1

0

1

0

0

2

1

3

0

0

0

4

0

0

0

0

0

0

2

0

1

0

0

3

11

8

3

6

2

30

2

1

0

1

0

4

0

0

0

0

0

0

5

7

7

5

4

28

2

1

1

1

1

6

1

1

1

1

1

5

24

11

14

15

14

78

5

8

10

5

6

34

25

18

27

17

12

99

0

0

3

0

1

4

15

13

11

9

7

55

0

0

1

1

0

2

3

1

2

2

2

10

.

3

2

2

2

9

.

1

2

0

1

4

.

7

11

6

6

30

77

59

64

50

45

295

12

5

6

3

2

28

0

0

0

0

0

0

36

43

47

34

30

190

24

33

30

24

17

128

21

28

29

23

14

115

.

1

2

8

12

23

1

0

2

0

0

3

1990
5226 1238
168

1991
5223 1236 167

Black
1992 1993

5219 1232
166

5217 1229 165

1994 5-year

5212 1225
164

26096 6161 829

19.1 17.0 23.5

18.4 22.5 24.5

18.1 .
27.0

18.1 17.6 24.0

17.7 16.6 26.0

18.2 17.5 25.0

24

31

31

31

33

150

11

12

8

7

9

47

121

121

139

138

122

641

21

27

29

27

29

133

96

102

120

117

99

534

5

9

9

5

6

34

2

1

1

2

3

9

6

9

7

7

9

38

1

1

0

4

1

7

1

4

2

3

3

13

1

3

1

2

2

9

0

1

1

1

1

4

3

4

2

4

5

18

2

0

0

1

0

3

0

1

0

2

0

3

20

13

12

17

15

77

5

3

2

3

2

15

0

0

0

0

0

0

9

6

10

23

16

64

0

1

1

0

2

4

4

3

3

3

3

16

42

42

72

66

52

274

61

64

61

66

45

297

51

61

56

57

43

268

0

0

0

1

0

1

9

9

15

9

12

54

5

6

3

1

1

16

10

14

12

8

10

54

.

2

4

1

2

9

.

0

0

2

7

9

.

24

33

19

19

95

82

79

101

92

75

429

13

8

11

15

8

55

1

0

0

2

0

3

92

94

121

123

106

536

96

97

123

127

107

550

76

77

109

117

98

477

.

0

9

61

84

154

0

3

0

5

2

10

278

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Early County - 049

17.5 82.7
2.5 53.2
0.8 4.0 0.1 42.9 6.0
100.0 41.9 87.1 85.2
* * *
* * * * * *
14.9 3.4 * 6.9 * 2.7
44.6 32.4 37.6
* 13.3
2.8 10.3
. . .
80.7 13.1
* 62.7 58.8 47.5
.

16.4 77.3
2.3 62.8
1.2 5.6 0.2 61.7 7.6
120.1 37.8
103.9 93.8 * * *
25.8 * *
35.5 * *
10.8 * *
6.8 * *
39.6 37.5 41.4
* 13.9
3.8 12.7
1.4 *
8.7
80.7 7.1 *
71.4 67.7 54.7
*

18.6 87.9 2.6 62.6 1.6 7.6 0.2 75.4 5.2
120.9 24.3
114.3 85.7 * * *
* * * * * *
6.8 * *
7.8 * *
56.6 32.9 38.5
* 14.8
* 11.9
1.7 *
12.5
78.8 8.1
* 77.2 70.3 63.5
5.0

16.9 80.1
2.4 64.8
1.0 4.8 0.1 53.8 4.4
118.6 25.0
105.4 90.6 * * *
* * * * * *
11.5 * *
14.1 * *
50.9 35.7 37.2
* 10.5
* 7.9
* * 7.7
71.4 9.8 *
78.9 75.9 70.4 34.7

14.9 70.7 2.1 63.2 1.0 4.8 0.1 59.1 6.0
116.0 28.6
102.8 96.8 * * *
* * * 27.9 * *
10.2 * *
11.5 * *
45.8 29.3 31.8
* 12.8
* 11.7
* 2.3 7.1
68.2 6.3 *
78.7 71.8 64.9 55.2

16.9 79.7
2.4 61.3
1.1 5.4 0.1 58.9 5.8
115.1 31.3 102.7 90.4
5.2 100.0
7.2
17.0 11.0
6.1 21.8
* 0.5
10.8 1.9 * 9.4 1.0 2.5
47.8 33.6 37.4
0.5 13.1
2.1 10.8
1.3 0.9 9.0
76.0 9.0 *
73.7 68.8 60.1 22.6

13.2 68.9
2.3 14.5
* * * * 4.8
49.6 *
42.6 * * * *
* * * * * *
12.6 * *
6.0 * *
42.1 6.0
29.8 *
23.8 * *
. . .
91.7 15.6
* 42.9 28.6 25.0
.

11.1 58.2
1.9 25.4
0.8 4.0
* 59.5
4.8

12.1 63.5 2.0 21.5 1.8 9.6 0.3 127.7
*

42.9 *
35.8 * * * *

43.3 *
43.3 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

11.0

*

*

*

*

*

9.7

8.9

*

*

*

*

28.2 11.1 25.0
* 31.7
* *

34.1 12.7 34.2
* 25.0
* *

*

*

*

*

4.6

7.4

86.8 7.2 *
59.7 45.8 38.9
*

85.3 7.7 *
59.5 38.0 36.7
*

9.6 50.2
1.6 19.7
0.8 4.0
* 71.4
*
36.4 *
36.4 * * * *
* * * * * *
9.7 * *
8.2 * *
39.5 8.2
27.9 *
22.5 * *
* * 4.1
80.6 * *
55.7 39.3 37.7 13.1

8.2 43.2 1.4 21.2
* * * * 4.9
* * * * * * *
* * * * * *
* * * * * *
46.7 11.5 23.1
* 23.3
* *
* * 4.1
84.9 * *
57.7 32.7 26.9 23.1

10.9 56.9
1.8 20.2
0.9 4.7 0.1 71.3 3.9
37.6 30.8 34.7 50.0
* * *
* * * * * *
8.5 * *
8.0 1.7 2.3
38.0 9.8
28.4 *
25.2 *
5.3
1.5 *
5.0
86.3 8.5 *
54.6 36.8 33.0
8.7

23.2 97.7
2.7 80.0
1.1 4.8 0.1 44.1 7.3

23.2 97.9
2.7 85.0
1.7 7.3 0.2 63.4 9.7

26.6 112.8
3.1 87.0 1.3 5.7 0.1 44.9 8.1

26.5 112.2
3.1 84.8
1.3 5.7 0.2 45.8 6.5

23.4 99.6 2.8 81.8 1.7 7.3 0.2 64.3 7.3

24.6 104.0
2.9 83.8
1.5 6.2 0.2 52.3 7.8

142.9 45.8 125.0 95.2
* * *

185.6 38.7
161.7 96.3 * * *

186.9 25.8
174.8 100.0
* * *

188.4 22.6
164.1 100.0
* * *

201.8 27.3
177.4 96.6 * * *

181.0 31.3
160.5 97.7 8.4 100.0 12.1

*

*

*

*

*

20.3

*

*

*

*

*

14.0

*

*

*

*

*

*

*

*

*

*

40.0

27.7

*

*

*

*

*

*

*

*

*

*

*

*

16.5 4.1 * 7.6 * *

10.7 * *
5.0 * *

8.6

12.3

12.3

12.0

*

*

*

2.3

*

*

*

*

7.4

16.7

13.2

10.1

*

*

*

*

*

*

*

2.6

46.2 50.8 43.2
* 7.6 4.2 12.8

44.2 53.3 51.3
* 7.7 5.1 17.5

64.9 44.2 40.9
* 11.0
* 14.6

54.5 47.8 41.3
* 6.9
* 9.1

45.6 37.2 35.8
* 10.2
* 13.9

51.5 46.6 42.4
* 8.7 2.6 13.5

.

*

*

*

*

1.1

.

*

*

*

3.5

1.1

.

12.0

16.6

9.6

9.6

11.9

72.6 11.4
* 76.7 80.0 63.3
.

76.7 7.0 *
78.3 80.8 64.2
*

74.8 8.5 *
87.7 89.1 79.0
6.5

67.2 11.9
* 89.1 92.0 84.8 44.2

61.5

70.3

7.1

9.2

*

*

87.6

84.1

88.4

86.3

81.0

74.9

69.4

29.8

279

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Echols County - 050

1990
2334 495 48
21.1 .
20.0
3 0 19 2 4 1 0 0 0
0 0 0 0 0 0
1 0 0 2 0 0
4 3 7 1 2 0 1
. . .
12 4 1
10 7 5 . 0

1991
2348 493
47
18.6 .
20.5
6 2 29 6 6 0 0 0 0
0 0 0 0 0 1
1 0 0 3 0 0
12 1
12 0 3 0 2
0 0 0
17 2 1
23 15 15
3 1

Total
1992 1993

2355 492 47

2369 489
47

20.1 .
19.0

20.1 .
19.0

2

3

0

1

26

29

2

3

5

5

3

2

0

0

0

0

0

0

1

0

1

0

0

0

1

0

0

0

0

0

0

1

0

0

0

0

3

1

0

1

2

1

12

12

1

3

9

9

0

0

3

4

0

0

1

1

0

1

0

4

2

17

18

22

5

7

0

1

19

23

18

19

16

18

8

7

0

0

1994 5-year

2378 488 47

11784 2457 236

20.7 17.8 18.0

20.1 17.8 19.0

4

18

1

4

24

127

2

15

12

32

2

8

0

0

4

4

1

1

1

2

0

1

1

1

0

1

0

0

0

1

4

7

2

2

0

0

2

11

1

2

0

3

12

52

4

12

8

45

0

1

4

16

0

0

1

6

2

3

7

11

23

42

18

87

0

18

1

4

10

85

19

78

9

63

8

26

1

2

1990
2007 416 39

1991
2028 416
38

White
1992 1993

2047 418 38

2067 417
38

1994 5-year

2086 418 38

10235 2085 191

21.1 .
19.5

18.4 .
20.5

20.1 .
19.0

20.1 .
19.0

20.4 17.8 19.0

20.1 17.8 19.0

3

6

2

3

4

18

0

2

0

1

1

4

16

24

25

27

18

110

2

6

2

3

2

15

1

6

5

5

7

24

1

0

2

1

2

6

0

0

0

0

0

0

0

0

0

0

2

2

0

0

0

0

1

1

0

0

1

0

0

1

0

0

1

0

0

1

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

1

0

0

0

1

1

1

0

1

2

5

0

0

0

0

0

0

0

0

0

0

0

0

1

3

3

1

1

9

0

0

0

1

0

1

0

0

2

1

0

3

4

11

12

11

0

1

1

3

6

11

9

9

1

0

0

0

2

2

3

4

0

0

0

0

0

1

0

1

8

46

3

8

8

43

0

1

2

13

0

0

1

3

.

0

0

1

2

3

.

0

0

4

3

7

.

0

1

14

19

34

9

13

17

22

15

76

3

2

5

7

0

17

1

1

0

1

0

3

9

19

18

21

7

74

7

13

17

17

14

68

5

13

15

16

6

55

.

3

8

6

5

22

0

1

0

0

0

1

1990
264 66
9

1991
266 66 9

Black
1992 1993

266

268

65

65

9

9

1994 5-year

269

1333

65

326

9

44

. . 34.0

22.7 . .

. . 19.0

. . 27.0

24.3 . .

22.9 .
27.0

0

0

0

0

0

0

0

0

0

0

0

0

3

5

1

2

6

17

0

0

0

0

0

0

3

0

0

0

5

8

0

0

1

1

0

2

0

0

0

0

0

0

0

0

0

0

2

2

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

2

2

0

0

0

0

2

2

0

0

0

0

0

0

1

0

0

0

1

2

0

0

0

0

1

1

0

0

0

0

0

0

0

1

0

1

4

6

3

0

0

0

1

4

1

1

0

0

0

2

0

0

0

0

0

0

0

1

0

0

2

3

0

0

0

0

0

0

1

1

1

0

0

3

.

0

0

0

0

0

.

0

0

0

2

2

.

0

1

0

2

3

3

4

1

0

3

11

1

0

0

0

0

1

0

0

0

0

1

1

1

4

1

2

3

11

0

2

1

2

5

10

0

2

1

2

3

8

.

0

0

1

3

4

0

0

0

0

1

1

280

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

8.1

12.4

11.0

12.2

10.1

10.8

General fertility rate

38.4

58.8

52.8

59.3

49.2

51.7

Total fertility rate

1.1

1.8

1.6

1.7

1.4

1.5

% Livebirths to unmarried women

*

20.7

19.2

17.9

52.2

25.6

Crude abortion rate

*

*

*

*

*

*

General abortion rate

*

*

*

*

*

*

Total abortion rate

*

*

*

*

*

*

Abortion ratio

*

*

*

*

*

*

Fetal Death rate

*

*

*

*

*

3.3

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

* 126.6

*

*

*

76.1

% Repeat conceptions to women under 18

*

*

*

*

*

*

Livebirths to women under 18

* 126.6

*

*

*

63.5

% Livebirths to unmarried women under 18

*

*

*

*

*

53.3

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

*

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

*

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

*

*

*

*

*

5.5

% Very low birthweight

*

*

*

*

*

*

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

*

*

*

*

*

8.9

% Multiple gestation

*

*

*

*

*

*

% Birth defect

*

*

*

*

*

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

*

50.0

50.0

46.2

54.5

47.3

% with father not named on birth certificate

*

*

*

*

*

9.6

% with maternal education less than high school

36.8

41.4

34.6

33.3

34.8

36.3

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

*

*

*

*

*

12.8

% Maternal alcohol use during pregnancy

*

*

*

*

*

*

% Interpregnancy interval less than 6 months

*

*

*

*

*

8.8

Child abuse and neglect rates

Physical

.

*

*

*

*

*

Sexual

.

*

*

*

10.4

4.0

Neglect

.

*

*

25.0

34.3

15.4

Interventions to improve infant & child survival

% Prenatal care first trimester

66.7

65.4

72.0

78.6

78.3

72.5

% Primary C-section delivery

*

*

20.8

29.2

*

15.9

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

52.6

79.3

73.1

82.1

43.5

68.0

% Medicaid during pregnancy

36.8

51.7

69.2

67.9

82.6

62.4

% Medicaid and WIC during pregnancy

26.3

51.7

61.5

64.3

39.1

50.4

% Perinatal case management

.

*

30.8

25.0

34.8

24.5

Echols County - 050

8.0 38.5
1.0 * * * * * *

11.8 57.7
1.7 25.0
* * * * *

* 156.3

*

*

* 156.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

* * 37.5 * * * *

52.4 *
45.8 * * * *

.

*

.

*

.

*

60.0 * *
56.3 43.8 31.3
.

61.9 * *
79.2 54.2 54.2
*

12.2 59.8 1.8 20.0
* * * * *
* * * * * * *
* * * * * *
* * * * * *
52.2 *
36.0 * * * *
* * *
70.8 21.7
* 72.0 68.0 60.0 32.0

13.1 64.7
1.9 19.2
* * * * *
* * * * * * *
* * * * * *
* * * * * *
45.8 *
36.0 * * * *
* * 24.8
84.6 30.4
* 80.8 65.4 61.5 23.1

8.6 43.1 1.2 38.9
* * * * *
* * * * * * *
* * * * * *
* * * * * *
47.1 *
44.4 * * * *
* * 33.8
83.3 * *
38.9 77.8 33.3 27.8

10.7 52.8
1.5 22.0
* * * * 2.9
94.0 *
78.4 53.3
* * *
* * * * * *
4.5 * *
8.3 * *
47.4 7.3
39.8 *
11.9 * *
* 3.1 15.1
73.1 17.0
* 67.9 62.4 50.5 23.7

*

18.8

*

*

22.3

12.8

*

76.2

*

*

92.9

52.1

*

2.6

*

*

2.3

1.5

*

*

*

* 100.0

50.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

46.2

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

68.8

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

68.8

*

*

*

* 100.0

62.5

*

*

*

*

*

50.0

.

*

*

*

*

*

281

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Effingham County - 051

1990
25687 6181 624
20.8 17.8 20.0
48 11 394 35 76 31
1 68 12
6 2 4 3 1 3
32 2 0
38 5 8
125 38 118
7 94
7 14
. . .
296 57
4 111 136 81
. 0

1991
26708 6396 642
20.6 18.4 20.0
47 7
448 38
124 28 4 63 7
4 2 2 6 1 1
37 8 1
39 5 4
127 78
126 3
78 8
18
3 5 22
349 76 7
160 168 108
1 3

Total
1992 1993

27730 6612 661

28749 6824 679

20.9 18.3 21.0

21.2 17.8 22.0

37

44

8

8

402

427

29

36

98

107

30

33

3

4

68

58

7

9

4

6

3

3

1

3

6

7

0

2

0

3

27

35

4

6

1

1

38

44

5

7

3

3

125

154

53

61

106

97

5

5

76

63

4

5

19

9

8

10

20

33

77

90

312

344

50

66

9

13

138

144

172

192

104

121

5

17

0

5

1994 5-year

29769 7038 698

138643 33051 3304

21.9 18.0 21.0

21.1 18.1 21.0

53

229

10

44

415

2086

40

178

109

514

27

149

6

18

56

313

10

45

6

26

3

13

3

13

8

30

1

5

0

7

39

170

2

22

1

4

44

203

7

29

7

25

163

694

62

292

94

541

7

27

50

361

1

25

13

73

22

43

24

82

80

269

328

1629

73

322

6

39

120

673

187

855

96

510

17

40

5

13

1990
21906 5273 499

1991
22910 5493 519

White
1992 1993

23915 5712 539

24914 5931 559

1994 5-year

25918 6150 578

119563 28559 2693

20.9 17.1 20.0

21.5 18.3 20.0

21.5 18.3 21.0

21.4 17.8 21.0

23.3 18.0 21.0

21.6 18.1 20.0

41

35

27

35

40

178

10

7

6

5

9

37

332

339

323

346

323

1663

31

28

21

27

29

136

46

62

48

60

53

269

23

25

24

26

21

119

1

2

1

4

6

14

46

51

50

49

38

234

9

5

6

9

8

37

5

2

3

5

3

18

1

1

2

3

2

9

4

1

1

2

1

9

2

3

3

7

7

22

1

1

0

0

0

2

3

1

0

2

0

6

30

15

16

23

24

108

2

3

2

4

1

12

0

0

0

1

1

2

30

23

25

31

27

136

5

1

4

4

7

21

8

2

2

3

2

17

96

85

96

116

110

503

18

32

21

28

24

123

98

88

76

71

61

394

5

2

4

2

3

16

89

70

71

58

41

329

3

6

2

4

0

15

11

12

10

3

8

44

.

2

5

5

15

27

.

4

17

24

24

69

.

12

58

57

45

172

260

281

261

296

278

1376

51

56

38

60

55

260

4

6

7

11

4

32

78

93

93

95

79

438

96

101

114

130

122

563

54

58

66

81

62

321

.

1

3

8

9

21

0

2

0

3

2

7

1990
3620 865 120

1991
3764 895 124

Black
1992 1993

3908 925 127

4052 954 131

1994 5-year

4195 984 134

19539 4623 635

20.3 18.7 21.5

18.7 18.9 23.0

19.0 18.5 26.0

19.6 22.2 23.0

19.4 15.7 23.0

19.2 18.9 23.0

7

11

10

9

13

50

1

0

2

3

1

7

62

108

77

80

89

416

4

10

8

9

11

42

30

62

50

47

56

245

8

3

5

6

6

28

0

2

2

0

0

4

21

11

17

9

16

74

3

1

1

0

2

7

1

2

1

1

3

8

1

1

1

0

1

4

0

1

0

1

2

4

1

3

3

0

1

8

0

0

0

2

1

3

0

0

0

1

0

1

2

22

11

12

14

61

0

5

2

2

1

10

0

1

1

0

0

2

8

16

13

13

15

65

0

4

1

3

0

8

0

2

1

0

4

7

29

42

29

37

50

187

20

46

32

33

38

169

20

38

29

26

33

146

2

1

1

3

4

11

5

8

5

5

9

32

4

2

2

1

1

10

3

6

8

6

5

28

.

1

3

3

7

14

.

1

2

2

0

5

.

9

18

25

25

77

36

67

49

47

47

246

6

20

12

6

17

61

0

1

2

2

2

7

33

67

45

48

41

234

40

66

57

61

64

288

27

50

38

39

34

188

.

0

2

9

8

19

0

1

0

2

3

6

282

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Effingham County - 051

15.3 63.7
2.0 19.5
2.6 11.0
0.3 137.4
5.3
76.9 22.9 56.1 41.2 19.2 100.0
*
15.2 * * * * *
8.1 * *
9.8 1.3 2.0
33.6 9.8
30.3 1.8
24.3 1.8 6.2
. . .
75.9 16.2
* 28.5 35.0 20.8
.

16.8 70.0
2.2 28.0
2.4 9.8 0.3 114.5 6.1
73.2 14.9 59.2 52.6 10.9 100.0
*
* * * 13.3 * *
8.3 1.8
* 8.8 1.1
*
29.6 17.6 28.6
* 17.8
1.8 7.1
* 0.6 2.7
78.3 18.9 17.1 36.1 37.9 24.4
*

14.5 60.8 1.9 24.6 2.5 10.3 0.3 134.7 5.3
56.0 21.6 43.9 58.6 10.6 100.0
*
* * * 14.8 * *
6.7 * *
9.5 1.3
*
32.2 13.3 26.7
1.3 19.1
* 7.7
0.9 2.3 9.0
77.6 14.4 17.6 34.7 43.2 26.1
1.3

14.9 62.6
1.9 25.5
2.0 8.5 0.3 110.5 5.9
64.8 18.2 53.0 74.3 13.2 100.0
*
14.1 * *
16.2 * *
8.2 1.4
* 10.5
1.7 *
37.6 14.5 23.2
1.2 15.1
1.2 3.6
1.1 3.7 10.2
80.9 17.8 26.0 34.3 45.7 28.8
4.0

13.9 59.0 1.8 26.7 1.9 8.0 0.2 110.7 5.0
76.0 18.9 57.3 72.5 14.3 100.0
*
14.5 * *
19.0 * *
9.4 * *
10.8 1.7 1.7
41.2 15.2 23.0
1.7 12.3
* 5.6
2.4 2.6 8.8
80.0 20.4 11.8 29.3 45.7 23.5
4.2

15.0 63.1
2.0 25.0
2.3 9.5 0.3 121.3 5.5
69.3 19.2 53.9 60.2 13.6 100.0
2.7
12.5 6.2 6.3
14.3 0.5 *
8.2 1.1
* 9.9 1.4 1.2
34.8 14.2 26.3
1.3 17.7
1.2 6.0
1.2 2.4 7.8
78.6 17.6 17.0 32.7 41.5 24.8
2.4

15.2 63.0
1.9 14.1
2.1 8.7 0.2 114.1 4.7

14.8 61.7
1.9 18.3
2.2 9.3 0.3 120.6 6.0

13.5 56.5 1.8 15.0 2.1
8.8 0.2 125.3 4.6

13.9 58.3
1.8 17.5
2.0 8.3 0.3 114.8 5.4

12.5 52.5 1.6 16.7 1.5
6.2 0.2 97.9 4.4

13.9 58.2
1.8 16.4
2.0 8.2 0.2 114.7 5.0

82.2 24.4 62.1 33.3 18.0 100.0
*

67.5 20.0 54.0 46.4
9.6 100.0
*

50.1 22.2 39.0 42.9 11.1 100.0
*

62.7 14.3 48.3 69.2 16.1 100.0
*

69.2 22.5 50.2 62.1 13.8 100.0
*

66.1 20.8 50.5 50.7 13.7 100.0
2.6

15.1

*

*

14.5

*

10.8

*

*

*

*

*

5.4

*

*

*

*

*

5.4

*

*

*

20.0

21.3

13.1

*

*

*

*

*

*

*

*

*

*

*

*

9.0

4.4

5.0

6.7

7.4

6.5

*

*

*

*

*

0.7

*

*

*

*

*

*

9.2

6.8

7.8

9.1

8.5

8.3

1.5

*

*

*

2.2

1.3

2.4

*

*

*

*

1.0

30.8 5.5
30.0 1.5
27.4 *
5.9

25.8 9.5
26.0 *
20.9 1.8 6.3

30.8 6.6 23.9
* 22.3
* 5.2

34.8 8.2
20.8 *
17.2 * *

35.3 7.6 19.2
* 13.0
* 4.5

31.5 7.5
24.0 1.0
20.2 0.9 4.6

.

*

0.7

0.7

1.9

0.9

.

*

2.4

3.2

3.1

2.4

.

1.7

8.1

7.7

5.8

5.9

78.8 17.2
* 23.9 29.4 16.5
.

83.4 18.4 18.2 27.5 29.9 17.2
*

80.8 13.5 18.9 29.2 35.7 20.7
*

86.0 19.7 28.9 27.8 38.0 23.7
2.3

86.6 19.6
* 24.9 38.5 19.6
2.8

83.1 17.7 18.3 26.7 34.3 19.5
1.6

17.1 71.7
2.2 48.4
5.8 24.3
0.7 230.8
9.2

28.7 120.7
3.6 59.6
2.9 12.3
0.4 88.0
6.7

19.7 83.3 2.5 64.9 4.4 18.4 0.5 166.7 8.6

58.3 * * * * * *

89.1 *
81.0 70.0
* * *

78.7 *
62.9 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

* * * 12.9 * *

20.4 4.6 *
15.4 * *

14.3 * *
16.9 * *

48.3 32.3 32.3
* 8.1
* *

42.4 44.2 37.3
* 7.8
* 9.4

39.2 41.6 37.7
* 6.5
* 15.4

.

*

*

.

*

*

.

6.6

12.8

60.0 10.7
* 53.2 64.5 43.5
.

62.0 20.8
* 64.4 63.5 48.1
*

63.6 18.8
* 58.4 74.0 49.4
*

19.7 83.8
2.5 61.0
2.2 9.4 0.3 93.8 7.3

21.2 90.4 2.8 62.9 3.8 16.3 0.5 141.6 8.1

21.3 90.0
2.7 59.9
3.8 16.0
0.5 140.4
8.0

68.9 *
68.9 88.9
* * *

96.9 *
82.0 100.0
* * *

78.7 14.0 66.1 90.5 11.0 100.0
*

*

*

19.2

*

*

*

*

*

*

*

*

19.0

*

*

*

*

*

*

15.0

15.7

14.7

*

*

2.4

*

*

*

16.9

16.9

15.9

*

*

2.0

*

*

1.7

48.7 42.9 34.2
* 6.5
* 11.5

61.7 42.7 37.1
* 10.2
* 10.0

47.9 41.3 36.0
2.7 7.9 2.5 10.8

* * 17.2

4.7 *
16.7

2.4 0.9 13.5

58.8

54.7

59.9

9.2

22.7

17.1

*

*

13.2

62.3

46.1

57.2

79.2

71.9

70.4

50.6

38.2

46.0

11.7

9.0

5.5

283

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Elbert County - 052

1990
18949 4026 363
19.8 18.0 20.0
54 13 308 43 123 16
5 73 10
5 5 0 10 0 2
33 7 3
25 6 3
101 70 101
6 49
7 18
. . .
186 51
3 148 147 112
. 0

1991
19042 4018 364
20.2 18.4 20.0
46 15 297 41 125 21
8 52
4
10 7 3
15 1 0
30 7 1
29 3 7
99 68 107
5 35
3 13
3 13
8
194 41 8
156 164 123
19 1

Total
1992 1993

19127 4008 365

19217 4001 365

20.5 18.6 22.0

19.9 17.8 22.0

39

51

10

10

279

274

35

41

113

131

13

14

6

3

56

63

4

9

8

2

7

2

1

0

13

5

0

1

1

2

29

32

9

7

2

0

26

27

3

4

8

11

66

86

58

70

81

87

1

4

32

30

4

4

8

14

4

8

10

11

12

18

199

196

48

29

1

4

153

154

154

179

129

135

90

92

0

1

1994 5-year

19302 3992 366

95637 20045
1823

20.4 16.1 21.0

20.3 18.0 21.0

59

249

18

66

262

1420

47

207

116

608

13

77

3

25

60

304

11

38

6

31

3

24

3

7

6

49

1

3

0

5

22

146

4

34

1

7

23

130

4

20

3

32

68

420

51

317

86

462

4

20

30

176

3

21

19

72

4

19

5

39

17

55

177

952

41

210

8

24

158

769

160

804

139

638

93

294

1

3

1990
13153 2599 231

1991
13220 2596 232

White
1992 1993

13284 2591 232

13348 2588 232

1994 5-year

13413 2584 232

66418 12958
1158

22.1 18.9 19.5

20.6 19.8 19.0

23.0 18.6 21.5

20.0 17.5 21.0

21.1 15.6 21.0

21.2 18.3 20.0

27

19

13

26

21

106

7

4

4

5

2

22

186

175

166

146

159

832

25

15

13

23

17

93

34

29

26

31

34

154

8

10

7

8

10

43

2

6

5

1

0

14

37

22

23

27

21

130

2

3

0

3

4

12

0

3

5

1

4

13

0

3

4

1

3

11

0

0

1

0

1

2

2

9

9

2

3

25

0

0

0

1

0

1

1

0

0

0

0

1

14

11

18

10

7

60

3

2

5

1

3

14

0

0

0

0

1

1

15

12

14

9

10

60

4

1

2

3

2

12

2

4

6

8

2

22

44

46

33

29

33

185

18

18

14

17

14

81

54

48

44

36

46

228

4

1

0

2

2

9

36

30

25

20

23

134

3

3

2

4

1

13

10

4

6

3

6

29

.

2

2

5

2

11

.

7

8

4

2

21

.

6

10

15

2

33

126

128

128

118

119

619

35

27

29

18

23

132

0

5

0

4

6

15

63

72

65

57

72

329

65

69

65

69

69

337

47

53

51

46

57

254

.

8

35

29

38

110

0

0

0

1

0

1

1990
5718 1408
132

1991
5746 1405 132

Black
1992 1993

5772 1401
133

5799 1398 133

1994 5-year

5825 1395
133

28859 7008 663

18.9 16.8 24.0

19.7 18.2 25.5

18.3 19.0 26.0

19.4 18.0 24.0

18.0 16.6 24.5

18.8 17.8 25.0

27

27

26

25

38

143

6

11

6

5

16

44

122

122

111

128

102

585

18

26

22

18

30

114

89

96

86

100

82

453

8

11

6

6

3

34

3

2

1

2

3

11

36

29

32

35

39

171

8

1

4

6

7

26

5

7

3

1

2

18

5

4

3

1

0

13

0

3

0

0

2

5

8

6

4

3

3

24

0

1

0

0

1

2

1

0

1

2

0

4

19

19

11

22

15

86

4

5

4

6

1

20

3

1

2

0

0

6

10

17

12

18

13

70

2

2

1

1

2

8

1

3

2

3

1

10

57

53

32

57

35

234

52

50

43

53

37

235

47

59

36

51

40

233

2

4

1

2

2

11

13

5

7

10

7

42

4

0

2

0

2

8

8

9

2

11

13

43

.

1

1

3

2

7

.

6

2

7

1

16

.

2

2

3

15

22

60

66

70

78

57

331

16

14

18

11

18

77

3

3

1

0

2

9

85

84

88

97

86

440

82

95

88

110

91

466

65

70

78

89

82

384

.

11

55

63

55

184

0

1

0

0

1

2

284

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Elbert County - 052

16.3 76.5
2.3 41.1
3.9 18.1
0.4 181.6
5.2
148.8 24.1 118.5 74.4 27.5 100.0
*
16.2 16.2
* 31.9
* *
10.7 2.3 * 8.3 2.0 *
42.6 23.3 33.8
2.0 17.7
2.5 10.4
. . .
61.4 19.5
* 49.2 48.8 37.2
.

15.6 73.9
2.2 42.5
2.7 12.9
0.3 137.2
7.5
126.3 32.6
112.6 67.5 * * 13.7
33.7 23.6
* 49.2
* *
10.1 2.4 * 9.9 * 2.6
42.5 23.1 36.4
1.7 13.3
* 7.4
* 2.5 1.6
66.0 15.8 23.5 53.1 55.8 41.8
6.5

14.6 69.6 2.1 40.9 2.9 14.0 0.4 158.2 4.7
107.0 25.6 96.0 71.4 * * *
28.7 25.1
* 45.6
* *
10.4 3.2 * 9.4 * 3.2
34.0 21.0 29.3
* 13.4
* 5.2
* 1.9 2.3
74.8 19.6
* 55.4 55.8 46.7 32.6

14.3 68.5
2.1 48.5
3.3 15.7
0.3 178.0
4.2
139.6 19.6
112.3 65.9 24.6
100.0 *
* * * 18.1 * *
11.7 2.6 *
10.0 *
4.5
45.0 25.9 32.3
* 13.1
* 8.9
1.5 2.1 3.5
72.9 12.3
* 57.0 66.3 50.0 34.1

13.6 65.6 2.0 45.0 3.1 15.0 0.3 177.0 4.3
161.3 30.5
128.5 83.0 30.1
100.0 *
22.9 * *
22.6 * *
8.4 * *
8.9 * *
34.5 19.8 33.3
* 13.0
* 13.2
* 1.0 3.3
69.7 18.1 25.8 61.2 62.0 53.9 36.0

14.8 70.8
2.1 43.5
3.2 15.2
0.3 166.3
5.2
136.6 26.5 113.6 72.8 20.8 100.0
6.0
21.8 16.9
5.0 33.9
* 0.3
10.3 2.4 0.5 9.3 1.4 2.5
39.9 22.7 33.1
1.4 14.2
1.7 9.0
0.9 1.9 2.7
68.7 17.1 14.1 55.0 57.5 45.6 26.8

14.1 71.6
2.2 19.0
2.8 14.2
0.3 158.8
3.8

13.2 67.4
2.1 16.7
1.7 8.5 0.2 102.8 6.5

12.5 64.1 2.0 15.9 1.7 8.9 0.2 114.4 4.6

10.9 56.4
1.7 21.7
2.0 10.4
0.2 148.4
3.5

11.9 61.5 1.9 21.7 1.6 8.1 0.1 109.9 4.3

12.5 64.2
2.0 18.8
2.0 10.0
0.2 127.3
4.6

116.9 25.9 108.2 56.0
* * *

82.1 *
64.8 * * * *

56.2 *
56.2 * * * *

112.0 19.2 99.1 47.8 * * *

90.5 *
73.2 58.8
* * *

91.5 20.8 80.3 45.2 10.4 100.0
*

*

*

30.1

*

*

15.6

*

*

*

*

*

13.2

*

*

*

*

*

*

*

49.7

52.6

*

*

29.6

*

*

*

*

*

*

*

*

*

*

*

*

7.5

6.3

10.8

6.8

4.4

7.2

*

*

3.0

*

*

1.7

*

*

*

*

*

*

8.3

6.9

8.5

6.3

6.4

7.3

*

*

*

*

*

1.5

*

*

4.3

6.6

*

3.1

33.8 9.9
30.0 *
22.8 *
10.5

35.9 10.3 27.6
* 20.8
* *

30.3 8.5 26.8
* 19.1
* 6.5

31.5 11.9 25.4
* 18.9
* *

28.0 8.9 29.3
* 17.8
* 7.1

32.1 9.9
27.9 1.1
20.1 1.9 6.5

.

*

*

1.6

.

2.2

2.5

*

.

1.9

3.1

4.7

*

0.9

*

1.6

*

2.6

68.5 21.5
* 34.8 35.9 26.0
.

73.6 17.1 31.3 41.4 39.7 30.5
4.6

80.5 19.7
* 39.6 39.6 31.1 21.3

82.5 14.3
* 39.9 48.3 32.2 20.3

76.3 16.4 35.3 45.9 43.9 36.3 24.2

75.9 18.0 17.6 40.2 41.1 31.0 17.2

21.3 86.6
2.5 74.2
6.3 25.6
0.7 213.0
7.8

21.2 86.8
2.5 80.0
5.0 20.6
0.4 176.8
9.3

19.2 79.2 2.3 78.2 5.5 22.8 0.5 213.3 5.0

22.1 91.5
2.6 78.7
6.0 25.0
0.6 204.7
5.7

17.5 73.1 2.1 82.0 6.7 28.0 0.7 265.3 4.3

20.3 83.5
2.4 78.5
5.9 24.4
0.6 213.5
6.4

204.5 22.2 136.4 100.0 60.6 100.0
*

203.9 40.7
196.4 96.0 * * *

196.1 23.1
165.9 95.5 * * *

188.3 20.0
135.5 88.9 45.2
100.0 *

285.7 42.1
225.6 96.7 52.6
100.0 *

215.8 30.8
172.0 95.6 39.2 100.0 12.1

41.0

57.4

*

*

*

30.8

41.0

*

*

*

*

22.2

*

*

*

*

*

8.7

64.0

48.4

*

*

*

40.3

*

*

*

*

*

*

*

*

*

*

*

*

15.6 * *
8.4 * *

15.6 4.1 *
14.3 * *

9.9 * *
10.9 * *

17.2 4.7 *
14.2 * *

14.7 * *
13.0 * *

14.7 3.4 1.0
12.2 1.4 1.7

53.3 43.3 39.5
* 10.9
* 10.3

50.5 41.7 49.2
* 4.2
* 11.8

38.1 39.1 32.7
* 6.6
* *

57.6 41.7 40.2
* 8.1
* 13.4

44.9 37.0 40.0
* 7.0
* 22.0

49.5 40.7 40.5
1.9 7.4 1.4 12.1

.

*

.

3.1

.

*

*

*

*

0.9

*

3.6

*

2.1

*

*

7.6

2.8

50.4 16.2
* 70.8 68.3 54.2
.

55.0 13.7
* 70.0 79.2 58.3
9.2

66.7 18.8
* 80.0 80.0 70.9 50.0

61.9 10.1
* 76.4 86.6 70.1 49.6

58.8

58.4

20.9

15.7

*

10.6

86.0

76.3

91.0

80.8

82.0

66.6

55.0

40.3

285

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Emanual County - 053

1990
20546 4499 504
19.8 18.5 21.0
53 7
360 43 145 33
3 53
6
9 4 5 7 2 0
38 4 2
33 9 0
133 77 140
6 60
2 15
. . .
239 69
6 172 155 116
. 0

1991
20684 4522 508
19.7 18.2 20.0
64 18 327 53 137 29
4 45
7
9 8 1 12 3 2
27 6 0
30 3 5
137 76
132 4
62 8
20
4 6 51
214 32 6
235 191 175
12 0

Total
1992 1993

20807 4543 511

20939 4565 515

19.9 19.0 21.0

19.3 19.3 21.0

51

52

15

12

321

305

44

43

161

148

24

25

5

2

38

62

5

6

1

5

1

2

0

3

6

4

0

0

1

2

26

20

4

3

0

1

17

22

4

2

4

3

130

128

91

75

120

114

7

6

33

37

5

3

25

8

7

10

15

14

55

31

190

192

49

53

5

4

219

238

215

226

190

203

18

97

0

3

1994 5-year

21067 4587 519

104043 22716 2557

19.4 19.0 21.0

19.6 18.8 21.0

64

284

14

66

328

1641

56

239

152

743

12

123

0

14

55

253

7

31

1

25

1

16

0

9

1

30

1

6

0

5

23

134

3

20

0

3

27

129

3

21

6

18

113

641

79

398

132

638

1

24

39

231

5

23

14

82

22

43

15

50

140

277

220

1055

47

250

2

23

228

1092

228

1015

197

881

143

270

2

5

1990
13772 2855 266

1991
13841 2859 268

White
1992 1993

13901 2862 271

13967 2866 273

1994 5-year

14029 2869 276

69510 14311
1354

20.4 18.5 20.0

20.7 18.1 20.0

20.5 17.2 20.0

20.4 19.6 20.0

20.6 19.3 21.0

20.5 18.6 20.0

28

30

18

17

30

123

3

8

4

5

6

26

205

173

147

166

179

870

23

24

13

15

24

99

33

33

32

41

44

183

19

18

14

9

10

70

0

0

2

1

0

3

31

25

18

32

36

142

3

5

3

2

5

18

5

3

1

2

1

12

3

3

1

1

1

9

2

0

0

1

0

3

3

3

3

2

1

12

1

0

0

0

0

1

0

1

1

0

0

2

15

6

12

9

9

51

3

1

2

1

1

8

1

0

0

1

0

2

16

9

8

9

15

57

4

0

2

2

1

9

0

2

3

2

4

11

54

55

49

50

49

257

18

14

20

22

18

92

68

68

50

56

68

310

1

0

3

2

0

6

44

49

26

33

33

185

2

4

2

3

2

13

3

9

8

2

6

28

.

2

4

4

10

20

.

4

8

6

9

27

.

36

31

14

62

143

164

140

109

126

140

679

39

21

25

32

31

148

3

2

3

3

0

11

76

108

82

118

111

495

59

74

72

102

104

411

46

69

64

94

89

362

.

4

7

46

64

121

0

0

0

2

2

4

1990
6681 1620
234

1991
6726 1629 236

Black
1992 1993

6766 1637
237

6809 1646 239

1994 5-year

6850 1654
241

33832 8186 1187

18.4 18.1 24.5

18.6 19.3 24.0

19.2 26.8 23.0

18.2 19.1 22.0

18.2 17.8 26.0

18.4 19.0 24.0

25

34

33

35

34

161

4

10

11

7

8

40

154

153

172

138

148

765

20

29

31

28

32

140

112

104

129

106

108

559

14

11

10

15

2

52

3

4

3

1

0

11

22

19

20

30

19

110

3

2

2

4

2

13

4

6

0

3

0

13

1

5

0

1

0

7

3

1

0

2

0

6

4

9

3

2

0

18

1

3

0

0

1

5

0

1

0

2

0

3

22

21

14

11

14

82

1

5

2

2

2

12

1

0

0

0

0

1

17

21

9

13

12

72

5

3

2

0

2

12

0

3

1

1

2

7

78

82

81

77

64

382

59

62

71

53

61

306

72

64

70

58

64

328

5

4

4

4

1

18

16

13

6

4

6

45

0

4

3

0

3

10

12

11

17

6

8

54

.

2

3

5

12

22

.

2

7

7

6

22

.

13

24

16

78

131

74

73

79

66

79

371

29

11

23

21

16

100

3

4

1

1

2

11

95

127

136

119

117

594

96

117

142

123

124

602

70

106

125

108

108

517

.

8

11

51

79

149

0

0

0

1

0

1

286

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Emanual County - 053

17.5 80.0
2.4 41.2
2.6 11.8
0.3 117.8
8.2
105.2 13.2 85.3 69.0 11.9 100.0
9.9
25.0 *
14.0 19.3
* *
10.6 * *
9.4 2.6
*
42.2 21.9 39.9
1.7 17.1
* 7.3
. . .
66.4 21.6 18.8 48.9 44.0 33.0
.

15.8 72.3
2.2 42.3
2.2 10.0
0.3 110.6
7.7
126.0 28.1
104.4 69.2 13.8
100.0 9.8
27.5 24.5
* 36.3
* *
8.3 1.8
* 9.3
* 1.5
46.4 23.5 40.9
* 19.3
2.5 10.1
* 1.0 8.2
65.8 11.0 17.6 72.5 59.0 54.0
3.7

15.4 70.7 2.1 51.1 1.8 8.4 0.3 97.7
6.6
99.8 29.4 86.1 93.2
9.8 100.0
*
* * * 18.4 * *
8.1 * *
5.4 * *
45.8 28.9 38.2 2.2 10.6 1.6 14.0
1.1 2.4 8.8
59.6 17.3 15.6 69.5 68.3 60.3
5.7

14.6 66.8
2.0 48.8
3.0 13.6
0.4 156.6
6.4
101.0 23.1 83.5 76.7 11.7 * *
16.4 * * * * *
6.6 * *
7.3 * *
46.0 24.8 37.6
2.0 12.2
* 4.6
1.6 2.2 5.0
63.2 19.5
* 78.5 74.6 67.0 32.0

15.6 71.5 2.1 46.9 2.6 12.0 0.4 139.2
2.6
123.4 21.9
107.9 76.8 13.5
100.0 *
* * * * * *
7.0 * *
8.3 *
1.8
39.5 24.4 40.7
* 12.1
1.6 7.8
3.5 2.4 22.4
67.7 16.3
* 70.4 70.4 60.8 44.1

15.8 72.2
2.1 45.9
2.4 11.1
0.3 124.2
6.3
111.1 23.2 93.5 76.8 12.1 90.3
6.6
15.2 9.8 5.5
18.1 0.8 0.2
8.2 1.2
* 8.0 1.3 1.1
44.0 24.6 39.5
1.5 14.4
1.4 8.8
1.7 2.0 11.1
64.6 17.2 13.9 67.5 62.7 54.4 21.3

14.9 71.8
2.2 16.5
2.3 10.9
0.3 121.1
7.0

12.5 60.5
1.9 19.1
1.8 8.7 0.3 115.2 6.6

105.3 *
86.5 40.9
* * *

111.8 26.7 89.4 45.8 18.6
100.0 *

24.4

*

*

*

*

*

*

*

*

*

*

*

7.3

3.5

*

*

*

*

8.0

5.2

*

*

*

*

30.9 9.0
34.2 *
22.1 * *

34.6 8.1
39.3 *
28.7 *
8.8

.

*

.

*

.

10.2

80.0 21.5
* 38.0 29.5 23.0
.

81.4 14.0
* 62.4 42.8 39.9
*

10.6 51.4 1.6 22.4 1.3 6.3 0.2 99.4
5.6

11.9 57.9
1.8 25.0
2.3 11.2
0.3 153.1
3.8

12.8 62.4 1.9 24.9 2.6 12.5 0.4 160.0
3.5

12.5 60.8
1.9 21.4
2.0 9.9 0.3 130.5 5.3

66.5 *
48.0 84.6
* * *

62.2 29.4 54.9 40.0
* * *

108.8 20.0 87.1 58.3 18.1
100.0 *

90.8 21.1 73.1 52.0 13.3 94.4
5.9

*

*

*

13.8

*

*

*

10.3

*

*

*

*

*

*

*

13.7

*

*

*

*

*

*

*

*

8.2

5.4

5.0

5.9

*

*

*

0.9

*

*

*

*

5.6

5.5

8.5

6.7

*

*

*

1.1

*

*

*

1.3

40.5 14.0 35.2
* 18.3
* 9.9

34.5 13.4 34.1
* 20.1
* *

32.2 10.2 38.4
* 18.9
* 6.3

34.2 10.7 36.3
0.7 21.7
1.5 5.8

*

*

2.8

1.4

2.3

1.7

2.6

1.9

8.8

4.0

17.6

10.2

75.2 19.4
* 57.3 50.3 44.8
4.9

76.4 22.7
* 72.0 62.2 57.3 28.0

78.7 20.3
* 62.7 58.8 50.3 36.2

78.5 19.6 10.7 57.8 48.0 42.2 18.4

23.1 95.1
2.7 74.2
3.3 13.6
0.3 114.0
10.5

22.7 93.9
2.6 69.3
2.8 11.7
0.3 101.1
9.8

25.4 105.1
2.9 75.9 3.0 12.2 0.4 97.1
8.6

20.3 83.9
2.3 76.8
4.4 18.2
0.5 162.2
10.3

21.6 89.5 2.5 74.0 2.8 11.5 0.3 112.4
*

22.6 93.5
2.6 74.0
3.3 13.4
0.4 116.9
8.1

106.8 *
85.5 100.0
* * *

144.2 29.4
123.0 89.3 * * *

139.1 33.3
130.6 96.8 * * *

146.4 20.0
117.1 96.4 * * *

141.1 23.5
132.8 90.6 * * *

135.6 24.8 117.9 94.2 11.0 84.6 7.6

*

39.2

*

*

*

17.0

*

32.7

*

*

*

9.2

*

*

*

*

*

7.9

*

57.3

*

*

*

23.2

*

*

*

*

*

1.7

*

*

*

*

*

*

14.3

13.7

8.1

8.0

9.5

10.7

*

3.3

*

*

*

1.6

*

*

*

*

*

*

11.3

14.0

5.3

9.4

8.2

9.5

3.3

*

*

*

*

1.6

*

*

*

*

*

0.9

56.1 39.1 47.7
3.3 10.6
* 12.5

60.7 41.3 43.0
* 8.7
* 11.5

50.3 41.8 41.2
* 3.6
* 17.7

58.3 38.4 42.0
* * * 7.9

47.8 41.8 43.8
* 4.1
* 9.6

54.5 40.5 43.5
2.4 6.0 1.3 12.1

.

*

*

1.8

4.4

2.0

.

*

2.6

2.6

2.2

2.0

.

4.8

8.9

5.9

28.9

12.1

48.1 21.0
* 62.9 63.6 46.4
.

48.0 7.9 *
84.7 78.0 70.7
5.3

45.9 15.0
* 80.0 83.5 73.5
6.5

47.8 16.2
* 86.2 89.1 78.3 37.0

54.1

48.7

11.9

14.4

*

18.3

80.1

78.7

84.9

79.7

74.0

68.5

54.1

24.7

287

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Evans County - 054

1990
8724 1843
190
19.3 19.7 22.0
22 6
132 20 54 13
1 17
1
3 2 1 3 0 1
12 2 0
14 1 4
53 34 43
2 25
6 7
. . .
92 15
3 73 73 55
. 1

1991
8787 1842 190
19.1 19.3 22.0
30 5
150 25 66 15 1 23 5
3 3 0 4 0 3
11 2 2 7 2 1
61 38 44
2 26
3 7
7 4 40
105 21 1 90 91 78 9 0

Total
1992 1993

8845 1838
191

8910 1837 191

20.4 18.2 20.5

18.8 17.5 21.0

21

27

5

5

150

128

19

23

66

55

18

14

1

2

20

15

2

3

0

1

0

0

0

1

1

2

0

0

0

0

13

10

4

0

0

0

13

9

3

2

1

3

57

44

49

30

41

41

2

1

39

18

2

1

12

4

10

12

5

11

65

109

100

91

24

31

1

2

92

90

99

84

74

73

48

52

0

0

1994 5-year

8968 1832
191

44234 9192 952

20.0 18.5 20.0

19.4 19.3 21.0

26

126

8

29

134

694

24

111

67

308

18

78

2

7

15

90

1

12

2

9

0

5

2

4

2

12

0

0

1

5

13

59

1

9

0

2

8

51

2

10

0

9

49

264

39

190

42

211

3

10

17

125

1

13

7

37

15

44

8

28

63

277

94

482

31

122

3

10

86

431

90

437

74

354

66

175

2

3

1990
5654 1185
111

1991
5693 1180 111

White
1992 1993

5728 1173
112

5764 1167 112

1994 5-year

5802 1159
112

28641 5864 557

23.9 20.1 20.0

20.3 18.5 21.0

21.2 22.4 19.5

21.1 23.7 22.0

21.3 18.9 19.0

21.8 19.9 20.0

4

12

6

7

9

38

1

1

0

1

2

5

67

75

69

72

71

354

3

8

6

6

8

31

8

13

14

13

19

67

8

10

10

8

8

44

0

0

0

1

0

1

10

13

10

7

9

49

0

4

0

0

0

4

2

1

0

1

1

5

1

1

0

0

0

2

1

0

0

1

1

3

1

1

0

1

0

3

0

0

0

0

0

0

0

2

0

0

0

2

3

3

2

2

7

17

1

0

1

0

0

2

0

0

0

0

0

0

6

3

4

4

4

21

0

1

1

1

1

4

2

1

1

3

0

7

22

23

16

18

23

102

3

10

10

6

9

38

17

18

23

19

22

99

1

0

0

1

0

2

16

18

25

15

13

87

4

1

1

0

1

7

3

2

2

1

4

12

.

3

6

3

6

18

.

1

2

8

4

15

.

28

22

51

23

124

56

62

57

59

58

292

10

10

12

20

15

67

3

1

1

1

3

9

24

32

39

43

39

177

25

29

34

36

35

159

16

26

29

32

30

133

.

3

19

18

28

68

0

0

0

0

1

1

1990
2963 644 79

1991
2984 643
79

Black
1992 1993

3004 641 79

3026 639
79

1994 5-year

3046 637 79

15024 3204 396

17.6 18.4 27.5

17.8 22.3 26.0

18.4 14.0 26.0

16.7 17.2 21.0

18.7 16.5 22.0

17.7 18.2 24.0

18

18

15

20

17

88

5

4

5

4

6

24

65

74

80

56

63

338

17

17

13

17

16

80

46

53

52

42

48

241

5

5

8

6

9

33

1

1

1

1

2

6

6

10

10

8

6

40

1

1

2

3

1

8

1

2

0

0

1

4

1

2

0

0

0

3

0

0

0

0

1

1

2

3

1

1

2

9

0

0

0

0

0

0

1

1

0

0

1

3

9

8

11

8

6

42

1

2

3

0

1

7

0

2

0

0

0

2

8

3

8

5

4

28

1

1

2

1

1

6

2

0

0

0

0

2

31

37

40

26

26

160

31

28

39

24

30

152

26

25

18

22

20

111

1

2

2

0

3

8

9

7

13

3

4

36

2

2

1

1

0

6

4

5

10

3

3

25

.

4

2

7

7

20

.

3

1

3

4

11

.

12

31

52

32

127

36

42

42

32

36

188

5

11

12

11

16

55

0

0

0

1

0

1

49

58

53

47

47

254

48

62

65

48

55

278

39

52

45

41

44

221

.

6

29

34

38

107

1

0

0

0

1

2

288

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Evans County - 054

15.1 71.6
2.2 41.2
1.9 9.2 0.2 103.7 8.1
115.8 27.3 105.3 85.0
* * *
* * * * * *
9.1 * *
10.7 * *
44.9 26.0 32.8
* 19.1
4.6 8.5
. . .
69.7 13.2
* 55.7 55.7 42.0
.

17.1 81.4
2.5 44.6
2.6 12.5
0.4 120.4
9.8
157.9 16.7
131.6 83.3 26.3
100.0 *
* * * * * *
7.3 * *
4.7 * *
41.8 25.7 30.1
* 17.6
* 8.0
2.7 *
15.5
70.0 14.8
* 60.8 61.5 52.7
6.1

17.0 81.6 2.5 45.2 2.3 10.9 0.3 104.7 11.4
110.2 23.8 99.7 78.9 * * *
* * * * * *
8.7 * *
8.9 * *
40.4 33.6 28.5
* 26.9
* 12.5
3.9 1.9 25.1
67.6 19.7
* 63.0 67.8 50.7 32.9

14.4 69.7
2.1 43.7
1.7 8.2 0.2 93.8 9.3
141.7 18.5
120.7 78.3 * * *
* * * * * *
7.8 * *
7.1 * *
37.9 23.8 32.8
* 14.3
* *
4.6 4.2 41.9
71.7 27.7
* 71.4 66.7 57.9 41.3

14.9 73.1 2.3 50.8 1.7 8.2 0.2 87.7 12.0
136.4 30.8
125.9 91.3 * * *
* * * * * *
9.7 * *
6.1 * *
39.8 29.5 31.8
* 12.9
* 9.7
5.7 3.1 24.0
74.6 26.1
* 65.2 68.2 56.1 50.0

15.7 75.5
2.3 45.1
2.0 9.8 0.3 102.6 10.1
132.4 23.0 116.6 83.5 12.6 100.0
7.4
13.0 7.2 *
17.1 * *
8.5 1.3
* 7.5 1.5 1.3
41.0 27.8 31.1
1.5 18.3
1.9 9.2
4.2 2.7 26.7
70.6 20.0 13.5 63.1 64.0 51.8 31.7

11.9 56.5
1.8 11.9
1.8 8.4 0.2 117.6 6.8

13.2 63.6
2.0 17.6
2.3 11.0
0.3 130.0
10.2

12.0 58.8 1.9 20.6 1.7 8.5 0.2 109.9 10.2

* 108.1

*

*

*

72.1

*

*

*

*

*

*

*

*

53.7 *
53.7 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

9.0

*

*

*

*

*

*

*

*

37.3 *
25.4 *
23.9 * *

31.1 13.5 24.3
* 24.3
* *

25.0 14.7 34.3
* 36.8
* *

.

*

4.2

.

*

*

.

19.7

15.5

83.6 16.9
* 35.8 37.3 23.9
.

82.7 14.1
* 43.2 39.2 35.1
*

82.6 20.7
* 57.4 50.0 42.6 27.9

12.5 61.7
1.9 18.3
1.2 6.0 0.2 79.5 7.7

12.2 61.3 1.9 27.1 1.6 7.8 0.2 101.1 7.8

12.4 60.4
1.9 19.1
1.7 8.4 0.2 108.2 8.5

62.7 *
53.7 * * * *

80.6 *
71.6 75.0
* * *

68.2 13.2 55.6 51.6
* * *

*

*

14.1

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

9.9

4.8

*

*

*

*

*

*

*

*

6.0

*

*

*

*

*

2.0

28.1 8.5
26.8 *
21.1 * *

34.8 12.9 31.4
* 18.6
* *

31.2 10.9 28.4
* 24.9
2.0 6.2

* 5.6 35.7

4.2 *
16.0

3.2 2.6 21.7

81.9 30.3
* 60.6 50.7 45.1 25.4

86.6 23.8
* 55.7 50.0 42.9 40.0

83.4 21.1 27.3 50.6 45.4 38.0 24.0

21.9 100.9
2.8 71.9
2.0 9.3 0.2 76.9 10.9

24.8 115.1
3.4 72.6
3.4 15.6
0.5 111.1
9.3

26.6 124.9
3.7 67.5 3.3 15.6 0.4 101.0 14.0

18.5 87.6
2.5 76.4
2.6 12.5
0.4 111.1
12.5

20.7 98.9 2.9 77.4 2.0 9.4 0.3 74.1 18.8

22.5 105.5
3.1 72.8
2.7 12.5
0.3 95.2 13.1

227.8 27.8 215.2 100.0
* * *

227.8 *
215.2 100.0
* * *

189.2 33.3
163.9 100.0
* * *

252.2 *
214.4 82.4 * * *

214.4 35.3
201.8 100.0
* * *

222.3 27.3
202.1 96.2 20.2 100.0 *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

26.2

*

*

*

*

*

*

*

*

*

*

*

*

13.8 * *
12.5 * *

10.8 * * * * *

13.8 * *
10.4 * *

14.3 * *
9.1 * *

9.5

12.4

*

2.1

*

*

*

8.5

*

1.8

*

*

52.5 48.4 40.6
* 14.1
* *

52.1 38.4 35.2
* 9.6
* 10.9

52.6 50.6 23.7
* 17.1
* 18.2

50.0 43.6 40.7
* * * *

45.6 48.4 32.3
* * * *

50.8 45.9 33.9
2.4 10.9
1.8 12.0

.

*

*

6.2

6.2

4.5

.

*

*

*

*

2.5

.

10.8

27.8

46.3

28.3

28.3

55.4 9.1 *
76.6 75.0 60.9
.

56.8 15.7
* 79.5 84.9 71.2
8.2

53.8 19.0
* 68.8 84.4 58.4 37.7

58.2 23.9
* 85.5 87.3 74.5 61.8

61.0

56.8

28.6

19.0

*

*

75.8

76.7

88.7

84.0

71.0

66.8

61.3

40.1

289

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Fannin County - 055

1990
15992 3187 328
19.6 21.4 21.0
23 3
189 20 35
6 2 32 3
3 1 2 3 0 1
11 3 0 9 2 2
55 21 59
1 27
5 4
. . .
155 28
2 94 73 57
. 1

1991
16179 3185 327
22.3 19.5 19.0
12 3
166 9
24 9 2
24 3
2 0 2 2 0 0
12 0 0
12 2 2
38 19 52
1 29
1 8
3 5 13
150 19 2 84 69 60 23 1

Total
1992 1993

16360 3181 325

16549 3179 324

20.4 19.2 20.0

20.1 18.2 20.0

17

23

1

2

158

192

13

23

25

34

7

4

1

1

23

16

3

1

3

1

1

0

2

1

2

1

0

1

1

4

13

13

2

2

1

0

11

14

0

3

4

3

35

47

12

19

41

58

1

1

22

27

4

1

3

4

11

11

7

8

41

65

139

148

27

21

4

3

94

121

75

118

66

105

50

69

0

5

1994 5-year

16729 3175 322

81809 15907
1625

21.0 18.5 19.0

20.4 19.4 20.0

24

99

4

13

200

905

20

85

38

156

1

27

3

9

25

120

4

14

0

9

0

2

0

7

3

11

0

1

2

8

8

57

1

8

0

1

17

63

3

10

4

15

41

216

15

86

52

262

3

7

29

134

1

12

7

26

14

39

17

37

41

160

171

763

24

119

5

16

120

513

112

447

100

388

92

234

2

9

1990
15927 3171 327

1991
16113 3168 325

White
1992 1993

16294 3165 323

16483 3163 321

1994 5-year

16662 3159 320

81479 15826
1616

19.6 21.4 21.0

22.3 19.5 19.0

20.4 19.2 20.0

20.1 18.2 20.0

21.0 18.5 19.0

20.4 19.4 20.0

23

12

17

23

24

99

3

3

1

2

4

13

189

166

157

192

199

903

20

9

13

23

20

85

35

24

25

34

38

156

6

9

7

4

1

27

2

2

1

1

3

9

30

24

23

16

25

118

3

3

3

1

4

14

3

2

3

1

0

9

1

0

1

0

0

2

2

2

2

1

0

7

3

2

2

1

3

11

0

0

0

1

0

1

1

0

1

4

2

8

11

12

13

13

8

57

3

0

2

2

1

8

0

0

1

0

0

1

9

12

11

14

16

62

2

2

0

3

3

10

2

2

4

3

4

15

55

38

35

47

41

216

21

19

12

19

15

86

59

52

41

58

52

262

1

1

1

1

3

7

27

29

22

27

29

134

5

1

4

1

1

12

4

8

3

4

6

25

.

2

11

11

14

38

.

5

7

7

17

36

.

12

33

60

41

146

155

150

138

148

170

761

28

19

27

21

24

119

2

2

4

3

5

16

94

84

94

121

120

513

73

69

75

118

112

447

57

60

66

105

100

388

.

23

50

69

92

234

1

1

0

5

2

9

1990
5 1 0

1991
5 1 0

Black
1992 1993

5

5

1

1

0

0

1994 5-year

5

26

1

5

0

0

.

.

.

.

.

.

.

.

.

.

.

.

27.5

.

.

.

.

27.5

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

0

0

0

0

0

0

290

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Fannin County - 055

11.8 59.3
1.9 18.7
2.0 10.0
0.3 139.7
2.5
70.1 *
61.0 35.0
* * *
* * * * * *
5.8 * *
4.8 * *
33.1 11.2 31.7
* 15.4
2.9 *
. . .
82.9 16.7
* 50.3 39.0 30.5
.

10.3 52.1
1.7 14.6
1.5 7.5 0.2 119.4 3.5
36.7 *
27.5 * * * *
* * * * * *
7.2 * *
7.3 * *
29.2 11.6 31.7
* 21.2
* 9.1
* 1.3 3.5
90.4 12.2
* 51.2 42.1 36.6 14.0

9.7 49.7 1.6 15.9 1.4 7.2 0.2 121.7 2.5
52.3 *
40.0 * * * *
* * * * * *
8.2 * *
7.0 * *
26.1 7.6 25.9
* 15.8
* *
2.9 1.9 10.9
88.5 19.4
* 59.5 47.5 41.8 31.6

11.6 60.4
2.0 18.0
1.0 5.0 0.1 74.8 1.9

12.0 63.0 2.0 19.3 1.5 7.9 0.2 109.2
*

11.1 56.9
1.8 17.4
1.5 7.5 0.2 113.0 2.3

71.1 *
71.1 45.5
* * *

74.6 *
62.2 45.0
* * *

60.9 13.1 52.3 40.5
8.6 92.9
*

*

*

9.9

*

*

*

*

*

7.8

*

*

12.0

*

*

*

*

*

0.6

6.8

4.0

6.3

*

*

0.9

*

*

*

7.4

8.5

7.0

*

*

1.1

*

*

1.9

28.8 10.1 31.0
* 16.0
* *

24.4 7.5 26.3
* 16.7
* 7.0

28.4 9.6
29.3 0.8
16.9 1.5 5.5

2.9 2.1 17.2

3.7 4.5 10.8

2.6 2.5 10.6

80.4 12.1
* 64.0 62.4 55.6 36.5

87.7 13.6 21.7 60.3 56.3 50.3 46.2

85.8 14.7 18.8 57.2 49.8 43.3 33.0

11.9 59.6
1.9 18.7
1.9 9.5 0.3 132.2 2.5

10.3 52.4
1.7 14.6
1.5 7.6 0.2 119.4 3.5

9.6 49.6 1.6 16.0 1.4 7.3 0.2 122.3 2.5

70.3 *
61.2 35.0
* * *

36.9 *
27.7 * * * *

52.6 *
40.2 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

5.8

7.2

8.3

*

*

*

*

*

*

4.8

7.3

7.0

*

*

*

*

*

*

33.1 11.2 31.7
* 15.4
2.9 *

29.2 11.6 31.7
* 21.2
* 9.1

26.1 7.6 26.1
* 15.8
* *

.

*

2.9

.

1.3

1.9

.

3.2

8.8

82.9 16.7
* 50.3 39.0 30.5
.

90.4 12.2
* 51.2 42.1 36.6 14.0

88.5 19.6
* 59.9 47.8 42.0 31.8

11.6 60.7
2.0 18.0
1.0 5.1 0.1 74.8 1.9

11.9 63.0 2.0 19.4 1.5
7.9 0.2 109.6
*

11.1 57.1
1.9 17.5
1.4 7.5 0.2 111.5 2.3

71.6 *
71.6 45.5
* * *

75.1 *
62.6 45.0
* * *

61.2 13.1 52.6 40.5
8.7 92.9
*

*

*

10.0

*

*

*

*

*

7.8

*

*

12.1

*

*

*

*

*

0.6

6.8

4.0

6.3

*

*

0.9

*

*

*

7.4

8.1

6.9

*

*

1.1

*

*

1.9

28.8 10.1 31.0
* 16.0
* *

24.4 7.6 26.4
* 16.7
* 6.1

28.4 9.6
29.4 0.8
16.9 1.5 5.3

2.9

3.7

2.5

1.9

4.5

2.4

16.0

10.8

9.7

80.4 12.1
* 64.0 62.4 55.6 36.5

87.6 13.7 21.7 60.6 56.6 50.5 46.5

85.8 14.7 18.8 57.3 49.9 43.4 33.1

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

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*

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*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

291

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Fayette County - 056

1990
62415 15557
1519
25.0 19.8 22.0
52 10 744 24 79 64
7 254 28
6 5 1 12 4 4
45 9 1
56 17
9
134 39 56
6 67 13 15
. . .
608 112 22 92 80 61
. 0

1991
66413 16242
1596
25.6 19.5 22.0
49 4
759 22 80 61 7
227 26
6 3 3 10 1 4
36 4 0
51 11 21
118 47 67 7 62 4 18
13 21 37
643 116
19 134 110
92 3 0

Total
1992 1993

70402 16927
1673

74403 17612
1749

26.2 20.1 23.0

25.3 19.9 23.0

44

38

10

4

822

767

17

20

86

98

71

39

6

3

246

206

26

17

3

4

3

2

0

2

9

5

1

0

1

4

45

48

8

12

1

0

67

63

14

10

9

4

128

122

39

42

57

61

3

5

47

64

11

5

23

15

14

25

30

16

41

34

700

652

99

90

32

28

114

149

102

165

78

107

3

17

0

0

1994 5-year

78394 18296
1826

352027 84634
8363

26.2 20.8 23.0

25.8 20.0 22.0

48

231

6

34

739

3831

25

108

94

437

45

280

5

28

197

1130

21

118

5

24

5

18

0

6

9

45

3

9

3

16

65

239

11

44

1

3

74

311

10

62

5

48

150

652

54

221

44

285

5

26

46

286

7

40

25

96

18

70

8

75

22

134

649

3252

78

495

30

131

127

616

131

588

96

434

13

36

0

0

1990
57729 14318
1400

1991
60704 14779
1457

White
1992 1993

63671 15237
1514

66650 15698
1570

1994 5-year

69621 16157
1627

318375 76189
7568

24.7 20.0 22.0

25.6 19.5 22.0

26.2 20.0 22.0

25.0 20.3 23.0

26.2 20.7 23.0

25.7 19.9 22.0

46

45

38

34

43

206

9

4

8

4

4

29

675

692

745

691

655

3458

22

20

16

19

23

100

56

59

66

77

76

334

59

56

63

34

40

252

6

6

4

2

3

21

222

198

204

167

164

955

25

24

21

14

19

103

4

5

3

4

3

19

4

2

3

2

3

14

0

3

0

2

0

5

10

8

7

4

6

35

4

1

0

0

1

6

3

4

1

3

2

13

33

27

37

40

52

189

6

4

6

11

8

35

1

0

1

0

0

2

43

43

57

55

59

257

15

7

13

10

9

54

9

20

7

4

4

44

121

109

112

108

127

577

23

31

28

34

42

158

46

59

53

58

41

257

6

3

3

4

2

18

61

58

45

64

44

272

13

4

8

5

5

35

13

18

18

13

23

85

.

9

12

21

15

57

.

20

27

15

8

70

.

24

29

31

13

97

561

597

640

585

585

2968

97

107

91

77

67

439

21

15

29

26

26

117

72

111

97

126

111

517

63

90

86

144

116

499

48

76

68

94

85

371

.

3

2

13

9

27

0

0

0

0

0

0

1990
3380 880 78

1991
3597 918
82

Black
1992 1993

3813 956 86

4029 994
90

1994 5-year

4245 1031
94

19064 4778 429

26.6 18.5 25.5

24.1 23.0 23.5

21.7 20.7 25.5

26.8 18.7 28.5

26.4 21.8 28.5

25.9 20.4 25.5

4

3

6

3

5

21

0

0

2

0

2

4

53

53

57

56

66

285

2

2

1

1

2

8

22

20

18

21

17

98

4

5

7

4

4

24

1

1

2

1

2

7

21

19

37

34

25

136

2

1

5

2

2

12

2

1

0

0

1

4

1

1

0

0

1

3

1

0

0

0

0

1

2

2

2

1

3

10

0

0

1

0

2

3

1

0

0

0

1

2

9

8

8

8

12

45

3

0

2

1

3

9

0

0

0

0

1

1

9

7

8

8

12

44

2

4

1

0

1

8

0

1

2

0

0

3

5

7

10

16

16

9

9

8

3

0

4

0

6

3

1

0

0

1

2

0

4

8

16

46

8

11

60

3

3

26

1

2

7

0

2

12

0

1

2

2

1

9

.

3

2

3

3

11

.

1

2

1

0

4

.

8

10

1

8

27

32

35

43

49

48

207

12

7

6

10

10

45

1

4

3

1

2

11

19

22

16

22

16

95

15

20

15

18

15

83

12

16

10

13

11

62

.

0

1

4

4

9

0

0

0

0

0

0

292

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Fayette County - 056

11.9 47.8
1.7 10.9
4.1 16.3
0.6 236.7
4.8
34.2 19.2 15.8 60.9 18.4 100.0
*
8.1 6.7
* 16.0
* *
6.0 1.2
* 7.7 2.3 1.2
25.8 5.4 7.8 0.8 9.3 1.8 3.8
. . .
84.6 17.2 29.7 12.7 11.0
8.4 .

11.4 46.7
1.6 10.7
3.4 14.0
0.5 215.0
4.3
30.7 *
13.8 50.0 16.3 100.0
*
7.9 * *
13.1 * *
4.7 * *
6.8 1.5 2.8
22.5 6.3 9.1 0.9 8.4 * 4.1
0.7 1.1 1.9
86.1 17.5 22.1 17.9 14.7 12.3
*

11.7 48.6 1.7 10.7 3.5 14.5 0.5 214.5 4.7
26.3 22.7 10.2 82.4 15.5 100.0
*
* * * 10.9 * *
5.5 1.0
* 8.3 1.7 1.1
23.1 4.8 7.2 * 5.9 1.4 4.6
0.7 1.5 2.0
85.6 14.0 32.7 14.1 12.6
9.7 *

10.3 43.5
1.5 13.0
2.8 11.7
0.4 202.8
2.4
21.7 *
11.4 55.0
9.7 94.1
*
* * * 6.5 * *
6.3 1.6
* 8.3 1.3
*
21.6 5.6 8.2 0.7 8.5 0.7 3.2
1.2 0.8 1.6
85.5 13.7 28.9 19.7 21.8 14.2
2.2

9.4 40.4 1.4 12.9 2.5 10.8 0.4 199.0 3.0
26.3 12.5 13.7 80.0 11.5 100.0
*
6.8 6.8
* 12.1
* *
8.8 1.5
* 10.2 1.4 0.7
23.4 7.4 6.1 0.7 6.4 1.0 5.8
0.8 0.4 1.0
87.9 12.2 32.6 17.4 18.0 13.2 1.8

10.9 45.3
1.6 11.6
3.2 13.4
0.5 213.9
3.8
27.6 14.7 12.9 65.4 14.1 99.1
0.7
6.3 4.7 1.6 11.7 0.4 0.2
6.2 1.1
* 8.3 1.6 1.3
23.3 5.9 7.7 0.7 7.6 1.1 4.3
0.8 0.9 1.6
85.9 14.9 29.3 16.4 15.6 11.5
1.2

11.7 47.1
1.7 8.5 3.8 15.5 0.6 230.1 4.7

11.4 46.8
1.6 8.6 3.3 13.4 0.5 207.8 4.3

11.7 48.9 1.7 9.0 3.2 13.4 0.5 200.4 4.5

10.4 44.0
1.5 11.3
2.5 10.6
0.4 186.6
2.4

9.4 40.5 1.3 11.8 2.4 10.2 0.4 189.4 2.9

10.9 45.4
1.6 9.8 3.0 12.5 0.4 203.3 3.7

32.9 19.6 15.7 57.1 17.9 100.0
*

30.9 *
13.7 45.0 16.5 100.0
*

25.1 21.1 10.6 81.3 13.9 100.0
*

21.7 *
12.1 52.6
8.9 92.9
*

26.4 *
14.1 78.3 11.7 100.0
*

27.2 14.1 13.2 62.6 13.6 99.0
*

*

7.2

*

*

*

*

*

*

*

14.7

11.5

9.3

*

*

*

*

*

*

*

*

5.5

*

*

4.0

*

*

1.5

*

9.1

10.1

*

*

0.3

*

*

0.2

4.9

3.9

5.0

5.8

7.9

5.5

0.9

*

0.8

1.6

1.2

1.0

*

*

*

*

*

*

6.5

6.3

7.8

8.1

9.1

7.6

2.3

1.0

1.8

1.5

1.4

1.6

1.3

2.9

0.9

*

*

1.3

25.6 3.5 7.0 0.9 9.3 2.0 3.6

22.0 4.5 8.7 * 8.6 * 4.4

22.3 3.8 7.3 * 6.2 1.1 4.1

20.8 5.0 8.6 * 9.4 0.7 3.1

22.2 6.5 6.4 * 6.9 0.8 6.0

22.5 4.6 7.6 0.5 8.0 1.0 4.2

.

0.5

0.7

1.2

0.8

0.8

.

1.2

1.5

0.8

0.4

1.0

.

1.4

1.6

1.7

0.7

1.3

85.1 16.5 30.0 10.9
9.6 7.3
.

87.5 17.6 19.5 16.2 13.1 11.1
*

86.3 14.2 32.6 13.3 11.7
9.3 *

84.9 13.1 28.6 18.5 21.2 13.8
1.9

89.3 11.8 33.3 17.2 18.0 13.2 1.4

86.6 14.6 28.9 15.2 14.7 10.9
1.0

15.7 60.2
2.3 43.1
6.2 23.9
0.9 265.8
5.7

14.7 57.7
2.2 40.8
5.3 20.7
0.8 243.6
6.5

15.0 59.6 2.3 32.7 9.7 38.7 1.5 359.2 9.4

13.9 56.4
1.9 37.5
8.4 34.2
1.2 357.9
5.0

15.5 64.0 2.2 26.2 5.9 24.2 0.9 257.7 5.8

15.0 59.6
2.2 35.5
7.1 28.5
1.1 300.9
6.5

*

*

69.8

*

53.3

48.9

*

*

*

*

*

*

*

*

*

*

*

18.6

*

*

*

*

* 100.0

*

*

58.2

*

*

27.9

*

* 100.0

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

34.2

*

*

*

*

*

*

*

*

*

*

*

*

17.0 * *
17.6 * *

15.1 * *
14.3 * *

14.0 * *
14.5 * *

14.3 * *
14.3 * *

18.2 * *
18.5 * *

15.8 3.2 *
15.9 2.9 *

15.6 31.4 18.4
* 11.8
* *

35.0 32.7 16.7
* * * *

27.8 16.4
* * * * *

25.8 14.3
* * * * *

30.2 16.9
* * * * *

26.7 21.7
9.7 2.6 4.4
* 5.5

.

*

*

.

*

*

.

6.7

7.9

*

*

2.1

*

*

*

*

5.8

5.2

72.7 25.5
* 37.3 29.4 23.5
.

67.3 17.1
* 44.9 40.8 32.7
*

76.8 13.0
* 29.1 27.3 18.2
*

89.1 19.6
* 39.3 32.1 23.2
*

73.8

76.1

18.5

18.8

*

29.7

24.6

34.4

23.1

30.1

16.9

22.5

*

4.0

293

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Floyd County - 057

1990
81251 18449
1615
20.8 19.2 20.0
230 54 1336 180 428 77 20 317 43
21 11 10 31
2 3
109 27
6 113
9 21
334 233 446 32 312 42 66
. . .
1034 237 11 593 373 309 . 0

1991
81696 18402
1613
20.9 19.5 21.0
179 50
1241 144 379
88 10 295 31
14 12
2 21
1 8
89 22
5 110
9 29
319 198 431
20 309
38 65
11 9
66
908 208
12 706 482 444
45 0

Total
1992 1993

82128 18354
1610

82578 18308
1607

20.8 19.2 22.0

20.9 18.9 22.0

174 43
1178 137 388 79 14 263 34

168 31
1130 129 359
95 9
260 34

19

3

16

2

3

1

30

11

1

0

9

6

101

83

24

13

6

0

104

82

14

14

47

306

286

307

186

183

383

351

13

11

269

245

36

25

58

44

36

58

38

49

250

222

873

919

183

201

20

21

643

647

542

575

470

493

133

241

2

1

1994 5-year

83014 18260
1605

410667 91773
8050

20.4 19.8 22.0

20.8 19.3 21.0

164 21
1124 136 345 59 8 242 25

915 199 6009 726 1899 398
61 1377
167

11

68

8

49

3

19

16

109

4

8

8

34

92

474

21

107

2

19

105

514

17

63

34

437

341

1587

194

994

339

1950

21

97

213

1348

15

156

45

278

44

149

33

129

159

697

917

4651

161

990

37

101

612

3201

588

2560

482

2198

319

738

11

14

1990
69338 15464
1271

1991
69563 15381
1267

White
1992 1993

69781 15296
1262

70006 15213
1258

1994 5-year

70225 15129
1254

348913 76483
6312

21.5 19.5 20.0

21.5 19.2 21.0

21.2 19.0 21.0

21.7 18.9 22.0

21.2 19.9 22.0

21.4 19.2 21.0

144

115

114

109

118

600

30

23

22

20

13

108

1050

969

947

915

929

4810

108

86

87

84

96

461

215

181

211

200

197

1004

67

69

62

77

49

324

14

5

9

3

4

35

237

222

185

195

187

1026

33

24

26

22

20

125

10

11

9

1

5

36

4

9

8

1

4

26

6

2

1

0

1

10

18

13

18

4

8

61

2

1

1

0

2

6

2

5

7

4

6

24

61

54

65

57

60

297

13

14

15

9

13

64

2

4

1

0

1

8

63

76

70

60

77

346

7

5

11

10

16

49

12

22

39

245

30

348

239

235

213

226

265

1178

123

102

97

103

109

534

329

307

285

267

269

1457

18

8

6

6

10

48

284

268

239

214

191

1196

28

28

25

17

10

108

40

43

35

36

32

186

.

5

24

43

34

106

.

3

33

45

30

111

.

34

152

136

103

425

851

755

748

774

781

3909

197

161

151

168

136

813

6

9

19

13

28

75

412

498

482

482

468

2342

239

304

368

414

442

1767

205

284

329

354

359

1531

.

31

96

181

257

565

0

0

1

0

5

6

1990
11106 2794 327

1991
11167 2786 327

Black
1992 1993

11226 2778 326

11287 2770 326

1994 5-year

11347 2761
325

56133 13888
1630

18.3 17.9 24.0

18.2 19.2 27.0

18.4 18.9 26.0

17.7 17.7 25.0

18.0 19.6 26.0

18.3 18.7 25.5

84

64

57

59

46

310

24

27

21

11

8

91

277

259

215

202

187

1140

72

58

49

45

40

264

213

197

171

155

144

880

9

19

16

18

10

72

6

4

5

6

4

25

67

58

62

56

48

291

8

7

6

12

5

38

11

3

10

2

6

32

7

3

8

1

4

23

4

0

2

1

2

9

13

7

12

7

8

47

0

0

0

0

2

2

1

3

2

1

2

9

47

34

35

25

31

172

14

8

9

3

8

42

4

1

5

0

1

11

49

33

34

21

28

165

2

3

3

4

1

13

9

7

8

57

3

84

92

82

67

73

73

387

110

95

84

76

81

446

116

121

94

82

70

483

14

12

7

5

11

49

27

39

29

30

21

146

14

9

11

8

5

47

25

22

22

8

13

90

.

1

11

12

10

34

.

2

4

3

3

12

.

10

70

54

49

183

175

146

117

135

130

703

40

45

32

33

25

175

5

1

1

8

9

24

180

202

154

159

137

832

132

175

165

154

141

767

104

158

135

135

118

650

.

14

36

57

59

166

0

0

1

1

6

8

294

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Floyd County - 057

16.4 72.4
2.1 32.3
3.9 17.2
0.5 181.0
5.3
142.4 23.5 111.5 67.6 26.6 97.6
6.2
15.7 8.2 7.5
22.9 * *
8.2 2.0 0.4 8.5 0.7 1.6
27.5 17.6 34.0
2.4 23.7
3.2 9.6
. . .
78.5 19.7
9.1 44.7 28.1 23.3
.

15.2 67.4
2.0 30.8
3.6 16.0
0.5 180.4
5.4
111.0 27.9 89.3 66.4 19.2
100.0 3.1
11.3 9.7 *
16.8 * *
7.2 1.8 0.4 9.0 0.7 2.4
28.9 16.1 35.6
1.7 25.6
3.2 9.3
0.6 0.5 3.4
75.1 18.8
9.4 57.3 39.1 36.0
3.7

14.3 64.2 1.9 33.3 3.2 14.3 0.4 170.9 5.3
108.1 24.7 85.1 74.8 21.1
100.0 4.3
16.1 13.6
* 25.2
* 0.6
8.6 2.0 0.5 8.9 1.2 4.0
27.3 16.0 34.0 1.1 23.5 3.1
8.9
1.8 1.9 12.6
76.2 17.4 17.7 55.2 46.6 40.4 11.4

13.7 61.7
1.8 32.2
3.1 14.2
0.4 174.0
5.7
104.5 18.5 80.3 71.9 21.2 97.0 3.7
* * * 9.7 * 0.4
7.3 1.2
* 7.3 1.3 27.2
28.2 16.4 32.2
1.0 22.1
2.3 7.7
2.9 2.4 11.0
81.5 20.2 17.5 58.0 51.5 44.2 21.6

13.5 61.6 1.8 31.2 2.9 13.3 0.4 168.6 3.8
102.2 12.8 84.7 67.2 15.6
100.0 3.1
9.8 7.1
* 14.1
* *
8.2 1.9
* 9.5 1.5 3.0
31.5 17.5 32.1 1.9 19.3 1.4
8.0
2.2 1.6 7.8
81.7 16.4 28.9 55.3 53.1 43.5 28.8

14.6 65.5
1.9 32.0
3.4 15.0
0.4 175.3
5.1
113.7 21.7 90.2 69.4 20.7 98.8
4.1
11.3 8.2 3.2
18.0 0.4 0.5
7.9 1.8 0.3 8.7 1.1 7.3
28.7 16.7 33.6
1.7 22.9
2.7 8.8
1.9 1.6 8.7
78.6 18.6 16.6 53.8 43.1 37.0 16.0

15.1 67.9
2.0 20.7
3.4 15.3
0.4 173.2
5.2

13.9 63.0
1.9 18.8
3.2 14.4
0.4 175.4
4.9

13.6 61.9 1.8 22.5 2.7 12.1 0.3 153.4 4.8

13.1 60.1
1.8 22.1
2.8 12.8
0.4 163.9
5.3

13.2 61.4 1.8 21.6 2.7 12.4 0.4 159.8 3.6

13.8 62.9
1.9 21.1
2.9 13.4
0.4 165.5
4.8

113.3 20.8 85.0 48.1 26.0 96.9
*

90.8 20.0 67.9 45.3 18.9 100.0
3.9

90.3 19.3 68.9 60.5 20.6 100.0
*

86.6 18.3 66.8 57.8 17.5 95.5
*

94.1 11.0 76.6 54.3 16.0 100.0
*

95.1 18.0 73.0 53.0 19.8 98.4
3.0

9.5 *
5.7 16.9
* *

11.4 9.3 *
13.3 * *

9.5 8.4
* 18.8
* 0.6

*

5.4

7.5

*

*

5.4

*

*

2.1

*

8.6

12.6

*

*

0.3

*

*

0.4

5.8

5.6

6.9

6.2

6.5

6.2

1.2

1.4

1.6

1.0

1.4

1.3

*

*

*

*

*

0.2

6.0

7.9

7.5

6.6

8.5

7.3

0.7

0.5

1.2

1.1

1.8

1.0

1.1

2.3

4.1

26.9

3.2

7.3

24.8 11.8 31.8
1.7 27.5
2.7 7.5

26.8 10.6 32.3
0.9 28.4
3.0 8.1

25.0 10.4 31.2 0.7 25.9 2.7
6.6

25.7 11.4 30.0
0.7 23.8
1.9 7.6

29.6 11.9 30.5 1.1 21.0 1.1
6.8

26.4 11.2 31.2
1.0 25.4
2.3 7.3

.

0.3

1.5

2.7

2.1

1.7

.

*

2.1

2.8

1.9

1.8

.

2.2

9.6

8.6

6.4

6.7

82.0 20.8
6.3 39.5 22.9 19.7
.

80.1 18.6
9.0 51.7 31.5 29.5
3.2

80.5 18.1 18.8 51.5 39.3 35.1 10.3

84.7 20.7 13.7 53.3 45.7 39.1 20.0

84.2 16.7 28.3 51.3 48.4 39.3 28.1

82.3 19.0 15.3 49.2 37.1 32.2 15.2

24.9 99.1
2.8 77.5
6.0 24.0
0.6 186.1
5.7

23.2 93.0
2.6 77.0
5.2 20.8
0.6 170.6
8.3

19.2 77.4 2.2 80.7 5.5 22.3 0.6 206.7 8.3

17.9 72.9
2.1 78.3
5.0 20.2
0.6 198.6
8.7

16.5 67.7 1.9 77.4 4.2 17.4 0.5 192.0 5.4

20.3 82.1
2.3 78.1
5.2 21.0
0.6 189.9
7.3

256.9 28.6 220.2 97.2 24.5 100.0 18.3

196.0 42.2
177.6 98.2 21.4
100.0 *

174.8 36.8
150.3 100.0
18.4 *
15.3

181.3 18.6
138.2 97.8 36.9
100.0 *

141.6 17.4
123.1 97.5 15.4
100.0 *

190.2 29.4
162.0 98.1 23.3 100.0 8.6

39.7 25.3
* 45.9
* *

* * * 26.6 * *

46.5 37.2
* 54.5
* *

* * * 33.7 * *

32.1 * *
41.9 * *

28.1 20.2
8.1 40.3
* *

17.0

13.1

16.3

12.4

16.6

15.1

5.1

3.1

4.2

*

4.3

3.7

*

*

2.3

*

*

1.0

17.8

13.0

16.0

10.6

15.1

14.7

*

*

*

*

*

1.2

3.2

2.7

3.7

28.2

*

7.4

38.0 40.0 43.4
5.2 9.9 5.1 16.8

37.8 37.1 49.2
4.8 15.5
3.6 13.8

36.0 39.6 46.1 3.5 13.9 5.3 19.8

37.6 38.4 43.2
2.6 15.2
4.0 8.6

41.2 43.5 41.4 5.9 11.4 2.7 14.6

38.1 39.6 44.9
4.4 13.1
4.2 15.0

.

*

2.9

3.1

2.6

2.2

.

*

*

*

*

0.8

.

2.7

18.5

14.1

12.7

12.0

64.8 15.9 20.8 65.5 48.0 37.8
.

57.7 19.5
* 78.9 68.4 61.7
5.5

57.9 16.0
* 72.6 77.8 63.7 17.0

67.5 19.1 32.0 80.3 77.8 68.2 28.8

69.9

63.3

15.9

17.3

31.0

20.9

73.7

73.8

75.8

68.1

63.4

57.7

31.7

19.5

295

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Forsyth County - 058

1990
44083 10808
928
23.9 19.4 21.0
52 6
712 36 97 58
9 143 15
6 4 2 13 5 1
46 7 0
58 6 9
128 36 175 11 104
7 17
. . .
575 76 10 194 137 110
. 0

1991
45799 11036
945
22.8 19.5 21.0
60 10 705 44 98 70
5 169
15
3 2 1 7 5 8
41 8 0
50 4
12
90 50 172
3 96 13 16
9 27 32
559 70 14
238 180 160
51 9

Total
1992 1993

47514 11262
961

49232 11488
977

24.6 21.3 22.0

25.1 20.7 21.0

68

66

7

12

790

821

50

47

107

114

68

48

4

5

170

172

19

16

1

3

1

2

0

1

6

7

0

2

4

2

49

46

5

9

0

1

55

50

14

9

7

8

166

166

52

45

151

152

4

6

106

93

9

8

22

19

27

43

45

41

135

114

646

716

82

94

19

17

254

246

211

243

185

194

85

87

4

1

1994 5-year

50941 11715
994

237569 56309
4804

25.1 19.0 22.0

24.3 20.0 21.0

80

326

16

51

857

3885

54

231

120

536

59

303

3

26

173

827

26

91

6

19

6

15

0

4

9

42

1

13

6

21

50

232

11

40

1

2

62

275

9

42

10

46

198

748

48

231

139

789

2

26

130

529

9

46

19

93

23

102

18

131

69

350

757

3253

90

412

35

95

228

1160

247

1018

184

833

118

341

0

14

1990
43573 10688
925

1991
45155 10906
941

White
1992 1993

46737 11122
957

48321 11338
973

1994 5-year

49900 11555
989

233686 55609
4784

23.9 19.4 21.0

22.8 19.5 21.0

24.7 21.0 21.0

25.0 20.8 21.0

25.0 19.0 22.0

24.3 19.9 21.0

52

59

67

65

80

323

6

10

7

12

16

51

709

701

786

817

850

3863

36

44

49

47

54

230

97

98

105

113

120

533

52

68

68

47

59

294

9

5

3

5

3

25

137

159

160

168

167

791

15

14

19

15

26

89

6

3

1

3

6

19

4

2

1

2

6

15

2

1

0

1

0

4

13

7

5

7

9

41

5

5

0

2

1

13

1

8

4

2

6

21

46

41

49

46

50

232

7

8

5

9

11

40

0

0

0

1

1

2

58

50

55

50

61

274

6

4

14

9

9

42

8

12

7

8

10

45

127

90

165

165

196

743

35

50

52

44

48

229

175

172

150

151

139

787

11

3

4

6

2

26

104

96

105

92

130

527

7

13

9

8

9

46

17

15

22

18

19

91

.

0

7

41

23

71

.

0

19

40

18

77

.

0

38

104

67

209

574

556

644

713

751

3238

76

70

81

93

89

409

10

14

19

17

35

95

194

238

252

245

228

1157

137

180

209

242

247

1015

110

160

183

193

184

830

.

51

84

86

118

339

0

9

4

1

0

14

1990
14 4 0

1991
15 4 0

Black
1992 1993

15

16

4

4

0

0

1994 5-year

16

75

4

20

0

0

.

.

16.1

.

21.6

29.0

.

.

22.0

.

.

16.1

.

20.1

23.8

.

33.0

27.5

0

0

1

0

0

1

0

0

0

0

0

0

1

0

1

1

3

6

0

0

1

0

0

1

0

0

1

1

0

2

0

0

0

1

0

1

0

0

1

0

0

1

3

2

4

1

4

14

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

2

0

0

0

1

0

1

0

0

1

1

0

2

0

0

0

0

0

0

0

0

0

1

0

1

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

1

0

0

1

3

5

0

0

0

1

0

1

0

0

0

0

0

0

0

0

1

1

0

2

0

0

1

1

0

2

0

0

1

1

0

2

.

0

0

1

0

1

0

0

0

0

0

0

296

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Forsyth County - 058

16.2 65.9
2.0 13.8
3.2 13.2
0.4 154.4
6.6
56.0 11.5 38.8 50.0 16.2 100.0
*
8.4 * *
18.0 1.8 *
6.5 1.0
* 8.3 0.8 1.3
30.7 5.1
25.0 1.6
14.9 1.0 4.6
. . .
81.8 11.9 15.4 27.5 19.4 15.6
.

15.4 63.9
2.0 14.0
3.7 15.3
0.5 177.7
7.0
63.5 16.7 46.6 59.1 15.9 93.3
*
* * * 9.9 1.7 1.0
5.8 1.1
* 7.1
* 1.7
21.0 7.1
24.8 *
13.8 1.9 4.4
0.8 2.3 2.7
80.3 11.0 21.9 34.0 25.7 22.9
7.3

16.6 70.1 2.2 13.8 3.6 15.1 0.5 164.6 6.5
70.8 10.3 52.1 46.9 19.8 94.7
*
* * * 7.6 * *
6.2 0.6
* 7.1 1.8 0.9
31.4 6.7 20.3
* 13.8 1.2 5.7
2.2 3.7 11.1
83.1 11.8 23.2 32.8 27.3 23.9 11.0

16.7 71.5
2.2 14.0
3.5 15.0
0.5 164.3
4.7
67.6 18.2 48.1 48.9 16.4 93.8
*
* * * 8.5 * *
5.6 1.1
* 6.2 1.1 1.0
26.8 5.5
19.7 0.7
11.5 1.0 4.6
3.4 3.3 9.1
88.1 12.5 27.9 30.3 29.9 23.9 10.7

16.8 73.2 2.3 14.2 3.4 14.8 0.5 158.1 5.5
80.5 20.0 54.3 53.7 26.2 100.0
*
7.0 7.0
* 10.5
* *
5.8 1.3
* 7.3 1.1 1.2
24.1 5.7 16.7
* 15.5 1.1 4.5
1.8 1.4 5.4
88.5 11.8 39.8 26.9 29.1 21.7 13.9

16.4 69.0
2.1 14.0
3.5 14.7
0.5 163.7
6.0
67.9 15.6 48.1 51.7 18.9 96.7
1.7
4.9 3.9
* 10.7
0.9 0.5
6.0 1.0
* 7.2 1.1 1.2
26.6 6.0
21.1 0.7
13.9 1.2 4.8
2.1 2.7 7.1
84.6 11.8 26.4 30.2 26.5 21.7 10.9

16.3 66.3
2.0 13.8
3.1 12.8
0.4 150.4
6.1

15.5 64.3
2.0 14.1
3.5 14.6
0.5 170.1
6.9

16.8 70.7 2.2 13.6 3.4 14.4 0.5 157.2 6.5

16.9 72.1
2.2 14.0
3.5 14.8
0.5 161.8
4.7

17.0 73.6 2.3 14.3 3.3 14.5 0.5 154.5 5.5

16.5 69.5
2.1 14.0
3.4 14.2
0.4 158.7
5.9

56.2 11.5 38.9 50.0 16.2 100.0
*

62.7 16.9 46.8 59.1 14.9 92.9
*

70.0 10.4 51.2 45.8 19.9 94.7
*

66.8 18.5 48.3 48.9 15.4 93.3
*

80.9 20.0 54.6 53.7 26.3 100.0
*

67.5 15.8 48.1 51.5 18.6 96.6
1.7

8.5

*

*

*

7.1

4.9

*

*

*

*

7.1

3.9

*

*

*

*

*

*

18.1

9.9

6.3

8.5

10.6

10.5

1.8

1.8

*

*

*

0.9

*

1.0

*

*

*

0.5

6.5

5.8

6.2

5.6

5.9

6.0

1.0

1.1

0.6

1.1

1.3

1.0

*

*

*

*

*

*

8.3

7.2

7.1

6.2

7.3

7.2

0.9

*

1.8

1.1

1.1

1.1

1.1

1.7

0.9

1.0

1.2

1.2

30.5 5.0
25.1 1.6
14.9 1.0 4.6

21.2 7.2
24.9 *
13.9 1.9 4.2

31.4 6.8 20.2
* 13.7 1.2 5.7

26.8 5.4
19.6 0.7
11.5 1.0 4.3

24.0 5.7 16.8
* 15.6 1.1 4.6

26.6 6.0
21.1 0.7
13.9 1.2 4.7

.

*

0.6

3.3

1.8

1.5

.

*

1.6

3.2

1.4

1.6

.

*

3.2

8.4

5.3

4.3

81.9 11.9 15.4 27.6 19.5 15.6
.

80.3 11.1 21.9 34.2 25.9 23.0
7.3

83.3 11.8 23.2 32.7 27.1 23.8 10.9

88.1 12.4 28.3 30.3 30.0 23.9 10.6

88.6 11.8 40.2 27.1 29.4 21.9 14.0

84.7 11.8 26.5 30.3 26.6 21.7 10.9

*

*

*

*

*

79.6

*

*

*

*

* 297.0

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

* 185.7

*

*

*

*

* 693.1

*

*

*

*

*

.

*

*

*

*

* 636.4

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

83.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

297

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Franklin County - 059

1990
16650 3586 360
19.8 20.3 20.0
34 4
260 30 60 12
1 45
4
3 2 1 3 0 2
25 1 0
23 5 5
92 38 93
3 41
6 17
. . .
176 42
5 155 100 90
. 0

1991
16912 3602 360
20.7 19.4 21.0
42 7
258 35 76 20 0 35 6
4 3 1 3 0 1
27 6 1
29 3 5
97 47 91
3 37
2 15
10 20 32
187 33 5
159 119 106
32 2

Total
1992 1993

17168 3615 358

17432 3631 358

20.9 18.7 20.5

20.6 18.1 20.0

36

36

8

8

231

259

29

28

63

73

20

15

3

2

43

40

4

7

4

1

3

1

1

0

5

3

0

0

0

0

18

26

3

2

0

0

16

28

0

1

8

5

76

78

38

39

74

82

1

2

31

37

2

2

9

8

31

23

42

19

92

67

167

202

16

35

3

3

135

146

115

132

98

114

44

8

2

2

1994 5-year

17690 3644 357

85852 18078
1792

19.8 22.0 20.0

20.3 19.0 20.0

26

174

7

34

238

1246

26

148

67

339

19

86

4

10

30

193

0

21

1

13

1

10

0

3

5

19

0

0

0

3

21

117

5

17

0

1

20

116

2

11

10

33

72

415

41

203

79

419

3

12

39

185

4

16

12

61

17

81

11

92

75

266

181

913

30

156

4

20

143

738

123

589

104

512

7

91

0

6

1990
14906 3131 301

1991
15133 3139 300

White
1992 1993

15355 3146 299

15583 3154 298

1994 5-year

15808 3161 297

76785 15731
1494

19.9 19.9 20.5

21.2 19.4 21.0

21.5 18.7 20.0

20.9 18.1 20.0

20.4 21.5 20.0

20.8 18.7 20.0

27

31

30

30

20

138

1

3

7

7

6

24

215

205

195

217

202

1034

23

25

23

23

20

114

27

36

37

38

37

175

11

15

19

14

14

73

0

0

1

2

4

7

38

31

41

33

23

166

4

6

4

6

0

20

2

2

2

1

1

8

1

1

1

1

1

5

1

1

1

0

0

3

1

1

2

3

5

12

0

0

0

0

0

0

2

1

0

0

0

3

18

14

10

17

15

74

0

3

2

1

3

9

0

0

0

0

0

0

18

18

9

16

15

76

4

1

0

1

2

8

4

1

7

3

8

23

71

67

62

58

57

315

15

19

18

16

26

94

73

65

59

67

66

330

2

0

1

1

2

6

37

34

30

32

32

165

5

1

1

1

3

11

11

8

6

4

8

37

.

8

26

16

14

64

.

19

37

15

9

80

.

11

57

53

60

181

153

165

150

177

163

808

37

27

16

27

26

133

4

4

2

2

4

16

119

114

111

117

117

578

71

82

88

101

95

437

64

71

80

88

83

386

.

22

37

7

5

71

0

2

2

2

0

6

1990
1681 436 57

1991
1708 438 57

Black
1992 1993

1733 439 57

1760 441 57

1994 5-year

1786 442 57

8668 2196
284

19.2 26.2 19.0

18.7 .
21.0

18.1 .
23.5

19.2 17.0 27.0

18.5 24.8 26.0

18.7 24.8 22.0

7

11

6

6

6

36

3

4

1

1

1

10

44

53

35

40

34

206

7

10

6

5

6

34

33

40

26

34

29

162

1

5

1

1

5

13

1

0

2

0

0

3

6

4

2

7

6

25

0

0

0

1

0

1

1

2

2

0

0

5

1

2

2

0

0

5

0

0

0

0

0

0

2

2

3

0

0

7

0

0

0

0

0

0

0

0

0

0

0

0

7

13

1

3

0

1

5

11

1

2

1

4

8

9

1

1

0

0

7

11

0

0

1

2

6

43

2

8

0

1

5

39

0

3

2

10

21

30

14

20

14

99

23

28

20

22

14

107

19

26

15

14

12

86

1

3

0

1

1

6

4

3

1

5

7

20

1

1

1

1

1

5

6

7

3

4

4

24

.

1

5

7

1

14

.

1

5

1

2

9

.

16

35

7

7

65

23

22

17

24

17

103

5

6

0

7

4

22

1

1

1

1

0

4

35

45

24

29

25

158

28

37

27

31

26

149

25

35

18

26

20

124

.

10

7

1

1

19

0

0

0

0

0

0

298

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Franklin County - 059

15.6 72.5
2.1 23.4
2.7 12.5
0.3 140.6
4.2
94.4 *
83.3 48.3
* * *
* * * * * *
9.6 * *
9.0 2.0 2.1
46.5 14.8 36.5
* 17.4
2.6 12.4
. . .
68.8 18.4 17.9 60.5 39.1 35.2
.

15.3 71.6
2.1 29.8
2.1 9.7 0.2 111.1 6.1
116.8 16.7 97.4 62.9 16.7
100.0 *
* * * * * *
10.5 2.3 *
11.4 *
2.2
46.4 18.4 35.8
* 16.7
* 12.6
2.5 5.0 8.0
73.0 13.8 31.3 62.4 46.7 41.6 12.5

13.5 63.9 1.9 27.3 2.5 11.9 0.2 144.3
6.6
100.4 22.2 80.9 58.6 * * *
* * * 21.4 * *
7.8 * *
7.0 *
3.9
43.4 16.5 32.2
* 16.7
* 7.4
7.6 10.3 22.5
73.2 7.5
* 58.4 49.8 42.4 19.0

14.9 71.3
2.1 28.3
2.3 11.0
0.2 126.2
5.0
100.6 22.2 78.3 53.6 19.6 85.7 *
* * * * * *
10.0 * *
10.9 *
2.2
39.0 15.1 31.8
* 17.1
* 6.0
5.5 4.6 16.1
78.0 14.8
* 56.6 51.2 44.2
3.1

13.5 65.3 1.9 28.5 1.7 8.2 0.2 103.1
6.3
72.9 26.9 72.9 50.0
* * *
* * * 20.7 * *
8.8 2.1
* 8.5
* 4.9
37.3 17.4 33.5
* 19.4
* 8.9
4.0 2.6 17.8
78.0 14.0
* 60.6 52.1 44.1 3.0

14.5 68.9
2.0 27.4
2.2 10.7
0.2 125.2
5.6
97.1 19.5 82.6 55.1 11.7 95.2
3.3
10.4 8.0 *
15.1 * *
9.4 1.4
* 9.4 0.9 3.0
42.6 16.4 34.0
1.0 17.5
1.5 9.4
4.9 5.6 16.2
74.2 13.8 19.0 59.7 47.7 41.4
9.3

14.4 68.7
2.0 12.8
2.5 12.1
0.3 142.9
4.2

13.5 65.3
1.9 17.6
2.0 9.9 0.2 122.5 5.4

12.7 62.0 1.9 19.0 2.7 13.0 0.3 159.5
6.7

13.9 68.8
2.1 17.6
2.1 10.5
0.2 123.6
5.4

89.7 *
76.4 31.8
* * *

103.4 *
83.4 48.0 20.0 100.0
*

100.4 23.3 76.9 47.8 * * *

100.7 23.3 77.2 43.5 20.1 83.3 *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

8.4

6.9

5.1

7.8

*

*

*

*

*

*

*

*

8.5

8.8

4.6

7.4

*

*

*

*

*

*

4.1

*

43.6 7.1
34.8 *
19.3 2.6
10.2

41.1 9.3
32.0 *
20.0 *
8.5

42.5 9.2 30.4
* 19.5
* 5.9

34.5 7.4
31.0 *
17.6 * *

.

2.3

7.5

4.5

.

5.5

10.6

4.2

.

3.2

16.4

15.0

72.2 19.6
* 56.4 33.6 30.3
.

80.9 14.0
* 55.9 40.2 34.8 10.8

77.7 8.9 *
56.9 45.1 41.0 19.0

81.6 13.6
* 54.2 46.8 40.7
3.2

12.8 63.9 1.9 18.6 1.5
7.3 0.1 94.7 5.7

13.5 65.7
2.0 17.1
2.2 10.6
0.2 129.1
5.5

67.4 30.0 67.4 35.0
* * *

92.4 17.4 76.3 41.6 13.4 95.0
3.3

* * * 24.3 * *

7.7 4.8
* 11.5
* *

7.4

7.2

*

0.9

*

*

7.6

7.4

*

0.8

4.7

2.6

35.2 13.0 33.0
* 19.0
* 7.0

39.3 9.2
32.3 0.6
19.1 1.3 7.0

3.9 2.5 16.7

4.6 5.7 12.9

83.2 14.4
* 58.5 47.5 41.5 2.5

79.1 14.1 18.8 56.3 42.6 37.6
8.7

26.2 100.9
2.7 75.0
3.6 13.8
* 115.4
*

31.0 121.1
3.3 78.4
* * * * 11.4

20.2 79.7 2.2 74.3
* * * * *

22.7 90.7
2.6 85.0
4.0 15.9
* 145.8
*

19.0 76.9 2.2 85.3 3.4 13.6 0.3 133.3 11.3

23.8 93.8
2.6 79.4
2.9 11.4
0.2 101.2
7.3

122.8 *
122.8 100.0
* * *

193.3 *
175.7 100.0
* * *

105.8 *
105.8 100.0
* * *

105.8 *
88.2 100.0
* * *

106.2 *
106.2 100.0
* * *

126.8 27.8 119.8
100.0 * * *

*

*

*

*

*

24.3

*

*

*

*

*

24.3

*

*

*

*

*

*

*

*

*

*

*

33.5

*

*

*

*

*

*

*

*

*

*

*

*

15.9 * *
11.4 * *

24.5 * *
21.6 * *

22.9 * *
20.0 * *

22.5 * *
27.5 * *

17.6 * *
14.7 * *

20.9 3.9 *
19.1 *
5.2

61.8 52.3 43.2
* * * 21.4

65.2 54.9 51.0
* * * 28.0

50.0 57.1 42.9
* * * *

64.5 55.0 35.0
* 15.2
* *

48.3 41.2 35.3
* 22.6
* *

58.9 52.5 42.2
3.0 10.6
2.7 20.9

.

*

8.6

11.8

*

6.0

.

*

8.6

*

*

3.8

.

27.9

60.1

11.8

11.6

27.7

53.5 13.2
* 79.5 63.6 56.8
.

42.3 13.0
* 88.2 72.5 68.6 19.6

50.0 * *
68.6 77.1 51.4 20.0

60.0 19.4
* 72.5 77.5 65.0
*

50.0

50.7

*

12.0

*

*

73.5

77.5

76.5

73.0

58.8

60.8

*

11.9

299

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Fulton County - 060

1990
648951 172947 12097
23.2 21.4 25.0
1922 649
11912 1275 6055 996 186 7727 573
176 113 63 298 23 49
1283 270 30
1531 154 146
1978 3737 2727
702 1386
567 724
. . .
7336 1436
351 5331 4651 3497
. 35

1991
655727 172614
12122
23.1 21.6 26.0
1835 633 11810 1249 6029 1043 208 7626 511
156 93 63
299 28 48
1292 259
24 1485 154 173
1875 3736 2779 627 1222 476 746
107 58
748
7702 1440 341 6101 5296 4368
343 77

Total
1992 1993

662502 172280 12146

669282 171947
12171

23.2 21.8 26.0

23.5 21.9 26.0

1848 670
11699 1214 6032 1134 170 7716 565

1921 601 12296 1331 6248 954 161 7593 523

131

147

87

97

44

50

256

259

13

27

55

53

1311 271 28
1499 163 124

1316 309
33 1489 173
90

2056 3639 2814
584 1005
399 770

2448 3683 2961 454 984 386 742

434 172 3124

419 194 2819

7806 1416
340 5606 5702 4328
748 44

8978 1496 355 6214 6696 5243 1373
73

1994 5-year
676054 3312516 171614 861402
12195 60730

24.0 22.1 26.0

23.4 21.8 26.0

1770 570
11895 1222 5715 921 149 7064 505

9296 3123 59612 6291 30079 5048
874 37726
2677

128

738

70

460

58

278

215

1327

32

123

28

233

1171 230 22
1321 183 85

6373 1339
137 7325
827 618

3203 3371 2783
258 989 414 669

11560 18166 14064
2625 5586 2242 3651

337 118 2178

1297 542
8869

9270 1440
324 5591 5850 4557 1885
51

41092 7228 1711
28843 28195 21993
4349 280

White
1990 1991 1992 1993 1994 5-year

309901 78224 4220

314101 78458 4245

318297 78690 4269

322498 78924 4293

326696 1591493 79158 393454 4317 21344

27.6 23.3 25.0

27.7 23.1 26.0

28.1 23.3 26.0

28.3 23.7 26.0

28.9 23.8 26.0

28.1 23.5 26.0

231 55 4104 132 533 363 34 2313 92

207 43
4135 124 528 377 37 2180 75

232 51
4151 134 554 408 27
2098 95

243 48
4507 147 613 404 25 2194 93

230 51
4726 140 535 410 32
2004 86

1143 248
21623 677
2763 1962
155 10789
441

30

27

19

37

18

131

18

17

12

30

8

85

12

10

7

7

10

46

52

53

40

53

42

240

3

4

5

4

7

23

6

10

12

8

2

38

210

226

238

239

265

1178

39

29

35

61

33

197

7

2

2

4

2

17

303

286

310

332

325

1556

48

48

52

61

89

298

39

47

27

28

38

179

531

465

551

674

975 3196

284

296

294

316

289

1479

572

594

596

638

653

3053

84

71

79

55

50

339

375

318

260

259

287

1499

151

100

88

81

154

574

106

111

125

113

114

569

.

8

24

29

33

94

.

10

25

37

18

90

.

66

213

271

161

711

3214 494 103 607 456 306 . 4

3360 532 111 777 573 417
22 12

3443 526 101 738 653 461 68 12

3890 552 124 858 973 648 114
13

4165 536 147 831 861 611 143 1

18072 2640 586 3811 3516 2443 347 42

Black
1990 1991 1992 1993 1994 5-year

324008 90705 7569

327391 90516 7584

330774 90327 7600

334159 90139 7615

337540 1653872 89950 451638 7630 37998

19.7 19.9 25.0

19.7 20.3 26.0

19.5 20.4 26.0

19.3 20.4 26.0

19.6 20.4 26.0

19.6 20.3 26.0

1680 589
7612 1139 5494
601 151 5127 475

1611 586 7460 1118 5476 640 168 5126 427

1607 615
7341 1079 5450
702 139 5320 463

1660 551 7561 1177 5600 527 133 5089 420

1532 516
6880 1077 5142
481 111 4834 417

8090 2857 36854 5590 27162 2951
702 25496
2202

145

128

106

108

109

596

94

75

69

65

61

364

51

53

37

43

48

232

243

243

211

201

167

1065

20

24

8

23

25

100

41

38

42

45

26

192

1059 227 23
1208 105 105

1052 230
22 1189 104 122

1053 235 26
1173 108 95

1058 243
28 1140 110
58

894

5116

196

1131

20

119

976

5686

90

517

47

427

1423 3441 2112
613 1008
415 615

1370 3423 2133 553 903 375 633

1459 3321 2175
502 740 309 636

1724 3338 2270 394 721 304 622

2149 3059 2082
205 698 259 549

8125 16582 10772
2267 4070 1662 3055

.

97

382

363

269

1111

.

47

129

152

95

423

.

673

2724

2403

1897

7697

3988 920 243
4669 4162 3173
. 30

4198 889 225 5243 4677 3914 319
65

4212 865 236
4790 4999 3827
677 31

4923 922 226 5259 5638 4530 1253
60

4873 869 170
4654 4907 3887 1727
49

22194 4465 1100
24615 24383 19331
3976 235
300

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Fulton County - 060

18.4 68.9
2.1 51.5 11.9 44.7
1.3 370.2
7.1
158.9 33.8 105.4 94.1 47.4 98.8
7.8
14.8 9.5 5.3
24.6 0.6 0.4
10.8 2.3 0.3
13.1 1.3 1.2
30.0 31.8 23.4
6.1 12.0
4.9 11.1
. . .
63.6 13.5 32.1 45.3 39.6 29.7
.

18.0 68.4
2.1 51.8 11.6 44.2
1.3 367.8
7.5
151.4 34.5
103.0 95.9 42.2 98.4 7.3
13.2 7.9 5.4
24.9 0.7 0.4
10.9 2.2 0.2
12.8 1.3 1.5
29.5 32.1 24.2
5.5 10.7
4.2 11.4
0.7 0.4 4.7
66.7 13.6 31.7 52.4 45.4 37.5
2.9

17.7 67.9 2.1 52.3 11.6 44.8 1.4 371.9 7.7
152.1 36.3
100.0 94.5 46.5 98.2 7.2
11.2 7.4 3.8
21.6 0.3 0.5
11.2 2.3 0.2
13.0 1.4 1.1
30.4 31.6 24.6
5.1 9.1 3.6 11.3
2.7 1.1 19.3
67.4 13.5 32.0 48.6 49.4 37.5
6.5

18.4 71.5
2.2 51.6 11.3 44.2
1.3 361.1
6.6
157.8 31.3
109.4 94.4 43.0 98.4 7.1
12.0 7.9 4.1
20.8 0.7 0.5
10.7 2.5 0.3
12.3 1.4 0.7
30.1 30.4 24.6
3.8 8.3 3.3 10.5
2.6 1.2 17.2
73.5 13.5 33.6 51.3 55.3 43.3 11.3

17.6 69.3 2.1 48.8 10.4 41.2 1.3 352.0 6.5
145.1 32.2
100.2 93.7 41.4 99.2 4.9
10.8 5.9 4.9
17.9 0.8 0.2
9.8 1.9 0.2 11.4 1.6 0.7
30.0 28.8 24.0
2.2 8.5 3.6 10.3
2.0 0.7 13.1
79.3 13.4 32.9 47.8 50.0 38.9 16.1

18.0 69.2
2.1 51.2 11.4 43.8
1.3 364.7
7.1
153.1 33.6 103.6 94.5 44.1 98.6
6.9
12.4 7.7 4.7
21.9 0.6 0.4
10.7 2.2 0.2
12.5 1.4 1.0
30.0 30.9 24.2
4.5 9.7 3.9 10.9
2.0 0.8 13.6
70.2 13.5 32.5 49.1 48.0 37.4
9.3

13.2 52.5
1.5 13.1
7.5 29.6
0.9 338.4
5.4

13.2 52.7
1.5 12.9
6.9 27.8
0.9 323.1
5.5

13.0 52.8 1.5 13.5 6.6 26.7 0.8 313.3 5.7

14.0 57.1
1.7 13.8
6.8 27.8
0.9 307.5
5.5

14.5 59.7 1.8 11.5
6.1 25.3 0.8 279.1 5.7

13.6 55.0
1.6 13.0
6.8 27.4
0.9 311.9
5.5

54.7 23.8 31.3 59.5 21.8 97.8
2.6

48.8 20.8 29.2 68.9 17.7 93.3
2.6

54.4 22.0 31.4 61.9 22.3 94.6
*

56.6 19.8 34.2 64.4 21.7 95.7
1.2

53.3 22.2 32.4 57.9 19.9 98.8
1.6

53.6 21.7 31.7 62.4 20.7 96.1
1.7

7.3 4.4 2.9 12.6
* 0.2

6.5 4.1 2.4 12.7
* 0.3

4.6

8.2

2.9

6.7

1.7

1.6

9.6

11.7

0.4

*

0.3

0.2

3.8

6.1

1.7

3.9

2.1

2.1

8.8

11.0

0.5

0.3

*

0.2

5.1

5.5

5.7

5.3

5.6

5.4

1.0

0.7

0.8

1.4

0.7

0.9

0.2

*

*

*

*

0.1

7.5

7.0

7.6

7.5

7.0

7.3

1.2

1.2

1.3

1.4

1.9

1.4

1.0

1.1

0.7

0.6

0.8

0.8

22.2 7.0
14.3 2.1 9.4 3.8 5.4

20.7 7.2
14.8 1.8 7.9 2.5 5.5

23.8 7.2 14.8 1.9 6.4 2.2 6.0

22.0 7.1
14.5 1.2 5.9 1.8 5.0

22.9 6.2
14.3 1.1 6.3 3.4 4.9

22.4 6.9
14.5 1.6 7.1 2.7 5.4

.

0.1

0.4

0.5

0.6

0.4

.

0.2

0.4

0.6

0.3

0.4

.

1.2

3.7

4.7

2.7

3.1

80.4 13.5 25.6 15.0 11.2
7.5 .

83.2 14.4 28.6 19.0 14.0 10.2
0.5

83.5 14.1 28.2 18.0 16.0 11.3 1.7

86.8 13.6 33.2 19.3 21.9 14.6
2.6

89.1 12.6 37.0 17.9 18.6 13.2
3.1

84.8 13.6 30.6 17.9 16.5 11.5
2.0

23.5 83.9
2.4 73.2 15.8 56.5
1.6 379.3
8.6

22.8 82.4
2.4 74.5 15.7 56.6
1.6 382.0
9.2

22.2 81.3 2.4 75.4 16.1 58.9 1.7 393.5 9.5

22.6 83.9
2.5 75.2 15.2 56.5
1.7 381.8
7.5

20.4 76.5 2.3 75.8 14.3 53.7 1.6 392.0 6.9

22.3 81.6
2.4 74.8 15.4 56.5
1.6 385.6
8.3

222.0 35.1 150.5 98.2 62.8 98.9 10.8

212.4 36.4
147.4 99.2 56.3 99.3 10.2

211.5 38.3
142.0 98.7 60.9 99.1 11.1

218.0 33.2
154.6 98.2 55.2 99.0 10.5

200.8 33.7
141.2 98.4 54.7 99.3 6.8

212.9 35.3
147.1 98.5 58.0 99.1 9.9

19.0 12.3
6.8 31.3
0.8 0.6

17.2 10.1
7.2 31.9
1.0 0.5

14.4 9.4 5.1 28.2 0.3 0.6

14.3 8.6 5.7
26.1 0.9 0.6

15.8 8.9 7.0 23.9 1.0 0.4

16.2 9.9 6.4
28.4 0.8 0.5

13.9 3.0 0.3
16.2 1.4 1.4

14.1 3.1 0.3
16.3 1.4 1.6

14.4 3.2 0.4 16.3 1.5 1.3

14.0 3.2 0.4
15.3 1.5 0.8

13.0 2.8 0.3 14.5 1.3 0.7

13.9 3.1 0.3
15.7 1.4 1.2

34.7 45.8 28.3
8.3 13.7
5.7 13.6

34.2 46.5 29.3
7.6 12.5
5.2 14.2

33.8 45.9 30.2 7.0 10.8 4.5 13.6

35.0 44.8 30.6
5.3 10.0
4.2 13.3

35.0 45.1 30.9 3.1 10.3 3.8 13.6

34.6 45.6 29.9
6.3 11.5
4.7 13.7

.

1.0

3.8

3.5

2.6

2.7

.

0.5

1.3

1.5

0.9

1.0

.

6.7

26.8

23.3

18.1

18.8

54.2 13.5 35.9 62.2 55.4 42.3
.

57.5 13.3 33.1 71.3 63.6 53.2
4.3

58.0 13.2 34.0 66.2 69.1 52.9
9.4

65.6 13.6 33.6 70.6 75.7 60.8 16.8

72.4

61.4

14.0

13.5

29.7

33.4

68.6

67.7

72.3

67.1

57.3

53.2

25.4

13.8

301

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Gilmer County - 061

1990
13368 2816 290
20.5 17.2 20.0
34 10 204 24 35 12
2 31
8
1 0 1 3 1 0
10 2 0
13 3 6
59 21 83
1 45
5 4
. . .
146 30
7 89 86 67
. 0

1991
13633 2848 291
21.2 18.3 20.0
22 6
224 20 34 9 3 19 2
1 0 1 3 0 1
9 0 0 23 0 3
71 19 83
2 48
6 6
3 3 7
178 25 6
117 84 77 16 0

Total
1992 1993

13896 2883 293

14156 2914 294

20.6 19.5 20.0

19.7 22.2 19.0

20

35

3

11

204

213

18

32

43

43

8

8

3

1

28

24

2

3

1

1

0

0

1

1

4

1

0

0

3

1

13

14

0

2

0

0

10

9

5

1

5

4

62

65

27

25

73

80

0

2

34

35

2

2

9

13

15

17

18

16

18

17

158

163

22

23

2

5

99

125

98

116

80

97

44

56

0

0

1994 5-year

14415 2948 296

69468 14409
1465

20.5 19.9 19.0

20.6 18.7 20.0

23

134

3

33

201

1046

22

116

41

196

7

44

3

12

29

131

1

16

0

4

0

0

0

4

3

14

2

3

1

6

13

59

2

6

1

1

12

67

2

11

3

21

61

318

16

108

74

393

2

7

40

202

4

19

2

34

12

47

22

59

42

84

157

802

26

126

5

25

107

537

111

495

85

406

63

179

0

0

1990
13258 2801 290

1991
13516 2831 291

White
1992 1993

13772 2862 292

14027 2891 293

1994 5-year

14280 2922 294

68853 14307
1459

20.5 17.2 19.0

21.2 18.5 20.0

20.6 19.5 19.5

19.5 22.2 19.0

20.5 19.9 19.0

20.6 18.8 19.0

34

21

20

35

23

133

10

6

3

11

3

33

204

223

202

212

200

1041

24

20

18

32

22

116

35

34

43

43

41

196

11

9

8

8

7

43

2

3

3

1

3

12

31

18

25

24

29

127

8

1

2

3

1

15

1

1

1

1

0

4

0

0

0

0

0

0

1

1

1

1

0

4

3

3

4

1

3

14

1

0

0

0

2

3

0

1

3

1

1

6

10

9

12

14

13

58

2

0

0

2

2

6

0

0

0

0

1

1

13

23

9

9

12

66

3

0

5

1

2

11

6

3

5

4

3

21

59

71

61

65

61

317

21

18

27

25

16

107

83

83

73

80

74

393

1

2

0

2

2

7

45

47

34

35

40

201

5

6

2

2

4

19

4

5

9

13

2

33

.

3

12

11

10

36

.

2

14

15

21

52

.

3

15

17

42

77

146

178

157

163

156

800

30

25

22

23

25

125

7

6

2

5

5

25

89

116

99

125

107

536

86

84

98

116

111

495

67

77

80

97

85

406

.

16

44

56

63

179

0

0

0

0

0

0

1990
37 0 0

1991
38 0 0

Black
1992 1993

39

39

0

0

0

0

1994 5-year

40

192

0

0

0

0

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

29.0

29.0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

0

1

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

0

0

0

0

0

0

302

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

15.3

General fertility rate

72.4

Total fertility rate

2.2

% Livebirths to unmarried women

17.4

Crude abortion rate

2.3

General abortion rate

11.0

Total abortion rate

0.3

Abortion ratio

124.5

Fetal Death rate

5.0

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

117.2

% Repeat conceptions to women under 18

29.4

Livebirths to women under 18

82.8

% Livebirths to unmarried women under 18

25.0

Induced abortions to women under 18

27.6

% Abortions to unmarried women under 18

100.0

Fetal deaths to women under 18

*

Infant and child survival rates

Infant mortality

*

Neonatal mortality

*

Postneonatal mortality

*

Perinatal mortality ratio

*

Deaths of children 1-4 yrs

*

Deaths of children 5-17 yrs

*

Infant health rates

% Low birthweight

4.9

% Very low birthweight

*

% Under 500 grams

*

% Preterm gestation

6.5

% Multiple gestation

*

% Birth defect

2.9

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

34.9

% with father not named on birth certificate

10.4

% with maternal education less than high school

41.5

% No prenatal care

*

% Maternal smoking during pregnancy

22.7

% Maternal alcohol use during pregnancy

2.6

% Interpregnancy interval less than 6 months

*

Child abuse and neglect rates

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

% Prenatal care first trimester

71.9

% Primary C-section delivery

16.8

% Vaginal birth after previous C-section

31.8

% WIC during pregnancy

44.3

% Medicaid during pregnancy

42.8

% Medicaid and WIC during pregnancy

33.3

% Perinatal case management

.

Gilmer County - 061

16.4 78.7
2.4 15.2
1.4 6.7 0.2 73.6 5.3

14.7 70.8 2.2 21.6 2.0 9.7 0.2 114.8 4.2

15.0 73.1
2.3 20.4
1.7 8.2 0.2 97.2 3.4

13.9 68.2 2.1 20.6 2.0 9.8 0.3 120.3 3.7

15.1 72.6
2.2 19.0
1.9 9.1 0.3 105.7 4.3

75.5 27.3 68.7 35.0
* * *

68.2 *
61.4 66.7
* * *

118.9 31.4
108.7 59.4 * * *

77.7 *
74.3 57.1
* * *

91.5 24.6 79.2 48.7 10.9 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

13.2

*

*

*

*

*

*

*

*

*

0.5

4.0

6.4

6.6

6.5

5.6

*

*

*

*

0.6

*

*

*

*

*

10.3

5.0

4.2

6.0

6.5

*

2.5

*

*

1.1

*

2.5

*

*

2.0

36.6 8.5
37.4 *
21.8 2.8 5.4

35.2 13.6 38.0
* 17.6
* 8.2

34.4 11.8 37.9
* 17.2
* 11.1

33.3 8.0 37.9
* 20.6
* *

34.9 10.4 38.5
0.7 20.0
1.9 6.2

*

4.3

4.8

3.3

3.3

*

5.2

4.5

6.1

4.2

2.0

5.2

4.8

11.7

6.0

80.9 12.4 26.1 52.2 37.5 34.4
7.1

83.2 12.6
* 49.7 49.2 40.2 22.1

81.9 12.2 20.8 59.0 54.7 45.8 26.4

82.2 14.8 21.7 53.8 55.8 42.7 31.7

80.0 13.7 21.4 51.9 47.8 39.2 21.5

15.4 72.8
2.2 17.4
2.3 11.1
0.3 125.0
4.6
117.2 29.4 82.8 25.0 27.6 100.0
*
* * * * * *
4.9 * *
6.5 *
2.9
34.9 10.4 41.5
* 22.7
2.6 *
. . .
71.9 16.8 31.8 44.3 42.8 33.3
.

16.5 78.8
2.4 15.2
1.3 6.4 0.2 70.3 5.3

14.7 70.6 2.2 21.8 1.8 8.7 0.2 104.6 4.2

15.1 73.3
2.3 20.5
1.7 8.3 0.2 97.6 3.5

14.0 68.4 2.1 20.7 2.0 9.9 0.3 120.8 3.8

15.1 72.8
2.3 19.0
1.8 8.9 0.2 103.3 4.3

72.3 28.6 68.8 35.0
* * *

68.5 *
61.7 66.7
* * *

119.7 31.4
109.4 59.4 * * *

78.3 *
74.9 57.1
* * *

91.2 24.8 79.5 48.7 10.3 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

13.3

*

*

*

*

*

*

*

*

*

0.5

4.0

5.9

6.6

6.5

5.6

*

*

*

*

0.6

*

*

*

*

*

10.4

4.6

4.3

6.1

6.4

*

2.5

*

*

1.1

*

2.5

*

*

2.0

36.8 8.1
37.6 *
21.5 2.8 4.5

35.1 13.7 38.4
* 17.8
* 8.3

34.6 11.8 37.9
* 17.2
* 11.1

33.5 8.1
38.1 *
20.7 * *

35.0 10.4 38.7
0.7 20.0
1.9 6.1

*

3.5

3.1

2.8

2.6

*

4.0

4.3

5.9

3.7

*

4.3

4.8

11.7

5.5

81.3 12.5 26.1 52.0 37.7 34.5
7.2

83.5 12.8
* 50.3 49.7 40.6 22.3

81.9 12.3 20.8 59.2 55.0 46.0 26.5

82.1 14.3 21.7 54.0 56.1 42.9 31.8

80.1 13.7 21.4 52.0 48.1 39.4 21.6

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

303

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Glascock County - 062

1990
2357 489 42
22.6 15.6 19.0
2 0 22 1 7 2 1 1 1
1 0 1 1 0 1
2 0 0 3 0 1
14 3 3 0 3 0 0
. . .
20 2 0
12 10
9 . 0

1991
2371 492
43
23.1 15.5 20.0
4 2 30 3 8 3 0 2 1
2 2 0 2 0 0
4 2 0 4 1 2
17 2
12 0 3 0 1
2 0 6
27 2 0
15 10 10
1 0

Total
1992 1993

2381 492 44

2398 495
45

21.6 26.7 19.0

21.0 26.6 19.5

2

4

1

1

23

34

1

4

4

8

3

4

0

0

4

5

1

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

1

1

0

0

0

1

1

1

0

0

5

17

3

1

5

9

0

0

2

1

0

0

1

2

0

2

0

1

6

4

19

29

6

4

0

1

7

17

9

18

3

15

0

3

0

0

1994 5-year

2409 496 46

11916 2464 220

20.6 18.5 19.0

21.6 18.5 19.0

7

19

1

5

33

142

5

14

15

42

2

14

1

2

6

18

2

5

0

3

0

2

0

1

1

4

0

0

0

1

2

10

0

4

0

0

3

11

0

3

0

3

13

66

6

15

9

38

0

0

10

19

0

0

0

4

0

4

2

3

3

19

30

125

3

17

1

2

21

72

21

68

18

55

3

7

0

0

1990
2055 411 38

1991
2073 415
39

White
1992 1993

2085 416 40

2106 419
41

1994 5-year

2118 420 41

10437 2081 199

22.6 15.6 19.0

22.2 15.5 20.0

21.6 26.7 19.0

22.3 26.6 19.0

20.6 17.9 19.0

21.6 17.9 19.0

1

3

1

4

6

15

0

1

1

1

1

4

14

23

18

28

24

107

0

2

0

4

4

10

1

1

1

4

9

16

2

2

3

4

2

13

1

0

0

0

1

2

1

2

4

3

3

13

1

1

1

0

2

5

0

2

0

0

0

2

0

2

0

0

0

2

0

0

0

0

0

0

1

2

0

0

1

4

0

0

0

0

0

0

1

0

0

0

0

1

1

4

1

0

1

7

0

2

1

0

0

3

0

0

0

0

0

0

2

4

0

0

2

8

0

1

1

1

0

3

1

2

0

0

0

3

6

11

0

0

1

7

0

0

2

3

0

0

0

0

2

12

1

1

2

7

0

0

2

1

0

0

0

1

8

39

2

4

6

23

0

0

8

16

0

0

0

1

.

0

0

1

0

1

.

0

0

1

1

2

.

3

6

3

1

13

13

21

14

24

22

94

1

2

6

4

3

16

0

0

0

1

0

1

5

8

4

12

12

41

4

4

6

13

13

40

4

4

2

11

10

31

.

1

0

1

0

2

0

0

0

0

0

0

1990
298 74
3

1991
300 74 3

Black
1992 1993

301

303

74

74

3

3

1994 5-year

305

1507

74

370

3

16

22.2 .
26.0

26.1 .
22.0

20.7 .
0.0

19.8 .
27.0

20.5 19.1 19.0

21.5 19.1 22.0

1

1

1

0

1

4

0

1

0

0

0

1

8

7

5

6

9

35

1

1

1

0

1

4

6

7

3

4

6

26

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

2

2

4

0

0

0

0

0

0

1

0

0

0

0

1

0

0

0

0

0

0

1

0

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

1

3

0

0

0

1

0

1

0

0

0

0

0

0

1

0

0

1

1

3

0

0

0

0

0

0

0

0

0

0

0

0

8

6

3

5

5

27

3

2

2

0

4

11

2

5

3

2

3

15

0

0

0

0

0

0

1

0

0

0

2

3

0

0

0

0

0

0

0

1

1

1

0

3

.

0

0

1

0

1

.

0

0

0

0

0

.

0

0

1

2

3

7

6

5

5

8

31

1

0

0

0

0

1

0

0

0

0

1

1

7

7

3

5

9

31

6

6

3

5

8

28

5

6

1

4

8

24

.

0

0

2

3

5

0

0

0

0

0

0

304

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

9.3

12.7

9.7

14.2

13.7

11.9

General fertility rate

45.0

61.0

46.7

68.7

66.5

57.6

Total fertility rate

1.4

1.9

1.4

2.1

2.1

1.8

% Livebirths to unmarried women

31.8

27.6

*

24.2

45.5

30.2

Crude abortion rate

*

*

*

2.1

2.5

1.5

General abortion rate

*

*

*

10.1

12.1

7.3

Total abortion rate

*

*

*

0.3

0.4

0.2

Abortion ratio

*

*

* 116.3 142.9 102.3

Fetal Death rate

*

*

*

*

*

6.5

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

*

*

*

* 152.5

86.4

% Repeat conceptions to women under 18

*

*

*

*

*

26.3

Livebirths to women under 18

*

*

*

* 108.9

63.6

% Livebirths to unmarried women under 18

*

*

*

*

*

71.4

Induced abortions to women under 18

*

*

*

*

*

22.7

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

*

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

*

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

*

*

*

*

*

7.0

% Very low birthweight

*

*

*

*

*

*

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

*

*

*

*

*

7.9

% Multiple gestation

*

*

*

*

*

*

% Birth defect

*

*

*

*

*

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

63.6

60.7

25.0

51.5

41.9

49.3

% with father not named on birth certificate

*

*

*

*

18.2

10.8

% with maternal education less than high school

*

42.9

22.7

27.3

27.3

27.7

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

*

*

*

*

30.3

13.7

% Maternal alcohol use during pregnancy

*

*

*

*

*

*

% Interpregnancy interval less than 6 months

*

*

*

*

*

*

Child abuse and neglect rates

Physical

.

*

*

*

*

*

Sexual

.

*

*

*

*

*

Neglect

.

10.9

10.9

*

*

8.7

Interventions to improve infant & child survival

% Prenatal care first trimester

90.9

90.0

86.4

85.3

90.9

88.7

% Primary C-section delivery

*

*

30.0

*

*

13.5

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

54.5

51.7

31.8

51.5

63.6

51.8

% Medicaid during pregnancy

45.5

34.5

40.9

54.5

63.6

48.9

% Medicaid and WIC during pregnancy

40.9

34.5

*

45.5

54.5

39.6

% Perinatal case management

.

*

*

*

*

6.0

Glascock County - 062

6.8 34.1
1.1 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
42.9 * * * * * *
. . .
92.9 * *
35.7 * * .

11.1 55.4
1.8 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
52.4 *
33.3 * * * *
* * *
91.3 * *
36.4 * * *

8.6 43.3 1.4
* * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* * 12.6
82.4 40.0
* * 35.3 * *

13.3 66.8
2.1 * * * * * *

11.3 57.1 1.8 37.5
* * * * *

* 144.9

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

44.4 *
25.9 * * * *

34.8 *
25.0 *
33.3 * *

*

*

*

*

*

*

85.7 * *
44.4 48.1 40.7
*

91.7 * *
50.0 54.2 41.7
*

10.3 51.4
1.6 15.4
1.2 6.2 0.2 96.3 7.2
75.4 *
50.3 60.0 25.1
* *
* * * * * *
6.5 * *
7.7 * *
39.0 *
22.3 *
15.4 * *
* * 6.8
88.7 16.8
* 39.4 38.5 29.8
*

26.8 108.1
3.1 75.0
* * * * *

23.3 94.3
2.7 100.0
* * * * *

16.6 67.6 2.4
* * * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

100.0

85.7

*

*

*

*

*

71.4

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

.

*

*

.

*

*

87.5 * *
87.5 75.0 62.5
.

85.7 * *
100.0 85.7 85.7 *

100.0 * * * * * *

19.8 81.1
2.3 * * * * * *

29.5 121.8
3.0 66.7
* * * * *

23.2 94.6
2.7 74.3
* * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

83.3 * * * * * *

62.5 * * * * * *

79.4 31.4 44.1
* * * *

*

*

*

*

*

*

*

*

*

83.3

88.9

88.6

*

*

*

*

*

*

83.3 100.0

88.6

83.3

88.9

80.0

*

88.9

68.6

*

*

18.5

305

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Glynn County - 063

1990
62496 14365
1298
21.1 19.1 22.0
119 23 1024 105 359 26 16 55
8
12 7 5
23 3 7
106 15
2 116 11 30
270 194 271 24 210 34 50
. . .
668 203 16 521 393 355
. 1

1991
63253 14374
1306
20.1 19.4 22.0
133 32
958 116 362
59 8
47 8
17 5
12 13
3 3
97 22
0 123
11 25
278 183 278
24 186
34 52
12 18 89
576 143
16 544 469 408
34 7

Total
1992 1993

64010 14382
1313

64762 14389
1321

20.8 19.4 22.0

20.4 19.4 22.0

104

138

26

32

975

932

98

125

370

364

8

10

3

7

45

49

6

10

11

11

7

9

4

2

10

16

3

5

3

3

89

88

12

18

0

4

109

106

9

15

22

12

257

246

186

181

254

252

15

13

164

150

33

25

50

42

55

36

40

15

287

230

639

614

158

148

16

20

556

534

526

499

460

432

340

323

2

11

1994 5-year

65519 14397
1328

320040 71907
6565

19.7 16.5 23.0

20.3 19.3 22.0

143

637

28

141

912

4801

133

577

387

1842

5

108

6

40

47

243

12

44

9

60

7

35

2

25

13

75

1

15

4

20

91

471

14

81

3

9

89

543

15

61

13

102

265

1316

154

898

244

1299

10

86

151

861

19

145

43

237

42

145

18

91

204

810

641

3138

127

779

20

88

522

2677

513

2400

438

2093

329

1026

5

26

1990
45989 10313
851

1991
46583 10302
853

White
1992 1993

47181 10292
855

47773 10279
857

1994 5-year

48371 10269
859

235897 51455
4275

21.8 19.1 21.0

21.1 21.7 22.0

22.1 20.0 22.0

22.2 19.5 22.0

21.1 15.4 23.0

21.7 19.7 22.0

67

66

56

62

62

313

11

16

14

13

13

67

673

593

617

604

574

3061

61

57

50

55

55

278

125

119

129

121

141

635

12

39

2

6

2

61

6

4

0

1

4

15

43

34

34

34

26

171

6

6

6

6

7

31

8

9

10

6

6

39

5

3

6

4

4

22

3

6

4

2

2

17

11

7

6

4

8

36

2

3

3

3

1

12

5

1

0

2

3

11

47

37

43

50

48

225

9

7

4

6

8

34

0

0

0

0

1

1

60

62

57

59

50

288

7

4

5

12

8

36

16

11

14

8

9

58

149

148

133

140

150

720

78

65

69

56

61

329

172

164

157

149

128

770

10

12

6

9

3

40

162

146

129

128

118

683

19

22

19

18

11

89

23

24

23

22

15

107

.

5

25

24

23

77

.

0

25

10

14

49

.

34

153

131

110

428

511

418

444

440

448

2261

145

95

107

97

80

524

10

10

13

16

11

60

269

270

270

267

254

1330

190

229

262

250

249

1180

171

193

222

203

202

991

.

15

155

151

157

478

0

3

2

8

5

18

1990
15941 3884 435

1991
16134 3884 438

Black
1992 1993

16327 3884 440

16519 3884 443

1994 5-year

16712 3884
445

81633 19419
2200

19.0 20.1 23.0

18.5 18.5 22.5

19.4 18.9 24.0

18.5 15.5 24.0

18.1 17.2 24.0

18.6 18.1 23.5

52

67

48

75

81

323

12

16

12

19

15

74

345

358

351

319

333

1706

44

59

48

69

78

298

234

243

240

241

244

1202

14

20

6

4

2

46

10

4

3

6

2

25

12

13

9

15

20

69

2

2

0

4

5

13

4

8

1

5

3

21

2

2

1

5

3

13

2

6

0

0

0

8

12

6

4

11

5

38

1

0

0

2

0

3

2

2

3

1

1

9

59

59

46

38

43

245

6

15

8

12

6

47

2

0

0

4

2

8

56

61

52

46

39

254

4

7

4

3

7

25

14

14

8

4

4

44

121

129

123

105

113

591

116

118

117

124

93

568

98

113

95

101

113

520

14

12

9

4

7

46

47

40

34

21

33

175

15

12

14

7

8

56

26

28

27

20

28

129

.

5

29

9

18

61

.

3

11

5

3

22

.

49

102

80

86

317

152

152

188

169

191

852

58

47

51

50

46

252

6

6

3

4

9

28

251

271

282

264

266

1334

202

239

261

246

262

1210

183

214

235

227

234

1093

.

19

182

170

171

542

1

3

0

3

0

7

306

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

16.4

15.1

15.2

14.4

13.9

15.0

General fertility rate

71.3

66.6

67.8

64.8

63.3

66.8

Total fertility rate

2.2

2.1

2.1

2.0

2.0

2.1

% Livebirths to unmarried women

35.5

38.2

38.3

39.7

43.1

38.9

Crude abortion rate

0.9

0.7

0.7

0.8

0.7

0.8

General abortion rate

3.8

3.3

3.1

3.4

3.3

3.4

Total abortion rate

0.1

0.1

0.1

0.1

0.1

0.1

Abortion ratio

49.1

43.8

43.6

49.1

48.5

46.8

Fetal Death rate

2.9

4.7

0.8

1.2

0.8

2.1

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

91.7 101.9

79.2 104.5 107.7

97.0

% Repeat conceptions to women under 18

19.3

24.1

25.0

23.2

19.6

22.1

Livebirths to women under 18

80.9

88.9

74.6

94.7 100.1

87.9

% Livebirths to unmarried women under 18

68.9

76.7

76.5

82.3

86.9

78.8

Induced abortions to women under 18

6.2

6.1

4.6

7.6

9.0

6.7

% Abortions to unmarried women under 18

100.0

87.5

83.3 100.0

91.7

93.2

Fetal deaths to women under 18

6.2

7.7

*

*

*

3.5

Infant and child survival rates

Infant mortality

11.7

17.7

11.3

11.8

9.9

12.5

Neonatal mortality

6.8

5.2

7.2

9.7

7.7

7.3

Postneonatal mortality

4.9

12.6

*

*

*

5.2

Perinatal mortality ratio

22.1

13.5

10.2

17.0

14.2

15.5

Deaths of children 1-4 yrs

*

*

*

1.3

*

0.8

Deaths of children 5-17 yrs

0.6

*

*

*

*

0.3

Infant health rates

% Low birthweight

10.4

10.1

9.1

9.4

10.0

9.8

% Very low birthweight

1.5

2.3

1.2

1.9

1.5

1.7

% Under 500 grams

*

*

*

*

*

0.2

% Preterm gestation

11.5

13.0

11.3

11.6

9.9

11.5

% Multiple gestation

1.1

1.2

0.9

1.6

1.7

1.3

% Birth defect

3.0

2.6

2.3

1.3

1.5

2.2

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

28.8

32.2

28.8

28.6

31.4

29.9

% with father not named on birth certificate

19.2

19.3

19.3

19.8

17.2

18.9

% with maternal education less than high school

27.0

29.7

26.4

27.5

27.3

27.6

% No prenatal care

2.4

2.5

1.6

1.4

1.1

1.8

% Maternal smoking during pregnancy

21.0

19.9

17.3

16.7

17.1

18.5

% Maternal alcohol use during pregnancy

3.4

3.6

3.5

2.8

2.2

3.1

% Interpregnancy interval less than 6 months

8.9

9.6

9.2

8.3

9.1

9.0

Child abuse and neglect rates

Physical

.

0.7

3.3

2.1

2.5

2.2

Sexual

.

1.1

2.4

0.9

1.1

1.4

Neglect

.

5.4

17.3

13.7

12.0

12.1

Interventions to improve infant & child survival

% Prenatal care first trimester

65.4

60.3

65.7

66.0

70.4

65.5

% Primary C-section delivery

22.8

17.4

19.4

18.9

16.0

19.0

% Vaginal birth after previous C-section

13.1

12.7

10.6

15.3

19.0

13.9

% WIC during pregnancy

51.4

57.4

57.6

58.3

58.2

56.5

% Medicaid during pregnancy

38.8

49.5

54.5

54.5

57.2

50.6

% Medicaid and WIC during pregnancy

35.0

43.1

47.6

47.2

48.8

44.2

% Perinatal case management

.

3.6

35.2

35.3

36.7

27.5

Glynn County - 063

14.6 65.3
2.0 18.8
0.9 4.2 0.1 58.6 1.7
78.7 16.4 71.7 51.7
7.1 100.0
*
11.9 7.4 *
16.2 * *
7.0 1.3
* 9.0 1.1 2.4
23.6 11.7 25.9
1.5 24.7
2.9 6.9
. . .
76.0 24.5 13.5 40.4 28.5 25.7
.

12.7 57.6
1.8 20.2
0.7 3.3 0.1 50.7 4.2
77.4 24.2 66.8 61.4
7.0 83.3
*
15.2 *
10.2 11.7
* *
6.2 1.2
* 10.5
* 1.9
27.1 11.0 28.0
2.0 25.3
3.8 7.5
0.5 *
3.2
70.7 18.6 13.0 45.8 38.9 32.8
2.5

13.1 59.9 1.9 21.1 0.7 3.3 0.1 52.1
*

12.6 58.8
1.9 20.5
0.7 3.3 0.1 52.7 0.7

65.5 25.0 58.5 60.0 7.0 83.3
*

72.4 21.0 64.2 60.0
7.0 100.0
*

16.2

9.9

9.7

*

*

*

.

*

*

*

*

*

7.0

8.3

*

1.0

*

*

9.3

10.0

0.8

2.0

2.3

1.4

23.0 11.3 25.7 1.0 21.5 3.2
7.0

25.1 9.5
25.2 1.5
22.3 3.1 6.9

2.3 2.3 14.2

2.2 0.9 12.1

72.1 20.7 13.7 44.1 42.8 36.3 25.3

72.8 19.3 18.0 45.2 42.3 34.3 25.5

11.9 55.9 1.8 24.9 0.5 2.5 0.1 42.9 0.6
72.2 21.0 64.0 70.4 8.1 85.7
*
10.5 * *
13.8 * *
8.4 1.4
* 8.8 1.4 1.6
27.9 10.8 22.7
* 21.3 2.0
5.1
2.1 1.3 10.0
78.3 16.2 15.5 44.9 44.0 35.7 27.7

13.0 59.5
1.9 21.0
0.7 3.3 0.1 51.7 1.5
73.2 21.4 65.0 60.5
7.3 90.3
1.4
12.7 7.2 5.6
11.7 1.0 0.3
7.4 1.1
* 9.5 1.2 1.9
25.3 10.9 25.5
1.3 23.1
3.0 6.7
1.8 1.1 9.9
74.0 20.0 14.8 44.0 39.0 32.8 20.3

21.6 88.8
2.6 68.6
0.8 3.1 0.1 31.5 6.2

22.2 92.2
2.7 69.2
0.8 3.3 0.1 32.8 6.4

21.5 90.4 2.6 69.2 0.6 2.3 0.1 24.4 2.3

19.3 82.1
2.4 76.3
0.9 3.9 0.1 43.6 2.6

19.9 85.7 2.5 74.8 1.2 5.1 0.2 56.0
*

20.9 87.9
2.5 71.5
0.8 3.6 0.1 37.4 3.7

119.5 23.1 101.1 93.0
* * 16.1

153.1 23.9
134.9 91.5 * * 16.0

109.1 25.0
109.1 93.8 * * *

169.5 25.3
155.9 100.0
* * *

182.0 18.5
175.2 98.7 11.2
100.0 *

146.8 22.9
135.4 95.9 5.9 100.0 7.7

* * * 33.8 * *

22.3 *
16.9 16.6
* *

*

15.7

*

12.3

*

15.7

*

7.6

*

*

*

4.7

*

33.8

14.9

22.0

*

*

*

*

*

*

*

0.4

17.1 1.7 *
16.4 *
4.1

16.5 4.2 *
17.4 2.0 3.9

13.1 2.3
* 15.0
* 2.3

11.9 3.8 *
14.6 * *

12.9 1.8
* 12.0 2.1
*

14.4 2.8 0.5
15.1 1.5 2.6

40.3 34.0 29.2
4.1 13.8
4.4 11.5

41.3 33.6 32.9
3.4 11.5
3.4 12.8

39.8 33.7 27.5 2.6 10.0 4.1 12.7

35.8 39.2 32.1
* 6.7 2.2 11.0

37.4 28.5 34.9 2.1 10.2 2.5 16.4

39.0 33.8 31.3
2.7 10.5
3.4 12.8

.

0.9

5.1

1.6

3.1

2.7

.

*

1.9

0.9

*

1.0

.

8.7

17.8

13.8

14.7

13.8

44.2 19.8 12.5 73.6 59.2 53.7
.

42.5 15.6 12.2 77.2 68.1 61.0
5.4

53.7 17.5
* 81.3 75.2 67.7 52.4

53.1 18.2
* 83.5 77.8 71.8 53.8

57.4

50.0

15.7

17.3

27.3

12.3

81.6

79.4

80.4

72.0

71.8

65.0

52.5

40.4

307

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Gordon County - 064

1990
35072 8226 834
20.1 19.8 19.0
87 18 624 73 152 44
4 92 10
7 5 2 9 2 2
58 8 1
60 10
9
159 80 221
5 173 12 19
. . .
433 128
7 248 169 147
. 0

1991
35903 8344 835
20.4 17.8 20.0
84 21 565 67 112 46
7 104
15
4 2 2 9 0 3
52 8 1
53 6 8
158 52
213 9
138 14 18
1 7 11
373 117
8 269 198 174
10 1

Total
1992 1993

36733 8460 834

37561 8577 835

20.6 19.9 20.0

20.4 18.8 20.0

82

89

22

17

557

567

67

77

132

131

37

19

4

6

91

81

12

11

4

4

2

3

2

1

6

8

0

2

4

3

23

40

3

5

0

0

29

39

2

6

8

26

162

198

67

52

199

208

5

6

136

131

5

6

26

19

21

23

18

31

60

56

375

432

102

103

6

5

268

299

235

276

193

225

23

90

0

0

1994 5-year

38385 8693 834

183654 42300 4171

20.8 19.0 20.0

20.4 19.1 20.0

75

417

9

87

541

2854

58

342

133

660

21

167

9

30

86

454

17

65

3

22

2

14

1

8

11

43

0

4

5

17

31

204

4

28

0

2

31

212

5

29

3

54

179

856

58

309

187

1028

3

28

109

687

4

41

15

97

30

75

15

71

80

207

427

2040

78

528

6

32

278

1362

277

1155

222

961

134

257

0

1

1990
33487 7826 789

1991
34279 7943 790

White
1992 1993

35071 8059 790

35863 8176 790

1994 5-year

36652 8292 790

175352 40296 3949

20.1 19.5 19.0

20.2 17.8 19.0

20.6 19.9 20.0

20.3 19.0 20.0

20.8 18.8 20.0

20.4 19.0 20.0

81

80

77

87

71

396

17

20

22

16

9

84

577

536

532

542

513

2700

68

65

65

76

54

328

115

95

118

114

117

559

41

45

35

18

21

160

4

7

4

6

7

28

82

87

78

71

80

398

10

13

10

10

17

60

6

4

3

3

3

19

4

2

2

3

2

13

2

2

1

0

1

6

8

9

6

8

9

40

2

0

0

2

0

4

2

3

4

3

4

16

54

46

22

37

29

188

6

7

3

4

4

24

1

1

0

0

0

2

53

48

25

36

29

191

9

5

2

6

4

26

9

8

8

24

2

51

146

150

150

184

171

801

64

44

59

47

53

267

207

207

193

204

179

990

4

8

5

6

3

26

163

136

135

130

107

671

11

12

4

6

4

37

18

17

26

17

13

91

.

1

18

19

25

63

.

7

15

29

14

65

.

9

49

53

74

185

402

355

361

418

410

1946

120

108

99

99

73

499

6

8

6

5

5

30

218

253

249

282

257

1259

144

186

220

257

258

1065

126

165

180

209

206

886

.

10

22

86

126

244

0

1

0

0

0

1

1990
1321 334 39

1991
1352 339
39

Black
1992 1993

1384 343 39

1415 347
39

1994 5-year

1446 352 39

6917 1714
195

18.7 23.5 19.0

22.1 17.9 28.0

17.0 21.0 25.0

21.7 16.3 22.0

19.4 24.2 27.0

19.9 19.7 25.0

6

3

4

2

4

19

1

1

0

1

0

3

46

25

19

22

23

135

5

2

2

1

4

14

37

17

14

17

15

100

3

0

2

1

0

6

0

0

0

0

2

2

7

12

10

8

5

42

0

1

1

1

0

3

1

0

1

1

0

3

1

0

0

0

0

1

0

0

1

1

0

2

1

0

0

0

2

3

0

0

0

0

0

0

0

0

0

0

1

1

4

6

1

3

2

16

2

1

0

1

0

4

0

0

0

0

0

0

7

4

3

1

1

16

1

1

0

0

1

3

0

0

0

2

1

3

12

6

8

12

7

45

16

8

8

5

3

40

14

6

6

4

7

37

1

1

0

0

0

2

10

2

1

1

1

15

1

2

1

0

0

4

1

1

0

2

2

6

.

0

1

0

4

5

.

0

1

1

0

2

.

0

1

1

3

5

31

14

10

12

17

84

8

9

1

4

5

27

1

0

0

0

1

2

30

15

14

16

17

92

25

11

11

17

14

78

21

8

9

15

12

65

.

0

1

4

6

11

0

0

0

0

0

0

308

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Gordon County - 064

17.8 75.9
2.3 24.8
2.6 11.2
0.3 119.9
6.2
104.3 20.7 87.5 46.6 12.0 90.0
7.2
11.2 8.0 *
14.3 * *
9.3 1.3
* 9.8 1.6 1.4
28.6 13.0 36.5
0.8 28.5
2.0 5.9
. . .
69.6 24.1
8.4 40.4 27.5 23.9
.

15.7 67.7
2.0 20.0
2.9 12.5
0.2 143.4
6.7
100.6 25.0 80.3 40.3 18.0 93.3 6.0
* * * 15.7 * *
9.2 1.4
* 9.5 1.1 1.4
30.8 9.3
38.5 1.6
25.1 2.6 6.3
* 0.7 1.1
66.7 23.9 11.4 48.1 35.4 31.1
1.8

15.2 65.8 2.0 23.8 2.5 10.8 0.3 132.1 4.8
98.3 26.8 80.3 53.7 14.4 100.0 9.6
* * * 10.7 * *
4.1 * *
5.3 *
1.4
32.2 12.1 36.4 0.9 24.9 0.9 9.0
2.1 1.8 6.0
68.9 21.0 8.8 48.4 42.4 34.8
4.2

15.1 66.1
2.1 23.4
2.2 9.4 0.3 120.0 3.1
106.6 19.1 92.3 49.4 13.2
100.0 *
* * * 14.0 * *
7.1 0.9
* 7.0 1.1 4.6
37.9 9.3
38.0 1.1
23.8 1.1 7.1
2.2 3.0 5.5
77.4 20.9
7.5 53.4 49.3 40.2 16.1

14.1 62.2 1.9 24.8 2.2 9.9 0.3 130.7 3.6
89.9 12.0 69.5 52.6 20.4 100.0
*
* * * 20.0 * 0.7
5.7 * *
5.8 0.9
*
35.4 10.8 35.6
* 21.0
* 5.2
2.9 1.4 7.6
81.0 16.9 8.1 51.9 51.7 41.4 25.0

15.5 67.5
2.1 23.4
2.5 10.7
0.3 129.2
4.9
100.0 20.9 82.0 48.4 15.6 96.9
5.5
7.7 4.9 2.8 14.9
* 0.5
7.2 1.0
* 7.5 1.0 1.9
32.9 10.9 37.0
1.0 24.8
1.5 6.7
1.9 1.8 5.1
72.6 21.5
8.8 48.2 40.9 34.0 11.6

17.2 73.7
2.2 20.3
2.4 10.5
0.2 116.0
6.1

15.6 67.5
2.0 17.9
2.5 11.0
0.2 128.3
6.9

15.2 66.0 2.0 22.3 2.2 9.7 0.2 120.2 4.8

15.1 66.3
2.1 21.3
2.0 8.7 0.3 111.1 3.2

14.0 61.9 1.9 23.0 2.2
9.6 0.3 128.6 3.5

15.4 67.0
2.1 20.9
2.3 9.9 0.3 120.8 4.9

102.7 21.0 86.2 42.6 12.7 90.0
*

101.3 25.0 82.3 38.5 16.5 92.3 6.3

97.5 28.6 82.3 52.3 12.7 100.0 8.9

110.1 18.4 96.2 48.7 12.7
100.0 *

89.9 12.7 68.3 49.1 21.5 100.0
*

100.3 21.2 83.1 46.2 15.2 96.7
5.1

10.4 * *
13.8 * *

* * * 16.6 * *

* * * 11.2 * *

* * * 14.6 * *

* * * 17.3 * *

7.0 4.8 2.2 14.7
* 0.5

9.4

8.6

4.1

6.8

5.7

7.0

1.0

1.3

*

*

*

0.9

*

*

*

*

*

*

9.3

9.1

4.7

6.7

5.7

7.2

1.6

0.9

*

1.1

*

1.0

1.6

1.5

1.5

4.5

*

1.9

28.1 11.3 37.0
* 29.0
2.0 6.1

30.5 8.3
39.2 1.5
26.1 2.3 6.3

31.0 11.2 36.8 1.0 25.9
* 9.5

36.8 8.8
39.0 1.1
24.6 1.1 6.8

35.6 10.4 35.9
* 21.7
* 4.8

32.4 10.0 37.6
1.0 25.6
1.4 6.7

.

*

1.9

2.0

2.5

1.6

.

0.8

1.6

3.0

1.4

1.7

.

1.0

5.2

5.5

7.5

4.8

69.7 24.5
7.7 38.4 25.4 22.2
.

66.7 23.2 12.1 47.6 35.0 31.1
1.9

69.4 21.3 9.4 47.1 41.6 34.0
4.2

78.4 20.9
8.2 52.7 48.0 39.1 16.1

82.2 16.4 7.8 50.5 50.7 40.5 24.8

73.1 21.3
9.0 47.1 39.9 33.2 11.6

34.8 137.7
3.9 82.2
5.3 21.0
0.6 125.0
*
153.8 *
128.2 100.0
* * *
* * * * * *
* * * 15.6 * *
34.3 35.6 31.1
* 22.7
* *
. . .
70.5 20.0
* 66.7 55.6 46.7
.

18.5 73.9
2.1 70.8
8.9 35.5
0.8 . *

13.7 55.4 1.5 73.7 7.2 29.2 0.8 322.6
*

15.6 63.3
1.9 77.3
5.7 23.0
0.6 258.1
*

15.9 65.4 2.0 68.2 3.5 14.2 0.4 166.7
*

19.5 78.7
2.3 75.8
6.1 24.5
0.6 227.0
4.7

*

*

*

*

97.4

*

*

*

*

*

*

*

*

*

71.8

*

*

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

24.0

*

*

*

11.9

*

*

*

*

*

*

*

*

*

*

*

*

*

*

12.2

*

*

*

*

*

*

*

*

*

*

33.3 33.3 26.1
* * * *

61.5 42.1 33.3
* * * *

57.1 22.7
* * * * *

33.3 *
31.8 * * * *

41.7 30.3 28.5
* 11.5
* 7.6

*

*

*

*

2.7

*

*

*

*

*

*

*

*

*

2.7

60.9

55.6

54.5

73.9

64.6

42.9

*

*

41.7

25.7

*

*

*

*

*

62.5

73.7

72.7

77.3

69.7

45.8

57.9

77.3

63.6

59.1

33.3

47.4

68.2

54.5

49.2

*

*

*

27.3

12.6

309

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Grady County - 065

1990
20279 4509 505
18.9 14.8 21.0
45 12 316 44 128 14
6 3 1
5 2 3 9 0 1
31 3 0
24 5 9
123 62 106
3 43
7 20
. . .
231 41
7 177 163 137
. 0

1991
20421 4523 501
20.1 .
20.0
51 12 322 51 132 19
1 1 0
5 3 2 3 0 2
26 3 0
28 3
10
140 54
104 3
49 10 19
8 11 27
236 48 8
181 166 146
21 3

Total
1992 1993

20556 4540 498

20698 4554 494

20.5 19.5 20.0

20.1 22.7 21.0

31

42

10

10

285

266

28

40

107

112

28

24

1

3

2

2

0

0

2

2

2

1

0

1

3

4

0

0

1

0

21

21

1

2

0

1

32

30

1

1

9

4

111

95

57

48

103

89

3

2

45

39

8

7

10

14

19

21

32

43

68

45

208

208

47

52

6

6

154

158

159

183

123

145

16

81

0

1

1994 5-year

20839 4571 491

102793 22697 2490

19.7 18.7 22.0

19.8 19.0 21.0

47

216

10

54

290

1479

44

207

123

602

19

104

2

13

5

13

0

1

4

18

4

12

0

6

5

24

0

0

1

5

25

124

6

15

1

2

25

139

5

15

4

36

96

565

52

273

103

505

2

13

37

213

4

36

10

73

33

81

26

112

78

218

236

1119

46

234

6

33

183

853

178

849

152

703

119

237

3

7

1990
13664 2908 287

1991
13750 2909 284

White
1992 1993

13827 2908 281

13909 2909 278

1994 5-year

13990 2911 275

69140 14545
1406

19.7 .
20.0

22.3 .
20.0

21.1 .
20.0

21.6 22.7 21.0

20.3 18.6 21.0

21.0 20.6 20.0

17

17

15

16

22

87

7

3

4

2

4

20

155

168

178

148

171

820

18

16

14

16

20

84

28

25

32

25

41

151

6

11

16

12

12

57

4

1

1

0

2

8

1

1

1

2

1

6

0

0

0

0

0

0

3

2

2

2

2

11

1

1

2

1

2

7

2

1

0

1

0

4

5

2

3

1

4

15

0

0

0

0

0

0

1

1

1

0

1

4

8

13

7

6

11

45

0

1

1

1

1

4

0

0

0

0

0

0

6

17

20

12

15

70

3

1

0

0

3

7

2

6

3

4

1

16

51

67

64

43

46

271

12

11

19

12

19

73

44

40

62

38

51

235

0

1

2

0

1

4

28

30

33

29

28

148

1

3

1

3

2

10

10

4

4

5

5

28

.

3

8

10

14

35

.

10

21

29

11

71

.

11

37

23

30

101

129

141

141

130

149

690

23

22

26

27

27

125

4

4

6

5

4

23

57

62

81

67

86

353

54

52

78

80

84

348

42

45

59

59

71

276

.

4

10

24

55

93

0

2

0

1

2

5

1990
6395 1571
213

1991
6440 1574 211

Black
1992 1993

6482 1579
210

6527 1582 209

1994 5-year

6572 1586
207

32416 7891 1050

18.0 14.8 26.0

18.4 .
21.0

19.7 19.5 27.0

18.3 .
25.0

19.0 19.0 26.5

18.4 19.0 25.0

28

34

16

26

25

129

5

9

6

8

6

34

161

154

107

118

119

659

26

35

14

24

24

123

100

107

75

87

82

451

8

8

12

12

7

47

2

0

0

3

0

5

2

0

1

0

4

7

1

0

0

0

0

1

2

3

0

0

2

7

1

2

0

0

2

5

1

1

0

0

0

2

4

1

0

3

1

9

0

0

0

0

0

0

0

1

0

0

0

1

23

13

14

15

14

79

3

2

0

1

5

11

0

0

0

1

1

2

18

11

12

18

10

69

2

2

1

1

2

8

7

4

6

0

3

20

72

73

47

52

50

294

50

43

38

36

33

200

62

64

41

51

52

270

3

2

1

2

1

9

15

19

12

10

9

65

6

7

7

4

2

26

10

15

6

9

5

45

.

5

11

9

14

39

.

1

11

14

14

40

.

4

27

8

32

71

102

95

18

26

3

4

120

119

109

114

95

101

.

17

0

1

67

78

21

25

0

1

73

91

81

103

64

86

6

57

0

0

87

429

19

109

2

10

97

500

94

501

81

427

64

144

0

1

310

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

15.6

15.8

13.9

12.9

13.9

14.4

General fertility rate

70.1

71.2

62.8

58.4

63.4

65.2

Total fertility rate

2.1

2.1

1.9

1.8

1.9

1.9

% Livebirths to unmarried women

41.0

41.4

37.7

42.3

43.3

41.1

Crude abortion rate

*

*

*

*

0.2

0.1

General abortion rate

*

*

*

*

1.1

0.6

Total abortion rate

*

*

*

*

*

0.0

Abortion ratio

*

*

*

*

15.8

8.1

Fetal Death rate

4.9

4.4

6.6

6.1

4.6

5.3

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

89.1 101.7

62.2

85.0

95.7

86.7

% Repeat conceptions to women under 18

26.7

23.5

32.3

23.8

21.3

25.0

Livebirths to women under 18

87.1 101.7

56.2

80.9

89.6

83.1

% Livebirths to unmarried women under 18

78.6

81.6

71.4

80.0

81.8

79.3

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

6.4

Infant and child survival rates

Infant mortality

15.8

15.5

*

*

*

12.2

Neonatal mortality

*

*

*

*

*

8.1

Postneonatal mortality

*

*

*

*

*

4.1

Perinatal mortality ratio

28.0

*

*

*

17.1

16.1

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

9.8

8.1

7.4

7.9

8.6

8.4

% Very low birthweight

*

*

*

*

2.1

1.0

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

7.7

8.8

11.3

11.3

8.8

9.5

% Multiple gestation

1.6

*

*

*

1.8

1.0

% Birth defect

2.9

3.4

3.4

*

*

2.6

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

41.3

48.3

42.9

37.8

36.2

41.5

% with father not named on birth certificate

19.9

16.9

20.1

18.1

18.2

18.6

% with maternal education less than high school

34.1

32.7

36.3

33.6

36.5

34.6

% No prenatal care

*

*

*

*

*

0.9

% Maternal smoking during pregnancy

14.3

16.7

16.9

15.4

13.8

15.4

% Maternal alcohol use during pregnancy

2.3

3.4

3.0

2.8

*

2.6

% Interpregnancy interval less than 6 months

10.3

10.9

5.8

9.3

7.0

8.7

Child abuse and neglect rates

Physical

.

1.4

3.3

3.7

5.7

3.5

Sexual

.

1.9

5.6

7.5

4.5

4.9

Neglect

.

4.7

11.8

7.8

13.5

9.5

Interventions to improve infant & child survival

% Prenatal care first trimester

73.1

73.8

73.2

78.2

81.7

75.9

% Primary C-section delivery

14.8

16.2

18.0

22.1

18.0

17.7

% Vaginal birth after previous C-section

20.0

34.8

26.1

20.0

20.7

23.6

% WIC during pregnancy

56.7

56.7

54.2

59.6

64.2

58.2

% Medicaid during pregnancy

52.2

52.0

56.0

69.1

62.5

58.0

% Medicaid and WIC during pregnancy

43.9

45.8

43.3

54.7

53.3

48.0

% Perinatal case management

.

6.6

5.6

30.6

41.8

20.6

Grady County - 065

11.3 53.3
1.7 18.4
* * * * 4.1
59.2 41.2 62.7 52.9
* * *
* * * 31.4 * *
5.2 * *
3.9 * *
35.2 7.9
28.9 *
19.2 *
11.2
. . .
83.2 18.0
* 37.5 35.5 27.6
.

12.2 57.8
1.8 15.0
* * * * 4.1
59.8 *
56.3 46.7
* * *
* * * * * *
7.7 * *
10.2 *
4.1
46.5 6.6
24.0 *
20.7 * *
* 2.9 3.2
84.9 14.5
* 37.1 31.1 26.9
*

12.9 61.2 1.9 18.0
* * * * 5.8
53.4 *
49.8 50.0
* * *
* * * * * *
3.9 * *
11.2 * *
40.8 10.7 34.8
* 20.5
* *
2.4 6.2 10.9
79.7 16.0 40.0 45.5 43.8 33.1
5.6

10.6 50.9
1.6 16.9
* * * * 4.1
57.5 *
57.5 62.5
* * *
* * * * * *
4.1 * *
8.1 * *
31.2 8.1
25.7 *
20.7 *
6.1
2.9 8.5 6.8
87.8 20.5 31.3 45.3 54.1 39.9 16.2

12.2 58.7 1.8 24.4
* * * * 4.8
79.9 *
72.6 60.0
* * *
* * * * * *
6.4 * *
8.9 * *
30.1 11.3 30.5
* 18.1
* 6.3
4.1 3.2 8.8
87.1 17.9
* 51.2 50.0 42.3 32.7

11.9 56.4
1.8 18.6
0.1 0.4 0.0 6.7 4.6
61.9 23.0 59.8 54.9
* * 5.0
13.4 8.5 *
18.1 * *
5.5 * *
8.6 0.9 2.1
36.8 9.0
28.9 *
19.8 1.3 6.3
2.6 5.2 7.4
84.5 17.2 26.4 43.4 42.8 33.9 14.1

25.2 102.5
2.8 62.5
* * * * 6.4

23.9 97.8
2.6 70.4
* * * * 5.1

131.5 17.9
122.1 96.0
* * *

160.8 26.5
165.6 97.1 * * *

*

*

*

*

*

*

*

*

*

*

*

*

14.3

8.4

*

*

*

*

11.3

7.2

*

*

4.5

*

47.1 31.3 39.0
* 9.7 3.9 9.5

50.0 28.3 42.4
* 12.8
4.7 17.6

.

2.2

.

*

.

*

63.4 12.1
* 75.0 68.1 59.4
.

61.7 18.1
* 78.3 75.0 66.4 11.2

16.5 67.8 1.9 70.8
* * * * 8.2

18.1 74.6
2.0 74.4
* * * * 10.1

18.1 75.0 2.0 70.7
* * * * 4.4

20.3 83.5
2.3 69.3
0.2 0.9 0.0 9.7 6.8

76.2 37.5 66.6 92.9
* * *

124.7 30.8
115.1 91.7 * * *

120.7 24.0
115.8 100.0
* * *

122.8 26.4 117.1 95.9
* * 8.6

*

*

*

10.6

*

*

*

7.6

*

*

*

*

*

*

*

13.6

*

*

*

*

*

*

*

*

13.1 * *
11.3 *
5.7

12.7 * *
15.4 * *

11.8 4.2
* 8.5
* *

12.0 1.7 *
10.6 1.2 3.1

46.1 35.8 38.7
* 11.4
6.7 8.6

46.0 30.8 43.6
* 8.8
* 13.2

44.6 28.2 45.2
* 7.9
* 7.9

47.0 30.7 41.7
1.4 10.2
4.1 11.5

4.9

4.0

6.2

4.3

4.9

6.2

6.2

4.4

11.9

3.5

14.1

7.8

62.6

66.1

73.7

65.2

21.4

24.3

18.1

18.2

*

*

*

18.9

68.9

77.8

82.9

76.7

76.4

88.0

80.3

76.8

60.4

73.5

69.2

65.5

5.7

48.7

54.7

29.3

311

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Greene County - 066

1990
11793 2547 307
19.8 17.8 20.5
42 8
238 33 120
6 3 42 9
2 1 1 4 1 0
24 3 0
17 4 1
73 61 80
7 51
4 13
. . .
141 23
1 145 82 75
. 0

1991
11897 2566 311
19.1 18.5 22.0
41 13 195 33 106
5 3 49 8
3 0 3 3 2 1
15 1 0
20 0 0
69 39 83
1 50
2 10
8 1 21
96 24
1 139 114 107
27 5

Total
1992 1993

12000 2585 314

12103 2604 318

22.2 19.3 23.5

20.5 17.8 23.0

23

35

8

9

165

194

18

27

93

104

3

4

2

2

35

42

6

8

3

2

3

1

0

1

5

3

0

0

2

1

13

18

3

2

2

0

23

15

2

3

4

2

47

59

34

41

50

69

5

2

19

43

4

5

10

10

16

6

4

4

78

89

98

98

12

21

4

2

104

129

92

139

74

120

62

100

0

0

1994 5-year

12204 2623 322

59997 12925
1571

19.3 19.1 22.0

20.0 18.2 22.0

28

169

6

44

180

972

26

137

104

527

2

20

5

15

33

201

2

33

5

15

1

6

4

9

6

21

0

3

0

4

20

90

2

11

0

2

19

94

1

10

6

13

55

303

47

222

57

339

2

17

17

180

3

18

14

57

18

48

11

20

93

281

111

544

28

108

0

8

115

632

125

552

107

483

93

282

1

6

1990
5860 1128
123

1991
5948 1136
123

White
1992 1993

6036 1145
123

6120 1152
123

1994 5-year

6205 1160
123

30169 5721 615

21.1 17.2 19.0

20.7 18.9 21.0

24.2 20.1 23.5

22.2 17.8 22.0

21.7 19.6 19.0

22.0 18.4 21.0

13

12

2

8

3

38

1

6

0

0

0

7

93

57

64

77

60

351

10

6

1

2

3

22

22

12

12

13

9

68

2

2

3

1

0

8

1

2

1

0

2

6

15

24

12

17

15

83

3

6

1

6

0

16

0

0

0

2

1

3

0

0

0

1

0

1

0

0

0

1

1

2

1

2

1

1

2

7

0

0

0

0

0

0

0

1

2

0

0

3

2

3

0

3

4

12

1

0

0

1

1

3

0

0

0

0

0

0

3

4

6

4

7

24

0

0

0

1

0

1

0

0

2

2

2

6

26

16

15

26

15

98

10

4

7

5

4

30

31

19

14

18

12

94

0

0

2

1

0

3

21

23

12

21

12

89

1

1

0

3

0

5

2

1

2

3

5

13

.

2

7

1

8

18

.

1

3

2

7

13

.

4

15

17

17

53

70

39

54

49

43

255

10

8

5

11

3

37

1

0

2

1

0

4

33

22

26

31

20

132

16

21

21

33

23

114

13

18

16

25

20

92

.

3

14

18

16

51

0

0

0

0

0

0

1990
5887 1408
183

1991
5939 1419 185

Black
1992 1993

5990 1429
187

6042 1440 189

1994 5-year

6092 1450
192

29950 7145 937

18.9 17.9 23.5

18.9 17.3 28.0

20.6 17.6 24.0

18.5 17.8 25.0

18.9 18.7 24.0

19.0 17.9 24.0

29

29

21

27

25

131

7

7

8

9

6

37

143

137

101

117

119

617

23

27

17

25

23

115

98

94

81

91

95

459

3

3

0

3

2

11

2

1

1

2

3

9

27

25

23

25

18

118

6

2

5

2

2

17

2

3

3

0

4

12

1

0

3

0

1

5

1

3

0

0

3

7

3

1

4

2

4

14

1

2

0

0

0

3

0

0

0

1

0

1

21

12

13

15

16

77

2

1

3

1

1

8

0

0

2

0

0

2

14

16

17

11

12

70

3

0

2

2

1

8

1

0

2

0

4

7

47

52

32

33

39

203

51

35

27

36

43

192

49

63

36

51

45

244

7

1

3

1

2

14

30

27

7

22

5

91

3

1

4

2

3

13

11

9

8

7

9

44

.

6

9

5

8

28

.

0

1

1

4

6

.

17

63

65

76

221

70

57

13

16

0

1

111

117

66

93

62

89

.

24

0

5

44

49

67

287

7

10

25

71

2

1

0

4

78

98

94

498

71

106

101

437

58

95

86

390

48

82

76

230

0

0

1

6

312

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Greene County - 066

20.2 93.4
2.9 51.3
3.6 16.5
0.5 143.3
5.1
136.8 19.0 107.5 84.8 29.3 100.0
*
* * * * * *
10.1 * *
7.3 * *
36.3 26.1 34.3
3.0 21.8
* 9.2
. . .
61.0 10.5
* 62.0 35.0 32.1
.

16.4 76.0
2.3 54.4
4.1 19.1
0.6 192.2
4.3
131.9 31.7
106.2 81.8 25.7 75.0 *
* * * * * *
7.7 * *
10.4 * *
41.8 20.0 42.8
* 25.9
* 8.4
2.2 *
5.8
58.9 13.2
* 71.3 58.5 54.9 13.8

13.8 63.8 1.9 57.1 2.9 13.5 0.4 170.7 1.9
73.2 34.8 57.3 94.1 19.1 100.0
*
* * * 29.9 * *
7.9 * *
14.3 * *
34.3 20.9 30.9 3.5 12.1
* 11.4
4.4 *
21.6
68.5 7.9
* 63.8 56.4 45.4 38.0

16.0 74.5
2.2 54.5
3.5 16.1
0.5 173.6
2.3
110.1 25.7 85.0
100.0 25.2
100.0 *
* * * * * *
9.3 * *
7.9 * *
34.7 21.5 36.1
* 22.8
2.6 8.5
1.7 *
24.6
64.1 11.6
* 67.5 72.8 62.8 52.4

14.7 68.6 2.0 58.1 2.7 12.6 0.4 150.0 2.7
87.1 21.4 80.8 96.2
* * *
27.8 * *
32.4 * *
11.1 * *
10.6 *
3.3
35.3 26.3 32.0
* 9.5
* 14.1
5.0 3.0 25.8
77.6 17.0
* 64.2 69.8 59.8 52.0

16.2 75.2
2.3 54.8
3.4 15.6
0.5 165.4
3.2
107.6 26.0 87.2 90.4 21.0 93.9
*
15.4 6.2 9.3
21.3 * *
9.3 1.1
* 9.8 1.0 1.3
36.6 23.1 35.4
2.0 18.9
1.9 10.1
3.3 1.4 19.5
65.3 12.0 12.7 65.7 57.4 50.2 38.7

15.9 82.4
2.7 23.7
2.6 13.3
0.4 131.6
5.3

9.6 50.2
1.7 21.1
4.0 21.1
0.7 279.1
4.4

10.6 55.9 1.9 18.8 2.0 10.5 0.3 150.0
*

12.6 66.8
2.2 17.1
2.8 14.8
0.4 178.9
*

9.7 51.7 1.7 15.0 2.4 12.9 0.4 194.8
*

11.6 61.4
2.0 19.4
2.8 14.5
0.5 183.6
3.1

105.7 *
81.3 50.0
* * *

97.6 50.0 48.8
* 48.8
* *

*

65.0

*

*

*

*

*

*

*

48.8

* 100.0

*

*

*

61.8

*

18.4

*

35.8

*

45.5

*

26.0

*

87.5

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

19.6

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

3.4

*

*

*

*

*

*

*

*

*

*

*

*

*

*

9.4

*

11.7

6.9

*

*

*

*

*

*

*

*

*

*

*

1.7

31.7 10.8 33.3
* 22.6
* *

36.4 *
33.9 *
41.1 * *

26.3 10.9 21.9
* 20.3
* *

37.7 6.6
23.7 *
28.4 * *

25.9 *
20.3 *
20.0 *
15.6

31.6 8.6
27.0 *
26.0 1.5 6.7

.

*

5.0

*

5.6

3.2

.

*

*

*

4.9

2.3

.

*

10.7

12.1

12.0

9.4

76.1 11.6
* 35.5 17.2 14.0
.

70.9 15.4
* 38.6 36.8 31.6
*

90.0 8.5
* 40.6 32.8 25.0 21.9

72.1 16.2
* 40.8 43.4 32.9 23.7

81.1 * *
33.3 38.3 33.3 26.7

77.7 11.6
* 37.7 32.6 26.3 19.8

24.3 101.6
2.9 70.0
4.6 19.2
0.5 153.4
4.3

23.1 96.6
2.7 68.6
4.2 17.6
0.5 148.8
4.2

16.9 70.7 2.0 81.8 3.8 16.1 0.5 184.0
*

19.4 81.3
2.3 79.1
4.1 17.4
0.5 170.1
3.5

19.5 82.1 2.3 80.5 3.0 12.4 0.4 126.8 3.4

20.6 86.4
2.4 75.4
3.9 16.5
0.5 155.7
3.2

158.5 24.1 125.7 100.0 32.8 100.0
*

156.5 24.1
145.7 96.3 * * *

112.2 38.1 90.8
100.0 26.7
100.0 *

142.6 33.3
132.0 100.0
* * *

130.4 24.0
120.0 100.0
* * *

139.9 28.2 122.8 99.1 18.2 100.0 *

*

*

*

*

*

19.4

*

*

*

*

*

8.1

*

*

*

*

*

11.4

*

*

*

*

*

22.4

*

*

*

*

*

*

*

*

*

*

*

*

14.7 * *
10.0 * *

8.8 * *
11.9 * *

12.9 * *
17.5 * *

12.8 * *
9.6 * *

13.4 * *
10.2 * *

12.5 1.3 *
11.6 1.3 1.1

39.8 36.4 35.3
5.1 21.4
* 12.0

43.3 25.5 46.0
* 19.9
* 10.5

40.0 27.3 36.7
* 7.1
* 15.1

32.7 31.3 44.3
* 19.1
* 9.9

40.2 36.4 38.1
* 4.2
* 13.4

39.3 31.5 40.2
2.7 15.0
2.1 11.9

.

2.7

4.0

2.2

3.6

3.1

.

*

*

*

*

0.7

.

7.6

28.3

29.1

34.1

24.8

51.1 9.8 *
79.3 47.1 44.3
.

52.8 12.4
* 85.4 67.9 65.0 17.5

53.0 7.6
* 78.8 71.7 58.6 48.5

57.6 8.8 *
85.2 92.2 82.6 71.3

75.3

57.2

22.7

12.3

*

*

79.7

81.8

85.6

71.8

72.9

64.0

64.4

49.0

313

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Gwinnett County - 067

1990
352910 99591
7073
25.8 21.2 23.0
411 72 6436 218 748 490 38 2430 183
55 41 14 78 13 20
348 74
6 438 80 89
1028 363 647 86 663 181 156
. . .
5333 833 194 968 795 567 . 16

1991
370821 102819
7412
26.1 21.2 23.0
361 70
6385 186 820 535
56 2279 172
49 37 12 93 10 21
423 83 9
484 93 72
990 390 667
73 701 124 170
35 16 88
5193 882 164 1321 1031 816 305
16

Total
1992 1993

388722 106045
7750

406630 109272
8089

26.3 21.4 23.0

26.2 21.8 24.0

354 60
6495 203 868 528 44
2301 142

367 65
6767 204 955 530
51 2153 154

35

46

25

34

10

12

67

84

6

13

25

21

345

427

56

97

4

9

467

556

72

91

88

90

1197 424 660 96 704 138 140

1292 450 654
52 644
90 137

118

124

69

47

224

191

5407 777 167
1360 1201
941 551
9

5770 769 167 1707 1742 1263 733
15

1994 5-year
424535 1943618 112499 530226
8427 38750

26.7 22.1 24.0

26.2 21.5 23.0

393 70
7211 244
1052 516 49
2134 139

1886 337
33294 1055 4443 2599 238
11297 790

53

238

33

170

20

68

84

406

8

50

10

97

425

1968

95

405

9

37

595

2540

87

423

66

405

1539 471 687 49 590 120 180

6046 2098 3315
356 3302
653 783

108

385

35

167

183

686

6337 795 210
1648 1656 1249
700 22

28040 4056 902 7004 6425 4836 2289 78

White
1990 1991 1992 1993 1994 5-year

320971 89562 6497

334177 91539 6744

347377 93516 6990

360579 95492 7237

373780 1736884 97469 467578 7484 34952

25.8 20.6 23.0

26.2 20.8 23.0

26.3 21.0 23.0

26.2 21.3 23.0

26.9 21.9 23.0

26.3 21.1 23.0

355 56
5662 186 542 422 31
1874 160

306 55
5534 158 608 458
46 1689
145

289 47
5577 172 641 433 30
1637 110

298 52
5667 168 656 447
40 1472
120

302 53
6063 182 728 426 37
1468 113

1550 263
28503 866
3175 2186
184 8140
648

41

35

27

36

43

182

30

27

20

24

27

128

11

8

7

12

16

54

60

73

48

64

66

311

10

7

6

9

4

36

18

19

18

18

10

83

267

345

273

319

320

1524

46

65

45

63

66

285

2

5

4

3

7

21

357

404

384

441

476

2062

63

81

64

77

77

362

78

62

75

73

53

341

894

853

986

1055

1222

5010

254

275

308

300

310

1447

581

593

582

554

583

2893

63

57

66

37

36

259

628

668

659

601

553

3109

160

110

120

83

104

577

112

134

107

98

132

583

.

22

70

79

62

233

.

15

54

34

28

131

.

61

152

118

132

463

4779 712 173 738 648 462 . 15

4586 751 150 990 820 640 242
11

4732 663 151
1006 932 724 413 8

4922 640 138 1195 1299 912 525
13

5412 665 182
1174 1228
909 497
18

24431 3431 794 5103 4927 3647 1677 65

1990
18175 6110 315

1991
19097 6258 330

Black
1992 1993

20019 6405 345

20942 6552 360

1994 5-year

21864 6700 375

100097 32025
1726

24.3 24.0 26.0

25.2 23.8 26.0

25.5 23.2 27.0

25.9 23.2 27.0

24.9 24.0 27.0

25.2 23.7 27.0

45

42

50

60

72

269

14

13

9

11

16

63

533

540

596

696

723

3088

30

24

27

33

50

164

194

195

208

268

281

1146

47

54

65

54

64

284

4

9

10

8

10

41

374

392

428

470

460

2124

14

18

21

28

19

100

12

11

8

10

7

48

9

9

5

10

4

37

3

2

3

0

3

11

13

18

15

17

15

78

2

3

0

4

3

12

2

2

5

2

0

11

65

56

55

84

81

341

25

15

10

26

26

102

4

4

0

6

2

16

62

59

70

85

95

371

14

9

8

11

8

50

9

7

9

12

8

45

92

84

141

142

209

668

104

105

104

126

135

574

38

38

43

54

59

232

22

15

25

13

9

84

30

28

37

39

32

166

20

14

14

6

14

68

35

21

22

30

33

141

.

9

34

25

32

100

.

1

4

4

1

10

.

17

35

54

32

138

379

384

431

541

572

2307

92

85

72

89

96

434

17

6

13

22

19

77

195

251

269

361

353

1429

122

155

196

300

291

1064

89

128

163

240

250

870

.

45

103

154

142

444

1

5

0

1

1

8

314

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Gwinnett County - 067

18.2 64.6
1.9 11.8
6.9 24.4
0.8 257.9
5.6
58.1 17.5 30.8 62.7 25.9 97.8
1.8
8.5 6.4 2.2 12.0 0.5 0.3
5.4 1.1 0.1 6.9 1.3 1.4
22.2 5.7
10.3 1.4
10.6 2.9 5.1
. . .
83.7 14.7 27.6 15.2 12.5
8.9 .

17.2 62.1
1.8 13.0
6.1 22.2
0.7 245.1
6.2
48.7 19.4 25.1 67.9 23.2 98.2
1.6
7.7 5.8 1.9 14.4 0.4 0.3
6.6 1.3 0.1 7.7 1.5 1.1
22.5 6.2
10.8 1.2
11.3 2.0 5.5
0.3 0.2 0.8
82.4 15.6 25.8 21.0 16.4 13.0
4.8

16.7 61.2 1.8 13.5
5.9 21.7 0.7 245.0
5.6
45.7 16.9 26.2 69.8 18.3 95.7 1.7
5.4 3.8 1.5 10.2 0.2 0.3
5.3 0.9
* 7.3 1.1 1.4
24.9 6.6
10.5 1.5
11.1 2.2 4.3
1.1 0.6 2.1
84.7 13.4 26.6 21.2 18.7 14.7
8.6

16.6 61.9
1.9 14.3
5.3 19.7
0.6 226.3
5.5
45.4 17.7 25.2 74.8 19.0 98.6
1.6
6.8 5.0 1.8 12.3 0.5 0.3
6.3 1.4 0.1 8.3 1.4 1.3
23.8 6.7 9.9 0.8 9.8 1.4 4.1
1.1 0.4 1.7
87.0 12.7 28.1 25.6 26.1 18.9 11.0

17.0 64.1 1.9 14.8
5.0 19.0 0.6 215.1
5.1
46.6 17.8 29.0 72.1 16.5 96.4 1.7
7.3 4.6 2.8 11.6 0.3 0.1
5.9 1.3 0.1 8.4 1.2 0.9
24.3 6.6 9.8 0.7 8.7 1.8 4.9
0.9 0.3 1.5
88.9 12.2 33.1 23.1 23.2 17.5 9.8

17.1 62.8
1.9 13.5
5.8 21.3
0.7 237.6
5.6
48.7 17.9 27.2 69.5 20.4 97.4
1.7
7.1 5.1 2.1 12.1 0.4 0.3
5.9 1.2 0.1 7.7 1.3 1.2
23.6 6.4
10.3 1.1
10.3 2.0 4.8
0.9 0.4 1.5
85.5 13.7 28.2 21.3 19.6 14.7
8.6

17.6 63.2
1.9 9.7 5.8 20.9 0.7 233.8 5.3

16.6 60.5
1.8 11.2
5.1 18.5
0.6 217.5
5.9

16.1 59.6 1.8 11.6
4.7 17.5 0.6 212.7
5.1

15.7 59.3
1.8 11.7
4.1 15.4
0.5 192.7
5.2

16.2 62.2 1.9 12.2
3.9 15.1 0.5 183.5
4.8

16.4 61.0
1.8 11.3
4.7 17.4
0.6 208.1
5.3

54.6 15.8 28.6 58.4 24.6 97.5
1.8

45.4 18.0 23.4 64.7 21.5 97.9
1.8

41.3 16.3 24.6 66.1 15.7 94.5 1.6

41.2 17.4 23.2 70.7 16.6 98.3
1.8

40.4 17.5 24.3 66.5 15.1 96.4 1.3

44.3 17.0 24.8 65.2 18.5 97.0
1.7

7.2 5.3 2.0 10.5 0.4 0.3

6.3 4.9 1.5 13.1 0.3 0.3

4.8

6.4

7.1

6.4

3.6

4.2

4.5

4.5

1.3

2.1

2.7

1.9

8.6

11.2

10.8

10.8

0.3

0.4

*

0.3

0.3

0.3

0.1

0.2

4.7

6.2

4.9

5.6

5.3

5.3

0.8

1.2

0.8

1.1

1.1

1.0

*

0.1

*

*

0.1

0.1

6.4

7.4

7.0

7.9

8.0

7.3

1.1

1.5

1.2

1.4

1.3

1.3

1.4

1.1

1.3

1.3

0.9

1.2

21.5 4.5
10.5 1.1
11.4 2.9 4.1

22.0 5.0
11.1 1.1
12.5 2.1 5.0

23.7 5.6
10.7 1.2
12.1 2.2 3.8

23.0 5.4
10.0 0.7
11.0 1.5 3.5

23.1 5.2 9.9 0.6 9.7 1.8 4.3

22.7 5.1
10.4 0.9
11.3 2.1 4.1

.

0.2

0.7

0.8

0.6

0.6

.

0.2

0.6

0.3

0.3

0.3

.

0.7

1.6

1.2

1.3

1.2

85.2 14.3 27.3 13.2 11.6
8.3 .

83.9 15.4 26.7 18.2 15.0 11.7
4.4

86.2 13.3 27.8 18.3 16.9 13.1
7.5

88.4 12.5 28.3 21.4 23.2 16.3
9.4

90.1 12.2 33.5 19.6 20.5 15.2
8.3

86.8 13.5 28.7 18.1 17.5 13.0
7.4

29.3 87.2
2.4 37.5 20.6 61.2
1.6 389.6
8.7

28.3 86.3
2.3 36.7 20.5 62.6
1.7 392.0
10.9

29.8 93.1 2.5 35.4 21.4 66.8 1.8 388.0 12.3

33.2 106.2
2.8 39.1 22.4 71.7
1.9 382.1
9.8

33.1 107.9
2.9 39.3 21.0 68.7 1.9 365.4 11.3

30.9 96.4
2.6 37.7 21.2 66.3
1.8 382.6 10.6

142.9 31.1 95.2 93.3 44.4 100.0
*

127.2 31.0 72.7 91.7 54.5
100.0 *

144.9 18.0 78.2 96.3 60.9
100.0 *

166.6 18.3 91.6 96.9 77.7
100.0 *

191.8 22.2
133.2 96.0 50.6
100.0 *

155.9 23.4 95.0 95.1 57.9
100.0 4.1

22.5 16.9
* 24.2
* *

20.4 16.7
* 32.8
* *

13.4 8.4
* 24.8
* *

14.4 14.4
* 24.1
* *

9.7 * *
20.5 * *

15.5 12.0
3.6 24.9
1.5 0.6

12.2

10.4

9.2

12.1

11.2

11.0

4.7

2.8

1.7

3.7

3.6

3.3

*

*

*

0.9

*

0.5

12.0

11.1

11.9

12.4

13.3

12.2

2.7

1.7

1.4

1.6

1.1

1.6

1.7

1.3

1.5

1.7

1.1

1.5

26.8 20.1
7.4 4.3 5.9 3.9 14.4

26.1 19.7
7.3 2.9 5.4 2.7 8.1

34.4 17.7 7.5 4.3 6.4 2.4 6.9

26.9 18.4
8.0 1.9 5.8 0.9 8.4

32.3 18.9 8.4 1.3 4.6 2.0 8.8

29.7 18.9
7.8 2.8 5.6 2.3 9.1

.

1.6

5.9

4.1

5.1

4.2

.

*

*

*

*

0.4

.

3.1

6.0

8.9

5.1

5.8

71.6 19.7 34.0 37.6 23.6 17.2
.

72.0 17.4 13.6 47.2 29.1 24.1
8.5

73.8 13.7 20.6 45.7 33.3 27.7 17.5

79.4 14.5 30.6 52.7 43.8 35.0 22.5

81.0

76.1

14.7

15.8

30.2

26.4

49.3

47.0

40.6

35.0

34.9

28.6

19.8

17.6

315

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Habersham County - 068

1990
27621 5757 547
20.4 20.6 20.0
38 8
352 31 59 29
3 57
5
5 2 3 5 2 0
27 4 0
22 4 4
74 38 109
3 75
4 13
. . .
272 45
4 155 106 89
. 2

1991
27979 5772 550
21.2 20.1 21.0
49 9
385 40 69 50 1 64 5
4 4 0 5 0 1
26 2 0
30 4
10
77 46 118
5 78
1 6
9 8 32
276 46 4
192 138 123
46 0

Total
1992 1993

28333 5787 553

28690 5801 555

22.0 18.6 21.0

21.2 19.6 21.0

36

49

11

6

374

367

28

38

81

60

21

33

0

1

57

56

6

8

3

7

1

6

2

1

2

7

1

0

2

2

25

36

6

11

1

4

33

51

3

6

12

13

90

69

38

25

121

127

6

5

59

48

4

4

12

17

16

23

12

25

78

66

274

260

58

37

2

5

190

177

151

168

126

134

80

101

0

0

1994 5-year

29044 5816 558

141667 28933 2762

21.4 21.1 21.0

21.3 19.9 21.0

39

211

4

38

407

1885

33

170

97

366

32

165

2

7

47

281

3

27

2

21

1

14

1

7

3

22

0

3

2

7

33

147

2

25

0

5

39

175

2

19

5

44

102

412

54

201

125

600

1

20

50

310

1

14

13

61

25

73

8

53

120

296

325

1407

54

240

6

21

201

915

199

762

172

644

130

357

3

5

1990
25324 5403 508

1991
25596 5400 509

White
1992 1993

25868 5398 510

26139 5393 511

1994 5-year

26409 5390 512

129336 26984 2550

20.3 20.6 20.0

21.3 20.3 21.0

22.0 18.5 21.0

21.3 19.6 21.0

21.3 20.1 21.0

21.3 19.8 21.0

36

45

35

45

38

199

8

8

11

6

4

37

336

368

358

356

388

1806

30

38

27

36

32

163

51

61

72

56

89

329

27

48

20

32

30

157

3

1

0

0

2

6

48

54

51

50

43

246

5

3

6

6

3

23

5

3

3

6

2

19

2

3

1

5

1

12

3

0

2

1

1

7

5

4

2

5

3

19

2

0

1

0

0

3

0

1

2

1

2

6

23

25

23

34

31

136

3

2

6

10

2

23

0

0

1

4

0

5

19

28

32

47

37

163

4

4

3

6

2

19

4

9

11

11

4

39

71

72

85

67

92

387

34

40

31

23

52

180

105

111

113

122

118

569

3

5

6

5

1

20

72

78

58

48

49

305

3

1

3

4

1

12

13

6

11

17

13

60

.

4

12

21

23

60

.

7

12

22

7

48

.

26

66

50

100

242

264

267

266

252

312

1361

43

43

57

37

52

232

4

4

2

5

6

21

144

181

180

173

190

868

100

130

142

161

189

722

85

117

120

130

163

615

.

43

75

96

123

337

1

0

0

0

3

4

1990
1554 175 11

1991
1574 176
11

Black
1992 1993

1594 176 11

1614 176
11

1994 5-year

1634 177 11

7970 880 56

22.8 18.8 23.0

19.3 17.5 22.0

21.9 24.1 28.0

18.0 15.3 30.0

20.7 .
22.0

20.4 18.1 24.5

1

3

1

2

0

7

0

1

0

0

0

1

10

9

10

4

5

38

0

2

1

1

0

4

7

8

7

2

4

28

1

1

0

0

1

3

0

0

0

0

0

0

3

4

1

1

1

10

0

1

0

1

0

2

0

1

0

0

0

1

0

1

0

0

0

1

0

0

0

0

0

0

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

2

0

2

0

1

5

0

0

0

0

0

0

0

0

0

0

0

0

1

2

1

1

1

6

0

0

0

0

0

0

0

0

1

0

0

1

1

1

3

0

2

7

4

6

6

1

1

18

2

2

5

1

0

10

0

0

0

0

0

0

2

0

1

0

0

3

1

0

1

0

0

2

0

0

1

0

0

1

.

2

1

0

1

4

.

1

0

0

0

1

.

0

4

6

2

12

5

5

5

3

3

21

1

1

1

0

0

3

0

0

0

0

0

0

9

6

6

2

5

28

3

7

8

3

5

26

3

5

5

2

5

20

.

3

4

2

3

12

0

0

0

0

0

0

316

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Habersham County - 068

12.7 61.1
1.8 17.0
2.1 9.9 0.3 129.0 5.7
69.5 21.1 56.7 32.3
9.1 * *
14.2 * *
14.1 * *
7.7 * *
6.3 * *
31.5 10.9 31.5
* 21.7
* 7.5
. . .
78.4 14.5
* 44.5 30.5 25.6
.

13.8 66.7
2.0 18.1
2.3 11.1
0.3 127.7
9.0
89.1 18.4 72.8 47.5
9.1 * *
* * * 13.0 * *
6.8 * *
7.9 *
2.6
32.4 12.0 31.5
1.3 20.7
* 4.5
1.4 1.2 4.8
73.6 13.2
* 50.3 36.1 32.2 12.0

13.2 64.6 2.0 21.8 2.0 9.8 0.3 125.3 4.1
65.1 30.6 50.7 46.4 10.9 100.0
*
* * * * * *
6.7 1.6
* 8.9
* 3.2
37.0 10.2 33.0
1.6 16.2
* 6.6
2.4 1.8 11.7
73.7 17.2
* 51.2 40.7 34.0 21.6

12.8 63.3
1.9 16.6
2.0 9.7 0.3 122.3 6.0
88.3 12.2 68.5 47.4 14.4 100.0
*
19.1 16.3
* 19.0
* *
9.8 3.0
* 14.1
1.7 3.6
29.6 6.9
35.7 1.4
13.3 *
8.0
3.4 3.7 9.8
71.0 11.4 13.9 49.0 46.5 37.1 28.0

14.0 70.0 2.1 24.0 1.6 8.1 0.2 95.7 6.4

13.3 65.2
2.0 19.6
2.0 9.7 0.3 119.7 6.3

69.9 *
59.2 45.5
* * *

76.4 18.0 61.5 44.1
9.8 92.6
5.4

*

11.1

*

7.4

*

3.7

*

11.6

*

*

*

0.3

8.1

7.8

*

1.3

*

0.3

9.6

9.4

*

1.0

1.2

2.3

27.1 13.3 32.1
* 12.4
* 6.6

31.1 10.8 32.7
1.1 16.8
0.8 6.8

3.7 1.2 17.6

2.7 2.0 11.0

81.3 14.8 15.0 49.6 49.1 42.5 32.1

75.6 14.2 11.5 49.0 40.8 34.5 23.5

13.3 62.2
1.9 15.4
1.9 8.9 0.3 115.7 5.7

14.4 68.1
2.1 16.7
2.1 10.0
0.3 114.4
9.3

13.8 66.3 2.0 20.3 2.0 9.4 0.3 118.1 4.3

13.6 66.0
2.0 16.0
1.9 9.3 0.3 113.9 6.1

70.9 22.2 59.1 33.3
9.8 * *

88.4 17.8 74.6 44.7
* * *

68.6 31.4 52.9 44.4 11.8 100.0
*

88.1 13.3 70.5 44.4 11.7 100.0
*

14.9

*

*

16.9

*

*

*

14.0

*

*

*

*

14.7

*

*

.

*

*

*

*

*

*

*

*

6.8

6.8

6.4

9.6

*

*

1.7

2.8

*

*

*

*

5.7

7.7

9.1

13.4

*

*

*

1.7

*

2.5

3.1

3.1

31.8 10.2 31.7
* 21.8
* 7.9

31.7 11.0 31.0
1.4 21.7
* 4.7

37.0 8.7 32.1 1.7 16.6
* 6.3

29.6 6.6
35.3 1.4
13.8 *
8.3

.

*

1.9

3.3

.

1.1

1.9

3.5

.

4.2

10.6

8.0

79.5 14.6
* 43.4 30.1 25.6
.

74.6 13.0
* 49.6 35.6 32.1 11.8

74.7 17.7
* 50.7 40.0 33.8 21.1

71.0 11.7 14.3 49.4 46.0 37.1 27.4

14.7 72.0 2.2 23.1 1.6 8.0 0.2 92.3 6.5

14.0 66.9
2.1 18.4
1.9 9.1 0.3 110.6 6.4

74.2 *
62.5 43.8
* * *

78.0 18.6 63.9 42.3
9.0 95.7
5.5

*

10.5

*

6.6

*

3.9

*

10.5

*

*

*

0.3

8.0

7.5

*

1.3

*

0.3

9.6

9.1

*

1.1

*

2.2

25.6 13.5 31.6
* 12.8
* 6.8

30.6 10.1 32.3
1.1 17.2
0.7 6.9

3.6

2.4

1.1

1.9

15.8

9.7

81.7 15.0 15.0 49.2 49.0 42.2 31.9

76.3 14.4 11.8 48.5 40.4 34.4 23.1

6.4 57.1
1.8 70.0
* * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
. . .
50.0 * *
90.0 * * .

5.7 51.3
1.3 88.9
* * * * *
* * * * * * *
* * * * * *
* * * * * *
* 66.7
* * * * *
* * *
55.6 * *
66.7 77.8 55.6
*

6.3 56.8 1.5 70.0
* * * * *
* * * * * * *
* * * * * *
* * * * * *
* 60.0 50.0
* * * *
* * *
50.0 * *
60.0 80.0 50.0
*

*

3.1

4.8

*

28.3

43.2

*

0.7

1.2

*

*

73.7

*

*

1.3

*

*

11.4

*

*

0.3

*

* 196.1

*

*

*

*

* 125.9

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

13.2

*

*

*

*

*

*

*

*

15.8

*

*

*

*

*

*

*

*

25.9

*

*

47.4

*

*

27.8

*

*

*

*

*

*

*

*

*

*

*

*

* * 30.7

*

*

*

*

*

15.4

*

*

*

*

*

*

* 100.0

* 100.0

* 100.0

*

*

55.3 * *
73.7 68.4 52.6 42.9
317

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Hall County - 069

1990
95428 22661
1907
21.7 19.9 21.0
192 37 1728 148 415 116 12 405 40
12 9 3
22 4 9
127 21
4 107 20 27
184 191 587 17 187 16 60
. . .
1386 242 22 800 494 420 . 0

Total
1991 1992 1993 1994 5-year

97891 22925
1932

100342 23187
1955

102807 23450 1979

105254 23710 2003

501722 115933
9775

21.9 20.3 21.0

22.2 19.9 22.0

22.5 20.0 22.0

21.8 20.4 22.0

22.0 20.1 22.0

218 42
1660 159 429 158
11 388
47

197 35
1736 142 434 171 16 390 45

188 36
1693 145 464 157
5 341
34

223 43
1842 178 507 143 6 304 37

1018 193
8659 772
2249 745 50
1828 203

12

20

15

10

69

5

14

11

4

43

7

6

4

6

26

16

27

16

10

91

5

4

0

4

17

8

11

4

9

41

119

129

120

150

645

18

27

23

24

113

1

3

1

1

10

110

92

91

72

472

12

23

15

23

93

13

22

18

8

88

107

133

116

131

671

199

210

228

246

1074

581

526

612

648

2954

5

11

11

4

48

123

137

112

49

608

9

21

11

6

63

54

64

70

64

312

38

77

88

67

270

36

84

64

60

244

166

138

248

214

766

1579 166
23 844 554 512 150
7

1628 158 35 791 643 532 236 2

1621 110
35 824 819 670 209
6

1793 157 17 870 849 682 239 10

8007 833 132
4129 3359 2816
834 25

1990
83108 19615
1640

1991
84818 19751
1653

White
1992 1993

86526 19887
1665

88238 20022
1677

1994 5-year

89942 20156
1690

432632 99431
8324

22.0 20.0 21.0

22.2 20.2 21.0

22.5 20.1 22.0

22.7 20.3 22.0

22.1 20.4 21.0

22.3 20.2 21.0

154 31
1531 120 277 98 9 323 30

170 30
1461 127 288 138
8 289
33

155 28
1564 115 319 149 13 295 31

152 27
1500 119 339 140
4 278
27

184 32
1649 149 375 120 5 241 29

815 148 7705 630 1598 645
39 1426
150

10

8

17

9

9

53

7

4

11

5

3

30

3

4

6

4

6

23

17

12

21

9

8

67

4

4

4

0

4

16

9

8

11

4

9

41

102

101

104

16

14

18

3

1

1

86

93

73

17

11

22

23

10

20

91

123

521

12

17

77

1

0

6

68

59

379

14

20

84

16

6

75

147

90

116

100

120

573

134

142

155

165

177

773

521

514

460

547

587

2629

13

5

11

8

3

40

180

113

132

107

46

578

12

5

17

11

4

49

47

44

56

63

53

263

.

27

62

61

53

203

.

27

71

45

41

184

.

85

82

119

154

440

1251 214 21 645 399 339 . 0

1386 143
19 687 438 401 112
0

1471 143 34 673 542 445 189 0

1441 98 29
684 693 566 164
4

1608 139 14 732 720 574 202 6

7157 737 117
3421 2792 2325
667 10

1990
8195 2152
215

1991
8407 2175
218

Black
1992 1993

8617 2197
220

8829 2219
223

1994 5-year

9039 2242
226

43086 10985
1102

19.4 19.0 27.0

20.2 19.5 25.0

18.8 18.2 26.0

18.8 19.3 27.5

19.4 23.8 23.5

19.6 19.4 25.0

34

47

39

33

34

187

6

12

7

8

11

44

190

192

157

164

159

862

27

32

27

24

27

137

135

140

109

112

116

612

16

18

20

16

20

90

3

3

3

1

1

11

57

75

65

46

47

290

7

13

11

6

5

42

2

4

3

6

1

16

2

1

3

6

1

13

0

3

0

0

0

3

5

4

5

7

2

23

0

1

0

0

0

1

0

0

0

0

0

0

25

17

22

27

26

117

5

4

8

10

7

34

1

0

1

0

1

3

20

17

17

21

11

86

3

1

1

1

3

9

4

3

2

2

2

13

37

16

17

15

10

95

55

56

50

54

56

271

62

64

59

49

48

282

4

0

0

3

1

8

7

10

5

5

3

30

4

4

4

0

2

14

13

10

8

6

9

46

.

8

7

16

8

39

.

3

8

10

6

27

.

63

41

104

33

241

132

186

144

152

152

766

28

22

14

12

13

89

1

4

1

6

1

13

151

154

112

119

114

650

93

115

95

108

113

524

80

110

83

88

93

454

.

38

46

43

32

159

0

0

0

1

0

1

318

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Hall County - 069

18.1 76.3
2.3 24.3
4.2 17.9
0.5 178.6
6.0
100.7 19.3 77.6 55.8 21.0 92.5 3.1
6.9 5.2
* 12.6
* 0.5
7.4 1.2
* 6.3 1.2 1.6
25.9 11.2 35.2
1.0 11.1
0.9 7.4
. . .
81.4 15.5 14.8 46.8 28.9 24.6
.

17.0 72.4
2.2 26.0
4.0 16.9
0.5 174.2
7.8
112.9 19.3 82.3 60.4 24.3
100.0 6.2
7.2 3.0 4.2 9.6 0.8 0.4
7.2 1.1
* 6.7 0.7 0.8
24.4 12.1 36.3
0.3 7.5 0.6 7.1
1.5 1.4 6.6
95.5 10.7 23.0 51.2 33.6 31.1
9.1

17.3 74.9 2.2 25.3 3.9 16.8 0.5 167.8
8.5
100.8 17.8 72.6 55.6 23.0 97.8 5.1
11.5 8.1 3.5 15.4
* 0.6
7.4 1.6
* 5.4 1.3 1.3
26.8 12.3 33.5 0.6 8.0 1.2
7.4
3.0 3.2 5.3
94.7 10.0 26.7 46.1 37.5 31.0 13.8

16.5 72.2
2.2 27.7
3.3 14.5
0.4 155.0
7.1
95.0 19.1 73.3 59.7 17.2 97.0
6.1
8.9 6.5
* 9.4
* *
7.1 1.4
* 5.4 0.9 1.1
25.9 13.6 37.8
0.7 6.7 0.7 8.5
3.3 2.4 9.3
96.4 7.0
34.3 49.1 48.8 39.9 12.5

17.5 77.7 2.4 27.9 2.9 12.8 0.4 131.9
6.7
111.3 19.3 88.9 61.6 18.5 94.4 4.5
5.4 *
3.3 5.4
* 0.5
8.1 1.3
* 4.0 1.3 0.4
7.8 13.5 38.1
* 2.7 0.3 7.5
2.4 2.2 7.8
97.6 9.1 16.5 47.8 46.7 37.5 13.1

17.3 74.7
2.2 26.3
3.6 15.8
0.5 161.4
7.2
104.1 19.0 79.0 58.8 20.8 96.5
5.0
8.0 5.0 3.0 10.4 0.5 0.4
7.5 1.3 0.1 5.5 1.1 1.0
17.8 12.5 36.2
0.6 7.2 0.7 7.6
2.6 2.3 7.3
93.1 10.4 22.6 48.2 39.2 32.9 12.2

18.4 78.1
2.3 18.3
3.9 16.5
0.5 164.2
5.8

17.2 74.0
2.2 19.9
3.4 14.6
0.4 151.6
7.9

18.1 78.6 2.4 20.7 3.4 14.8 0.5 145.3
8.6

17.0 74.9
2.3 22.8
3.2 13.9
0.4 144.3
7.4

18.3 81.8 2.5 23.0 2.7 12.0 0.4 119.2
6.5

17.8 77.5
2.4 21.0
3.3 14.3
0.4 144.8
7.2

93.9 20.1 73.2 47.1 18.3 90.0
3.7

102.9 17.6 76.8 50.4 20.0
100.0 6.1

93.1 18.1 69.1 47.0 18.6 96.8 5.4

90.6 17.8 70.9 52.5 16.1 96.2
5.4

108.9 17.4 88.2 54.4 17.2 92.9 3.6

97.9 18.2 75.7 50.5 18.0 95.2
4.8

6.5

5.5

10.9

6.0

5.5

6.9

4.6

*

7.0

3.3

*

3.9

*

*

3.9

*

3.6

3.0

11.0

8.2

13.3

6.0

4.8

8.7

*

*

*

*

*

0.6

0.6

0.5

0.7

*

0.5

0.5

6.7

6.9

6.7

6.1

7.5

6.8

1.0

1.0

1.2

0.8

1.0

1.0

*

*

*

*

*

0.1

5.7

6.4

4.8

4.6

3.6

5.0

1.1

0.8

1.4

0.9

1.2

1.1

1.5

0.7

1.3

1.1

0.4

1.0

23.9 8.8
35.3 0.9
12.0 0.8 6.5

23.4 9.8
36.6 0.3 7.8 0.3 6.6

25.8 10.0 32.7 0.7 8.6 1.1
7.0

24.4 11.1 38.0
0.5 7.2 0.7 8.6

8.0 10.9 38.3
* 2.9
* 6.9

17.1 10.1 36.2
0.5 7.6 0.6 7.1

.

1.3

2.9

2.7

2.3

2.3

.

1.3

3.3

2.0

1.8

2.1

.

4.0

3.8

5.4

6.8

5.0

82.8 15.5 15.7 42.6 26.3 22.4
.

95.2 10.5 20.9 47.4 30.2 27.7
7.7

94.8 10.0 28.6 43.6 35.1 28.8 12.2

96.6 7.0
31.5 46.0 46.6 38.1 11.0

97.8 9.1 15.1 45.0 44.2 35.3 12.4

93.5 10.4 22.1 44.9 36.6 30.5 10.9

23.2 88.3
2.5 72.2
7.0 26.5
0.7 213.5
9.3

22.8 88.3
2.5 73.3
8.9 34.5
1.0 260.4
9.7

18.2 71.5 2.0 69.9 7.5 29.6 0.9 263.2 11.4

18.6 73.9
2.1 68.7
5.2 20.7
0.6 202.6
7.7

17.6 70.9 2.1 73.9 5.2 21.0 0.6 205.2 10.3

20.0 78.5
2.3 71.7
6.7 26.4
0.8 230.5
9.6

158.1 17.6 125.6 92.6 32.6 100.0
*

215.8 25.5
146.9 100.0
59.7 100.0
*

177.0 17.9
122.5 92.6 49.9
100.0 *

147.8 24.2
107.5 100.0
26.9 100.0
*

150.6 32.4
119.6 100.0
22.1 100.0
*

169.7 23.5
124.3 97.1 38.1
100.0 8.2

* * * 25.9 * *

*

*

36.6

*

*

36.6

*

*

*

*

31.3

42.4

*

*

*

*

*

*

*

18.6

*

15.1

*

*

*

26.3

*

*

*

*

13.2 2.6 *
10.8 * *

8.9

14.0

16.5

16.4

13.6

*

5.1

6.1

4.4

3.9

*

*

*

*

*

8.9

11.0

12.9

7.0

10.1

*

*

*

*

1.1

*

*

*

*

1.5

40.2 29.4 33.5
* 3.8
* 14.3

30.8 29.3 34.0
* 5.3
* 10.3

39.5 32.1 38.3
* 3.2
* 11.9

42.9 33.1 31.0
* 3.1
* 6.9

6.9 35.7 32.4
* * * 11.1

26.0 31.7 33.9
0.9 3.6 1.7 10.9

.

2.9

2.4

5.4

2.6

3.3

.

*

2.8

3.4

2.0

2.3

.

22.6

14.3

35.1

10.9

20.7

71.0 16.3
* 80.7 49.7 42.8
.

97.4 12.1
* 80.6 60.2 57.6 19.9

92.3 9.7
* 71.8 60.9 53.2 29.5

93.3 7.8
66.7 73.0 66.3 54.0 26.4

95.6

89.6

8.7

11.1

*

24.5

72.6

76.1

72.0

61.4

59.2

53.2

20.4

23.8

319

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Hancock County - 070

1990
8908 2071
249
19.7 16.5 25.0
18 3
133 10 85 11
4 40
8
3 2 1 6 0 0
15 2 1
18 2 4
75 51 19
2 16
2 7
. . .
83 15
0 96 65 55
. 0

1991
8965 2085 250
19.8 18.8 25.0
28 4
165 22
110 11 2 41 6
4 4 0 6 0 2
16 8 3
25 3 4
88 61 35
5 11
1 14
0 1 15
103 19 2
124 104
91 0 0

Total
1992 1993

9011 2097
252

9065 2113 253

20.9 22.4 25.0

20.1 16.5 26.0

12

20

3

5

145

130

9

14

98

87

11

5

4

2

27

35

2

6

1

6

1

3

0

3

5

5

0

0

0

0

12

20

2

4

1

0

21

14

2

2

1

1

67

62

55

53

25

26

4

4

9

5

3

1

6

9

21

4

4

0

46

31

98

84

17

16

1

3

113

103

90

95

79

87

30

70

0

0

1994 5-year

9112 2125
254

45061 10491
1258

20.8 19.8 24.5

20.1 18.8 25.0

20

98

4

19

137

710

16

71

98

478

5

43

3

15

31

174

3

25

3

17

2

12

1

5

5

27

1

1

1

3

15

78

7

23

1

6

15

93

3

12

1

11

60

352

51

271

24

129

0

15

6

47

1

8

3

39

3

28

3

8

4

96

104

472

20

87

1

7

108

544

101

455

90

402

83

183

0

0

1990
1802 309 24

1991
1807 306
24

White
1992 1993

1802 300 24

1802 298
23

1994 5-year

1801 293 23

9014 1506
119

23.3 18.2 29.0

22.2 27.9 22.5

27.0 29.4 23.0

24.6 .
24.5

24.2 17.3 19.0

24.6 21.5 22.0

2

1

0

0

1

4

0

0

0

0

0

0

19

21

17

12

12

81

1

1

0

0

0

2

4

2

4

4

5

19

1

2

0

0

2

5

0

0

0

0

0

0

4

1

4

5

3

17

1

0

0

0

1

2

1

0

0

0

0

1

1

0

0

0

0

1

0

0

0

0

0

0

1

0

0

0

0

1

0

0

0

0

0

0

0

0

0

0

1

1

3

1

3

1

1

9

1

0

1

0

0

2

0

0

0

0

0

0

5

5

3

2

0

15

0

0

0

0

0

0

0

0

0

0

0

0

5

2

7

4

4

22

2

1

1

3

3

10

1

6

3

3

1

14

0

0

0

0

0

0

4

5

4

1

1

15

0

0

0

0

1

1

0

2

1

0

0

3

.

0

0

0

0

0

.

0

0

0

0

0

.

0

5

1

1

7

14

18

16

11

12

71

5

5

3

3

4

20

0

0

0

0

0

0

9

9

8

7

4

37

10

7

6

9

4

36

6

7

6

7

3

29

.

0

3

6

2

11

0

0

0

0

0

0

1990
7077 1753
220

1991
7122 1765
221

Black
1992 1993

7159 1775
223

7202 1788
223

1994 5-year

7239 1798
225

35799 8877 1112

19.7 16.5 25.0

19.6 18.7 26.0

19.4 20.4 25.5

19.3 16.5 26.0

20.4 20.0 26.0

19.6 18.6 25.0

16

27

12

20

19

94

3

4

3

5

4

19

114

144

128

117

124

627

9

21

9

14

16

69

81

108

94

83

93

459

10

8

11

5

3

37

4

2

4

2

3

15

36

39

23

30

28

156

7

6

2

6

2

23

2

4

1

6

3

16

1

4

1

3

2

11

1

0

0

3

1

5

5

6

5

5

5

26

0

0

0

0

1

1

0

2

0

0

0

2

12

15

9

19

14

69

1

8

1

4

7

21

1

3

1

0

1

6

13

20

18

12

15

78

2

3

2

2

3

12

4

4

1

1

1

11

70

86

60

58

56

330

49

60

54

50

48

261

18

29

22

23

23

115

2

5

4

4

0

15

12

6

5

4

5

32

2

1

3

1

0

7

7

12

5

9

3

36

.

0

21

4

.

1

3

0

.

15

35

29

3

28

3

7

2

81

69

85

82

10

14

14

0

2

1

87

115

105

55

97

84

49

84

73

.

0

27

0

0

0

72

91

399

13

16

67

3

1

7

95

103

505

85

96

417

79

86

371

63

80

170

0

0

0

320

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Hancock County - 070

14.9 64.2
1.9 64.9
4.5 19.3
0.6 210.5
8.2
72.3 *
40.2 100.0
32.1 100.0
*
* * * 43.8 * *
11.3 * *
13.7 * *
62.0 38.9 14.6
* 12.2
* 9.3
. . .
62.9 11.8
* 73.3 49.6 42.0
.

18.4 79.1
2.3 67.9
4.6 19.7
0.6 187.2
6.2
111.9 *
87.9 90.9 24.0 83.3
*
* * * 35.9 * *
9.8 4.9
* 15.7
* *
72.1 37.7 21.9
3.1 6.8
* 16.1
* * 5.4
65.6 12.9
* 76.5 64.2 56.2
*

16.1 69.1 2.0 68.5 3.0 12.9 0.4 144.4 7.2
47.6 *
35.7 100.0
* * *
* * * 33.6 * *
8.3 * *
14.7 * *
51.9 38.5 17.6
* 6.3
* 6.3
7.6 *
16.6
69.5 13.0
* 79.0 62.9 55.2 21.0

14.3 61.5
1.8 69.0
3.9 16.6
0.5 202.3
3.8
79.1 25.0 55.4 100.0 23.7 100.0
*
46.2 * *
37.9 * *
15.4 * *
11.1 * *
50.4 42.1 21.0
* 4.0
* 12.5
* * 11.2
65.6 14.0
* 81.7 75.4 69.0 55.6

15.0 64.5 1.9 72.6 3.4 14.6 0.4 176.1 3.8
78.7 *
63.0 100.0
* * *
* * * 35.7 * *
10.9 5.1
* 11.1
* *
46.9 37.8 17.8
* 4.4
* *
* * *
77.6 16.3
* 80.0 74.8 66.7 61.5

15.8 67.7
2.0 68.6
3.9 16.6
0.5 184.1
5.8
77.9 19.4 56.4 97.2 19.9 96.0
*
23.9 16.9
7.2 37.2
* *
11.0 3.2 0.8
13.4 1.7 1.5
56.5 38.9 18.7
2.2 6.8 1.2 9.6
2.5 0.7 8.7
68.2 13.6 12.7 78.0 65.3 57.7 32.3

10.5 61.5
2.0 * * * * * *
* * * * * * *
* * * * * *
* * * 26.3 * *
29.4 * * * * * *
. . .
73.7 . *
47.4 52.6 31.6
.

11.6 68.6
2.3 * * * * * *
* * * * * * *
* * * * * *
* * * 23.8 * *
* * 28.6 * 23.8 * *
* * *
90.0 29.4
* 42.9 33.3 33.3
*

9.4 56.7 1.7
* * * * * *
* * * * * * *
* * * * * *
* * * * * *
43.8 * * * * * *
* * 18.0
94.1 * *
47.1 35.3 35.3
*

6.7 40.3
1.4 *
2.8 16.8
* . *

6.7 41.0 1.3 41.7
* * * * *

9.0 53.8
1.7 23.5
1.9 11.3
0.3 163.5
4.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

11.1

*

*

*

*

*

*

*

*

18.5

*

*

*

*

*

*

*

*

32.8

*

*

12.3

*

*

17.3

*

*

*

*

*

18.5

*

*

*

*

*

*

*

*

*

*

*

*

*

*

6.3

91.7 * *
58.3 75.0 58.3 50.0

100.0 * * * * * *

88.8 27.0
* 45.7 44.4 35.8 17.7

16.1 65.0
1.9 72.3
5.1 20.5
0.6 218.2
8.6

20.2 81.6
2.3 76.6
5.5 22.1
0.6 202.1
5.7

17.9 72.1 2.1 74.6 3.2 13.0 0.4 138.6 8.5

16.2 65.4
1.9 73.5
4.2 16.8
0.5 193.5
4.5

17.1 69.0 2.0 76.2 3.9 15.6 0.5 177.2 3.3

17.5 70.6
2.0 74.8
4.4 17.6
0.5 186.4
6.1

72.7 *
40.9 100.0 31.8 100.0
*

122.1 *
95.0 95.2 27.1 83.3
*

53.9 *
40.4 100.0
* * *

89.5 25.0 62.7 100.0 26.9 100.0
*

84.6 *
71.3 100.0
* * *

84.5 20.2 62.1 98.6 20.7 95.7
*

* * * 42.4 * *

* * * 41.1 * *

* * * 37.9 * *

51.3 * *
42.0 * *

* * * 39.4 * *

25.5 17.5
8.1 40.5
* *

10.5 * *
11.6 * *

10.5 5.6 *
14.5 * *

7.0 * *
14.3 * *

16.2 * *
10.6 * *

11.3 5.6
* 12.3
* *

11.0 3.4 1.0
12.8 2.0 1.8

67.3 43.8 16.2
* 10.7
* 10.6

77.5 42.6 20.9
3.6 4.3
* 15.8

53.1 42.9 17.6
* 4.0
* 5.9

52.7 44.2 20.7
* * * 13.8

48.3 39.3 18.9
* 4.1
* *

59.6 42.5 18.9
2.5 5.2 1.1 9.9

.

*

8.4

*

.

*

*

*

.

6.0

14.1

11.7

*

2.8

*

0.7

*

8.2

61.1 9.3 *
77.7 49.1 43.8
.

62.0 10.8
* 81.6 68.8 59.6
*

66.1 12.2
* 83.3 66.7 57.9 21.4

62.6 12.7
* 84.1 75.2 69.9 55.8

75.2

65.4

14.3

11.8

*

14.9

84.4

82.2

78.7

67.9

70.5

60.4

65.6

33.9

321

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Haralson County - 071

1990
21966 4915 496
20.3 18.1 19.0
37 4
284 21 53 16
4 68 15
4 3 1 7 1 2
20 2 0
20 4
13
71 29 81 11 70
4 12
. . .
175 40
5 106 102 67
. 0

1991
22319 4968 501
20.7 18.1 20.0
37 3
320 30 74 30 5 53 7
4 2 2 7 0 2
22 2 0
22 4
29
77 33 105
7 89
3 8
13 12 66
206 29 9
174 141 121
0 1

Total
1992 1993

22675 5023 507

23025 5076 512

20.1 18.4 20.0

20.2 18.0 20.0

51

36

9

8

309

330

40

31

83

84

30

27

2

2

56

50

9

5

3

2

3

1

0

1

5

4

0

1

3

1

18

25

8

5

0

2

22

22

1

3

39

51

60

83

41

41

120

104

9

1

85

100

4

5

17

19

28

28

15

18

58

87

207

250

34

45

7

6

176

207

161

199

141

169

5

8

1

1

1994 5-year

23377 5131 518

113362 25113 2534

20.9 20.3 20.0

20.4 18.3 20.0

36

197

9

33

288

1531

29

151

71

365

30

133

3

16

34

261

3

39

3

16

3

12

0

4

6

29

0

2

2

10

16

101

3

20

2

4

22

108

2

14

21

153

85

376

36

180

98

508

1

29

57

401

3

19

11

67

15

84

16

61

79

290

225

1063

21

169

7

34

160

823

156

759

134

632

10

23

3

6

1990
20438 4523 461

1991
20781 4575 467

White
1992 1993

21125 4628 472

21468 4681 478

1994 5-year

21810 4734 484

105622 23141 2361

20.8 18.1 19.0

20.7 18.4 20.0

20.2 18.4 20.0

20.3 18.0 20.0

20.8 20.9 20.0

20.4 18.3 20.0

33

31

47

35

34

180

4

3

9

8

8

32

259

289

288

305

267

1408

18

26

37

30

27

138

37

59

72

68

55

291

15

30

26

24

24

119

3

5

2

2

2

14

67

47

51

43

31

239

15

5

8

5

3

36

3

4

3

2

1

13

2

2

3

1

1

9

1

2

0

1

0

4

5

7

5

4

3

24

1

0

0

1

0

2

2

2

2

1

2

9

16

18

18

23

13

88

1

2

8

5

0

16

0

0

0

2

0

2

19

19

21

21

19

99

3

4

1

3

2

13

10

28

38

50

20

146

61

71

55

77

78

342

20

27

34

34

27

142

72

99

113

99

93

476

11

5

8

1

1

26

64

84

83

97

55

383

1

3

3

4

2

13

12

7

14

18

9

60

.

13

26

27

14

80

.

10

15

16

16

57

.

48

55

81

66

250

165

193

195

233

216

1002

37

26

32

41

20

156

5

9

6

6

6

32

90

152

163

186

144

735

86

122

147

177

141

673

54

104

129

149

121

557

.

0

5

7

9

21

0

1

1

1

3

6

1990
1427 358 33

1991
1450 362
33

Black
1992 1993

1473 365 34

1496 369
34

1994 5-year

1519 373 34

7364 1827
169

19.6 .
23.0

20.2 13.3 21.5

19.1 25.9 25.5

19.8 .
35.0

21.4 19.2 27.0

19.9 19.2 24.0

4

5

3

1

2

15

0

0

0

0

1

1

24

30

21

25

20

120

3

4

3

1

2

13

16

15

11

16

16

74

1

0

3

3

6

13

1

0

0

0

1

2

0

5

4

6

3

18

0

1

0

0

0

1

1

0

0

0

2

3

1

0

0

0

2

3

0

0

0

0

0

0

2

0

0

0

3

5

0

0

0

0

0

0

0

0

1

0

0

1

4

4

0

2

3

13

1

0

0

0

3

4

0

0

0

0

2

2

1

3

1

1

3

9

1

0

0

0

0

1

3

1

1

1

1

7

10

5

5

6

6

32

9

6

7

7

9

38

9

6

7

5

5

32

0

2

1

0

0

3

6

5

2

3

2

18

3

0

1

1

1

6

0

1

3

1

2

7

.

0

2

1

1

4

.

1

0

2

0

3

.

11

3

5

12

31

9

12

12

17

9

59

3

3

2

4

1

13

0

0

1

0

1

2

15

21

13

21

16

86

15

18

14

22

14

83

12

16

12

20

13

73

.

0

0

1

1

2

0

0

0

0

0

0

322

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Haralson County - 071

12.9 57.8
1.7 19.0
3.1 13.8
0.4 182.3
4.3
74.6 *
42.3 57.1 30.2 93.3
*
* * * 24.3 * *
7.0 * *
7.1 *
4.6
27.8 10.4 29.5
3.9 25.1
* 8.0
. . .
61.8 15.9 17.2 37.9 36.4 23.9
.

14.3 64.4
1.9 23.4
2.4 10.7
0.3 129.6
7.2
73.8 *
59.8 46.7 14.0 100.0
*
* * * 21.5 * *
6.9 * *
7.0 *
9.1
26.8 10.4 33.5
2.3 28.4
* 4.4
2.2 2.0 11.2
65.8 10.4 23.7 55.1 44.6 38.3
*

13.6 61.5 1.9 26.9 2.5 11.1 0.3 140.4 6.8
100.6 17.6 78.9 62.5 17.8 88.9 *
* * * 16.1 * *
5.8 2.6
* 7.1
* 12.7
22.1 13.3 39.1 2.9 27.9
* 9.9
4.7 2.5 9.7
67.4 12.5 18.9 57.1 52.3 45.8
1.6

14.3 65.0
2.0 25.7
2.2 9.9 0.3 121.4 6.3
70.3 22.2 60.5 51.6
9.8 100.0
*
* * * * * *
7.6 1.5
* 6.7
* 15.5
27.8 12.5 32.2
* 30.9
1.5 10.2
4.6 3.0 14.3
76.0 15.0 23.1 63.3 60.9 51.7
2.4

12.3 56.1 1.7 24.8 1.5 6.6 0.2 95.8 6.4

13.5 61.0
1.8 24.1
2.3 10.4
0.3 134.0
6.2

69.5 25.0 56.0 41.4
* * *

77.7 16.8 59.6 52.3 15.4 94.9
2.8

* * * 20.6 * *

10.5 7.8 *
18.7 *
0.5

5.6

6.6

*

1.3

*

*

7.7

7.1

*

0.9

7.3

10.0

31.0 12.6 34.6
* 20.0
* 7.1

27.1 11.9 33.8
1.9 26.6
1.3 7.9

2.4 2.6 12.8

3.5 2.5 12.0

79.5 8.2 24.1 55.9 54.5 46.9 3.5

70.2 12.4 21.4 54.3 50.0 41.7
1.9

12.7 57.3
1.7 14.5
3.3 14.8
0.4 194.2
4.2

13.9 63.2
1.9 20.7
2.3 10.3
0.3 126.7
7.7

13.6 62.2 1.9 25.1 2.4 11.0 0.3 138.2 6.5

14.2 65.2
2.0 22.5
2.0 9.2 0.3 114.1 6.2

71.6 *
39.0 50.0 32.5 93.3
*

66.5 *
55.7 42.3 10.7 100.0
*

99.6 19.1 78.4 62.2 16.9 87.5
*

73.2 22.9 62.7 53.3 10.5 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

19.1

23.8

17.2

*

*

*

*

*

*

*

*

*

6.2

6.2

6.3

7.5

*

*

2.8

1.6

*

*

*

*

7.4

6.7

7.3

7.0

*

*

*

*

3.9

9.8

13.2

16.4

26.0 7.8
28.6 4.3
25.1 *
8.7

27.1 9.5
34.9 1.8
29.8 *
4.3

21.6 11.8 39.5 2.8 29.1
* 8.6

28.0 11.3 33.2
* 32.4
* 10.5

.

2.4

4.7

4.8

.

1.8

2.7

2.9

.

8.9

10.0

14.5

64.0 16.2 18.5 35.2 33.6 21.1
.

68.2 10.3 27.3 53.3 42.8 36.5
*

68.2 12.5 19.4 56.8 51.2 44.9
1.7

76.6 14.8 24.0 61.6 58.6 49.3
2.3

12.2 56.4 1.7 20.8 1.4 6.5 0.2 95.7 5.5

13.3 60.8
1.8 20.9
2.3 10.3
0.3 133.8
6.0

70.3 23.5 55.8 44.4
* * *

76.2 17.8 58.4 51.4 15.2 94.4
2.5

*

9.2

*

6.4

*

*

*

16.9

*

*

*

0.5

4.9

6.3

*

1.1

*

*

7.2

7.1

*

0.9

7.5

10.4

30.4 10.2 35.5
* 20.8
* 6.2

26.6 10.2 34.4
1.9 27.7
0.9 7.7

2.5 2.8 11.6

3.6 2.6 11.3

82.1 8.4 22.2 54.3 53.2 45.7 3.4

71.9 12.5 22.4 52.7 48.2 39.9
1.8

16.8 67.0
1.9 69.6
* * * * *

20.7 83.0
2.3 50.0
3.4 13.8
0.4 138.9
*

* 149.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

50.0 39.1 39.1
* 26.1
* *

20.8 20.0 21.4
* 16.7
* *

.

*

.

*

.

23.1

37.5 * *
65.2 65.2 52.2
.

41.4 * *
70.0 60.0 53.3
*

14.3 57.5 1.7 52.4
* * * * *

16.7 67.8
1.9 64.0
4.0 16.3
0.5 176.5
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

31.3 33.3 33.3
* * * *

25.0 28.0 20.0
* * * *

*

*

*

*

*

10.2

57.1 * *
61.9 66.7 57.1
*

68.0 * *
84.0 88.0 80.0
*

13.2 53.6 1.5 80.0
* * * * 18.8

16.3 65.7
1.9 62.2
2.4 9.9 0.3 116.9 8.8

*

89.0

*

*

*

77.1

*

61.5

*

*

*

*

*

*

*

*

*

*

*

*

*

41.0

*

*

*

*

*

10.8

*

*

*

*

*

7.6

*

*

*

5.9

37.5 45.0 25.0
* * * *

32.0 31.9 27.4
* 15.3
5.1 10.8

*

*

*

*

24.1

15.9

47.4

50.0

*

12.6

*

*

80.0

72.3

70.0

69.7

65.0

61.3

*

*

323

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Harris County - 072

1990
17788 3902 388
21.6 19.5 20.0
30 9
279 21 78
9 3 65 8
1 0 1 3 0 1
22 0 0
21 3 0
88 46 59
4 48
4 12
. . .
202 49
2 112 73 55
. 0

1991
18101 3934 394
20.0 20.0 22.0
41 8
277 35 91 14 2 55 5
1 0 1 2 1 2
15 3 0
16 4 0
74 58 62
3 41
5 13
8 6 40
179 32 7
121 112
80 6 2

Total
1992 1993

18408 3966 400

18723 3998 407

22.7 18.9 21.0

22.6 22.5 22.0

30

35

5

8

265

255

24

26

73

66

11

13

2

0

68

60

6

8

2

4

1

4

1

0

4

3

0

0

2

0

16

21

4

4

0

1

25

20

2

0

3

2

80

74

51

42

48

48

4

4

44

36

6

5

9

7

15

11

26

15

47

45

165

170

46

37

3

2

102

94

121

105

84

73

15

8

0

0

1994 5-year

19027 4028 412

92047 19828
2001

23.1 22.0 23.0

21.8 20.2 22.0

29

165

7

37

259

1335

21

127

75

383

8

55

4

11

57

305

7

34

2

10

2

7

0

3

6

18

0

1

1

6

27

101

5

16

1

2

32

114

2

11

3

8

94

410

45

242

49

266

5

20

25

194

2

22

6

47

9

43

16

63

56

188

191

907

32

196

10

24

105

534

109

520

82

374

7

36

0

2

1990
13103 2889 268

1991
13484 2944 276

White
1992 1993

13862 2999 282

14245 3053 290

1994 5-year

14621 3106 297

69315 14991
1412

21.7 20.1 19.0

20.5 19.8 21.0

23.9 18.6 21.0

24.6 21.3 21.0

24.8 21.0 22.0

23.1 20.0 21.0

19

20

18

21

19

97

4

2

4

4

5

19

196

185

190

192

186

949

14

16

14

16

11

71

32

31

25

24

28

140

5

8

8

9

1

31

2

2

2

0

3

9

45

36

42

37

37

197

5

4

4

5

7

25

0

1

1

3

2

7

0

0

1

3

2

6

0

1

0

0

0

1

2

2

4

2

5

15

0

1

0

0

0

1

1

2

1

0

1

5

14

9

8

14

14

59

0

2

2

2

2

8

0

0

0

0

1

1

15

6

18

14

15

68

1

3

1

0

1

6

0

0

2

1

3

6

59

44

55

50

62

270

18

17

14

15

13

77

39

33

29

33

29

163

2

0

2

1

1

6

41

34

39

33

25

172

4

2

4

3

2

15

6

5

4

7

2

24

.

5

9

6

8

28

.

4

16

7

13

40

.

18

19

13

25

75

152

138

130

146

145

711

41

20

31

28

25

145

1

3

2

2

8

16

58

62

55

60

61

296

37

58

65

62

60

282

24

45

41

44

46

200

.

1

7

7

5

20

0

2

0

0

0

2

1990
4571 982 119

1991
4651 989 121

Black
1992 1993

4730 997 123

4811 1004 125

1994 5-year

4889 1011
126

23653 4983 614

21.3 18.2 22.0

18.5 20.3 25.0

19.5 20.2 29.0

18.8 24.7 26.5

19.5 27.5 25.0

19.3 22.0 24.0

10

21

12

14

10

67

5

6

1

4

2

18

83

91

75

63

73

385

7

19

10

10

10

56

46

60

48

42

47

243

4

6

3

4

7

24

1

0

0

0

1

2

19

18

24

22

19

102

2

1

2

3

0

8

1

0

0

1

0

2

0

0

0

1

0

1

1

0

0

0

0

1

1

0

0

1

1

3

0

0

0

0

0

0

0

0

1

0

0

1

8

6

8

7

13

42

0

1

2

2

3

8

0

0

0

1

0

1

6

10

7

6

17

46

2

1

1

0

1

5

0

0

1

1

0

2

29

29

25

24

32

139

28

41

37

27

32

165

20

28

19

15

20

102

2

3

2

3

4

14

7

7

5

3

0

22

0

3

2

2

0

7

6

8

5

0

4

23

.

3

5

4

0

12

.

1

9

5

2

17

.

22

26

29

29

106

50

40

35

24

46

195

8

12

15

9

7

51

1

4

1

0

2

8

54

59

47

34

44

238

36

54

56

43

49

238

31

35

43

29

36

174

.

5

8

1

2

16

0

0

0

0

0

0

324

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Harris County - 072

15.7 71.5
2.3 28.4
3.7 16.7
0.5 182.6
3.1
77.3 30.0 54.1 71.4 20.6 100.0
*
* * * * * *
7.9 * *
7.7 * *
34.9 16.7 21.5
* 17.8
* 7.8
. . .
72.7 19.4
* 40.7 26.5 20.0
.

15.3 70.4
2.3 33.3
3.0 14.0
0.4 157.6
4.3
104.0 19.5 88.7 80.0 12.7
100.0 *
* * * * * *
5.4 * *
5.9 * *
29.5 21.2 22.9
* 15.2
1.9 8.3
1.8 1.3 8.8
64.6 13.4 20.0 44.3 41.0 29.3
2.2

14.4 66.8 2.2 27.8 3.7 17.1 0.6 196.5 3.3
75.0 16.7 60.0 66.7 15.0 100.0
*
* * * * * *
6.0 * *
9.5 * *
32.3 19.4 18.3
* 16.9
2.3 5.8
3.2 5.6 10.2
62.3 19.9
* 38.8 46.0 31.9
5.7

13.6 63.8
2.0 25.9
3.2 15.0
0.5 182.9
3.3
86.1 22.9 64.0 80.8 19.7 100.0
*
* * * * * *
8.2 * *
7.8 * *
32.3 16.5 18.8
* 14.8
2.0 4.7
2.3 3.2 9.6
66.7 16.4
* 36.9 41.2 28.6
3.1

13.6 64.3 2.1 29.2 3.0 14.2 0.5 173.8 3.0
70.4 24.1 50.9 85.7 17.0 71.4
*
* * * 22.8 * *
10.4 1.9
* 12.5
* *
38.4 17.5 19.1
2.0 9.9
* 4.4
1.9 3.4 11.8
74.3 14.4 28.6 40.9 42.4 31.9
2.7

14.5 67.3
2.2 28.9
3.3 15.4
0.5 178.7
3.4
82.5 22.4 63.5 77.2 17.0 94.1
*
7.5 5.2
* 13.4
* 0.3
7.6 1.2
* 8.6 0.8 0.6
33.5 18.3 20.1
1.5 15.0
1.7 6.3
2.3 3.4 10.1
68.1 16.8 15.6 40.4 39.3 28.3
3.4

15.0 67.8
2.2 16.4
3.4 15.6
0.5 181.5
2.4

13.7 62.8
2.1 17.0
2.7 12.2
0.4 155.8
3.4

13.7 63.4 2.1 13.2 3.0 14.0 0.5 173.6 3.3

13.5 62.9
2.0 12.5
2.6 12.1
0.4 155.5
2.9

12.7 59.9 2.0 15.1 2.5 11.9 0.4 163.0
*

13.7 63.3
2.1 14.8
2.8 13.1
0.4 166.1
2.7

70.9 *
52.2 57.1 18.7 100.0
*

72.6 *
58.1 62.5
* * *

63.8 *
49.6 42.9
* * *

72.5 *
55.2 68.8 17.3 100.0
*

64.0 26.3 37.1 72.7 23.6 71.4
*

68.7 19.6 50.3 60.6 17.7 92.0
*

*

*

*

*

*

7.4

*

*

*

*

*

6.3

*

*

*

*

*

*

*

*

*

*

26.5

15.7

*

*

*

*

*

*

*

*

*

*

*

0.4

7.1

4.9

4.2

7.3

7.5

6.2

*

*

*

*

*

0.8

*

*

*

*

*

*

7.7

3.3

9.5

7.3

8.1

7.2

*

*

*

*

*

0.6

*

*

*

*

*

0.6

33.0 9.2
20.0 *
21.7 *
5.9

25.0 9.3
18.2 *
18.9 *
4.9

30.1 7.4 15.3
* 20.9
* *

28.1 7.8
17.2 *
17.6 *
6.1

35.0 7.0
15.7 *
13.7 * *

30.2 8.2
17.3 0.6
18.6 1.6 4.6

.

1.5

2.7

1.8

2.3

2.1

.

*

4.8

2.0

3.7

3.0

.

5.5

5.7

3.8

7.1

5.6

77.6 22.5
* 29.7 19.0 12.3
.

74.6 12.7
* 34.1 31.9 24.7
*

68.4 18.9
* 29.1 34.4 21.7
3.7

76.0 16.8
* 31.3 32.3 22.9
3.6

78.4 15.5 33.3 33.0 32.4 24.9
2.7

75.0 17.4 14.3 31.4 29.9 21.2
2.7

18.2 84.5
2.5 57.5
4.2 19.3
0.6 177.6
5.1

19.6 92.0
2.7 66.7
3.9 18.2
0.5 155.2
7.1

15.9 75.3 2.3 64.9 5.1 24.1 0.7 235.3
*

13.1 62.7
1.9 66.7
4.6 21.9
0.6 247.2
*

14.9 72.2 2.2 65.3 3.9 18.8 0.6 190.0 7.9

16.3 77.3
2.3 64.1
4.3 20.5
0.6 198.4
5.4

84.0 50.0 58.8 100.0
* * *

173.6 28.6
157.0 94.7 * * *

97.8 *
81.5 100.0
* * *

112.3 *
80.2 100.0
* * *

79.1 *
79.1 100.0
* * *

109.2 26.9 91.2 98.2 13.0 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

9.6

6.6

10.7

11.1

17.8

10.9

*

*

*

*

*

2.1

*

*

*

*

*

*

7.6

11.1

9.5

9.5

23.6

12.2

*

*

*

*

*

1.3

*

*

*

*

*

*

39.7 35.0 25.0
* 8.8
* 11.5

39.2 45.6 31.5
* 7.9
* 14.5

38.5 50.0 25.7
* 6.8
* 12.2

47.1 42.9 23.8
* * * *

47.1 44.4 27.8
* * * *

42.0 43.5 27.0
3.7 6.0 1.9 10.2

.

*

3.7

*

*

2.2

.

*

6.7

3.7

*

3.1

.

16.6

19.3

21.3

21.0

19.6

61.0 11.3
* 67.5 45.0 38.8
.

44.0 15.0
* 65.6 60.0 38.9
5.6

46.7 22.4
* 63.5 75.7 58.1 10.8

38.1 15.5
* 54.0 68.3 46.0
*

63.9

50.9

11.5

15.1

*

19.0

61.1

62.8

68.1

62.8

50.0

45.9

*

5.4

325

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Hart County - 073

1990
19712 4139 426
20.4 20.7 21.0
36 10 303 32 88
4 3 52 4
4 3 1 6 0 2
34 5 1
37 4 5
80 46 86
4 55 11 13
. . .
208 42
1 175 114 96
. 0

1991
19984 4136 421
20.9 19.9 21.0
28 7
269 25 92 15 3 39 1
2 1 1 5 0 1
18 2 0
26 1
10
77 50 78
3 41
4 13
11 4
51
204 32 3
181 139 127
20 0

Total
1992 1993

20251 4135 416

20526 4133 410

21.5 17.8 21.0

19.7 18.7 21.0

33

30

9

3

251

246

25

26

74

87

9

3

0

1

44

50

8

3

4

2

3

0

1

2

3

1

1

0

2

3

27

29

6

12

1

1

32

26

3

7

6

4

48

29

49

50

74

67

2

5

32

14

5

0

18

6

20

15

13

8

79

149

202

190

29

10

2

2

151

91

85

62

71

54

12

2

0

0

1994 5-year

20791 4131 405

101264 20674 2077

20.4 19.9 22.0

20.5 18.8 21.0

24

151

3

32

219

1288

20

128

78

419

4

35

1

8

42

227

3

19

1

13

1

8

0

5

2

17

0

1

0

8

12

120

5

30

0

3

16

137

1

16

0

25

26

260

53

248

50

355

0

14

10

152

2

22

8

58

29

75

15

40

140

419

185

989

11

124

0

8

86

684

55

455

48

396

1

35

0

0

1990
15646 3105 281

1991
15888 3102 279

White
1992 1993

16132 3102 278

16376 3100 276

1994 5-year

16616 3099 274

80658 15508
1389

20.9 21.7 21.0

22.3 18.1 20.0

22.2 17.9 20.5

20.9 19.6 20.0

22.9 19.9 22.0

21.7 19.8 21.0

18

13

19

16

13

79

6

3

4

0

2

15

216

176

171

166

158

887

15

10

14

15

10

64

27

29

23

26

30

135

1

12

3

2

1

19

2

3

0

0

0

5

38

27

25

28

31

149

3

1

5

1

3

13

4

0

3

2

0

9

3

0

2

0

0

5

1

0

1

2

0

4

5

4

1

0

0

10

0

0

0

0

0

0

0

1

2

3

0

6

22

8

14

15

7

66

5

0

3

5

3

16

1

0

0

1

0

2

20

13

16

15

12

76

3

0

3

4

0

10

3

6

4

4

0

17

49

44

30

16

16

155

12

14

14

13

20

73

56

46

51

39

35

227

0

0

2

1

0

3

47

34

25

12

10

128

8

1

3

0

1

13

7

6

9

1

3

26

.

8

13

6

14

41

.

2

9

6

3

20

.

30

47

70

80

227

160

142

150

139

143

734

31

21

21

5

8

86

1

2

0

2

0

5

112

106

96

56

58

428

59

70

43

31

35

238

52

66

37

30

31

216

.

8

10

1

1

20

0

0

0

0

0

0

1990
4002 1016
145

1991
4057 1014 143

Black
1992 1993

4111 1013
141

4167 1012 140

1994 5-year

4221 1010
138

20559 5066 707

17.7 15.4 23.0

18.7 22.4 23.0

17.9 16.9 24.5

18.6 18.0 27.0

18.2 .
25.0

18.3 17.4 25.0

18

15

14

14

11

72

4

4

5

3

1

17

85

91

78

79

60

393

17

15

11

11

10

64

61

63

51

61

48

284

3

3

6

1

3

16

1

0

0

1

1

3

14

12

16

21

11

74

1

0

3

2

0

6

0

2

1

0

1

4

0

1

1

0

1

3

0

1

0

0

0

1

1

1

2

1

2

7

0

0

1

0

0

1

2

0

0

0

0

2

12

9

13

14

0

2

3

7

0

0

1

0

17

13

16

11

1

1

0

3

2

3

2

0

5

53

2

14

0

1

4

61

1

6

0

7

31

33

18

13

9

104

34

35

35

37

33

174

30

32

23

28

15

128

4

3

0

4

0

11

8

6

7

2

0

23

3

3

2

0

1

9

6

7

9

5

5

32

.

1

7

9

14

31

.

2

3

2

12

19

.

20

32

76

55

183

46

61

50

50

41

248

10

11

8

5

3

37

0

1

2

0

0

3

63

75

55

35

28

256

55

69

41

31

20

216

44

61

34

24

17

180

.

12

2

1

0

15

0

0

0

0

0

0

326

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Hart County - 073

15.4 73.2
2.2 29.4
2.6 12.6
0.2 143.3
1.9
84.5 27.8 75.1 53.1
* * *
* * * 19.6 * *
11.2 1.7 *
12.4 *
2.0
38.8 15.4 28.8
* 22.4
4.5 7.6
. . .
70.7 15.3
* 58.5 38.1 32.1
.

13.5 65.0
1.9 34.6
2.0 9.4 0.1 119.6 4.4
66.6 25.0 59.5 64.0
* * *
* * * 18.4 * *
6.7 * *
9.7 *
4.9
42.1 18.7 29.3
* 20.9
* 8.8
2.2 *
10.3
76.7 12.7
* 67.5 51.9 47.4
7.5

12.4 60.7 1.8 30.0 2.2 10.6 0.2 144.7 2.2
79.4 27.3 60.2 68.0 19.3 100.0
*
* * * * * *
10.8 2.4
* 13.0
* 4.0
34.8 19.8 30.2
* 22.2
3.4 12.1
4.0 2.6 15.8
80.8 12.6
* 61.1 34.4 28.7
4.9

12.0 59.5
1.8 36.7
2.4 12.1
0.1 166.7
*
73.2 *
63.4 69.2
* * *
* * * * * *
11.8 4.9 *
10.9 2.9 *
32.6 21.0 28.2
2.1 14.3
* 4.5
3.0 1.6 29.4
77.6 4.4 *
38.2 26.1 22.7
*

10.5 53.0 1.6 35.9 2.0 10.2 0.1 157.9 1.2
59.3 *
49.4 90.0
* * *
* * * * * *
5.5 2.3
* 7.3
* *
31.7 24.3 23.6
* 11.6
* 7.2
5.7 2.9 27.4
85.3 5.1
* 39.4 25.2 22.0
*

12.7 62.3
1.9 33.1
2.2 11.0
0.1 145.6
2.1
72.7 21.2 61.6 67.2
9.2 94.4
2.4
10.1 6.2 3.9
13.1 *
0.4
9.3 2.3
* 10.8
1.3 3.1
37.2 19.5 28.2
1.1 19.8
2.9 8.2
3.7 2.0 20.8
77.8 10.4 11.1 53.9 35.8 31.2
3.6

13.8 69.6
2.1 12.7
2.4 12.2
0.2 147.3
*

11.1 56.7
1.7 16.6
1.7 8.7 0.1 123.9 4.8

10.6 55.1 1.7 13.8 1.5 8.1 0.1 125.6
*

10.1 53.5
1.6 16.1
1.7 9.0 0.1 142.9
*

9.5 51.0 1.5 19.1 1.9 10.0 0.1 163.2
*

11.0 57.2
1.7 15.5
1.8 9.6 0.1 140.4 1.6

64.1 33.3 53.4
* * * *

46.6 *
35.8 * * * *

68.3 *
50.4 50.0 18.0 100.0
*

57.9 *
54.3 46.7
* * *

47.4 *
36.4 80.0
* * *

56.9 19.0 46.1 40.6
9.4 91.7
*

*

*

*

*

*

10.1

*

*

*

*

*

5.6

*

*

*

*

*

*

22.9

*

*

*

*

11.2

*

*

*

*

*

*

*

*

*

*

*

0.5

10.2

4.5

8.2

9.0

4.4

7.4

2.3

*

*

3.0

*

1.8

*

*

*

*

*

*

9.4

7.4

9.6

9.3

7.6

8.7

*

*

*

*

*

1.1

*

4.8

*

*

*

3.3

36.8 5.6
26.3 *
29.2 5.0 6.3

39.6 8.0
26.1 *
28.3 *
6.4

35.7 8.4 30.5
* 29.1
* 10.1

27.1 8.1
24.2 *
19.0 * *

25.4 12.7 22.2
* 15.4
* *

34.4 8.3
25.9 *
25.9 2.6 5.6

.

2.3

3.6

1.7

3.8

2.8

.

*

2.5

1.7

*

1.4

.

8.5

13.1

19.3

21.7

15.7

77.3 15.7
* 52.6 27.7 24.4
.

81.1 12.7
* 60.2 39.8 37.5
4.5

88.2 13.2
* 57.5 25.7 22.2
6.0

83.7 3.3 *
34.8 19.3 18.6
*

91.7 5.2
* 36.7 22.2 19.6
*

84.0 10.4 10.9 48.9 27.2 24.7
3.0

21.2 83.7
2.3 72.6
3.5 13.8
0.2 135.9
*

22.4 89.7
2.5 70.0
3.0 11.8
0.1 113.2
*

19.0 77.0 2.2 65.4 3.9 15.8 0.2 160.0 5.9

19.0 78.1
2.2 81.3
5.0 20.8
0.2 205.9
*

14.2 59.4 1.6 81.4 2.6 10.9 0.2 146.7
*

19.1 77.6
2.2 73.6
3.6 14.6
0.2 152.3
3.8

124.1 *
117.2 94.1
* * *

104.8 *
104.8 86.7 * * *

99.0 35.7 77.8 90.9
* * *

100.3 *
78.8 100.0
* * *

79.9 *
72.6 100.0
* * *

101.9 23.6 90.5 93.8
8.5 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

17.7

*

*

*

*

*

*

*

*

*

*

*

*

14.1 * *
20.2 * *

9.9 * *
14.4 * *

16.7 * *
20.5 * *

17.7 8.9 *
14.5 * *

8.3

13.5

*

3.6

*

*

*

15.8

*

1.6

*

2.6

43.7 40.5 35.7
* 9.8
* 10.5

46.5 38.9 36.0
* 8.0
* 13.0

34.6 44.9 30.3
* 12.5
* 15.0

43.3 48.7 36.8
* * * 11.4

50.0 55.9 28.3
* * * 18.5

43.0 45.0 33.9
2.8 8.6 3.4 13.2

.

*

4.9

6.2

9.5

5.3

.

*

*

*

8.1

3.3

.

14.0

22.2

52.1

37.3

31.5

54.1 13.3
* 75.0 65.5 52.4
.

67.8 12.9
* 83.3 76.7 67.8 13.3

64.1 11.6
* 70.5 52.6 43.6
*

64.1 6.8 *
46.1 40.8 31.6
*

68.3

63.4

*

10.2

*

*

47.5

66.1

33.9

55.8

28.8

46.5

*

5.0

327

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Heard County - 074

1990
8628 1971
230
21.1 19.4 20.0
10 2
114 9
28 12
2 13
1
1 1 0 2 1 0
9 0 0 4 3 0
23 14 46
4 34
0 4
. . .
87 14
2 56 42 36
. 0

1991
8843 2021 236
20.0 19.7 20.0
14 2
117 10 34 8 1 24 3
1 1 0 3 0 3
9 1 0 9 0 11
26 18 38
0 30
1 5
2 11 30
89 13
3 69 52 47
2 0

Total
1992 1993

9054 2072
241

9272 2124 247

21.8 19.8 19.5

20.6 20.1 20.0

16

13

3

3

129

147

13

11

27

41

9

6

1

1

19

15

2

2

1

2

1

2

0

0

1

3

0

2

1

1

12

14

2

3

0

1

13

12

3

2

8

19

23

43

15

21

40

61

2

1

26

39

3

4

4

4

13

12

14

27

60

46

93

118

19

19

3

3

78

93

73

85

61

75

32

14

0

1

1994 5-year

9479 2175
252

45276 10363
1206

19.6 19.0 20.5

20.7 19.4 20.0

19

72

4

14

125

632

17

60

44

174

11

46

0

5

10

81

1

9

0

5

0

5

0

0

0

9

2

5

3

8

17

61

7

13

0

1

13

51

2

10

2

40

38

153

22

90

47

232

4

11

27

156

0

8

5

22

10

37

10

62

51

187

100

487

18

83

4

15

72

368

72

324

58

277

4

52

2

3

1990
7418 1635
174

1991
7645 1688
181

White
1992 1993

7870 1740
188

8101 1795
195

1994 5-year

8325 1848
202

39359 8706 941

21.3 19.4 19.0

19.6 18.9 19.5

21.6 17.1 19.0

21.3 17.2 19.0

19.6 18.7 20.0

20.8 18.6 19.5

8

11

15

10

13

57

2

1

3

3

3

12

99

94

115

132

107

547

7

8

13

8

12

48

14

19

19

30

31

113

11

8

8

6

10

43

2

0

0

1

0

3

11

19

12

12

8

62

1

3

1

2

1

8

1

1

1

2

0

5

1

1

1

2

0

5

0

0

0

0

0

0

2

2

0

3

0

7

1

0

0

2

2

5

0

2

0

1

3

6

9

4

8

12

13

46

0

0

0

3

7

10

0

0

0

1

0

1

4

4

10

9

11

38

3

0

2

2

2

9

0

9

8

17

1

35

23

18

21

37

32

131

6

9

9

16

14

54

41

29

38

58

40

206

4

0

2

1

3

10

34

24

23

36

26

143

0

0

2

4

0

6

4

4

3

3

4

18

.

2

12

9

8

31

.

11

13

27

9

60

.

20

51

39

48

158

77

76

85

107

85

430

13

8

17

16

15

69

1

3

3

3

4

14

44

50

69

79

59

301

34

40

65

73

58

270

28

36

55

64

47

230

.

1

29

13

4

47

0

0

0

1

2

3

1990
1163 317 51

1991
1192 325
52

Black
1992 1993

1220 332 53

1250 340
55

1994 5-year

1278 348 56

6103 1661
268

20.9 .
22.0

21.9 20.6 29.0

24.3 22.2 22.5

19.6 23.4 24.5

20.2 21.0 29.0

20.7 22.4 25.0

2

3

1

3

6

15

0

1

0

0

1

2

15

23

14

15

17

84

2

2

0

3

5

12

14

15

8

11

12

60

1

0

1

0

1

3

0

1

1

0

0

2

2

4

6

3

2

17

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

0

0

2

0

0

0

0

0

0

0

1

1

0

0

2

0

5

4

2

4

15

0

1

2

0

0

3

0

0

0

0

0

0

0

5

3

3

2

13

0

0

1

0

0

1

0

2

0

2

1

5

0

8

2

6

5

21

8

9

6

5

8

36

5

9

2

3

7

26

0

0

0

0

1

1

0

6

3

3

1

13

0

1

1

0

0

2

0

1

1

1

1

4

.

0

0

3

2

5

.

0

0

0

0

0

.

10

9

3

3

25

10

13

1

5

1

0

12

19

8

12

8

11

.

1

0

0

8

11

14

56

2

3

3

14

0

0

0

1

9

14

12

66

8

12

13

53

6

11

10

46

3

1

0

5

0

0

0

0

328

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

13.2

13.2

14.2

15.9

13.2

14.0

General fertility rate

57.8

57.9

62.3

69.2

57.5

61.0

Total fertility rate

1.7

1.7

1.9

2.1

1.7

1.8

% Livebirths to unmarried women

25.2

29.1

21.4

28.3

36.1

28.0

Crude abortion rate

1.5

2.7

2.1

1.6

1.1

1.8

General abortion rate

6.6

11.9

9.2

7.1

4.6

7.8

Total abortion rate

0.2

0.4

0.3

0.2

0.1

0.2

Abortion ratio

92.2 160.0 118.8

88.8

68.5 105.7

Fetal Death rate

7.1

4.5

5.8

3.3

5.1

5.1

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

43.5

59.4

66.4

52.6

75.3

59.7

% Repeat conceptions to women under 18

*

*

*

*

*

19.4

Livebirths to women under 18

39.1

42.4

54.0

44.5

67.4

49.7

% Livebirths to unmarried women under 18

77.8

60.0

*

54.5

76.5

60.0

Induced abortions to women under 18

*

*

*

*

*

7.5

% Abortions to unmarried women under 18

*

*

*

*

* 100.0

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

7.9

Neonatal mortality

*

*

*

*

*

7.9

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

14.1

Deaths of children 1-4 yrs

*

*

*

*

*

1.8

Deaths of children 5-17 yrs

*

*

*

*

*

0.8

Infant health rates

% Low birthweight

7.9

7.7

9.3

9.5

13.6

9.7

% Very low birthweight

*

*

*

*

5.6

2.1

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

*

7.7

10.3

8.3

10.7

8.2

% Multiple gestation

*

*

*

*

*

1.6

% Birth defect

*

9.6

6.3

13.0

*

6.4

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

31.5

29.5

23.5

32.8

31.7

30.0

% with father not named on birth certificate

12.6

15.4

11.9

14.5

18.0

14.5

% with maternal education less than high school

41.4

32.8

32.3

42.1

38.5

37.5

% No prenatal care

*

*

*

*

*

1.8

% Maternal smoking during pregnancy

31.2

26.1

21.0

27.1

22.3

25.4

% Maternal alcohol use during pregnancy

*

*

*

*

*

1.3

% Interpregnancy interval less than 6 months

*

7.9

*

*

7.7

6.6

Child abuse and neglect rates

Physical

.

*

5.1

4.6

3.7

3.6

Sexual

.

4.4

5.5

10.3

3.7

6.0

Neglect

.

12.0

23.5

17.6

19.1

18.1

Interventions to improve infant & child survival

% Prenatal care first trimester

77.7

76.7

73.2

80.3

80.0

77.7

% Primary C-section delivery

13.3

13.0

16.8

14.1

15.8

14.6

% Vaginal birth after previous C-section

*

*

*

*

*

27.8

% WIC during pregnancy

50.5

59.0

61.9

64.1

59.0

59.3

% Medicaid during pregnancy

37.8

44.4

57.9

58.6

59.0

52.2

% Medicaid and WIC during pregnancy

32.4

40.2

48.4

51.7

47.5

44.6

% Perinatal case management

.

*

25.4

9.7

*

10.2

Heard County - 074

13.3 60.6
1.8 14.6
1.5 6.7 0.2 89.4 8.0

12.3 55.7
1.7 20.2
2.5 11.3
0.3 157.0
4.7

46.0 *
40.2 71.4
* * *

60.6 *
44.1 62.5
* * *

*

*

*

*

*

*

*

*

*

*

*

*

9.1

*

*

*

*

*

*

*

*

*

*

9.8

34.3 6.3
42.7 *
35.8 * *

25.0 9.6
31.2 *
26.1 * *

.

*

.

5.2

.

9.5

79.4 14.3
* 45.8 35.4 29.2
.

81.7 10.0
* 53.2 42.6 38.3
*

14.6 66.1 2.0 16.8 1.5
6.9 0.2 87.6 5.7
79.7 *
69.1 * * * *
* * * * * *
7.0 * *
8.8 *
7.0
23.9 8.0 34.2
* 20.5
* *
5.6 6.0 23.6
75.2 16.8
* 61.1 57.5 48.7 25.7

16.3 73.5
2.2 23.1
1.5 6.7 0.2 79.5 3.9
51.2 *
40.9 * * * *
* * * * * *
9.1 * *
6.9 *
13.0
31.6 12.3 44.6
* 27.9
* *
4.0 12.1 17.5
81.1 13.3
* 60.8 56.2 49.2 10.0

12.9 57.9 1.8 29.8 1.0
4.3 0.1 64.0 5.4

13.9 62.8
1.9 21.0
1.6 7.1 0.2 94.4 5.5

64.3 *
59.3 66.7
* * *

60.6 21.1 51.0 52.1
8.5 100.0
*

*

9.1

*

9.1

*

*

*

12.7

*

2.1

*

0.8

12.1

8.4

6.5

1.8

*

*

10.6

7.1

*

1.7

*

6.5

31.4 13.5 38.5
* 25.2
* *

29.4 10.1 38.6
1.9 26.9
1.1 6.1

3.5 3.9 21.0

3.5 6.8 18.0

79.4 15.5
* 56.7 55.8 45.2
*

79.3 14.1 29.2 56.1 50.3 42.8 10.7

12.9 47.3
1.3 93.3
* * * * *
* * * * * * *
* * * * * *
* * * * * *
* 53.3 33.3
* * * *
. . .
66.7 * *
80.0 53.3 53.3
.

19.3 70.9
2.0 65.2
* * * * *

11.5 42.2 1.2 61.5 4.9 18.1 0.5 272.7
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

21.7

*

*

*

*

*

21.7

*

*

*

*

*

50.0 39.1 39.1
* 26.1
* *

* 46.2
* * * * *

* * 24.5

* * 21.6

56.5 25.0
* 82.6 52.2 47.8
*

57.1 * *
69.2 61.5 46.2
*

12.0 44.1
1.1 73.3
* * * * *

13.3 48.9 1.3 70.6
* * * * *

13.8 50.6
1.4 72.3
2.8 10.2
0.3 160.4
3.0

* 107.1

*

*

*

89.3

* 100.0

*

*

*

*

*

*

56.1 *
44.9 91.7
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

17.9

*

*

*

*

*

*

*

*

15.7

*

*

*

*

*

6.0

42.9 33.3
* * * * *

29.4 47.1 41.2
* * * *

33.3 43.4 31.3
* 16.0
* *

*

*

3.0

*

*

*

*

*

14.8

73.3

82.4

66.7

*

*

18.2

*

*

*

93.3

70.6

79.5

80.0

76.5

63.9

73.3

58.8

55.4

*

*

7.4

329

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Henry County - 075

1990
58741 14453
1236
22.9 19.4 21.0
104 24 1109 67 192 88
6 266 34
7 5 2 10 1 3
74 13
0 99 13 17
215 97 202 16 159 11 35
. . .
818 188 40 288 261 193
. 3

1991
61349 14934
1280
23.4 20.0 21.0
99 12 1093 70 217 83 15 270 27
9 6 3 20 1 4
66 13
1 86 12 20
187 104 183
16 166
12 33
0 0 8
857 166
37 333 282 223
4 3

Total
1992 1993

63953 15417
1322

66561 15901
1367

24.0 19.8 21.0

24.3 18.6 22.0

122 28
1191 86
206 99 6
292 30

98 15 1189 57 218 82
8 267
40

6

7

4

4

2

3

11

12

4

1

4

1

75

73

5

14

1

1

98

99

17

12

10

6

201

187

88

84

217

176

17

17

129

123

7

8

41

36

32

42

38

46

118

126

919

950

159

170

33

30

325

357

317

379

242

277

4

24

3

2

1994 5-year

69164 16382
1410

319768 77087
6614

24.3 19.7 22.0

23.8 19.4 22.0

116 26
1376 76
246 80 10
271 32

539 105 5958 356 1079 432
45 1366
163

6

35

4

23

2

12

14

67

3

10

3

15

76

364

7

52

2

5

101

483

10

64

7

60

199

989

98

471

212

990

8

74

117

694

15

53

40

185

42

116

39

123

122

374

1125 180 55 354 383 270 44 6

4669 863 195
1657 1622 1205
76 17

1990
52112 12757
1049

1991
54849 13285
1096

White
1992 1993

57586 13813
1142

60318 14342
1190

1994 5-year

63053 14869
1236

287918 69066
5712

23.2 19.4 21.0

23.9 19.3 21.0

24.4 19.6 21.0

24.4 18.6 22.0

24.5 19.6 22.0

24.2 19.3 21.0

82

78

86

69

78

393

18

7

20

10

16

71

980

950

1052

1040

1202

5224

52

51

60

38

49

250

117

126

121

134

162

660

80

75

80

65

68

368

4

12

3

4

8

31

223

213

233

215

201

1085

28

26

22

31

25

132

6

7

3

6

6

28

4

4

2

4

4

18

2

3

1

2

2

10

7

15

6

8

12

48

1

1

4

1

2

9

2

3

4

0

3

12

58

41

65

52

62

278

11

7

3

11

6

38

0

0

0

1

2

3

81

61

83

75

80

380

10

10

14

9

8

51

16

17

9

5

5

52

187

163

179

164

163

856

58

65

53

50

60

286

170

148

171

137

168

794

9

10

11

7

4

41

153

150

125

116

114

658

8

6

6

8

13

41

30

28

32

27

36

153

.

0

26

37

38

101

.

0

31

43

31

105

.

4

86

111

92

293

754

770

841

868

1005

4238

166

144

138

147

159

754

34

33

30

27

50

174

221

242

250

269

268

1250

199

200

245

288

304

1236

149

153

188

205

211

906

.

4

3

17

36

60

2

3

3

1

6

15

1990
6068 1516
174

1991
6337 1567
180

Black
1992 1993

6606 1619
186

6876 1671
192

1994 5-year

7145 1722
198

33032 8095 931

20.1 17.2 24.0

20.1 22.3 25.0

18.0 19.8 27.0

21.1 17.9 26.0

20.4 22.6 26.0

20.0 19.4 26.0

22

21

34

28

38

143

6

5

8

4

10

33

124

132

128

135

164

683

15

19

26

19

27

106

75

90

84

84

83

416

6

8

15

13

10

52

2

3

1

4

2

12

36

50

45

44

65

240

6

1

7

8

7

29

1

2

3

1

0

7

1

2

2

0

0

5

0

0

1

1

0

2

3

5

3

4

2

17

0

0

0

0

1

1

0

1

0

1

0

2

16

25

10

19

12

82

2

6

2

3

1

14

0

1

1

0

0

2

18

23

15

23

21

100

3

2

3

1

2

11

1

3

1

1

2

8

28

24

22

22

36

132

39

38

35

34

38

184

32

33

45

38

44

192

7

5

6

8

3

29

6

15

4

5

3

33

3

5

1

0

2

11

5

5

9

9

4

32

.

0

5

2

4

11

.

0

4

3

7

14

.

0

26

13

28

67

60

79

67

72

114

392

21

22

19

21

21

104

6

4

3

3

4

20

67

90

74

84

82

397

61

80

70

85

73

369

44

69

53

68

55

289

.

0

1

7

8

16

0

0

0

1

0

1

330

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Henry County - 075

18.9 76.7
2.3 17.6
4.5 18.4
0.6 180.6
6.8
84.1 23.1 54.2 71.2 27.5 93.9
*
6.3 4.5
* 9.0
* *
6.7 1.2
* 9.1 1.2 1.5
25.9 8.9
18.6 1.5
14.6 1.0 6.1
. . .
74.6 20.0 26.0 26.3 23.9 17.6
.

17.8 73.2
2.2 20.1
4.4 18.1
0.6 183.9
7.0
77.4 12.1 54.7 70.0 21.1 100.0
*
8.2 5.5
* 18.1
* *
6.0 1.2
* 8.0 1.1 1.8
23.7 9.6
17.0 1.5
15.4 1.1 5.9
* * 0.5
79.0 17.5 27.4 30.8 26.1 20.6
*

18.6 77.3 2.4 17.5 4.6 18.9 0.6 183.2
7.2
92.3 23.0 65.0 63.5 22.7 96.7
5.3
5.0 * *
9.2 * *
6.3 0.4
* 8.3 1.4 0.8
23.0 7.5
18.5 1.4 11.0 0.6 6.4
1.8 2.1 6.7
77.2 15.3 23.9 27.7 27.0 20.6
*

17.9 74.8
2.3 18.5
4.0 16.8
0.5 172.4
5.8
71.7 15.3 41.7 84.2 29.3 97.5
*
5.9 * *
10.0 * *
6.1 1.2
* 8.4 1.0 0.5
20.3 7.1
15.0 1.4
10.5 0.7 5.8
2.3 2.5 6.8
80.0 15.8 28.6 30.3 32.1 23.5
2.0

19.9 84.0 2.6 18.0 3.9 16.5 0.5 155.9
5.6
82.3 22.4 53.9 72.4 22.7 100.0
6.4
4.4 * *
10.1 * *
5.5 0.5
* 7.4 0.7 0.5
17.4 7.2
15.7 0.6 8.6 1.1 5.6
2.2 2.0 6.3
82.1 14.7 38.2 25.9 28.1 19.8 3.2

18.6 77.3
2.4 18.3
4.3 17.7
0.6 174.6
6.5
81.5 19.5 53.8 71.5 24.6 97.5
3.5
5.9 3.9 2.0 11.2 0.5 0.2
6.1 0.9 0.1 8.2 1.1 1.0
21.7 8.0
16.9 1.3
11.8 0.9 6.0
1.6 1.7 5.2
78.7 16.5 28.8 28.1 27.5 20.4
1.6

18.8 76.8
2.3 12.1
4.3 17.5
0.5 172.9
6.8

17.3 71.5
2.2 13.4
3.9 16.0
0.5 169.6
7.0

18.3 76.2 2.3 11.7 4.0 16.9 0.5 169.7
6.4

17.2 72.5
2.2 13.0
3.6 15.0
0.5 162.0
5.0

19.1 80.8 2.5 13.6 3.2 13.5 0.4 135.8
5.2

18.1 75.6
2.3 12.8
3.8 15.7
0.5 161.3
6.0

78.2 22.0 49.6 64.7 26.7 92.9
*

71.2 9.0
46.5 58.8 23.7 100.0
*

75.3 23.3 52.5 49.2 19.3 95.5 4.4

58.0 14.5 31.9 76.3 26.1 96.8
*

63.1 20.5 39.6 59.2 20.2 100.0 4.0

68.8 18.1 43.8 60.5 23.1 97.0
2.5

6.1

7.4

*

5.8

5.0

5.4

*

*

*

*

*

3.4

*

*

*

*

*

1.9

7.1

15.6

5.7

7.7

9.9

9.1

*

*

*

*

*

0.5

*

*

*

*

*

0.2

5.9

4.3

6.2

5.0

5.2

5.3

1.1

0.7

*

1.1

0.5

0.7

*

*

*

*

*

*

8.4

6.5

8.0

7.3

6.7

7.4

1.0

1.1

1.3

0.9

0.7

1.0

1.6

1.8

0.9

0.5

0.4

1.0

25.2 6.0
17.7 0.9
15.9 0.8 5.9

23.0 6.9
15.8 1.1
16.0 0.6 5.7

23.0 5.1
16.5 1.1 12.0 0.6 5.7

20.1 4.8
13.4 0.7
11.3 0.8 5.0

16.3 5.0
14.2 *
9.6 1.1 5.8

21.2 5.5
15.5 0.8
12.7 0.8 5.6

.

*

1.6

2.2

2.2

1.6

.

*

2.0

2.6

1.8

1.6

.

*

5.4

6.7

5.3

4.5

77.9 19.9 25.6 22.8 20.6 15.4
.

81.7 17.5 27.7 25.7 21.3 16.3
*

79.9 15.0 25.0 24.1 23.6 18.1
*

83.5 15.7 28.4 26.1 27.9 19.9
1.6

84.0 14.9 40.7 22.5 25.5 17.7 3.0

81.5 16.5 29.5 24.2 23.9 17.5
1.4

20.4 81.8
2.4 62.0
5.9 23.7
0.7 213.0
5.9

20.8 84.2
2.5 69.2
7.9 31.9
1.0 257.7
7.7

19.4 79.1 2.4 67.2 6.8 27.8 0.8 236.8 10.5

19.6 80.8
2.4 62.7
6.4 26.3
0.8 224.5
10.2

23.0 95.2 2.9 51.2 9.1 37.7 1.1 269.7 7.0

20.7 84.4
2.5 61.9
7.3 29.6
0.9 242.4
8.3

126.4 27.3 86.2 93.3 34.5
100.0 *

116.6 23.8
105.5 100.0
* * *

182.6 23.5
139.6 96.2 37.6
100.0 *

145.5 *
98.8 100.0
41.6 100.0
*

191.5 26.3
136.1 96.3 35.3
100.0 *

153.6 23.1
113.8 97.2 31.1
100.0 8.6

*

*

*

*

*

10.2

*

*

*

*

*

7.3

*

*

*

*

*

*

*

37.0

*

*

*

24.5

*

*

*

*

*

*

*

*

*

*

*

*

12.9 * *
15.1 * *

18.9 4.5 *
17.7 * *

7.8 * *
12.0 * *

14.1 * *
17.2 * *

7.3 * *
13.0 * *

12.0 2.0 *
14.9 1.6 1.2

33.7 32.2 26.9
5.8 5.0
* 7.5

32.0 29.2 25.6
3.8 11.5
3.8 7.8

25.0 28.0 36.0 4.8
* * 12.0

22.2 25.4 28.4
6.0 3.8
* 11.7

26.5 23.5 27.2
* * * *

27.4 27.4 28.7
4.3 4.9 1.6 8.8

.

*

2.6

*

*

1.4

.

*

*

*

3.3

1.8

.

*

13.4

6.4

13.3

8.5

48.8 21.0 28.6 55.4 50.4 36.4
.

59.8 19.3
* 69.2 61.5 53.1
*

52.3 17.6
* 59.2 56.0 42.4
*

53.3 16.9
* 62.7 63.4 50.7
5.2

69.9

57.6

14.7

17.7

*

24.1

50.6

59.1

45.1

54.9

34.0

43.0

4.9

2.9

331

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Houston County - 076

1990
89208 21903
1977
22.1 19.3 22.0
176 37 1513 129 430 99 22 366 41
18 7
11 29
1 10
113 18
1 117 18 13
466 216 320 15 269 53 55
. . .
1097 244 27 533 428 326 . 1

1991
91072 22207
1997
22.1 19.8 22.0
152 34
1486 111 461
87 11 367 40
19 13
6 24
2 6
126 29 1
132 23 8
463 227 280
23 238
39 85
48 46 125
1059 240
33 600 510 397
4 7

Total
1992 1993

92940 22511
2017

94799 22814
2037

22.1 20.2 22.0

21.6 19.8 22.0

170 35
1549 125 464 78 15 370 44

161 29
1406 123 466
99 13 362 35

19

14

13

13

6

1

28

27

2

4

6

4

122

136

27

36

3

4

119

127

23

20

10

29

471

462

244

221

277

292

21

13

214

218

25

31

53

41

109

87

123

84

172

198

1092 215 51 590 546 385 25 4

1028 202
38 554 609 414
29 5

1994 5-year

96665 23120
2057

464684 112555
10084

22.3 19.1 22.0

22.1 19.6 22.0

171 37
1508 130 477 94 11 354 34

830 172 7462 618 2298 457 72 1819 194

23

93

15

61

8

32

28

136

4

13

7

33

126

623

27

137

3

12

133

628

22

106

15

75

459

2321

227

1135

279

1448

24

96

199

1138

25

173

48

282

107

351

108

361

237

732

1143 228 37 643 586 454 170 7

5419 1129
186 2920 2679 1976
228 24

1990
68097 15987
1400

1991
69308 16142
1413

White
1992 1993

70525 16298
1426

71737 16453
1439

1994 5-year

72950 16609
1452

352617 81489
7130

23.3 19.1 21.0

23.2 20.0 21.0

23.1 20.2 22.0

22.5 20.4 22.0

24.3 18.5 22.0

23.3 19.8 22.0

97 17 1048 63 165 62
6 250
32

84

99

14

14

997

1074

58

68

181

188

56

56

5

8

225

224

25

29

94

82

456

17

18

80

989

1044

5152

68

58

315

205

193

932

71

61

306

5

5

29

211

197

1107

22

19

127

7

7

10

5

15

44

3

3

7

4

10

27

4

4

3

1

5

17

9

8

15

10

16

58

0

2

1

2

2

7

7

6

3

2

4

22

61

61

68

78

69

337

10

10

15

16

15

66

1

0

2

0

1

4

76

68

76

80

70

370

7

15

15

13

17

67

4

6

5

11

9

35

302

285

299

311

306

1503

73

82

96

95

87

433

183

157

163

173

156

832

3

9

8

4

6

30

222

201

188

194

174

979

36

27

12

21

16

112

27

43

24

26

25

145

.

30

60

52

63

205

.

32

91

53

77

253

.

50

80

91

139

360

835

783

833

770

852

4073

182

174

150

146

156

808

17

22

36

31

26

132

289

316

334

327

353

1619

201

233

262

327

289

1312

161

191

195

222

227

996

.

1

15

15

91

122

1

5

2

2

2

12

1990
19376 5330 531

1991
19781 5401 536

Black
1992 1993

20187 5472 542

20590 5543 547

1994 5-year

20996 5614 552

100930 27359 2708

19.6 20.9 24.0

20.2 18.8 25.0

20.1 20.7 24.0

20.2 18.7 24.0

18.9 19.3 24.0

19.7 19.4 24.0

76

67

68

66

89

366

20

20

21

12

19

92

446

465

443

393

428

2175

65

53

57

55

72

302

265

279

272

257

280

1353

36

30

21

27

32

146

16

6

7

7

6

42

101

129

125

129

146

630

7

14

12

12

15

60

11

12

9

9

8

49

4

10

6

9

5

34

7

2

3

0

3

15

20

16

13

16

12

77

1

0

1

2

2

6

3

0

2

2

3

10

49

62

54

56

57

278

8

17

12

20

12

69

0

1

1

4

2

8

39

61

40

45

59

244

11

8

8

7

5

39

9

2

5

18

6

40

156

173

163

145

142

779

143

145

147

124

139

698

133

118

108

115

118

592

12

14

13

9

18

66

46

36

24

22

22

150

17

12

13

9

9

60

27

41

26

13

22

129

.

10

42

28

33

113

.

12

24

18

26

80

.

68

89

102

80

339

247

261

239

248

264

1259

59

59

62

54

66

300

10

11

14

7

10

52

244

277

247

216

280

1264

227

273

279

271

287

1337

165

203

186

183

219

956

.

3

10

14

75

102

0

1

2

3

4

10

332

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Houston County - 076

17.0 69.1
2.1 28.8
4.1 16.7
0.5 181.8
6.1
89.0 21.0 65.3 76.4 20.7 100.0
4.6
11.9 4.6 7.3
18.9 *
0.6
7.5 1.2
* 7.8 1.2 0.9
33.0 14.5 21.5
1.0 18.0
3.6 6.7
. . .
74.0 18.5 15.3 35.7 28.6 21.8
.

16.3 66.9
2.0 31.5
4.0 16.5
0.5 186.8
5.0
76.1 22.4 55.6 79.6 20.0 97.4
2.5
12.8 8.7 4.1
16.0 *
0.3
8.5 2.0
* 9.0 1.6 0.5
33.8 15.5 19.2
1.6 16.3
2.7 10.2
1.9 1.8 4.9
74.4 18.4 20.2 41.0 34.8 27.1
*

16.7 68.8 2.1 30.4 4.0 16.4 0.5 182.9 4.6
84.3 20.6 62.0 81.8 21.8 100.0
2.5
12.3 8.4 3.9
17.9 *
0.3
7.9 1.7
* 7.8 1.5 0.6
33.5 16.0 18.2
1.4 14.1
1.7 6.1
4.2 4.7 6.6
72.3 15.9 28.7 38.6 35.8 25.2
1.6

14.8 61.6
1.9 33.7
3.8 15.9
0.5 191.7
5.3
79.1 18.0 60.4 79.3 17.2 97.1
2.5
10.0 9.2 *
19.0 * *
9.7 2.6
* 9.2 1.4 2.1
35.5 16.0 21.1
0.9 15.8
2.3 5.4
3.3 3.1 7.4
73.5 16.5 24.1 40.0 44.0 29.9
2.1

15.6 65.2 2.0 32.2 3.7 15.3 0.5 179.3 4.8
83.1 21.6 63.2 86.2 16.5 97.1
3.9
15.3 9.9 5.4
18.4 *
0.4
8.4 1.8
* 9.0 1.5 1.0
33.7 15.3 18.9
1.6 13.5
1.7 5.8
3.9 4.0 8.7
76.8 17.4 21.5 43.4 39.5 30.6 11.5

16.1 66.3
2.0 31.3
3.9 16.2
0.5 184.4
5.2
82.3 20.7 61.3 80.7 19.2 98.4
3.2
12.5 8.2 4.3
18.1 0.4 0.4
8.4 1.8 0.2 8.5 1.4 1.0
33.9 15.4 19.7
1.3 15.6
2.4 6.9
3.3 3.4 6.9
74.2 17.4 22.0 39.7 36.4 26.9
3.9

15.4 65.6
2.0 15.9
3.7 15.6
0.5 182.2
4.6

14.4 61.8
1.8 18.4
3.2 13.9
0.4 174.3
4.3

15.2 65.9 2.0 17.8 3.2 13.7 0.4 164.0 4.2

13.8 60.1
1.8 21.0
2.9 12.8
0.4 164.6
5.0

14.3 62.9 1.9 18.8 2.7 11.9 0.4 150.4 4.2

14.6 63.2
1.9 18.3
3.1 13.6
0.4 167.2
4.4

69.3 17.5 45.0 57.1 22.9 100.0
*

59.4 16.7 41.0 63.2 17.7 96.0
*

69.4 14.1 47.7 71.6 20.3 100.0
*

65.3 18.1 47.3 65.7 15.3 100.0
3.5

56.5 22.0 39.9 72.4 13.1 94.7
3.4

64.0 17.5 44.2 66.0 17.8 98.4
2.5

6.7

7.0

9.3

5.1

14.4

8.5

*

*

6.5

*

9.6

5.2

*

*

*

*

4.8

3.3

8.5

8.0

13.9

10.1

15.3

11.2

*

*

*

*

*

0.3

0.6

0.5

*

*

*

0.3

5.8

6.1

6.3

7.9

6.6

6.5

1.0

1.0

1.4

1.6

1.4

1.3

*

*

*

*

*

*

7.3

6.9

7.2

8.2

6.8

7.3

0.7

1.5

1.4

1.3

1.7

1.3

*

0.6

0.5

1.1

0.9

0.7

30.0 7.0
17.6 *
21.4 3.5 4.9

30.2 8.3
16.0 0.9
20.5 2.8 7.9

30.1 9.1 15.4 0.8 17.9 1.1 4.1

33.4 9.7
17.7 *
20.0 2.2 4.8

32.0 8.5
15.3 0.6 17.1 1.6 4.3

31.1 8.5
16.4 0.6
19.4 2.2 5.2

.

1.7

3.3

2.8

3.3

2.8

.

1.8

5.0

2.8

4.1

3.4

.

2.8

4.4

4.9

7.3

4.9

81.1 19.9 13.7 27.8 19.3 15.5
.

80.5 19.9 20.6 32.1 23.7 19.4
*

79.0 16.0 30.0 31.5 24.7 18.4 1.4

78.3 16.9 27.9 33.5 33.5 22.7
1.5

82.5 17.3 21.0 34.5 28.2 22.2 8.9

80.3 18.0 22.5 31.9 25.8 19.6
3.0

23.0 83.7
2.4 60.9
5.2 18.9
0.5 166.7 11.1

23.5 86.1
2.5 61.1
6.5 23.9
0.7 202.8
7.8

21.9 81.0 2.4 62.5 6.2 22.8 0.7 207.3 6.4

19.1 70.9
2.1 66.9
6.3 23.3
0.7 231.2
6.5

20.4 76.2 2.3 66.2 7.0 26.0 0.8 237.4 7.3

21.5 79.5
2.3 63.4
6.2 23.0
0.7 208.7
7.8

143.1 26.3 122.4 96.8 13.2 100.0 13.2

124.9 29.9 98.8 98.0 26.1
100.0 *

125.5 30.9
105.2 94.4 22.2
100.0 *

120.7 18.2
100.5 96.3 21.9 91.7 *

161.1 21.3
130.3 97.2 27.2
100.0 *

135.1 25.1 111.5 96.6 22.2 98.3 5.2

24.7 *
15.8 43.3
* *

25.8 21.5
* 34.0
* *

20.3 13.5
* 28.9
* *

22.9 22.9
* 40.0
* *

18.7 11.7
* 27.6
* *

22.5 15.6
7.0 34.7
0.7 0.4

11.0

13.3

12.2

14.2

13.3

12.8

1.8

3.7

2.7

5.1

2.8

3.2

*

*

*

*

*

0.4

9.0

13.3

9.2

11.7

13.9

11.4

2.5

1.8

1.8

1.8

1.2

1.8

2.0

*

1.1

4.6

1.4

1.8

40.1 32.9 30.8
2.8 10.6
3.9 10.6

42.8 31.7 26.1
3.1 7.9 2.6 15.0

42.6 33.8 24.9 3.0 5.5 3.0 10.0

41.7 32.2 29.9
2.4 5.8 2.4 6.3

38.0 32.9 28.0 4.3 5.2 2.1 9.7

41.0 32.7 27.9
3.1 7.1 2.8 10.6

.

1.4

5.7

3.7

4.3

3.8

.

1.7

3.3

2.4

3.4

2.7

.

9.4

12.1

13.6

10.5

11.4

57.0 15.2 20.8 56.1 52.2 37.9
.

61.0 14.7 20.0 60.6 59.7 44.4
*

56.5 16.2 26.9 56.8 64.1 42.8
2.3

63.6 15.8 16.3 56.1 70.4 47.5
3.6

62.9

60.1

17.4

15.8

22.7

21.5

66.2

59.2

67.8

62.6

51.8

44.8

17.7

6.0

333

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Irwin County - 077

1990
8649 1809
190
20.0 24.5 22.0
11 2
106 11 43
1 3 6 0
1 1 0 4 0 0
6 3 0 8 1 9
43 20 42
0 17
1 6
. . .
80 15
2 61 53 44
. 0

1991
8652 1812 191
20.6 17.6 21.0
19 8
118 14 48 7 2 14 5
0 0 0 2 0 2
7 2 0 13 0 2
49 22 35
1 13
4 6
13 8
59
84 8 0
76 61 51
8 2

Total
1992 1993

8656 1814
191

8663 1818 192

19.5 20.4 22.0

20.8 20.1 22.0

14

17

3

3

118

105

14

15

53

48

1

4

0

1

4

10

0

2

4

2

2

2

2

0

2

2

0

0

2

0

12

7

1

2

0

0

10

7

3

0

7

2

41

36

27

23

43

39

1

1

22

14

2

1

10

2

16

9

22

23

124

59

95

82

18

11

2

1

74

70

73

74

59

64

34

34

0

0

1994 5-year

8666 1822
192

43286 9075 956

20.8 17.4 23.0

20.2 19.0 22.0

20

81

8

24

121

568

18

72

46

238

1

14

1

7

8

42

2

9

1

8

1

6

0

2

2

12

0

0

1

5

12

44

2

10

1

1

14

52

3

7

5

25

40

209

20

112

35

194

0

3

17

83

0

8

4

28

7

45

17

70

102

344

94

435

16

68

0

5

63

344

69

330

50

268

31

107

1

3

1990
5992 1200
112

1991
5995 1197 112

White
1992 1993

6003 1195
111

6008 1194 110

1994 5-year

6014 1192
110

30012 5978 555

23.3 22.1 21.0

22.7 17.5 20.0

20.1 .
20.0

25.0 20.1 21.0

22.0 17.4 23.0

22.5 18.2 21.0

3

6

6

7

7

29

0

1

0

1

3

5

58

65

58

54

78

313

3

2

6

6

7

24

7

11

8

7

11

44

1

4

0

3

0

8

2

0

0

0

0

2

5

6

2

6

6

25

0

4

0

1

1

6

0

0

2

1

0

3

0

0

0

1

0

1

0

0

2

0

0

2

2

0

0

0

0

2

0

0

0

0

0

0

0

1

1

0

1

3

1

3

3

1

6

14

1

2

0

0

1

4

0

0

0

0

0

0

3

8

2

1

8

22

0

0

1

0

3

4

3

0

4

2

3

12

17

22

15

12

21

87

3

5

4

2

6

20

16

9

21

14

15

75

0

1

0

1

0

2

12

9

16

9

16

62

0

1

0

0

0

1

2

1

2

0

2

7

.

0

6

4

4

14

.

0

19

15

8

42

.

1

39

17

28

85

49

51

54

44

68

266

8

7

8

9

11

43

2

0

1

1

0

4

21

29

31

23

30

134

18

22

29

28

31

128

12

17

23

21

20

93

.

5

16

13

17

51

0

2

0

0

1

3

1990
2630 603 78

1991
2631 604
78

Black
1992 1993

2632 605 79

2634 606
79

1994 5-year

2635 608 79

13163 3026 392

18.2 36.9 24.5

16.4 19.0 25.0

18.6 20.4 25.0

18.5 .
25.5

17.2 18.5 25.0

18.3 19.6 25.0

8

13

8

10

13

52

2

7

3

2

5

19

48

53

60

50

43

254

8

12

8

9

11

48

36

37

45

41

35

194

0

3

1

1

1

6

1

2

0

1

1

5

1

8

2

4

2

17

0

1

0

1

1

3

1

0

2

1

1

5

1

0

2

1

1

5

0

0

0

0

0

0

2

2

2

2

2

10

0

0

0

0

0

0

0

1

1

0

0

2

5

4

9

6

6

30

2

0

1

2

1

6

0

0

0

0

1

1

5

5

8

6

6

30

1

0

2

0

0

3

6

2

3

0

2

13

26

27

26

23

19

121

17

17

23

21

14

92

26

26

22

25

20

119

0

0

1

0

0

1

5

4

6

4

1

20

1

3

2

1

0

7

4

5

8

2

2

21

.

0

3

1

2

6

.

0

2

6

7

15

.

0

21

30

68

119

31

33

41

37

26

168

7

1

10

2

5

25

0

0

1

0

0

1

40

47

43

47

33

210

35

39

44

46

38

202

32

34

36

43

30

175

.

3

18

21

14

56

0

0

0

0

0

0

334

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

12.3

13.6

13.6

12.1

14.0

13.1

General fertility rate

58.6

65.1

65.0

57.8

66.4

62.6

Total fertility rate

1.8

1.9

1.9

1.7

2.0

1.9

% Livebirths to unmarried women

41.0

40.7

45.3

45.7

39.0

42.3

Crude abortion rate

0.7

1.6

*

1.2

0.9

1.0

General abortion rate

3.3

7.7

*

5.5

4.4

4.6

Total abortion rate

0.1

0.2

*

0.2

0.1

0.1

Abortion ratio

50.8

99.3

*

82.6

60.2

66.0

Fetal Death rate

3.3

5.0

*

3.3

*

2.9

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

57.9

99.7

73.3

88.7 104.1

84.8

% Repeat conceptions to women under 18

*

42.1

*

*

40.0

29.6

Livebirths to women under 18

57.9

73.5

73.3

78.2

93.7

75.3

% Livebirths to unmarried women under 18

90.9

92.9

71.4

66.7

64.7

76.1

Induced abortions to women under 18

*

26.2

*

*

*

9.4

% Abortions to unmarried women under 18

* 100.0

*

*

* 100.0

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

14.1

Neonatal mortality

*

*

*

*

*

10.6

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

20.9

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

0.6

Infant health rates

% Low birthweight

5.7

5.9

10.2

6.7

9.9

7.7

% Very low birthweight

*

*

*

*

*

1.8

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

7.6

11.0

8.5

6.7

11.9

9.2

% Multiple gestation

*

*

*

*

*

1.2

% Birth defect

8.5

*

5.9

*

4.1

4.4

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

43.9

46.2

36.9

35.0

35.4

39.4

% with father not named on birth certificate

19.0

18.6

23.1

21.9

16.9

19.9

% with maternal education less than high school

40.8

30.2

36.8

37.1

29.9

34.8

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

16.3

11.0

18.8

13.3

14.5

14.8

% Maternal alcohol use during pregnancy

*

*

*

*

*

1.4

% Interpregnancy interval less than 6 months

8.3

7.9

13.2

*

*

8.1

Child abuse and neglect rates

Physical

.

5.3

6.5

3.7

2.9

4.6

Sexual

.

3.2

8.9

9.4

6.9

7.1

Neglect

.

23.8

50.3

24.0

41.7

34.9

Interventions to improve infant & child survival

% Prenatal care first trimester

76.2

73.0

80.5

79.6

77.7

77.4

% Primary C-section delivery

16.5

8.0

18.2

11.8

14.8

13.8

% Vaginal birth after previous C-section

*

*

*

*

*

6.9

% WIC during pregnancy

58.1

64.4

63.2

66.7

53.4

61.1

% Medicaid during pregnancy

50.5

51.7

62.4

70.5

58.5

58.6

% Medicaid and WIC during pregnancy

41.9

43.2

50.4

61.0

42.4

47.6

% Perinatal case management

.

6.8

29.1

32.4

26.3

23.4

Irwin County - 077

9.7 48.3
1.5 12.1
0.8 4.2 0.1 75.8
*
* * * * * * *
* * * * * *
* * * * * *
30.4 *
28.1 *
20.7 * *
. . .
86.0 15.7
* 36.2 31.0 20.7
.

10.8 54.3
1.7 16.9
1.0 5.0 0.2 80.0
*
53.8 * * * * * *
* * * * * *
* * * 12.3 * *
34.9 7.7
14.3 *
13.8 * *
* * *
78.5 12.3
* 44.6 33.8 26.2
7.7

9.7 48.5 1.5 14.0
* * * * *
54.1 *
54.1 * * * *
* * * * * *
* * * * * *
26.8 *
36.8 *
28.1 * *
4.1 13.0 26.6
93.1 16.3
* 54.4 50.9 40.4 28.1

9.0 45.2
1.4 13.0
1.0 5.0 0.2 93.8
*
63.4 *
54.3 * * * *
* * * * * *
* * * * * *
22.2 *
25.9 *
16.7 * *
* 10.3 11.6
84.6 18.0
* 42.6 51.9 38.9 24.1

13.0 65.4 2.0 14.7 1.0
5.0 0.2 70.6
*

10.4 52.4
1.6 14.2
0.8 4.2 0.1 71.4 2.0

63.8 *
63.8 * * * *

52.3 17.2 43.3 34.8 10.8 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

7.7

4.5

*

*

*

*

10.7

7.1

*

*

*

3.8

28.4 8.0 20.3
* 21.3
* *

28.7 6.5
24.6 *
20.1 *
4.0

* 5.5 19.2

2.4 7.2 14.5

87.2 15.7
* 40.0 41.3 26.7 22.7

85.8 15.5
* 43.4 41.4 30.1 20.3

18.3 79.6
2.1 76.6
* * * * *

20.1 87.7
2.3 69.8
3.0 13.2
0.4 121.2
8.3

22.8 99.2 2.6 75.0
* * * * *

19.0 82.5
2.1 82.0
* * * * *

16.3 70.7 1.9 81.4
* * * * *

19.3 83.9
2.2 76.7
1.3 5.6 0.1 59.6 4.6

102.6 *
102.6 100.0
* * *

166.2 53.8
153.5 100.0
* * *

101.9 *
101.9 100.0
* * *

127.1 *
114.4 100.0
* * *

164.8 38.5
139.4 81.8 * * *

132.6 36.5
122.4 95.8 * * *

*

*

*

*

*

19.7

*

*

*

*

*

19.7

*

*

*

*

*

*

*

*

*

*

*

38.6

*

*

*

*

*

*

*

*

*

*

*

*

10.4 * *
10.6 *
12.5

*

15.0

12.0

14.0

11.8

*

*

*

*

2.4

*

*

*

*

*

9.4

13.3

12.0

14.0

11.9

*

*

*

*

*

*

*

*

*

5.1

61.9 36.2 56.5
* 10.9
* *

62.8 32.1 49.1
* * * 12.5

47.3 38.3 36.7
* 10.0
* 19.0

47.9 42.0 50.0
* * * *

48.7 32.6 46.5
* * * *

53.3 36.4 47.2
* 8.0 2.8 12.4

.

*

*

*

*

1.5

.

*

*

6.0

7.1

3.8

.

*

21.0

30.1

68.5

29.8

64.6 17.5
* 85.1 74.5 68.1
.

66.0 * *
88.7 73.6 64.2
*

68.3 20.0
* 71.7 73.3 60.0 30.0

74.0 * *
94.0 92.0 86.0 42.0

60.5

66.9

13.2

11.7

*

*

76.7

83.0

88.4

79.8

69.8

69.2

32.6

27.2

335

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Jackson County - 078

1990
30005 6711 623
20.4 18.4 20.0
76 17 499 58 114 36
7 98 15
7 4 3 11 0 3
33 6 0
43 4 6
107 46 182
5 121
8 19
. . .
370 73
5 213 173 127
. 0

1991
30484 6769 630
20.9 21.0 21.0
56 20 470 49 123 24
1 90
8
10 7 3 6 0 1
39 7 2
49 6 9
93 70 172
2 96 13 16
3 4 12
357 82 5
234 204 175
36 0

Total
1992 1993

30958 6827 638

31432 6883 645

20.9 20.3 21.0

20.8 20.8 21.0

54

65

12

14

485

461

46

58

128

126

35

38

6

4

77

76

3

5

4

2

3

2

1

0

9

6

2

2

5

2

40

35

11

4

1

1

38

33

8

3

20

28

88

78

61

52

175

174

6

0

94

79

8

6

19

25

24

12

32

22

75

58

382

367

54

52

8

13

235

242

232

255

191

211

147

169

0

0

1994 5-year

31906 6942 653

154785 34132 3190

21.6 18.6 22.0

20.9 19.7 21.0

72

323

17

80

502

2417

59

270

126

617

30

163

5

23

78

419

11

42

3

26

1

17

2

9

7

39

1

5

7

18

46

193

10

38

1

5

42

205

5

26

9

72

115

481

52

281

170

873

2

15

86

476

4

39

17

96

5

44

25

83

34

179

435

1911

59

320

9

40

251

1175

257

1121

211

915

157

509

1

1

1990
26942 5995 545

1991
27411 6054 552

White
1992 1993

27871 6113 560

28335 6170 566

1994 5-year

28797 6229 574

139356 30561 2797

20.8 18.4 20.0

20.9 21.0 20.0

21.2 20.5 21.0

20.8 20.6 21.0

22.2 19.0 21.0

21.1 19.9 21.0

66

47

44

60

57

274

15

16

10

13

13

67

448

423

436

419

461

2187

50

44

37

54

47

232

77

88

90

97

93

445

34

23

33

34

30

154

7

1

6

2

5

21

82

71

64

60

61

338

13

4

3

5

8

33

6

8

4

2

1

21

3

5

3

2

1

14

3

3

1

0

0

7

10

4

9

4

7

34

0

0

2

1

1

4

3

1

4

1

5

14

29

30

33

30

38

160

5

5

10

4

8

32

0

1

1

1

1

4

34

39

29

29

34

165

4

6

8

2

5

25

6

8

17

22

7

60

91

82

76

69

100

418

29

50

41

37

33

190

160

152

155

162

150

779

4

1

5

0

2

12

110

86

86

73

81

436

8

11

7

6

1

33

18

10

15

21

16

80

.

3

22

12

4

41

.

4

31

22

24

81

.

11

58

53

27

149

342

326

353

343

405

1769

68

75

46

47

54

290

5

3

5

12

9

34

173

204

201

212

220

1010

149

173

195

222

229

968

107

151

162

183

188

791

.

33

128

149

135

445

0

0

0

0

0

0

1990
2904 670 75

1991
2950 676
76

Black
1992 1993

2996 682 77

3042 687
78

1994 5-year

3088 693 79

14981 3407 384

18.2 17.1 24.0

20.6 17.0 22.0

19.0 19.9 31.0

21.2 23.9 25.0

16.6 17.2 30.0

19.1 18.9 24.0

10

9

10

5

15

49

2

4

2

1

4

13

49

45

48

42

38

222

8

5

9

4

12

38

36

35

38

29

32

170

2

0

2

4

0

8

0

0

0

2

0

2

12

15

12

13

14

66

2

4

0

0

3

9

1

2

0

0

2

5

1

2

0

0

0

3

0

0

0

0

2

2

1

2

0

2

0

5

0

0

0

1

0

1

0

0

1

1

2

4

4

9

7

5

8

33

1

2

1

0

2

6

0

1

0

0

0

1

9

10

9

4

8

40

0

0

0

1

0

1

0

1

3

6

2

12

16

11

11

9

15

62

17

20

20

15

18

90

22

20

19

12

20

93

1

1

1

0

0

3

11

10

7

6

5

39

0

2

1

0

3

6

1

6

4

4

1

16

.

0

1

0

1

2

.

0

0

0

1

1

.

1

13

4

7

25

27

30

28

24

27

136

4

7

8

5

4

28

0

2

3

1

0

6

38

29

34

30

29

160

24

30

36

33

27

150

20

23

29

28

22

122

.

3

18

20

22

63

0

0

0

0

1

1

336

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Jackson County - 078

16.6 74.4
2.2 23.0
3.3 14.6
0.4 152.6
6.7
122.0 22.4 93.1 54.4 24.1 100.0
*
14.0 * *
21.7 * *
6.6 1.2
* 8.7
* 1.2
28.9 9.3
37.6 1.0
24.7 1.6 7.3
. . .
75.1 16.3 10.2 42.9 34.9 25.6
.

15.4 69.4
2.1 26.6
3.0 13.3
0.4 153.1
4.1
88.8 35.7 77.7 62.5 12.7 100.0
*
21.3 14.9
* 12.7
* *
8.3 1.5
* 10.6
1.3 1.9
26.6 15.2 38.3
* 21.4
2.9 6.3
* * 1.5
76.4 19.3 13.5 50.6 44.2 37.9
7.8

15.7 71.0 2.2 26.8 2.5 11.3 0.3 127.3 6.3
84.6 22.2 72.1 58.7
* * 9.4
* * * 18.3 * 0.8
8.3 2.3
* 8.0 1.7 4.1
25.7 12.8 37.2 1.3 22.0 1.9 7.4
2.9 3.9 9.1
79.4 12.6 16.3 49.3 48.6 40.0 30.8

14.7 67.0
2.1 27.6
2.4 11.0
0.3 131.0
6.2
100.7 21.5 89.9 55.2 7.7
100.0 *
* * * 12.9 * *
7.6 * *
7.2 *
6.1
25.7 11.4 38.3
* 20.2
1.5 9.6
1.4 2.6 7.0
80.0 12.6 28.9 53.0 55.8 46.2 37.0

15.7 72.3 2.2 25.4 2.4 11.2 0.3 126.6 5.2
110.2 23.6 90.3 67.8 16.8
100.0 *
* * * 13.8 * 1.1
9.2 2.0
* 8.5 1.0 1.8
24.0 10.5 35.1
* 17.5
* 6.3
0.6 3.0 4.0
87.3 13.6 14.3 50.5 51.7 42.5 31.6

15.6 70.8
2.2 25.8
2.7 12.3
0.4 138.2
5.7
101.2 24.8 84.6 59.7 13.2 100.0
4.4
10.8 7.0 3.8
16.0 0.5 0.6
8.0 1.6 0.2 8.6 1.1 3.0
26.1 11.8 37.3
0.6 21.2
1.7 7.4
1.3 2.5 5.4
79.7 14.9 16.5 49.2 46.9 38.3 26.9

16.6 74.7
2.3 17.3
3.0 13.7
0.4 143.1
7.2

15.4 69.9
2.1 21.2
2.6 11.7
0.3 136.5
4.3

15.6 71.3 2.2 21.0 2.3 10.5 0.3 118.3 6.7

14.8 67.9
2.1 23.3
2.1 9.7 0.3 116.3 6.0

16.0 74.0 2.3 20.4 2.1
9.8 0.3 109.3 5.8

15.7 71.6
2.2 20.6
2.4 11.1
0.3 124.8
6.0

121.1 22.7 91.7 46.9 23.9 100.0
*

85.1 34.0 79.7 58.1
* * *

78.6 22.7 66.1 48.6
* * 8.9

105.9 21.7 95.3 51.9 8.8
100.0 *

99.4 22.8 81.9 61.7 13.9 100.0
*

98.0 24.5 82.9 53.5 11.8 100.0
4.3

13.4 * *
22.0 * *

18.9 11.8
* * * *

* * * 20.4 * *

*

*

9.6

*

*

6.4

*

*

3.2

*

15.0

15.4

*

*

*

*

0.9

0.5

6.5

7.1

7.6

7.2

8.2

7.3

1.1

1.2

2.3

*

1.7

1.5

*

*

*

*

*

*

7.6

9.4

6.8

7.0

7.5

7.6

*

1.4

1.9

*

1.1

1.2

1.3

1.9

3.9

5.3

1.5

2.7

28.0 6.5
36.7 *
25.1 1.8 7.8

26.7 12.0 37.3
* 21.4
2.7 4.5

24.9 9.6 36.6 1.2 22.3 1.8 6.5

25.3 8.9
39.1 *
20.2 1.7 8.9

22.6 7.2
33.7 *
18.0 *
6.4

25.3 8.8
36.6 0.6
21.4 1.6 6.8

.

*

3.0

1.6

*

1.4

.

*

4.2

3.0

3.2

2.7

.

1.5

7.9

7.1

3.6

5.1

77.2 17.1 10.6 38.9 33.5 24.0
.

77.4 19.5
* 49.2 41.7 36.4
8.0

81.7 11.9 12.5 47.0 45.6 37.9 29.9

82.3 12.4 31.6 50.8 53.2 43.9 35.7

88.4 13.6 15.3 48.2 50.2 41.2 29.6

81.5 14.9 15.9 46.7 44.8 36.6 25.9

16.9 73.1
2.1 73.5
4.1 17.9
0.5 190.5
*

15.3 66.6
1.9 77.8
5.1 22.2
0.6 . *

16.0 70.4 2.1 79.2 4.0 17.6 0.5 193.5
*

13.8 61.1
1.8 72.5
4.3 18.9
0.5 213.1
8.7

12.3 54.8 1.6 84.2 4.5 20.2 0.5
. *

14.8 65.2
1.9 77.3
4.4 19.4
0.5 221.5
2.9

133.3 *
106.7 100.0
* * *

118.6 *
65.9 100.0
* * *

130.0 *
117.0 100.0
* * *

64.4 * * * * * *

190.8 *
152.7 91.7 * * *

127.6 26.5 98.9 97.4 23.4 100.0
*

*

*

*

*

*

22.5

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

22.3

*

*

*

*

*

*

*

*

*

*

*

*

* * * 18.4 * *

20.0 * *
22.2 * *

14.6 * *
18.8 * *

11.9 * * * *
14.3

21.1 * *
21.1 * *

14.9 2.7 *
18.2 *
5.4

37.2 34.7 47.8
* 22.9
* *

26.8 44.4 51.3
* 22.7
* 19.4

30.6 41.7 41.3
* 16.7
* *

29.0 37.5 30.0
* 19.4
* *

42.9 47.4 54.1
* 13.2
* *

33.3 40.9 44.7
* 19.2
3.0 12.3

.

*

*

*

*

*

.

*

*

*

*

*

.

*

14.8

*

7.7

7.0

56.3 * *
77.6 49.0 40.8
.

68.2 18.4
* 64.4 66.7 51.1
*

58.3 20.0
* 70.8 75.0 60.4 37.5

57.1 15.2
* 75.0 82.5 70.0 50.0

73.0

62.1

*

14.6

*

21.4

76.3

72.7

71.1

68.2

57.9

55.5

57.9

36.8

337

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Jasper County - 079

1990
8453 1885
194
19.1 23.8 22.0
19 1
129 16 46
7 1 33 2
0 0 0 1 0 0
17 2 0
17 2 0
45 20 41
1 16
2 5
. . .
103 15
1 77 55 50
. 0

1991
8471 1873 195
19.8 18.3 19.5
21 3
132 17 49 12 2 25 2
0 0 0 2 0 0
8 0 0 14 1 2
35 21 36
1 24
2 7
0 2 5
98 18
2 86 69 59
0 0

Total
1992 1993

8479 1861
196

8500 1848 196

21.1 17.5 22.0

20.0 17.3 24.0

21

19

6

3

115

122

11

16

48

47

2

4

1

1

28

27

10

3

1

1

0

1

1

0

1

2

0

0

0

0

16

12

4

3

0

0

15

15

2

1

1

1

38

34

22

22

27

41

3

0

21

24

1

1

9

5

1

11

2

10

16

33

91

95

21

14

0

3

77

79

70

76

59

63

3

11

0

0

1994 5-year

8516 1834
197

42419 9301 977

20.0 17.7 20.0

20.0 17.7 22.0

25

105

9

22

126

624

18

78

56

246

6

31

1

6

29

142

5

22

2

4

0

1

2

3

1

7

0

0

1

1

17

70

3

12

0

0

13

74

2

8

2

6

38

190

24

109

37

182

1

6

24

109

2

8

5

31

2

14

5

19

82

136

100

487

16

84

1

7

75

394

76

346

62

293

42

56

0

0

1990
5481 1151
116

1991
5546 1157 117

White
1992 1993

5603 1163
119

5668 1168 120

1994 5-year

5733 1174
122

28031 5813 594

20.0 16.4 20.0

22.9 20.3 19.0

20.8 18.4 21.5

21.7 21.9 20.0

24.3 17.7 19.0

21.4 18.1 20.0

11

10

6

7

10

44

1

2

1

2

3

9

79

68

61

73

69

350

8

7

3

6

6

30

12

8

11

12

12

55

6

8

1

2

3

20

0

0

1

0

0

1

14

14

13

12

13

66

2

1

3

1

3

10

0

0

1

1

1

3

0

0

0

1

0

1

0

0

1

0

1

2

0

0

1

1

0

2

0

0

0

0

0

0

0

0

0

0

0

0

7

3

8

6

8

32

1

0

0

3

1

5

0

0

0

0

0

0

8

6

5

9

7

35

2

1

2

1

2

8

0

1

1

0

0

2

23

12

16

16

20

87

3

3

5

5

5

21

22

19

11

23

20

95

0

0

0

0

0

0

12

21

13

20

17

83

2

1

0

1

1

5

0

2

3

3

2

10

.

0

1

8

0

9

.

1

2

7

3

13

.

1

9

8

19

37

71

54

52

59

64

300

8

7

7

7

10

39

1

1

0

2

0

4

40

34

35

38

31

178

24

25

30

33

30

142

22

19

26

26

24

117

.

0

2

1

15

18

0

0

0

0

0

0

1990
2940 728 78

1991
2946 724
78

Black
1992 1993

2949 719 79

2956 715
79

1994 5-year

2962 709 79

14754 3595 393

16.9 28.1 30.0

17.9 14.1 20.0

21.7 17.1 27.0

17.0 17.3 26.0

18.9 18.3 23.5

18.6 17.6 26.0

8

11

15

12

15

61

0

1

5

1

6

13

50

64

54

48

57

273

8

10

8

10

12

48

34

41

37

35

44

191

1

4

1

2

3

11

1

2

0

1

1

5

19

11

14

15

16

75

0

1

7

2

2

12

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

1

1

1

2

0

1

1

5

0

0

0

0

0

0

0

0

0

0

1

1

10

5

8

6

9

38

1

0

4

0

2

7

0

0

0

0

0

0

9

8

10

6

6

39

0

0

0

0

0

0

0

1

0

1

2

4

22

23

22

18

18

103

17

18

17

17

19

88

19

17

16

18

17

87

1

1

3

0

1

6

4

3

8

4

7

26

0

1

1

0

1

3

5

5

6

2

3

21

.

0

0

1

0

1

.

1

0

2

1

4

.

4

7

13

14

38

32

44

39

35

36

186

7

11

14

6

6

44

0

1

0

1

1

3

37

52

42

40

44

215

31

44

40

43

46

204

28

40

33

37

38

176

.

0

1

10

27

38

0

0

0

0

0

0

338

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Jasper County - 079

15.3 68.4
2.1 36.2
3.9 17.5
0.5 193.0
4.8
97.9 *
82.5 81.3
* * *
* * * * * *
13.2 * *
13.4 * *
39.1 15.7 32.3
* 12.7
* 6.8
. . .
79.8 12.7
* 60.6 43.3 39.4
.

15.6 70.5
2.2 37.4
3.0 13.3
0.4 146.2
7.5
107.9 *
87.4 76.5
* * *
* * * * * *
6.1 * *
10.7 * *
29.4 16.0 27.5
* 18.3
* 9.2
* * 2.1
74.2 15.4
* 65.6 52.7 45.0
*

13.6 61.8 1.9 42.5 3.3 15.0 0.5 191.8
*
107.2 28.6 56.2 81.8 51.0
100.0 *
* * * * * *
13.9 * *
13.4 * *
35.8 19.5 23.9
* 18.6
* 12.5
* * 6.7
79.1 20.0
* 68.1 61.9 52.2
*

14.4 66.0
2.1 38.8
3.2 14.6
0.5 175.3
2.7
97.0 *
81.7 81.3
* * *
* * * * * *
9.8 * *
12.4 * *
29.3 18.2 33.9
* 19.8
* 7.5
4.6 4.2 13.9
77.9 12.5
* 65.3 62.8 52.1
9.1

14.8 68.7 2.1 45.2 3.4 15.8 0.5 179.0 3.8
127.2 36.0 91.6 88.9 25.4
100.0 *
* * * * * *
13.5 * *
10.5 * *
33.6 19.4 30.1
* 19.8
* 7.6
* 2.1 34.6
79.4 13.6
* 60.5 61.3 50.0 33.9

14.7 67.1
2.1 39.9
3.3 15.3
0.5 176.6
4.1
107.5 21.0 79.8 82.1 22.5 100.0
5.1
* * * 11.1 * *
11.2 1.9 *
12.0 1.3 1.0
33.4 17.7 29.6
1.0 17.8
1.3 8.8
1.5 2.0 14.3
78.0 14.7 15.2 64.0 56.2 47.6 11.5

14.4 68.6
2.2 15.6
2.6 12.2
0.4 141.4
5.2

12.3 58.8
1.9 11.9
2.5 12.1
0.4 155.6
6.9

10.9 52.5 1.6 18.6 2.3 11.2 0.3 171.1
*

12.9 62.5
2.0 16.7
2.1 10.3
0.3 137.9
*

12.0 58.8 1.9 17.9 2.3 11.1 0.3 152.9
*

12.5 60.2
1.9 16.1
2.4 11.4
0.4 151.0
3.6

94.8 *
69.0 62.5
* * *

85.3 *
59.7 * * * *

50.4 * * * * * *

58.2 *
49.9 * * * *

82.3 *
49.4 * * * *

74.1 20.5 50.5 53.3 16.8 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

8.9 * *
10.4 * *

*

13.1

8.2

11.6

9.1

*

*

*

*

1.4

*

*

*

*

*

9.0

8.6

12.5

10.4

10.3

*

*

*

*

2.3

*

*

*

*

*

31.5 *
28.6 *
15.8 * *

19.4 *
28.4 *
31.3 * *

28.6 8.5 18.6
* 22.0
* *

23.5 6.9
31.9 *
27.8 * *

30.8 7.5 29.9
* 26.2
* *

26.9 6.1
27.8 *
24.5 1.5 5.4

.

*

*

5.6

*

1.6

.

*

*

4.9

*

2.3

.

*

6.4

5.6

13.3

6.5

89.9 11.3
* 51.9 31.2 28.6
.

79.4 12.3
* 50.7 37.3 28.4
*

85.2 13.0
* 59.3 50.8 44.1
*

80.8 10.6
* 52.8 45.8 36.1
*

92.8 16.1
* 46.3 44.8 35.8 22.4

85.7 12.6
* 52.0 41.5 34.2
6.8

17.0 68.7
2.0 68.0
6.5 26.1
0.8 263.9
*

21.7 88.4
2.7 64.1
3.7 15.2
0.5 135.8
8.3

18.3 75.1 2.3 68.5 4.7 19.5 0.6 202.9
*

16.2 67.2
2.0 72.9
5.1 21.0
0.6 227.3
*

19.2 80.4 2.4 77.2 5.4 22.6 0.7 207.8
*

18.5 75.9
2.3 70.0
5.1 20.9
0.6 205.5
4.7

102.6 *
102.6 100.0
* * *

140.5 *
127.7 100.0
* * *

190.4 33.3
101.5 100.0
88.8 100.0
*

152.3 *
126.9 100.0
* * *

189.9 40.0
151.9 100.0
* * *

155.3 21.3
122.2 100.0
30.5 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

18.0

*

*

*

*

*

*

*

*

*

*

*

*

20.0 * *
18.0 * *

7.8 * *
12.5 * *

14.8 * *
18.5 * *

12.5 * *
12.5 * *

15.8 * *
10.5 * *

13.9 2.6 *
14.3 * *

52.4 34.0 38.0
* * * 14.7

40.4 28.1 26.6
* * * 11.4

44.0 31.5 29.6
* 14.8
* 17.1

38.3 35.4 37.5
* * * *

37.5 33.3 30.4
* 12.5
* *

42.2 32.2 32.0
2.2 9.6
* 12.4

.

*

*

*

*

*

.

*

*

*

*

*

.

*

7.2

13.4

14.4

9.8

64.0 14.9
* 74.0 62.0 56.0
.

68.8 18.3
* 81.3 68.8 62.5
*

72.2 27.5
* 77.8 74.1 61.1
*

72.9 13.3
* 83.3 89.6 77.1 20.8

63.2

68.1

10.7

17.0

*

*

77.2

78.8

80.7

74.7

66.7

64.5

47.4

17.0

339

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Jeff Davis County - 080

1990
12032 2767 281
20.4 16.8 20.0
20 5
195 15 51 21
2 5 2
3 2 1 4 0 3
30 5 0
40 6 4
70 26 62
1 45
1 3
. . .
139 36
3 96 73 57
. 0

1991
12161 2771 278
19.7 21.8 20.0
26 1
177 24 49 14 5 4 0
3 2 1 7 0 3
12 4 0
25 1 1
60 22 79
2 52
1 9
2 2 23
136 34 2
112 95 85 6 0

Total
1992 1993

12280 2776 276

12409 2781 273

20.4 18.4 20.0

20.1 16.6 20.0

29

28

7

7

185

179

23

25

51

56

22

12

0

2

9

7

3

2

2

0

0

0

2

0

0

2

0

1

0

2

11

11

1

1

0

0

21

13

1

0

4

2

54

60

27

22

65

67

0

4

47

36

0

2

6

4

10

12

22

9

67

87

132

133

30

38

2

2

107

106

108

113

88

91

59

80

0

0

1994 5-year

12525 2785 270

61407 13880
1378

19.9 .
21.0

20.1 17.8 20.0

23

126

6

26

174

910

22

109

51

258

19

88

0

9

0

25

0

7

1

9

0

4

1

5

0

13

0

1

1

9

16

80

3

14

0

0

21

120

1

9

1

12

68

312

26

123

61

334

2

9

39

219

1

5

7

29

4

28

10

43

58

235

126

666

30

168

2

11

110

531

115

504

93

414

80

225

0

0

1990
10084 2306 226

1991
10186 2308 224

White
1992 1993

10278 2309 222

10378 2311 219

1994 5-year

10471 2313 217

51397 11547
1108

20.5 16.7 20.0

19.9 21.8 20.0

20.5 19.7 20.0

20.1 16.6 19.5

20.0 .
20.0

20.2 17.8 20.0

15

24

22

22

18

101

4

0

4

7

6

21

152

149

142

145

142

730

11

22

19

19

17

88

26

29

28

40

32

155

18

11

18

10

18

75

2

3

0

0

0

5

3

4

5

6

0

18

2

0

2

2

0

6

3

3

0

0

0

6

2

2

0

0

0

4

1

1

0

0

0

2

4

5

0

0

0

9

0

0

0

1

0

1

3

3

0

1

1

8

21

10

5

4

4

0

0

0

0

30

23

11

5

1

1

2

1

4

6

13

55

0

2

10

0

0

0

8

18

90

0

1

8

2

1

10

54

49

39

46

49

237

13

15

11

10

15

64

53

71

57

55

50

286

1

2

0

3

1

7

39

48

40

34

35

196

1

1

0

1

1

4

1

5

4

3

6

19

.

2

5

9

2

18

.

1

18

9

8

36

.

15

35

62

41

153

114

116

107

115

107

559

30

29

23

33

23

138

3

2

2

2

2

11

63

87

73

80

83

386

48

73

76

84

88

369

37

63

60

68

70

298

.

3

38

61

59

161

0

0

0

0

0

0

1990
1834 443 52

1991
1854 444 52

Black
1992 1993

1872 444 51

1892 445 51

1994 5-year

1909 446 50

9360 2222
255

18.0 19.8 22.0

18.4 .
26.5

19.2 15.9 22.5

18.0 .
25.5

18.8 .
24.5

18.6 17.9 24.0

5

2

7

6

5

25

1

1

3

0

0

5

41

28

41

34

30

174

4

2

4

6

5

21

24

20

22

16

19

101

3

3

4

2

1

13

0

2

0

2

0

4

2

0

4

1

0

7

0

0

1

0

0

1

0

0

2

0

1

3

0

0

0

0

0

0

0

0

2

0

1

3

0

2

0

2

0

4

0

0

0

0

0

0

0

0

0

1

0

1

9

2

5

5

3

24

1

0

1

1

1

4

0

0

0

0

0

0

10

2

9

5

3

29

1

0

0

0

0

1

2

0

0

0

0

2

15

11

13

14

19

72

13

7

16

12

10

58

9

8

8

12

11

48

0

0

0

1

1

2

6

4

7

2

3

22

0

0

0

1

0

1

2

4

2

1

1

10

.

0

4

2

2

8

.

0

2

0

1

3

.

8

30

20

11

69

24

20

24

18

18

104

5

5

7

5

6

28

0

0

0

0

0

0

33

25

34

26

26

144

24

22

31

29

26

132

20

22

28

23

22

115

.

3

21

19

20

63

0

0

0

0

0

0

340

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Jeff Davis County - 080

1990
16.2 70.5
2.1 27.0
0.4 1.8
* 22.4
8.3
71.2 25.0 53.4
* * * *
* * * * * *
15.4 2.6 *
21.2 3.2 *
38.3 13.8 32.8
* 24.1
* *
. . .
72.4 21.8
* 50.8 38.6 30.2
.

1991
14.6 63.9
1.9 27.8
* * * * 6.9
93.5 *
86.3 37.5
* * *
* * * 38.5 * *
6.8 * *
14.1 * *
36.8 12.4 45.1
* 30.2
* 10.0
* * 6.8
77.7 21.8
* 63.3 53.7 48.0
3.4

Total
1992 1993

15.1

14.4

66.6

64.4

2.0

1.9

27.7

31.3

0.7

0.6

3.2

2.5

0.1

0.1

41.7

35.0

7.9

5.0

105.1 24.1 83.4 47.8 * * *

102.6 25.0 91.6 68.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

5.9

6.1

*

*

*

*

11.4

7.3

*

*

*

*

30.9

36.1

14.7

12.3

35.3

37.4

*

*

25.5

20.2

*

*

5.3

*

3.0

3.5

6.5

2.7

19.8

25.6

72.9

76.0

20.1

23.3

*

*

58.2

59.2

58.7

63.1

47.8

50.8

32.1

44.7

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

13.9 62.5
1.8 29.7
* * * * 6.8

14.8 65.6
1.9 28.7
0.4 1.8 0.0 24.2 7.0

85.2

91.4

26.1

20.6

81.5

79.1

63.6

49.5

*

5.1

* 100.0

*

8.0

*

9.9

*

*

*

5.5

*

14.1

*

*

*

0.7

9.2 * *
12.2 * *

8.8 1.5
* 13.3
1.0 1.3

41.7 15.0 35.5
* 22.7
* 7.3

36.7 13.6 37.2
1.0 24.5
0.6 5.8

* 2.9 17.1

2.1 3.2 17.3

73.3

74.4

20.7

21.6

*

8.9

63.6

58.9

66.5

55.9

53.8

45.9

46.2

31.6

15.1 65.9
2.0 17.7
* * * * 8.7

14.6 64.6
1.9 19.6
* * * * 6.1

66.4 107.2

*

*

48.7

98.3

*

36.4

*

*

*

*

*

*

*

*

*

*

*

*

*

32.9

*

*

*

*

13.8 * *
20.4 3.4 *

6.7 * *
15.4 * *

38.3 8.8
36.1 *
26.9 * *

35.8 10.1 48.3
* 33.3
* 7.4

.

*

.

*

.

5.5

76.5 23.6
* 42.9 32.7 25.2
.

78.9 22.5
* 58.4 49.0 42.3
*

13.8

14.0

61.5

62.7

1.8

1.9

19.9

27.6

0.5

0.6

2.2

2.6

0.1

0.1

30.3

37.3

7.8

4.3

99.3 100.3

*

31.8

85.7

86.6

36.8

57.9

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

3.5

4.1

*

*

*

*

7.8

5.5

*

*

*

*

29.5

34.8

7.8

6.9

40.4

37.9

*

*

28.4

23.6

*

*

*

*

1.8

3.3

6.6

3.3

12.8

22.6

77.5

81.6

20.4

25.4

*

*

51.8

55.2

53.9

57.9

42.6

46.9

27.0

42.1

13.6 61.4
1.8 22.7
* * * * 7.8

14.2 63.2
1.9 21.5
0.4 1.6 0.0 21.7 6.9

82.9

91.2

33.3

20.8

78.3

79.4

52.9

40.9

*

5.4

* 100.0

*

7.2

*

8.2

*

*

*

*

*

12.2

*

*

*

0.8

9.2 * *
12.8 * *

7.5 1.4
* 12.4
1.1 1.4

37.1 10.6 35.5
* 24.8
* 7.7

35.2 8.9
39.7 1.0
27.4 *
5.0

* 2.9 14.9

1.6 3.3 13.9

75.9

78.1

19.3

22.3

*

10.5

58.9

53.4

62.4

51.0

49.6

41.2

41.8

28.0

22.4 92.6
2.7 60.0
* * * * *
96.2 * * * * * *
* * * * * *
22.0 * *
25.0 * *
37.5 32.5 22.5
* 15.0
* *
. . .
58.5 13.9
* 82.5 60.0 50.0
.

15.1

21.9

18.0

15.7

18.6

63.1

92.3

76.4

67.3

78.3

1.8

2.7

2.2

2.0

2.3

71.4

53.7

47.1

63.3

58.4

*

*

*

*

0.7

*

*

*

*

3.2

*

*

*

*

0.1

*

*

*

*

35.4

11.3

*

*

*

7.7

* 137.3 118.8 100.0

98.0

*

*

*

*

20.0

*

* 118.8 100.0

82.4

*

* 100.0 100.0

85.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

12.2

14.7

*

*

*

*

*

*

*

22.0

14.7

*

*

*

*

*

*

*

13.8

*

*

*

*

*

16.8

*

*

*

*

42.3

31.7

41.2

63.3

42.1

25.0

39.0

35.3

33.3

33.5

28.6

19.5

35.3

36.7

27.7

*

*

*

*

*

*

17.1

*

*

12.7

*

*

*

*

*

*

*

*

*

8.4

*

*

*

*

3.2

*

*

*

*

*

12.9

48.1

32.0

17.6

27.6

71.4

58.5

52.9

60.0

59.8

18.5

20.6

15.2

25.0

18.2

*

*

*

*

*

89.3

82.9

76.5

86.7

83.2

78.6

75.6

85.3

86.7

76.3

78.6

68.3

67.6

73.3

66.5

*

51.2

55.9

66.7

47.4

341

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Jefferson County - 081

Total
1990 1991 1992 1993 1994 5-year

17408 4007 460

17440 4003 456

17472 3999 452

17504 3993 448

17532 3987 444

87356 19989
2259

19.8 19.5 22.0

20.2 18.9 22.0

20.7 19.3 23.0

20.8 18.5 24.0

20.7 16.9 25.0

20.5 18.6 23.0

50

54

40

41

51

236

13

13

7

7

12

52

320

325

299

302

281 1527

43

46

36

32

36

193

184

189

177

183

158

891

18

14

13

10

13

68

5

9

1

0

3

18

62

67

63

74

59

325

7

6

4

10

13

40

3

6

5

5

4

23

3

3

3

5

4

18

0

3

2

0

0

5

8

12

4

5

7

36

3

1

0

1

1

6

3

2

2

0

2

9

41

46

34

38

38

197

5

7

2

9

8

31

1

1

2

1

0

5

35

39

38

42

33

187

3

9

2

4

3

21

5

2

7

6

2

22

187

221

121

141

89

759

114

116

101

97

97

525

147

143

135

127

111

663

6

8

16

4

4

38

29

28

29

18

27

131

5

1

6

2

5

19

23

13

22

15

12

85

.

5

6

4

.

14

6

8

.

65

53

93

0

15

0

28

0

211

204

244

213

238

236 1135

31

21

33

37

22

144

4

4

4

6

6

24

205

229

209

214

203 1060

171

185

179

211

201

947

135

169

159

187

176

826

.

4

8

57

124

193

0

0

0

0

0

0

White
1990 1991 1992 1993 1994 5-year

7660 1511
148

7652 1510 149

7645 1507
149

7640 1506
151

7631 1503 151

38228 7537 747

20.9 18.8 21.0

21.2 19.0 22.0

22.4 .
21.0

23.4 19.3 23.0

23.2 18.9 22.0

22.4 19.1 22.0

12

8

8

10

8

46

2

2

4

0

0

8

94

103

89

93

90

469

11

7

7

7

6

38

15

25

18

11

10

79

9

8

7

6

5

35

0

4

1

0

0

5

12

13

13

14

13

65

1

1

1

3

2

8

0

2

1

0

1

4

0

1

0

0

1

2

0

1

1

0

0

2

0

5

1

0

1

7

0

0

0

0

0

0

1

1

1

0

1

4

8

9

5

6

6

34

2

2

0

0

2

6

0

0

0

0

0

0

10

9

4

10

7

40

1

1

0

0

1

3

0

1

2

1

1

5

39

51

31

37

25

183

9

11

11

5

4

40

33

39

33

20

28

153

1

1

1

1

1

5

12

15

15

12

20

74

2

0

3

0

2

7

3

3

3

3

1

13

.

0

2

2

0

4

.

6

4

7

0

17

.

13

11

7

0

31

71

86

77

80

82

396

10

10

10

19

9

58

2

2

0

1

0

5

39

45

42

33

40

199

23

32

32

32

40

159

20

30

30

27

31

138

.

0

4

6

16

26

0

0

0

0

0

0

Black
1990 1991 1992 1993 1994 5-year

9700 2480
308

9718 2477 305

9736 2474
302

9754 2470
300

9769 2466 297

48676 12367
1513

19.5 19.5 23.0

19.1 18.9 24.5

19.0 19.3 25.0

20.3 18.4 25.0

20.0 16.6 27.0

19.5 18.5 25.0

38

46

32

31

43

190

11

11

3

7

12

44

225

222

210

208

191 1056

32

39

29

25

30

155

169

164

159

172

148

812

9

6

6

4

8

33

5

5

0

0

3

13

49

54

49

60

46

258

6

5

3

7

11

32

3

4

4

5

3

19

3

2

3

5

3

16

0

2

1

0

0

3

8

7

3

5

6

29

3

1

0

1

1

6

2

1

1

0

1

5

33

37

29

32

32

163

3

5

2

9

6

25

1

1

2

1

0

5

25

30

34

31

26

146

2

8

2

4

2

18

5

1

5

5

1

17

148

170

90

104

105

105

90

92

114

104

102

107

5

7

15

3

17

13

14

6

3

1

3

2

20

10

19

12

64

576

93

485

83

510

3

33

7

57

3

12

11

72

.

3

4

2

.

8

2

1

.

51

42

85

0

9

0

11

0

178

132

158

136

157

154

737

21

11

23

18

13

86

2

2

4

5

6

19

166

184

167

180

163

860

148

153

147

179

161

788

115

139

129

160

145

688

.

4

4

51

108

167

0

0

0

0

0

0

342

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Jefferson County - 081

18.4 79.9
2.3 58.0
3.6 15.5
0.4 153.1
5.7
108.7 26.0 93.5 83.7 15.2 100.0
*
* * * 24.6 * *
12.8 1.6 *
11.0 *
1.6
64.0 36.0 46.7
1.9 9.2 1.6 13.1
. . .
64.8 10.8
* 64.7 53.9 42.6
.

18.6 81.2
2.3 59.8
3.8 16.7
0.5 161.1
6.0
118.5 24.1
100.9 95.7 13.2
100.0 *
18.5 * *
35.9 * *
14.2 2.2 *
12.4 2.8 *
74.4 36.7 46.1
2.5 8.9
* 7.3
1.0 2.7 12.4
75.3 7.1 *
72.5 58.5 53.5
*

17.1 74.8 2.2 59.8 3.6 15.8 0.4 166.2 4.3
88.6 17.5 79.7 91.7
* * *
16.7 * * * * *
11.4 * *
12.8 *
2.3
42.6 34.1 45.9
5.4 9.8 2.0 12.2
1.1 1.1 10.1
71.2 12.1
* 70.6 60.5 53.7
2.7

17.3 75.6
2.2 61.4
4.2 18.5
0.5 191.7
2.5
91.5 17.1 71.4 96.8 22.3 100.0
*
16.6 16.6
* . * *
12.6 3.0 *
14.1 *
2.0
48.5 32.6 42.9
* 6.1
* 8.7
* 1.5 17.7
79.1 13.8 20.7 71.8 70.8 62.8 19.1

16.0 70.5 2.1 56.8 3.4 14.8 0.4 165.3 4.3
114.9 23.5 81.1 91.7 29.3
100.0 *
* * * 24.6 * *
13.5 2.8 *
11.9 * *
33.2 34.9 40.2
* 9.7 1.8 7.4
* * *
84.0 8.6 26.1 73.0 72.3 63.3 44.6

17.5 76.4
2.2 59.2
3.7 16.3
0.5 167.3
4.6
104.5 22.0 85.4 91.7 17.7 100.0
2.2
15.1 11.8
3.3 23.3
1.0 0.5
12.9 2.0 0.3
12.4 1.4 1.4
53.0 34.9 44.5
2.5 8.7 1.3 9.8
0.7 1.3 10.0
74.7 10.4 18.9 70.4 62.9 54.9 16.2

12.3 62.2
1.9 16.1
1.6 7.9 0.2 104.3 6.0

13.5 68.2
2.1 24.5
1.7 8.6 0.3 101.6 7.9

11.6 59.1 1.8 20.2 1.7 8.6 0.2 118.2 5.3

12.2 61.8
1.9 11.8
1.8 9.3 0.3 123.9 4.0

11.8 59.9 1.8 11.2 1.7
8.6 0.2 120.4 3.3

12.3 62.2
1.9 17.0
1.7 8.6 0.2 113.2 5.3

81.1 *
74.3 45.5
* * *

53.8 *
47.1 71.4
* * *

53.6 *
46.9 * * * *

66.4 *
46.5 85.7
* * *

52.9 *
39.7 * * * *

61.5 17.4 50.8 60.5 10.7 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

46.7

*

*

*

14.8

*

*

*

*

*

*

*

*

*

*

*

*

8.5

8.8

5.6

6.5

6.7

7.3

*

*

*

*

*

1.3

*

*

*

*

*

*

10.8

8.9

*

10.8

7.9

8.6

*

*

*

*

*

*

*

*

*

*

*

1.1

42.4 9.7
36.3 *
12.9 * *

52.0 10.8 39.4
* 15.0
* *

35.6 12.4 37.5
* 17.0
* *

40.7 5.4
21.5 *
13.0 * *

28.7 *
31.8 *
22.7 * *

40.2 8.6
33.3 1.1
16.1 1.5 5.2

.

*

*

*

.

3.4

*

3.9

.

7.3

6.2

3.9

*

*

*

2.4

*

4.3

76.3 12.3
* 41.9 24.7 21.5
.

83.5 10.5
* 44.1 31.4 29.4
*

86.5 12.3
* 47.2 36.0 33.7
*

86.0 22.6
* 35.5 34.4 29.0
6.5

91.1 11.1
* 44.9 44.9 34.8 18.0

84.6 13.7 11.4 42.7 34.1 29.6
7.0

23.2 90.7
2.5 75.8
5.1 19.8
0.6 170.1
5.6

22.8 89.6
2.5 76.6
5.6 21.8
0.6 187.5
4.8

21.6 84.9 2.4 76.8 5.0 19.8 0.6 182.8 3.6

21.3 84.2
2.4 84.3
6.2 24.3
0.7 220.6
*

19.6 77.5 2.2 78.3 4.7 18.7 0.5 184.7 4.9

21.7 85.4
2.4 78.3
5.3 20.9
0.6 189.0
4.1

123.4 28.9 103.9 96.9 19.5 100.0
*

150.7 23.9
127.8 100.0
16.4 100.0
*

105.9 *
95.9 100.0
* * *

103.4 22.6 83.4
100.0 23.3
100.0 *

144.7 27.9
101.0 100.0
37.0 100.0
*

125.6 23.2 102.5 99.4 21.2 100.0 *

* * * 34.8 * *

* * * 30.8 * *

*

24.0

*

18.0

*

24.0

*

15.2

*

*

*

*

*

.

30.9

27.1

*

*

*

1.6

*

*

*

0.4

14.7 * *
11.2 *
2.2

16.7 2.3 *
14.0 3.7 *

13.8 * *
16.4 *
2.4

15.4 4.3 *
15.2 *
2.4

16.8 3.1
* 13.8
* *

15.4 2.4 0.5
14.1 1.7 1.6

74.0 47.1 51.1
2.3 7.7
* 15.2

85.4 49.1 49.3
3.3 6.1
* 7.9

45.7 43.5 49.5
7.2 6.8
* 15.1

52.3 45.1 53.0
* 2.9
* 9.4

35.4 49.2 44.1
* 3.7
* 10.0

59.0 46.8 49.5
3.2 5.5 1.2 11.6

.

*

*

*

.

2.3

*

*

.

14.8

12.2

24.7

*

0.7

*

0.8

*

12.9

59.7 10.2
* 74.4 66.4 51.6
.

71.5 5.5 *
86.0 71.5 65.0
*

64.8 12.0
* 80.7 71.0 62.3
*

75.8 9.7
26.3 88.2 87.7 78.4 25.0

80.6

70.2

7.5

9.0

40.0

23.2

86.2

82.9

85.2

76.0

76.7

66.3

57.1

20.5

343

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Jenkins County - 082

1990
8247 1835
203
20.3 19.0 22.0
19 4
162 16 73
8 4 19 3
0 0 0 4 0 1
9 1 0 20 2 5
65 41 55
4 24
4 10
. . .
102 26
1 99 64 52
. 0

1991
8232 1824 203
18.4 23.2 22.0
26 5
144 25 66 15 0 14 0
2 2 0 1 0 1
13 2 0
12 0 2
84 45 59
4 27
2 12
0 0 2
98 26
2 106
75 69 11
0

Total
1992 1993

8209 1812
203

8187 1800 203

19.3 18.6 22.0

20.2 19.0 24.0

21

21

3

7

142

127

17

19

70

68

6

8

4

2

11

15

2

2

1

2

1

2

0

0

5

4

2

0

0

0

17

14

2

5

0

0

13

11

4

1

1

0

60

52

40

35

52

46

0

0

26

10

3

2

9

6

14

9

2

4

53

55

93

74

23

19

1

4

96

99

86

84

73

80

2

21

1

0

1994 5-year

8162 1786
203

41037 9057 1015

19.1 24.8 22.0

19.5 19.5 22.0

24

111

9

28

125

700

23

100

61

338

8

45

1

11

14

73

1

8

3

8

2

7

1

1

3

17

1

3

1

3

18

71

5

15

2

2

14

70

2

9

0

8

46

307

25

186

47

259

0

8

17

104

3

14

8

45

7

30

5

11

108

218

89

456

29

123

2

10

86

486

79

388

70

344

39

73

0

1

1990
4811 996 110

1991
4795 986 108

White
1992 1993

4770 974 106

4752 964 104

1994 5-year

4729 952 103

23857 4872 531

21.6 19.0 19.5

20.2 .
21.0

20.2 18.6 20.0

22.4 19.0 21.0

22.1 .
21.0

21.4 18.8 21.0

7

8

8

2

9

34

1

1

1

0

4

7

75

73

70

53

56

327

5

7

6

1

8

27

12

13

17

10

14

66

6

8

2

5

4

25

0

0

0

2

0

2

11

4

8

7

9

39

2

0

2

1

1

6

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

2

0

2

0

0

1

0

0

1

1

0

0

0

1

2

2

6

7

2

3

20

0

1

0

1

0

2

0

0

0

0

0

0

7

7

9

1

6

30

0

0

2

0

0

2

3

1

0

0

0

4

23

35

20

16

17

111

6

8

10

9

4

37

20

22

25

15

16

98

3

2

0

0

0

5

18

22

21

8

11

80

2

1

2

0

1

6

2

3

5

2

2

14

.

0

7

3

0

10

.

0

1

0

1

2

.

2

11

16

37

66

59

61

46

43

45

254

15

11

11

8

17

62

0

1

0

1

1

3

38

47

39

30

28

182

20

22

32

24

23

121

18

22

26

21

19

106

.

1

1

7

10

19

0

0

0

0

0

0

1990
3412 832 93

1991
3406 827
93

Black
1992 1993

3396 821 93

3387 816
93

1994 5-year

3377 809 93

16978 4105 465

19.4 18.9 26.0

16.3 23.2 26.0

19.1 18.5 24.0

18.0 19.3 27.5

18.1 24.8 23.0

18.4 22.1 24.0

12

18

13

19

15

77

3

4

2

7

5

21

86

71

71

74

69

371

11

18

11

18

15

73

61

53

53

58

47

272

2

5

4

3

4

18

4

0

4

0

1

9

8

10

3

8

5

34

1

0

0

1

0

2

0

2

1

2

3

8

0

2

1

2

2

7

0

0

0

0

1

1

4

1

5

2

3

15

0

0

1

0

1

2

0

1

0

0

0

1

7

7

10

12

15

51

1

1

2

4

5

13

0

0

0

0

2

2

13

5

4

10

8

40

2

0

2

1

2

7

2

1

1

0

0

4

42

49

40

36

29

196

35

37

30

26

21

149

35

37

27

31

31

161

1

2

0

0

0

3

6

5

5

2

6

24

2

1

1

2

2

8

8

9

4

4

6

31

.

0

7

6

7

20

.

0

1

4

4

9

.

0

41

37

70

148

42

37

46

31

44

200

11

15

12

11

12

61

1

1

1

3

1

7

61

59

57

69

58

304

44

53

54

60

56

267

34

47

47

59

51

238

.

10

1

14

29

54

0

0

0

0

0

0

344

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Jenkins County - 082

19.6 88.3
2.6 45.9
2.3 10.4
0.3 95.5
9.8

17.5 78.9
2.3 45.8
1.7 7.7 0.2 80.5 8.8

17.3 78.4 2.3 50.7 1.3 6.1 0.2 67.5 5.5

15.5 70.6
2.1 54.0
1.8 8.3 0.3 98.7 5.6

15.3 70.0 2.1 50.0 1.7 7.8 0.2 94.6 5.0

17.1 77.3
2.3 49.1
1.8 8.1 0.2 87.3 7.0

93.6 *
78.8 80.0
* * *

128.1 19.2
123.2 76.0 * * *

103.4 *
83.7 58.8
* * *

103.4 33.3 93.6 89.5 * * *

118.2 37.5
113.3 72.7 * * *

109.4 25.2 98.5 75.5
7.9 100.0
*

*

*

*

*

*

11.4

*

*

*

*

*

10.0

*

*

*

*

*

*

*

*

34.2

*

*

23.9

*

*

*

*

*

*

*

*

*

*

*

*

5.6 * *
12.5 *
3.1

9.0

12.0

11.0

14.4

10.1

*

*

3.9

4.0

2.1

*

*

*

*

*

8.3

9.4

8.7

11.5

10.1

*

*

*

*

1.3

*

*

*

*

1.1

41.7 25.6 34.6
* 15.2
* 9.1

58.7 31.3 41.0
* 18.8
* 13.5

45.5 29.0 37.7
* 19.0
* 12.2

44.4 27.8 36.8
* 7.9
* 7.9

38.7 20.5 39.5
* 13.9
* 11.4

46.0 27.0 37.8
1.2 15.1
2.0 10.7

.

*

5.8

3.7

2.9

3.1

.

*

*

*

2.1

1.1

.

*

21.8

22.7

44.6

22.4

63.8 19.0
* 61.9 40.0 32.5
.

69.0 21.0
* 73.6 52.1 47.9
7.6

66.4 18.1
* 69.6 62.3 52.9
*

59.7 18.3
* 78.6 66.7 63.5 16.7

72.4 27.1
* 70.5 64.8 57.4 32.0

66.2 20.5 11.0 70.4 56.2 49.9 13.8

15.6 75.3
2.3 16.2
2.3 11.0
0.3 115.8
9.0
63.6 *
45.5 * * * *
* * * * * *
* * * 9.3 * *
31.5 8.0
27.0 *
24.3 * *
. . .
79.7 23.8
* 50.7 26.7 24.0
.

15.2 74.0
2.2 17.8
* * * * 9.1

14.7 71.9 2.1 25.0 1.7 8.2 0.2 100.0
*

11.2 55.0
1.6 18.9
1.5 7.3 0.2 104.5 7.3

11.8 58.8 1.8 25.0 1.9 9.5 0.2 130.4
*

13.7 67.1
2.0 20.4
1.6 8.0 0.2 98.2 6.4

74.0 *
64.8 * * * *

75.3 *
56.5 * * * *

*

87.8

64.0

*

*

20.6

*

78.0

50.8

*

*

26.9

*

*

11.3

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

8.2

10.0

*

*

*

*

9.6

13.2

*

*

*

*

*

*

6.1

*

*

*

*

*

*

*

10.7

9.2

*

*

*

*

*

*

48.6 11.0 30.1
* 30.1
* *

31.3 14.7 36.8
* 31.3
* 14.3

32.7 17.0 28.3
* 15.1
* *

31.5 *
29.1 *
19.6 * *

35.6 11.4 30.3
1.5 24.8
1.9 7.6

*

6.0

*

*

2.2

*

*

*

*

*

*

9.5

13.8

32.1

14.2

85.9 18.3
* 64.4 30.1 30.1
*

67.6 16.9
* 57.4 47.1 38.2
*

81.1 17.8
* 56.6 45.3 39.6 13.2

80.4 35.4
* 50.0 41.1 33.9 17.9

78.9 22.1
* 56.0 37.2 32.6
7.6

25.2 103.4
3.1 72.6
2.3 9.6 0.3 77.7 10.8

20.8 85.9
2.5 74.6
2.9 12.1
0.3 116.3
6.0

20.9 86.5 2.5 76.8
* * * * 9.7

21.8 90.7
2.7 79.5
2.4 9.8 0.3 94.1
*

20.4 85.3 2.5 71.2 1.5 6.2
* 63.3 6.2

21.9 90.4
2.7 74.9
2.0 8.3 0.2 78.2 7.3

129.0 *
118.3 90.9
* * *

193.5 *
193.5 94.4 * * *

139.8 *
118.3 90.9 * * *

204.3 36.8
193.5 94.4 * * *

161.3 33.3
161.3 92.9 * * *

165.6 27.3
157.0 93.1 * * *

*

*

*

*

*

21.6

*

*

*

*

*

18.9

*

*

*

*

*

*

*

*

66.7

*

*

39.5

*

*

*

*

*

*

*

*

*

*

*

*

8.1 * *
15.5 * *

9.9

14.1

16.2

21.7

13.7

*

*

*

7.2

3.5

*

*

*

*

*

7.0

*

13.7

12.1

11.0

*

*

*

*

1.9

*

*

*

*

*

51.2 41.7 41.7
* 7.2
* 13.3

69.0 52.1 52.1
* 7.0
* 19.6

59.7 43.5 39.1
* 7.2
* *

52.9 35.6 43.1
* * * *

44.6 31.8 48.4
* 9.1
* 15.0

55.5 41.0 44.7
* 6.6 2.2 13.3

.

*

5.6

4.8

5.6

4.0

.

*

*

*

*

1.8

.

*

32.6

29.5

55.9

29.5

49.4 15.1
* 72.6 52.4 40.5
.

52.1 23.4
* 83.1 74.6 66.2 14.1

64.8 19.7
* 82.6 78.3 68.1
*

43.7 18.6
* 94.5 82.2 80.8 19.2

65.7

54.8

20.3

19.3

*

14.9

87.9

83.7

84.8

73.6

77.3

65.6

43.9

19.4

345

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Johnson County - 083

1990
8329 1787
212
21.5 21.4 21.0
20 7
149 18 67 13
1 14
2
4 2 2 3 0 1
11 3 0 8 1 2
39 39 55
3 19
5 6
. . .
112 30
0 90 82 66
. 0

1991
8368 1799 213
19.8 17.9 21.5
24 5
120 22 54 8 2 10 2
0 0 0 2 1 1
10 2 0 5 1 0
24 41 53
1 16
2 10
0 2 11
90 26
0 90 81 71 48
2

Total
1992 1993

8405 1812
215

8444 1824 216

19.3 20.1 21.5

20.0 19.0 19.0

23

18

7

8

112

115

21

18

65

57

5

10

4

1

10

11

1

1

4

3

1

1

3

2

5

3

2

0

1

0

6

12

1

2

0

0

8

8

0

4

2

4

13

20

31

34

50

48

0

2

11

9

1

4

8

9

2

6

3

5

32

22

87

87

26

22

0

0

90

81

76

83

70

68

60

50

1

1

1994 5-year

8485 1837
216

42031 9059 1072

18.7 15.2 20.0

20.0 19.2 21.0

32

117

8

35

134

630

28

107

72

315

9

45

1

9

13

58

3

9

2

13

2

6

0

7

3

16

0

3

3

6

14

53

3

11

1

1

12

41

1

7

2

10

31

127

45

190

64

270

1

7

21

76

2

14

9

42

8

16

4

14

36

101

108

484

25

129

0

0

96

447

94

416

79

354

67

225

1

5

1990
5474 1067
113

1991
5475 1067 112

White
1992 1993

5476 1068
112

5476 1068 112

1994 5-year

5475 1068
111

27376 5338 561

22.5 24.6 20.0

21.2 18.0 21.0

21.3 20.8 19.0

20.6 19.0 18.0

19.4 19.1 20.0

21.3 19.9 20.0

3

8

5

6

8

30

0

1

2

1

0

4

69

58

50

53

70

300

3

7

5

6

8

29

10

9

15

9

15

58

12

5

2

5

5

29

1

1

1

0

0

3

9

7

7

6

5

34

0

1

0

0

0

1

1

0

1

2

0

4

0

0

0

0

0

0

1

0

1

2

0

4

1

1

1

0

0

3

0

0

0

0

0

0

0

0

0

0

2

2

3

4

3

1

3

14

0

1

0

0

0

1

0

0

0

0

0

0

3

3

4

2

6

18

1

1

0

1

1

4

1

0

1

0

0

2

16

10

6

11

14

57

5

4

6

2

10

27

20

21

17

15

23

96

0

0

0

0

1

1

13

11

8

4

17

53

0

1

0

0

0

1

2

4

2

2

2

12

.

0

1

1

2

4

.

0

1

3

3

7

.

3

9

4

12

28

60

49

47

46

60

262

15

16

12

11

9

63

0

0

0

0

0

0

30

35

34

32

41

172

25

29

25

28

37

144

20

26

23

22

29

120

.

14

18

17

23

72

0

0

0

1

0

1

1990
2839 715 97

1991
2852 720
98

Black
1992 1993

2865 724 98

2878 729
99

1994 5-year

2892 734 99

14327 3622 491

20.7 17.4 25.0

18.1 17.6 27.0

17.5 14.7 26.0

19.5 .
27.0

18.1 14.3 20.5

18.8 15.0 25.0

17

16

18

12

24

87

7

4

5

7

8

31

80

62

62

62

64

330

15

15

16

12

20

78

57

45

50

48

57

257

1

3

3

5

4

16

0

1

3

1

1

6

5

3

3

5

8

24

2

1

1

1

3

8

3

0

3

1

2

9

2

0

1

1

2

6

1

0

2

0

0

3

2

1

4

3

3

13

0

1

2

0

0

3

1

1

1

0

1

4

8

6

3

11

11

39

3

1

1

2

3

10

0

0

0

0

1

1

5

2

4

6

6

23

0

0

0

3

0

3

1

0

1

4

2

8

23

14

7

9

17

70

34

37

25

32

35

163

35

32

33

33

41

174

3

1

0

2

0

6

6

5

3

5

4

23

5

1

1

4

2

13

4

6

6

7

7

30

.

0

1

5

6

12

.

2

0

1

1

4

.

8

23

18

23

72

52

41

40

41

48

222

15

10

14

11

16

66

0

0

0

0

0

0

60

55

56

49

55

275

57

52

51

55

57

272

46

45

47

46

50

234

.

34

42

33

44

153

0

2

1

0

1

4

346

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Johnson County - 083

17.9 83.4
2.4 45.3
1.7 7.8 0.2 79.1 7.8

14.3 66.7
1.9 45.4
1.2 5.6 0.2 70.9 6.1

13.3 61.8 1.8 58.6 1.2 5.5 0.2 76.3 5.0

94.3 35.0 84.9 83.3
* * *

112.5 20.8
103.1 72.7 * * *

107.2 30.4 97.9 81.0 * * *

*

*

*

*

*

*

*

*

*

*

*

43.1

*

*

*

*

*

*

7.4

8.3

5.4

*

*

*

*

*

*

5.4

4.2

7.1

*

*

*

*

*

*

41.5 26.4 37.2
* 12.8
3.4 6.7

35.8 34.5 44.9
* 13.4
* 15.4

23.2 27.7 44.6
* 9.9
* 11.8

.

*

*

.

*

*

.

4.5

13.0

75.2 22.2
* 60.8 55.4 44.6
.

75.6 25.2
* 75.6 68.1 59.7 40.3

78.4 28.0
* 80.4 67.9 62.5 53.6

13.6 63.0
1.8 51.4
1.3 6.0 0.2 80.3 6.0

15.8 72.9 2.1 54.1 1.5 7.1 0.2 82.3 6.0

15.0 69.5
2.0 50.6
1.4 6.4 0.2 78.0 6.2

83.4 44.4 83.4 64.7
* * *

147.9 25.0
129.4 89.3 * * *

109.1 29.9 99.8 79.2
8.4 100.0
*

*

*

20.6

*

*

9.5

*

*

11.2

*

*

25.0

*

*

*

*

*

0.7

10.4

10.4

8.4

*

*

1.7

*

*

*

7.2

9.0

6.6

*

*

1.1

*

*

1.6

31.3 30.6 43.2
* 8.1
* 13.4

40.8 33.8 48.1
* 15.9
* 14.1

35.6 30.5 43.4
1.1 12.2
2.3 11.9

2.4

3.2

1.6

2.0

*

1.4

8.9

14.6

10.3

75.7 23.7
* 73.0 74.8 61.3 45.0

81.2 21.2
* 72.2 70.7 59.4 50.4

77.2 23.8
* 71.7 66.8 56.8 47.4

12.6 64.7
1.9 14.7
1.6 8.4 0.3 98.9 12.2
* * * * * * *
* * * * * *
* * * * * *
34.0 7.4
29.4 *
19.1 * *
. . .
87.0 24.6
* 44.1 36.8 29.4
.

10.6 54.4
1.6 15.8
1.3 6.6 0.2 98.6 5.6

9.1 46.8 1.4 30.0 1.3 6.6 0.2 116.7
*

71.2 *
62.3 * * * *

44.5 *
44.5 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

27.8 *
36.8 *
19.3 * *

20.7 12.0 34.0
* 16.0
* *

*

*

*

*

*

6.9

84.5 33.3
* 61.4 50.9 45.6 24.6

94.0 27.3
* 68.0 50.0 46.0 36.0

9.7 49.6
1.5 17.3
1.1 5.6 0.2 93.8 4.7
53.7 *
53.7 * * * *
* * * * * *
* * * * * *
35.5 *
28.8 * * * *
* * *
86.8 24.4
* 61.5 53.8 42.3 32.7

12.8 65.5 2.0 21.7 0.9 4.7 0.1 61.7 5.6
72.0 *
72.0 62.5
* * *
* * * * * *
* * * 8.7 * *
33.3 14.5 33.3
* 25.0
* *
* * 9.2
87.0 15.8
* 59.4 53.6 42.0 33.3

11.0 56.2
1.7 19.6
1.2 6.4 0.2 92.6 6.2
53.5 *
51.7 37.9
* * *
* * * * * *
4.7 * *
6.1 * *
30.8 9.1
32.4 *
18.0 *
7.6
* 1.3 5.3
87.6 24.7
* 58.1 48.6 40.5 31.6

28.2 111.9
3.2 71.3
1.8 7.0 0.2 58.1
*

21.7 86.2
2.4 72.6
* * * * 6.9

21.6 85.6 2.3 82.0
* * * * 8.3

21.5 85.1
2.3 81.4
1.7 6.9 0.2 68.5 8.2

22.1 87.2 2.3 89.1 2.8 10.9 0.3 103.9 6.8

23.0 91.1
2.5 78.8
1.7 6.6 0.2 63.7 6.4

175.3 41.2 154.6 93.3
* * *

163.9 *
153.7 93.3 * * *

183.3 27.8
162.9 93.8 * * *

121.6 58.3
121.6 90.9 * * *

242.4 33.3
202.0 100.0
* * *

177.4 35.6
159.0 94.8 16.3 100.0 *

*

*

*

*

*

27.3

*

*

*

*

*

18.2

*

*

*

*

*

*

*

*

*

*

*

38.7

*

*

*

*

*

*

*

*

*

*

*

*

10.0

9.7

*

*

*

*

6.3

*

*

*

*

*

*

17.7

17.2

11.8

*

*

*

3.0

*

*

*

*

*

10.2

9.4

7.0

*

*

*

*

*

*

*

2.4

48.9 42.5 43.8
* 7.5 6.3
*

45.2 59.7 52.5
* 8.1
* 16.7

25.9 40.3 53.2
* * * 15.0

27.3 54.2 55.9
* 8.5
* 17.1

50.0 54.7 64.1
* * * 25.9

40.7 49.8 53.4
1.8 7.1 4.0 15.3

.

*

*

4.4

5.3

2.7

.

*

*

*

*

*

.

7.1

20.5

16.0

20.3

16.0

65.0 20.3
* 75.0 71.3 57.5
.

67.2 18.2
* 88.7 83.9 72.6 54.8

65.6 28.6
* 90.3 82.3 75.8 67.7

66.1 22.9
* 83.1 93.2 78.0 55.9

75.0

67.7

26.2

23.0

*

*

85.9

84.1

89.1

83.2

78.1

71.6

68.8

61.9

347

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Jones County - 084

1990
20739 5101 462
20.3 17.8 21.0
48 8
268 29 67 19
2 77 18
7 3 4 5 0 1
26 6 0
29 5 1
64 40 52
2 45
2 6
. . .
223 30
5 121 80 70
. 0

1991
21345 5217 472
22.1 18.6 21.5
35 8
296 23 74 9 2 77 12
5 3 2 5 0 3
20 4 1
28 4 1
74 34 66
2 27
1 14
4 6 15
251 39 5
152 103
90 0 0

Total
1992 1993

21948 5335 483

22556 5451 494

20.5 19.4 21.0

23.1 21.6 22.0

41

24

7

7

264

274

27

17

87

79

7

2

1

2

71

55

13

7

1

5

1

4

0

1

2

4

1

0

2

0

20

20

1

4

0

0

22

28

1

0

2

3

87

87

37

32

57

49

0

0

41

26

1

1

9

11

14

13

5

6

57

50

229

236

34

33

1

4

125

139

107

124

88

103

31

81

0

2

1994 5-year

23158 5569 504

109746 26673 2416

22.9 21.2 22.0

21.9 19.0 21.0

22

170

3

33

234

1336

19

115

69

376

3

40

3

10

54

334

3

53

2

20

1

12

1

8

4

20

0

1

1

7

20

106

5

20

1

2

22

129

0

10

0

7

75

387

31

174

49

273

4

8

40

179

1

6

16

56

19

50

11

28

115

237

199

1138

29

165

4

19

115

652

111

525

95

446

73

185

0

2

1990
15318 3727 304

1991
15864 3832 314

White
1992 1993

16409 3939 324

16959 4044 333

1994 5-year

17503 4150 342

82053 19692
1616

20.2 17.8 21.0

22.5 18.5 20.5

20.8 20.1 21.0

23.8 21.8 22.0

23.3 21.7 21.0

22.2 18.8 21.0

36

21

25

15

19

116

3

5

3

6

2

19

195

226

184

200

182

987

20

15

17

10

16

78

31

33

41

31

37

173

12

6

3

1

2

24

1

2

0

2

1

6

48

44

47

33

31

203

15

6

8

5

3

37

4

0

1

1

2

8

2

0

1

1

1

5

2

0

0

0

1

3

3

2

1

3

2

11

0

0

0

0

0

0

1

2

0

0

1

4

15

11

9

12

10

57

3

0

0

1

3

7

0

0

0

0

1

1

19

15

11

19

12

76

4

4

1

0

0

9

1

1

1

3

0

6

42

56

60

66

53

277

15

14

17

10

17

73

39

52

43

39

41

214

1

2

0

0

2

5

40

26

39

26

36

167

2

1

1

0

1

5

5

11

5

8

10

39

.

3

10

12

11

36

.

6

4

5

9

24

.

12

34

41

72

159

167

198

167

181

163

876

26

33

25

22

21

127

4

5

0

4

3

16

80

109

74

84

79

426

51

71

64

82

73

341

47

63

52

65

62

289

.

0

16

57

50

123

0

0

0

2

0

2

1990
5317 1349
156

1991
5472 1379 160

Black
1992 1993

5627 1410
163

5783 1440 167

1994 5-year

5937 1470
170

28136 7047 816

21.0 18.4 28.0

20.3 19.4 24.0

19.3 19.0 26.0

20.8 20.8 25.0

19.4 23.4 24.0

20.3 19.3 25.0

12

14

15

9

3

53

5

3

3

1

1

13

72

70

77

72

51

342

9

8

10

7

3

37

36

41

46

48

32

203

7

3

4

1

1

16

1

0

1

0

2

4

28

33

22

20

20

123

3

6

4

2

0

15

3

5

0

4

0

12

1

3

0

3

0

7

2

2

0

1

0

5

2

3

1

1

2

9

0

0

1

0

0

1

0

1

2

0

0

3

10

9

11

3

4

1

0

1

0

9

13

11

1

0

0

0

0

1

6

10

46

3

2

13

0

0

1

8

10

51

0

0

1

0

0

1

21

18

26

20

22

107

25

20

20

22

14

101

13

14

14

10

8

59

1

0

0

0

2

3

4

1

2

0

4

11

0

0

0

1

0

1

1

3

4

3

6

17

.

1

0

0

7

8

.

0

1

0

2

3

.

3

16

8

35

62

55

53

59

53

36

256

4

6

9

10

8

37

1

0

1

0

1

3

41

43

51

55

35

225

29

32

43

42

37

183

23

27

36

38

32

156

.

0

15

24

23

62

0

0

0

0

0

0

348

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Jones County - 084

12.9 52.5
1.7 25.5
3.7 15.1
0.5 210.4
4.1
103.9 16.7 62.8 58.6 39.0 94.1
*
26.1 * *
18.5 * *
9.7 2.2
* 11.0
1.9 *
27.1 15.2 19.8
* 17.1
* 4.0
. . .
84.2 13.3 13.2 46.0 30.4 26.6
.

13.9 56.7
1.8 25.3
3.6 14.8
0.5 200.0
2.3
74.1 22.9 48.7 82.6 25.4 100.0
*
16.9 * *
16.8 * *
6.8 * *
9.6 * *
28.8 11.6 22.6
* 9.2
* 8.3
* 1.0 2.5
85.7 15.1 15.2 52.1 35.3 30.8
*

12.0 49.5 1.6 33.1 3.2 13.3 0.4 207.0 1.5
84.8 17.1 55.9 66.7 26.9 100.0
*
* * * * * *
7.6 * *
8.4 * *
34.4 14.1 21.8
* 15.6
* 6.7
2.3 0.8 9.4
87.1 13.8
* 47.5 40.7 33.5 11.8

12.1 50.3
1.6 28.9
2.4 10.1
0.3 165.2
*
48.6 29.2 34.4 70.6 14.2 100.0
*
18.2 * * * * *
7.3 * *
10.3 * *
33.1 11.7 17.9
* 9.5
* 6.9
2.1 1.0 8.1
86.4 13.6
* 50.9 45.4 37.7 29.7

10.1 42.0 1.3 29.6 2.3 9.7 0.3 183.7 1.1
43.6 *
37.7 78.9
* * *
* * * * * *
8.5 2.1
* 9.4
* *
33.9 13.2 21.0
* 17.2
* 10.4
3.0 1.8 18.3
85.4 13.7
* 49.1 47.4 40.6 31.2

12.2 50.1
1.6 28.4
3.0 12.5
0.4 194.1
1.9
70.4 19.4 47.6 70.4 21.9 98.1
*
15.0 9.0 6.0
14.9 * *
7.9 1.5
* 9.7 0.8 0.5
31.5 13.1 20.7
0.6 13.5
0.5 7.3
2.1 1.1 9.7
85.8 13.9 13.5 49.2 39.6 33.7 17.4

12.7 52.3
1.7 16.2
3.1 12.9
0.4 187.5
3.5

14.2 59.0
1.9 14.9
2.8 11.5
0.4 158.3
2.1

11.2 46.7 1.5 22.4 2.9 11.9 0.4 200.9
*

11.8 49.5
1.6 15.6
1.9 8.2 0.3 139.8
*

10.4 43.9 1.4 20.3 1.8 7.5 0.2 143.5
*

12.0 50.1
1.6 17.7
2.5 10.3
0.3 166.4
1.5

118.4 *
65.8 45.0 49.3 92.9
*

67.0 23.8 47.8 73.3 19.1 100.0
*

77.3 *
52.6 52.9 24.7 100.0
*

45.0 40.0 30.0 50.0 15.0 100.0
*

55.5 *
46.7 75.0
* * *

71.8 16.4 48.3 59.0 22.9 97.2
*

*

*

*

*

*

8.1

*

*

*

*

*

5.1

*

*

*

*

*

*

*

*

*

*

*

11.1

*

*

*

*

*

*

*

*

*

*

*

*

7.7

4.9

4.9

6.0

5.5

5.8

*

*

*

*

*

0.7

*

*

*

*

*

*

9.9

6.8

6.0

9.5

6.6

7.8

*

*

*

*

*

0.9

*

*

*

*

*

0.6

23.9 7.9
20.5 *
20.9 *
4.7

27.7 6.3
23.4 *
11.7 *
8.7

33.7 9.3 23.6
* 21.3
* 5.5

34.0 5.0
19.6 *
13.1 *
6.8

30.5 9.3
22.7 *
19.8 *
8.5

30.0 7.5
22.0 0.5
17.1 0.5 7.0

.

*

2.3

2.7

2.4

2.0

.

1.4

*

1.1

1.9

1.3

.

2.8

7.7

9.1

15.5

8.9

86.5 16.6
* 41.9 26.7 24.6
.

88.8 17.1 17.2 49.1 32.0 28.4
*

91.3 14.6
* 40.4 35.0 28.4
8.7

91.0 12.9
* 42.2 41.2 32.7 28.6

90.1 12.8
* 43.4 40.1 34.1 27.5

89.5 14.8 13.2 43.6 34.9 29.6 15.6

13.5 53.4
1.6 50.7
5.3 20.8
0.6 259.3
5.9

12.8 50.8
1.5 58.6
6.0 23.9
0.7 308.4
*

13.7 54.6 1.6 59.7 3.9 15.6 0.5 211.5 3.5

12.5 50.0
1.5 66.7
3.5 13.9
0.4 215.1
*

8.6 34.7 1.1 64.0 3.4 13.6 0.4 270.3
*

12.2 48.5
1.5 59.7
4.4 17.5
0.5 253.1
3.0

76.9 41.7 57.7 88.9
* * *

87.8 *
50.2 100.0
37.6 100.0
*

91.9 *
61.3 90.0
* * *

54.0 *
42.0 100.0
* * *

*

65.0

*

24.5

*

45.4

*

94.6

*

18.4

* 100.0

*

*

*

71.4

*

*

*

35.1

*

*

*

*

*

20.5

*

*

*

*

*

14.9

*

*

*

*

*

26.0

*

*

*

*

*

*

*

*

*

*

*

*

13.9

12.9

14.3

8.3

19.6

13.5

*

*

*

*

*

3.8

*

*

*

*

*

*

12.7

18.6

14.3

11.1

19.6

15.0

*

*

*

*

*

*

*

*

*

*

*

*

35.6 35.2 18.3
* * * *

32.7 28.6 20.0
* * * *

36.1 26.0 18.2
* * * *

29.9 30.6 13.9
* * * *

47.8 27.5 15.7
* * * 17.1

35.8 29.6 17.3
* 3.2
* 8.5

.

*

*

*

4.0

1.2

.

*

*

*

*

*

.

*

9.5

4.7

20.0

9.1

77.5 * *
57.7 40.8 32.4
.

75.7 9.1 *
61.4 45.7 38.6
*

76.6 12.5
* 66.2 55.8 46.8 19.5

73.6 14.3
* 76.4 58.3 52.8 33.3

70.6

75.1

17.4

11.5

*

*

68.6

66.0

72.5

53.7

62.7

45.7

45.1

23.0

349

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Lamar County - 085

1990
13038 3008 303
19.5 19.3 20.5
44 7
203 32 79 18
2 57
8
1 0 1 2 0 2
12 0 0
12 1 1
54 37 71
6 44
4 15
. . .
107 29
3 100 80 55
. 0

1991
13104 2994 302
20.0 19.1 20.0
42 8
212 30 83 8 0 55 10
2 0 2 0 0 2
9 1 0 11 0 3
63 46 65
8 47
2 9
8 5 12
130 25 5
123 101
87 0 0

Total
1992 1993

13160 2979 300

13229 2964 299

19.8 18.6 21.0

20.4 19.0 21.5

36

30

13

4

200

207

31

26

93

85

19

22

1

4

51

33

4

2

3

4

2

1

1

3

3

5

0

1

1

0

17

26

2

5

0

0

20

20

1

3

1

5

55

65

47

33

72

60

5

2

44

38

6

5

9

7

6

11

14

10

46

18

117

146

31

37

1

4

122

136

113

133

92

114

3

8

0

0

1994 5-year

13285 2947 298

65816 14892
1503

21.9 19.1 21.0

19.9 19.1 21.0

34

186

13

45

190

1012

30

149

78

418

15

82

4

11

32

228

3

27

3

13

1

4

2

9

5

15

2

3

1

6

18

82

2

10

0

0

19

82

2

7

1

11

65

302

36

199

55

323

1

22

44

217

7

24

17

57

11

36

5

34

32

108

153

653

27

149

3

16

118

599

119

546

104

452

8

19

0

0

1990
8559 1842
188

1991
8602 1838
187

White
1992 1993

8640 1833
185

8683 1828
184

1994 5-year

8721 1821
183

43205 9162 927

19.9 19.3 20.0

21.0 18.9 19.0

19.9 20.5 20.0

20.8 18.6 20.0

21.9 19.2 21.0

20.5 19.2 20.0

18

20

17

14

20

89

2

4

4

1

6

17

110

131

118

117

117

593

13

12

15

11

18

69

16

25

30

27

24

122

10

3

8

15

8

44

0

0

0

1

1

2

30

29

27

14

18

118

5

7

2

1

2

17

0

1

3

2

1

7

0

0

2

1

1

4

0

1

1

1

0

3

0

0

2

2

2

6

0

0

0

1

1

2

2

1

0

0

1

4

6

5

9

16

8

44

0

1

1

1

2

5

0

0

0

0

0

0

7

7

7

13

13

47

1

0

1

2

0

4

1

2

0

3

0

6

24

33

25

29

34

145

9

15

18

8

12

62

38

37

40

34

35

184

3

3

1

0

0

7

35

36

37

30

37

175

2

1

5

1

2

11

5

4

1

1

11

22

.

8

6

4

6

24

.

4

10

6

2

22

.

6

28

9

28

71

67

93

82

96

103

441

23

18

17

24

18

100

2

3

0

3

3

11

45

61

62

61

59

288

29

49

60

59

65

262

21

41

52

47

54

215

.

0

2

3

5

10

0

0

0

0

0

0

1990
4442 1155
113

1991
4465 1149 113

Black
1992 1993

4484 1142
112

4507 1136 112

1994 5-year

4526 1128
111

22423 5710 560

19.3 18.2 24.0

19.0 19.1 26.0

19.8 18.1 28.0

19.2 19.3 23.0

21.5 18.6 26.0

19.3 18.6 25.0

26

21

19

16

14

96

5

4

9

3

7

28

93

81

82

89

73

418

19

18

16

15

12

80

63

58

63

58

54

296

8

4

11

7

7

37

2

0

1

3

3

9

25

23

22

17

14

101

3

2

2

1

1

9

1

1

0

2

2

6

0

0

0

0

0

0

1

1

0

2

2

6

2

0

1

3

3

9

0

0

0

0

1

1

0

1

1

0

0

2

6

4

8

9

10

37

0

0

1

4

0

5

0

0

0

0

0

0

5

4

13

6

6

34

0

0

0

1

2

3

0

1

1

2

1

5

30

30

30

35

31

156

28

31

29

24

24

136

33

28

32

26

20

139

3

5

4

2

1

15

9

11

7

8

7

42

2

1

1

4

5

13

10

5

8

6

6

35

.

0

0

6

3

9

.

1

4

1

3

9

.

6

14

2

3

25

40

37

35

50

50

212

6

7

14

12

9

48

1

2

1

1

0

5

55

62

60

74

59

310

51

52

53

74

54

284

34

46

40

67

50

237

.

0

1

5

3

9

0

0

0

0

0

0

350

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Lamar County - 085

15.6 67.5
2.0 39.3
4.4 18.9
0.6 202.1
7.3
145.2 15.9 105.6 71.9 26.4 87.5
*
* * * * * *
5.9 * *
6.0 * *
30.3 18.4 35.5
3.0 22.0
* 14.2
. . .
53.2 16.0
* 49.8 39.8 27.4
.

16.2 70.8
2.1 39.2
4.2 18.4
0.5 200.0
2.7
139.1 19.0 99.3 76.7 33.1 90.0 *
* * * * * *
4.2 * *
5.2 * *
31.8 21.7 30.7
3.9 22.3
* 7.4
2.3 1.4 3.5
62.8 13.6 17.9 58.0 47.6 41.0
*

15.2 67.1 2.0 46.7 3.9 17.1 0.5 186.8
7.4
119.8 36.1
103.2 77.4 * * *
* * * * * *
8.5 * *
10.1 * *
29.9 23.6 36.5 2.5 22.3 3.0
7.9
1.7 4.0 13.2
58.8 17.1
* 61.3 56.8 46.2
*

15.6 69.8
2.1 41.7
2.5 11.1
0.3 122.7
9.8
100.2 *
86.8 80.0
* * *
* * * 23.7 * *
12.6 2.4 * 9.8 * 2.4
32.5 16.2 29.6
* 18.6
2.5 6.4
3.1 2.9 5.1
70.5 19.9
* 66.7 65.2 55.9
3.9

14.3 64.5 2.0 41.5 2.4 10.9 0.3 132.8
6.4
114.2 38.2
100.7 63.3 * * *
* * * 25.8 * *
9.5 * *
10.1 * *
34.6 19.1 29.3
* 23.4
3.7 16.8
3.1 1.4 9.1
80.5 15.6
* 62.8 63.3 55.3 4.3

15.4 68.0
2.0 41.6
3.5 15.3
0.5 170.1
6.7
123.8 24.2 99.2 73.6 18.0 92.6
8.0
12.8 *
8.9 14.7
* 0.5
8.1 1.0
* 8.2 0.7 1.1
31.9 19.8 32.3
2.2 21.7
2.4 10.3
2.6 2.4 7.7
65.0 16.5 16.2 59.7 54.4 45.0
2.4

12.9 59.7
1.9 14.8
3.5 16.3
0.5 198.7
6.0

15.2 71.3
2.3 19.1
3.4 15.8
0.5 177.9
*

13.7 64.4 2.0 25.6 3.1 14.7 0.5 176.5
4.4

95.7 *
69.1 *
26.6 * *

107.0 *
64.2 50.0 37.5 85.7
*

91.7 *
80.9 60.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

5.5

3.8

7.6

*

*

*

*

*

*

6.5

5.3

6.0

*

*

*

*

*

*

24.7 8.3
35.2 *
32.4 *
9.6

26.8 11.5 28.2
* 27.7
* *

23.1 15.4 34.8
* 31.6
4.3 *

.

4.0

3.0

.

*

4.9

.

3.0

13.8

60.9 24.0
* 41.7 26.9 19.4
.

71.5 15.9
* 46.6 37.4 31.3
*

69.5 16.0
* 53.0 51.3 44.4
*

13.5 64.0
2.0 23.5
1.6 7.7 0.2 94.6 9.3

13.4 64.3 2.0 20.7 2.1
9.9 0.3 125.0 4.9

13.7 64.7
2.0 20.8
2.7 12.9
0.4 155.5
5.2

76.0 *
59.7 50.0
* * *

109.5 30.0 98.6 38.9 * * *

96.0 19.1 74.4 45.6 18.3 88.2
*

*

*

11.8

*

*

*

*

*

*

*

*

10.1

*

*

*

*

*

*

13.7

6.8

7.4

*

*

0.8

*

*

*

11.3

11.2

8.0

*

*

*

*

*

1.0

26.1 7.0
29.8 *
26.1 * *

29.3 10.3 30.2
* 31.9
* 19.3

26.1 10.6 31.5
1.2 29.9
1.9 7.2

*

2.9

3.0

2.9

*

2.7

4.4

13.7

8.7

82.1 23.1
* 53.0 51.3 40.9
*

88.0 16.7
* 50.9 56.0 46.6 4.3

74.5 19.0 18.3 49.1 44.6 36.6
2.1

20.9 80.5
2.2 67.7
5.6 21.6
0.6 193.8
9.5

18.1 70.5
1.9 71.6
5.2 20.0
0.6 213.0
*

18.3 71.8 2.0 76.8 4.9 19.3 0.5 186.4 12.3

19.7 78.4
2.2 65.9
3.8 15.0
0.4 144.1
10.6

16.1 64.7 1.8 75.0 3.1 12.4 0.4 144.3 8.9

18.6 73.2
2.0 71.2
4.5 17.7
0.5 177.2
8.9

230.1 19.2 168.1 100.0
* * *

186.5 *
159.9 94.4 * * *

169.6 47.4
142.9 93.8 * * *

143.2 *
134.3 100.0
* * *

126.0 50.0
108.0 100.0
* * *

171.3 29.2
142.8 97.5 16.1
100.0 12.5

*

*

*

*

*

14.4

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

21.1

*

*

*

*

*

*

*

*

*

*

*

*

6.5

*

9.8

10.1

13.9

8.9

*

*

*

*

*

1.2

*

*

*

*

*

*

5.4

*

15.9

6.8

8.3

8.2

*

*

*

*

*

*

*

*

*

*

*

1.2

37.0 30.1 35.9
* 9.8
* 18.5

40.0 38.3 34.6
6.5 13.6
* 10.9

39.5 35.4 39.0
* 8.8
* 15.7

39.8 27.3 29.5
* 9.1
* 11.5

43.1 33.3 27.8
* 9.7 6.9 13.6

39.8 32.7 33.5
3.7 10.2
3.1 14.2

.

*

*

4.2

.

*

*

*

.

4.2

9.8

*

*

1.6

*

1.6

*

4.4

44.0 7.1 *
59.1 54.8 36.6
.

48.1 9.9 *
76.5 64.2 56.8
*

43.2 18.7
* 73.2 64.6 48.8
*

56.2 14.8
* 84.1 84.1 76.1
5.7

68.5

51.6

13.8

12.7

*

12.8

81.9

74.5

75.0

68.3

69.4

57.0

*

2.8

351

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Lanier County - 086

1990
5531 1270
136
19.7 .
21.5
12 3
92 12 27
2 1 0 0
2 1 1 2 0 1
4 1 0 6 0 1
39 13 34
0 25
1 1
. . .
55 14
0 48 49 37
. 0

1991
5609 1280 136
20.8 18.8 21.0
14 6
83 14 38
2 0 1 0
1 1 0 1 1 1
8 0 0 7 1 2
32 21 33
0 19
2 4
3 6 16
57 5 2
54 56 46 23
0

Total
1992 1993

5671 1286
135

5754 1298 135

19.3 .
20.0

21.2 .
20.5

7

9

1

3

86

74

7

9

36

33

3

6

0

1

0

1

0

0

0

1

0

1

0

0

0

2

0

0

2

1

7

3

1

1

0

0

6

6

0

1

1

1

35

30

19

15

36

24

0

3

19

18

0

2

5

2

1

11

18

9

27

34

56

50

4

12

3

2

58

54

60

49

51

44

29

20

0

0

1994 5-year

5819 1305
135

28384 6439 677

18.3 .
20.0

19.6 18.8 21.0

17

59

4

17

88

423

16

58

36

170

7

20

2

4

2

4

0

0

2

6

1

4

1

2

2

7

0

1

0

5

4

26

1

4

0

0

5

30

1

3

3

8

40

176

16

84

32

159

1

4

21

102

1

6

4

16

6

21

14

47

26

103

55

273

8

43

4

11

55

269

50

264

41

219

21

93

0

0

1990
3978 893 99

1991
4016 893
98

White
1992 1993

4045 891 96

4084 892
94

1994 5-year

4116 890 93

20239 4459 481

20.5 .
20.0

21.1 18.8 21.0

19.6 .
19.0

21.3 .
20.0

18.7 .
20.0

20.7 18.8 20.0

7

3

3

5

8

26

1

1

0

1

1

4

62

45

56

47

57

267

7

3

3

5

7

25

8

12

17

11

17

65

1

2

3

4

6

16

0

0

0

0

2

2

0

1

0

1

1

3

0

0

0

0

0

0

2

0

0

0

1

3

1

0

0

0

1

2

1

0

0

0

0

1

1

0

0

0

2

3

0

0

0

0

0

0

1

1

0

1

0

3

0

4

6

1

2

13

0

0

1

0

1

2

0

0

0

0

0

0

3

4

4

4

3

18

0

1

0

1

1

3

1

0

1

0

1

3

24

15

19

14

23

95

2

7

10

4

7

30

23

17

24

15

19

98

0

0

0

2

1

3

22

15

17

16

18

88

1

0

0

0

0

1

0

4

4

1

2

11

.

1

0

7

5

13

.

3

13

7

6

29

.

8

12

21

18

59

46

31

40

36

37

190

12

1

3

8

7

31

0

1

3

2

2

8

29

27

34

30

33

153

30

24

36

26

28

144

22

20

29

23

23

117

.

10

19

12

13

54

0

0

0

0

0

0

1990
1470 356 34

1991
1491 359
34

Black
1992 1993

1507 360 34

1529 363
34

1994 5-year

1547 365 34

7544 1803
169

18.4 .
26.0

17.5 .
25.0

17.9 .
26.0

21.2 .
23.0

17.4 .
23.0

18.4 .
24.5

5

11

4

4

9

33

2

5

1

2

3

13

30

37

29

27

30

153

5

11

4

4

9

33

19

26

19

22

19

105

1

0

0

2

1

4

1

0

0

1

0

2

0

0

0

0

1

1

0

0

0

0

0

0

0

1

0

1

1

3

0

1

0

1

0

2

0

0

0

0

1

1

1

1

0

2

0

4

0

1

0

0

0

1

0

0

2

0

0

2

4

4

1

2

2

13

1

0

0

1

0

2

0

0

0

0

0

0

3

3

2

2

2

12

0

0

0

0

0

0

0

2

0

1

2

5

15

16

15

16

17

79

11

14

9

11

9

54

11

16

12

9

13

61

0

0

0

1

0

1

3

4

2

2

3

14

0

2

0

2

1

5

1

0

1

1

2

5

.

1

1

2

1

5

.

3

5

2

4

14

.

8

10

12

7

37

9

26

16

14

18

83

2

4

1

4

1

12

0

1

0

0

2

3

19

27

24

24

22

116

19

32

24

23

22

120

15

26

22

21

18

102

.

13

10

8

8

39

0

0

0

0

0

0

352

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

16.6

14.8

15.2

12.9

15.1

14.9

General fertility rate

72.4

64.8

66.9

57.0

67.4

65.7

Total fertility rate

2.0

1.9

2.0

1.7

2.0

1.9

% Livebirths to unmarried women

29.3

46.9

41.9

45.2

40.9

40.5

Crude abortion rate

*

*

*

*

*

*

General abortion rate

*

*

*

*

*

*

Total abortion rate

*

*

*

*

*

*

Abortion ratio

*

*

*

*

*

*

Fetal Death rate

4.7

*

*

5.4

9.2

5.0

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

88.2 102.9

51.7

66.8 126.2

87.2

% Repeat conceptions to women under 18

*

42.9

*

*

*

28.8

Livebirths to women under 18

88.2 102.9

51.7

66.8 118.8

85.7

% Livebirths to unmarried women under 18

66.7

92.9

71.4

66.7

75.0

75.9

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

14.2

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

16.4

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

0.8

Infant health rates

% Low birthweight

*

9.6

8.1

*

*

6.1

% Very low birthweight

*

*

*

*

*

*

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

6.7

8.6

7.0

8.2

5.7

7.2

% Multiple gestation

*

*

*

*

*

*

% Birth defect

*

*

*

*

*

1.9

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

45.9

44.4

45.5

42.3

46.5

45.0

% with father not named on birth certificate

14.1

25.9

22.1

20.5

18.2

20.0

% with maternal education less than high school

37.4

42.3

42.4

32.9

36.4

38.3

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

27.2

23.7

22.4

24.7

23.9

24.4

% Maternal alcohol use during pregnancy

*

*

*

*

*

1.4

% Interpregnancy interval less than 6 months

*

*

9.1

*

*

6.3

Child abuse and neglect rates

Physical

.

*

*

6.7

3.6

3.2

Sexual

.

3.7

11.0

5.5

8.4

7.1

Neglect

.

9.8

16.5

20.6

15.7

15.7

Interventions to improve infant & child survival

% Prenatal care first trimester

60.4

70.4

67.5

67.6

62.5

65.5

% Primary C-section delivery

16.1

7.4

*

18.2

10.4

11.7

% Vaginal birth after previous C-section

*

*

*

*

*

21.2

% WIC during pregnancy

52.2

66.7

67.4

74.0

62.5

64.0

% Medicaid during pregnancy

53.3

69.1

69.8

67.1

56.8

62.9

% Medicaid and WIC during pregnancy

40.2

56.8

59.3

60.3

46.6

52.1

% Perinatal case management

.

28.4

33.7

27.4

23.9

28.4

Lanier County - 086

15.6 69.4
1.9 12.9
* * * * *
70.7 *
70.7 * * * *
* * * * * *
* * * * * *
42.1 *
37.1 *
35.5 * *
. . .
75.4 20.3
* 46.8 48.4 35.5
.

11.2 50.4
1.4 27.3
* * * * *
* * * * * * *
* * * * * *
* * * * * *
40.5 15.9 40.5
* 34.9
* *
* * 7.6
68.9 * *
61.4 54.5 45.5 22.7

13.8 62.9 1.8 30.4
* * * * *
* * * * * * *
* * * * * *
10.7 * * * * *
38.8 17.9 42.9
* 30.9
* *
* 12.3 11.3
74.1 * *
60.7 64.3 51.8 33.9

11.5 52.7
1.5 23.9
* * * * *
53.0 *
53.0 * * * *
* * * * * *
* * * * * *
30.4 *
32.6 *
34.8 * *
6.6 6.6 19.7
76.6 19.5
* 65.2 56.5 50.0 26.1

13.8 64.0 1.9 29.8
* * * * 11.2
85.9 *
75.2 * * * *
* * * * * *
* * * * * *
41.1 12.3 33.3
* 31.6
* *
4.7 5.6 16.9
64.9 13.7
* 57.9 49.1 40.4 22.8

13.2 59.9
1.7 24.5
* * * * 5.2
54.1 *
52.0 48.0
* * *
* * * * * *
4.9 * *
6.8 * *
38.8 11.3 37.3
* 33.5
* 7.1
3.1 6.8 13.9
72.0 13.4 23.5 57.7 54.3 44.2 26.6

20.4 84.3
2.3 63.3
* * * * *

24.8 103.2
3.0 72.2
* * * * *

147.1 *
147.1 100.0
* * *

323.5 45.5
323.5 90.9 * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

53.6 36.7 37.9
* * * *

47.1 38.9 45.7
* * * *

.

*

.

*

.

15.2

30.0 * *
63.3 63.3 50.0
.

74.3 * *
75.0 88.9 72.2 36.1

19.2 80.5 2.4 65.5
* * * * *
* * * * * * *
* * * * * *
* * * * * *
55.6 31.0 42.9
* * * *
* 9.4 18.9
57.1 * *
82.8 82.8 75.9 34.5

17.7 74.3
2.3 81.5
* * * * *

19.4 82.2 2.4 63.3
* * * * *

20.3 84.9
2.5 69.1
* * * * 5.0

* 267.1 195.0

*

*

39.4

* 267.1 195.0

* 100.0

97.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

8.5

*

*

*

*

*

*

*

*

7.9

*

*

*

*

*

3.3

64.0 40.7 33.3
* * * *

58.6 30.0 43.3
* * * *

55.2 35.5 40.9
* 9.2 3.3 5.2

* * 22.5

* * 13.0

2.4 6.6 17.4

51.9

60.0

55.3

*

*

9.0

*

*

*

88.9

73.3

76.3

85.2

73.3

78.9

77.8

60.0

67.1

29.6

26.7

32.0

353

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Laurens County - 087

1990
39988 8982 894
20.2 19.7 22.0
98 24 649 83 253 28 17 111 15
12 10
2 27
1 2
64 6 2
47 5 9
116 143 221
6 87 11 41
. . .
487 93
4 339 318 245
. 0

1991
40392 9029 904
20.6 19.6 22.0
89 16 682 70 276 41
9 116
14
16 14
2 22
1 1
58 17
5 43
4 16
103 155 224
5 85
9 45
27 6
95
511 125
2 406 353 298 174
0

Total
1992 1993

40780 9075 914

41186 9121 924

21.2 19.2 21.0

20.7 19.3 22.0

85

94

22

17

622

639

68

70

241

263

36

39

9

7

122

96

12

19

6

4

3

1

3

3

12

8

1

2

3

0

44

59

5

5

1

0

31

54

4

5

9

13

134

129

143

127

172

183

4

9

74

86

9

6

37

26

41

47

24

51

113

129

504

529

111

114

5

5

327

385

334

379

264

328

219

229

0

3

1994 5-year

41580 9168 934

203926 45375 4570

21.1 19.2 23.0

20.7 19.5 22.0

94

460

16

95

659

3251

74

365

277

1310

38

182

7

49

103

548

16

76

16

54

12

40

4

14

18

87

2

7

3

9

69

294

24

57

6

14

59

234

10

28

25

72

117

599

158

726

180

980

7

31

73

405

9

44

22

171

39

154

39

120

132

469

536

2567

106

549

4

20

378

1835

393

1777

325

1460

293

915

5

8

1990
26485 5675 500

1991
26704 5682 504

White
1992 1993

26914 5687 508

27137 5694 512

1994 5-year

27349 5700 517

134589 28438 2541

21.8 18.9 21.0

21.6 19.9 21.0

22.2 20.5 21.0

23.0 19.6 21.0

23.1 20.1 21.0

22.3 19.6 21.0

46

44

33

38

34

195

9

3

7

7

4

30

348

395

354

369

357

1823

33

32

28

29

26

148

59

75

57

65

68

324

20

23

18

26

24

111

6

3

3

3

3

18

66

65

65

55

48

299

13

9

4

8

7

41

4

5

5

1

7

22

4

5

3

0

6

18

0

0

2

1

1

4

10

8

6

3

8

35

1

0

0

2

1

4

2

0

3

0

0

5

24

22

22

16

26

110

2

6

3

1

7

19

0

1

1

0

2

4

14

17

18

23

28

100

2

2

3

3

3

13

4

5

6

6

11

32

59

64

79

66

56

324

32

39

32

35

34

172

101

113

81

96

75

466

1

1

1

1

3

7

68

67

57

63

56

311

6

4

4

4

2

20

11

17

13

7

8

56

.

14

22

29

19

84

.

6

10

30

24

70

.

29

49

55

55

188

296

329

310

328

317

1580

47

73

61

62

63

306

2

1

2

4

2

11

133

188

145

166

161

793

109

154

132

157

160

712

81

127

110

131

129

578

.

79

87

89

121

376

0

0

0

1

0

1

1990
13304 3244 390

1991
13438 3260 394

Black
1992 1993

13568 3276 399

13703 3292 403

1994 5-year

13834 3308 408

67846 16379
1994

18.8 19.9 24.0

19.8 19.3 24.0

19.0 18.7 23.0

19.0 16.9 24.0

19.0 18.3 26.0

19.1 18.8 24.0

52

45

52

56

60

265

15

13

15

10

12

65

301

285

265

267

297

1415

50

38

40

41

48

217

194

201

184

198

209

986

8

18

18

13

14

71

11

6

6

4

4

31

44

51

54

41

55

245

2

5

8

11

9

35

8

11

1

3

9

32

6

9

0

1

6

22

2

2

1

2

3

10

17

14

6

5

10

52

0

1

1

0

1

3

0

1

0

0

3

4

40

36

22

43

42

183

4

11

2

4

17

38

2

4

0

0

4

10

33

26

13

31

31

134

3

2

1

2

7

15

5

11

3

7

14

40

57

39

54

111

116

111

120

110

91

5

4

3

19

18

17

5

5

5

30

28

24

62

60

272

92

124

554

87

105

513

8

4

24

23

17

94

2

7

24

19

14

115

.

13

17

17

20

67

.

0

12

20

13

45

.

65

63

73

76

277

191

180

191

198

215

975

46

52

50

51

42

241

2

1

3

1

2

9

206

217

182

219

216

1040

209

198

202

222

232

1063

164

170

154

197

195

880

.

94

132

140

172

538

0

0

0

2

5

7

354

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Laurens County - 087

16.2 72.3
2.2 39.3
2.8 12.4
0.4 137.2
5.5
109.6 24.5 92.8 73.2 16.8 100.0
*
18.5 15.4
* 40.5
* *
9.9 0.9
* 7.3 0.8 1.4
32.9 22.2 34.3
0.9 13.6
1.7 10.9
. . .
75.4 16.8
* 52.6 49.4 38.0
.

16.9 75.5
2.3 40.8
2.9 12.8
0.4 136.3
5.9
98.5 18.0 77.5 82.9 15.5 100.0
5.5
23.5 20.5
* 31.8
* *
8.5 2.5 0.7 6.4
* 2.4
29.5 22.9 33.2
0.7 12.6
1.3 11.0
2.4 0.5 8.4
75.5 21.4
* 60.0 52.1 44.0 25.7

15.3 68.5 2.1 39.0 3.0 13.4 0.4 154.4 5.1
93.0 25.9 74.4 80.9 13.1 100.0
5.5
9.6 * *
19.0 * *
7.1 0.8
* 5.0
* 1.4
35.8 23.1 27.9
* 12.0
1.5 9.9
3.6 2.1 9.9
81.4 20.8 5.9 52.9 54.0 42.7 35.4

15.5 70.1
2.1 41.5
2.3 10.5
0.3 122.6
5.3
101.7 18.1 75.8 78.3 20.6
100.0 6.5
* * * 12.4 * *
9.2 0.8
* 8.5 0.8 2.0
33.3 20.1 29.0
1.4 13.6
0.9 6.9
4.1 4.4 11.2
82.9 21.3
5.2 60.8 59.9 51.8 36.2

15.8 71.9 2.2 42.6 2.5 11.2 0.3 127.5 5.0
100.6 17.0 79.2 82.2 17.1 93.8 5.4
24.3 18.2
* 27.0
* *
10.5 3.6 0.9 9.1 1.5 3.8
29.7 24.3 27.8
1.1 11.2
1.4 5.7
3.4 3.4 11.3
82.5 19.4
* 58.2 60.5 50.0 45.1

15.9 71.6
2.2 40.7
2.7 12.1
0.4 135.6
5.3
100.6 20.7 79.9 79.3 16.6 98.7
4.8
16.6 12.3
4.4 26.4
0.6 0.2
9.0 1.8 0.4 7.3 0.9 2.2
32.3 22.5 30.5
1.0 12.6
1.4 8.9
3.3 2.6 10.2
79.5 19.9
4.3 57.0 55.2 45.3 35.5

13.1 61.3
1.9 17.1
2.5 11.6
0.4 149.0
5.1

14.8 69.5
2.2 19.1
2.4 11.4
0.4 133.2
4.9

13.2 62.2 1.9 16.2 2.4 11.4 0.4 147.7 3.7

13.6 64.8
2.0 17.8
2.0 9.7 0.3 120.9 5.4

13.1 62.6 2.0 19.2 1.8
8.4 0.3 111.1 4.7

13.5 64.1
2.0 17.9
2.2 10.5
0.3 132.4
4.8

92.0 19.6 66.0 39.4 26.0 100.0
*

87.3 *
63.5 65.6 17.9 100.0
*

64.9 21.2 55.1 57.1
* * *

74.2 18.4 56.6 48.3 15.6 100.0
*

65.8 *
50.3 52.0 13.6 100.0
*

76.7 15.4 58.2 52.4 16.1 100.0
2.8

* * * 28.2 * *

12.7 12.7
* 20.1
* *

14.1 * *
16.8 * *

*

19.6

12.1

*

16.8

9.9

*

*

*

*

22.2

19.0

*

*

*

*

*

0.2

6.9

5.6

6.2

4.3

7.3

6.0

*

1.5

*

*

2.0

1.0

*

*

*

*

*

*

4.0

4.3

5.1

6.3

7.9

5.5

*

*

*

*

*

0.7

*

1.3

1.7

1.6

3.1

1.8

28.0 9.2
29.2 *
19.7 1.7 5.9

28.7 9.9
28.8 *
17.2 *
7.7

33.1 9.1 23.1
* 16.2
* 6.6

28.1 9.6
26.3 *
17.2 *
3.2

24.0 9.6
21.2 *
15.9 *
4.0

28.4 9.5
25.8 0.4
17.2 1.1 5.4

.

2.1

3.4

4.4

2.8

3.2

.

0.9

1.5

4.5

3.6

2.7

.

4.5

7.5

8.3

8.2

7.1

85.3 15.5
* 38.4 31.5 23.4
.

83.9 21.3
* 47.8 39.2 32.3 20.1

87.8 19.6
* 41.3 37.6 31.3 24.8

89.1 20.0
* 45.4 42.9 35.8 24.3

89.5 20.8
* 45.5 45.2 36.4 34.2

87.1 19.5
4.6 43.8 39.3 31.9 25.7

22.6 92.8
2.6 65.1
3.3 13.6
0.4 120.5
6.2

21.2 87.4
2.5 71.3
3.8 15.6
0.4 141.3
7.7

19.5 80.9 2.3 69.7 4.0 16.5 0.5 157.0 7.6

19.5 81.1
2.3 75.0
3.0 12.5
0.3 126.2
5.2

21.5 89.8 2.6 71.8 4.0 16.6 0.5 148.2 5.7

20.9 86.4
2.5 70.5
3.6 15.0
0.4 138.7
6.5

133.3 28.8 128.2 95.9
* * *

114.1 28.9 96.4 97.4 12.7
100.0 *

130.4 28.8
100.3 97.5 20.1
100.0 *

138.9 17.9
101.7 100.0
27.3 100.0
12.4

147.2 20.0
117.8 97.9 22.1 88.9 *

132.9 24.5 108.8 97.7 17.6 97.1 7.5

26.6 19.9
* 54.5
* *

38.6 31.6
* 48.1
* *

* * * 22.1 * *

* * * 18.5 * *

30.3 20.2
* 33.2
* *

22.6 15.5
7.2 36.0
* *

13.3 * *
11.1 *
1.7

12.6 3.9 * 9.2 * 3.9

8.3

16.1

14.1

12.9

*

*

5.7

2.7

*

*

*

0.7

4.9

11.7

10.7

9.6

*

*

2.4

1.1

*

2.6

4.7

2.8

40.1 37.2 40.3
1.7 6.4 1.7 15.7

31.5 41.1 39.3
* 6.4 1.8 15.1

40.6 42.0 34.6
* 6.4 1.9 13.8

41.3 34.8 33.0
3.0 8.7
* 12.1

38.0 42.6 36.3
* 5.8 2.4 7.7

38.5 39.6 36.8
1.7 6.7 1.7 12.9

.

2.7

3.5

3.5

4.1

3.5

.

*

2.5

4.1

2.7

2.3

.

13.6

13.1

15.0

15.5

14.3

63.9 18.3
* 69.1 70.1 55.0
.

63.6 21.7
* 77.0 70.2 60.3 33.3

72.6 22.8
* 68.9 76.5 58.3 50.0

74.2 22.9
* 83.0 84.1 74.6 53.0

73.6

69.4

17.6

20.6

*

4.0

74.2

74.3

79.7

76.0

67.0

62.9

59.1

48.9

355

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Lee County - 088

1990
16250 4039 438
22.3 17.9 20.0
25 2
241 18 62 17
1 36
7
5 3 2 4 0 1
18 3 2
28 6 2
84 25 57
3 23
2 6
. . .
200 44
0 85 67 53
. 0

1991
16965 4209 468
21.6 19.1 21.0
29 4
227 23 69 18 1 43 6
3 3 0 4 1 2
22 5 2
22 3 3
74 38 59
1 12
0 12
0 0 2
194 41 1 94 74 61 1 0

Total
1992 1993

17669 4378 498

18379 4546 528

22.1 17.8 21.0

21.3 17.7 21.0

32

27

8

5

239

213

21

20

69

67

10

13

0

1

35

33

10

6

1

2

1

0

0

2

1

1

0

1

0

2

15

13

0

2

0

0

15

19

2

1

1

1

75

52

37

36

54

53

0

0

26

32

0

2

10

10

6

2

6

9

3

9

211

190

27

29

1

1

102

90

99

90

83

71

15

32

0

0

1994 5-year

19084 4714 558

88347 21886
2491

22.0 19.1 21.0

21.7 18.4 21.0

22

135

7

26

203

1123

18

100

49

316

26

84

0

3

30

177

2

31

2

13

2

9

0

4

2

12

2

4

0

5

17

85

4

14

1

5

18

102

4

16

2

9

71

356

24

160

41

264

4

8

25

118

0

4

4

42

9

17

5

20

28

42

170

965

24

165

4

7

90

461

89

419

75

343

68

116

0

0

1990
13007 3364 352

1991
13685 3529 383

White
1992 1993

14359 3694 414

15032 3857 445

1994 5-year

15708 4022 476

71791 18466
2071

22.6 17.9 20.0

21.8 18.8 20.0

23.1 17.4 20.0

21.7 17.5 20.0

23.1 18.8 21.0

22.4 18.1 20.0

17

17

22

19

15

90

0

1

5

1

4

11

186

173

188

167

163

877

11

12

15

14

11

63

28

27

33

35

19

142

14

14

7

10

21

66

0

1

0

1

0

2

26

27

23

27

22

125

6

5

7

4

2

24

4

1

1

1

0

7

3

1

1

0

0

5

1

0

0

1

0

2

3

2

1

1

0

7

0

0

0

1

1

2

0

1

0

2

0

3

11

19

10

9

2

3

0

1

2

1

0

0

19

17

12

11

6

3

1

0

2

1

1

1

9

58

1

7

0

3

9

68

4

14

2

7

61

53

51

39

56

260

11

14

18

18

8

69

39

39

42

41

28

189

3

1

0

0

2

6

19

9

22

28

25

103

1

0

0

1

0

2

2

7

5

7

3

24

.

0

5

0

3

8

.

0

6

8

2

16

.

0

3

9

12

24

164

153

177

158

145

797

37

33

21

21

17

129

0

1

1

1

3

6

51

54

65

56

62

288

35

40

64

56

59

254

28

33

53

41

52

207

.

1

6

20

45

72

0

0

0

0

0

0

1990
3135 647 82

1991
3273 675 88

Black
1992 1993

3409 703 93

3546 731 99

1994 5-year

3682 759 105

17044 3515 466

19.7 19.1 24.0

19.3 19.8 23.0

20.9 18.4 24.0

20.7 17.7 25.0

20.2 25.0 25.5

20.0 19.4 24.0

7

12

10

8

6

43

2

3

3

4

3

15

55

54

50

45

38

242

7

11

6

6

6

36

34

42

36

31

28

171

3

4

3

3

5

18

1

0

0

0

0

1

9

15

11

6

8

49

0

1

3

2

0

6

1

2

0

1

2

6

0

2

0

0

2

4

1

0

0

1

0

2

1

2

0

0

2

5

0

1

0

0

1

2

1

1

0

0

0

2

7

3

5

4

8

27

1

2

0

1

3

7

0

1

0

0

1

2

9

5

3

7

9

33

0

0

1

1

0

2

0

2

0

0

0

2

23

21

23

13

14

94

14

24

19

18

15

90

18

20

12

12

12

74

0

0

0

0

2

2

4

3

4

3

0

14

1

0

0

1

0

2

4

5

5

3

1

18

.

0

0

0

6

6

.

0

0

1

3

4

.

2

0

0

16

18

36

41

33

31

23

164

7

8

5

8

6

34

0

0

0

0

1

1

34

40

37

33

26

170

32

34

35

33

29

163

25

28

30

29

22

134

.

0

9

12

22

43

0

0

0

0

0

0

356

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Lee County - 088

14.8 59.7
2.0 26.4
2.2 8.9 0.3 122.0 4.5
57.1 *
41.1 77.8 16.0 100.0
*
20.7 * * * * *
7.5 * *
11.9 2.6 *
38.0 10.6 24.3
* 9.8
* 4.4
. . .
83.3 19.9
* 36.2 28.5 22.6
.

13.4 53.9
1.8 30.8
2.5 10.2
0.3 146.3
5.7
62.0 *
49.2 82.6 12.8 100.0
*
* * * * * *
9.7 2.2
* 9.8
* *
35.1 17.0 26.3
* 5.4
* 9.8
* * *
87.0 20.2
* 42.0 33.0 27.2
*

13.5 54.6 1.8 29.1 2.0 8.0 0.3 119.5 4.3
64.2 25.0 42.1 71.4 20.1 90.0
*
* * * * * *
6.3 * *
6.3 * *
34.9 15.6 22.9
* 11.1
* 7.0
1.1 1.1
*
88.7 12.9
* 43.0 41.8 35.0
6.3

11.6 46.9
1.5 31.6
1.8 7.3 0.2 126.4 3.3
51.1 18.5 37.9 80.0 11.4 83.3
*
* * * * * *
6.1 * *
9.0 * *
27.8 17.0 25.0
* 15.2
* 8.4
* 1.5 1.5
90.5 15.8
* 42.5 42.5 33.5 15.1

10.6 43.1 1.5 24.6 1.6
6.4 0.2 114.9 5.9
39.4 31.8 32.2 72.2
* * *
* * * * * *
8.4 * *
9.0 * *
37.2 12.1 20.6
* 12.6
* *
1.5 0.8 4.6
84.2 13.6
* 45.2 44.7 37.7 34.2

12.7 51.3
1.7 28.5
2.0 8.1 0.3 126.1 4.8
54.2 19.3 40.1 77.0 12.4 93.5
2.4
11.6 8.0 *
10.7 *
0.2
7.6 1.2 0.4 9.2 1.4 0.8
34.7 14.5 23.9
0.7 10.7
* 6.5
0.7 0.9 1.8
86.7 16.6
6.2 41.6 37.9 31.0 13.3

14.3 55.3
1.9 15.6
2.0 7.7 0.3 115.0 4.2

12.6 49.0
1.7 15.9
2.0 7.7 0.2 123.3 5.4

13.1 50.9 1.7 17.6 1.6
6.2 0.2 103.1 3.2

11.1 43.3
1.5 21.0
1.8 7.0 0.2 131.1 3.1

10.4 40.5 1.4 11.9 1.4
5.5 0.2 106.3 5.5

12.2 47.5
1.6 16.5
1.7 6.8 0.2 115.6 4.3

48.3 *
31.3 63.6 17.0 100.0
*

44.4 *
31.3 66.7 13.1 100.0
*

53.1 22.7 36.2 60.0 16.9 85.7
*

42.7 *
31.4 71.4
* * *

31.5 *
23.1 54.5
* * *

43.5 12.2 30.4 63.5 11.6 91.7
*

*

*

*

*

*

8.0

*

*

*

*

*

5.7

*

*

*

*

*

*

*

*

*

*

*

8.0

*

*

*

*

*

*

*

*

*

*

*

*

5.9

11.0

5.3

5.4

5.5

6.6

*

*

*

*

*

0.8

*

*

*

*

*

*

10.6

10.0

6.4

6.6

5.7

7.9

3.3

*

*

*

*

1.6

*

*

*

*

*

0.8

34.7 6.1
21.7 *
10.6 * *

32.1 8.2
22.9 *
5.3 *
7.3

29.0 9.6 22.5
* 12.0
* 4.5

25.8 10.8 24.6
* 16.9
* 7.3

36.1 5.0
17.6 *
15.7 * *

31.6 8.0
21.9 0.7
12.0 *
4.7

.

*

1.1

*

*

0.4

.

*

1.3

1.6

*

0.8

.

*

*

1.8

2.3

1.3

88.2 21.8
* 28.3 19.4 15.6
.

89.0 21.9
* 31.8 23.5 19.4
*

94.7 12.7
* 34.8 34.2 28.3 3.2

95.2 14.5
* 33.5 33.5 24.6 12.0

89.5 12.0
* 39.0 37.1 32.7 28.3

91.3 16.7
6.7 33.4 29.4 24.0 10.5

17.5 85.0
2.5 61.8
2.9 13.9
0.4 132.4
*

16.5 80.0
2.2 77.8
4.6 22.2
0.7 202.7
7.4

14.7 71.1 2.2 73.5 3.2 15.6 0.4 161.8 10.0

12.7 61.6
1.8 70.5
1.7 8.2 0.2 111.1
*

10.3 50.1 1.4 73.7 2.2 10.5 0.3 153.8 7.9

14.2 68.8
2.0 71.3
2.9 13 .9
0.4 155.1
7.1

85.4 *
85.4 100.0
* * *

137.0 *
125.6 100.0
* * *

107.2 *
64.3 100.0
* * *

80.9 *
60.7 100.0
* * *

57.4 *
57.4 100.0
* * *

92.2 34.9 77.2 100.0 12.9 100.0
*

*

*

*

*

*

24.8

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

20.6

*

*

*

*

*

*

*

*

*

*

*

*

12.7 * *
16.4 * *

*

10.0

*

21.1

11.2

*

*

*

*

2.9

*

*

*

*

*

9.3

*

15.9

23.7

13.8

*

*

*

*

*

*

*

*

*

*

51.1 25.5 32.7
* * * *

45.7 44.4 37.0
* * * 19.2

60.5 38.8 25.0
* * * 15.2

37.1 40.9 27.3
* * * *

41.2 39.5 31.6
* * * *

47.5 37.5 31.0
* 5.8
* 13.5

.

*

*

*

5.3

1.4

.

*

*

*

*

*

.

*

*

*

14.2

4.2

66.7 13.7
* 61.8 58.2 45.5
.

80.4 15.4
* 74.1 63.0 51.9
*

66.0 11.6
* 75.5 71.4 61.2 18.4

72.1 21.1
* 75.0 75.0 65.9 27.3

60.5

69.5

18.2

15.7

*

*

68.4

70.8

76.3

67.9

57.9

55.8

57.9

23.2

357

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Liberty County - 089

1990
52745 13064
858
20.9 20.0 21.0
95 12 1453 73 281 132 19 230 18
16 8 8
27 3 5
97 21
6 122 18 19
406 183 244 24 250 13 63
. . .
926 217 25 715 219 165
. 3

1991
54022 13565
893
21.3 20.8 22.0
76 19 1057 54 243 148
9 309
19
15 9 6
18 1 6
79 19
2 102
13 12
285 157 155
8 159
13 50
23 25 171
756 125
18 660 209 178
14 8

Total
1992 1993

55302 14070
929

56586 14576
965

21.3 20.2 22.0

21.2 18.6 22.0

120 30
1689 103 355 145 11 305 14

116 30
1437 89
343 142
16 249
23

19

13

7

6

12

7

18

24

1

8

3

2

141

126

27

29

2

2

155

165

22

16

19

20

451

413

235

222

233

181

13

8

223

175

19

9

62

78

75

92

59

77

265

257

1174 197 59 952 286 236 146 2

1021 167
56 931 392 306 115
10

1994 5-year

57863 15079
1001

276518 70354
4646

20.4 20.4 22.0

21.1 19.9 22.0

124 31
1476 101 376 152 13 265 14

531 122 7112 420 1598 719
68 1358
88

21

84

19

49

2

35

33

120

7

20

3

19

129

572

32

128

9

21

154

698

21

90

15

85

517

2072

226

1023

185

998

11

64

193

1000

4

58

72

325

78

268

45

206

318

1011

1039 154 50 850 308 242 50 3

4916 860 208
4108 1414 1127
325 26

1990
28935 6922 429

1991
29255 7074 439

White
1992 1993

29570 7227 449

29894 7382 459

1994 5-year

30211 7535
469

147865 36140
2245

21.0 20.3 20.0

21.3 20.8 20.0

21.2 20.1 21.0

21.5 18.6 21.0

20.8 21.4 21.0

21.1 20.1 21.0

44

27

60

46

47

224

5

5

11

13

10

44

815

568

904

817

820

3924

33

22

50

33

42

180

81

62

91

98

101

433

63

80

74

76

68

361

11

3

4

9

7

34

101

125

114

93

103

536

9

6

7

11

4

37

5

7

8

6

5

31

3

6

3

3

4

19

2

1

5

3

1

12

15

9

7

13

12

56

1

0

0

3

2

6

5

2

1

0

0

8

38

30

49

56

48

221

12

8

9

9

9

47

3

2

0

1

2

8

64

42

66

66

64

302

5

6

9

9

12

41

6

8

9

10

8

41

192

146

225

200

242

1005

47

36

51

52

49

235

143

88

125

84

92

532

6

1

0

3

4

14

179

119

167

135

159

759

9

6

6

3

1

25

26

22

25

32

33

138

.

5

22

37

26

90

.

13

24

44

18

99

.

61

96

70

99

326

582

416

669

617

602

2886

116

60

94

94

75

439

15

10

30

30

24

109

357

329

492

507

466

2151

72

73

86

151

104

486

52

59

74

117

83

385

.

5

41

50

18

114

0

1

1

2

2

6

1990
20655 5168 392

1991
21155 5359 408

Black
1992 1993

21656 5551 425

22159 5743 441

1994 5-year

22659 5935 457

108285 27755 2123

20.2 19.8 22.0

21.3 21.0 23.0

21.3 20.4 22.0

20.8 18.4 22.0

20.0 20.3 23.0

20.7 19.7 22.0

51

46

57

66

75

295

7

14

19

14

20

74

588

445

715

572

610

2930

40

30

50

52

58

230

197

174

251

238

266

1126

63

62

69

66

82

342

8

6

7

7

6

34

119

164

175

143

150

751

9

13

7

12

9

50

11

8

11

7

15

52

5

3

4

3

14

29

6

5

7

4

1

23

12

8

11

10

20

61

2

1

1

5

5

14

0

4

2

2

3

11

54

47

89

65

78

333

9

10

18

19

22

78

3

0

2

1

6

12

54

58

86

92

87

377

12

6

12

6

9

45

13

4

9

9

7

42

201

132

212

207

257

1009

135

116

176

165

173

765

96

64

93

91

90

434

17

7

13

5

7

49

55

31

48

35

28

197

4

6

13

6

3

32

33

28

37

41

36

175

.

13

39

45

39

136

.

10

25

27

24

86

.

85

136

170

165

556

314

310

460

372

403

1859

90

54

95

69

72

380

10

8

25

25

25

93

332

300

429

398

369

1828

144

133

196

235

197

905

112

116

159

184

157

728

.

9

104

63

31

207

3

7

0

7

1

18

358

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Liberty County - 089

27.5 111.2
2.8 19.6
4.4 17.6
0.4 124.7 12.4
110.7 12.6 85.1 74.0 21.0 94.4
*
11.0 5.5 5.5
18.3 *
0.5
6.7 1.4 0.4 8.5 1.3 1.3
29.2 12.7 17.0
1.7 17.6
0.9 7.2
. . .
64.2 17.0 15.9 49.8 15.2 11.5
.

19.6 77.9
2.0 23.3
5.7 22.8
0.5 202.1
12.0
85.1 25.0 60.4 66.0 21.3 100.0
*
14.2 8.5 5.7
16.9 *
0.6
7.5 1.8
* 9.8 1.2 1.2
28.1 15.0 14.9
0.8 15.5
1.3 7.9
1.4 1.5 10.5
71.6 13.4 16.2 63.2 20.0 17.0
1.3

30.5 120.0
3.2 21.3 5.5 21.7 0.5 141.5 11.4
129.1 25.0
110.8 73.8 15.1
100.0 *
11.2 4.1 7.1
10.6 * *
8.3 1.6
* 9.3 1.3 1.1
27.9 14.1 14.0
0.8 13.6
1.2 6.4
4.5 3.5 15.9
69.6 13.2 33.0 57.1 17.2 14.2
8.8

25.4 98.6
2.7 24.1
4.4 17.1
0.4 134.6
11.3
120.2 25.9 92.2 71.6 23.8 91.3 5.2
9.0 4.2 4.9 16.5 1.6
*
8.8 2.0
* 11.6
1.1 1.4
29.7 15.6 12.7
0.6 12.4
0.6 9.4
5.4 4.5 15.2
71.2 13.1 39.4 65.5 27.6 21.5
8.1

25.5 97.9 2.7 25.8 4.6 17.6 0.5 138.7 11.2
123.9 25.0
100.9 69.3 14.0
100.0 9.0
14.2 12.9
* 22.2 1.4
*
8.7 2.2 0.6 10.6 1.4 1.0
36.4 15.5 12.8
0.8 13.4
* 8.5
4.5 2.6 18.5
70.6 11.7 35.7 58.4 21.2 16.6
3.4

25.7 101.1
2.7 22.8
4.9 19.3
0.5 146.2 11.6
114.3 23.0 90.4 71.3 18.9 96.6
5.4
11.8 6.9 5.0
16.7 0.8 0.4
8.0 1.8 0.3 9.9 1.3 1.2
30.3 14.6 14.2
0.9 14.4
0.8 7.8
4.0 3.1 15.1
69.3 13.7 28.5 58.5 20.1 16.0
5.8

28.2 117.7
3.0 10.0
3.5 14.6
0.4 101.8 11.0

19.4 80.3
2.1 11.0
4.3 17.7
0.4 160.5
12.2

30.6 125.1
3.3 10.2 3.9 15.8 0.4 104.0 10.8

27.3 110.7
3.0 12.1
3.1 12.6
0.3 93.1 12.1

27.1 108.8
3.0 12.5 3.4 13.7 0.3 103.1 10.1

26.5 108.6
2.9 11.2
3.6 14.8
0.4 110.2 11.2

102.6 11.4 76.9 48.5 21.0 88.9
*

61.5 18.5 50.1 28.6 13.7 100.0
*

133.7 18.3
111.4 52.0 15.6
100.0 *

100.2 28.3 71.9 40.6 24.0 81.8 *

100.2 21.3 89.5 42.9 * * *

99.8 19.6 80.2 44.4 16.5 91.9
4.0

6.1 * *
18.2 *
1.0

12.3 10.6
* 15.8
* *

8.8

7.3

6.1

7.9

*

*

*

4.8

5.5

*

*

3.1

7.7

15.7

14.5

14.1

*

*

*

0.5

*

*

*

0.3

4.7

5.3

5.4

6.9

5.9

5.6

1.5

1.4

1.0

1.1

1.1

1.2

*

*

*

*

*

0.2

7.9

7.5

7.4

8.2

7.9

7.8

0.6

1.1

1.0

1.1

1.5

1.1

0.7

1.4

1.0

1.2

1.0

1.1

24.4 5.8
17.7 0.7
22.3 1.1 5.6

26.7 6.4
15.7 *
21.6 1.1 6.7

25.8 5.7 14.0
* 19.0
0.7 5.1

25.0 6.4
10.4 *
16.8 *
7.3

30.5 6.1
11.4 *
19.9 *
7.2

26.4 6.1
13.7 0.4
19.8 0.7 6.3

.

0.6

2.9

4.9

3.5

3.0

.

1.7

3.1

5.8

2.4

3.2

.

7.9

12.5

9.2

13.2

10.7

71.9 15.8 19.7 44.0
8.9 6.4
.

73.2 12.0 16.4 58.5 13.0 10.5
0.9

74.1 11.6 36.1 55.0
9.6 8.3 4.6

75.7 12.6 46.9 62.7 18.7 14.5
6.2

73.5 10.0 39.3 57.7 12.9 10.3
2.2

73.7 12.4 31.6 55.4 12.5
9.9 3.7

28.5 113.8
2.9 34.1
5.8 23.0
0.5 151.2 15.5

21.0 83.0
2.2 39.6
7.8 30.6
0.7 241.2
13.2

33.0 128.8
3.4 35.8 8.1 31.5 0.7 180.4 14.4

25.8 99.6
2.7 42.0
6.5 24.9
0.6 181.0
13.1

26.9 102.8
2.9 44.3 6.6 25.3 0.6 176.3 15.3

27.1 105.6
2.8 39.0
6.9 27.1
0.7 184.2 14.3

130.1 13.7 102.0 95.0 23.0 100.0
*

112.7 30.4 73.5 90.0 31.8
100.0 *

134.3 33.3
117.8 96.0 16.5
100.0 *

149.7 21.2
117.9 92.3 27.2
100.0 *

164.1 26.7
126.9 89.7 19.7
100.0 17.5

139.0 25.1 108.4 92.6 23.6
100.0 7.1

18.7 8.5
10.3 20.1
* *

18.0 *
11.3 17.7
* *

15.4 *
9.8 15.2
* *

12.2 * *
17.3 2.4 *

24.6 23.0
* 32.5 2.3
*

17.7 9.9 7.9
20.6 1.3 0.5

9.2

10.6

12.4

11.4

12.8

11.4

1.5

2.2

2.5

3.3

3.6

2.7

*

*

*

*

1.0

0.4

9.4

13.2

12.3

16.3

14.5

13.1

2.1

1.4

1.7

1.1

1.5

1.6

2.2

*

1.3

1.6

1.2

1.5

36.2 23.4 16.7
3.0 9.6
* 8.6

31.2 26.4 14.6
1.6 7.2 1.4 9.8

31.4 25.1 13.3 1.9 6.9 1.9 8.6

38.0 29.2 16.1
0.9 6.3 1.1 11.5

44.2 28.8 15.1 1.2 4.7
* 9.7

36.3 26.5 15.1
1.7 6.9 1.1 9.6

.

1.8

5.2

5.9

5.0

4.5

.

1.4

3.3

3.5

3.1

2.8

.

11.5

18.1

22.3

21.3

18.4

54.0 18.0 12.8 57.5 25.0 19.4
.

69.8 13.8 16.3 68.3 30.3 26.4
2.1

64.3 15.5 28.1 61.1 27.9 22.6 14.8

65.1 14.1 32.5 70.3 41.5 32.5 11.1

66.5

63.7

13.7

15.1

32.5

25.1

61.4

63.4

32.8

31.4

26.1

25.2

5.2

9.0

359

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Lincoln County - 090

1990
7442 1602
173
20.9 17.8 22.0
17 5
86 11 38
4 1 30 6
0 0 0 1 0 0
7 0 0 5 0 3
45 20 19
2 10
1 5
. . .
59 12
0 46 36 28
. 0

1991
7491 1598 172
21.5 17.8 23.0
17 4
129 12 57 5 1 35 5
0 0 0 1 0 1
10 2 0 8 1 0
59 24 34
3 12
1 6
0 0 5
92 13
0 68 64 50
4 1

Total
1992 1993

7538 1596
172

7588 1591 171

21.3 18.9 20.5

21.7 19.0 25.0

17

13

4

3

105

99

12

12

40

41

7

5

0

1

24

25

5

1

2

1

2

0

0

1

2

1

0

0

1

0

16

5

4

1

0

0

11

5

3

1

2

1

35

38

16

16

28

22

1

0

17

12

0

0

6

4

8

5

3

4

38

20

76

71

15

12

0

2

56

55

50

62

41

48

0

2

2

0

1994 5-year

7636 1589
171

37695 7976 860

21.1 18.1 24.0

21.2 18.3 23.0

17

81

7

23

80

499

12

59

34

210

6

27

2

5

24

138

4

21

1

4

0

2

1

2

2

7

0

0

0

2

6

44

3

10

0

0

5

34

1

6

2

8

21

198

17

93

15

118

0

6

9

60

1

3

1

22

9

22

3

10

23

86

65

363

21

73

1

3

49

274

52

264

44

211

33

39

0

3

1990
4600 870 94

1991
4668 875
95

White
1992 1993

4738 882 95

4807 886
95

1994 5-year

4876 893 96

23689 4406 475

21.1 17.8 22.0

22.7 17.1 22.0

24.8 19.8 20.0

23.0 18.3 23.0

21.1 18.9 22.0

22.4 18.0 22.0

6

9

7

3

7

32

0

1

2

1

5

9

42

66

58

56

38

260

2

5

4

3

5

19

5

8

2

8

5

28

4

2

4

5

5

20

0

0

0

1

0

1

13

14

10

6

8

51

4

4

3

0

1

12

0

0

1

0

1

2

0

0

1

0

0

1

0

0

0

0

1

1

0

0

1

1

0

2

0

0

0

0

0

0

0

1

1

0

0

2

0

5

8

4

1

18

0

1

1

1

0

3

0

0

0

0

0

0

0

5

4

3

1

13

0

0

2

1

0

3

1

0

0

1

1

3

12

23

12

16

1

4

1

1

10

11

13

7

0

0

0

0

6

12

16

10

0

1

0

0

1

3

2

2

5

68

2

9

7

48

0

0

8

52

0

1

0

8

.

0

5

3

3

11

.

0

0

2

0

2

.

1

15

7

14

37

34

55

46

47

33

215

7

9

8

8

10

42

0

0

0

2

0

2

13

20

20

22

20

95

10

19

20

26

21

96

8

14

16

19

19

76

.

2

0

1

14

17

0

1

2

0

0

3

1990
2826 728 78

1991
2845 726
78

Black
1992 1993

2863 725 78

2881 722
77

1994 5-year

2900 720 77

14314 3621 388

20.4 17.8 24.0

19.9 20.3 24.5

19.5 18.0 24.0

17.6 19.4 27.5

20.4 17.8 35.0

19.6 18.6 27.0

11

8

10

10

10

49

5

3

2

2

2

14

44

63

47

43

42

239

9

7

8

9

7

40

33

49

38

33

29

182

0

3

3

0

1

7

1

1

0

0

2

4

17

21

14

19

16

87

2

1

2

1

3

9

0

0

1

1

0

2

0

0

1

0

0

1

0

0

0

1

0

1

1

1

1

0

2

5

0

0

0

0

0

0

0

0

0

0

0

0

7

5

8

1

5

26

0

1

3

0

3

7

0

0

0

0

0

0

5

3

7

2

4

21

0

1

1

0

1

3

2

0

2

0

1

5

33

36

23

22

16

130

19

20

15

15

15

84

9

23

15

15

8

70

2

3

1

0

0

6

4

0

1

2

1

8

1

0

0

0

1

2

4

3

4

2

1

14

.

0

3

2

6

11

.

0

3

1

3

7

.

4

20

13

9

46

25

37

30

24

32

148

5

4

7

4

11

31

0

0

0

0

1

1

33

48

36

33

29

179

26

45

30

36

31

168

20

36

25

29

25

135

.

2

0

1

19

22

0

0

0

0

0

0

360

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Lincoln County - 090

11.6 53.7
1.6 44.2
4.0 18.7
0.5 245.9
3.7
98.3 29.4 63.6 90.9 34.7 100.0
*
* * * * * *
8.1 * *
5.8 * *
54.9 23.3 22.1
* 11.9
* 9.1
. . .
69.4 15.0
* 53.5 41.9 32.6
.

17.2 80.7
2.4 44.5
4.7 21.9
0.6 204.7
4.4
98.6 *
69.6 75.0 29.0 100.0
*
* * * * * *
7.8 * *
6.3 * *
49.6 18.8 27.0
* 9.6
* 7.9
* * 2.5
71.9 10.9
* 53.1 50.0 39.1
*

13.9 65.8 2.0 39.6 3.2 15.0 0.4 176.5 4.4
98.6 *
69.6 75.0 29.0 100.0
*
* * * * * *
15.2 * *
11.0 * *
37.2 15.8 28.6
* 17.5
* 11.5
4.0 *
19.2
72.4 16.5
* 55.4 49.5 40.6
*

13.0 62.2
1.9 41.8
3.3 15.7
0.4 192.3
3.8
76.0 *
70.1 83.3
* * *
* * * * * *
5.1 * *
5.1 * *
39.6 16.3 22.4
* 12.5
* *
2.5 *
10.1
72.4 13.8
* 56.1 63.3 49.0
*

10.5 50.3 1.5 43.0 3.1 15.1 0.4 214.3 5.0
99.4 41.2 70.1 75.0
* * *
* * * * * *
7.5 * *
6.3 * *
26.9 21.5 19.0
* 11.5
* *
4.6 *
11.7
81.3 28.4
* 62.0 65.8 55.7 41.8

13.2 62.6
1.9 42.7
3.7 17.3
0.5 205.7
4.3
94.2 28.4 68.6 79.7 24.4 100.0
*
* * * 13.9 * *
8.8 2.0
* 6.9 1.2 1.6
42.2 18.9 24.2
1.2 12.5
* 7.9
2.8 1.3 10.9
73.2 16.2
* 55.7 53.7 42.9
9.6

9.1 48.3
1.5 11.9
2.8 14.9
0.4 216.7
5.7

14.1 75.4
2.3 12.1
3.0 16.0
0.4 168.7
*

12.2 65.8 2.0
* 2.1 11.3 0.3 138.9
*

63.8 * * * * * *

95.0 *
52.8 * * * *

73.5 * * * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

7.6

13.8

*

*

*

*

*

*

*

7.6

*

*

*

*

*

*

*

30.8 *
23.8 *
15.0 * *

37.7 *
16.9 *
18.8 * *

24.0 *
24.1 *
30.2 * *

.

*

4.6

.

*

*

.

*

13.7

81.0 17.5
* 31.0 23.8 19.0
.

83.3 14.5
* 30.3 28.8 21.2
*

79.3 17.0
* 36.4 36.4 29.1
*

11.6 63.2
1.9 14.5
1.2 6.8 0.2 88.2 6.8

7.8 42.6 1.3 13.2 1.6
9.0 0.3 156.9 5.6

11.0 59.0
1.8 10.9
2.2 11.6
0.3 152.7
5.2

*

72.9

67.3

*

71.4

28.1

*

52.1

40.0

*

*

36.8

*

*

25.2

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

6.9

*

*

*

*

*

*

*

*

5.1

*

*

*

*

*

*

30.2 *
12.7 *
18.9 * *

13.2 *
18.4 *
21.1 * *

28.2 3.5
18.9 *
21.0 *
5.6

*

*

2.5

*

*

*

6.3

12.5

8.4

83.9 16.3
* 40.0 47.3 34.5
*

86.8 28.6
* 52.6 55.3 50.0 36.8

82.7 18.0
* 37.1 37.5 29.7
7.9

15.6 60.4
1.8 75.0
6.0 23.4
0.6 274.2
*

22.1 86.8
2.5 79.0
7.4 28.9
0.7 238.6
*

16.4 64.9 1.9 82.6 4.9 19.3 0.5 218.8
*

14.9 59.6
1.8 76.7
6.6 26.3
0.7 . *

14.5 58.3 1.7 70.7 5.5 22.2 0.7 262.3
*

16.7 66.0
1.9 77.1
6.1 24.0
0.6 258.2
3.0

141.0 45.5
115.4 100.0
* * *

103.0 *
90.1 100.0
* * *

128.7 *
103.0 100.0
* * *

129.7 *
116.7 100.0
* * *

129.7 *
90.8 100.0
* * *

126.4 28.6 103.2
100.0 23.2 100.0 *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

20.6

*

*

*

*

*

*

*

*

*

*

*

*

15.9 * *
11.4 * *

7.9

17.0

*

*

*

*

*

15.6

*

*

*

*

*

11.9

10.9

*

*

2.9

*

*

*

*

*

8.9

*

*

*

*

*

2.1

76.7 43.2 20.5
* * * *

62.1 32.3 37.7
* * * *

52.3 32.6 34.1
* * * *

51.2 34.9 34.9
* * * *

40.0 36.6 19.5
* * * *

57.0 35.6 30.0
2.6 3.4
* 10.1

.

*

*

*

6.6

3.0

.

*

*

*

*

1.9

.

*

22.0

14.3

10.0

12.7

58.1 12.5
* 75.0 59.1 45.5
.

59.7 * *
77.4 72.6 58.1
*

63.8 15.9
* 78.3 65.2 54.3
*

57.1 * *
76.7 83.7 67.4
*

76.2

62.7

28.2

14.2

*

*

70.7

75.8

75.6

71.2

61.0

57.2

46.3

11.5

361

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Long County - 091

1990
6202 1510
151
19.9 16.9 19.0
18 2
157 14 33 10
1 18
3
1 0 1 1 0 3
13 1 0
16 3 2
53 18 37
2 31
4 10
. . .
104 23
4 76 34 27
. 0

1991
6264 1512 149
19.3 21.0 20.0
13 3
96 12 21 10
0 13
0
0 0 0 0 0 0
8 0 0 6 2 2
35 10 23
3 21
2 5
3 4 41
69 18
1 58 28 24
1 3

Total
1992 1993

6314 1509
147

6377 1512 145

21.3 20.2 20.0

19.6 18.2 20.0

15

18

6

5

175

162

14

18

38

30

14

11

0

0

14

8

0

0

0

2

0

2

0

0

0

2

0

0

0

0

8

17

1

2

0

0

7

16

1

2

1

2

48

51

24

20

34

32

2

2

42

39

4

2

7

9

6

9

9

15

82

102

119

112

26

23

4

5

101

121

43

49

30

45

13

22

0

0

1994 5-year

6428 1511
143

31585 7554 736

20.6 18.9 20.0

20.1 19.3 20.0

11

75

1

17

138

728

9

67

29

151

5

50

1

2

18

71

2

5

3

6

2

4

1

2

3

6

0

0

1

4

10

56

4

8

0

0

8

53

3

11

1

8

39

226

18

90

24

150

0

9

29

162

1

13

4

35

6

24

7

35

63

288

107

511

13

103

3

17

95

451

36

190

31

157

24

60

3

6

1990
4685 1146
115

1991
4744 1151 113

White
1992 1993

4796 1154
111

4858 1159 110

1994 5-year

4912 1163
108

23995 5773 558

20.0 16.9 19.0

19.9 21.0 19.0

21.3 20.2 20.0

19.6 18.1 20.0

20.6 18.5 19.0

20.4 18.9 20.0

11

11

11

13

9

55

1

3

4

1

1

10

123

80

136

126

113

578

8

10

10

13

7

48

12

13

22

12

17

76

8

7

10

11

3

39

1

0

0

0

1

2

13

9

9

6

12

49

2

0

0

0

2

4

1

0

0

0

2

3

0

0

0

0

2

2

1

0

0

0

0

1

1

0

0

0

3

4

0

0

0

0

0

0

0

0

0

0

1

1

9

8

6

11

6

40

1

0

1

1

2

5

0

0

0

0

0

0

11

6

4

9

5

35

2

2

0

1

3

8

2

2

1

1

1

7

38

29

32

40

30

169

4

7

12

5

8

36

30

16

26

23

17

112

2

3

1

0

0

6

30

19

39

37

26

151

3

0

2

0

0

5

7

3

5

5

3

23

.

1

1

1

5

8

.

1

2

9

5

17

.

22

40

30

36

128

86

56

97

91

91

421

16

15

19

17

9

76

1

1

3

4

3

12

57

46

72

93

77

345

19

18

23

32

28

120

16

15

15

29

23

98

.

1

4

17

18

40

0

0

0

0

0

0

1990
1342 312 34

1991
1355 313
34

Black
1992 1993

1366 314 33

1380 315
33

1994 5-year

1391 316 32

6834 1570
166

19.0 18.3 31.5

16.7 .
18.0

20.2 21.7 20.0

19.9 18.2 22.5

19.9 23.9 24.5

19.4 19.2 23.0

7

2

4

5

2

20

1

0

2

4

0

7

34

14

37

36

23

144

6

2

4

5

2

19

21

8

16

18

11

74

2

3

3

0

1

9

0

0

0

0

0

0

5

4

5

2

5

21

1

0

0

0

0

1

0

0

0

2

1

3

0

0

0

2

0

2

0

0

0

0

1

1

0

0

0

2

0

2

0

0

0

0

0

0

3

0

0

0

0

3

4

0

2

6

4

16

0

0

0

1

2

3

0

0

0

0

0

0

5

0

3

7

3

18

1

0

1

1

0

3

0

0

0

1

0

1

15

5

15

11

9

55

14

3

12

15

10

54

7

6

8

9

7

37

0

0

1

2

0

3

1

2

1

2

3

9

1

2

1

2

1

7

3

2

2

4

1

12

.

0

1

0

0

1

.

0

0

3

1

4

.

4

9

5

17

35

18

11

21

21

15

86

7

2

7

6

3

25

3

0

1

1

0

5

19

11

27

28

16

101

15

10

19

17

8

69

11

9

14

16

8

58

.

0

9

5

6

20

0

3

0

0

2

5

362

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Long County - 091

25.3 104.0
2.7 21.4
2.9 11.9
0.3 96.8
7.3
119.2 *
92.7 61.5
* * *
* * * * * *
8.3 * *
10.4 * *
36.8 11.7 24.2
* 20.4
* 10.9
. . .
66.7 16.7
* 49.4 22.1 17.5
.

15.3 63.5
1.7 22.3
2.1 8.6 0.2 108.3 7.3
87.0 *
80.3 * * * *
* * * * * *
8.3 * *
6.4 * *
37.2 10.6 24.5
* 22.3
* 10.2
* * 21.7
71.9 20.5
* 61.7 29.8 25.5
*

27.7 116.0
3.1 21.8 2.2 9.3 0.2 68.6 9.9
101.9 40.0 95.1 57.1 * * *
* * * * * *
4.6 * *
4.0 * *
28.2 13.8 19.5
* 24.3
* 8.0
3.2 4.7 43.2
68.8 16.2
* 58.0 24.7 17.2
7.5

25.4 107.1
2.9 18.8
1.3 5.3 0.1 44.2 7.3
124.1 27.8
124.1 38.9 * * *
* * * * * *
10.5 * *
10.0 * *
32.5 12.5 20.0
* 24.7
* 9.9
4.7 7.9 53.5
69.1 16.1 29.4 75.6 30.6 28.1 13.8

21.5 91.3 2.5 21.5 2.8 11.9 0.3 111.1 4.0
76.7 *
62.8 55.6
* * *
* * * * * *
7.2 * *
5.9 * *
29.1 13.3 17.8
* 21.6
* *
3.1 3.7 32.9
78.1 10.7
* 70.4 26.7 23.0 17.8

23.0 96.4
2.6 21.1
2.2 9.4 0.2 83.2 7.1
101.9 22.7 91.0 48.5
6.8 100.0
*
8.2 * *
8.2 * *
7.7 1.1
* 7.4 1.5 1.1
32.3 12.6 20.9
1.3 22.8
1.8 9.0
3.2 4.6 37.8
70.6 15.8 25.8 62.9 26.5 21.9 10.7

26.3 107.3
2.7 9.9 2.8 11.3 0.3 89.7 7.9
95.7 *
69.6 * * * *
* * * * * *
7.3 * *
9.1 * *
33.0 *
24.8 *
24.8 *
9.9
. . .
69.9 14.3
* 47.1 15.7 13.2
.

16.9 69.5
1.8 16.7
1.9 7.8 0.2 93.8 6.1

28.4 117.9
3.1 16.2 1.9
7.8 0.2 57.7 9.5

25.9 108.7
2.9 9.6 1.2 5.2 0.1 42.0 9.5

97.0 *
88.2 * * * *

98.8 *
89.8 * * * *

118.5 *
118.5 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

10.0

4.4

8.7

*

*

*

*

*

*

7.7

*

7.2

*

*

*

*

*

*

37.2 9.0
20.5 *
24.4 * *

24.2 8.8 19.1
* 28.9
* 7.6

32.3 4.0
18.4 *
29.8 *
7.2

* * 16.2

* * 29.2

* 6.5 21.6

70.0 20.5
* 59.0 23.1 19.2
*

71.9 15.2
* 52.9 16.9 11.0
*

72.2 15.2
* 74.4 25.6 23.2 13.6

23.0 97.2 2.6 15.5 2.4 10.3 0.2 93.0
*

24.1 100.1
2.6 13.3
2.0 8.5 0.2 73.2 7.3

83.2 *
64.7 * * * *

98.6 18.2 86.1 31.3
* * *

*

*

*

*

*

*

*

*

*

*

*

*

5.3

6.9

*

0.9

*

*

4.5

6.1

*

1.4

*

1.2

27.5 7.3
15.5 *
23.9 * *

30.3 6.3
19.6 1.1
26.6 0.9 7.6

3.6 3.6 25.7

1.5 3.1 23.2

81.3 9.2
* 70.0 25.5 20.9 16.4

73.1 14.6 24.0 60.5 21.1 17.2
8.9

25.3 109.0
3.1 63.6
3.7 16.0
0.5 122.0
*
205.9 *
176.5 100.0
* * *
* * * * * *
* * * 15.2 * *
51.7 42.4 21.9
* * * *
. . .
54.5 26.9
* 57.6 45.5 33.3
.

10.3 44.7
1.3 57.1
* * * * *

27.1 118.0
3.5 44.4 3.7 15.9 0.5 111.1
*

26.1 114.2
3.5 51.4
* * * * *

16.5 72.8 2.3 47.8 3.6 15.8
* 172.4
*

21.1 91.7
2.7 52.5
3.1 13.4
0.4 120.0
6.4

*

* 152.9

* 120.7

*

*

*

*

35.0

*

* 152.9

* 114.7

*

*

*

*

94.4

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

16.7

*

11.1

*

*

*

*

*

*

*

*

*

*

*

*

20.0

*

12.8

*

*

*

*

*

*

*

*

*

*

35.7 *
42.9 * * * *

41.7 33.3 22.2
* * * *

33.3 42.9 25.7
* * * *

39.1 43.5 30.4
* * * *

40.7 38.3 26.4
* 6.5 5.0 13.8

*

*

*

*

*

*

*

*

*

*

*

18.5

10.3

34.7

18.0

78.6

58.3

58.3

65.2

60.6

*

21.2

19.4

*

20.0

*

*

*

*

31.3

78.6

75.0

80.0

69.6

71.6

71.4

52.8

48.6

34.8

48.9

64.3

38.9

45.7

34.8

41.1

*

25.0

14.3

26.1

18.5

363

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Lowndes County - 092

1990
75981 19112
1675
20.6 20.0 22.0
154 41 1350 143 443 121 22 28
2
22 13
9 36
6 10
87 23
6 107
6 17
546 218 371 35 198 19 62
. . .
932 180 14 608 487 387
. 8

1991
77088 19359
1681
21.0 19.9 22.0
134 35
1315 117 465 107
17 34
2
9 7 2 23 5 5
103 24 3
121 16 7
467 236 355
13 150
12 64
33 9
102
815 153
17 676 600 494 179
10

Total
1992 1993

78178 19600
1687

79282 19847
1693

20.6 19.9 21.0

20.8 20.2 22.0

153 34
1354 141 486 141 18 43 1

143 42
1366 134 500 133
15 39
6

17

17

11

11

6

6

29

26

3

5

6

10

115

112

21

17

3

3

120

133

14

20

10

13

528

634

255

262

357

337

24

16

167

157

8

15

57

82

51

74

33

57

247

412

951

1023

126

136

24

29

689

746

652

733

537

586

316

334

0

17

1994 5-year

80376 20090
1700

390905 98008
8436

21.1 20.2 22.0

20.8 19.9 22.0

152 35
1428 143 516 98 18 42 2

736 187 6813 678 2410 600 90 186
13

14

79

8

50

6

29

26

140

2

21

5

36

113

530

18

103

5

20

123

604

14

70

16

63

509

2684

247

1218

352

1772

19

107

159

831

19

73

54

319

55

213

46

145

420

1181

1064 141 32 773 740 604 412 9

4785 736 116
3492 3212 2608 1241
44

1990
50566 12511
983

1991
51113 12611
984

White
1992 1993

51657 12709
985

52203 12808
987

1994 5-year

52748 12907
988

258287 63546
4927

22.0 20.0 21.0

22.4 19.3 21.0

21.8 19.4 21.0

21.8 21.7 21.0

22.4 20.6 22.0

22.0 20.2 21.0

40

36

49

46

62

233

10

5

7

9

8

39

778

759

791

787

862

3977

36

32

46

44

56

214

100

106

121

123

143

593

77

59

81

79

61

357

12

5

6

6

7

36

17

19

20

19

20

95

2

0

1

1

2

6

10

2

6

9

5

32

5

2

3

7

2

19

5

0

3

2

3

13

17

7

9

13

9

55

4

1

1

2

2

10

6

3

3

8

2

22

29

44

44

57

49

223

4

9

7

7

7

34

0

1

0

1

1

3

43

51

54

73

59

280

3

10

7

14

6

40

6

5

7

9

9

36

295

232

260

345

278

1410

53

48

62

66

78

307

159

153

138

147

169

766

11

4

6

8

5

34

149

114

127

127

130

647

10

4

1

8

11

34

23

31

14

36

21

125

.

8

14

23

24

69

.

3

7

31

28

69

.

8

45

107

117

277

617

551

620

630

676

3094

117

108

79

80

89

473

6

12

15

18

21

72

237

295

294

325

367

1518

146

226

246

285

327

1230

113

188

205

217

253

976

.

77

125

119

187

508

2

1

0

10

4

17

1990
24241 6230 676

1991
24594 6308 679

Black
1992 1993

24942 6385 681

25294 6463 683

1994 5-year

25643 6540
686

124715 31925
3405

18.3 22.2 23.5

19.2 20.1 23.0

18.8 22.6 23.0

19.1 15.5 23.0

19.0 19.2 23.0

18.9 19.6 23.0

112

98

104

97

89

500

30

30

27

33

27

147

561

538

548

560

549

2756

105

85

95

90

87

462

342

358

364

375

370

1809

42

45

60

54

33

234

9

12

12

9

11

53

10

14

19

19

20

82

0

2

0

5

0

7

12

7

11

8

9

47

8

5

8

4

6

31

4

2

3

4

3

16

18

16

20

13

17

84

2

4

2

3

0

11

3

2

3

2

3

13

58

58

70

55

63

304

19

15

14

10

11

69

6

2

3

2

4

17

63

70

66

60

61

320

3

6

7

6

8

30

11

2

3

2

7

25

249

230

266

287

227

1259

164

187

192

196

167

906

209

196

215

188

179

987

24

9

18

8

13

72

49

35

40

30

29

183

9

8

7

7

8

39

38

33

43

46

33

193

.

8

18

28

22

76

.

2

3

13

14

32

.

44

73

190

257

564

309

252

320

379

377

1637

59

44

45

53

51

252

8

4

9

11

11

43

368

376

392

416

399

1951

340

373

405

445

411

1974

273

305

331

366

350

1625

.

102

191

212

224

729

5

9

0

7

5

26

364

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

17.8

17.1

17.3

17.2

17.8

17.4

General fertility rate

70.6

67.9

69.1

68.8

71.1

69.5

Total fertility rate

1.9

1.9

1.9

1.9

2.0

1.9

% Livebirths to unmarried women

33.0

35.8

36.3

37.2

36.6

35.8

Crude abortion rate

0.4

0.4

0.6

0.5

0.5

0.5

General abortion rate

1.5

1.8

2.2

2.0

2.1

1.9

Total abortion rate

0.0

0.0

0.1

0.1

0.1

0.0

Abortion ratio

18.1

22.9

27.3

24.7

26.2

23.9

Fetal Death rate

8.7

7.1

9.1

8.9

6.7

8.1

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

91.9

79.7

90.7

84.5

89.4

87.2

% Repeat conceptions to women under 18

26.6

26.1

22.2

29.4

23.0

25.4

Livebirths to women under 18

85.4

69.6

83.6

79.1

84.1

80.4

% Livebirths to unmarried women under 18

81.1

87.2

82.0

82.0

84.5

83.2

Induced abortions to women under 18

*

*

*

3.5

*

1.5

% Abortions to unmarried women under 18

*

*

*

83.3

*

92.3

Fetal deaths to women under 18

5.4

8.9

8.3

*

4.7

5.9

Infant and child survival rates

Infant mortality

16.3

6.8

12.6

12.4

9.8

11.6

Neonatal mortality

9.6

5.3

8.1

8.1

5.6

7.3

Postneonatal mortality

6.7

*

4.5

4.4

4.2

4.3

Perinatal mortality ratio

26.2

17.3

21.1

18.8

18.0

20.3

Deaths of children 1-4 yrs

1.2

1.0

*

0.9

*

0.8

Deaths of children 5-17 yrs

0.7

0.3

0.4

0.6

0.3

0.5

Infant health rates

% Low birthweight

6.4

7.8

8.5

8.2

7.9

7.8

% Very low birthweight

1.7

1.8

1.6

1.2

1.3

1.5

% Under 500 grams

0.4

*

*

*

0.4

0.3

% Preterm gestation

8.1

9.4

9.0

9.9

8.7

9.0

% Multiple gestation

0.4

1.2

1.0

1.5

1.0

1.0

% Birth defect

1.3

0.5

0.7

1.0

1.1

0.9

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

47.7

44.4

43.0

48.5

36.8

43.9

% with father not named on birth certificate

16.2

18.2

19.0

19.5

17.5

18.1

% with maternal education less than high school

27.8

27.8

26.7

25.1

25.0

26.4

% No prenatal care

2.7

1.1

1.8

1.2

1.3

1.6

% Maternal smoking during pregnancy

14.9

11.7

12.6

11.8

11.3

12.5

% Maternal alcohol use during pregnancy

1.4

0.9

0.6

1.1

1.4

1.1

% Interpregnancy interval less than 6 months

8.0

8.7

7.6

10.4

6.5

8.2

Child abuse and neglect rates

Physical

.

1.5

2.3

3.3

2.5

2.4

Sexual

.

0.4

1.5

2.6

2.1

1.7

Neglect

.

4.7

11.3

18.6

18.8

13.5

Interventions to improve infant & child survival

% Prenatal care first trimester

71.3

68.8

73.0

75.3

74.7

72.8

% Primary C-section delivery

14.7

12.9

10.4

10.9

10.8

11.9

% Vaginal birth after previous C-section

11.7

15.5

18.9

28.4

29.1

20.4

% WIC during pregnancy

45.2

52.0

51.4

55.4

54.8

51.8

% Medicaid during pregnancy

36.2

46.2

48.7

54.5

52.4

47.7

% Medicaid and WIC during pregnancy

28.8

38.0

40.1

43.5

42.8

38.7

% Perinatal case management

.

13.8

23.6

24.8

29.2

23.0

Lowndes County - 092

15.4 62.2
1.7 12.9
0.3 1.4 0.0 18.9 8.2
40.7 25.0 36.6 44.4
* * *
12.9 6.4 6.5
21.5 *
0.7
3.7 * *
5.6 *
0.8
43.6 6.8
20.6 1.4
19.4 1.3 5.4
. . .
81.6 16.5
9.2 30.6 18.8 14.6
.

14.8 60.2
1.7 14.2
0.4 1.5 0.0 22.4 5.7
36.6 13.9 32.5 56.3
* * *
* * * 9.2 * *
5.8 1.2
* 6.9 1.3 0.7
36.9 6.4
20.6 *
15.5 *
8.0
0.6 *
0.6
77.1 15.7 19.0 39.4 30.2 25.1 10.3

15.3 62.2 1.8 15.4 0.4 1.6 0.0 21.9
7.9
49.7 14.3 46.7 53.3
* * *
7.6 * *
11.3 * *
5.6 0.9
* 6.9 0.9 0.9
36.3 7.9 17.7 0.8 16.5
* 3.4
1.1 0.6 3.6
80.8 11.1 20.3 37.5 31.4 26.1 15.9

15.1 61.4
1.7 15.9
0.4 1.5 0.0 21.1 7.5
46.6 19.6 44.6 46.5
* * *
11.4 8.9 *
16.4 *
0.9
7.2 0.9
* 9.4 1.8 1.2
46.2 8.5
19.1 1.0
16.7 1.1 8.3
1.8 2.4 8.4
80.4 11.2 32.1 42.0 36.9 28.1 15.4

16.3 66.8 1.9 16.7 0.4 1.5 0.0 20.8
6.1

15.4 62.6
1.8 15.1
0.4 1.5 0.0 21.0 7.1

62.8 12.9 56.7 60.7
* * *

47.3 16.7 43.4 52.8
1.2 100.0
3.2

5.8 * *
10.4 * *

8.0 4.8 3.3 13.7 0.7 0.5

5.7

5.6

0.8

0.9

*

*

6.9

7.1

0.7

1.0

1.1

0.9

33.1 9.1
19.8 0.6 15.3 1.3 4.3

39.1 7.8
19.5 0.9
16.7 0.9 5.8

1.9

1.4

2.2

1.4

9.2

5.5

78.6 11.2 34.4 42.9 38.2 29.6 21.9

79.7 13.1 22.6 38.6 31.3 24.8 16.1

23.1 90.0
2.3 61.3
0.4 1.6 0.0 15.8 9.8

21.9 85.3
2.2 67.3
0.6 2.2 0.1 22.8 9.8

22.0 85.8 2.3 67.3 0.8 3.0 0.1 29.5 11.9

22.1 86.6
2.3 67.7
0.8 2.9 0.1 28.9 12.2

21.4 83.9 2.3 68.6 0.8 3.1 0.1 32.4 7.5

22.1 86.3
2.3 66.4
0.7 2.6 0.1 25.9 10.2

165.7 26.8 155.3 94.3
* * 10.4

144.4 30.6
125.3 98.8 * * 16.2

152.8 26.0
139.5 95.7 * * 14.7

141.9 34.0
131.7 98.9 7.3 * *

129.8 30.3
126.8 100.0
* * *

146.9 29.4
135.7 97.4 2.1 85.7 9.7

21.4 14.3
* 31.6
* *

13.0 9.3 *
29.1 * *

20.1 14.6
* 35.7
* *

14.3 * *
22.8 * *

16.4 10.9
* 30.4
* *

17.1 11.2
5.9 29.9
1.0 0.4

10.3

10.8

12.8

9.8

11.5

11.0

3.4

2.8

2.6

1.8

2.0

2.5

1.1

*

*

*

*

0.6

11.5

13.4

12.3

10.8

11.3

11.8

*

1.1

1.3

1.1

1.5

1.1

2.0

*

*

*

1.3

0.9

54.1 29.4 37.8
4.4 9.0 1.6 11.0

56.2 35.2 37.8
1.9 6.7 1.5 9.8

53.4 35.5 39.9 3.4 7.4 1.3 12.8

53.1 35.4 34.0
1.4 5.5 1.3 13.7

43.1 31.0 33.3 2.4 5.4 1.5 9.9

51.7 33.3 36.5
2.7 6.8 1.4 11.4

.

0.9

2.1

3.2

2.4

2.2

.

*

*

1.5

1.6

0.9

.

5.1

8.3

21.4

28.5

16.0

57.2 11.7 14.8 65.9 60.9 48.9
.

55.8 9.1 *
70.7 70.1 57.3 19.2

61.4 9.2 17.0
72.5 74.9 61.2 35.3

68.2 10.4 23.9 75.1 80.3 66.1 38.3

68.9

62.6

10.3

10.2

24.4

17.6

74.0

71.6

76.3

72.5

64.9

59.7

41.6

33.7

365

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Lumpkin County - 093

1990
14573 3740 286
19.7 20.7 20.0
26 2
209 23 41 18
1 44
4
1 1 0 1 0 1
22 1 0
20 2 7
36 13 67
3 33
4 8
. . .
173 44
4 103 75 62
. 0

1991
14970 3806 288
20.4 18.5 20.0
38 6
230 32 48 21 1 20 4
0 0 0 1 1 1
17 0 0
22 3 3
42 20 83
1 38
3 8
4 0 4
188 37 4
130 78 71 7 0

Total
1992 1993

15357 3871 290

15753 3937 292

22.3 19.3 21.0

21.2 19.4 21.0

26

23

6

2

203

180

18

20

41

41

16

13

1

0

35

46

6

4

1

3

0

2

1

1

1

2

0

0

1

1

13

15

1

4

0

0

13

13

2

3

2

2

29

25

16

17

56

53

1

1

35

29

0

0

2

2

4

5

4

11

16

23

172

156

29

20

5

4

102

116

74

85

70

80

17

7

1

2

1994 5-year

16144 4003 294

76797 19357
1450

21.3 21.3 21.0

21.0 20.1 20.0

23

136

1

17

201

1023

20

113

49

220

14

82

0

3

38

183

2

20

2

7

1

4

1

3

1

6

0

1

0

4

15

82

4

10

0

0

17

85

4

14

3

17

31

163

23

89

51

310

1

7

31

166

2

9

9

29

7

20

9

24

18

61

172

861

26

156

3

20

118

569

94

406

84

367

6

37

1

4

1990
14002 3601 277

1991
14361 3655 279

White
1992 1993

14717 3708 280

15075 3762 281

1994 5-year

15432 3816 283

73587 18542
1399

19.9 20.1 20.0

20.1 18.5 20.0

22.3 19.1 21.0

21.2 19.4 21.0

21.3 21.3 21.0

21.0 20.0 20.0

25

38

26

23

22

134

2

6

6

2

1

17

204

225

202

179

191

1001

22

32

18

20

19

111

40

46

41

40

47

214

17

20

16

12

14

79

1

1

1

0

0

3

42

19

34

46

38

179

4

4

6

4

2

20

1

0

1

3

2

7

1

0

0

2

1

4

0

0

1

1

1

3

1

1

1

2

1

6

0

1

0

0

0

1

1

1

1

1

0

4

22

17

13

15

15

82

1

0

1

4

4

10

0

0

0

0

0

0

19

21

13

13

17

83

2

3

2

3

4

14

7

3

2

2

3

17

35

42

29

24

29

159

12

19

16

16

23

86

65

82

56

53

51

307

3

1

1

1

1

7

31

37

35

29

30

162

3

3

0

0

2

8

6

7

2

2

9

26

.

4

3

5

6

18

.

0

4

10

9

23

.

4

15

22

16

57

169

183

171

156

165

844

43

36

29

20

24

152

4

4

5

4

2

19

99

126

102

115

110

552

71

76

74

84

88

393

58

69

70

79

78

354

.

7

17

7

6

37

0

0

1

2

1

4

1990
238 50 3

1991
245 51 3

Black
1992 1993

251

257

51

52

3

3

1994 5-year

264 1254

52

256

3

15

. . 29.0

23.9 . .

.

20.3

14.8

21.3

.

.

.

.

.

25.0

.

27.0

0

0

0

0

1

1

0

0

0

0

0

0

2

5

0

1

4

12

0

0

0

0

1

1

1

2

0

1

1

5

0

1

0

1

0

2

0

0

0

0

0

0

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

0

2

1

1

0

1

0

3

1

1

0

0

0

2

0

0

0

0

0

0

1

1

0

0

0

2

1

0

0

0

0

1

1

1

0

0

0

2

.

0

0

0

0

0

.

0

0

0

0

0

.

0

1

0

0

1

1

5

0

0

4

10

1

1

0

0

1

3

0

0

0

0

0

0

1

4

0

1

3

9

1

2

0

1

1

5

1

2

0

1

1

5

.

0

0

0

0

0

0

0

0

0

0

0

366

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Lumpkin County - 093

14.3 55.9
1.5 19.8
3.0 11.8
0.3 161.8
5.1
90.9 *
80.4 40.9
* * *
* * * * * *
10.5 * *
9.7 *
3.3
29.5 6.3
32.7 *
16.0 *
7.0
. . .
84.4 23.9
* 49.8 36.2 30.0
.

15.4 60.4
1.7 21.2
1.3 5.3 0.1 73.3 6.0
131.9 15.8
111.0 54.8 * * *
* * * * * *
7.4 * *
9.7 * *
33.3 8.8
36.6 *
16.9 *
6.5
* * *
82.8 18.0
* 57.3 34.4 31.3
3.1

13.2 52.4 1.5 20.4 2.3 9.0 0.2 136.2 4.9
89.6 23.1 62.0 72.2 20.7 100.0
*
* * * * * *
6.4 * *
6.6 * *
25.9 8.0
29.5 *
17.7 * *
* * 4.3
86.4 15.9 26.3 50.7 36.8 34.8 8.5

11.4 45.7
1.3 23.2
2.9 11.7
0.3 191.7
3.6
78.8 *
68.5 47.4
* * *
* * * * * *
8.3 * *
7.3 * *
25.5 9.6
31.7 *
16.4 * *
1.3 2.9 6.0
88.1 11.9
* 65.5 48.0 45.2
4.0

12.5 50.2 1.4 24.6 2.4 9.5 0.3 150.2 3.5
78.2 *
68.0 70.0
* * *
* * * * * *
7.5 * *
8.5 * *
16.7 11.6 27.0
* 15.7
* 8.8
1.8 2.3 4.6
85.6 14.7
* 59.3 47.2 42.2 3.0

13.3 52.8
1.5 21.8
2.4 9.5 0.3 141.3 4.6
93.8 12.5 77.9 56.4 13.8 100.0
3.4
6.8 * *
5.8 * *
8.0 1.0
* 8.4 1.4 1.7
25.3 8.8
31.7 0.7
16.6 0.9 5.3
1.3 1.6 4.0
85.3 17.0 21.1 56.3 40.2 36.3
4.6

14.6 56.7
1.6 19.8
3.0 11.7
0.3 159.1
5.0

15.7 61.6
1.7 20.8
1.3 5.2 0.1 71.4 6.0

13.7 54.5 1.5 20.5 2.3 9.2 0.2 133.3 5.1

11.9 47.6
1.3 22.7
3.1 12.2
0.3 193.3
3.5

12.4 50.1 1.4 24.9 2.5 10.0 0.3 156.4 3.7

13.6 54.0
1.5 21.7
2.4 9.7 0.3 141.4 4.6

90.3 *
79.4 42.9
* * *

136.4 15.8
114.9 54.8 * * *

93.0 23.1 64.4 72.2 21.5 100.0
*

81.8 *
71.1 47.4
* * *

77.9 *
67.3 68.4
* * *

95.8 12.7 79.4 56.5 14.3 100.0
3.6

*

*

*

*

*

7.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

6.0

*

*

*

*

*

*

*

*

*

*

*

*

10.8

7.6

6.4

8.4

7.9

8.2

*

*

*

*

*

1.0

*

*

*

*

*

*

9.4

9.5

6.6

7.4

9.0

8.4

*

*

*

*

*

1.4

3.4

*

*

*

*

1.7

29.4 5.9
32.5 *
15.4 *
5.5

33.9 8.6
36.9 *
16.8 *
5.8

26.1 8.0 29.6
* 17.8
* *

24.7 9.1
31.9 *
16.5 * *

16.3 12.2 28.3
* 16.0
* 9.6

25.3 8.7
32.1 0.7
16.5 0.8 4.9

.

*

*

1.4

1.6

1.3

.

*

*

2.8

2.4

1.6

.

*

4.3

6.1

4.3

4.0

84.5 23.8
* 49.0 35.1 28.7
.

82.4 17.8
* 56.8 34.2 31.1
3.2

86.4 16.0 26.3 51.0 37.0 35.0 8.5

88.6 12.0
* 65.3 47.7 44.9
4.0

86.4 14.2
* 58.2 46.6 41.3 3.2

85.5 16.9 21.3 55.8 39.7 35.8
4.7

*

20.4

*

*

*

9.6

*

98.8

*

*

*

46.9

*

2.1

*

*

*

1.5

*

*

*

*

*

41.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

* 100.0

*

*

*

83.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

75.0

*

*

*

*

*

41.7

*

*

*

*

*

41.7

.

*

*

*

*

*

367

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Macon County - 094

1990
13114 2978 352
20.9 18.6 21.0
36 11 247 28 120 19
6 45
8
3 1 2 7 0 0
21 3 0
25 4 7
103 68 79
9 31 10 16
. . .
137 34
4 125 120 85
. 1

1991
13188 2992 353
19.2 17.9 23.0
37 9
236 31
126 7 1
40 6
3 1 2 2 0 0
24 5 1
26 4 4
102 66 89 2 24 3 14
3 5 55
138 23 7
154 130 107
26 1

Total
1992 1993

13251 3003 353

13322 3017 354

19.5 18.7 22.5

20.3 18.2 22.0

37

35

8

8

219

213

30

30

116

119

18

19

1

0

49

35

7

4

0

2

0

0

0

2

1

0

0

0

2

0

22

18

5

1

0

0

21

19

4

3

3

2

84

95

61

59

81

76

8

2

25

14

6

5

14

9

12

13

14

19

161

135

113

145

30

21

6

9

126

140

128

149

94

119

16

22

0

0

1994 5-year

13385 3028 355

66260 15018
1766

19.7 18.5 23.0

19.8 18.5 22.0

40

185

6

42

210

1125

33

152

120

601

14

77

2

10

43

212

5

30

2

10

0

2

2

8

2

12

0

0

2

4

15

100

3

17

0

1

23

114

3

18

1

17

96

480

61

315

77

402

3

24

19

113

3

27

7

60

14

42

6

44

77

428

129

662

24

132

1

27

132

677

145

672

113

518

20

84

0

2

1990
5358 1108
110

1991
5339 1097
110

White
1992 1993

5321 1086
110

5300 1075
110

1994 5-year

5280 1063
110

26598 5429 550

21.3 18.8 20.5

21.3 19.7 20.0

22.1 18.8 22.0

25.6 26.3 21.0

22.4 18.8 21.5

22.4 18.8 21.0

6

8

7

4

6

31

0

2

2

1

0

5

79

73

73

73

75

373

3

7

5

4

4

23

6

11

13

13

13

56

3

6

9

6

6

30

0

0

1

0

0

1

15

11

18

10

11

65

3

1

2

0

1

7

1

0

0

1

1

3

0

0

0

0

0

0

1

0

0

1

1

3

0

0

1

0

0

1

0

0

0

0

0

0

0

0

1

0

1

2

4

7

1

3

1

16

0

2

0

0

0

2

0

0

0

0

0

0

4

7

2

4

2

19

1

2

1

1

1

6

1

0

0

1

1

3

24

19

17

28

31

119

3

4

7

6

5

25

29

30

31

28

29

147

2

0

3

0

0

5

14

9

12

7

10

52

0

1

0

2

0

3

0

2

2

2

2

8

.

0

1

0

2

3

.

0

3

4

4

11

.

8

10

25

27

70

60

55

45

56

59

275

13

8

12

5

10

48

0

3

3

6

0

12

23

28

29

27

30

137

17

18

19

30

32

116

14

16

17

22

23

92

.

6

3

8

3

20

0

0

0

0

0

0

1990
7694 1854
240

1991
7737 1863 240

Black
1992 1993

7774 1869
241

7816 1878 241

1994 5-year

7853 1884
242

38875 9347 1204

20.4 18.5 27.0

18.8 16.9 24.0

18.9 18.1 23.0

18.9 17.9 26.5

19.3 16.5 26.0

19.3 17.8 24.5

30

29

30

31

34

154

11

7

6

7

6

37

167

162

144

139

134

746

25

24

25

26

29

129

114

115

103

106

106

544

16

1

9

13

8

47

6

1

0

0

2

9

29

29

31

25

32

146

5

5

5

4

4

23

2

3

0

1

1

7

1

1

0

0

0

2

1

2

0

1

1

5

7

2

0

0

2

11

0

0

0

0

0

0

0

0

1

0

1

2

17

17

21

15

13

83

3

3

5

1

3

15

0

1

0

0

0

1

21

19

19

15

20

94

3

2

3

2

2

12

6

4

3

1

0

14

78

83

67

67

65

360

65

62

54

53

56

290

50

59

50

48

48

255

7

2

5

2

3

19

17

15

13

7

9

61

10

2

6

3

3

24

16

12

12

7

5

52

.

3

11

12

7

33

.

4

9

13

1

27

.

46

146

102

42

336

77

82

66

88

69

382

21

15

18

16

13

83

4

4

3

3

1

15

101

125

96

113

101

536

102

111

109

118

112

552

70

90

77

97

89

423

.

20

13

14

17

64

0

1

0

0

0

1

368

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Macon County - 094

18.8 82.9
2.5 49.4
3.4 15.1
0.4 141.1
9.1
102.3 30.6 79.5 96.3 22.7 100.0 *
* * * 27.7 * *
8.5 * *
10.3 *
2.8
45.8 28.0 32.6
3.7 12.9
4.1 10.1
. . .
56.6 15.8
* 51.4 49.4 35.0
.

17.9 78.9
2.3 54.3
3.0 13.4
0.4 139.4
3.7
104.9 24.3 87.9 96.8 17.0
100.0 *
* * * * * *
10.2 2.1 *
11.2 * *
45.7 28.4 38.9
* 10.4
* 9.5
* 1.2 13.3
61.9 11.5 21.9 66.4 56.0 46.1 11.2

16.5 72.9 2.2 54.0 3.7 16.3 0.5 169.6 7.0
104.7 21.6 84.9 83.3 19.8
100.0 *
* * * * * *
10.0 2.3
* 9.8
* *
42.9 28.4 37.7
3.7 11.6
2.8 10.7
2.9 3.4 38.8
52.8 16.0 22.2 58.6 59.5 43.7 7.4

16.0 70.6
2.1 56.7
2.6 11.6
0.3 131.1
6.3
98.9 22.9 84.8 96.7
* * *
* * * * * *
8.5 * *
9.0 * *
48.0 28.1 36.2
* 6.7 2.4 7.3
3.1 4.6 32.5
68.4 11.5 33.3 66.7 71.0 56.7 10.5

15.7 69.4 2.0 58.0 3.2 14.2 0.4 159.9 5.3
112.8 15.0 93.1 97.0 14.1
100.0 *
* * * * * *
7.1 * *
11.1 * *
48.5 29.5 37.2
* 9.2
* 6.5
3.4 1.4 18.5
61.7 12.7
* 63.8 70.0 54.6 9.7

17.0 74.9
2.2 54.3
3.2 14.1
0.4 148.1
6.3
104.7 22.7 86.1 94.0 17.0 100.0
2.8
8.9 *
7.1 10.6
* *
8.9 1.5
* 10.3
1.6 1.5
46.2 28.5 36.4
2.2 10.3
2.4 9.0
2.5 2.6 25.7
60.2 13.5 20.5 61.2 60.7 46.8
9.7

14.7 71.3
2.3 7.7 2.8 13.5 0.5 153.1
*

13.7 66.5
2.2 15.5
2.1 10.0
0.3 120.9
6.4

13.7 67.2 2.2 18.1 3.4 16.6 0.5 178.2 9.2

13.8 67.9
2.2 18.1
1.9 9.3 0.3 112.4 5.6

14.2 70.6 2.2 17.6 2.1 10.3 0.3 119.6 5.6

14.0 68.7
2.2 15.3
2.4 12.0
0.4 138.0
6.1

54.5 * * * * * *

72.7 *
63.6 85.7
* * *

63.6 *
45.5 * * * *

*

54.5

56.4

*

*

16.1

*

*

41.8

*

*

73.9

*

*

12.7

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

9.6

*

*

*

4.3

*

*

*

*

*

*

*

*

*

*

*

*

*

9.9

*

*

*

5.2

*

*

*

*

*

1.6

*

*

*

*

*

*

32.0 *
37.2 *
17.9 * *

27.1 *
42.3 *
12.7 * *

25.4 9.7 43.1
* 16.7
* *

40.0 8.3
38.9 *
9.9 * *

43.1 6.8 39.2
* 13.5
* *

33.6 6.8
40.1 1.4
14.2 *
3.5

.

*

*

*

*

*

.

*

*

*

*

2.1

.

5.9

7.4

18.8

20.6

13.1

75.9 17.8
* 29.5 21.8 17.9
.

78.6 13.1
* 39.4 25.4 22.5
8.5

61.6 20.3
* 40.3 26.4 23.6
*

76.7 8.2
54.5 37.5 41.7 30.6 11.1

78.7 14.7
* 40.5 43.2 31.1
*

74.3 14.9 26.7 37.3 31.6 25.1
6.9

21.7 90.1
2.5 69.5
3.8 15.6
0.4 132.4 12.4

20.9 87.0
2.5 71.9
3.7 15.6
0.4 148.7
*

18.5 77.0 2.2 73.0 4.0 16.6 0.5 166.7 5.9

17.8 74.0
2.1 77.4
3.2 13.3
0.4 141.2
6.9

17.1 71.1 2.0 80.3 4.1 17.0 0.5 181.8 5.3

19.2 79.8
2.2 74.1
3.8 15.6
0.4 153.2
6.5

125.0 36.7 104.2 100.0 20.8 100.0
*

120.6 24.1 99.8
100.0 20.8
100.0 *

124.5 20.0
103.8 92.0 20.8
100.0 *

128.5 22.6
107.7 96.2 * * *

140.6 17.6
119.9 100.0
* * *

127.9 24.0 107.1 97.7 19.1 100.0 *

*

*

*

*

*

9.4

*

*

*

*

*

*

*

*

*

*

*

6.7

40.5

*

*

*

*

14.6

*

*

*

*

*

*

*

*

*

*

*

*

10.2 * *
12.8 *
3.6

10.5 * *
11.9 * *

14.6 3.5
* 13.5
* *

10.8 * *
10.9 * *

9.7 * *
15.2 * *

11.1 2.0 *
12.8 1.6 1.9

52.3 39.6 30.7
4.3 10.5
6.1 15.4

54.6 38.8 37.6
* 9.4
* 11.4

52.8 38.3 35.5 3.6 9.2 4.3 14.3

52.8 38.7 35.0
* 5.1
* 9.1

51.6 42.4 36.4
* 6.8
* 7.5

52.9 39.5 34.9
2.6 8.4 3.3 11.9

.

*

4.0

4.4

2.5

3.0

.

*

3.3

4.7

*

2.5

.

16.8

53.2

37.1

15.3

30.6

47.5 14.9
* 61.6 62.2 42.7
.

53.9 10.9
* 78.1 69.4 56.3 12.5

47.5 14.2
* 68.1 77.3 54.6
9.2

63.8 13.2
* 82.5 86.1 70.8 10.2

51.9

52.8

10.8

12.8

*

17.2

76.5

73.0

84.8

75.2

67.4

57.6

12.9

11.2

369

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Madison County - 095

1990
21050 4960 443
21.1 19.7 20.0
55 15 387 45 85 25
1 68
5
6 4 2 5 1 2
36 5 0
41 5 8
105 39 123
5 85 13 25
. . .
275 57
5 158 126 101
. 0

1991
21370 4986 445
20.7 19.8 20.0
44 10 324 37 66 24
4 61
6
2 0 2 4 0 3
20 1 0
20 4 3
59 27 101
3 54
4 4
3 2 32
267 55 0
145 133 112
23 1

Total
1992 1993

21683 5008 448

21998 5030 450

21.8 20.9 20.0

21.0 19.9 21.0

43

38

8

8

345

320

37

31

91

72

20

14

7

2

68

56

5

5

6

1

3

0

3

1

10

2

1

0

1

4

32

9

6

2

0

0

27

16

2

6

19

26

90

94

38

35

115

78

6

2

49

30

7

5

11

10

6

12

16

23

51

36

288

273

67

33

3

8

157

133

161

153

126

111

103

86

0

0

1994 5-year

22307 5054 452

108408 25038 2239

20.7 21.5 21.0

21.0 19.9 21.0

38

218

10

51

312

1688

35

185

81

395

20

103

4

18

55

308

2

23

3

18

2

9

1

9

6

27

0

2

2

12

15

112

2

16

1

1

23

127

0

17

8

64

92

440

38

177

100

517

6

22

52

270

3

32

9

59

15

36

17

58

53

172

269

1372

30

242

4

20

159

752

156

729

134

584

83

295

0

1

1990
19051 4471 387

1991
19374 4503 391

White
1992 1993

19695 4533 394

20014 4563 398

1994 5-year

20331 4594 401

98465 22664
1970

21.4 19.6 20.0

21.0 19.8 20.0

21.8 20.9 20.0

21.0 20.8 21.0

21.1 21.8 21.0

21.4 19.9 20.0

47

39

37

31

24

178

11

8

7

7

5

38

338

290

308

289

277

1502

40

32

34

26

24

156

53

45

63

52

57

270

17

21

17

12

14

81

1

2

4

2

3

12

61

56

52

43

42

254

4

6

3

4

0

17

6

2

3

1

2

14

4

0

1

0

1

6

2

2

2

1

1

8

5

2

5

2

4

18

1

0

1

0

0

2

2

3

1

2

2

10

25

17

27

8

12

89

5

0

3

2

1

11

0

0

0

0

0

0

33

18

22

16

20

109

5

3

1

6

0

15

8

3

17

24

7

59

91

54

83

86

74

388

22

16

28

27

31

124

109

89

106

65

86

455

3

2

3

1

6

15

76

53

47

28

49

253

10

4

5

4

3

26

20

4

10

10

9

53

.

3

6

9

9

27

.

1

15

18

13

47

.

32

45

27

37

141

255

252

266

250

243

1266

46

51

58

31

26

212

4

0

3

8

4

19

129

121

130

110

136

626

105

110

135

129

131

610

83

93

106

92

114

488

.

19

87

73

71

250

0

1

0

0

0

1

1990
1849 451 55

1991
1877 454 55

Black
1992 1993

1905 456 56

1932 458 56

1994 5-year

1959 461 56

9522 2279
278

20.3 33.5 24.5

18.9 .
28.0

21.9 21.1 26.0

18.5 19.2 24.5

17.8 19.4 28.5

19.5 19.5 26.0

7

5

6

7

14

39

4

2

1

1

5

13

46

32

35

30

34

177

5

5

3

5

11

29

31

21

27

20

24

123

7

3

2

2

6

20

0

2

3

0

1

6

6

5

15

11

12

49

1

0

2

1

2

6

0

0

3

0

1

4

0

0

2

0

1

3

0

0

1

0

0

1

0

2

5

0

2

9

0

0

0

0

0

0

0

0

0

2

0

2

11

3

5

1

3

23

0

1

3

0

1

5

0

0

0

0

1

1

7

2

4

0

3

16

0

1

1

0

0

2

0

0

2

2

1

5

14

5

7

8

17

51

17

11

10

8

7

53

13

12

8

12

14

59

2

1

3

1

0

7

8

1

2

2

3

16

3

0

2

1

0

6

5

0

1

0

0

6

.

0

0

2

6

8

.

1

1

1

1

4

.

0

6

8

9

23

17

14

22

23

25

101

11

3

9

2

4

29

1

0

0

0

0

1

28

23

26

22

23

122

20

22

24

23

24

113

17

18

19

18

20

92

.

3

15

13

12

43

0

0

0

0

0

0

370

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Madison County - 095

18.4 78.0
2.4 22.3
3.2 13.7
0.4 140.8
5.6
124.2 27.3 101.6 45.5 11.3 * 13.5
15.5 * *
12.9 * *
9.3 1.3
* 10.8
1.3 2.1
36.0 10.2 33.0
1.3 22.8
3.5 13.5
. . .
72.2 16.8 12.2 41.5 33.1 26.5
.

15.2 65.0
2.0 20.6
2.9 12.2
0.4 147.3
5.8
98.8 22.7 83.1 45.9 13.5 100.0
*
* * * * * *
6.2 * *
6.3 * *
25.5 8.4
32.4 *
18.1 * *
* * 5.6
84.0 19.6
* 45.3 41.6 35.0
7.2

15.9 68.9 2.1 26.5 3.1 13.6 0.4 154.2
5.6
96.0 18.6 82.6 52.8 11.2 100.0
*
17.4 * *
28.4 * *
9.3 1.7
* 7.9
* 5.6
36.9 11.1 33.8 1.7 18.7 2.7 5.9
1.0 2.8 8.9
83.7 22.1
* 45.8 46.9 36.7 30.0

14.5 63.6
2.0 22.8
2.5 11.1
0.3 142.5
3.4
84.4 21.1 68.9 67.7 11.1 100.0
*
* * * * * *
2.8 * *
5.1 1.9 8.2
40.7 11.1 25.0
* 12.8
2.1 5.9
2.1 4.0 6.2
86.1 12.1 18.6 42.1 48.4 35.1 27.2

14.0 61.7 1.9 26.0 2.5 10.9 0.3 140.7
4.7
84.0 26.3 77.4 62.9
* * *
* * * 19.0 * *
4.8 * *
7.4 *
2.6
30.3 12.2 32.2
1.9 16.9
* 5.4
2.6 2.9 9.0
88.2 10.8
* 51.0 50.0 42.9 26.6

15.6 67.4
2.1 23.6
2.8 12.3
0.4 145.1
5.0
97.4 23.4 82.6 54.1 10.3 95.5
5.4
10.7 5.3 5.4
15.8 *
0.6
6.6 0.9
* 7.6 1.0 3.8
33.8 10.6 31.4
1.3 18.3
2.2 6.7
1.6 2.5 7.4
82.4 16.4 10.1 45.0 43.6 34.9 22.9

17.7 75.6
2.3 16.0
3.2 13.6
0.4 145.6
4.5

15.0 64.4
1.9 15.7
2.9 12.4
0.4 151.8
5.1

15.6 67.9 2.1 20.5 2.6 11.5 0.3 136.1
4.9

14.4 63.3
2.0 18.2
2.1 9.4 0.3 123.9 3.3

13.6 60.3 1.9 20.6 2.1
9.1 0.3 125.0 3.7

15.3 66.3
2.0 18.1
2.6 11.2
0.3 137.1
4.3

121.4 23.4 103.4 38.5 * * *

99.9 20.5 81.9 37.5 15.4 100.0
*

93.9 18.9 86.3 48.5
* * *

78.0 22.6 65.4 61.5
* * *

59.8 20.8 59.8 45.8
* * *

90.3 21.3 79.2 45.5
8.6 93.8
3.6

17.8

*

*

*

*

9.3

*

*

*

*

*

4.0

*

*

*

*

*

5.3

14.7

*

16.0

*

*

11.9

*

*

*

*

*

*

*

*

*

*

*

0.5

7.4

5.9

8.8

2.8

4.3

5.9

1.5

*

*

*

*

0.7

*

*

*

*

*

*

9.9

6.3

7.2

5.6

7.2

7.3

1.5

*

*

2.1

*

1.0

2.4

*

5.6

8.3

2.5

4.0

35.8 6.6
33.5 *
23.5 3.1
12.3

25.8 5.6
31.9 *
19.6 * *

37.6 9.1
34.9 *
19.7 2.1 5.9

40.2 9.5
23.1 *
12.9 *
6.7

27.5 11.2 31.2 2.2 17.9
* 5.8

33.2 8.3
31.1 1.0
19.1 2.0 6.7

.

*

1.2

1.7

1.7

1.3

.

*

2.9

3.4

2.5

2.3

.

6.3

8.7

5.2

7.0

6.8

76.3 15.3
* 38.9 31.6 25.0
.

88.4 20.2
* 42.2 38.3 32.4
6.6

86.4 21.3
* 42.3 44.0 34.5 28.3

87.1 12.8 19.0 38.6 45.3 32.3 25.6

89.3 10.6
* 49.1 47.3 41.2 25.6

85.2 16.2 10.8 42.1 41.0 32.8 21.6

24.9 102.0
3.1 67.4
3.2 13.3
0.4 101.7
15.5

17.0 70.5
2.0 67.7
2.7 11.0
0.3 116.3
13.2

18.4 76.8 2.3 79.4 7.9 32.9 1.0 272.7 11.0

15.5 65.5
2.0 66.7
5.7 24.0
0.7 255.8
*

17.4 73.8 2.1 70.6 6.1 26.1 0.8 226.4 15.2

18.6 77.7
2.3 70.3
5.1 21.5
0.6 193.7 11.8

127.3 *
90.9 100.0
* * *

90.4 *
90.4 100.0
* * *

107.9 * * * * * *

125.2 *
89.4 100.0
* * *

249.1 35.7
195.7 100.0
* * *

140.3 33.3 104.3 100.0 21.6 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

* 131.6

*

*

49.2

*

*

*

*

*

*

*

*

*

*

*

*

23.9

*

14.3

*

*

13.0

*

*

*

*

*

2.8

*

*

*

*

*

*

15.2

*

*

*

*

9.2

*

*

*

*

*

*

*

*

*

*

*

2.8

37.8 37.0 28.3
* 17.8
* 25.0

23.8 35.5 38.7
* * * *

30.4 29.4 23.5
* * * *

47.1 26.7 40.0
* * * *

50.0 20.6 41.2
* * * *

38.6 30.3 33.7
4.0 11.0
4.1 6.9

.

*

*

*

10.1

3.4

.

*

*

*

*

*

.

*

10.3

13.6

15.1

9.8

38.6 28.9
* 60.9 43.5 37.0
.

45.2 * *
74.2 71.0 58.1
*

62.9 31.0
* 76.5 70.6 55.9 44.1

79.3 * *
73.3 76.7 60.0 43.3

78.1

59.1

*

18.7

*

*

67.6

69.7

70.6

64.6

58.8

52.6

35.3

33.3

371

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Marion County - 096

1990
5590 1280
117
20.8 .
21.0
10 2
84 10 35
4 0 3 0
0 0 0 1 0 1
5 0 0 8 0 0
31 12 26
0 14
1 4
. . .
57 17
0 59 39 34
. 0

1991
5605 1271 119
19.5 17.2 22.0
14 4
86 10 33
4 0 16 4
1 1 0 0 0 1
7 2 0 7 2 1
29 20 27
1 15
1 3
0 0 1
57 16
4 61 41 35
2 0

Total
1992 1993

5610 1261
121

5624 1252 123

20.4 19.0 21.0

22.5 15.4 22.0

8

11

0

4

77

80

6

7

33

38

1

6

3

1

16

7

2

3

0

0

0

0

0

0

3

1

0

0

1

0

5

9

2

1

0

0

9

13

2

0

0

0

28

31

24

23

20

20

1

1

13

13

1

0

2

10

1

0

3

1

54

6

49

48

13

11

2

1

41

60

36

52

26

46

1

10

0

0

1994 5-year

5630 1242
124

28059 6306 604

19.4 20.9 21.5

20.0 18.4 22.0

14

57

4

14

92

419

11

44

52

191

8

23

1

5

11

53

2

11

2

3

2

3

0

0

3

8

0

0

0

3

9

35

2

7

2

2

10

47

0

4

1

2

41

160

32

111

30

123

4

7

8

63

1

4

5

24

8

9

7

11

133

194

52

263

14

71

2

9

69

290

58

226

48

189

19

32

0

0

1990
3250 733 72

1991
3286 733
74

White
1992 1993

3315 733 75

3349 731
77

1994 5-year

3378 730 78

16578 3660 377

21.4 .
20.5

19.5 18.5 20.0

23.5 19.1 20.0

22.5 16.7 21.0

19.4 14.6 20.0

20.4 18.4 20.0

4

5

2

3

6

20

1

0

0

1

2

4

40

46

33

32

34

185

4

4

1

1

4

14

6

8

6

5

8

33

2

0

0

1

3

6

0

0

1

0

0

1

0

6

7

2

2

17

0

1

1

2

2

6

0

0

0

0

1

1

0

0

0

0

1

1

0

0

0

0

0

0

0

0

1

0

1

2

0

0

0

0

0

0

0

0

1

0

0

1

3

4

2

2

1

12

0

0

1

0

1

2

0

0

0

0

1

1

4

5

4

4

1

18

0

1

1

0

0

2

0

0

0

0

0

0

12

12

9

9

12

54

1

4

3

2

3

13

13

15

8

9

10

55

0

0

1

1

1

3

7

10

7

7

6

37

0

0

0

0

0

0

2

2

1

4

0

9

.

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

29

34

21

23

25

132

10

10

4

5

3

32

0

2

1

0

1

4

25

27

11

23

27

113

15

19

6

18

18

76

14

17

4

17

17

69

.

1

0

3

10

14

0

0

0

0

0

0

1990
2306 534 45

1991
2312 529
46

Black
1992 1993

2314 523 46

2320 518
47

1994 5-year

2323 512 48

11575 2615 232

19.8 .
22.0

20.1 17.2 25.0

20.1 16.7 25.0

22.8 14.2 23.5

19.5 27.2 24.0

19.8 17.2 24.0

6

9

6

8

8

37

1

4

0

3

2

10

44

40

44

47

52

227

6

6

5

6

7

30

29

25

27

33

39

153

2

4

1

5

5

17

0

0

2

1

1

4

3

10

8

5

9

35

0

3

1

1

0

5

0

1

0

0

1

2

0

1

0

0

1

2

0

0

0

0

0

0

1

0

2

1

2

6

0

0

0

0

0

0

1

1

0

0

0

2

2

3

3

7

7

22

0

2

1

1

1

5

0

0

0

0

1

1

4

2

5

9

8

28

0

1

1

0

0

2

0

1

0

0

1

2

19

17

19

21

25

101

11

16

21

21

27

96

13

12

12

11

16

64

0

1

0

0

2

3

7

5

6

6

2

26

1

1

1

0

1

4

2

1

1

6

4

14

.

0

0

0

7

7

.

0

0

0

6

6

.

0

8

0

126

134

28

23

28

24

26

129

7

6

9

6

10

38

0

2

1

1

1

5

34

34

30

36

39

173

24

22

30

34

39

149

20

18

22

29

30

119

.

1

1

7

9

18

0

0

0

0

0

0

372

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Marion County - 096

15.0 65.6
1.9 41.7
* * * * *

15.3 67.7
2.0 39.3
2.9 12.6
0.4 150.9
*

13.7 61.1 1.9 44.6 2.9 12.7 0.4 164.9
*

85.5 *
85.5 70.0
* * *

117.3 *
83.8 80.0
* * *

66.3 *
49.8 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

6.0

8.1

6.5

*

*

*

*

*

*

9.5

8.3

12.2

*

*

*

*

*

*

38.3 14.3 31.3
* 16.7
* *

34.9 23.8 32.1
* 17.9
* *

39.4 32.4 27.0
* 17.8
* *

.

*

*

.

*

*

.

*

33.6

67.9 22.1
* 70.2 46.4 40.5
.

66.3 23.9
* 72.6 48.8 41.7
*

63.6 20.3
* 55.4 48.6 35.1
*

14.2 63.9
2.0 47.5
1.2 5.6 0.2 74.5 5.6

16.3 74.1 2.3 56.5 2.0 8.9 0.3 97.3
8.1

14.9 66.4
2.0 46.1
1.9 8.4 0.3 105.8 4.6

89.4 *
56.9 85.7
* * *

112.7 *
88.6 90.9
* * *

94.3 24.6 72.8 84.1 18.2 100.0
*

*

*

*

*

*

*

*

*

*

*

*

18.9

*

*

*

*

*

*

11.3 * *
16.2 * *

9.8 * *
10.9 * *

8.4 1.7
* 11.4
* *

41.3 28.7 25.6
* 16.5
* 18.5

51.3 34.8 33.7
* 8.8
* 10.6

41.0 26.8 30.1
1.7 15.3
* 9.6

*

5.0

1.4

*

4.3

1.7

3.7

82.5

30.2

60.8 15.5
* 75.0 65.0 57.5 12.5

56.5 17.1
* 75.0 63.0 52.2 20.7

62.9 19.7 17.0 70.0 54.6 45.7
9.7

12.3 54.6
1.8 15.0
* * * * *
* * * * * * *
* * * * * *
* * * * * *
31.6 *
32.5 *
17.5 * *
. . .
72.5 27.8
* 62.5 37.5 35.0
.

14.0 62.8
2.0 17.8
1.8 8.2 0.3
. *

10.0 45.0 1.5 19.4 2.1
9.5 0.3 170.7
*

67.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

11.1

*

*

*

*

*

26.7 *
33.3 *
22.2 * *

30.0 *
25.8 *
23.3 * *

*

*

*

*

*

*

73.9 26.3
* 60.0 42.2 37.8
*

63.6 * *
35.5 19.4
* *

9.6 43.8
1.5 15.6
* * * * *
* * * * * * *
* * * * * *
* * * * * *
31.0 *
30.0 *
22.6 * *
* * *
71.9 17.9
* 71.9 56.3 53.1
*

10.1 46.6 1.5 23.5
* * * * *

11.2 50.5
1.7 18.1
1.0 4.6 0.1 81.0 2.2

76.6 * * * * * *

53.1 *
37.2 50.0 15.9 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

6.5

*

*

*

*

*

9.9

*

*

*

*

37.5 *
30.3 *
18.2 * *

31.0 7.1
30.7 *
20.7 *
8.7

*

*

*

*

*

*

73.5 * *
79.4 52.9 50.0 29.4

71.4 20.8
* 62.1 41.8 37.9
9.9

19.1 82.4
2.3 65.9
* * * * *

17.3 75.7
2.2 64.1
4.3 18.9
0.5 185.2
*

19.0 84.2 2.3 62.8 3.5 15.3 0.4 145.5
*

20.3 90.8
2.6 70.2
2.2 9.7 0.3 86.2 11.6

22.4 101.6
3.0 75.0 3.9 17.6 0.5 134.3 11.7

19.6 86.8
2.5 68.0
3.0 13.4
0.4 123.7
8.0

133.3 *
133.3 100.0
* * *

196.1 *
130.7 100.0
* * *

129.3 *
107.8 100.0
* * *

169.1 *
126.8 100.0
* * *

167.4 *
146.4 100.0
* * *

159.2 27.0
129.1 100.0
21.5 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

26.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

14.9

13.5

9.7

*

*

*

*

*

2.2

*

*

*

*

*

*

*

*

11.6

19.1

15.4

12.4

*

*

*

*

*

*

*

*

*

*

*

*

44.2 25.0 30.2
* 15.9
* *

44.7 41.0 30.8
* 12.8
* *

46.3 48.8 27.9
* 14.0
* *

46.7 44.7 23.4
* 12.8
* 18.8

56.8 51.9 30.8
* * * *

47.9 42.7 28.6
* 11.6
* 9.9

.

*

*

*

9.1

2.3

.

*

*

*

7.8

2.0

.

*

10.4

* 163.6

43.6

63.6 17.1
* 77.3 54.5 45.5
.

57.5 20.7
* 87.2 56.4 46.2
*

63.6 22.5
* 69.8 69.8 51.2
*

52.2 14.3
* 76.6 72.3 61.7 14.9

50.0

57.1

20.8

19.0

*

20.0

75.0

76.9

75.0

66.2

57.7

52.9

17.3

9.9

373

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
McDuffie County - 097

1990
20119 4742 479
20.7 18.5 22.0
53 14 311 40 133 15
4 79 10
0 0 0 4 2 6
29 5 0
36 2 4
204 65 118 11 34 14 17
. . .
245 35
0 178 127 116
. 0

1991
20411 4777 483
20.4 18.1 22.5
59 11 350 48 156 18
1 69 12
4 3 1 4 1 1
36 5 0
36 8 3
228 70
117 7
38 8
17
6 2 31
287 36 4
212 183 168
6 0

Total
1992 1993

20698 4809 487

20990 4847 492

20.8 19.6 23.0

19.6 18.3 23.0

53

50

18

7

317

333

43

43

164

147

15

18

2

6

70

54

10

6

1

5

0

4

1

1

2

10

0

0

1

4

35

36

4

4

0

0

42

36

3

1

4

3

126

129

84

65

109

93

9

4

39

47

6

1

20

12

18

10

7

5

61

84

248

274

36

36

5

4

209

198

191

194

172

170

8

9

0

1

1994 5-year

21275 4879 496

103493 24054 2436

20.9 18.4 22.0

20.5 18.4 22.0

65

280

15

65

305

1616

50

224

138

738

23

89

6

19

56

328

11

49

1

11

0

7

1

4

6

26

1

4

2

14

26

162

0

18

0

0

34

184

3

17

5

19

101

788

77

361

95

532

4

35

41

199

1

30

9

75

5

39

7

21

45

221

240

1294

40

183

8

21

191

988

187

882

162

788

9

32

1

2

1990
12720 2840 275

1991
12900 2858 277

White
1992 1993

13072 2874 279

13252 2893 281

1994 5-year

13425 2909 283

65369 14374
1395

22.4 18.6 20.0

21.9 16.9 21.0

22.6 16.9 21.0

20.6 18.8 22.0

23.2 18.3 21.0

22.1 18.1 21.0

8

15

12

23

18

76

2

2

1

2

2

9

156

175

148

196

170

845

5

9

6

19

12

51

25

32

28

46

28

159

8

11

10

12

14

55

1

0

0

0

5

6

32

29

29

27

25

142

3

5

6

4

5

23

0

2

1

3

1

7

0

1

0

3

0

4

0

1

1

0

1

3

1

1

0

3

5

10

1

1

0

0

0

2

6

1

1

2

0

10

5

9

11

19

9

53

0

1

0

2

0

3

0

0

0

0

0

0

7

12

13

17

14

63

0

2

1

0

3

6

1

3

1

2

3

10

77

85

47

63

53

325

17

11

14

22

10

74

40

43

34

41

34

192

0

1

0

2

1

4

24

30

29

41

34

158

10

6

3

0

1

20

5

4

5

5

3

22

.

4

8

5

3

20

.

2

3

4

4

13

.

2

14

34

33

83

136

152

118

159

140

705

26

26

22

21

23

118

0

1

3

3

5

12

61

76

66

82

74

359

34

59

57

80

66

296

30

53

48

65

56

252

.

2

2

4

3

11

0

0

0

0

0

0

1990
7320 1876
202

1991
7426 1888 204

Black
1992 1993

7531 1900
205

7637 1913 207

1994 5-year

7741 1925
209

37654 9502 1027

18.8 18.4 25.0

17.5 18.8 25.5

18.6 20.6 25.0

18.4 18.2 26.0

17.8 18.4 26.5

18.3 18.8 26.0

45

43

41

27

47

203

12

9

17

5

13

56

153

174

168

136

135

766

35

39

37

24

38

173

108

124

136

101

110

579

7

7

5

6

9

34

3

1

2

6

1

13

46

37

40

26

31

180

7

6

4

2

6

25

0

2

0

2

0

4

0

2

0

1

0

3

0

0

0

1

0

1

3

3

2

7

1

16

1

0

0

0

1

2

0

0

0

2

0

2

24

27

24

17

17

109

5

4

4

2

0

15

0

0

0

0

0

0

29

24

29

19

20

121

2

6

2

1

0

11

3

0

3

1

2

9

126

142

79

66

48

461

48

59

70

43

67

287

78

73

75

52

61

339

11

6

9

2

3

31

10

8

10

6

7

41

4

2

3

1

0

10

12

13

15

7

6

53

.

1

7

4

.

0

3

1

.

26

42

48

0

12

1

5

4

120

107

134

129

114

100

584

8

10

14

15

17

64

0

3

2

1

3

9

117

136

143

116

117

629

93

124

134

113

121

585

86

115

124

105

106

536

.

4

6

5

6

21

0

0

0

1

1

2

374

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
McDuffie County - 097

15.5 65.6
2.0 43.0
3.9 16.7
0.5 193.2
4.0
110.6 26.4 83.5 92.5 20.9 100.0
*
* * * * * 1.4
9.4 1.6
* 11.7
* *
66.9 21.0 38.2
3.6 11.0
4.6 9.3
. . .
79.3 12.4
* 57.6 41.1 37.5
.

17.1 73.3
2.3 45.6
3.4 14.4
0.4 157.5
4.0
122.2 18.6 99.4 89.1 24.8
100.0 *
* * * * * *
10.3 1.4 *
10.5 2.3 *
68.1 20.5 34.2
2.0 11.3
2.4 8.7
1.0 *
5.2
82.0 11.5
* 62.0 53.5 49.1
1.8

15.3 65.9 2.0 52.4 3.4 14.6 0.5 173.3 3.5
108.9 34.0 88.4 97.7 20.5
100.0 *
* * * * * *
11.0 * *
13.4 * *
40.8 26.8 34.8
2.9 12.5
1.9 10.4
3.0 1.2 10.1
78.2 12.7 17.2 66.8 61.0 55.0
2.6

15.9 68.7
2.1 44.3
2.6 11.1
0.3 130.4
5.6
101.7 14.0 87.4 86.0 12.2
100.0 *
15.0 * *
29.5 * *
10.8 * *
10.8 * *
39.6 19.6 28.2
* 14.2
* 6.4
1.6 0.8 13.7
82.5 12.1
* 59.6 58.4 51.2
2.7

14.3 62.5 1.9 45.8 2.6 11.5 0.3 142.9 6.4
131.1 23.1
100.9 91.8 22.2
100.0 10.1
* * * 19.3 * *
8.5 * *
11.3 *
1.6
33.9 25.6 31.7
* 13.6
* 5.2
0.8 1.1 7.3
78.7 14.9 24.2 63.5 62.1 53.8
3.0

15.6 67.2
2.1 46.2
3.2 13.6
0.4 159.5
4.7
114.9 23.2 92.0 91.4 20.1 100.0
4.5
6.8 4.3
* 15.9
* 0.6
10.0 1.1 *
11.5 1.1 1.2
50.1 22.6 33.4
2.2 12.5
1.9 8.1
1.6 0.9 9.1
80.2 12.7 13.9 61.9 55.2 49.3
2.5

12.3 54.9
1.7 16.0
2.5 11.3
0.3 162.4
3.2

13.6 61.2
1.9 18.5
2.2 10.1
0.3 134.9
3.8

11.3 51.5 1.6 19.0 2.2 10.1 0.3 155.1 3.5

14.8 67.7
2.1 23.5
2.0 9.3 0.3 114.4 4.5

12.7 58.4 1.8 16.9 1.9 8.6 0.3 116.8 6.5

12.9 58.8
1.8 19.0
2.2 9.9 0.3 135.4 4.3

29.1 *
18.2 * * * *

54.2 *
32.5 *
18.1 100.0
*

43.0 *
21.5 83.3 21.5 100.0
*

81.8 *
67.5 68.4
* * *

63.6 *
42.4 63.6 17.7 100.0
*

54.5 11.8 36.6 62.0 16.5 100.0
*

*

*

*

*

*

8.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

28.6

11.8

*

*

*

*

*

*

2.5

*

*

*

*

0.8

3.2

5.1

7.4

9.7

5.3

6.3

*

*

*

*

*

*

*

*

*

*

*

*

4.5

6.9

8.8

8.7

8.4

7.5

*

*

*

*

*

0.7

*

*

*

*

*

1.2

50.0 10.9 25.6
* 15.5
6.4 5.4

50.3 6.4
24.9 *
17.6 3.6 *

32.4 9.5 23.1
* 19.7
* 6.1

32.6 11.2 21.0
* 21.0
* 4.8

32.1 6.0 20.6
* 20.5
* *

39.3 8.8
23.0 *
19.0 2.4 4.7

.

*

2.4

1.5

*

1.5

.

*

*

*

*

1.0

.

*

4.2

10.0

9.6

6.1

88.3 18.7
* 39.1 21.8 19.2
.

86.9 17.0
* 43.9 34.1 30.6
*

79.7 16.8
* 44.9 38.8 32.7
*

81.1 12.2
* 41.8 40.8 33.2
*

82.4 16.3 20.0 44.6 39.8 33.7
*

83.6 16.0 11.8 42.8 35.3 30.1
1.6

20.9 81.6
2.4 71.5
6.3 24.5
0.7 220.1
5.3

23.4 92.1
2.8 73.8
5.0 19.6
0.6 168.9
4.2

22.3 88.4 2.7 82.4 5.3 21.1 0.6 186.0 3.7

17.8 71.1
2.1 74.8
3.4 13.6
0.4 148.6
6.8

17.4 70.1 2.1 81.5 4.0 16.1 0.5 174.2 6.2

20.3 80.6
2.4 76.8
4.8 18.9
0.6 180.7
5.3

222.8 26.7 173.3 100.0 34.7 100.0
*

211.2 20.9
191.6 100.0
29.5 100.0
*

199.8 41.5
180.3 100.0
* * *

130.2 18.5
115.7 100.0
* * *

224.9 27.7
181.8 100.0
28.7 100.0
*

197.6 27.6
168.4 100.0
24.3 100.0
7.8

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

49.3

*

20.5

*

*

*

*

*

*

*

*

*

*

*

*

15.8 3.3 *
19.3 * *

15.5 * *
14.3 3.6 *

14.3 * *
17.6 * *

12.5 * *
14.1 * *

12.6 * *
14.8 * *

14.2 2.0 *
16.1 1.5 1.2

84.6 31.8 51.7
7.3 6.6
* 13.5

86.1 35.1 43.5
3.6 4.8
* 12.5

48.5 42.4 45.5 5.5 6.1
* 13.8

50.0 31.9 38.8
* 4.5
* 8.6

36.1 49.6 45.2
* 5.2
* 7.9

62.1 38.1 45.0
4.1 5.5 1.3 11.5

.

*

2.6

*

.

*

*

*

.

9.8

15.7

17.7

*

1.1

*

0.5

*

11.1

69.9 5.7 *
77.5 61.6 57.0
.

77.0 6.3 *
81.0 73.8 68.5
*

76.8 9.2
* 86.7 81.2 75.2 3.6

84.4 12.0
* 85.9 83.7 77.8
3.7

74.1

76.3

13.4

9.1

*

18.4

86.7

83.4

89.6

77.6

78.5

71.1

4.4

3.5

375

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
McIntosh County - 098

1990
8634 1946
240
19.5 17.9 21.0
18 2
140 13 55
6 0 21 5
3 2 1 2 1 0
7 2 0 15 0 2
50 30 44
3 30
4 5
. . .
84 18
7 81 76 63
. 0

1991
8881 1972 239
19.8 18.0 21.0
30 6
162 25 76 5 2 25 3
4 3 1 5 1 1
17 5 0
17 1 4
53 39 60
1 32
5 10
4 3 27
96 30
1 117 108
92 18
2

Total
1992 1993

9123 1998
239

9375 2025 238

19.7 17.1 22.0

18.5 19.9 22.0

23

30

6

2

163

160

18

25

79

69

2

4

1

3

12

16

4

3

5

1

3

1

2

0

4

4

0

0

3

1

11

17

4

2

0

0

24

15

0

2

3

1

67

49

37

36

49

54

4

4

23

26

3

3

7

6

16

11

5

6

70

28

98

100

32

19

2

2

109

112

105

113

86

95

73

85

2

0

1994 5-year

9617 2051
237

45630 9992 1193

21.0 19.0 22.0

19.7 18.0 22.0

15

116

1

17

165

790

14

95

60

339

2

19

1

7

13

87

1

16

1

14

1

10

0

4

2

17

1

3

0

5

14

66

2

15

0

0

12

83

1

4

2

12

59

278

26

168

51

258

1

13

25

136

1

16

7

35

4

35

5

19

29

154

115

493

20

119

5

17

110

529

113

515

93

429

83

259

1

5

1990
4880 1045
110

1991
5030 1053 110

White
1992 1993

5174 1062
111

5326 1071 111

1994 5-year

5471 1080
111

25881 5311 553

20.7 19.3 21.0

21.3 19.2 19.0

21.4 17.7 21.0

18.9 34.6 20.0

21.4 21.3 19.0

20.7 19.2 20.0

7

14

10

17

8

56

0

4

3

1

1

9

73

79

79

89

105

425

6

11

8

16

8

49

13

22

17

21

17

90

1

3

0

3

1

8

0

1

0

1

1

3

6

9

6

6

3

30

1

1

2

0

0

4

2

2

1

1

1

7

2

2

1

1

1

7

0

0

0

0

0

0

1

3

1

2

2

9

0

0

0

0

0

0

0

1

0

0

0

1

5

8

6

5

10

34

2

2

2

1

2

9

0

0

0

0

0

0

10

8

13

7

8

46

0

1

0

0

1

2

0

3

2

0

1

6

22

25

32

23

31

133

7

9

7

10

8

41

28

36

30

38

41

173

1

0

1

3

1

6

25

25

15

21

21

107

2

0

2

0

1

5

0

6

1

2

7

16

.

1

16

6

2

25

.

1

4

4

4

13

.

21

59

23

19

122

49

58

56

60

78

301

11

17

18

12

17

75

4

0

2

0

0

6

35

49

46

57

58

245

30

43

44

58

65

240

25

35

35

50

50

195

.

2

31

45

45

123

0

1

0

0

0

1

1990
3719 894 130

1991
3825 906 130

Black
1992 1993

3930 917 129

4038 930 129

1994 5-year

4142 941 129

19655 4588 646

18.5 17.2 23.0

19.0 17.2 24.5

19.1 16.5 24.0

18.4 18.0 25.5

19.9 16.8 26.0

19.0 17.1 24.5

11

16

13

13

7

60

2

2

3

1

0

8

67

83

84

71

60

365

7

14

10

9

6

46

42

54

62

48

43

249

5

2

2

1

1

11

0

1

1

2

0

4

15

16

6

10

10

57

4

2

2

3

1

12

1

2

4

0

0

7

0

1

2

0

0

3

1

1

2

0

0

4

1

2

3

2

0

8

1

1

0

0

1

3

0

0

3

1

0

4

2

9

5

12

4

32

0

3

2

1

0

6

0

0

0

0

0

0

5

9

11

8

4

37

0

0

0

2

0

2

2

1

1

1

1

6

28

28

35

26

28

145

23

30

30

26

18

127

16

24

19

16

10

85

2

1

3

1

0

7

5

7

8

5

4

29

2

5

1

3

0

11

5

4

6

4

0

19

.

3

0

5

2

10

.

2

0

2

1

5

.

4

9

5

7

25

35

38

42

40

37

192

7

13

14

7

3

44

3

1

0

2

5

11

46

68

63

55

52

284

46

65

61

55

48

275

38

57

51

45

43

234

.

16

42

40

38

136

0

1

2

0

1

4

376

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

16.2

18.2

17.9

17.1

17.2

17.3

General fertility rate

71.9

82.2

81.6

79.0

80.4

79.1

Total fertility rate

2.2

2.5

2.4

2.4

2.4

2.4

% Livebirths to unmarried women

39.6

47.2

48.5

43.7

36.6

43.2

Crude abortion rate

2.4

2.8

1.3

1.7

1.4

1.9

General abortion rate

10.8

12.7

6.0

7.9

6.3

8.7

Total abortion rate

0.3

0.4

0.2

0.2

0.2

0.3

Abortion ratio

125.0 128.9

67.4

87.4

71.8

96.2

Fetal Death rate

3.6

3.5

*

3.5

*

2.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

75.0 125.4

96.4 126.1

63.2

97.2

% Repeat conceptions to women under 18

*

20.0

26.1

*

*

14.7

Livebirths to women under 18

54.2 104.5

75.4 105.0

59.0

79.6

% Livebirths to unmarried women under 18

92.3

80.0

83.3

64.0

57.1

74.7

Induced abortions to women under 18

20.8

*

*

*

*

13.4

% Abortions to unmarried women under 18

*

*

*

*

*

93.8

Fetal deaths to women under 18

*

*

*

*

*

4.2

Infant and child survival rates

Infant mortality

*

*

30.7

*

*

17.7

Neonatal mortality

*

*

*

*

*

12.7

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

30.5

*

*

*

21.3

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

0.5

Infant health rates

% Low birthweight

5.0

10.5

6.7

10.6

8.5

8.4

% Very low birthweight

*

3.1

*

*

*

1.9

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

10.7

10.6

14.7

9.5

7.3

10.6

% Multiple gestation

*

*

*

*

*

*

% Birth defect

*

*

*

*

*

1.5

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

38.2

36.1

45.3

32.0

38.1

37.9

% with father not named on birth certificate

21.4

24.2

22.7

22.8

15.9

21.4

% with maternal education less than high school

31.7

37.5

30.4

34.2

31.1

33.0

% No prenatal care

*

*

*

*

*

1.7

% Maternal smoking during pregnancy

21.7

20.0

14.5

16.5

15.2

17.5

% Maternal alcohol use during pregnancy

*

3.1

*

*

*

2.1

% Interpregnancy interval less than 6 months

6.3

11.2

7.4

6.7

8.0

7.9

Child abuse and neglect rates

Physical

.

*

6.4

4.3

*

3.4

Sexual

.

*

2.0

2.3

1.9

1.9

Neglect

.

10.9

27.8

10.9

11.1

15.1

Interventions to improve infant & child survival

% Prenatal care first trimester

60.0

59.3

60.1

63.3

69.7

62.6

% Primary C-section delivery

15.8

21.7

23.4

14.2

14.3

17.9

% Vaginal birth after previous C-section

26.9

*

*

*

20.8

13.8

% WIC during pregnancy

57.9

72.7

66.9

70.9

67.1

67.3

% Medicaid during pregnancy

54.3

67.1

64.4

71.5

68.9

65.5

% Medicaid and WIC during pregnancy

45.0

57.1

52.8

60.1

56.7

54.6

% Perinatal case management

.

11.2

44.8

53.8

50.6

40.1

McIntosh County - 098

15.0 69.9
2.1 17.8
1.2 5.7 0.2 74.1
*

15.7 75.0
2.3 28.2
1.8 8.5 0.3 97.8
*

63.6 *
54.5 83.3
* * *

127.3 *
100.0 63.6 * * *

*

*

*

*

*

*

*

*

*

*

*

*

6.8 * *
13.7 * *

10.1 * *
10.3 * *

32.4 9.6
38.9 *
34.7 * *

34.7 11.5 46.8
* 32.1
* 14.3

.

*

.

*

.

17.2

67.1 18.6
* 47.9 41.1 34.2
.

73.4 25.8
* 62.8 55.1 44.9
*

15.3 74.4 2.3 21.5 1.2
5.6 0.2
. *

16.7 83.1
2.6 23.6
1.1 5.6 0.2 60.6
*

90.3 *
72.3 62.5
* * *

153.6 *
144.5 43.8 * * *

*

*

*

*

*

*

*

*

*

*

*

*

7.6

5.6

*

*

*

*

16.5

7.9

*

*

*

*

43.8 8.9 38.5
* 19.7
* *

25.8 11.2 42.7
* 23.6
* *

12.9 *
47.4

4.7 *
18.2

70.9 27.3
* 58.2 55.7 44.3 39.2

68.2 15.8
* 64.0 65.2 56.2 50.6

19.2 97.2 3.0 16.3
* * * * *

16.4 80.0
2.5 21.3
1.2 5.6 0.2 64.2 2.3

71.9 *
71.9 * * * *

101.3 16.1 88.7 53.1
* * *

*

16.5

*

16.5

*

*

*

21.0

*

*

*

*

9.5

8.0

*

2.1

*

*

7.7

10.9

*

*

*

1.4

31.0 7.7 39.4
* 20.2
* 13.2

33.1 9.7
41.2 1.4
25.5 1.2 6.9

* * 14.8

5.0 2.6 24.3

74.3 19.1
* 55.8 62.5 48.1 43.3

71.0 21.1
9.0 57.9 56.7 46.1 35.1

18.0 74.9
2.2 63.6
4.0 16.8
0.5 172.4
5.6

21.7 91.6
2.7 65.1
4.2 17.7
0.5 156.9
*

21.4 91.6 2.6 73.8 1.5 6.5 0.2 64.5
*

17.6 76.4
2.2 69.6
2.5 10.8
0.3 119.0
*

14.5 63.7 1.9 71.7 2.4 10.6 0.3 140.8
*

18.6 79.6
2.3 68.8
2.9 12.4
0.4 130.4
3.3

84.6 *
53.8 100.0
* * *

123.5 *
108.0 92.9 * * *

100.5 *
77.3 100.0
* * *

100.9 *
69.8 100.0
* * *

54.4 *
46.7 100.0
* * *

92.8 13.3 71.2 97.8 18.6 100.0
*

*

*

*

*

*

19.2

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

21.7

*

*

*

*

*

*

*

*

*

*

*

*

*

10.8

6.0

16.9

*

*

*

*

*

*

*

*

7.5

10.8

13.1

11.6

*

*

*

*

*

*

*

*

*

8.8

*

1.6

*

*

*

10.2

*

*

*

1.6

44.4 34.3 23.9
* 7.6
* 12.8

37.3 36.1 28.9
* 8.5 6.1
*

46.7 35.7 22.9
* 9.6
* 12.5

40.6 37.7 23.2
* 7.2
* *

50.9 30.0 16.7
* * * *

43.7 35.0 23.5
1.9 8.1 3.1 9.1

.

*

*

3.9

*

2.0

.

*

*

*

*

1.0

.

*

7.2

3.9

5.4

4.9

52.2 12.7
* 68.7 68.7 56.7
.

45.8 18.1
* 81.9 78.3 68.7 19.3

50.0 19.7
* 75.0 72.6 60.7 50.0

57.1 12.1
* 79.7 79.7 65.2 58.0

61.7

52.7

*

14.3

55.6

19.6

86.7

78.2

80.0

75.8

71.7

64.5

63.3

45.9

377

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Meriwether County - 099

1990
22411 4985 567
19.8 19.2 23.0
59 14 365 48 174 26
3 92 10
3 2 1 5 3 1
40 7 0
39 2 6
116 101 137 18 73
9 22
. . .
194 32
4 192 153 118
. 0

1991
22468 4958 565
20.3 19.1 21.0
44 11 346 34 183 12
5 87
9
3 3 0 7 1 2
38 7 1
34 5 4
105 105 120
17 70
5 23
6 4 37
189 51 4
222 190 162
2 0

Total
1992 1993

22513 4926 563

22566 4898 561

20.6 18.6 22.0

18.9 19.4 21.0

52

68

9

8

318

347

41

55

154

183

28

23

5

1

75

89

10

12

5

4

1

2

4

2

7

3

1

2

2

1

30

39

6

6

0

0

27

37

1

5

5

6

100

117

108

112

99

127

17

11

44

53

8

6

13

12

11

7

22

11

104

49

182

189

49

52

4

2

194

242

174

237

139

204

22

14

0

0

1994 5-year

22612 4866 558

112570 24633 2814

19.4 19.3 23.0

19.8 19.0 22.0

62

285

13

55

335

1711

53

231

178

872

14

103

3

17

67

410

6

47

6

21

5

13

1

8

8

30

0

7

1

7

40

187

11

37

1

2

38

175

8

21

3

24

135

573

98

524

113

596

9

72

34

274

6

34

23

93

8

32

16

53

107

297

221

975

43

227

7

21

215

1065

218

972

186

809

8

46

0

0

1990
12357 2561 253

1991
12390 2547 252

White
1992 1993

12420 2530 251

12448 2514 251

1994 5-year

12478 2497 249

62093 12649
1257

21.0 20.6 21.0

22.7 18.4 21.0

22.2 18.9 21.0

21.4 17.7 20.0

20.5 18.5 21.0

21.4 19.1 21.0

23

15

14

26

15

93

8

4

0

1

1

14

160

155

130

162

141

748

21

9

9

17

12

68

32

36

21

45

32

166

15

8

13

14

7

57

0

0

1

0

0

1

41

35

31

38

28

173

2

6

4

9

3

24

1

2

2

2

2

9

1

2

1

1

2

7

0

0

1

1

0

2

1

1

2

1

2

7

1

1

0

0

0

2

0

1

1

0

1

3

10

15

7

17

11

60

2

2

2

3

4

13

0

1

0

0

0

1

15

11

10

15

12

63

0

3

1

1

1

6

2

2

2

3

1

10

45

33

28

38

55

199

11

13

12

25

15

76

53

52

36

48

40

229

1

2

1

0

1

5

43

46

33

41

24

187

1

0

1

3

3

8

3

6

4

4

8

25

.

3

7

3

1

14

.

3

16

7

8

34

.

12

49

30

54

145

113

105

20

31

0

4

62

80

45

62

32

55

.

1

0

0

96

115

111

540

15

29

22

117

2

1

3

10

65

93

68

368

46

84

75

312

42

70

58

257

5

8

3

17

0

0

0

0

1990
9989 2413
314

1991
10014 2399 313

Black
1992 1993

10035 2383 312

10058 2369 311

1994 5-year

10079 2353 309

50175 11918
1558

18.8 17.0 24.0

19.2 20.9 23.0

19.1 17.8 25.0

18.6 20.7 25.5

18.9 19.5 25.5

18.8 18.6 25.0

36

29

38

42

47

192

6

7

9

7

12

41

205

191

188

184

192

960

27

25

32

38

41

163

142

147

133

138

145

705

11

3

15

9

7

45

3

5

4

1

3

16

50

50

44

51

39

234

8

3

6

3

3

23

2

1

3

2

4

12

1

1

0

1

3

6

1

0

3

1

1

6

4

6

5

2

6

23

2

0

1

2

0

5

1

1

1

1

0

4

30

23

23

22

29

127

5

5

4

3

7

24

0

0

0

0

1

1

24

23

17

21

25

110

2

2

0

4

7

15

4

2

3

3

1

13

71

72

72

79

79

373

90

92

96

87

83

448

84

68

63

78

72

365

17

15

16

11

8

67

30

24

11

11

9

85

8

5

7

3

3

26

19

17

9

8

15

68

.

3

4

3

7

17

.

1

6

4

8

19

.

23

52

17

52

144

81

84

86

73

109

433

12

20

34

23

21

110

4

0

2

1

4

11

130

142

129

148

146

695

108

128

128

152

142

658

86

107

97

133

127

550

.

1

17

5

5

28

0

0

0

0

0

0

378

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Meriwether County - 099

16.3 73.2
2.1 47.9
4.1 18.5
0.5 189.3
5.8
104.1 23.7 84.7 77.1 17.6 100.0 *
* * * 13.6 * *
11.0 1.9 *
10.7 *
1.7
39.3 27.8 38.0
5.0 20.3
2.5 9.5
. . .
53.7 9.7 *
52.9 42.1 32.5
.

15.4 69.8
2.0 53.7
3.9 17.5
0.5 192.5
3.8
77.9 25.0 60.2 88.2 15.9 100.0
*
* * * 19.9 * *
11.0 2.0 *
10.0 1.5 *
34.8 30.8 35.4
5.0 20.7
1.5 10.7
0.9 *
5.6
55.9 16.6
* 65.1 55.7 47.5
*

14.1 64.6 1.9 48.6 3.3 15.2 0.4 176.1 6.7
92.4 17.3 72.9 80.5 17.8 100.0
*
15.7 * *
21.7 * *
9.4 1.9
* 8.5
* 1.6
35.0 34.1 31.3
5.4 13.9
2.5 6.8
1.7 3.4 15.8
57.4 17.2
* 61.2 54.9 43.8
6.9

15.4 70.8
2.1 53.5
3.9 18.2
0.5 193.5
4.9
121.3 11.8 98.1 87.3 21.4
100.0 *
* * * * * *
11.2 1.7 *
10.8 1.5 1.7
37.5 32.7 37.2
3.2 15.6
1.8 6.7
1.1 1.7 7.4
54.6 16.5
* 70.8 69.3 59.6
4.1

14.8 68.8 2.0 54.6 3.0 13.8 0.4 159.5 3.7
111.1 21.0 94.9 96.2 10.7
100.0 *
17.9 14.9
* 23.7
* *
11.9 3.3
* 11.7
2.5 *
42.6 30.1 34.7
2.8 10.5
1.8 12.8
1.2 2.4 16.2
66.2 15.0 17.9 66.0 66.9 57.1 2.5

15.2 69.5
2.0 51.6
3.6 16.6
0.5 182.7
5.0
101.3 19.3 82.1 86.1 16.7 100.0
2.8
12.3 7.6 4.7
17.4 1.0 0.3
10.9 2.2 *
10.4 1.2 1.4
37.9 31.0 35.4
4.3 16.3
2.0 9.3
1.2 2.0 11.3
57.5 14.9 13.0 63.1 57.5 47.9
3.5

12.9 62.5
1.9 20.0
3.3 16.0
0.5 189.8
5.9

12.5 60.9
1.8 23.7
2.8 13.7
0.4 175.9
3.5

10.5 51.4 1.6 16.3 2.5 12.3 0.4 177.1 5.5

13.0 64.4
2.0 28.0
3.1 15.1
0.5 177.6
5.6

11.3 56.5 1.8 22.9 2.2 11.2 0.3 159.1 2.8

12.0 59.1
1.8 22.4
2.8 13.7
0.4 176.5
4.7

90.9 34.8 83.0 47.6
* * *

59.4 *
35.7 55.6 23.8 100.0
*

55.7 *
35.8 * * * *

103.8 *
67.8 58.8 35.9 100.0
*

60.1 *
48.1 83.3
* * *

74.0 15.1 54.1 55.9 19.1 100.0
*

*

*

*

*

*

12.0

*

*

*

*

*

9.4

*

*

*

*

*

*

*

*

*

*

*

9.3

*

*

*

*

*

*

*

*

*

*

*

*

6.3

9.7

5.4

10.5

7.8

8.0

*

*

*

*

*

1.7

*

*

*

*

*

*

9.4

7.3

7.8

9.3

8.6

8.5

*

*

*

*

*

0.8

*

*

*

*

*

1.3

33.1 6.9
33.1 *
27.2 * *

24.3 8.6
34.4 *
30.5 *
6.5

23.7 9.3 27.9
* 25.6
* *

25.9 15.5 30.0
* 25.8
* *

40.4 10.7 28.6
* 17.1
* 10.7

29.6 10.2 30.9
0.7 25.4
1.1 6.0

.

*

2.3

*

*

1.2

.

*

5.3

2.3

2.6

2.8

.

4.0

16.3

10.0

17.8

12.1

71.5 13.2
* 38.8 28.1 20.0
.

69.5 23.0
* 52.6 40.8 36.2
*

73.8 13.2
* 50.4 35.7 32.6 3.9

71.0 20.0
* 57.8 52.2 43.5
5.0

79.3 17.1
* 48.6 53.6 41.4
*

72.9 17.4 14.7 49.6 42.0 34.6
2.9

20.5 85.0
2.4 70.0
5.0 20.7
0.6 185.9
5.8

19.1 79.6
2.2 77.8
5.0 20.8
0.6 200.0
3.8

18.7 78.9 2.2 70.7 4.4 18.5 0.5 175.3 8.0

18.3 77.7
2.2 76.7
5.1 21.5
0.6 208.2
4.2

19.1 81.6 2.3 78.8 3.9 16.6 0.5 161.2 4.7

19.1 80.5
2.3 74.7
4.7 19.6
0.6 186.2
5.3

114.6 16.7 86.0 100.0 25.5 100.0
*

92.7 24.1 79.9 100.0
* * *

122.0 23.7
102.7 93.8 19.3
100.0 *

135.3 16.7
122.4 100.0
* * *

152.0 25.5
132.6 100.0
* * *

123.2 21.4
104.6 98.8 14.8 100.0 4.5

*

*

*

*

*

*

*

*

*

*

30.6

26.0

*

*

*

*

*

*

*

*

12.5

*

*

6.3

*

*

6.3

*

30.8

23.6

*

*

1.3

*

*

*

14.6 2.4 *
11.8 * *

12.0 2.6 *
12.2 * *

12.2 * *
9.0 * *

12.0 * *
11.7 * *

15.1 3.6
* 13.6
3.8 *

13.2 2.5 *
11.7 1.6 1.4

44.7 44.3 41.8
8.4 14.9
4.0 12.8

43.4 48.7 36.2
8.0 12.8
2.7 13.9

42.9 51.1 33.7
8.6 5.9 3.7 8.0

48.2 48.3 43.3
6.1 6.1
* 8.4

44.1 45.1 39.1
4.3 4.9
* 14.6

44.6 47.5 38.8
7.1 9.0 2.8 11.7

.

*

*

*

2.0

1.2

.

*

1.7

*

2.2

1.3

.

6.5

14.6

4.8

14.6

10.1

39.9 6.7 *
64.0 53.2 42.4
.

44.9 11.6
* 75.1 67.7 56.6
*

46.0 19.9
* 68.6 68.1 51.6 9.0

39.9 13.5
* 82.2 84.4 73.9
2.8

56.8

45.5

13.5

12.9

*

11.7

79.3

73.6

77.2

69.7

69.0

58.3

2.7

3.8

379

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Miller County - 100

1990
6280 1273
140
20.6 17.9 21.0
6 1 79 5 24 6 2 3 1
4 4 0 5 0 0
6 3 0 5 2 2
18 16 30
2 15
3 6
. . .
50 12
2 44 43 30
. 0

1991
6272 1270 141
22.0 25.4 20.0
9 5 88 8 35 7 1 5 1
1 0 1 1 0 0
5 0 0 2 1 1
17 15 26
1 15
1 2
0 0 6
66 20
0 52 43 33
0 0

Total
1992 1993

6242 1262
143

6233 1259 145

20.9 19.7 22.0

19.4 23.5 21.0

10

8

2

1

91

69

10

8

34

27

2

10

1

1

5

8

0

0

2

0

2

0

0

0

3

1

0

0

1

2

6

4

2

1

0

0

6

3

0

0

1

3

33

16

20

14

23

27

0

0

12

8

1

2

5

2

3

4

6

0

21

11

70

56

14

11

0

0

58

39

57

39

49

33

2

16

1

0

1994 5-year

6215 1254
146

31242 6318 715

20.4 21.0 21.0

20.6 19.8 21.0

8

41

1

10

86

413

8

39

42

162

3

28

1

6

5

26

0

2

0

7

0

6

0

1

1

11

0

0

5

8

11

32

0

6

0

0

11

27

3

6

1

8

29

113

18

83

32

138

0

3

10

60

0

7

4

19

3

10

3

9

13

51

69

311

8

65

1

3

58

251

58

240

53

198

45

63

4

5

1990
4542 847 88

1991
4534 844
89

White
1992 1993

4516 839 91

4507 835
92

1994 5-year

4496 832 94

22595 4197 454

21.6 17.9 20.0

22.8 25.4 19.5

22.5 19.9 19.0

19.3 23.5 20.0

20.7 21.0 21.0

21.4 20.4 20.0

4

3

5

5

2

19

0

1

1

1

0

3

39

51

51

38

43

222

3

2

5

5

2

17

7

7

8

7

10

39

4

5

0

6

0

15

2

1

1

0

0

4

2

5

3

6

4

20

1

1

0

0

0

2

2

0

0

0

0

2

2

0

0

0

0

2

0

0

0

0

0

0

4

1

1

0

0

6

0

0

0

0

0

0

0

0

1

2

4

7

3

2

2

3

3

13

2

0

0

0

0

2

0

0

0

0

0

0

2

1

2

0

4

9

1

1

0

0

1

3

2

1

0

3

0

6

6

5

13

7

11

42

3

5

4

2

4

18

13

11

6

14

12

56

1

0

0

0

0

1

12

14

10

7

9

52

0

0

0

1

0

1

1

1

1

0

2

5

.

0

0

1

2

3

.

0

5

0

2

7

.

1

16

2

5

24

26

43

46

32

36

183

8

14

7

9

3

41

1

0

0

0

1

2

17

24

28

16

20

105

11

17

25

15

22

90

7

12

22

13

18

72

.

0

1

7

15

23

0

0

0

0

4

4

1990
1726 422 52

1991
1724 421
53

Black
1992 1993

1716 418 53

1713 417
54

1994 5-year

1708 415 54

8587 2093
266

20.1 .
24.0

20.1 .
20.0

19.3 19.2 24.0

19.4 .
29.0

18.0 .
24.5

19.3 19.2 24.0

2

6

5

3

6

22

1

4

1

0

1

7

40

37

40

31

43

191

2

6

5

3

6

22

17

28

26

20

32

123

2

2

2

4

3

13

0

0

0

1

1

2

1

0

2

1

1

5

0

0

0

0

0

0

2

1

2

0

0

5

2

0

2

0

0

4

0

1

0

0

0

1

1

0

2

1

1

5

0

0

0

0

0

0

0

0

0

0

1

1

3

3

4

1

8

19

1

0

2

1

0

4

0

0

0

0

0

0

3

1

4

3

7

18

1

0

0

0

2

3

0

0

1

0

1

2

12

12

20

9

18

71

13

10

16

12

14

65

17

15

17

13

20

82

1

1

0

0

0

2

3

1

2

1

1

8

3

1

1

1

0

6

5

1

4

2

2

14

.

0

3

3

1

7

.

0

1

0

1

2

.

0

5

9

8

22

24

23

24

24

33

128

4

6

7

2

5

24

1

0

0

0

0

1

27

28

30

23

38

146

32

26

32

24

36

150

23

21

27

20

35

126

.

0

1

9

30

40

0

0

1

0

0

1

380

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

12.6

14.0

14.6

11.1

13.8

13.2

General fertility rate

62.1

69.3

72.1

54.8

68.6

65.4

Total fertility rate

1.8

2.0

2.1

1.6

2.0

1.9

% Livebirths to unmarried women

30.8

40.2

37.4

39.1

50.0

39.6

Crude abortion rate

*

0.8

0.8

1.3

0.8

0.8

General abortion rate

*

3.9

4.0

6.4

4.0

4.1

Total abortion rate

*

0.1

0.1

0.1

0.1

0.1

Abortion ratio

*

49.0

50.5

90.9

52.6

54.7

Fetal Death rate

7.1

7.1

*

8.7

*

5.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

42.9

63.6

70.1

55.2

54.8

57.3

% Repeat conceptions to women under 18

*

55.6

*

*

*

24.4

Livebirths to women under 18

35.7

56.6

70.1

55.2

54.8

54.5

% Livebirths to unmarried women under 18

*

75.0

60.0

*

87.5

61.5

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

16.9

Neonatal mortality

*

*

*

*

*

14.5

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

61.7

*

*

*

*

26.3

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

7.6

5.7

6.6

*

12.8

7.7

% Very low birthweight

*

*

*

*

*

1.5

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

6.4

*

6.6

*

13.1

6.6

% Multiple gestation

*

*

*

*

*

1.5

% Birth defect

*

*

*

*

*

2.1

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

24.3

20.7

40.7

25.8

38.7

30.2

% with father not named on birth certificate

20.5

17.2

22.0

20.3

21.4

20.3

% with maternal education less than high school

38.5

29.9

25.3

39.1

38.1

33.7

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

19.7

18.1

14.6

12.7

12.8

15.7

% Maternal alcohol use during pregnancy

*

*

*

*

*

1.8

% Interpregnancy interval less than 6 months

12.5

*

8.9

*

*

7.9

Child abuse and neglect rates

Physical

.

*

*

*

*

1.5

Sexual

.

*

3.5

*

*

1.3

Neglect

.

3.5

12.4

6.6

7.9

7.6

Interventions to improve infant & child survival

% Prenatal care first trimester

63.3

75.0

76.9

83.6

80.2

75.7

% Primary C-section delivery

16.9

24.7

17.1

17.7

11.6

17.8

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

56.4

59.8

63.7

56.5

69.0

61.4

% Medicaid during pregnancy

55.1

49.4

62.6

56.5

69.0

58.7

% Medicaid and WIC during pregnancy

38.5

37.9

53.8

47.8

63.1

48.4

% Perinatal case management

.

*

*

23.2

53.6

19.0

Miller County - 100

8.6 46.0
1.4 17.9
* * * * 8.3
* * * * * * *
* * * * * *
* * * * * *
16.2 *
33.3 *
32.4 * *
. . .
66.7 21.6
* 43.6 28.2 17.9
.

11.2 60.4
1.9 14.0
1.1 5.9 0.2 79.4 8.3
* * * * * * *
* * * * * *
* * * * * *
11.1 10.0 22.0
* 30.4
* *
* * *
84.3 29.2
* 48.0 34.0 24.0
*

11.3 60.8 1.9 15.7
* * * * *

8.4 45.5
1.4 18.4
1.3 7.2
* 120.0
7.2

55.1 *
55.1 * * * *

54.2 *
54.2 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

29.5 *
11.8 *
22.7 * *

21.2 *
36.8 *
20.6 * *

*

*

4.7

*

15.1

*

90.2 15.9
* 54.9 49.0 43.1
*

86.5 25.7
* 42.1 39.5 34.2 18.4

9.6 51.7 1.6 23.8
* * * * *
* * * * * * *
* * * * * *
* * * * * *
31.4 *
28.6 *
25.0 * *
* * 4.8
83.7 * *
47.6 52.4 42.9 35.7

9.8 52.9
1.6 17.7
0.9 4.8 0.1 76.0 5.0
41.9 *
37.5 35.3
* * *
* * * 26.5 * *
5.9 * *
4.1 *
3.0
21.6 8.2
25.5 *
26.4 *
4.2
* 1.7 5.7
82.8 20.7
* 47.7 40.9 32.7 12.7

23.2 94.8
2.5 43.6
* * * * *

21.5 87.9
2.3 75.7
* * * * *

* 114.3

*

*

* 114.3

*

83.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

32.4 33.3 43.6
* * * 18.5

32.4 27.0 40.5
* * * *

.

*

.

*

.

*

60.0 * *
69.2 82.1 59.0
.

62.2 18.2
* 75.7 70.3 56.8
*

23.3 95.7 2.6 65.0
* * * * *
94.3 *
94.3 * * * *
* * * * * *
* * * * * *
54.1 40.0 42.5
* * * *
* * 8.1
60.0 18.4
* 75.0 80.0 67.5
*

18.1 74.4
1.9 64.5
* * * * 12.0

25.2 103.6
2.7 76.2
* * * * *

22.2 91.3
2.4 65.1
0.6 2.4 0.1 23.7 7.2

* 110.5

*

*

* 110.5

* 100.0

*

*

*

*

*

*

82.8 31.8 82.8 81.8
* * *

*

*

26.2

*

*

*

*

*

*

*

*

25.9

*

*

*

*

*

*

*

18.6

9.9

*

*

*

*

*

*

*

16.7

9.5

*

*

*

*

*

*

31.0 38.7 41.9
* * * *

45.0 33.3 47.6
* * * *

39.4 34.4 43.4
* 4.3 3.2 11.4

*

*

2.8

*

*

*

14.7

13.2

8.9

80.0

76.7

67.4

*

14.3

14.4

*

*

*

74.2

90.5

77.2

77.4

85.7

79.4

64.5

83.3

66.7

29.0

71.4

26.7

381

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Mitchell County - 101

1990
20275 4528 548
19.1 20.5 21.0
58 16 379 56 194 32
2 12
1
1 1 0 3 1 0
46 7 0
42 6 8
141 82 163
4 46
9 39
. . .
251 54
1 262 210 186
. 0

1991
20353 4543 546
18.8 16.2 21.0
69 16 371 65 216 34
6 12
2
5 4 1 10 1 2
36 8 1
42 4 8
177 107 166
6 33
7 25
0 5 17
255 63 0
255 234 206
61 1

Total
1992 1993

20416 4554 543

20495 4570 540

19.7 17.4 21.0

19.0 21.6 22.0

59

60

16

17

358

328

52

57

187

188

39

29

2

5

20

15

5

0

2

5

2

2

0

3

4

7

1

2

1

2

35

37

6

3

0

1

37

33

7

1

10

15

158

152

89

91

143

136

3

1

43

40

8

9

21

16

12

4

5

7

51

77

255

241

50

42

1

2

228

238

227

247

188

210

27

134

0

3

1994 5-year

20556 4581 538

102095 22776 2715

20.1 19.5 22.0

19.2 18.7 21.0

54

300

14

79

300

1736

48

278

178

963

35

169

4

19

12

71

2

10

3

16

1

10

2

6

6

30

1

6

2

7

36

190

8

32

0

2

36

190

3

21

7

48

117

745

81

450

120

728

1

15

27

189

7

40

17

118

21

37

18

35

92

237

229

1231

40

249

3

7

213

1196

204

1122

181

971

158

380

1

5

1990
10414 2099 215

1991
10443 2101 215

White
1992 1993

10465 2101 215

10492 2102 214

1994 5-year

10512 2102 214

52326 10505
1074

22.6 17.5 20.0

20.2 22.9 20.0

20.8 22.8 20.0

20.0 18.7 21.0

21.9 19.5 21.0

21.0 19.2 20.0

13

13

14

14

11

65

3

1

2

2

3

11

148

131

150

126

106

661

12

12

13

12

7

56

23

21

23

22

21

110

14

12

9

12

12

59

0

2

0

1

2

5

4

7

9

6

8

34

1

0

0

0

1

2

0

2

0

0

0

2

0

1

0

0

0

1

0

1

0

0

0

1

0

3

0

1

2

6

0

0

1

0

0

1

0

1

1

0

0

2

14

6

5

10

1

2

0

0

0

1

0

0

13

14

12

15

2

1

3

0

3

3

3

4

3

38

0

3

0

1

5

59

0

6

1

14

39

45

49

47

23

203

10

11

11

11

9

52

44

31

46

38

35

194

1

2

0

0

0

3

22

19

24

26

15

106

1

2

3

2

1

9

7

4

4

5

4

24

.

0

7

1

7

15

.

4

3

2

7

16

.

4

10

20

34

68

119

101

130

109

25

24

24

18

1

0

0

1

69

61

73

63

40

45

61

69

33

40

55

49

.

7

9

35

0

0

0

0

96

555

15

106

1

3

56

322

48

263

41

218

39

90

0

0

1990
9647 2391
329

1991
9684 2399 328

Black
1992 1993

9714 2404
326

9752 2412 324

1994 5-year

9781 2417
323

48578 12023
1630

18.5 20.9 24.0

18.2 14.1 22.0

18.9 16.9 28.0

18.4 24.6 24.5

18.7 19.5 24.0

18.5 17.9 24.0

45

56

45

46

43

235

13

15

14

15

11

68

231

239

207

201

192

1070

44

53

39

45

41

222

171

195

164

165

156

851

18

22

30

17

23

110

2

4

2

4

2

14

8

5

11

8

4

36

0

2

5

0

1

8

1

3

2

5

3

14

1

3

2

2

1

9

0

0

0

3

2

5

3

7

4

6

4

24

1

1

0

2

1

5

0

1

0

2

2

5

32

30

30

27

33

152

6

6

6

3

8

29

0

0

0

1

0

1

29

28

25

18

31

131

4

3

4

1

3

15

5

5

7

10

6

33

102

131

108

104

72

96

78

80

119

134

96

97

3

4

2

1

24

14

19

14

8

5

5

7

32

21

17

11

94

539

72

398

85

531

1

11

12

83

6

31

13

94

.

0

0

3

14

17

.

1

2

4

11

18

.

13

38

53

55

159

132

154

125

132

131

674

29

39

26

24

25

143

0

0

1

1

2

4

193

193

155

175

156

872

170

189

166

178

155

858

153

166

133

161

139

752

.

54

18

99

118

289

0

1

0

3

1

5

382

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Mitchell County - 101

18.7 83.7
2.4 52.0
0.6 2.7 0.1 27.8 8.8
105.8 27.6 102.2 87.5
* * *
* * * * * *
12.2 1.9 *
11.3 1.6 2.1
41.1 22.0 43.9
* 12.4
2.4 17.6
. . .
67.3 15.7
* 70.2 56.3 49.9
.

18.2 81.7
2.4 58.9
0.6 2.6 0.1 28.1 9.7
126.5 23.2
119.1 92.3 * * 9.2
13.5 * *
26.5 * *
9.7 2.2
* 11.5
* 2.2
51.0 29.2 45.5
1.7 9.1 1.9 11.8
* 0.8 2.6
70.1 18.8
* 69.5 63.8 56.1 16.6

17.5 78.6 2.3 53.3 1.0 4.4 0.1 46.8 10.8
108.6 27.1 95.7 90.2 9.2
100.0 *
* * * * * *
9.8 1.7
* 10.6
2.0 2.8
47.6 25.4 40.7
* 12.4 2.3 10.0
1.9 0.8 8.0
72.2 15.8
* 65.0 64.7 53.6 7.7

16.0 71.8
2.1 57.5
0.7 3.3 0.1 39.6 7.9
111.1 28.3
105.5 91.1 * * *
15.2 * *
21.0 * *
11.3 * *
10.1 *
4.6
49.4 27.8 41.6
* 12.3
2.8 8.3
* 1.1 12.0
73.9 14.2
* 72.8 75.5 64.2 41.0

14.6 65.5 1.9 59.9 0.6 2.6 0.1 34.2
8.5
100.4 25.9 89.3 85.4 * * *
* * * 19.7 * *
12.0 2.7
* 12.1
* 2.3
41.2 27.3 40.4
* 9.2 2.4 9.7
3.3 2.8 14.4
76.3 15.0
* 71.7 68.7 60.9 53.2

17.0 76.2
2.2 56.2
0.7 3.1 0.1 35.2 9.1
110.5 26.3 102.4 89.5
3.7 100.0
6.6
9.2 5.8 3.5 17.1 0.9 0.3
11.0 1.8 *
11.1 1.2 2.8
46.2 26.2 42.5
0.9 11.1
2.4 11.6
1.4 1.4 9.2
71.7 16.0
4.5 69.7 65.4 56.6 28.3

14.2 70.5
2.2 15.8
* * * * 7.6
60.5 *
55.8 50.0
* * *
* * * * * *
9.5 * *
8.9 * *
28.5 6.8
30.3 *
15.2 *
8.9
. . .
81.5 18.9
* 47.3 27.4 22.6
.

12.5 62.4
2.0 16.2
0.7 3.3 0.1 45.8 7.1
60.5 *
55.8 75.0
* * *
* * * * * *
4.6 * *
10.9 * *
35.7 8.5
23.8 *
15.0 * *
* * *
77.7 21.1
* 46.9 34.6 30.8
5.4

14.3 71.4 2.2 15.6 0.9 4.3 0.1 52.3
6.2
65.1 *
60.5 61.5
* * *
* * * * * *
3.3 * *
8.2 * *
34.8 7.5 31.3
* 16.4
* *
2.7 *
3.8
87.2 17.9
* 49.7 41.5 37.4
6.1

12.0 59.9
1.8 17.5
0.6 2.9 0.1 41.1 6.7
65.3 *
56.0 58.3
* * *
* * * * * *
7.9 * *
11.9 * *
38.5 8.7
30.2 *
20.8 *
7.4
* * 7.7
86.5 15.9
* 50.0 54.8 38.9 27.8

10.1 50.4 1.6 19.8 0.8 3.8 0.1 62.5
6.7
51.3 *
32.6 * * * *
* * * * * *
* * * 4.7 * *
22.8 8.5
33.0 *
14.4 * *
2.7 2.7 13.1
90.6 15.3
* 52.8 45.3 38.7 36.8

12.6 62.9
2.0 16.8
0.6 3.2 0.1 44.3 6.9
60.5 16.9 52.2 55.4
* * 6.5
* * * 9.0 * *
5.8 * *
9.0 0.9 2.1
32.4 7.9
29.7 *
16.4 1.4 6.5
1.4 1.5 6.5
84.5 17.9
* 49.2 40.2 33.3 17.7

23.9 96.6
2.6 75.3
0.8 3.3 0.1 30.4 10.0

24.7 99.6
2.7 82.6
0.5 2.1 0.1 18.3 12.1

21.3 86.1 2.3 80.8 1.1 4.6 0.1 43.3 15.0

20.6 83.3
2.2 82.5
0.8 3.3 0.1 34.6 9.1

19.6 79.4 2.1 82.5
* * * * 10.3

22.0 89.0
2.4 80.7
0.7 3.0 0.1 29.0 11.3

136.8 28.9 133.7 97.7
* * *

171.0 26.8
161.8 96.2 * * *

138.0 31.1
119.6 100.0
15.3 100.0
*

141.8 32.6
138.8 100.0
* * *

133.2 25.6
127.0 97.6 * * *

144.2 28.9
136.2 98.2 4.9 100.0 6.7

*

*

*

*

*

*

*

28.8

*

*

*

*

*

24.9

*

*

*

*

*

29.3

*

*

*

*

*

13.1

*

8.4

*

4.7

*

22.1

*

1.3

*

*

14.0 2.6 *
12.8 *
2.2

12.6 2.5 *
11.9 *
2.1

14.6 2.9
* 12.4
* 3.4

13.4 * *
9.0 *
5.0

17.2 4.2 * 16.4 * 3.1

14.3 2.7 *
12.4 1.4 3.1

49.5 31.7 52.7
* 10.7
3.6 22.4

59.5 40.7 57.3
* 6.0 2.1 15.3

56.8 38.4 47.3
* 9.5 2.5 13.3

56.2 40.0 48.5
* 7.0 3.5 8.9

51.9 38.1 45.0
* 6.3 3.2 11.8

54.9 37.7 50.5
1.1 7.9 3.0 14.6

.

*

*

*

3.8

1.1

.

*

*

*

2.9

1.2

.

3.5

10.2

14.2

14.7

10.6

58.1 13.6
* 85.0 74.9 67.4
.

66.1 17.6
* 81.8 80.1 70.3 22.9

61.6 14.4
* 76.4 81.8 65.5 8.9

66.3 13.3
* 87.5 89.0 80.5 49.5

68.2

63.9

15.1

14.9

*

*

82.5

82.7

82.0

81.3

73.5

71.3

62.4

34.9

383

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Monroe County - 102

1990
17113 3943 394
20.7 19.7 21.0
40 6
264 29 80 22
4 70 10
5 3 2 7 0 1
21 2 0
28 3 2
65 38 72
4 48
2 11
. . .
172 42
7 103 99 62
. 0

1991
17383 3982 398
21.4 18.0 21.0
47 12 290 31 115 12
3 62 12
2 1 1 4 0 1
32 6 0
33 4 1
76 53 70
7 31
7 7
3 9 51
183 37 5
139 128 102
0 0

Total
1992 1993

17640 4019 401

17906 4058 404

21.0 17.2 21.5

21.6 17.8 21.0

22

33

4

5

254

283

16

22

80

100

8

15

1

0

65

64

6

11

4

4

1

2

3

2

2

2

0

0

1

2

21

28

5

7

0

1

26

30

2

4

4

5

79

98

40

49

68

61

8

4

50

41

4

8

20

15

7

7

13

15

51

43

181

206

19

42

10

5

122

136

119

155

93

121

21

55

0

1

1994 5-year

18168 4095 407

88210 20097
2004

20.5 20.5 22.0

21.0 18.6 22.0

41

183

5

32

286

1377

34

132

115

490

6

63

8

16

53

314

8

47

3

18

1

8

2

10

9

24

0

0

0

5

30

132

6

26

0

1

33

150

5

18

0

12

103

421

56

236

74

345

6

29

36

206

5

26

13

66

3

20

7

44

42

187

214

956

29

169

5

32

132

632

154

655

111

489

54

130

3

4

1990
11597 2548 233

1991
11893 2598 242

White
1992 1993

12184 2646 250

12479 2697 259

1994 5-year

12773 2746 267

60926 13235
1251

20.9 19.8 20.0

23.7 18.1 20.5

21.0 17.6 21.0

23.8 17.2 21.0

20.5 20.8 22.0

22.2 18.3 21.0

20

19

15

13

26

93

1

5

1

1

1

9

162

166

158

174

178

838

18

12

12

6

22

70

15

24

15

27

39

120

12

6

7

6

2

33

1

0

0

0

0

1

30

30

31

25

19

135

2

4

3

7

4

20

3

1

3

2

2

11

2

0

0

1

0

3

1

1

3

1

2

8

3

0

0

1

0

4

0

0

0

0

0

0

0

0

0

0

0

0

12

15

8

11

9

55

1

4

1

1

2

9

0

0

0

0

0

0

15

15

13

13

11

67

1

3

1

2

3

10

1

1

2

4

0

8

44

39

42

51

51

227

7

10

6

9

17

49

42

32

41

31

42

188

0

3

1

1

1

6

36

22

36

34

28

156

1

1

1

3

2

8

4

2

6

5

5

22

.

2

3

5

2

12

.

3

12

9

5

29

.

19

20

28

22

89

127

123

126

147

153

676

31

24

13

25

15

108

3

4

6

4

2

19

38

54

54

55

63

264

38

45

50

63

69

265

21

37

39

47

52

196

.

0

8

15

23

46

0

0

0

0

2

2

1990
5406 1364
158

1991
5491 1377 160

Black
1992 1993

5573 1388
161

5657 1401 162

1994 5-year

5739 1413
163

27866 6943 804

20.6 19.8 25.0

20.0 17.1 23.5

21.1 16.7 26.5

20.0 19.1 24.0

20.4 19.1 25.0

20.1 18.6 25.0

19

28

5

7

101

121

11

19

65

91

10

6

3

3

37

28

7

8

7

20

15

89

3

4

4

23

95

108

108

533

4

16

12

62

65

73

76

370

1

9

4

30

1

0

8

15

33

38

33

169

3

4

4

26

2

1

1

2

1

7

1

1

1

1

1

5

1

0

0

1

0

2

4

4

2

1

9

20

0

0

0

0

0

0

1

1

1

2

0

5

9

17

13

17

21

77

1

2

4

6

4

17

0

0

0

1

0

1

13

18

13

17

22

83

2

1

1

2

2

8

1

0

2

1

0

4

21

37

37

47

52

194

31

43

34

40

39

187

30

38

27

30

32

157

4

4

7

3

5

23

12

9

14

7

8

50

1

6

3

5

3

18

7

5

14

10

8

44

.

0

4

2

1

7

.

5

1

2

2

10

.

17

31

14

13

75

44

58

54

58

61

275

11

13

5

17

14

60

4

1

4

1

3

13

65

83

68

81

69

366

61

82

69

92

85

389

41

64

54

74

59

292

.

0

13

40

31

84

0

0

0

1

1

2

384

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Monroe County - 102

15.4 67.0
2.1 30.7
4.1 17.8
0.6 194.4
6.6
101.5 15.0 73.6 62.1 25.4 100.0
*
18.9 * *
26.1 * *
8.0 * *
10.7 * *
28.3 14.6 27.6
* 18.4
* 7.5
. . .
66.2 17.6 30.4 39.5 37.9 23.8
.

16.7 72.8
2.3 40.5
3.6 15.6
0.5 168.5
4.0
118.2 25.5 77.9 80.6 30.2
100.0 *
* * * * * *
11.0 2.1 *
11.6 * *
30.8 18.7 24.6
2.5 11.0
2.5 4.8
* 1.9 10.8
64.2 14.2 21.7 48.9 45.1 35.9
*

14.4 63.2 2.0 31.7 3.7 16.2 0.5 198.2 2.2
54.9 *
39.9 43.8 15.0 100.0
*
* * * * * *
8.3 2.0
* 10.3
* *
33.6 15.9 27.0
3.2 19.9
* 12.1
1.5 2.7 10.7
71.8 8.6 32.3 48.4 47.2 36.9 8.3

15.8 69.7
2.2 35.8
3.6 15.8
0.5 176.8
3.7
81.6 15.2 54.4 86.4 27.2 100.0
*
* * * * * *
9.9 2.5
* 10.8
* 1.8
37.4 17.6 21.9
* 14.7
2.9 9.4
1.4 3.1 8.8
73.0 17.3 13.9 48.7 55.6 43.4 19.7

15.7 69.8 2.2 40.9 2.9 12.9 0.4 149.3 3.9
100.6 12.2 83.5 75.8 19.6
100.0 *
* * * 30.6 * *
10.5 2.1
* 11.8
1.8 *
37.5 19.9 26.4
2.1 12.8
1.8 8.1
* 1.4 8.5
75.1 11.3 20.0 47.0 54.8 39.5 19.2

15.6 68.5
2.2 36.1
3.6 15.6
0.5 177.1
4.1
91.3 17.5 65.9 71.8 23.5 100.0
2.5
13.1 5.8 7.3
17.2 * *
9.6 1.9
* 11.1
1.3 0.9
33.7 17.4 25.4
2.2 15.2
1.9 8.5
1.0 2.3 9.7
70.1 13.9 23.2 46.6 48.3 36.0 11.9

14.0 63.6
2.0 9.3 2.6 11.8 0.4 146.3 5.1

14.0 63.9
2.0 14.9
2.5 11.5
0.4 148.5
2.3

13.0 59.7 1.9
9.6 2.5 11.7 0.4 158.2 2.6

13.9 64.5
2.1 15.7
2.0 9.3 0.3 122.0 2.2

85.8 *
77.3 38.9
* * *

78.5 26.3 49.6 50.0
* * *

60.0 *
48.0 * * * *

50.2 *
23.2 *
27.0 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

7.4

9.0

5.1

6.3

*

*

*

*

*

*

*

*

9.3

9.3

8.3

7.6

*

*

*

*

*

*

*

*

28.9 4.3
26.1 *
22.4 * *

26.9 6.2
19.9 *
13.8 * *

28.6 3.8 26.1
* 23.1
* 6.3

31.3 5.2
18.0 *
19.8 *
4.8

.

*

*

1.5

.

*

3.7

2.7

.

6.1

6.2

8.5

78.9 21.5
* 23.6 23.6 13.0
.

75.5 16.3
* 33.5 28.0 23.0
*

79.7 9.8 25.0 34.4 31.8 24.8 5.1

84.5 17.5
* 32.0 36.6 27.3
8.7

13.9 64.8 2.1 22.3 1.5
6.9 0.2 94.5
*

13.8 63.3
2.0 14.5
2.2 10.2
0.3 133.8
2.7

97.3 *
82.3 63.6
* * *

74.3 9.7
55.9 47.1 16.0 100.0
*

*

13.1

*

*

*

9.6

*

*

*

*

*

*

5.1

6.6

*

1.1

*

*

6.3

8.1

*

1.2

*

1.0

29.7 9.7
24.1 *
16.0 *
5.4

29.1 5.9
22.8 0.7
18.9 1.0 4.8

*

0.9

1.5

2.2

6.5

6.8

86.4 9.4
* 36.0 39.4 29.7 13.1

81.2 14.9 19.2 32.0 32.1 23.7
6.9

18.7 74.0
2.2 65.7
6.8 27.1
0.8 245.0
9.5

22.0 87.9
2.6 75.8
5.1 20.3
0.6 176.1
7.3

17.0 68.4 2.0 69.1 5.9 23.8 0.7 253.8
*

19.1 77.1
2.3 68.9
6.7 27.1
0.8 245.2
6.4

18.8 76.4 2.4 71.7 5.7 23.4 0.7 215.7 8.5

19.1 76.8
2.3 70.5
6.1 24.3
0.7 225.9
6.6

120.3 26.3 69.6
100.0 44.3 100.0
*

175.5 25.0
119.1 100.0
50.2 100.0
*

43.6 * * * * * *

123.3 *
98.6 100.0
* * *

91.8 *
73.4 100.0
* * *

110.7 25.8 77.1 100.0 32.3 100.0 *

*

*

*

*

*

13.1

*

*

*

*

*

9.4

*

*

*

*

*

*

*

*

*

*

77.6

36.5

*

*

*

*

*

*

*

*

*

*

*

*

8.9 * *
13.1 * *

14.0 * *
15.0 * *

13.7 * *
13.8 * *

15.7 5.6 *
16.0 * *

19.4 * *
20.8 * *

14.4 3.2 *
15.8 1.5 *

26.9 31.3 30.3
* 12.1
* 12.1

36.3 35.8 31.7
* 7.5 5.0 7.9

42.0 36.2 28.7 7.5 14.9
* 20.3

48.0 37.7 28.3
* 6.6 4.7 18.2

50.5 36.8 30.2 4.7 7.5
* 11.9

41.4 35.6 29.9
4.4 9.5 3.4 14.1

.

*

*

*

*

1.1

.

3.2

*

*

*

1.5

.

10.7

19.2

8.5

7.8

11.5

44.9 11.8
* 65.7 61.6 41.4
.

48.7 11.7
* 69.2 68.3 53.3
*

58.1 5.7
* 72.3 73.4 57.4 13.8

54.2 17.2
* 76.4 86.8 69.8 37.7

56.5

52.4

14.6

12.3

*

33.3

65.1

69.7

80.2

74.1

55.7

55.6

29.2

19.7

385

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Montgomery County - 103

1990
7163 1675
165
20.7 21.6 21.0
10 1
90 10 39 11
1 9 0
0 0 0 1 1 0
7 1 0 9 1 1
29 18 26
0 10
0 4
. . .
65 20
0 54 43 37
. 0

1991
7233 1690 165
19.7 20.7 22.0
15 4
102 13 41 5 1 14 2
1 1 0 2 0 0
8 1 0 6 2 0
28 24 37
1 9 1 5
0 0 1
71 14
2 65 45 41 25
0

Total
1992 1993

7301 1708
165

7379 1725 165

20.9 18.5 22.5

21.1 17.5 20.0

19

10

4

1

107

105

14

8

41

36

16

5

2

0

10

7

2

2

1

0

0

0

1

0

2

0

0

0

0

1

6

11

3

1

0

0

7

11

1

2

2

3

23

31

12

16

36

32

0

0

18

14

1

1

6

7

6

8

2

4

12

19

58

73

23

14

0

0

69

76

60

64

53

56

45

38

0

0

1994 5-year

7446 1742
165

36522 8540 825

19.8 19.0 21.0

20.5 18.8 21.0

12

66

1

11

109

513

11

56

30

187

13

50

0

4

12

52

1

7

0

2

0

1

0

1

0

5

0

1

1

2

7

39

1

7

0

0

6

39

3

9

5

11

26

137

14

84

38

169

2

3

12

63

1

4

5

27

3

17

6

12

13

45

73

340

12

83

0

2

66

330

62

274

50

237

42

150

0

0

1990
4998 1148
104

1991
5046 1160 105

White
1992 1993

5093 1176
106

5147 1189 107

1994 5-year

5193 1203
108

25477 5876 531

20.7 21.1 20.0

21.4 19.5 22.0

21.0 18.8 22.0

22.3 17.9 19.0

21.7 19.0 20.5

21.1 18.8 21.0

6

7

11

5

10

39

0

0

2

0

0

2

50

60

69

68

86

333

6

5

8

4

9

32

11

12

18

15

16

72

8

3

9

2

12

34

0

0

1

0

0

1

6

10

9

4

9

38

0

2

1

1

1

5

0

0

1

0

0

1

0

0

0

0

0

0

0

0

1

0

0

1

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

1

1

2

3

4

3

6

6

22

0

1

2

1

1

5

0

0

0

0

0

0

6

3

6

7

6

28

1

1

1

1

2

6

0

0

2

2

5

9

15

16

12

19

20

82

4

6

8

8

7

33

15

25

25

23

33

121

0

1

0

0

2

3

6

6

12

10

12

46

0

0

1

1

1

3

0

3

2

5

4

14

.

0

5

7

2

14

.

0

2

3

6

11

.

1

6

12

4

23

41

46

46

51

62

246

13

6

16

8

11

54

0

2

0

0

0

2

22

29

36

44

48

179

17

20

34

34

44

149

15

17

27

29

35

123

.

10

23

20

31

84

0

0

0

0

0

0

1990
2026 503 57

1991
2046 508
57

Black
1992 1993

2065 513 57

2087 518
57

1994 5-year

2106 523 57

10330 2565 285

20.4 21.6 26.0

19.1 22.0 22.0

20.2 17.0 27.0

20.3 15.2 26.0

18.6 23.9 23.0

19.7 20.0 25.0

4

8

8

5

2

27

1

4

2

1

1

9

39

42

38

37

23

179

4

8

6

4

2

24

28

29

23

21

14

115

3

2

7

3

1

16

1

1

1

0

0

3

3

4

1

3

2

13

0

0

1

1

0

2

0

1

0

0

0

1

0

1

0

0

0

1

0

0

0

0

0

0

1

2

1

0

0

4

1

0

0

0

0

1

0

0

0

0

0

0

4

4

3

5

1

17

1

0

1

0

0

2

0

0

0

0

0

0

3

3

1

4

0

11

0

1

0

1

1

3

1

0

0

1

0

2

14

12

11

12

14

18

4

8

11

12

11

9

0

0

0

0

4

3

6

4

0

1

0

0

4

2

4

2

6

55

7

51

5

48

0

0

0

17

0

1

1

13

.

0

1

0

1

2

.

0

0

1

0

1

.

0

3

7

5

15

24

25

12

22

11

94

6

8

7

6

1

28

0

0

0

0

0

0

31

36

33

32

18

150

25

25

26

30

18

124

21

24

26

27

15

113

.

15

22

18

11

66

0

0

0

0

0

0

386

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Montgomery County - 103

12.6 53.7
1.5 43.8
1.3 5.4 0.1 80.4 7.8

14.1 60.4
1.7 41.0
1.9 8.3 0.3 113.8 4.1

14.7 62.6 1.8 39.0 1.4 5.9 0.2 74.1 10.5

14.2 60.9
1.7 35.0
0.9 4.1 0.1 59.8 2.9

60.6 *
60.6 50.0
* * *

90.9 *
78.8 84.6
* * *

115.2 *
84.8 57.1
* * *

60.6 *
48.5 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

7.8

7.8

5.6

10.5

*

*

*

*

*

*

*

*

10.1

6.0

6.7

10.7

*

*

*

*

*

*

*

*

38.7 20.2 29.2
* 11.2
* *

33.7 24.0 37.4
* 9.2
* 9.6

28.7 11.4 34.3
* 17.5
* 10.3

39.7 15.5 31.7
* 13.6
* 11.5

.

*

3.2

4.3

.

*

*

*

.

*

6.4

10.1

72.2 24.1
* 60.7 48.3 41.6
.

72.4 15.9
* 65.0 45.0 41.0 25.0

61.7 23.5
* 65.7 57.1 50.5 42.9

70.2 16.3
* 73.8 62.1 54.4 36.9

14.6 62.6 1.7 28.3 1.6 6.9 0.2 89.6
7.5

14.0 60.1
1.7 37.2
1.4 6.1 0.2 83.7 6.6

72.7 *
66.7 63.6
* * *

80.0 16.7 67.9 69.6
8.5 100.0
6.1

*

*

*

*

*

*

*

9.7

*

*

*

*

6.4

7.6

*

1.4

*

*

5.7

7.8

*

1.8

4.6

2.2

26.8 13.2 35.8
* 11.3
* 8.6

33.2 16.7 33.8
* 12.6
* 10.0

*

2.3

3.2

1.6

6.9

6.0

67.0 12.4
* 62.3 58.5 47.2 39.6

68.7 18.4
* 65.6 54.5 47.1 36.2

10.0 43.6
1.2 22.4
1.2 5.2 0.1 92.3 7.8

11.9 51.7
1.5 20.3
2.0 8.6 0.3 137.0
*

13.5 58.7 1.7 26.5 1.8 7.7 0.2 102.3
8.5

57.7 *
57.7 * * * *

66.7 *
47.7 * * * *

103.4 *
75.2 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

* * * 12.2 * *

*

*

*

*

*

*

*

8.8

*

*

*

*

42.9 *
30.6 *
12.2 * *

35.6 10.2 42.4
* 10.5
* *

24.0 11.8 36.8
* 17.9
* *

.

*

4.1

.

*

*

.

*

4.9

82.0 27.7
* 44.9 34.7 30.6
.

78.0 11.3
* 49.2 33.9 28.8 16.9

76.7 25.0
* 52.9 50.0 39.7 33.8

13.2 57.2
1.6 22.4
* * * * *
46.6 * * * * * *
* * * * * *
8.8 * *
10.4 * *
38.0 11.9 34.8
* 14.9
* 13.2
5.7 *
9.8
76.1 14.0
* 65.7 50.7 43.3 29.9

16.6 71.5 2.0 19.0 1.7 7.5 0.2 84.1 10.0

13.1 56.7
1.6 22.0
1.5 6.5 0.2 93.4 6.1

92.3 *
83.1 55.6
* * *

73.5 *
60.3 46.9
9.4 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

7.0

6.6

*

1.5

*

*

7.1

8.6

*

1.8

5.8

2.7

26.7 8.3 39.3
* 14.3
* *

32.2 10.1 37.1
* 14.2
* 8.3

*

2.9

4.9

2.2

*

4.7

72.1 14.1
* 57.1 52.4 41.7 36.9

76.4 18.1
* 54.7 45.6 37.6 30.2

19.2 77.5
2.0 71.8
* * * * *

20.5 82.7
2.2 70.7
* * * * *

18.4 74.1 2.0 62.2
* * * * 15.6

* 140.4 140.4

*

*

*

* 140.4 105.3

* 100.0 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

35.9 35.9 28.2
* * * *

31.6 43.9 30.0
* * * *

36.7 *
29.7 *
16.7 * *

.

*

*

.

*

*

.

*

*

61.5 17.1
* 79.5 64.1 53.8
.

64.1 22.9
* 87.8 61.0 58.5 36.6

35.3 20.6
* 89.2 70.3 70.3 59.5

17.7 71.4
2.0 58.3
* * * * *
87.7 * * * * * *
* * * * * *
13.5 * * * * *
42.9 22.2 25.7
* * * *
* * 11.8
59.5 20.7
* 88.9 83.3 75.0 50.0

10.9 44.0 1.1 63.6
* * * * *

17.3 69.8
1.9 65.7
1.3 5.1 0.1 61.3 7.8

*

94.7

*

33.3

*

84.2

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

9.5

*

*

*

*

*

6.3

*

*

*

*

27.3 31.8 22.7
* * * *

35.0 29.1 27.7
* 9.8
* 12.7

*

*

*

*

8.4

6.3

47.8

54.7

*

18.4

*

*

81.8

85.7

81.8

70.9

68.2

64.6

50.0

48.5

387

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Morgan County - 104

1990
12883 2886 289
19.2 18.6 21.0
47 14 209 38 88 12
5 49
9
0 0 0 5 0 3
21 5 0
16 2 2
67 47 71
9 34
2 7
. . .
133 24
1 90 91 64
. 0

1991
13109 2912 289
20.3 18.1 22.0
26 5
214 18 87 16 1 65 8
4 3 1 4 0 4
21 5 0
26 5 2
60 44 55
2 27
3 14
1 2 6
151 34 5
101 96 74 13 3

Total
1992 1993

13329 2937 288

13555 2962 288

20.6 18.4 21.0

20.6 18.9 22.0

31

32

8

8

213

192

23

23

84

92

11

5

0

1

61

66

7

8

0

2

0

0

0

2

0

1

0

0

0

1

26

17

3

3

0

0

24

21

3

2

5

6

46

62

44

44

63

58

4

1

21

22

3

5

14

7

3

9

1

5

1

39

144

130

27

25

3

4

114

104

127

115

100

89

76

62

0

0

1994 5-year

13778 2986 288

66654 14683
1443

20.6 22.3 23.0

20.4 18.7 22.0

21

157

4

39

190

1018

17

119

80

431

9

53

0

7

33

274

4

36

0

6

0

3

0

3

0

10

0

0

3

11

14

99

0

16

0

0

16

103

4

16

0

15

52

287

34

213

51

298

2

18

26

130

5

18

11

53

5

18

6

14

9

55

145

703

24

134

6

19

94

503

109

538

82

409

57

208

3

6

1990
8355 1759
166

1991
8576 1791
168

White
1992 1993

8795 1823
171

9015 1854
173

1994 5-year

9235 1886
175

43976 9113 853

21.5 19.1 21.0

20.4 20.1 21.0

21.0 18.6 20.0

21.4 20.3 21.0

20.9 20.9 21.0

20.9 19.6 21.0

17

2

14

14

9

56

5

0

3

1

0

9

116

106

129

107

111

569

15

2

8

10

7

42

17

14

22

21

21

95

6

7

7

3

8

31

3

0

0

1

0

4

13

29

32

28

19

121

2

0

5

4

2

13

0

3

0

0

0

3

0

3

0

0

0

3

0

0

0

0

0

0

3

3

0

1

0

7

0

0

0

0

0

0

1

2

0

1

2

6

10

7

10

10

8

45

3

4

0

3

0

10

0

0

0

0

0

0

7

9

11

15

8

50

1

2

1

2

3

9

1

2

3

4

0

10

32

25

29

30

24

140

7

6

10

7

7

37

29

26

31

22

27

135

1

0

0

1

1

3

29

20

19

18

22

108

0

2

0

1

4

7

3

5

5

1

4

18

.

0

1

7

3

11

.

2

0

2

6

10

.

0

0

9

6

15

89

89

99

85

90

452

15

14

17

16

14

76

0

2

3

1

3

9

40

40

58

40

44

222

38

36

65

46

46

231

27

30

51

33

34

175

.

6

38

19

23

86

0

1

0

0

2

3

1990
4459 1112
123

1991
4537 1121 123

Black
1992 1993

4613 1129
123

4692 1138 123

1994 5-year

4769 1146
123

23070 5645 614

18.2 18.2 22.0

19.7 15.9 23.5

18.8 18.2 24.0

19.8 18.9 27.0

19.4 22.3 27.5

19.1 18.4 25.0

30

24

17

18

12

101

9

5

5

7

4

30

92

108

84

85

77

446

23

16

15

13

10

77

71

73

62

71

59

336

6

9

4

2

1

22

2

1

0

0

0

3

36

36

28

37

14

151

7

8

2

4

2

23

0

1

0

2

0

3

0

0

0

0

0

0

0

1

0

2

0

3

2

1

0

0

0

3

0

0

0

0

0

0

2

2

0

0

1

5

11

14

16

7

6

54

2

1

3

0

0

6

0

0

0

0

0

0

9

17

13

6

8

53

1

3

2

0

1

7

1

0

2

2

0

5

35

35

17

32

27

146

40

38

34

37

27

176

42

29

32

36

24

163

8

2

4

0

1

15

5

7

2

4

4

22

2

1

3

4

1

11

4

9

9

6

7

35

.

0

0

2

2

4

.

0

1

3

0

4

.

3

1

30

3

37

43

62

45

45

53

248

9

20

10

9

10

58

1

3

0

3

2

9

50

61

56

64

50

281

53

60

62

69

63

307

37

44

49

56

48

234

.

7

38

43

34

122

0

2

0

0

1

3

388

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Morgan County - 104

16.2 72.4
2.2 42.7
3.8 17.0
0.5 176.9
6.6
162.6 29.8 131.5 73.7 31.1 100.0
*
* * * 23.4 * *
10.0 2.4 * 7.8 * *
38.7 22.8 34.5
4.5 16.7
* 6.7
. . .
65.5 12.9
* 43.7 44.2 31.1
.

16.3 73.5
2.2 41.6
5.0 22.3
0.6 219.6
5.8
90.0 19.2 62.3 83.3 27.7 100.0
*
* * * * * *
9.8 2.3
* 12.4
2.4 *
35.5 21.1 26.6
* 14.1
* 12.4
* * 1.7
73.3 18.2 22.7 48.3 45.9 35.4
6.2

16.0 72.5 2.2 40.2 4.6 20.8 0.6 214.0 3.7
107.5 25.8 79.8 82.6 24.3
100.0 *
* * * * * *
12.2 * *
11.5 *
2.3
27.4 21.1 30.4
* 11.6
* 11.1
* * *
72.4 14.5
* 54.5 60.8 47.8 36.4

14.2 64.8
2.0 48.7
4.9 22.3
0.7 249.1
2.4
111.0 25.0 79.8 91.3 27.7
100.0 *
* * * * * *
8.9 * *
11.1 *
3.1
38.5 23.3 31.0
* 12.7
2.9 6.7
2.4 1.4 10.6
73.9 14.5
* 55.0 60.8 47.1 32.8

13.8 63.6 2.0 43.0 2.4 11.1 0.3 142.2 3.0
73.0 *
59.1 64.7
* * *
* * * * * *
7.4 * *
8.6 * *
28.6 18.3 27.7
* 14.1
2.7 11.2
1.3 1.6 2.4
79.7 14.4 31.6 50.5 58.6 44.1 30.6

15.3 69.3
2.1 43.1
4.1 18.7
0.6 202.2
4.3
108.8 24.8 82.5 79.0 25.0 100.0
*
5.9 * *
9.8 *
0.8
9.7 1.6
* 10.3
1.6 1.5
33.6 21.3 30.1
1.9 13.9
1.9 9.7
1.2 1.0 3.7
72.8 14.9 19.0 50.4 53.9 40.9 26.2

13.9 65.9
2.1 14.8
1.6 7.4 0.2 93.5 5.7

12.4 59.2
1.9 13.3
3.4 16.2
0.5 204.2
3.9

14.7 70.8 2.3 17.3 3.6 17.6 0.6 190.5 3.8

11.9 57.7
1.8 20.2
3.1 15.1
0.5 200.0
2.7

12.0 58.9 1.9 19.4 2.1 10.1 0.3 137.7 4.2

12.9 62.4
2.0 17.0
2.8 13.3
0.4 166.4
4.1

102.4 29.4 90.4 33.3
* * *

*

82.0

*

*

*

46.9

*

*

*

29.3

* 100.0

*

*

80.9 *
57.8 80.0
* * *

51.3 *
39.9 * * * *

65.6 16.1 49.2 45.2 15.2 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

12.2

*

*

*

*

*

*

*

*

*

*

*

0.7

8.6

6.6

7.8

9.3

7.2

7.9

*

*

*

*

*

1.8

*

*

*

*

*

*

6.1

8.6

8.7

14.4

7.4

9.0

*

*

*

*

*

1.6

*

*

*

*

*

1.8

34.8 6.1
25.2 *
25.7 * *

30.9 5.7
24.8 *
20.8 *
8.2

27.9 7.9 24.8
* 17.3
* 7.0

33.3 6.7
21.2 *
19.4 * *

22.6 6.5
25.2 *
20.6 * *

29.6 6.6
24.3 *
20.8 1.3 5.8

.

*

*

3.0

*

1.2

.

*

*

*

2.5

1.1

.

*

*

3.9

2.5

1.6

80.2 14.7
* 34.8 33.0 23.5
.

86.4 14.7
* 38.1 34.3 28.6
5.7

80.5 15.3
* 45.7 51.2 40.2 29.9

83.3 16.8
* 38.5 44.2 31.7 18.3

83.3 14.7
* 40.7 42.6 31.5 21.3

82.6 15.3 14.8 39.7 41.3 31.3 19.4

20.6 82.7
2.3 78.9
8.1 32.4
0.9 262.8
8.1

23.8 96.4
2.7 70.2
7.9 32.1
0.8 233.8
8.9

18.2 74.4 2.1 75.6 6.1 24.8 0.7 241.4
*

18.1 74.7
2.1 83.5
7.9 32.5
0.9 298.4
*

16.1 67.2 1.9 77.6 2.9 12.2 0.3 152.2
*

19.3 79.0
2.2 76.9
6.5 26.8
0.7 242.4
4.6

243.9 30.0 187.0 100.0 56.9 100.0
*

195.1 20.8
130.1 93.8 65.0
100.0 *

138.4 29.4
122.1 100.0
* * *

146.6 38.9
105.9 100.0
* * *

98.0 *
81.6 90.0
* * *

164.5 29.7 125.4 97.4 37.5 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

1.0

12.0 * *
10.0 * *

13.0 * *
16.3 * *

19.0 * *
15.9 * *

8.2

7.8

12.1

*

*

1.3

*

*

*

7.1

10.5

12.1

*

*

1.6

*

*

1.1

43.8 44.4 46.7
9.0 5.6
* *

39.8 36.5 28.4
* 7.3
* 17.3

26.6 41.5 39.0
* * * 16.4

45.1 43.5 43.4
* * * 13.0

36.5 35.5 32.0
* * * 17.1

38.7 40.3 37.7
3.7 5.3 2.7 14.8

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

21.2

*

6.6

47.3 10.8
* 55.6 58.9 41.1
.

60.2 21.7
* 58.7 57.7 42.3
6.7

59.2 13.3
* 68.3 75.6 59.8 46.3

60.8 11.5
* 75.3 81.2 65.9 50.6

73.6

59.6

14.1

14.5

*

23.7

65.8

64.3

82.9

70.3

63.2

53.5

44.7

35.2

389

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Murray County - 105

1990
26147 6479 617
19.3 18.0 19.0
80 19 458 72 98 23
2 68
7
3 3 0 5 0 2
33 6 1
32 6 3
133 49 207
1 135 16 21
. . .
316 59
6 206 159 137
. 0

1991
26909 6606 621
20.3 21.0 19.0
58 15 450 54 79 26
5 63
1
4 2 2 7 3 4
29 5 0
29 1 3
133 36
187 1
127 13 19
9 15 20
345 58 9
254 182 158
72 0

Total
1992 1993

27667 6728 623

28426 6854 626

20.0 27.6 20.0

20.5 18.5 20.0

55

60

14

7

414

429

48

56

84

91

25

24

5

0

59

61

3

4

3

0

1

0

2

0

6

0

1

0

5

2

27

34

5

6

1

0

29

38

3

3

2

2

124

141

41

43

190

180

2

0

141

139

12

8

15

10

17

26

25

19

50

53

299

306

51

67

10

10

241

248

202

214

176

178

108

93

0

3

1994 5-year

29183 6979 629

138332 33646 3116

20.5 18.7 20.0

20.1 19.0 19.0

64

317

9

64

449

2200

57

287

104

456

36

134

3

15

61

312

4

19

5

15

3

9

2

6

5

23

0

4

0

13

31

154

10

32

0

2

34

162

5

18

4

14

139

670

41

210

166

930

2

6

111

653

6

55

16

81

22

74

19

78

59

182

328

1594

63

298

11

46

231

1180

205

962

169

818

143

416

1

4

1990
25956 6433 612

1991
26694 6553 614

White
1992 1993

27433 6672 616

28171 6791 617

1994 5-year

28907 6911 618

137161 33360 3076

19.4 18.0 19.0

20.2 21.0 19.0

19.9 28.8 20.0

20.5 18.5 20.0

20.4 18.7 20.0

20.1 18.8 19.0

80

58

54

60

63

315

19

15

13

7

9

63

456

445

413

426

448

2188

72

54

48

56

57

287

98

79

83

90

104

454

23

26

25

24

35

133

2

5

5

0

3

15

67

60

56

58

60

301

7

1

2

4

4

18

3

4

3

0

5

15

3

2

1

0

3

9

0

2

2

0

2

6

5

7

6

0

5

23

0

3

1

0

0

4

2

4

5

2

0

13

33

28

27

34

31

153

6

4

5

6

10

31

1

0

1

0

0

2

32

28

29

38

34

161

6

1

3

3

5

18

3

3

2

2

4

14

132

130

123

139

139

663

49

36

41

43

41

210

206

186

190

179

166

927

1

1

2

0

2

6

135

127

141

139

111

653

16

13

12

8

6

55

20

19

15

9

16

79

.

9

16

25

21

71

.

14

24

19

19

76

.

15

46

51

55

167

316

342

299

304

327

1588

59

57

51

67

63

297

6

9

10

10

11

46

205

250

241

246

231

1173

158

179

202

212

205

956

136

155

176

177

169

813

.

71

108

92

143

414

0

0

0

3

1

4

1990
41 7 1

1991
42 7 1

Black
1992 1993

43

45

7

7

1

1

1994 5-year

46

217

8

36

1

5

.

24.7

27.2

.

.

.

.

20.8

.

.

.

.

.

25.4

.

20.8

.

.

0

0

1

0

0

1

0

0

1

0

0

1

1

3

1

2

0

7

0

0

0

0

0

0

0

0

1

1

0

2

0

0

0

0

0

0

0

0

0

0

0

0

0

0

2

3

1

6

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

1

0

1

0

0

0

1

0

0

0

0

0

0

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

2

1

2

0

5

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

0

2

.

0

0

0

0

0

.

0

1

0

0

1

.

0

1

0

0

1

0

2

0

2

0

4

0

1

0

0

0

1

0

0

0

0

0

0

1

2

0

2

0

5

1

2

0

1

0

4

1

2

0

1

0

4

.

0

0

1

0

1

0

0

0

0

0

0

390

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Murray County - 105

17.5 70.7
2.1 21.7
2.6 10.5
0.1 123.2
4.0
129.7 23.7 116.7 39.4 11.3 100.0
*
* * * 10.9 * *
7.2 1.3
* 7.1 1.3
*
34.0 10.8 46.0
* 31.3
3.7 9.1
. . .
69.6 14.1 17.1 45.6 35.2 30.3
.

16.7 68.1
2.0 17.6
2.3 9.5 0.1 115.6 4.8
93.5 25.9 87.0 33.3
* * *
* * * 15.4 * *
6.4 1.1
* 6.5
* *
34.1 8.0
41.7 *
29.7 3.2 8.5
1.2 2.0 2.6
77.9 14.2 22.0 56.6 40.5 35.2 16.0

15.0 61.5 1.8 20.4
2.1 8.8 0.1 116.8 4.8
88.2 25.5 77.0 37.5
* * *
* * * 14.3 * 0.9
6.5 1.2
* 7.1
* *
35.1 10.0 46.3
* 35.7 3.1 6.3
2.2 3.2 6.4
74.0 13.8 24.4 58.6 49.1 42.8 26.3

15.1 62.6
1.9 21.4
2.1 8.9 0.2 118.4 3.6
95.8 11.7 89.4 42.9
* * *
* * * * * *
7.9 1.4
* 8.9
* *
38.0 10.1 42.6
* 33.5
1.9 4.3
3.2 2.4 6.6
75.4 17.4 25.6 58.4 50.4 41.9 21.9

15.4 64.3 2.0 23.5
2.1 8.7 0.3 110.9 5.7
101.7 14.1 90.6 50.9 * * *
11.1 * *
11.1 * *
6.9 2.2
* 7.7 1.1
*
34.9 9.3 37.8
* 26.2 1.4 7.5
2.7 2.3 7.2
79.0 15.8 25.0 52.3 46.4 38.2 32.4

15.9 65.4
2.0 20.9
2.3 9.3 0.2 117.0 4.6
101.7 20.2 92.1 40.9
6.1 100.0
4.8
6.8 4.1 2.7 10.4
* 0.5
7.0 1.5
* 7.4 0.8 0.7
35.2 9.6
42.9 0.3
31.2 2.7 7.1
2.3 2.5 5.7
75.1 15.1 23.0 54.2 44.1 37.5 24.1

17.6 70.9
2.1 21.8
2.6 10.4
0.1 122.0
4.0

16.7 67.9
2.0 17.8
2.2 9.2 0.1 111.7 4.9

15.1 61.9 1.9 20.2
2.0 8.4 0.1 111.8 4.8

15.1 62.7
1.9 21.3
2.1 8.5 0.2 113.9 3.7

15.5 64.8 2.0 23.6
2.1 8.7 0.3 109.7 5.6

16.0 65.6
2.0 21.0
2.2 9.0 0.2 113.9 4.6

130.7 23.7 117.6 39.4 11.4 100.0
*

94.5 25.9 88.0 33.3
* * *

87.7 24.1 78.0 37.5
* * *

97.3 11.7 90.8 42.9
* * *

101.9 14.3 92.2 50.9 * * *

102.4 20.0 93.3 40.9
5.9 100.0
4.6

* * * 10.9 * *

* * * 15.6 * *

* * * 14.4 * 0.9

*

11.2

6.9

*

*

4.1

*

*

2.8

*

11.1

10.4

*

*

*

*

*

0.5

7.2

6.3

6.5

8.0

6.9

7.0

1.3

*

1.2

1.4

2.2

1.4

*

*

*

*

*

*

7.1

6.3

7.1

9.0

7.7

7.4

1.3

*

*

*

1.1

0.8

*

*

*

*

*

0.7

33.9 10.9 46.0
* 31.5
3.8 8.7

33.6 8.1
42.0 *
30.0 3.2 8.6

34.9 10.0 46.5
* 35.8 3.1 6.3

37.8 10.2 42.6
* 33.7
2.0 3.9

35.0 9.3 37.9
* 26.3 1.4 7.5

35.0 9.7
43.0 0.3
31.4 2.7 7.0

.

1.2

2.1

3.2

2.6

2.3

.

1.9

3.1

2.4

2.3

2.4

.

2.0

6.0

6.5

6.8

5.3

69.9 14.2 17.1 45.6 35.1 30.2
.

77.9 14.1 22.0 56.3 40.3 34.9 16.0

74.2 13.8 24.4 58.8 49.3 42.9 26.3

75.4 17.4 26.3 58.3 50.2 41.9 21.8

79.0 15.9 25.0 52.4 46.5 38.3 32.4

75.2 15.1 23.1 54.1 44.1 37.5 24.1

*

*

*

*

*

32.3

*

*

*

*

* 192.8

*

*

*

*

*

4.9

*

*

*

*

*

*

*

*

*

*

*

27.6

*

*

*

*

* 165.3

*

*

*

*

*

5.0

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

83.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

71.4

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

391

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Muscogee County - 106

1990
179278 42389
3702
20.8 18.9 22.0
535 126 3567 381 1356 180 55 998 141
59 37 22 92
2 10
333 77
9 334 40 38
1039 906 884 105 652 100 205
. . .
2286 565 39
1608 1277
945 . 0

1991
181049 42777 3733
20.8 19.3 22.0
488 129 3417 374 1344 205
38 925
97
37 26 11 63
9 8
297 53 7
315 34 34
1068 902 893 109 578
78 184
62 30 307
2042 519
71 1775 1435 1066 279
0

Total
1992 1993

182814 43164 3764

184586 43556 3795

20.9 19.5 22.0

20.5 19.8 23.0

482 132 3694 385 1405 228
52 930
84

513 139 3301 384 1360 225
27 980 110

44

39

34

27

10

12

88

53

5

9

15

11

363

297

75

72

11

12

359

319

51

33

45

41

1100

993

980

885

916

835

120

66

554

485

70

64

205

183

191

196

103

87

852

905

2124 456 80
1799 1585 1103
201 0

2001 413
88 1776 1696 1241 441
1

1994 5-year

186353 43945 3826

914080 215831
18820

20.6 19.1 23.0

20.7 19.3 22.0

497 142 3223 382 1332 139
25 924 105

2515 668
17202 1906 6797 977 197 4757 537

43

222

30

154

13

68

54

350

6

31

8

52

314

1604

57

334

7

46

328

1655

42

200

27

185

1127 879 759 69 363 39 181

5327 4552 4287
469 2632
351 958

200

649

96

316

755

2819

2080 377 57
1723 1531 1137
405 17

10533 2330 335 8681 7524 5492 1326 18

White
1990 1991 1992 1993 1994 5-year

105762 23365 1808

105676 23250 1800

105588 23133 1791

105499 23019 1783

105411 22903 1775

527936 115670
8957

22.1 19.4 22.0

22.6 19.8 21.0

22.5 20.0 22.0

22.1 20.8 22.0

21.9 20.0 22.0

22.2 19.9 22.0

189 33 1812 122 305 68 21 474 63

162 34
1708 120 317 75 15 446 39

136 25
1785 103 269 97 16 414 27

152 34
1639 113 310 91 7 439 35

157 31
1546 122 290 52 6 350 34

796 157 8490 580 1491 383
65 2123
198

21

15

14

10

7

67

14

11

6

4

5

40

7

4

8

6

2

27

34

26

22

12

12

106

1

8

0

4

3

16

6

7

6

8

4

31

106

113

116

85

102

522

19

13

25

20

12

89

1

3

2

2

1

9

117

118

126

124

105

590

9

16

24

15

12

76

17

16

18

16

11

78

456

441

449

398

488

2232

184

194

179

186

174

917

400

372

356

354

272

1754

24

30

20

16

14

104

443

399

382

327

244

1795

41

27

25

22

13

128

73

53

62

52

51

291

.

20

61

73

62

216

.

13

54

41

41

149

.

117

277

278

225

897

1341 299 21 603 345 259 . 0

1183 275 30 683 431 310 112 0

1209 256 34 692 440 322 93 0

1120 214 48 680 546 385 182 1

1114 204 28 658 453 337 166 2

5967 1248
161 3316 2215 1613
553 3

1990
68161 17477
1780

1991
68834 17631
1795

Black
1992 1993

69505 17785
1810

70179 17940
1825

1994 5-year

70851 18094 1840

347531 88927
9049

19.3 18.4 23.0

19.2 18.6 22.0

19.2 18.7 24.0

19.1 18.6 24.0

19.4 18.5 24.0

19.2 18.6 23.0

342 93
1697 258
1048 94 33
498 75

324 94
1659 253 1023 116
23 451
57

346 107 1839 282 1127 126
36 500
57

357 104 1599 269 1043 133
20 515
73

336 111 1599 256 1023
81 19 542 71

1705 509
8393 1318 5264
550 131 2506 333

37

22

30

28

36

153

23

15

28

23

25

114

14

7

2

5

11

39

56

37

65

41

42

241

1

1

5

5

3

15

4

1

9

3

4

21

224

182

241

209

204

1060

57

40

48

52

45

242

8

4

9

10

6

37

214

196

227

191

215

1043

29

18

27

17

28

119

20

18

25

24

16

103

572

612

633

574

614

3005

720

706

796

696

693

3611

479

517

556

472

468

2492

81

79

99

50

55

364

205

168

163

153

112

801

57

50

45

42

26

220

129

127

139

130

125

650

.

33

105

101

118

357

.

12

46

38

48

144

.

172

523

557

482

1734

906

822

871

846

921

4366

254

237

193

193

167

1044

18

41

44

40

28

171

988

1075

1084

1064

1032

5243

930

1000

1134

1140

1054

5258

684

754

774

849

787

3848

.

167

106

256

233

762

0

0

0

0

15

15

392

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Muscogee County - 106

19.9 84.1
2.5 38.5
5.6 23.5
0.7 207.3
5.9
144.5 23.6 102.9 83.8 38.1 99.3
4.9
16.5 10.4
6.2 25.4
* 0.3
9.3 2.2 0.3 9.5 1.1 1.1
30.0 25.7 25.1
3.0 18.6
2.9 10.0
. . .
64.2 17.9 10.4 45.6 36.2 26.8
.

18.9 79.9
2.4 39.7
5.1 21.6
0.6 200.8
6.2
130.7 26.4
100.2 84.1 26.0 95.8 5.6
10.8 7.6 3.2
18.2 0.7 0.2
8.7 1.6 0.2 9.3 1.0 1.0
32.1 26.6 26.4
3.2 17.2
2.3 9.3
1.3 0.6 6.2
59.8 17.2 19.3 52.4 42.4 31.5
8.2

20.2 85.6 2.6 38.6 5.1 21.5 0.6 189.2 6.8
128.1 27.4
102.3 85.8 22.3
100.0 5.0
11.9 9.2 2.7 23.5 0.4 0.4
9.8 2.0 0.3 9.9 1.4 1.2
30.9 26.9 25.2 3.3 15.3 1.9 9.5
3.8 2.1 17.1
57.6 14.2 18.6 49.4 43.5 30.3
5.5

17.9 75.8
2.3 41.6
5.3 22.5
0.7 215.6
6.1
135.2 27.1
101.2 87.9 29.0 98.1 6.6
11.8 8.2 3.7
15.9 0.7 0.3
9.0 2.2 0.4 9.8 1.0 1.2
31.4 27.1 25.6
2.0 14.9
2.0 10.0
3.9 1.7 17.9
60.9 14.1 25.5 54.3 51.9 38.0 13.5

17.3 73.3 2.2 41.9 5.0 21.0 0.6 213.5 4.1
129.9 28.6 99.8 87.5 27.4 99.0 4.4
13.3 9.3 4.1
16.6 0.5 0.2
9.7 1.8 0.2 10.3 1.3 0.8
36.2 27.7 23.9 2.2 11.5 1.2 10.2
3.9 1.9 14.8
65.0 13.3 16.2 54.2 48.2 35.8 12.7

18.8 79.7
2.4 40.0
5.2 22.0
0.7 205.0
5.8
133.6 26.6 101.3 85.8 28.5 98.5
5.3
12.9 9.0 4.0
20.1 0.5 0.3
9.3 1.9 0.3 9.7 1.2 1.1
32.0 26.8 25.2
2.8 15.6
2.1 9.8
3.2 1.6 14.1
61.4 15.4 17.9 51.1 44.3 32.3
9.8

17.1 77.6
2.3 16.9
4.5 20.3
0.6 199.2
4.0

16.2 73.5
2.2 18.7
4.2 19.2
0.6 198.4
4.0

16.9 77.2 2.3 15.3 3.9 17.9 0.5 178.8 5.0

15.5 71.2
2.2 19.1
4.2 19.1
0.6 201.1
4.6

14.7 67.5 2.1 18.9 3.3 15.3 0.5 178.4 2.9

16.1 73.4
2.2 17.7
4.0 18.4
0.6 191.5
4.1

104.5 17.5 67.5 55.8 34.8 100.0
3.3

90.0 21.0 66.7 58.3 21.7 97.4
*

75.9 18.4 57.5 51.5 15.1 100.0 4.5

85.2 22.4 63.4 64.5 19.6 97.1
3.9

88.5 19.7 68.7 66.9 19.2 97.0
*

88.9 19.7 64.8 59.6 22.1 98.5
3.0

11.6

8.8

7.8

6.1

4.5

7.9

7.7

6.4

3.4

*

3.2

4.7

3.9

*

4.5

3.7

*

3.2

18.5

15.1

12.2

7.3

7.7

12.4

*

1.3

*

*

*

0.5

0.4

0.4

0.4

0.5

*

0.4

5.8

6.6

6.5

5.2

6.6

6.1

1.0

0.8

1.4

1.2

0.8

1.0

*

*

*

*

*

0.1

6.5

7.0

7.2

7.6

6.9

7.0

0.5

0.9

1.4

0.9

0.8

0.9

0.9

0.9

1.0

1.0

0.7

0.9

25.7 10.2 22.2
1.3 24.7
2.3 7.5

26.6 11.5 22.0
1.8 23.8
1.6 5.9

26.0 10.2 20.2 1.1 21.9 1.4
6.4

25.0 11.4 21.8
1.0 20.2
1.4 6.2

32.5 11.4 17.8 0.9 16.1 0.9
6.6

27.0 10.9 20.9
1.2 21.5
1.5 6.5

.

0.8

2.5

3.0

2.6

2.3

.

0.5

2.3

1.7

1.7

1.6

.

4.9

11.6

11.6

9.3

9.3

74.1 18.7 10.3 33.5 19.1 14.4
.

69.3 18.1 16.9 40.3 25.4 18.3
6.6

67.8 16.5 16.2 39.3 25.0 18.3
5.3

68.5 14.7 27.6 41.8 33.6 23.7 11.2

72.5 14.9 17.7 43.0 29.6 22.0 10.8

70.4 16.7 17.5 39.4 26.3 19.2
8.4

24.9 97.1
2.8 62.9
7.3 28.5
0.8 214.0
7.6

24.1 94.1
2.8 62.3
6.6 25.6
0.7 199.5
8.6

26.5 103.4
3.1 62.3 7.2 28.1 0.8 199.2 9.6

22.8 89.1
2.6 65.9
7.3 28.7
0.8 226.7
8.8

22.6 88.4 2.6 65.1 7.6 30.0 0.9 241.0 6.0

24.2 94.4
2.8 63.6
7.2 28.2
0.8 215.7
8.1

192.1 27.2 144.9 96.9 42.1 98.7
6.7

180.5 29.0
141.0 96.4 31.8 94.6 9.5

191.2 30.9
155.8 98.2 31.5
100.0 6.1

195.6 29.1
147.4 97.8 40.0 98.6 9.9

182.7 33.0
139.2 97.6 38.6
100.0 8.2

188.4 29.9
145.7 97.4 36.8 98.5 8.1

21.8 13.6
8.4 32.4
* *

13.3 9.0 4.3
22.0 * *

16.3 15.2
* 34.7 0.9
*

17.5 14.4
3.2 25.3
0.8 *

22.5 15.6 7.0 26.0
* *

18.2 13.6
4.7 28.3
0.5 0.3

13.2 3.4 0.5
12.9 1.7 1.2

11.0 2.4 *
11.9 1.1 1.1

13.1 2.6 0.5 12.6 1.5 1.4

13.1 3.3 0.6
12.1 1.1 1.5

12.8 2.8 0.4 13.7 1.8 1.0

12.6 2.9 0.4
12.6 1.4 1.2

35.2 43.2 28.8
4.9 12.4
3.4 12.4

37.9 43.0 31.5
4.8 10.3
3.1 12.1

35.8 44.0 30.8 5.5 9.0 2.5 12.3

38.0 44.0 29.9
3.2 9.8 2.7 13.6

40.0 44.1 29.8 3.5 7.2 1.7 13.1

37.3 43.6 30.2
4.4 9.7 2.7 12.7

.

1.4

4.4

4.2

4.9

3.7

.

0.5

1.9

1.6

2.0

1.5

.

7.4

22.1

23.2

19.8

18.2

53.5 17.0 10.6 59.3 55.8 41.0
.

49.6 16.2 22.9 65.5 60.9 45.9 10.2

47.4 12.1 21.0 59.9 62.7 42.8
5.9

53.2 13.6 24.2 67.3 72.1 53.7 16.2

58.1

52.2

12.0

14.2

15.1

18.8

65.6

63.4

67.0

63.6

50.1

46.5

14.8

11.5

393

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Newton County - 107

1990
41808 10175
981
20.6 18.9 21.0
128 43 754 97 264 62 10 199 25
8 3 5 13 1 5
60 6 1
61 5 7
246 128 271 11 163
5 36
. . .
548 104 14 363 287 235
. 0

1991
43464 10469
987
19.9 18.9 21.0
117 23
847 92
286 43 7
178 19
13 8 5
15 1 7
57 13
3 86
7 11
236 146 313
9 181
10 43
5 7 123
630 124
14 517 428 382
15 0

Total
1992 1993

45099 10758
992

46757 11052
998

20.9 19.3 21.0

21.8 19.9 22.0

122

101

39

21

792

829

90

78

278

299

28

32

9

9

194

199

31

19

5

11

5

7

0

4

15

17

2

4

4

1

69

70

16

19

1

2

75

82

17

11

12

7

223

225

142

139

277

255

9

7

161

166

7

14

46

31

30

38

32

38

264

204

602

679

102

112

12

12

408

485

389

421

315

366

31

25

2

2

1994 5-year

48398 11342
1003

225526 53796
4960

21.6 18.7 22.0

21.1 19.2 21.0

115

583

18

144

761

3983

87

444

275

1402

29

194

5

40

201

971

30

124

7

44

5

28

2

16

10

70

1

9

1

18

66

322

11

65

0

7

59

363

10

50

4

41

213

1143

111

666

237

1353

4

40

145

816

14

50

27

183

42

115

32

109

269

860

653

3112

102

544

15

67

430

2203

392

1917

345

1643

15

86

2

6

1990
32171 7592 712

1991
33558 7855 720

White
1992 1993

34936 8114 727

36321 8376 735

1994 5-year

37701 8637
743

174687 40574
3637

21.2 19.1 20.0

20.4 19.4 20.0

21.8 19.3 20.0

22.8 19.9 21.0

22.4 18.9 21.0

21.8 19.4 20.0

80

60

61

54

75

330

24

11

9

12

9

65

531

592

564

611

551

2849

60

48

45

41

52

246

95

107

109

129

116

556

45

33

19

25

23

145

8

4

8

6

3

29

135

96

108

123

118

580

16

10

16

11

21

74

6

7

3

6

5

27

3

5

3

3

5

19

3

2

0

3

0

8

11

9

12

11

8

51

1

0

1

1

1

4

4

6

3

1

0

14

39

30

41

38

40

188

4

7

6

9

10

36

1

3

0

2

0

6

42

47

48

50

34

221

3

6

12

6

4

31

5

8

6

4

3

26

155

144

138

159

134

730

43

46

51

57

39

236

189

200

178

153

155

875

7

7

3

1

1

19

140

152

140

146

123

701

2

4

2

9

3

20

19

26

21

19

18

103

.

3

22

25

23

73

.

6

18

30

21

75

.

67

150

138

151

506

408

460

455

525

505

2353

81

84

69

75

69

378

8

10

11

9

12

50

214

310

255

306

275

1360

154

253

228

256

240

1131

128

222

191

215

218

974

.

11

15

17

8

51

0

0

1

2

0

3

1990
9357 2503
263

1991
9728 2573
265

Black
1992 1993

10094 2642 266

10465 2713 267

1994 5-year

10832 2782 269

50475 13213
1330

19.5 18.6 24.0

18.8 18.6 25.0

18.8 19.0 27.5

18.7 18.7 25.0

19.1 18.1 26.0

18.9 18.5 26.0

48

57

61

47

40

253

19

12

30

9

9

79

222

249

224

215

203

1113

37

44

45

37

35

198

169

179

168

170

157

843

17

9

9

7

6

48

2

3

1

3

2

11

63

80

79

71

81

374

9

9

15

8

9

50

2

6

2

5

2

17

0

3

2

4

0

9

2

3

0

1

2

8

2

6

3

6

2

19

0

1

1

3

0

5

1

1

1

0

1

4

21

25

26

31

25

128

2

6

10

10

1

29

0

0

1

0

0

1

19

38

26

32

24

139

2

0

4

5

6

17

2

3

6

3

1

15

90

88

85

100

82

111

4

2

23

29

3

6

17

17

82

65

90

82

99

101

6

6

21

20

5

5

25

12

76

401

71

428

80

473

2

20

20

113

10

29

9

80

.

0

8

9

11

28

.

1

13

7

3

24

.

45

97

47

62

251

139

165

144

153

142

743

23

39

31

36

33

162

6

4

1

3

3

17

148

204

153

178

152

835

133

171

160

164

149

777

107

157

124

150

125

663

.

4

16

8

7

35

0

0

1

0

2

3

394

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Newton County - 107

18.0 74.1
2.1 35.3
4.8 19.6
0.6 193.6
7.4
130.5 33.6 98.9 68.0 25.5 96.0 10.2
10.6 *
6.7 17.0
* 0.6
8.0 0.8
* 8.2 0.7 0.9
35.8 17.1 36.6
1.5 21.9
0.7 8.9
. . .
73.3 15.3 20.3 48.5 38.4 31.4
.

19.5 80.9
2.3 34.1
4.1 17.0
0.5 165.0
5.2
118.6 19.7 93.2 63.0 19.3
100.0 6.1
15.3 9.4 6.0
17.6 *
0.8
6.7 1.5
* 10.3
0.8 1.3
30.9 17.4 37.5
1.1 21.7
1.2 9.5
0.4 0.6 10.1
74.6 16.2 18.9 61.6 51.0 45.5
1.8

17.6 73.6 2.2 35.8 4.3 18.0 0.5 189.3 3.6
123.0 32.0 90.8 80.7 31.3
100.0 *
6.3 6.3
* 18.7
* *
8.7 2.0
* 9.7 2.2 1.5
30.5 18.3 36.0
1.2 20.9 0.9 10.4
2.4 2.5 20.8
76.1 14.5 16.2 52.6 50.1 40.6 4.0

17.7 75.0
2.2 36.6
4.3 18.0
0.5 186.2
3.7
101.3 20.8 78.2 75.6 19.0 89.5 5.0
13.3 8.4 *
20.3 * *
8.4 2.3
* 10.0
1.3 0.8
29.2 17.0 31.4
0.9 20.4
1.7 7.1
2.9 2.9 15.5
82.4 15.1 15.4 59.3 51.5 44.7
3.1

15.7 67.1 2.0 36.7 4.2 17.7 0.5 201.2 3.3
114.7 15.7 86.7 72.3 29.9 96.6 *
9.2 6.6
* 13.1
* *
8.7 1.4
* 7.9 1.3
*
30.7 14.8 31.7
* 19.4 1.9
7.3
3.1 2.3 19.7
86.4 14.8 24.2 57.3 52.3 46.0 2.0

17.7 74.0
2.2 35.7
4.3 18.0
0.5 186.7
4.6
117.5 24.7 89.5 71.7 25.0 96.7
5.4
11.0 7.0 4.0
17.4 0.6 0.4
8.1 1.6 0.2 9.2 1.3 1.0
31.3 16.9 34.7
1.0 20.9
1.3 8.7
2.2 2.1 16.6
78.5 15.2 18.8 56.0 48.8 41.8
2.7

16.5 69.9
2.0 18.0
4.2 17.8
0.5 187.0
7.4

17.6 75.4
2.2 18.3
2.9 12.2
0.4 131.9
5.1

16.1 69.5 2.1 19.7 3.1 13.3 0.4 154.3 3.5

16.8 72.9
2.2 21.3
3.4 14.7
0.4 160.8
3.7

14.6 63.8 1.9 21.2 3.1 13.7 0.4 169.1 3.4

16.3 70.2
2.1 19.7
3.3 14.3
0.4 160.5
4.5

112.4 30.0 84.3 50.0 22.5 100.0
9.8

83.3 18.3 66.7 35.4 13.9 100.0
*

83.9 14.8 61.9 63.6 22.0 100.0
*

73.5 22.2 55.8 56.1 15.0 81.8
*

100.9 12.0 70.0 55.8 28.3
100.0 *

90.7 19.7 67.6 51.8 20.3 97.3
4.4

11.3 * *
20.4 * *

11.8 8.4 *
15.1 *
1.0

* * * 21.0 * *

9.8 * *
17.8 * *

9.1 9.1
* 14.4
* *

9.5 6.7 2.8 17.7
* 0.4

7.3

5.1

7.3

6.2

7.3

6.6

*

1.2

1.1

1.5

1.8

1.3

*

*

*

*

*

0.2

8.0

8.0

8.7

8.3

6.2

7.8

*

1.0

2.2

1.0

*

1.1

0.9

1.4

1.1

*

*

0.9

31.6 8.2
36.1 1.3
26.7 *
6.7

27.4 7.9
34.4 1.2
26.1 *
7.8

26.2 9.2 32.5
* 25.5
* 6.9

27.7 9.4
25.4 *
24.2 1.5 5.9

26.7 7.1
28.3 *
22.6 *
6.9

27.9 8.4
31.2 0.7
25.0 0.7 6.8

.

*

2.4

2.6

2.3

1.9

.

0.7

1.9

3.1

2.1

2.0

.

7.6

16.2

14.3

15.1

13.4

77.4 16.9 17.0 40.6 29.2 24.3
.

78.0 16.1 15.6 53.0 43.2 37.9
1.9

80.7 13.9 20.0 46.1 41.2 34.5 2.7

86.2 13.8 15.0 50.6 42.3 35.5
2.8

92.0 13.9 24.0 50.3 43.9 39.9 1.5

82.9 14.9 18.1 48.3 40.1 34.6
2.2

23.7 88.7
2.4 76.8
6.7 25.2
0.7 207.2
7.6

25.6 96.8
2.7 71.9
8.2 31.1
0.9 233.9
5.1

22.2 84.8 2.4 76.4 7.8 29.9 0.8 251.6 4.2

20.5 79.3
2.3 81.0
6.8 26.2
0.7 239.9
3.7

18.7 73.0 2.1 80.1 7.5 29.1 0.8 277.4 2.9

22.1 84.2
2.4 77.0
7.4 28.3
0.8 241.6
4.6

182.5 39.6 140.7 97.3 34.2 88.9
*

215.4 21.1
166.3 93.2 34.0
100.0 *

229.4 49.2
169.2 97.7 56.4
100.0 *

175.8 19.1
138.4 97.3 29.9
100.0 *

148.8 22.5
130.2 100.0
33.5 87.5
*

190.3 31.2
148.9 96.9 37.6 95.9 8.3

*

24.1

*

*

*

*

*

23.8

*

*

*

*

*

23.3

*

*

*

*

*

27.5

*

*

*

*

*

15.3

*

8.1

*

7.2

*

16.9

*

1.2

*

*

9.5

10.0

11.6

14.4

12.3

11.5

*

2.4

4.5

4.7

*

2.6

*

*

*

*

*

*

8.6

15.3

11.8

15.2

12.2

12.7

*

*

*

2.4

3.1

1.6

*

*

2.7

*

*

1.3

46.2 38.6 37.8
* 10.6
* 14.2

37.9 40.2 44.9
* 11.7
2.4 14.2

40.4 40.9 45.4 2.7 9.7 2.3 18.0

33.7 39.0 48.6
2.9 9.6 2.4 10.8

40.9 36.2 41.5
* 10.3 5.2 8.5

39.7 39.1 43.7
1.8 10.4
2.7 13.4

.

*

2.4

2.6

3.0

2.0

.

*

3.8

2.0

*

1.7

.

13.8

28.6

13.3

16.9

18.1

63.2 11.6 27.3 67.3 60.5 48.6
.

66.3 16.3
* 81.9 68.7 63.1
*

64.6 15.4
* 69.5 72.7 56.4 7.3

72.2 18.8
* 84.8 78.1 71.4
3.8

71.0

67.3

17.8

16.0

*

21.2

77.6

76.3

76.0

71.0

63.8

60.5

3.6

4.0

395

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Oconee County - 108

1990
17618 4339 395
23.5 22.0 21.0
22 5
278 13 38 11
1 68
8
4 2 2 3 1 2
16 3 0
26 1 5
54 15 53
4 45
4 10
. . .
235 42
4 61 56 42
. 0

1991
18192 4407 407
22.9 20.3 23.0
21 6
243 16 39 7 1 66 4
1 1 0 2 0 1
14 1 0
17 4 4
51 23 39
2 31
1 4
0 0 0
205 30 3 76 69 54 14 0

Total
1992 1993

18755 4473 419

19330 4539 431

24.7 20.3 22.0

23.7 19.9 22.0

18

14

2

2

258

264

12

8

41

40

16

14

0

1

62

55

6

6

2

5

1

5

1

0

1

6

0

0

0

2

13

23

1

5

0

0

18

29

3

8

17

15

57

53

15

15

34

42

0

1

20

17

5

2

4

7

6

11

8

2

25

29

220

227

25

31

7

7

60

66

62

81

42

61

31

43

0

0

1994 5-year

19894 4605 443

93789 22363
2094

24.9 20.4 22.0

24.1 20.3 22.0

22

97

7

22

267

1310

14

63

60

218

13

61

3

6

43

294

6

30

3

15

3

12

0

3

6

18

0

1

1

6

15

81

4

14

2

2

17

107

5

21

5

46

70

285

15

83

30

198

2

9

26

139

3

15

3

28

13

30

15

25

18

72

234

1121

31

159

3

24

95

358

84

352

74

273

59

147

0

0

1990
16154 3984 351

1991
16720 4054 362

White
1992 1993

17283 4123 373

17847 4192 384

1994 5-year

18409 4260 395

86413 20613
1865

25.3 22.6 21.0

24.0 20.5 22.0

24.7 20.4 22.0

24.1 19.5 22.0

24.9 20.5 22.0

24.7 20.7 22.0

16

16

15

11

18

76

4

4

1

1

4

14

255

219

242

243

243

1202

10

12

11

6

12

51

25

24

31

27

43

150

9

7

12

13

11

52

0

1

0

1

3

5

52

56

48

43

35

234

5

3

4

5

5

22

3

1

2

5

3

14

1

1

1

5

3

11

2

0

1

0

0

3

1

2

1

6

6

16

1

0

0

0

0

1

2

1

0

1

1

5

11

11

11

19

13

65

1

1

1

5

4

12

0

0

0

0

2

2

22

13

18

28

14

95

1

4

3

8

5

21

5

4

13

13

5

40

47

37

52

46

61

243

10

15

10

7

7

49

42

33

30

31

24

160

2

1

0

1

1

5

43

27

19

16

25

130

4

0

5

2

2

13

8

4

3

7

2

24

.

0

5

10

10

25

.

0

8

1

14

23

.

0

22

11

9

42

219

189

212

213

215

1048

38

28

22

27

30

145

4

3

6

6

3

22

48

63

53

55

77

296

44

56

54

67

70

291

32

47

36

51

60

226

.

11

25

36

50

122

0

0

0

0

0

0

1990
1315 319 40

1991
1358 324 41

Black
1992 1993

1400 329 42

1443 334 44

1994 5-year

1485 339 45

7000 1646
212

17.9 18.6 25.0

19.8 19.9 23.0

29.0 19.1 27.0

18.6 20.0 24.0

20.0 19.8
.

19.8 19.6 24.5

6

5

3

3

4

21

1

2

1

1

3

8

19

23

14

20

20

96

3

4

1

2

2

12

13

15

10

13

17

68

2

0

3

0

2

7

1

0

0

0

0

1

13

10

9

10

7

49

3

1

2

1

1

8

1

0

0

0

0

1

1

0

0

0

0

1

0

0

0

0

0

0

2

0

0

0

0

2

0

0

0

0

0

0

0

0

0

1

0

1

5

3

2

3

2

15

2

0

0

0

0

2

0

0

0

0

0

0

4

4

0

1

3

12

0

0

0

0

0

0

0

0

3

2

0

5

7

13

5

8

10

6

2

1

2

4

0

1

2

0

3

7

5

8

3

10

0

0

0

1

0

0

1

0

7

37

8

34

5

34

1

4

1

8

1

2

1

4

.

0

0

0

1

1

.

0

0

1

0

1

.

0

3

11

8

22

13

15

4

2

0

0

13

13

12

13

10

7

.

3

0

0

7

14

16

65

2

3

1

12

1

1

0

2

7

11

18

62

7

14

14

60

6

10

14

47

5

7

9

24

0

0

0

0

396

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Oconee County - 108

15.8 64.1
2.0 13.7
3.9 15.7
0.5 189.9
2.8
55.7 22.7 32.9 53.8 20.3 87.5
*
* * * * * *
5.8 * *
9.4 *
1.8
26.7 5.4
19.4 *
16.5 *
6.7
. . .
85.5 16.9
* 22.0 20.2 15.2
.

13.4 55.1
1.7 16.4
3.6 15.0
0.5 208.2
1.8
51.7 28.6 39.4 56.3
* * *
* * * * * *
5.8 * *
7.2 * *
29.5 9.7
16.7 *
13.7 * *
* * *
85.8 13.7
* 31.9 29.0 22.7
5.9

13.8 57.7 1.8 16.1 3.3 13.9 0.5 184.0 3.8
43.0 *
28.7 63.6 14.3 100.0
*
* * * * * *
5.0 * *
7.1 *
6.6
30.6 5.9
13.4 *
10.2 2.6 *
1.1 1.5 4.7
85.6 11.2 22.6 23.5 24.3 16.5 12.2

13.7 58.2
1.8 15.6
2.8 12.1
0.4 164.2
3.5
32.5 *
18.6 87.5 13.9 100.0
*
18.9 18.9
* 22.6
* *
8.7 1.9
* 11.3
3.1 5.7
27.3 5.9
16.5 *
8.6 *
4.5
2.0 *
5.2
86.0 14.2 18.4 25.8 31.6 23.8 16.8

13.4 58.0 1.9 22.9 2.2 9.3 0.3 131.9 3.5
49.7 31.8 31.6 85.7 13.5 100.0
*
* * * 22.2 * *
5.6 * *
6.5 1.9 1.9
28.1 5.7
11.7 *
10.2 * *
2.3 2.6 3.2
90.7 13.1
* 36.3 32.1 28.2 22.5

14.0 58.6
1.9 16.9
3.1 13.1
0.4 175.7
3.1
46.3 22.7 30.1 67.7 14.3 96.7
*
11.5 9.2 *
13.7 *
0.3
6.2 1.1
* 8.3 1.6 3.5
28.4 6.4
15.6 0.7
12.1 1.3 3.9
1.4 1.1 3.3
86.7 13.9 16.8 27.8 27.3 21.2 14.5

15.8 64.0
2.0 9.8 3.2 13.1 0.4 164.6 2.3

13.1 54.0
1.7 11.2
3.3 13.8
0.5 197.9
2.0

14.0 58.7 1.9 13.0 2.8 11.6 0.4 158.4 3.2

13.6 58.0
1.8 11.5
2.4 10.3
0.3 142.9
3.6

13.2 57.0 1.8 18.1 1.9
8.2 0.3 119.9 3.3

13.9 58.3
1.8 12.7
2.7 11.4
0.4 156.5
2.9

45.6 *
28.5 *
14.2 100.0
*

44.2 *
33.2 41.7
* * *

40.2 *
29.5 60.0
* * *

28.6 *
15.6 83.3 13.0 100.0
*

45.6 *
30.4 83.3 12.7 100.0
*

40.8 18.4 27.3 60.0 11.8 100.0
*

*

*

*

20.6

*

11.6

*

*

*

20.6

*

9.2

*

*

*

*

*

*

*

*

*

24.6

24.4

13.3

*

*

*

*

*

*

*

*

*

*

*

0.3

4.3

5.0

4.5

7.8

5.3

5.4

*

*

*

2.1

*

1.0

*

*

*

*

*

*

8.7

6.2

7.6

11.9

5.9

8.1

*

*

*

3.4

2.1

1.8

2.0

*

5.4

5.3

2.1

3.3

25.4 3.9
16.8 *
17.1 *
5.8

23.7 7.0
15.7 *
13.2 * *

29.4 4.2
12.7 *
10.2 2.7 *

25.3 3.0
13.3 *
8.6 *
4.9

27.0 2.9
10.2 *
10.8 * *

26.2 4.2
13.7 0.4
12.3 1.2 3.7

.

*

1.0

2.0

1.9

1.3

.

*

1.6

*

2.7

1.2

.

*

4.5

2.2

1.7

2.1

86.9 16.8
* 18.9 17.3 12.6
.

87.9 14.2
* 29.4 26.2 22.0
5.1

88.0 10.5 20.7 22.2 22.6 15.1 10.5

87.7 13.6 16.7 23.4 28.5 21.7 15.3

91.5 14.0
* 32.4 29.4 25.2 21.0

88.4 13.8 16.5 25.1 24.7 19.2 13.2

14.4 59.6
1.9 68.4
9.9 40.8
1.2 371.4
*

16.9 70.9
2.2 65.2
7.4 30.8
1.0 . *

10.0 42.5 1.3 71.4 6.4 27.3 0.8 346.2
*

150.0 121.4

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

26.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

46.7

81.3

*

26.3

34.8

35.7

52.6

27.3

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

.

*

*

.

*

*

68.4 * *
68.4 63.2 52.6
.

65.2 * *
56.5 56.5 30.4
*

50.0 * *
50.0 50.0 42.9 35.7

13.9 59.8
2.0 65.0
6.9 29.9
0.9 . *

13.5 58.9 1.9 85.0 4.7 20.6 0.6 241.4
*

13.7 58.3
1.9 70.8
7.0 29.8
0.9 320.3
4.9

*

*

99.0

*

*

38.1

*

*

56.6

*

* 100.0

*

*

37.7

*

*

87.5

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

15.6

*

*

*

*

*

*

*

*

12.6

*

*

*

*

*

5.3

63.6 40.0 50.0
* * * *

35.0 40.0 25.0
* * * *

53.6 35.4 35.8
* 10.5
* *

* * 22.3

* * 15.7

* * 11.3

70.0

80.0

67.7

*

*

13.8

*

*

*

55.0

90.0

64.6

70.0

70.0

62.5

50.0

70.0

49.0

35.0

45.0

31.2

397

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Oglethorpe County - 109

1990
9763 2247
217
20.6 20.5 22.0
13 3
141 9
48 8 1
27 4
2 0 2 1 1 2
3 1 0 5 0 2
30 20 45
3 8 0 5
. . .
106 13
4 62 50 39
. 1

1991
9922 2259 217
22.3 19.1 22.0
14 1
163 10 44 6 0 24 4
1 0 1 0 1 0
15 1 0
16 2 1
34 18 42
1 13
0 9
3 3 4
127 26 2 75 53 44 10 1

Total
1992 1993

10073 2270 218

10228 2284 218

22.7 18.0 21.0

22.1 19.8 24.0

21

19

3

2

153

144

13

15

44

58

5

5

0

1

32

32

8

4

1

2

0

0

1

2

0

1

0

2

1

1

14

9

4

1

0

0

14

12

4

2

9

9

31

32

23

25

51

44

2

4

10

13

2

0

6

4

8

11

8

10

11

30

117

103

19

10

6

3

83

73

76

74

69

64

50

50

1

3

1994 5-year

10384 2295 218

50370 11355
1087

22.0 18.9 22.0

22.0 19.3 22.0

15

82

3

12

130

731

13

60

47

241

7

31

1

3

26

141

2

22

0

6

0

0

0

6

1

3

0

4

0

4

8

49

1

8

0

0

8

55

1

9

2

23

42

169

26

112

33

215

1

11

17

61

1

3

4

28

3

25

4

25

37

82

110

563

26

94

2

17

64

357

63

316

47

263

40

150

1

7

1990
7294 1678
158

1991
7470 1699
159

White
1992 1993

7641 1720
160

7813 1741
160

1994 5-year

7988 1762
162

38206 8600 798

22.0 19.5 21.0

22.8 20.7 21.0

23.1 17.8 21.0

23.1 18.6 22.0

22.2 19.5 21.5

22.6 19.1 21.0

7

5

14

11

2

0

0

0

92

120

108

103

4

3

8

10

11

11

15

24

5

4

3

4

0

0

0

1

20

17

23

18

3

2

6

2

9

46

3

5

90

513

7

32

16

77

7

23

1

2

17

95

2

15

0

1

1

2

0

4

0

0

0

0

0

0

0

1

1

2

0

4

0

0

0

1

1

2

1

1

0

2

0

4

2

0

1

1

0

4

1

13

9

5

6

34

1

0

4

0

1

6

0

0

0

0

0

0

1

12

9

9

4

35

0

2

2

1

1

6

1

1

5

6

2

15

14

22

20

23

25

104

4

3

10

11

9

37

19

18

28

28

17

110

1

1

2

3

0

7

5

8

7

12

13

45

0

0

1

0

1

2

2

4

4

2

3

15

.

2

8

7

1

18

.

2

7

6

3

18

.

2

2

21

12

37

79

100

86

82

76

423

8

24

14

7

20

73

2

1

3

3

2

11

24

42

42

39

32

179

21

24

41

42

38

166

14

18

35

33

25

125

.

2

23

25

20

70

0

1

0

0

1

2

1990
2419 553 57

1991
2458 555
57

Black
1992 1993

2496 557 57

2534 560
57

1994 5-year

2573 562 57

12480 2786 286

19.2 21.8 29.0

19.9 17.2 28.5

19.4 21.6 28.0

19.7 22.6 28.0

19.4 18.3 26.0

19.4 20.9 28.0

6

9

7

8

6

36

1

1

3

2

0

7

48

41

44

39

39

211

5

7

5

5

6

28

37

32

29

34

31

163

3

2

2

1

0

8

1

0

0

0

0

1

6

7

9

12

9

43

1

2

2

2

0

7

2

0

0

0

0

2

0

0

0

0

0

0

2

0

0

0

0

2

1

0

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

2

2

5

4

2

15

0

1

0

1

0

2

0

0

0

0

0

0

4

4

5

3

4

20

0

0

2

1

0

3

1

0

4

3

0

8

16

12

11

9

16

64

16

15

13

14

17

75

26

24

23

16

16

105

2

0

0

1

1

4

3

5

3

0

4

15

0

0

1

0

0

1

3

5

2

2

1

13

.

1

0

2

2

5

.

1

0

4

1

6

.

2

8

9

20

39

26

25

30

19

33

133

5

2

5

3

6

21

2

1

3

0

0

6

38

32

40

34

31

175

29

28

35

32

24

148

25

26

34

31

21

137

.

8

27

25

19

79

1

0

1

0

0

2

398

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Oglethorpe County - 109

14.4 62.8
1.9 34.0
2.8 12.0
0.4 151.7
4.5
59.9 *
41.5 66.7
* * *
* * * * * *
* * * 3.5 * *
30.3 14.2 32.4
* 5.8
* 6.8
. . .
77.9 10.6
* 44.0 35.5 27.7
.

16.4 72.2
2.2 27.3
2.4 10.6
0.3 124.4
2.7
64.5 *
46.1 90.0
* * *
* * * * * *
9.2 * *
10.1 * *
31.2 11.2 26.1
* 8.4
* 11.4
* * *
82.5 17.4
* 46.6 32.9 27.3
6.2

15.2 67.4 2.1 29.5 3.2 14.1 0.4 168.4 2.2
96.5 *
59.7 61.5 36.8 100.0
*
* * * * * *
9.2 * *
9.4 *
5.9
30.1 15.4 34.5
* 8.9
* 7.1
3.0 3.0 4.2
78.5 14.5 33.3 55.7 51.0 46.3 33.6

14.1 63.0
2.1 41.1
3.1 14.0
0.4 175.8
2.6
87.3 *
68.9 64.3
* * *
* * * * * *
6.3 * *
8.5 *
6.3
32.0 17.7 31.2
* 12.5
* *
4.1 3.7 11.2
71.5 7.8 *
51.8 52.5 45.4 35.5

12.5 56.6 1.9 36.7 2.5 11.3 0.4 158.5 3.5
68.7 *
59.6 69.2
* * *
* * * * * *
6.2 * *
6.3 * *
33.6 20.3 26.0
* 13.4
* *
* * 13.6
86.6 22.0
* 50.0 49.2 36.7 31.3

14.5 64.4
2.0 33.5
2.8 12.4
0.4 155.5
3.1
75.4 14.6 55.2 69.5 20.2 100.0
*
8.2 * . * * *
6.7 1.1
* 7.7 1.2 3.2
31.5 15.6 30.0
1.6 9.6
* 7.4
2.3 2.3 7.7
79.3 14.5 24.3 49.6 43.9 36.5 25.9

12.6 54.8
1.7 12.0
2.7 11.9
0.4 169.5
3.6

16.1 70.6
2.2 9.3 2.3 10.0 0.3 120.6
*

14.1 62.8 2.0 14.2 3.0 13.4 0.4 171.6
*

13.2 59.2
2.0 23.8
2.3 10.3
0.3 142.9
2.9

11.3 51.1 1.7 18.2 2.1 9.6 0.3 147.8 4.5

13.4 59.7
1.9 15.2
2.5 11.0
0.4 149.8
3.0

44.3 * * * * * *

31.5 * * * * * *

87.6 *
50.1 *
37.5 100.0
*

68.6 *
62.3 * * * *

55.7 *
43.3 * * * *

57.6 10.9 40.1 41.9 18.8 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

10.8

8.3

4.9

6.7

6.6

*

*

*

*

*

1.2

*

*

*

*

*

*

*

10.2

8.5

8.9

*

6.9

*

*

*

*

*

1.2

*

*

4.6

5.8

*

2.9

21.2 *
21.1 *
5.6 * *

26.8 *
15.3 *
7.1 * *

27.0 9.4 26.7
* 8.8
* *

30.3 10.9 27.7
* 15.2
* *

28.4 10.2 19.3
* 14.8
* *

26.9 7.3
21.9 1.4
10.0 *
5.6

.

*

4.3

3.7

*

2.4

.

*

3.8

3.1

*

2.4

.

*

*

11.0

6.1

4.9

86.8 10.4
* 26.1 22.8 15.2
.

84.7 22.0
* 35.6 20.3 15.3
*

80.4 14.7
* 39.6 38.7 33.0 21.7

79.6 7.7 *
38.6 41.6 32.7 24.8

86.4 24.4
* 36.4 43.2 28.4 22.7

83.4 16.1 21.6 35.4 32.9 24.8 16.9

19.8 86.8
2.5 77.1
2.5 10.8
0.3 103.4
*

16.7 73.9
2.1 78.0
2.8 12.6
0.4 140.0
*

17.6 79.0 2.4 69.0 3.6 16.2 0.5 163.6
*

15.4 69.7
2.2 89.5
4.7 21.4
0.7 230.8
*

15.2 69.5 2.1 79.5 3.5 16.0 0.5
. *

16.9 75.7
2.3 78.4
3.4 15.4
0.5 163.5
3.2

105.3 *
87.7 100.0
* * *

157.9 *
122.8 100.0
* * *

122.4 *
87.4 100.0
* * *

139.9 *
87.4 100.0
* * *

104.7 *
104.7 100.0
* * *

126.0 19.4 98.0
100.0 24.5 100.0 *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

11.4

*

*

7.1

*

*

*

*

*

*

*

*

*

*

*

*

*

*

11.9

*

*

9.7

*

*

*

*

*

*

*

*

*

*

*

3.8

48.5 33.3 54.2
* * * *

48.0 36.6 58.5
* 12.8
* 23.8

37.9 31.0 54.8
* * * *

40.9 36.8 42.1
* * * *

44.4 43.6 42.1
* * * *

44.1 36.1 50.7
* 8.3
* 11.9

.

*

*

*

*

1.5

.

*

*

*

*

1.8

.

*

9.9

10.9

23.9

12.0

59.1 11.1
* 79.2 60.4 52.1
.

73.5 * *
78.0 68.3 63.4 19.5

73.2 14.3
* 95.2 83.3 81.0 64.3

48.7 * *
89.5 84.2 81.6 65.8

86.8

67.9

17.1

11.1

*

31.6

79.5

84.1

61.5

71.2

53.8

65.9

48.7

49.4

399

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Paulding County - 110

1990
41611 10723
880
22.7 18.6 20.0
75 11 793 45 120 66
2 165 26
4 1 3 3 2 1
42 10
0 49
5 14
207 61 172 29 177 15 31
. . .
601 121 13 203 195 141
. 0

1991
43542 11089
906
22.7 19.2 20.0
79 17 854 57 138 75
6 175
15
4 3 1 9 4 2
45 6 0
54 6 7
160 71
201 22
195 13 38
37 23 68
658 114
13 282 220 189
2 0

Total
1992 1993

45470 11449
933

47401 11814
959

23.1 18.8 20.0

23.3 17.8 21.0

71

80

16

16

936

968

52

59

140

137

82

76

10

3

154

152

16

20

9

3

5

2

4

1

15

5

2

1

2

3

52

50

7

12

1

0

66

75

10

6

12

13

212

222

57

58

199

202

8

4

188

155

11

6

35

30

53

64

30

28

158

116

747

832

137

124

11

30

259

295

270

327

194

231

11

24

0

0

1994 5-year

49324 12176
986

227348 57251
4664

23.8 19.1 22.0

23.2 18.9 21.0

76

381

17

77

959

4510

57

270

122

657

58

357

12

33

163

809

17

94

5

25

1

12

4

13

13

45

0

9

3

11

59

248

7

42

0

1

76

320

8

35

9

55

226

1027

56

303

166

940

5

68

172

887

6

51

25

159

49

203

15

96

132

474

863

3701

133

629

21

88

283

1322

272

1284

209

964

36

73

0

0

1990
39711 10227
831

1991
41582 10581
855

White
1992 1993

43449 10930
878

45320 11283
902

1994 5-year

47183 11633
926

217245 54654
4393

23.0 18.3 20.0

22.9 19.1 20.0

23.2 18.4 20.0

23.3 18.2 21.0

23.6 19.1 21.0

23.3 18.8 20.0

70

73

65

71

70

349

10

15

13

13

15

66

752

819

888

924

919

4302

41

54

47

54

53

249

96

114

117

114

104

545

59

67

74

68

50

318

2

5

10

2

12

31

152

158

136

135

145

726

25

13

15

16

15

84

4

2

8

3

5

22

1

1

5

2

1

10

3

1

3

1

4

12

3

6

15

4

13

41

2

4

2

1

0

9

1

2

2

3

3

11

40

38

48

44

57

227

10

4

6

11

7

38

0

0

1

0

0

1

49

49

62

70

74

304

5

4

10

6

8

33

11

7

10

12

8

48

192

155

201

207

216

971

48

54

44

45

48

239

163

194

189

192

160

898

27

18

5

3

4

57

172

190

184

148

170

864

14

12

9

5

5

45

29

34

32

25

23

143

.

34

49

59

47

189

.

20

28

26

15

89

.

63

133

94

103

393

576

644

714

802

827

3563

118

109

130

121

125

603

13

13

10

29

19

84

184

262

236

273

266

1221

169

199

245

303

255

1171

124

173

178

214

200

889

.

2

10

23

34

69

0

0

0

0

0

0

1990
1648 418 46

1991
1725 433
47

Black
1992 1993

1801 447 49

1877 462
50

1994 5-year

1954 476 52

9004 2235
244

19.6 19.4 25.0

20.6 20.0 20.0

21.2 .
25.0

19.3 18.0 29.0

25.2 20.5 27.0

21.0 19.7 25.0

5

6

6

8

6

31

1

2

3

3

2

11

40

33

46

41

38

198

4

3

5

5

4

21

24

24

23

23

18

112

3

4

3

4

3

17

0

1

0

1

0

2

8

13

14

13

15

63

1

2

1

3

2

9

0

2

1

0

0

3

0

2

0

0

0

2

0

0

1

0

0

1

0

3

0

1

0

4

0

0

0

0

0

0

0

0

0

0

0

0

2

7

4

6

2

21

0

2

1

1

0

4

0

0

0

0

0

0

0

5

4

5

2

16

0

2

0

0

0

2

3

0

1

1

1

6

15

5

10

14

10

54

13

17

13

13

8

64

9

7

10

10

6

42

2

4

3

1

1

11

5

4

4

6

2

21

1

1

2

1

1

6

2

4

3

4

2

15

.

3

3

4

2

12

.

3

2

0

0

5

.

4

14

15

25

58

24

12

31

27

34

128

3

5

6

3

8

25

0

0

1

1

2

4

19

19

23

21

17

99

26

20

25

23

17

111

17

15

16

16

9

73

.

0

1

1

2

4

0

0

0

0

0

0

400

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Paulding County - 110

19.1 74.0
2.1 15.2
4.0 15.4
0.5 160.0
6.8
85.2 14.7 51.1 47.7 29.5 100.0
6.8
* * * * * *
5.3 1.3
* 6.2 0.6 1.8
29.4 7.7
21.8 3.7
22.5 1.9 7.0
. . .
76.2 17.7 12.5 25.8 24.7 17.9
.

19.6 77.0
2.3 16.3
4.0 15.8
0.5 157.4
7.5
87.2 21.5 62.9 52.6 16.6 100.0
7.7
* * * 10.5 * *
5.3 0.7
* 6.4 0.7 0.8
21.9 8.4
23.8 2.6
23.1 1.5 8.3
2.9 1.8 5.3
77.7 15.2 13.1 33.3 25.9 22.3
*

20.6 81.8 2.4 15.1 3.4 13.5 0.4 130.0
8.3
76.1 22.5 55.8 53.8 17.2 100.0
*
9.6 5.3
* 15.9
* *
5.6 0.7
* 7.1 1.1 1.3
26.2 6.2
21.5 0.9 20.4 1.2 6.6
4.0 2.2 11.8
80.4 16.6 10.8 28.0 29.2 21.0
1.2

20.4 81.9
2.5 14.2
3.2 12.9
0.4 126.2
7.1
83.4 20.0 61.5 57.6 20.9 100.0
*
* * * 5.1 * *
5.2 1.2
* 7.8 0.6 1.3
25.2 6.0
21.0 *
16.2 0.6 5.7
4.6 2.0 8.3
86.3 14.7 24.8 30.7 34.0 24.0
2.5

19.4 78.8 2.4 12.8 3.3 13.4 0.4 136.2
6.2
77.1 22.4 57.8 50.9 17.2 100.0
*
5.2 * *
13.4 * *
6.2 0.7
* 8.0 0.8 0.9
24.6 5.9
17.5 0.5 18.1 0.6 5.0
3.3 1.0 9.0
90.1 15.8 19.4 29.8 28.6 22.0 3.8

19.8 78.8
2.3 14.7
3.6 14.1
0.4 141.2
7.2
81.7 20.2 57.9 52.8 20.2 100.0
4.3
5.5 2.7 2.9 9.9 0.5 0.2
5.5 0.9
* 7.2 0.8 1.2
25.4 6.8
21.0 1.5
19.9 1.1 6.5
3.7 1.7 8.6
82.5 16.0 16.5 29.5 28.7 21.5
2.0

18.9 73.5
2.1 12.9
3.8 14.9
0.5 157.0
6.3

19.7 77.4
2.3 14.0
3.8 14.9
0.5 150.3
7.0

20.4 81.2 2.4 13.3 3.1 12.4 0.4 122.4
8.0

20.4 81.9
2.4 12.4
3.0 12.0
0.4 119.3
6.5

19.5 79.0 2.4 11.4 3.1 12.5 0.4 128.5
5.5

19.8 78.7
2.3 12.8
3.3 13.3
0.4 134.7
6.6

84.2 14.3 49.3 42.5 30.1 100.0
7.2

85.4 20.5 63.2 50.0 15.2 100.0
7.0

74.0 20.0 53.5 48.9 17.1 100.0
*

78.7 18.3 59.8 53.7 17.7 100.0
*

75.6 21.4 57.2 47.2 16.2 100.0
*

79.4 18.9 56.7 48.8 19.1 100.0
4.3

*

*

9.0

*

*

5.6

*

*

*

*

7.3

16.7

*

*

*

*

*

*

*

5.4

5.1

*

*

2.3

*

*

2.8

*

14.0

9.5

*

*

0.6

*

*

0.3

5.3

4.6

5.4

4.8

6.2

5.3

1.3

*

0.7

1.2

0.8

0.9

*

*

*

*

*

*

6.6

6.0

7.1

7.6

8.1

7.1

0.7

*

1.1

0.7

0.9

0.8

1.5

0.9

1.1

1.3

0.9

1.1

28.4 6.4
21.8 3.6
23.1 1.9 6.9

21.9 6.6
23.9 2.2
23.4 1.5 7.8

26.1 5.0
21.6 0.6 21.0 1.0 6.4

24.5 4.9
21.0 *
16.2 0.5 5.1

24.5 5.3
17.6 *
18.7 0.6 4.9

25.0 5.6
21.1 1.3
20.3 1.1 6.2

.

2.8

3.8

4.4

3.4

3.6

.

1.7

2.2

1.9

1.1

1.7

.

5.2

10.4

7.0

7.4

7.5

77.0 18.2 13.4 24.6 22.6 16.6
.

79.3 15.1 13.7 32.1 24.4 21.2
*

80.9 16.6 10.5 26.9 27.9 20.3 1.1

87.2 15.1 25.0 29.7 33.0 23.3
2.5

90.1 15.4 19.0 29.2 28.0 22.0 3.7

83.2 16.0 16.7 28.6 27.4 20.8
2.0

24.3 95.7
2.8 60.0
4.9 19.1
0.5 156.9
*

19.1 76.3
2.2 77.4
7.5 30.1
0.9 254.9
11.6

25.5 102.9
3.0 50.0 7.8 31.3 1.0 222.2
*

21.8 88.8
2.7 56.1
6.9 28.2
0.9 220.3
10.8

19.5 79.8 2.4 47.4 7.7 31.5 1.0 263.2
*

22.0 88.6
2.6 57.1
7.0 28.2
0.8 224.2
8.9

108.7 * * * * * *

126.6 * * * * * *

123.0 *
102.5 100.0
* * *

159.7 *
99.8 100.0
* * *

116.5 * * * * * *

127.2 35.5 86.1 100.0 36.9 100.0 *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

21.2

*

*

*

*

*

16.1

*

*

*

*

*

14.6

*

*

*

*

*

12.2

*

*

*

*

*

10.7

*

*

*

*

*

8.2

*

*

*

3.0

51.7 32.5 22.5
* 12.5
* *

25.0 54.8 22.6
* * * *

27.0 28.3 21.7
* * * *

40.0 31.7 24.4
* 14.6
* *

27.8 21.1 15.8
* * * *

34.4 32.7 21.4
5.6 10.7
3.1 11.7

.

*

*

*

*

4.8

.

*

*

*

*

2.0

.

*

23.0

23.5

37.5

23.3

60.0 * *
47.5 65.0 42.5
.

36.4 17.9
* 61.3 64.5 48.4
*

70.5 15.4
* 50.0 54.3 34.8
*

65.9 * *
51.2 56.1 39.0
*

89.5

65.3

26.7

15.0

*

*

44.7

50.5

44.7

56.6

23.7

37.2

*

*

401

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Peach County - 111

1990
21189 5385 467
19.5 19.2 21.0
72 12 381 58 180 31
3 98 12
8 6 2 9 1 5
32 5 0
45 5 5
114 90 130
4 46
5 16
. . .
252 63
4 206 164 140
. 0

1991
21387 5406 471
21.5 20.3 23.0
52 19 360 44 158 13
4 105
8
7 5 2 9 1 0
34 14
2 35
5 4
104 77
117 4
45 8
24
7 3 16
251 45 9
202 187 156
1 0

Total
1992 1993

21588 5427 475

21782 5447 479

20.2 19.9 23.0

20.9 19.4 22.0

48

54

10

11

328

348

34

40

145

164

16

18

8

6

102

104

12

13

3

3

3

2

0

1

11

8

2

0

1

1

35

35

5

6

2

0

24

41

6

7

3

10

116

111

68

77

107

97

2

9

42

45

1

4

20

16

9

10

10

7

44

47

208

244

46

47

15

12

174

196

184

215

141

167

9

14

2

1

1994 5-year

21977 5468 483

107923 27133 2376

20.2 20.2 24.0

20.4 19.8 22.0

47

273

12

64

338

1755

41

217

161

808

20

98

2

23

107

516

5

50

8

29

6

22

2

7

7

44

1

5

1

8

44

180

11

41

2

6

41

186

6

29

8

30

101

546

76

388

96

547

3

22

50

228

7

25

18

94

8

34

12

32

37

144

242

1197

59

260

6

46

193

971

202

952

160

764

43

67

1

4

1990
10716 2394 220

1991
10850 2405 222

White
1992 1993

10987 2416 226

11116 2426 228

1994 5-year

11248 2436 230

54917 12077
1126

21.3 19.5 20.0

24.0 19.7 21.0

21.9 17.3 21.0

22.6 18.9 22.0

23.5 18.5 21.0

22.8 18.8 21.0

22

8

16

11

12

69

3

4

2

1

2

12

169

161

165

162

174

831

19

6

8

7

8

48

31

19

23

18

29

120

15

8

9

15

12

59

1

1

3

1

0

6

24

35

23

29

31

142

2

2

7

4

3

18

2

0

3

1

2

8

2

0

3

0

2

7

0

0

0

1

0

1

2

1

6

1

1

11

0

0

0

0

0

0

3

0

0

0

0

3

5

10

15

10

17

57

2

3

3

2

1

11

0

0

2

0

0

2

11

12

9

13

18

63

3

1

3

6

2

15

1

1

1

1

4

8

54

47

57

42

45

245

17

6

11

10

9

53

42

41

37

35

33

188

0

0

0

3

2

5

30

35

32

28

42

167

2

6

1

1

4

14

7

6

9

6

5

33

.

0

0

2

2

4

.

0

0

1

5

6

.

0

10

7

16

33

133

130

126

126

140

655

32

23

30

20

29

134

3

3

8

6

4

24

58

53

59

57

74

301

41

48

59

60

71

279

35

38

43

44

55

215

.

0

5

4

15

24

0

0

0

0

0

0

1990
10075 2904 240

1991
10169 2912 242

Black
1992 1993

10265 2920 244

10357 2927 246

1994 5-year

10450 2936 248

51316 14599
1221

18.3 18.9 23.5

17.9 20.7 28.0

19.0 20.3 26.0

19.7 19.8 26.0

18.3 21.0 27.0

18.5 20.2 26.0

50

44

32

43

34

203

9

15

8

10

10

52

210

196

161

185

161

913

39

38

26

33

32

168

149

139

122

146

131

687

16

5

7

3

8

39

2

3

5

5

2

17

73

68

77

73

74

365

10

6

5

9

2

32

6

7

0

2

6

21

4

5

0

2

4

15

2

2

0

0

2

6

7

8

5

7

6

33

1

1

2

0

1

5

2

0

1

1

1

5

27

24

20

25

26

122

3

11

2

4

9

29

0

2

0

0

2

4

34

23

15

28

22

122

2

4

3

1

4

14

4

3

2

9

4

22

60

56

58

69

56

299

73

71

57

67

66

334

88

76

70

61

61

356

4

4

2

6

1

17

16

10

10

17

8

61

3

2

0

3

3

11

9

18

11

10

13

61

.

0

3

8

5

16

.

0

1

5

7

13

.

1

1

31

17

50

118

118

81

117

101

535

31

20

16

26

29

122

1

6

6

6

2

21

148

148

114

138

117

665

122

138

125

154

130

669

105

117

98

122

104

546

.

1

4

10

28

43

0

0

2

1

1

4

402

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Peach County - 111

18.0 70.8
2.0 47.9
4.6 18.2
0.5 190.7
6.5
154.2 16.7 124.2 80.7 25.7 91.7
*
21.0 15.7
* 23.4
* 1.2
8.4 1.3
* 12.0
1.3 1.3
40.1 23.9 34.8
* 12.3
1.3 7.3
. . .
67.6 18.3
* 54.8 43.6 37.2
.

16.8 66.6
1.9 44.5
4.9 19.4
0.5 214.7
4.4
110.4 36.5 93.4 83.7 17.0
100.0 *
19.4 13.9
* 24.7
* *
9.4 3.9
* 9.9 1.4
*
35.4 21.7 33.0
* 12.7
2.3 11.6
1.2 *
2.8
72.8 14.5 20.0 56.9 52.7 43.9
*

15.2 60.4 1.7 45.0 4.7 18.8 0.5 224.7 4.4
101.0 20.8 71.5 85.3 25.2 91.7 *
* * * 32.7 * *
10.7 1.5
* 7.5 1.9
*
41.7 21.1 33.4
* 13.0
* 10.5
1.5 1.7 7.5
65.8 16.2 39.5 54.0 57.1 43.8
2.8

16.0 63.9
1.8 48.1
4.8 19.1
0.5 217.6
4.8
112.7 20.4 83.5 85.0 27.1 92.3 *
* * * 22.6 * *
10.1 1.7 *
12.0 2.1 2.9
37.6 22.6 28.5
2.7 13.3
* 7.7
1.7 1.2 8.0
70.9 15.4 33.3 57.5 63.0 49.0
4.1

15.4 61.8 1.8 48.5 4.9 19.6 0.6 228.1 4.4
97.2 25.5 84.8 100.0 10.3 100.0
*
23.7 17.8
* 20.6
* *
13.0 3.3
* 12.3 1.8 2.4
32.6 22.9 29.0
* 15.2
2.1 8.8
1.3 2.0 6.2
72.9 20.2 15.0 58.1 60.8 48.2 13.0

16.3 64.7
1.8 46.8
4.8 19.0
0.5 214.6
4.9
114.9 23.4 91.3 86.5 21.0 94.0
4.2
16.5 12.5
4.0 24.7
0.8 0.4
10.3 2.3 0.3
10.8 1.7 1.7
37.4 22.5 31.8
1.3 13.3
1.5 9.1
1.4 1.4 6.1
70.0 16.9 24.2 56.3 55.2 44.3
5.0

15.8 70.6
2.2 18.7
2.2 10.0
0.3 114.8
6.7

14.8 66.9
2.1 11.9
3.2 14.6
0.5 168.3
5.0

15.0 68.3 2.1 14.2 2.1 9.5 0.3 115.0 5.0

14.6 66.8
2.1 11.5
2.6 12.0
0.4 139.4
7.0

15.5 71.4 2.3 16.9 2.8 12.7 0.4 142.9 4.9

15.1 68.8
2.2 14.7
2.6 11.8
0.4 136.3
5.7

100.0 *
86.4 52.6
* * *

36.0 *
27.0 * * * *

71.0 *
35.5 *
31.0 85.7
*

48.3 *
30.7 * * * *

52.1 *
34.7 100.0
* * *

61.3 17.4 42.6 47.9 16.0 94.4
*

*

*

*

*

*

9.6

*

*

*

*

*

8.4

*

*

*

*

*

*

*

*

35.7

*

*

13.1

*

*

*

*

*

*

*

*

*

*

*

*

3.0

6.2

9.1

6.2

9.8

6.9

*

*

*

*

*

1.3

*

*

*

*

*

*

6.6

7.5

5.6

8.3

10.5

7.7

*

*

*

3.8

*

1.8

*

*

*

*

*

1.0

36.0 10.2 25.5
* 18.2
* 7.8

31.8 3.8
25.6 *
21.9 3.8 6.9

37.5 6.8 23.0
* 19.8
* 9.7

29.4 6.4
22.6 *
18.1 *
6.1

28.3 5.2
19.2 *
24.6 *
4.7

32.6 6.5
23.1 0.6
20.5 1.7 7.0

.

*

*

*

*

*

.

*

*

*

1.8

0.5

.

*

3.7

2.5

5.7

3.0

79.6 21.6
* 34.9 24.7 21.1
.

82.8 16.7
* 33.1 30.0 23.7
*

77.8 21.1 40.0 36.4 36.4 26.5 3.1

77.8 14.7 30.0 36.5 38.5 28.2
*

80.9 19.3
* 43.0 41.3 32.0 8.7

79.8 18.8 23.5 36.9 34.2 26.3
3.7

20.8 72.3
1.9 71.6
7.2 25.1
0.6 241.7
6.5

19.3 67.3
1.8 72.4
6.7 23.4
0.6 246.4
4.1

15.7 55.1 1.5 77.2 7.5 26.4 0.6 308.0 4.1

17.9 63.2
1.7 79.3
7.0 24.9
0.6 273.4
3.1

15.4 54.8 1.4 83.4 7.1 25.2 0.7 299.6 4.1

17.8 62.5
1.7 76.4
7.1 25.0
0.6 272.0
4.4

208.3 18.0 162.5 94.7 41.7 90.0
*

181.8 34.1
157.0 97.3 24.8
100.0 *

131.0 25.0
106.4 100.0
20.5 100.0
*

174.6 23.3
134.0 97.0 36.5 88.9 *

136.9 29.4
128.8 100.0
* * *

166.3 25.6
137.6 97.6 26.2 93.8 5.7

28.6 * *
33.0 * *

35.7 25.5
* 40.2
* *

* * * 30.1 * *

* * * 36.8 * *

37.3 * *
36.8 * *

23.0 16.4
6.7 35.5
1.6 0.4

12.9 * *
16.3 * *

12.2 5.6 *
12.0 * *

12.4 * *
9.5 * *

13.5 * *
15.2 *
4.9

16.1 5.6
* 14.0
* *

13.4 3.2 *
13.6 1.6 2.4

45.1 35.1 42.5
* 7.8
* 7.0

38.9 37.0 39.6
* 5.2
* 15.0

46.8 36.1 44.6
* 6.3
* 11.5

45.7 36.4 33.2
3.3 9.3
* 9.2

37.8 42.0 39.1
* 5.1
* 13.4

42.7 37.2 39.7
1.9 6.8 1.2 11.1

.

*

*

2.6

1.6

1.3

.

*

*

1.6

2.3

1.1

.

*

*

10.1

5.5

4.1

57.8 15.9
* 71.2 58.7 50.5
.

63.8 11.8 26.1 77.1 71.9 60.9
*

53.3 11.3 35.3 72.2 79.1 62.0
*

64.6 15.5 37.5 75.0 83.7 66.3
5.4

64.7

60.9

20.9

15.0

*

24.1

74.5

74.0

82.8

74.4

66.2

60.7

17.8

6.2

403

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Pickens County - 112

1990
14432 3220 297
20.5 18.1 20.0
26 8
203 21 31 14
0 36
5
7 7 0 5 0 1
19 4 1
19 2 5
48 20 84
1 47
3 14
. . .
151 23
2 99 70 57
. 1

1991
14853 3283 299
21.3 19.1 20.0
28 6
220 25 44 16 1 47 3
5 5 0 6 0 3
13 6 1
14 1 4
58 17 74
1 53
1 9
4 4 13
166 21 5
115 74 70 14 0

Total
1992 1993

15264 3343 299

15689 3407 301

22.3 20.4 20.0

21.9 19.2 20.0

30

13

9

1

212

204

27

10

43

29

9

9

2

0

47

44

3

3

1

3

1

2

0

1

2

2

1

1

0

1

17

17

1

3

0

0

17

23

2

0

7

4

58

45

17

16

74

63

2

1

32

35

0

0

3

5

27

16

10

18

29

42

158

154

26

33

3

3

105

117

78

106

72

95

50

60

1

1

1994 5-year

16100 3468 302

76338 16721
1499

22.3 20.8 20.0

21.6 19.2 20.0

24

121

3

27

232

1071

19

102

44

191

11

59

2

5

31

205

4

18

2

18

1

16

1

2

2

17

2

4

1

6

25

91

4

18

0

2

15

88

3

8

6

26

75

284

20

90

69

364

3

8

49

216

2

6

2

33

17

64

10

42

42

126

182

811

30

133

3

16

116

552

107

435

90

384

81

205

3

6

1990
14119 3150 289

1991
14529 3212 291

White
1992 1993

14934 3274 292

15346 3337 294

1994 5-year

15750 3397 295

74678 16370
1461

20.5 18.1 20.0

21.3 19.1 20.0

22.3 20.4 20.0

21.9 19.2 20.0

22.3 20.8 20.0

21.7 19.2 20.0

26

28

28

13

20

115

8

6

9

1

2

26

200

219

204

201

227

1051

21

25

25

10

16

97

29

44

39

28

42

182

11

14

9

8

11

53

0

1

2

0

2

5

35

44

45

42

27

193

5

3

3

3

3

17

7

4

1

3

2

17

7

4

1

2

1

15

0

0

0

1

1

2

5

6

2

2

2

17

0

0

1

1

2

4

1

3

0

1

1

6

19

13

16

17

25

90

4

6

1

3

4

18

1

1

0

0

0

2

19

14

16

23

15

87

2

1

2

0

3

8

5

4

6

4

6

25

48

57

56

44

73

278

18

17

14

15

19

83

84

74

72

63

69

362

1

1

2

1

3

8

47

53

31

35

48

214

3

1

0

0

2

6

13

9

3

5

2

32

.

4

25

14

16

59

.

4

10

17

10

41

.

13

29

35

36

113

149

166

154

151

180

800

23

21

24

32

28

128

1

5

3

3

3

15

96

114

99

114

113

536

69

74

73

104

103

423

56

70

67

93

87

373

.

14

46

58

77

195

1

0

1

1

3

6

1990
247 52 8

1991
254 53 8

Black
1992 1993

261

269

54

55

8

8

1994 5-year

276 1306

56

270

8

40

. . 22.0

. . 34.0

23.2 .
30.0

21.6 . .

18.0 .
24.0

19.8 .
27.0

0

0

1

0

2

3

0

0

0

0

1

1

2

0

6

2

2

12

0

0

1

0

1

2

2

0

4

1

1

8

0

0

0

0

0

0

0

0

0

0

0

0

1

2

1

0

4

8

0

0

0

0

1

1

0

1

0

0

0

1

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

1

3

2

0

3

1

1

7

0

0

2

0

0

2

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

1

0

0

0

0

1

.

0

2

1

0

3

.

0

0

0

0

0

.

0

0

3

5

8

1

0

4

2

1

8

0

0

2

1

0

3

1

0

0

0

0

1

2

0

4

2

0

8

1

0

3

1

1

6

1

0

3

1

0

5

.

0

2

1

1

4

0

0

0

0

0

0

404

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Pickens County - 112

14.1 63.0
1.9 15.4
2.5 11.2
0.3 141.2
5.0
87.5 30.8 70.7 33.3 16.8 100.0
*
34.5 34.5
* . * *
9.4 * *
9.5 *
2.5
27.4 10.0 43.1
* 23.6
* 12.2
. . .
79.1 12.5
* 49.3 34.8 28.4
.

14.8 67.0
2.0 20.1
3.2 14.3
0.4 163.8
6.1
93.7 21.4 83.7 44.0
* * *
22.7 22.7
* 27.1
* *
5.9 2.7
* 6.4
* *
30.1 7.8
34.7 *
24.4 *
7.6
* * 3.5
79.4 10.9 18.5 52.5 33.8 32.0
6.4

13.9 63.4 1.9 20.6 3.1 14.1 0.4 171.5 4.5
100.2 30.0 90.2 55.6 * * *
* * * * * *
8.0 * *
8.1 *
3.3
31.2 8.1 37.4
* 15.9
* *
7.1 2.6 7.6
84.9 13.5
* 50.0 37.1 34.3 23.8

13.0 59.9
1.8 14.2
2.8 12.9
0.4 170.5
2.9
43.2 *
33.2 * * * *
* * * * * *
8.3 * *
11.3 * *
24.1 7.8
32.1 *
17.3 *
4.9
4.1 4.6 10.7
86.0 17.9
* 57.4 52.0 46.6 29.4

14.4 66.9 2.1 19.2 1.9 8.9 0.3 111.1 4.6
79.4 *
62.8 66.7
* * *
* * * * * *
10.8 * *
6.6 *
2.6
36.2 8.7 31.4
* 21.6
* *
4.2 2.5 10.5
83.1 14.9
* 50.7 46.7 39.3 35.4

14.0 64.1
2.0 18.0
2.7 12.3
0.4 151.5
4.6
80.7 22.3 68.1 48.5 12.0 94.4
*
16.8 14.9
* 15.8
* *
8.5 1.7
* 8.3 0.8 2.4
30.0 8.5
35.6 0.8
20.7 0.6 6.1
4.1 2.7 8.2
82.4 13.9 14.8 51.9 40.9 36.1 23.8

14.2 63.5
1.9 14.6
2.5 11.1
0.3 141.7
3.8

15.1 68.2
2.1 20.2
3.0 13.7
0.4 156.6
5.6

13.7 62.3 1.9 19.3 3.0 13.7 0.4 170.5 4.6

13.1 60.2
1.9 13.9
2.7 12.6
0.4 166.7
2.7

14.4 66.8 2.1 18.8 1.7 7.9 0.2 100.4 4.4

14.1 64.2
2.0 17.4
2.6 11.8
0.3 147.0
4.2

90.0 30.8 72.7 33.3 17.3 100.0
*

96.3 21.4 86.0 44.0
* * *

95.9 32.1 85.6 56.0
* * *

44.2 *
34.0 * * * *

67.8 *
54.2 66.7
* * *

78.7 22.6 66.4 47.9 11.6 94.1
*

35.0

*

*

*

*

16.2

35.0

*

*

*

*

14.3

*

*

*

*

*

*

.

27.3

*

*

*

16.1

*

*

*

*

*

*

*

*

*

*

*

*

9.5

6.0

7.8

8.5

11.0

8.6

*

2.8

*

*

*

1.7

*

*

*

*

*

*

9.6

6.5

7.9

11.4

6.7

8.4

*

*

*

*

*

0.8

2.5

*

3.0

*

2.6

2.4

27.7 9.1
43.8 *
24.0 *
11.6

29.7 7.8
34.7 *
24.5 *
7.6

31.1 6.9 37.5
* 15.9
* *

23.9 7.5
32.5 *
17.6 *
4.9

36.1 8.5
31.7 *
21.6 * *

29.9 8.0
35.9 0.8
20.8 0.6 6.0

.

*

6.7

3.7

4.1

3.9

.

*

2.7

4.5

2.6

2.7

.

3.6

7.8

9.2

9.2

7.5

79.3 12.6
* 48.5 34.8 28.3
.

79.4 11.0 18.5 52.3 33.9 32.1
6.4

85.6 12.9
* 49.0 36.1 33.2 22.8

85.8 17.7
* 56.7 51.7 46.3 28.9

82.9 14.2
* 50.4 46.0 38.8 34.4

82.5 13.7 14.2 51.4 40.6 35.8 23.1

*

*

23.0

*

*

9.2

*

* 111.1

*

*

44.4

*

*

3.7

*

*

1.4

*

*

*

*

*

72.7

*

*

*

*

*

6.1

*

*

*

*

*

29.6

*

*

*

*

*

0.8

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

58.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

66.3

27.5

*

*

*

*

*

72.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

66.7

*

*

*

*

*

50.0

*

*

*

*

*

41.7

.

*

*

*

*

*

405

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Pierce County - 113

1990
13328 3058 362
20.5 28.6 20.0
26 4
198 25 45 13
2 1 0
0 0 0 3 1 0
12 1 0
13 1 1
61 30 57
3 36
6 7
. . .
133 39
0 95 73 55
. 0

1991
13508 3070 360
20.6 .
19.0
22 7
202 22 40 23 4 1 0
3 1 2 5 0 0
11 1 0
21 1 4
60 21 68
3 41
1 5
2 4 18
134 36 3
118 90 82 10 0

Total
1992 1993

13683 3081 358

13863 3093 355

20.1 16.1 20.0

19.8 .
20.0

27

23

1

5

202

207

26

23

59

62

14

18

2

3

3

2

1

0

4

4

3

2

1

2

4

6

2

2

2

2

11

13

3

2

0

0

11

18

1

2

1

2

61

69

35

32

71

59

2

2

40

37

0

1

10

6

5

10

15

14

40

66

121

156

28

30

0

0

120

141

123

131

101

120

73

97

1

4

1994 5-year

14034 3105 353

68416 15407
1788

19.6 19.3 21.0

20.1 19.3 20.0

27

125

2

19

200

1009

25

121

50

256

10

78

0

11

2

9

1

2

3

14

2

8

1

6

1

19

2

7

0

4

13

60

2

9

0

0

8

71

0

5

2

10

56

307

17

135

65

320

1

11

42

196

0

8

10

38

2

19

11

44

47

171

158

702

29

162

1

4

149

623

137

554

127

485

101

281

1

6

1990
11683 2683 302

1991
11854 2691 300

White
1992 1993

12024 2698 297

12199 2707 295

1994 5-year

12366 2714 292

60126 13493
1486

20.6 28.6 19.5

20.8 .
19.0

19.7 .
19.5

20.6 .
20.0

20.1 21.0 21.0

20.4 24.8 20.0

21

21

21

17

21

101

3

7

1

5

2

18

165

175

168

177

171

856

21

21

21

17

20

100

24

25

38

42

28

157

11

22

12

15

9

69

1

1

1

2

0

5

1

0

1

2

1

5

0

0

0

0

0

0

0

2

1

4

3

10

0

1

1

2

2

6

0

1

0

2

1

4

2

2

2

5

1

12

0

0

2

2

2

6

0

0

2

2

0

4

7

8

1

0

0

0

11

15

1

1

0

3

7

10

2

2

0

0

8

15

1

1

0

2

7

39

1

6

0

0

6

55

0

4

2

7

51

46

46

55

48

246

17

12

18

22

9

78

47

61

61

50

54

273

0

1

0

2

1

4

33

37

38

35

40

183

4

1

0

1

0

6

3

4

7

4

8

26

.

2

4

9

2

17

.

4

13

11

10

38

.

15

35

56

42

148

123

121

112

139

136

631

32

31

24

24

20

131

0

2

0

0

1

3

69

97

96

118

122

502

50

75

96

106

111

438

35

70

81

98

101

385

.

8

58

77

76

219

0

0

1

4

0

5

1990
1569 356 56

1991
1590 357 56

Black
1992 1993

1611 358 55

1632 359 55

1994 5-year

1652 360 55

8054 1789
277

19.2 .
22.0

18.6 .
25.0

21.3 16.1 28.5

18.1 .
26.5

18.6 17.5 25.0

18.7 16.8 26.0

5

1

6

6

6

24

1

0

0

0

0

1

32

26

33

29

26

146

4

1

5

6

5

21

21

15

21

20

21

98

2

1

2

3

1

9

1

3

1

1

0

6

0

1

2

0

1

4

0

0

1

0

1

2

0

1

3

0

0

4

0

0

2

0

0

2

0

1

1

0

0

2

1

3

2

1

0

7

1

0

0

0

0

1

0

0

0

0

0

0

5

3

4

3

6

21

0

1

1

0

1

3

0

0

0

0

0

0

2

6

3

3

2

16

0

0

0

1

0

1

1

0

1

0

0

2

10

14

15

14

8

61

13

9

17

10

7

56

10

7

10

9

11

47

3

2

2

0

0

7

3

3

2

2

1

11

2

0

0

0

0

2

4

1

3

2

2

12

.

0

1

1

0

2

.

0

2

3

1

6

.

3

4

4

5

16

9

12

8

16

20

65

7

5

4

6

8

30

0

1

0

0

0

1

26

20

24

23

24

117

23

14

27

25

23

112

20

11

20

22

23

96

.

2

15

20

23

60

0

0

0

0

1

1

406

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

14.9

15.0

14.8

14.9

14.3

14.7

General fertility rate

64.7

65.8

65.6

66.9

64.4

65.5

Total fertility rate

2.0

2.0

2.0

2.1

2.0

2.0

% Livebirths to unmarried women

22.8

19.9

29.4

30.2

25.0

25.5

Crude abortion rate

*

*

*

*

*

0.1

General abortion rate

*

*

*

*

*

0.6

Total abortion rate

*

*

*

*

*

0.0

Abortion ratio

*

*

*

*

*

8.1

Fetal Death rate

5.2

9.1

5.5

7.1

3.5

6.1

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

71.8

61.2

75.5

64.8

76.4

69.9

% Repeat conceptions to women under 18

*

31.8

*

21.7

*

15.2

Livebirths to women under 18

69.1

61.2

72.7

64.8

70.7

67.7

% Livebirths to unmarried women under 18

52.0

27.3

53.8

63.6

44.0

48.3

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

6.7

Infant and child survival rates

Infant mortality

*

*

*

*

*

13.9

Neonatal mortality

*

*

*

*

*

7.9

Postneonatal mortality

*

*

*

*

*

6.0

Perinatal mortality ratio

*

24.3

*

28.6

*

18.6

Deaths of children 1-4 yrs

*

*

*

*

*

1.8

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

6.1

5.4

5.4

6.3

6.5

5.9

% Very low birthweight

*

*

*

*

*

0.9

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

6.6

10.4

5.5

8.8

4.0

7.1

% Multiple gestation

*

*

*

*

*

0.5

% Birth defect

*

*

*

*

*

1.0

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

32.1

30.9

31.4

35.0

29.0

31.7

% with father not named on birth certificate

15.2

10.4

17.4

15.6

8.5

13.4

% with maternal education less than high school

28.9

33.8

35.5

29.2

32.5

32.0

% No prenatal care

*

*

*

*

*

1.1

% Maternal smoking during pregnancy

18.4

20.4

19.9

18.2

21.4

19.7

% Maternal alcohol use during pregnancy

3.1

*

*

*

*

0.8

% Interpregnancy interval less than 6 months

6.3

4.6

9.7

5.4

8.9

6.9

Child abuse and neglect rates

Physical

.

*

1.3

2.7

*

1.3

Sexual

.

*

4.0

3.7

2.9

2.9

Neglect

.

4.8

10.6

17.5

12.5

11.4

Interventions to improve infant & child survival

% Prenatal care first trimester

68.2

68.0

61.1

75.7

80.2

70.7

% Primary C-section delivery

21.7

18.9

15.4

16.7

16.8

17.9

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

48.2

58.7

59.7

68.8

74.5

62.1

% Medicaid during pregnancy

37.1

44.8

61.2

63.9

68.5

55.2

% Medicaid and WIC during pregnancy

27.9

40.8

50.2

58.5

63.5

48.3

% Perinatal case management

.

5.0

36.3

47.3

50.5

34.8

Pierce County - 113

14.1 61.5
1.9 14.6
* * * * 4.8
69.5 *
69.5 42.9
* * *
* * * * * *
4.2 * *
6.7 * *
32.1 10.4 28.7
* 20.2
* *
. . .
75.9 21.5
* 42.1 30.5 21.3
.

14.8 65.0
2.0 14.4
* * * * 8.5
70.1 33.3 70.1 23.8
* * *
* * * * * *
4.6 * *
8.6 * *
27.4 6.9
35.1 *
21.3 * *
* * 4.7
71.2 18.7
* 55.7 43.1 40.2
4.6

14.0 62.3 2.0 22.8
* * * * 5.2
70.7 *
70.7 42.9
* * *
* * * * * *
4.2 * *
4.8 * *
28.2 10.8 36.7
* 22.8
* 8.6
* 4.1 11.0
68.3 15.7
* 57.5 57.5 48.5 34.7

14.5 65.4
2.0 23.9
* * * * 6.6
57.7 29.4 57.7 50.0
* * *
* * * 27.9 * *
5.6 * *
8.5 * *
32.5 12.5 28.7
* 20.1
* *
2.8 3.4 17.5
79.0 15.8
* 67.0 60.2 55.7 43.8

13.8 63.0 2.0 16.4
* * * * 3.3
71.9 *
68.4 30.0
* * *
* * * * * *
4.1 * *
3.5 * *
28.9 5.3 31.6
* 23.8
* 7.9
* 3.1 13.1
81.0 13.8
* 71.3 64.9 59.1 44.4

14.2 63.4
2.0 18.4
0.1 0.4 0.0 5.3 5.7
68.0 17.8 67.3 37.4
* * 6.7
11.7 7.0 *
13.9 1.9 *
4.6 0.7
* 6.5
* 0.8
29.8 9.2
32.2 *
21.6 0.7 5.7
1.3 3.0 11.6
75.1 17.1
* 58.9 51.4 45.2 31.8

20.4 89.9
2.5 65.6
* * * * *
89.3 * * * * * *
* * * * * *
15.6 * * * * *
33.3 40.6 31.3
* * * *
. . .
28.1 23.3
* 81.3 71.9 62.5
.

16.4 72.8
2.1 57.7
* * * * 14.0

20.5 92.3 2.7 63.6
* * * * *

17.8 80.9
2.2 71.4
* * * * *

15.7 72.3 1.9 80.8
* * * * *

18.1 81.6
2.3 67.6
* * * * 9.5

* 108.5 109.3 109.7

86.8

*

*

*

*

*

*

90.4 109.3

91.4

75.9

* 100.0 100.0 100.0 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

46.1

*

*

*

*

*

*

*

*

*

*

*

*

*

23.1

14.4

*

*

*

*

*

*

*

*

*

*

23.1

*

*

*

11.0

*

*

*

*

*

*

*

*

*

*

56.0 34.6 26.9
* * * *

50.0 51.5 30.3
* * * *

51.9 35.7 33.3
* * * *

33.3 26.9 42.3
* * * *

44.9 38.6 32.6
4.8 7.6
* 14.0

*

*

*

*

*

*

*

*

*

2.8

*

*

*

9.2

7.4

46.2

24.2

55.2

76.9

44.5

21.7

*

22.2

32.0

22.6

*

*

*

*

*

76.9

72.7

82.1

92.3

80.7

53.8

81.8

89.3

88.5

77.2

42.3

60.6

78.6

88.5

66.2

*

45.5

71.4

88.5

53.1

407

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Pike County - 114

1990
10224 2244 248
20.0 20.6 21.0
24 8
165 19 34 10
1 32
3
0 0 0 1 0 1
9 2 0 9 2 4
41 24 43
3 29
3 2
. . .
101 17
5 74 49 37
. 0

1991
10356 2250 248
20.3 19.2 22.0
16 2
148 14 40 11 1 29 2
3 2 1 3 0 1
12 3 0
16 2 4
39 16 47
4 28
2 6
1 1 27
89 20
0 76 61 49
0 0

Total
1992 1993

10476 2257 248

10606 2265 248

21.0 19.6 21.0

21.0 20.4 20.0

20

13

4

5

144

152

15

11

41

38

23

19

1

0

27

20

4

0

1

0

1

0

0

0

2

0

0

0

1

1

17

8

2

0

0

0

14

14

1

2

0

0

40

39

17

16

44

38

1

3

36

29

4

0

9

9

1

5

5

9

55

56

104

122

20

18

0

0

72

66

67

73

57

53

11

15

0

1

1994 5-year

10729 2271 247

52391 11287
1239

19.8 20.7 21.0

20.6 19.7 21.0

21

94

4

23

134

743

18

77

45

198

17

80

0

3

24

132

2

11

1

5

0

3

1

2

0

6

1

1

0

4

10

56

1

8

0

0

10

63

2

9

1

9

40

199

20

93

34

206

2

13

22

144

2

11

10

36

10

17

11

26

35

173

114

530

14

89

1

6

69

357

71

321

59

255

15

41

1

2

1990
8122 1762
189

1991
8287 1780
191

White
1992 1993

8444 1798
194

8605 1818
195

1994 5-year

8763 1836
197

42221 8994 966

21.1 19.8 20.0

21.4 19.6 21.5

20.8 20.2 21.0

22.6 23.0 20.0

20.3 18.6 20.0

21.2 19.7 20.0

14

10

11

6

13

54

4

1

1

2

0

8

129

107

106

125

105

572

12

9

8

5

10

44

13

14

14

19

22

82

3

11

15

14

17

60

1

1

1

0

0

3

20

18

16

12

14

80

2

1

3

0

2

8

0

2

1

0

1

4

0

1

1

0

0

2

0

1

0

0

1

2

1

2

2

0

0

5

0

0

0

0

1

1

1

1

1

1

0

4

7

5

2

2

0

0

7

12

2

0

2

2

7

7

0

0

0

0

8

13

1

2

0

0

6

32

1

5

0

0

9

49

2

7

1

5

27

24

21

29

29

130

11

5

5

7

8

36

36

37

29

26

23

151

0

0

0

1

0

1

24

24

27

28

22

125

1

1

2

0

2

6

0

1

6

7

7

21

.

0

0

4

8

12

.

1

5

8

10

24

.

27

51

22

27

127

87

76

83

103

97

446

15

15

19

14

11

74

4

0

0

0

1

5

49

45

42

47

42

225

30

36

41

50

45

202

23

29

34

36

35

157

.

0

5

11

9

25

0

0

0

1

1

2

1990
2053 466 55

1991
2080 467 55

Black
1992 1993

2104 468 55

2130 469
55

1994 5-year

2154 470 55

10520 2341 275

19.2 23.9 22.0

20.0 18.8 25.0

21.4 19.3 24.0

18.7 20.1 26.0

19.1 24.2 23.0

19.6 20.4 23.0

10

6

9

7

8

40

4

1

3

3

4

15

36

40

38

26

28

168

7

5

7

6

8

33

21

26

27

18

23

115

7

0

8

5

0

20

0

0

0

0

0

0

11

11

11

8

10

51

1

1

1

0

0

3

0

1

0

0

0

1

0

1

0

0

0

1

0

0

0

0

0

0

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

2

7

10

1

3

23

0

1

2

0

0

3

0

0

0

0

0

0

2

4

6

1

0

13

0

2

0

0

0

2

2

2

0

0

0

4

14

15

19

10

10

68

13

11

12

9

12

57

7

10

15

12

11

55

3

4

1

2

2

12

5

4

9

1

0

19

2

1

2

0

0

5

2

5

3

2

3

15

.

0

0

1

1

2

.

0

0

1

1

2

.

0

3

32

7

42

14

12

21

19

16

82

2

5

1

4

2

14

1

0

0

0

0

1

25

31

30

18

26

130

19

25

26

22

25

117

14

20

23

16

23

96

.

0

6

4

6

16

0

0

0

0

0

0

408

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Pike County - 114

16.1 73.5
2.2 20.9
3.1 14.3
0.4 153.8
4.9
96.8 33.3 76.6 47.4
* * *
* * * * * *
5.5 * *
5.6 * *
27.9 14.7 26.5
* 17.9
* *
. . .
62.7 12.1 22.7 45.4 30.1 22.7
.

14.3 65.8
2.1 27.4
2.8 12.9
0.4 151.8
6.2
64.5 *
56.5 57.1
* * *
* * * * * *
8.1 * *
11.0 * *
28.7 11.0 32.4
* 19.3
* 8.3
* * 9.5
61.0 14.7
* 52.1 41.8 33.6
*

13.7 63.8 2.0 28.7 2.6 12.0 0.4 137.8 11.1
80.6 *
60.5 66.7
* * *
* * * * * *
11.8 * *
9.8 * *
29.4 11.9 30.8
* 25.2
* 10.2
* 1.7 19.2
72.7 14.9
* 50.3 46.9 39.9
7.7

14.3 67.1
2.1 25.3
1.9 8.8 0.3 104.2 8.8
52.4 38.5 44.4 90.9
* * *
* * * * * *
5.3 * *
9.3 * *
27.1 10.7 25.3
* 19.3
* 9.6
1.7 3.1 19.3
80.3 13.1
* 44.0 48.7 35.3 10.0

12.5 59.0 1.8 34.1 2.2 10.6 0.3 137.1
7.5
84.9 *
72.8 88.9
* * *
* * * * * *
7.5 * *
7.6 * *
30.5 15.2 25.8
* 16.7
* 12.5
3.4 3.7 11.9
85.1 11.8
* 52.3 53.8 44.7 11.4

14.2 65.8
2.0 27.0
2.5 11.7
0.4 137.2
7.7
75.8 24.5 62.1 68.8
8.9 100.0
4.8
6.7 * *
8.0 * *
7.5 1.1
* 8.6 1.2 1.2
28.7 12.7 28.1
1.8 19.7
1.5 8.4
1.5 2.3 15.0
72.0 13.3
9.0 48.6 43.7 34.7
7.2

15.9 73.2
2.2 10.2
2.5 11.4
0.3 130.7
*

12.9 60.1
1.9 13.1
2.2 10.1
0.3 130.4
7.3

12.6 59.0 1.8 13.3 1.9 8.9 0.3 115.9
8.9

74.1 *
63.5 * * * *

52.4 *
47.1 * * * *

56.8 *
41.3 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

5.4

4.7

6.6

*

*

*

*

*

*

5.6

11.2

7.6

*

*

*

*

*

*

22.9 8.7
28.6 *
19.0 * *

24.0 4.7
34.6 *
22.6 * *

21.2 4.8 27.6
* 25.7
* 9.1

.

*

*

.

*

2.2

.

12.1

22.5

68.5 13.9
* 38.6 23.6 18.1
.

71.7 15.2
* 42.1 33.6 27.1
*

79.0 19.6
* 40.0 39.0 32.4 4.8

14.5 68.8
2.2 15.4
1.4 6.6 0.2 79.5 7.7

12.0 57.2 1.8 21.4 1.6
7.6 0.2 102.9 9.3

13.5 63.6
2.0 14.5
1.9 8.9 0.3 111.7 7.1

30.7 *
25.6 * * * *

65.9 *
50.7 80.0
* * *

55.9 14.8 45.5 52.3
8.3 100.0
*

*

*

*

*

*

*

*

*

*

*

*

8.7

*

*

*

*

*

*

5.6

5.7

5.6

*

*

0.9

*

*

*

10.6

8.7

8.7

*

*

1.2

*

*

0.9

24.8 5.7
21.1 *
22.8 *
8.6

28.4 7.8
22.3 *
21.4 *
10.9

24.3 6.4
26.8 *
22.2 1.1 6.2

*

3.4

1.3

3.5

4.2

2.6

9.5

11.4

13.8

82.4 12.2
* 38.2 40.7 29.3
8.9

92.4 12.2
* 40.8 43.7 34.0
8.7

78.5 14.5
8.9 39.8 35.8 27.8
5.7

17.5 77.3
2.2 58.3
5.4 23.6
0.7 203.7
15.0

19.2 85.7
2.4 68.4
5.3 23.6
0.6 . *

18.1 81.2 2.3 71.1 5.2 23.5 0.7 189.7 19.2

12.2 55.4
1.6 69.2
3.8 17.0
0.5 200.0
12.8

13.0 59.5 1.6 82.1 4.6 21.3 0.7
. *

16.0 71.8
2.0 69.3
4.8 21.8
0.6 211.6
9.4

181.8 *
127.3 85.7 * * *

109.1 *
90.9 * * * *

163.6 *
127.3 85.7 * * *

127.3 *
109.1 100.0
* * *

145.7 *
145.7 100.0
* * *

145.5 37.5 120.0 90.9 * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

17.5

26.3

*

*

13.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

15.8

*

*

7.8

*

*

*

*

*

*

*

*

*

*

*

*

48.3 36.1 19.4
* 13.9
* *

42.9 28.9 27.0
* * * 27.8

51.4 31.6 39.5
* 23.7
* *

38.5 34.6 46.2
* * * *

35.7 42.9 39.3
* * * *

43.9 34.3 33.3
7.3 11.4
3.0 16.7

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

51.0

11.0

16.8

41.2 * *
69.4 52.8 38.9
.

30.8 13.9
* 81.6 65.8 52.6
*

55.3 * *
78.9 68.4 60.5 15.8

73.1 * *
69.2 84.6 61.5
*

57.1

49.7

*

9.0

*

*

92.9

78.3

89.3

70.5

82.1

57.8

21.4

12.3

409

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Polk County - 115

1990
33815 7386 765
20.9 18.1 20.0
92 22 534 65 161 26
5 97 22
7 4 3 9 2 0
52 4 1
45 6 7
150 79 185 16 156 18 30
. . .
390 94
2 301 175 144
. 0

1991
33949 7366 760
19.7 17.8 20.0
95 20 506 74 173 29
2 122
21
3 3 0 6 2 3
27 6 1
38 3 9
110 102 198
13 139
13 24
12 11 56
340 98 3
359 214 198
25 0

Total
1992 1993

34085 7348 755

34214 7329 750

20.5 19.2 20.0

20.3 18.4 21.0

73

72

20

8

477

485

58

58

165

155

29

36

10

2

91

100

13

13

5

8

4

4

1

4

14

5

1

2

4

7

45

52

9

5

1

0

42

50

4

9

19

120

141

142

96

79

179

176

10

16

126

118

9

10

25

19

21

18

43

16

76

83

351

348

71

88

6

12

298

319

236

277

210

241

129

148

0

0

1994 5-year

34344 7309 746

170407 36738 3776

19.6 18.8 21.0

20.2 18.4 20.0

73

405

5

75

498

2500

57

312

165

819

26

146

1

20

80

490

15

84

5

28

4

19

1

9

5

39

1

8

3

17

44

220

3

27

0

3

48

223

5

27

9

164

138

681

99

455

170

908

9

64

120

659

7

57

18

116

18

69

20

90

70

285

391

1820

66

417

10

33

338

1615

274

1176

247

1040

140

442

1

1

1990
28561 6113 625

1991
28665 6095 620

White
1992 1993

28771 6079 614

28870 6061 609

1994 5-year

28972 6043 603

143839 30391 3070

20.8 18.1 19.0

19.7 17.5 20.0

20.6 19.2 20.0

20.2 17.9 20.0

19.9 19.1 21.0

20.2 18.4 20.0

70

76

52

59

55

312

14

13

14

5

4

50

423

415

396

396

417

2047

49

58

42

46

43

238

84

103

101

87

102

477

22

23

24

28

24

121

5

1

3

0

0

9

76

98

64

80

62

380

18

18

11

12

11

70

2

0

3

5

3

13

1

0

3

4

3

11

1

0

0

1

0

2

7

3

6

3

3

22

2

2

1

1

1

7

0

3

4

2

2

11

40

18

34

35

33

160

3

2

6

5

2

18

0

0

1

0

0

1

32

28

31

35

37

163

4

2

4

7

4

21

5

8

13

97

7

130

108

84

106

103

111

512

43

60

55

44

62

264

153

165

151

147

152

768

11

7

6

7

7

38

139

126

115

107

112

599

13

9

4

4

5

35

16

12

15

17

15

75

.

7

17

16

16

56

.

9

32

12

19

72

.

46

46

38

54

184

319

296

307

294

343

1559

78

82

65

68

54

347

1

1

5

8

8

23

223

282

245

245

275

1270

124

166

180

212

216

898

100

153

168

182

196

799

.

17

106

110

115

348

0

0

0

0

1

1

1990
4791 1174
130

1991
4810 1170 129

Black
1992 1993

4829 1167
128

4848 1164 128

1994 5-year

4866 1160
127

24144 5835 642

20.7 17.9 25.0

19.5 18.7 25.0

19.8 18.3 27.0

20.3 19.2 25.0

18.4 17.3 24.0

19.7 18.2 25.0

22

19

21

13

17

92

8

7

6

3

1

25

107

91

81

87

78

444

16

16

16

12

14

74

77

70

64

68

63

342

4

5

5

8

1

23

0

1

6

2

1

10

17

21

22

20

12

92

4

3

2

1

3

13

5

3

2

3

2

15

3

3

1

0

1

8

2

0

1

3

1

7

2

3

7

2

2

16

0

0

0

1

0

1

0

0

0

5

1

6

11

9

11

17

10

58

1

4

3

0

1

9

1

1

0

0

0

2

12

10

11

15

10

58

2

1

0

2

0

5

2

1

6

23

2

34

41

26

35

38

27

167

36

42

41

35

37

191

32

33

28

29

18

140

4

6

4

9

2

25

17

13

11

11

8

60

5

4

5

6

2

22

14

12

10

2

3

41

.

4

4

2

2

12

.

2

9

4

1

16

.

7

19

31

13

70

69

44

44

53

46

256

16

16

6

19

12

69

1

2

1

4

2

10

77

77

53

72

63

342

51

48

56

64

57

276

44

45

42

58

51

240

.

8

23

37

24

92

0

0

0

0

0

0

410

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Polk County - 115

15.8 72.3
2.2 30.5
2.9 13.1
0.4 146.3
4.3
120.3 23.9 85.0 52.3 28.8 95.2
6.5
13.1 * *
16.7 * *
9.7 * *
8.6 1.1 1.3
30.9 15.0 35.4
3.1 30.0
3.5 10.5
. . .
74.3 19.7
* 57.0 33.1 27.3
.

14.9 68.7
2.1 34.4
3.6 16.6
0.5 184.3
4.6
125.0 21.1 97.4 59.5 27.6
100.0 *
* * * 11.8 * *
5.3 1.2
* 7.6
* 1.8
24.3 20.3 40.7
2.6 28.0
2.6 9.7
1.3 1.2 6.2
68.7 21.8
* 71.4 42.5 39.4
5.0

14.0 64.9 2.0 35.0 2.7 12.4 0.4 149.9 5.3
96.7 27.4 76.8 67.9 17.2 92.3
*
10.5 * *
28.7 * *
9.5 1.9
* 8.9
* 4.0
32.1 20.3 38.5 2.2 27.0 1.9 9.7
2.3 4.8 8.4
75.8 16.5 14.3 63.0 49.9 44.4 27.3

14.2 66.2
2.0 32.7
2.9 13.6
0.4 160.5
5.2
95.9 11.1 77.3 57.9 17.3 100.0
*
16.5 * *
10.3 *
1.1
10.7 1.0 *
10.5 1.9
24.9
31.2 16.7 38.1
3.4 25.1
2.1 7.0
2.0 1.8 9.2
72.3 21.0 21.8 67.3 58.4 50.8 31.2

14.5 68.1 2.1 33.5 2.3 10.9 0.3 132.0 3.8
97.9 6.8 76.4 71.9 20.1 100.0
*
10.0 * *
10.0 * *
8.8 * *
9.7 1.0 1.8
28.6 20.1 35.5 1.8 24.4 1.4
7.3
2.0 2.2 7.7
79.3 15.2 16.7 68.6 55.6 50.1 28.4

14.7 68.0
2.1 33.2
2.9 13.3
0.4 155.0
4.7
107.2 18.5 82.6 61.5 22.2 97.5
3.7
11.2 7.6 3.6
15.5 0.8 0.5
8.8 1.1
* 9.0 1.1 6.6
29.4 18.4 37.6
2.6 26.9
2.3 8.9
1.9 2.5 7.9
74.1 18.9 12.6 65.4 47.6 42.1 22.7

14.8 69.2
2.1 20.0
2.7 12.4
0.4 144.2
4.6

14.5 68.1
2.1 24.9
3.4 16.1
0.5 182.2
4.1

13.8 65.1 2.0 25.8 2.2 10.5 0.3 131.4 4.4

13.7 65.3
2.0 22.5
2.8 13.2
0.4 158.7
4.6

14.4 69.0 2.1 24.6 2.1 10.3 0.3 123.3 4.0

14.2 67.4
2.1 23.6
2.6 12.5
0.4 148.5
4.3

112.0 20.0 78.4 36.7 28.8 94.1
*

122.7 17.1 93.6 48.3 29.1
100.0 *

84.7 26.9 68.4 55.0 17.9 90.9
*

96.9 8.5
75.6 46.7 19.7 100.0
*

91.2 *
71.3 62.8 18.2 100.0
*

101.6 16.0 77.5 49.4 22.8 97.0
2.9

* * * 16.4 * *

*

*

12.6

*

*

*

*

*

*

*

15.0

*

*

*

*

*

*

*

*

6.4

*

5.4

*

*

*

10.7

*

0.9

*

0.4

9.5

4.3

8.6

8.8

7.9

7.8

*

*

1.5

1.3

*

0.9

*

*

*

*

*

*

7.7

6.8

7.9

9.0

8.9

8.1

*

*

*

1.8

*

1.0

1.2

1.9

3.3

24.7

1.7

6.4

28.0 10.3 36.9
2.7 33.6
3.2 7.4

22.5 14.5 41.3
1.7 30.8
2.2 6.0

28.9 14.0 39.2 1.6 29.6
* 7.0

27.5 11.4 39.0
1.8 27.9
* 7.5

27.3 15.0 37.7 1.7 27.1 1.2
7.3

26.8 13.0 38.8
1.9 29.8
1.7 7.1

.

1.0

2.3

2.2

2.2

1.9

.

1.2

4.4

1.7

2.6

2.5

.

6.4

6.4

5.2

7.4

6.3

77.1 20.3
* 53.2 29.6 23.9
.

72.5 22.3
* 68.3 40.2 37.0
4.1

79.7 17.9 17.2 62.5 45.9 42.9 27.0

74.8 19.9 17.4 63.3 54.8 47.0 28.4

82.9 14.8 16.7 66.4 52.2 47.3 27.8

77.4 19.0 11.4 62.7 44.3 39.5 21.7

22.3 91.1
2.5 73.3
3.5 14.5
0.4 132.8
*

18.9 77.8
2.2 77.8
4.4 17.9
0.5 175.0
6.8

16.8 69.4 2.0 79.0 4.6 18.9 0.6 193.0 9.4

17.9 74.8
2.2 80.0
4.1 17.2
0.5 170.9
8.6

16.0 67.2 1.9 81.8 2.5 10.3 0.3 129.0
*

18.4 76.1
2.2 78.1
3.8 15.8
0.4 160.8
6.2

169.2 36.4 123.1 100.0
* * *

147.1 36.8
123.8 100.0
* * *

163.7 28.6
124.7 100.0
* * *

102.0 *
94.1 100.0
* * *

134.2 *
110.5 100.0
* * *

143.4 27.2 115.3 100.0 20.3 100.0
7.8

46.7 * * * * *

*

*

*

*

*

*

*

*

*

*

80.5

*

*

*

*

*

*

4.4

*

33.8

*

18.0

*

16.1

*

35.2

*

*

*

1.1

10.3 * *
11.5 * *

9.9 * *
11.1 * *

13.8 * *
13.8 *
7.4

19.5 * *
17.6 *
26.4

12.8 * *
13.0 * *

13.1 2.0 *
13.3 1.1 7.7

42.7 34.3 30.8
* 16.7
4.9 20.0

33.3 46.7 37.9
7.0 14.9
* 25.5

48.6 50.6 35.0
* 13.9 6.3 22.2

48.1 41.2 34.9 10.7 12.9
7.1 *

36.5 48.1 24.3
* 10.5
* *

41.9 43.6 32.7
5.8 14.0
5.1 16.9

.

*

*

*

*

1.9

.

*

5.6

*

*

2.5

.

4.4

11.8

19.3

8.0

10.9

64.5 18.2
* 73.3 48.6 41.9
.

50.6 19.5
* 85.6 53.3 50.0
8.9

56.4 8.8
* 65.4 69.1 51.9 28.4

61.6 25.0
* 84.7 75.3 68.2 43.5

60.5

59.0

18.2

18.2

*

17.2

81.8

78.1

74.0

63.0

66.2

54.8

31.2

27.6

411

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Pulaski County - 116

1990
8108 1691
197
20.3 19.7 22.0
16 6
136 13 51
3 2 30 3
1 0 1 2 0 2
11 4 0
18 1 0
48 29 35
3 24
2 9
. . .
73 25
3 76 60 51
. 0

1991
8130 1693 196
20.4 18.2 22.0
17 2
126 13 47 8 2 22 4
2 1 1 3 1 2
7 1 1 8 2 0
40 25 36
4 23
2 10
1 1 25
64 20
3 80 67 59 37
0

Total
1992 1993

8142 1695
195

8162 1696 195

21.8 18.8 24.0

23.4 19.2 23.0

13

10

4

0

110

120

10

8

46

48

1

1

0

2

18

22

3

2

0

2

0

2

0

0

0

4

0

0

1

1

14

15

3

2

0

1

12

10

2

3

1

4

34

34

18

24

30

25

1

3

17

21

2

0

10

1

2

25

5

8

19

45

67

75

22

18

4

1

63

68

62

77

51

62

45

48

0

0

1994 5-year

8175 1696
193

40717 8471 976

22.2 22.0 22.0

21.6 19.7 22.0

10

66

2

14

103

595

9

53

50

242

3

16

0

6

21

113

1

13

2

7

1

4

1

3

0

9

0

1

0

6

5

52

1

11

0

2

8

56

0

8

0

5

33

189

17

113

29

155

0

11

9

94

1

7

4

34

7

35

5

19

46

135

67

346

14

99

5

16

57

344

54

320

46

269

38

168

0

0

1990
5397 1088
128

1991
5408 1087 127

White
1992 1993

5413 1085
126

5421 1083 124

1994 5-year

5425 1080
123

27064 5423 627

23.8 19.8 21.0

22.2 18.6 21.0

22.3 18.8 23.0

24.1 19.2 21.0

24.0 23.0 22.0

23.4 20.0 22.0

9

7

6

4

3

29

5

1

0

0

2

8

72

68

53

73

57

323

6

4

3

3

3

19

8

9

9

14

17

57

1

5

1

0

2

9

0

1

0

1

0

2

15

15

12

14

10

66

3

3

3

1

0

10

0

1

0

1

1

3

0

0

0

1

0

1

0

1

0

0

1

2

0

1

0

2

0

3

0

1

0

0

0

1

1

2

0

1

0

4

4

3

3

5

3

18

3

0

1

1

1

6

0

0

0

0

0

0

9

5

6

5

4

29

1

2

0

1

0

4

0

0

0

1

0

1

21

21

13

18

13

86

4

6

3

5

5

23

19

15

12

14

15

75

0

1

1

0

0

2

20

19

14

16

9

78

1

1

1

0

1

4

3

1

4

0

1

9

.

0

2

8

4

14

.

0

5

4

3

12

.

6

11

12

16

45

53

47

41

53

39

233

14

15

12

11

4

56

3

2

1

0

1

7

31

28

20

32

22

133

25

25

23

37

22

132

22

21

17

28

16

104

.

11

16

21

12

60

0

0

0

0

0

0

1990
2632 592 67

1991
2639 593
67

Black
1992 1993

2643 594 66

2650 594
66

1994 5-year

2654 594 66

13217 2967 332

18.7 19.0 22.5

16.9 17.5 27.0

19.2 .
25.0

19.1 20.8 31.5

20.5 18.3 26.0

18.7 18.3 25.0

7

10

7

6

7

37

1

1

4

0

0

6

64

58

57

46

44

269

7

9

7

5

6

34

43

38

37

34

33

185

2

3

0

1

1

7

2

1

0

1

0

4

15

7

6

8

10

46

0

1

0

1

1

3

1

1

0

1

1

4

0

1

0

1

1

3

1

0

0

0

0

1

2

2

0

2

0

6

0

0

0

0

0

0

1

0

1

0

0

2

7

4

11

10

2

34

1

1

2

1

0

5

0

1

0

1

0

2

9

3

6

5

4

27

0

0

2

2

0

4

0

0

1

3

0

4

27

19

21

16

19

102

25

19

15

19

12

90

16

21

18

11

13

79

3

3

0

3

0

9

4

4

3

5

0

16

1

1

1

0

0

3

6

9

6

1

3

25

.

1

.

1

.

14

0

13

3

17

0

4

2

7

8

26

29

77

20

17

26

21

27

111

11

5

10

7

10

43

0

1

3

1

4

9

45

52

43

36

35

211

35

42

39

40

32

188

29

38

34

34

30

165

.

26

29

27

26

108

0

0

0

0

0

0

412

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Pulaski County - 116

16.8 80.4
2.5 37.8
3.7 17.7
0.5 175.4
3.0
81.2 37.5 66.0 69.2
* * *
* * * * * *
8.1 * *
13.3 * *
38.1 21.5 25.9
* 17.8
* 10.0
. . .
58.4 21.2
* 56.3 44.4 37.8
.

15.5 74.4
2.3 37.9
2.7 13.0
0.4 139.2
5.9
86.6 *
66.2 76.9
* * *
* * * * * *
5.6 * *
6.5 * *
37.0 20.2 29.3
* 18.5
* 12.5
* * 11.5
54.2 18.5
* 64.5 54.0 47.6 29.8

13.5 64.9 2.0 42.6 2.2 10.6 0.3 139.5
*
66.6 *
51.3 80.0
* * *
* * * * * *
12.7 * *
11.1 * *
35.1 16.7 28.0
* 15.9
* 17.9
* 2.3 8.8
63.8 23.2
* 58.3 57.4 47.2 41.7

14.7 70.8
2.1 41.0
2.7 13.0
0.4 150.7
*
51.4 *
41.1 87.5
* * *
* * * * * *
12.5 * *
8.5 * *
31.5 20.5 21.6
* 17.9
* *
11.6 3.7
20.8
64.7 17.0
* 58.1 65.8 53.0 41.0

12.6 60.7 1.8 48.5 2.6 12.4 0.4 165.4
*
51.7 *
46.6 88.9
* * *
* * * * * *
4.9 * *
7.8 * *
35.1 16.5 29.0
* 8.7
* *
3.3 2.3 21.4
70.5 15.4 41.7 55.3 52.4 44.7 36.9

14.6 70.2
2.1 41.2
2.8 13.3
0.4 154.6
2.7
67.6 21.2 54.3 79.2 13.3 100.0
*
11.8 * *
15.0 *
0.7
8.7 1.8
* 9.6 1.4 0.8
35.5 19.3 26.7
2.0 16.0
1.2 9.9
4.0 2.2 15.6
61.9 19.1 23.2 58.6 54.5 45.8 37.2

13.3 66.2
2.2 11.3
2.8 13.8
0.5 170.5
*

12.6 62.6
2.1 13.6
2.8 13.8
0.4 168.5
5.5

9.8 48.8 1.6 17.0 2.2 11.1 0.4 181.8
*

13.5 67.4
2.1 19.4
2.6 12.9
0.4 157.3
*

10.5 52.8 1.6 29.8 1.8
9.3 0.3 144.9
*

11.9 59.6
1.9 17.9
2.4 12.2
0.4 164.6
2.2

70.3

55.2

47.8

*

*

46.2

55.6

*

*

*

*

27.6

46.9

*

*

*

*

30.3

*

*

*

*

*

47.4

*

*

*

*

*

15.9

*

*

*

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

6.8

*

*

*

*

*

*

*

*

12.7

7.6

11.3

6.9

*

*

*

*

*

*

*

*

*

5.6

*

1.9

*

*

*

9.1

*

*

*

*

31.3 *
26.8 *
28.2 * *

34.4 9.1
23.1 *
28.8 * *

25.5 *
23.1 *
26.4 * *

26.1 6.9
19.4 *
22.2 * *

24.1 8.8 27.3
* 15.8
* *

28.5 7.2
23.8 *
24.5 *
5.5

.

*

*

6.6

*

2.9

.

*

4.1

*

*

2.5

.

4.8

9.0

9.9

13.3

9.2

77.9 22.6
* 43.7 35.2 31.0
.

71.2 24.2
* 42.4 37.9 31.8 16.7

82.0 24.5
* 37.7 43.4 32.1 30.2

74.6 17.2
* 44.4 51.4 38.9 29.2

73.6 * *
38.6 38.6 28.1 21.1

75.6 19.4 22.6 41.7 41.4 32.6 24.2

24.3 108.1
3.1 67.2
5.7 25.3
0.7 180.7
*

22.0 97.8
2.7 65.5
2.7 11.8
0.3 101.4
*

21.6 96.0 2.6 67.3 2.3 10.1 0.3
. *

17.4 77.4
2.1 77.3
3.0 13.5
0.4 142.9
*

16.6 74.1 2.1 75.0 3.8 16.8 0.4 181.8
*

20.4 90.7
2.5 69.8
3.5 15.5
0.4 141.1
3.7

104.5 *
104.5 100.0
* * *

149.7 *
134.7 88.9 * * *

105.4 *
105.4 100.0
* * *

90.6 *
75.5 100.0
* * *

106.5 *
91.3 100.0
* * *

111.4 16.2 102.4 97.1 * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

22.0

*

*

*

*

*

*

*

*

*

*

*

*

10.9 * *
14.1 * *

*

19.3

21.7

*

*

*

*

*

*

*

10.9

11.4

*

*

*

*

*

*

*

12.6

*

1.9

*

*

*

10.2

*

*

*

*

45.8 39.1 25.0
* * * 14.6

40.4 32.8 36.2
* * * 20.5

45.7 27.3 32.7
* * * 15.4

42.1 43.2 25.6
* 11.4
* *

50.0 27.3 30.2
* * * *

44.7 34.0 30.0
3.6 6.1
* 14.3

.

*

.

*

.

15.4

*

14.4

*

4.7

*

*

*

1.9

8.8

28.8

32.3

21.3

35.1 19.6
* 70.3 54.7 45.3
.

32.7 10.9
* 89.7 72.4 65.5 44.8

47.3 21.7
* 78.2 70.9 61.8 52.7

47.7 16.7
* 81.8 90.9 77.3 61.4

67.5

44.8

26.3

18.9

*

24.3

79.5

79.6

72.7

70.9

68.2

62.3

59.1

53.7

413

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Putnam County - 117

1990
14137 3093 293
21.0 19.7 21.0
25 4
209 16 85 15
3 61
6
5 4 1 7 1 0
22 8 2
19 2 2
62 45 60 10 24
2 15
. . .
138 33
0 106 94 75
. 0

1991
14372 3123 298
20.1 18.6 22.0
29 4
197 22 79 12 4 49 6
4 4 0 8 1 2
13 3 1
23 2 1
49 46 61
4 21
2 7
3 5 33
123 29 5 98 91 69 0 0

Total
1992 1993

14593 3146 303

14825 3175 308

19.4 18.7 23.0

21.9 19.1 21.0

25

15

3

3

191

163

19

9

74

70

10

15

0

0

43

35

6

6

0

4

0

1

0

3

0

1

0

1

2

0

25

16

8

4

0

1

19

15

5

2

0

2

78

69

37

31

55

50

3

4

22

12

0

1

8

7

18

5

10

9

75

45

119

122

22

24

2

5

100

104

101

97

78

79

5

63

0

2

1994 5-year

15051 3199 313

72978 15736
1515

21.3 19.4 23.0

21.1 19.1 22.0

26

120

6

20

190

950

17

83

82

390

9

61

3

10

40

228

9

33

4

17

4

13

0

4

6

22

1

4

1

5

19

95

8

31

1

5

20

96

3

14

1

6

73

331

43

202

48

274

3

24

28

107

2

7

7

44

10

36

14

38

40

193

142

644

32

140

0

12

116

524

98

481

93

394

83

151

0

2

1990
9300 1896
157

1991
9586 1934
161

White
1992 1993

9863 1968
163

10151 2006 167

1994 5-year

10431 2041 170

49331 9845 818

21.1 21.3 21.0

22.7 17.1 21.5

22.2 22.5 20.0

22.2 20.0 20.0

23.5 19.1 21.0

22.3 19.6 21.0

11

14

8

0

2

0

120

113

112

7

9

8

20

20

16

8

6

6

1

1

0

32

25

15

2

4

0

6

10

49

2

2

6

87

111

543

4

7

35

15

24

95

8

4

32

0

1

3

17

19

108

2

3

11

1

2

0

0

3

6

1

2

0

0

3

6

0

0

0

0

0

0

2

3

0

0

3

8

0

1

0

1

0

2

0

1

1

0

1

3

6

4

9

3

8

30

1

1

3

0

5

10

1

0

0

0

0

1

6

10

8

4

9

37

0

1

1

1

3

6

2

1

0

1

0

4

34

26

36

33

38

167

11

13

11

5

11

51

29

32

28

25

32

146

3

1

0

0

1

5

18

18

19

10

25

90

1

1

0

1

2

5

5

3

3

3

2

16

.

1

3

1

9

14

.

1

4

6

8

19

.

10

14

26

15

65

93

81

84

68

93

419

19

20

14

12

18

83

0

4

2

3

0

9

41

44

46

44

52

227

39

38

44

37

45

203

30

31

34

30

42

167

.

0

2

24

36

62

0

0

0

0

0

0

1990
4748 1175
131

1991
4827 1185 133

Black
1992 1993

4901 1192
135

4979 1201 138

1994 5-year

5055 1208
140

24510 5960 677

20.5 19.0 23.0

17.9 19.1 23.0

18.3 17.9 25.5

21.6 16.9 23.0

20.0 18.2 27.5

19.5 18.5 24.0

13

15

17

9

16

70

4

2

3

1

4

14

89

83

79

76

77

404

9

13

11

5

10

48

65

59

58

55

58

295

7

6

4

7

5

29

2

3

0

0

2

7

27

23

28

17

20

115

3

2

6

4

6

21

4

2

0

4

1

11

3

2

0

1

1

7

1

0

0

3

0

4

5

5

0

1

3

14

1

0

0

0

1

2

0

1

1

0

0

2

16

9

16

13

11

65

7

2

5

4

3

21

1

1

0

1

1

4

13

13

11

11

10

58

2

1

4

1

0

8

0

0

0

1

1

2

28

23

42

36

35

164

34

33

26

26

32

151

31

29

27

25

16

128

7

3

3

4

2

19

6

3

3

2

2

16

1

1

0

0

0

2

10

4

5

4

5

28

.

0

2

4

1

7

.

1

1

2

5

9

.

10

17

11

23

61

45

42

35

54

48

224

14

9

8

12

14

57

0

1

0

2

0

3

65

54

54

60

63

296

55

53

57

60

53

278

45

38

44

49

51

227

.

0

3

39

47

89

0

0

0

2

0

2

414

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Putnam County - 117

14.8 67.6
2.0 41.1
4.3 19.7
0.6 211.1
6.1
85.3 *
54.6 68.8 20.5 100.0
*
23.9 * *
33.0 * *
10.5 3.8 * 9.2 * *
33.9 21.7 29.0
4.9 11.6
* 12.2
. . .
67.0 17.7
* 51.2 45.4 36.2
.

13.7 63.1
1.9 40.5
3.4 15.7
0.5 187.0
5.1
97.2 *
73.7 81.8 20.1 100.0
*
* * * 39.8 * *
6.6 * *
11.9 * *
37.1 23.6 31.6
* 10.9
* 5.9
* 1.4 9.0
67.6 16.9 21.7 50.3 46.7 35.4
*

13.1 60.7 1.8 39.8 2.9 13.7 0.4 176.2 3.2
82.6 *
62.8 78.9 19.8 100.0
*
* * * * * *
13.1 4.2
* 10.2
2.7 *
45.3 19.9 29.6
* 12.0
* 7.1
4.9 2.7 20.4
65.0 13.4
* 53.8 54.3 41.9
2.7

11.0 51.3
1.6 43.5
2.4 11.0
0.3 164.3
4.7
48.7 *
29.2 66.7 19.5 100.0
*
* * * * * *
9.8 * *
9.3 * *
45.1 19.3 31.1
* 7.5
* 6.9
1.3 2.4 12.1
75.8 17.5 20.8 64.6 60.2 49.1 39.1

12.6 59.4 1.8 43.9 2.7 12.5 0.4 164.6 4.1
83.1 23.1 54.4 76.5 28.8 100.0
*
* * * 31.1 * *
10.0 4.2 *
10.7 * *
40.8 23.0 25.7
* 15.0
* 7.4
2.7 3.8 10.7
75.1 18.2
* 62.0 52.4 49.7 44.4

13.0 60.4
1.8 41.7
3.1 14.5
0.4 182.3
4.6
79.2 16.7 54.8 75.9 21.8 100.0
4.6
17.9 13.7
* 22.9
* 0.4
10.0 3.3 0.5
10.3 1.5 0.6
40.4 21.6 29.3
2.6 11.5
0.8 8.0
2.4 2.6 13.1
69.9 16.8 11.9 56.0 51.4 42.1 20.7

12.9 63.3
2.0 16.7
3.4 16.9
0.5 198.8
4.7

11.8 58.4
1.9 17.9
2.6 12.9
0.4 172.4
3.6

11.4 56.9 1.8 14.4 1.5 7.6 0.3 112.8 3.0

8.6 43.4
1.4 17.4
1.7 8.5 0.3 151.8 4.0

10.6 54.4 1.7 22.2 1.8 9.3 0.3 139.7 2.9

11.0 55.2
1.8 17.7
2.2 11.0
0.4 157.2
3.7

70.1 *
44.6 * * * *

87.2 *
56.1 77.8
* * *

49.0 *
49.0 * * * *

35.9 * * * * * *

58.7 *
41.1 * * * *

59.9 12.2 42.8 48.6 13.4 100.0
*

*

*

*

*

*

11.0

*

*

*

*

*

11.0

*

*

*

*

*

*

*

*

*

*

*

14.7

*

*

*

*

*

*

*

*

*

*

*

*

5.0

*

8.0

*

*

*

*

*

*

5.0

8.9

7.2

*

*

*

*

*

*

*

7.2

5.5

*

4.5

1.8

*

*

*

*

8.3

6.9

*

*

1.1

*

*

*

30.4 9.2
24.2 *
15.0 *
7.8

31.0 11.6 28.8
* 16.4
* *

34.6 9.9 25.2
* 17.6
* *

38.8 5.8
29.1 *
11.6 * *

36.5 10.2 29.6
* 23.1
* *

34.2 9.5
27.2 0.9
16.9 0.9 5.3

.

*

*

*

4.1

1.7

.

*

*

2.8

3.7

2.2

.

4.9

6.7

12.1

6.9

7.7

78.8 18.4
* 34.2 32.5 25.0
.

76.4 21.1
* 39.3 33.9 27.7
*

77.8 14.7
* 41.4 39.6 30.6
*

79.1 16.7
* 51.2 43.0 34.9 27.9

84.5 17.3
* 48.1 41.7 38.9 33.3

79.4 17.7 13.2 42.3 37.8 31.1 14.9

18.7 75.7
2.1 74.7
5.7 23.0
0.6 214.3
8.5

17.2 70.1
1.9 72.0
4.8 19.4
0.5 200.0
7.6

16.1 66.3 1.8 77.3 5.7 23.5 0.7 252.3
*

15.3 63.3
1.7 73.3
3.4 14.2
0.4 170.0
5.8

15.2 63.7 1.8 75.3 4.0 16.6 0.4 192.3 5.8

16.5 67.8
1.9 74.5
4.7 19.3
0.5 206.8
6.2

99.2 *
68.7 100.0
* * *

112.4 *
97.5 84.6
* * *

125.6 *
81.3 100.0
44.3 100.0
*

65.4 *
36.3 100.0
* * *

114.4 *
71.5 100.0
42.9 100.0
*

103.4 20.0 70.9 95.8 31.0 100.0 *

*

*

*

*

*

27.2

*

*

*

*

*

17.3

*

*

*

*

*

*

54.9

58.1

*

*

*

34.1

*

*

*

*

*

*

*

*

*

*

*

*

18.0

10.8

20.3

17.1

14.3

16.1

7.9

*

6.3

*

*

5.2

*

*

*

*

*

*

14.9

16.0

14.7

14.7

13.0

14.7

*

*

*

*

*

2.0

*

*

*

*

*

*

39.4 39.1 35.6
8.0 6.9
* 16.9

47.9 40.2 35.4
* * * *

61.8 34.7 36.0
* * * 10.6

52.9 34.7 33.3
* * * *

47.9 41.6 20.8
* * * 13.9

50.0 38.1 32.3
4.9 4.1
* 11.5

.

*

*

*

*

1.1

.

*

*

*

3.1

1.4

.

6.2

10.5

6.8

14.1

9.4

51.1 16.9
* 74.7 63.2 51.7
.

56.0 11.8
* 65.9 64.6 46.3
*

46.7 11.6
* 72.0 76.0 58.7
*

72.0 18.5
* 80.0 80.0 65.3 52.0

62.3

57.4

19.7

15.7

*

*

81.8

74.7

68.8

70.2

66.2

57.3

61.0

28.8

415

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Quitman County - 118

1990
2209 459 42
20.5 .
21.0
4 1 35 3 14 1 1 2 1
1 1 0 2 0 0
7 1 0 5 0 1
7 11 12
0 7 0 0
. . .
28 7 0
26 20 18
. 0

1991
2198 451
41
18.1 .
21.0
7 1 45 7 29 2 0 0 0
1 0 1 0 0 0
6 0 0 8 0 0
11 23 21
3 5 1 3
0 0 10
30 8 1
41 32 31
0 0

Total
1992 1993

2176 444 41

2162 436
40

19.4 .
22.0

20.1 17.4 20.0

2

5

0

1

23

41

2

3

11

17

1

2

1

0

0

3

0

2

1

0

1

0

0

0

2

0

0

0

0

0

1

5

0

0

0

0

1

6

1

0

0

0

8

13

9

13

5

12

0

1

2

7

0

1

0

1

2

0

0

1

5

0

15

33

5

3

0

0

17

35

13

28

11

28

0

0

0

0

1994 5-year

2141 429 39

10886 2219 202

20.7 .
19.0

19.9 17.4 21.0

8

26

1

4

29

173

6

21

14

85

3

9

0

2

3

8

0

3

0

3

0

2

0

1

0

4

0

0

1

1

4

23

0

1

0

0

3

23

0

1

0

1

14

53

9

65

12

62

0

4

5

26

0

2

2

6

6

8

7

8

8

23

20

126

7

30

0

1

22

141

25

118

20

108

1

1

0

0

1990
1093 192 17

1991
1101 192 16

White
1992 1993

1102 191 16

1108 191 16

1994 5-year

1112 192 16

5516 958 82

20.5 .
20.0

27.0 .
21.0

20.4 . .

21.2 17.4 19.0

22.0 .
19.0

21.1 17.4 20.0

2

0

0

0

15

10

2

0

1

2

0

2

0

0

1

0

0

0

1

2

1

6

0

0

1

1

9

20

11

65

1

0

1

4

2

3

2

10

0

0

0

2

1

0

0

1

0

3

0

4

0

2

0

2

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

2

2

0

3

1

8

0

0

0

0

0

0

0

0

0

0

0

0

2

2

0

4

0

8

0

0

0

0

0

0

0

0

0

0

0

0

1

2

2

5

2

12

0

0

0

1

1

2

7

4

1

6

3

21

0

0

0

0

0

0

2

2

2

5

3

14

0

0

0

0

0

0

0

1

0

1

1

3

.

0

0

0

0

0

.

0

0

1

5

6

.

9

0

0

0

9

13

10

5

4

0

0

8

7

7

5

5

5

.

0

0

0

9

17

10

59

2

2

4

17

0

0

0

0

7

15

8

45

3

12

8

35

3

12

6

31

0

0

1

1

0

0

0

0

1990
1107 266 25

1991
1102 261
24

Black
1992 1993

1091 257 24

1083 252
24

1994 5-year

1073 248 23

5455 1283
120

21.7 .
23.0

17.4 .
31.0

19.2 .
22.0

17.4 .
39.5

19.3 .
21.0

18.4 .
23.0

2

7

1

3

7

20

1

1

0

1

0

3

20

35

14

21

18

108

1

7

1

3

5

17

13

27

9

14

12

75

1

0

1

2

3

7

1

0

0

0

0

1

1

0

0

0

3

4

1

0

0

0

0

1

1

1

1

0

0

3

1

0

1

0

0

2

0

1

0

0

0

1

2

0

1

0

0

3

0

0

0

0

0

0

0

0

0

0

1

1

5

4

1

2

3

15

1

0

0

0

0

1

0

0

0

0

0

0

3

6

1

2

3

15

0

0

1

0

0

1

1

0

0

0

0

1

6

9

11

23

5

17

0

3

5

3

0

1

0

2

6

8

12

41

9

12

8

63

4

6

9

41

0

1

0

4

0

2

2

12

0

1

0

2

0

0

1

3

.

0

0

0

0

0

.

0

0

0

2

2

.

1

4

0

2

7

15

20

6

16

10

67

2

4

3

1

3

13

0

1

0

0

0

1

18

34

10

20

14

96

13

27

10

16

17

83

13

26

8

16

14

77

.

0

0

0

0

0

0

0

0

0

0

0

416

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Quitman County - 118

1990
15.8 76.3
2.1 40.0
* * * * *
* * * * * * *
* * * * * *
20.0 * *
14.3 * *
23.3 31.4 34.3
* 21.9
* *
. . .
80.0 20.6
* 74.3 57.1 51.4
.

1991
20.5 99.8
2.8 64.4
* * * * *
171.6 *
171.6 100.0
* * *
* * * * * *
13.3 * *
17.8 * *
30.6 51.1 46.7
* 13.5
* *
* * 17.7
66.7 20.5
* 91.1 71.1 68.9
*

Total
1992 1993

10.6 51.8 1.5 50.0
* * * * *

19.0 94.0
2.7 41.5
* * * * *

* 126.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

12.2

*

*

*

*

*

14.6

*

*

*

*

42.1 40.9 22.7
* * * *

39.4 31.7 29.3
* 19.4
* *

*

*

*

*

8.9

*

65.2 25.0
* 77.3 59.1 50.0
*

80.5 * *
85.4 68.3 68.3
*

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

13.5 67.6 2.0 48.3
* * * * *

15.9 78.0
2.2 49.4
0.7 3.6 0.1 41.7 5.0

205.1 *
153.8 100.0
* * *

128.6 *
103.9 85.7
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

13.3

*

*

*

*

*

13.4

*

*

*

*

51.9 31.0 41.4
* 17.9
* *

36.6 37.8 36.0
* 17.1
* 5.8

11.0 12.8 14.7

3.6 3.6 10.4

69.0 25.9
* 75.9 86.2 69.0
*

72.8 18.8
* 82.0 68.6 62.8
*

13.7 78.1
2.1 * * * * * *

9.1 52.1
1.5 * * * * * *

8.2 47.1 1.3
* * * * * *

18.1 104.7
3.1 * * * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

35.7

*

*

*

*

46.7

*

*

30.0

*

*

*

*

*

*

*

33.3

*

*

*

*

*

*

*

*

.

*

*

*

.

*

*

*

.

46.7

*

*

86.7 . *
53.3 46.7 33.3
.

100.0 * *
70.0 50.0 50.0
*

100.0 * *
77.8 * * *

85.0 * *
75.0 60.0 60.0
*

9.9 57.3 1.8
* * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* 25.1
*
90.9 * *
72.7 72.7 54.5
*

11.8 67.8
2.0 15.4
* * * * *
73.5 * * * * * *
* * * * * *
12.3 * *
12.3 * *
25.5 *
32.3 *
28.0 * *
* 7.6 11.5
90.8 26.6
* 69.2 53.8 47.7
*

18.1 75.2
2.1 65.0
* * * * *

31.8 134.1
3.7 77.1
* * * * *

* 288.1

*

*

* 288.1

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

25.0 * * * * *

* * * 17.1 * *

31.6 55.0 25.0
* 25.0
* *

31.0 65.7 48.6
* * * *

.

*

.

*

.

*

75.0 * *
90.0 65.0 65.0
.

57.1 * *
97.1 77.1 74.3
*

12.8 54.5 1.5 69.2
* * * * *
* * * * * * *
* * * * * *
* * * * * *
46.2 69.2
* * * * *
* * *
42.9 * *
76.9 76.9 61.5
*

19.4 83.4
2.3 66.7
* * * * *

16.8 72.7 2.1 66.7
* * * * *

19.8 84.2
2.3 70.1
* * * * 6.2

* 301.7 166.1

*

*

*

* 215.5 141.2

* 100.0 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

13.9

*

*

*

*

*

*

*

*

14.0

*

*

*

*

*

*

42.1 57.1 28.6
* * * *

66.7 44.4 50.0
* * * *

41.8 58.9 38.3
* 11.8
* *

*

*

*

*

*

*

*

*

4.8

76.2

55.6

62.0

*

*

13.5

*

*

*

95.2

77.8

89.7

76.2

94.4

77.6

76.2

77.8

72.0

*

*

*

417

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Rabun County - 119

1990
11648 2378 267
20.2 20.1 19.0
20 3
161 18 30 10
1 26
2
5 3 2 4 0 0
11 3 0
14 1 4
30 19 46
1 33
2 1
. . .
130 22
0 83 67 52
. 0

1991
11812 2373 260
22.2 22.5 21.0
23 3
140 18 35 10 1 20 5
1 1 0 2 0 0
9 1 0 10 1 1
40 14 42
1 35
1 2
1 0 6
103 23 1 78 59 52 0 0

Total
1992 1993

11978 2367 254

12145 2363 248

21.4 20.4 21.0

21.6 25.3 21.0

20

20

4

3

130

143

18

19

27

28

5

9

2

1

25

31

1

1

1

1

0

1

1

0

2

2

0

0

2

0

16

6

2

1

0

0

13

11

4

2

8

4

25

35

14

12

36

39

1

0

32

32

1

2

4

8

2

3

2

9

33

32

101

104

15

25

3

2

77

88

73

79

62

69

28

26

1

0

1994 5-year

12306 2357 241

59889 11838
1270

21.3 21.1 21.5

21.3 21.5 21.0

12

95

3

16

150

724

12

85

24

144

10

44

0

5

19

121

0

9

0

8

0

5

0

3

0

10

1

1

1

3

6

48

2

9

0

0

9

57

1

9

2

19

34

164

9

68

29

192

2

5

27

159

1

7

6

21

3

9

1

12

22

93

127

565

16

101

1

7

83

409

73

351

64

299

44

98

0

1

1990
11524 2356 262

1991
11686 2352 256

White
1992 1993

11849 2348 250

12011 2344 244

1994 5-year

12169 2339 238

59239 11739
1249

20.2 21.3 19.0

22.2 22.5 21.0

21.4 19.1 21.0

21.6 25.3 21.0

21.3 21.1 21.5

21.3 21.5 21.0

19

23

20

20

12

94

3

3

4

3

3

16

161

140

130

142

147

720

18

18

18

19

12

85

30

35

27

28

23

143

10

10

5

9

10

44

1

1

2

1

0

5

24

19

22

29

18

112

1

5

1

1

0

8

5

1

1

1

0

8

3

1

0

1

0

5

2

0

1

0

0

3

4

2

2

2

0

10

0

0

0

0

1

1

0

0

2

0

1

3

11

9

16

6

3

1

2

1

0

0

0

0

14

10

13

11

1

1

4

2

4

1

8

4

6

48

2

9

0

0

9

57

1

9

2

19

30

40

25

35

34

164

19

14

14

12

8

67

46

42

36

39

29

192

1

1

1

0

2

5

33

35

32

32

27

159

2

1

1

2

1

7

1

2

4

8

5

20

.

0

1

3

3

7

.

0

2

9

1

12

.

2

21

26

22

71

130

103

101

103

125

562

22

23

15

25

15

100

0

1

3

2

1

7

83

78

77

87

81

406

67

59

73

78

72

349

52

52

62

68

63

297

.

0

28

26

44

98

0

0

1

0

0

1

1990
41 6 1

1991
42 6 1

Black
1992 1993

42

43

6

6

1

1

1994 5-year

43

211

6

30

1

5

.

.

.

.

31.7

31.7

17.2

.

.

.

.

17.2

.

.

.

.

.

.

1

0

0

0

0

1

0

0

0

0

0

0

0

0

0

1

3

4

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

1

3

1

0

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

.

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

0

0

0

1

2

3

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

1

2

3

0

0

0

1

1

2

0

0

0

1

1

2

.

0

0

0

0

0

0

0

0

0

0

0

418

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Rabun County - 119

13.8 67.7
2.2 18.8
2.2 10.9
0.3 131.3
4.6
74.9 *
67.4 29.4
* * *
31.1 * * * * *
6.8 * *
8.8 * *
25.9 11.9 29.1
* 23.6
* *
. . .
82.8 15.1
* 51.9 41.9 32.5
.

11.9 59.0
1.9 25.2
1.7 8.4 0.3 116.3 5.1
88.4 *
69.2 44.4 19.2
* *
* * * * * *
6.4 * *
7.2 * *
41.7 10.1 30.4
* 28.2
* *
* * 2.3
74.1 18.5
* 56.1 42.4 37.4
*

10.9 54.9 1.8 21.4 2.1 10.6 0.3 154.3 3.0
78.6 *
70.8 61.1
* * *
* * * * * *
12.3 * *
10.3 *
7.0
27.8 11.1 29.0
* 28.6
* *
* * 12.8
77.7 13.2
* 61.1 57.9 49.2 22.2

11.8 60.5
2.0 19.9
2.6 13.1
0.4 167.6
4.7
80.8 *
76.8 42.1
* * *
* * * * * *
4.2 * *
7.8 * *
36.1 8.5
27.7 *
24.6 *
11.3
* 3.5 12.3
73.2 19.4
* 62.4 56.0 48.9 18.4

12.2 63.6 2.1 16.1 1.5 8.1 0.2 106.1 4.2
49.8 *
49.8 50.0
* * *
* * * * * *
4.0 * *
6.0 * *
26.2 6.0 20.1
* 20.3
* 7.4
* * 8.4
84.7 11.7
* 55.7 49.0 43.0 29.5

12.1 61.2
2.0 20.1
2.0 10.2
0.3 135.0
4.3
74.8 16.8 66.9 45.2
7.1 77.8
*
11.0 6.9 *
13.7 * *
6.6 1.2
* 8.0 1.3 2.9
31.0 9.5
27.2 0.7
24.9 1.1 6.4
0.9 1.2 9.0
78.7 15.5 10.8 57.2 49.1 41.8 17.7

14.0 68.3
2.2 18.8
2.1 10.2
0.3 122.4
4.7

12.0 59.5
1.9 25.2
1.6 8.1 0.2 111.1 5.1

11.0 55.4 1.8 21.4 1.9 9.4 0.3 138.4 3.0

11.8 60.6
2.0 20.0
2.4 12.4
0.3 159.3
4.7

12.1 62.8 2.1 15.8 1.5 7.7 0.1 102.9 4.3

12.2 61.3
2.0 20.1
1.9 9.5 0.3 126.8 4.3

72.5 *
68.7 29.4
* * *

89.9 *
70.4 44.4 19.6
* *

80.0 *
72.0 61.1
* * *

82.0 *
77.9 42.1
* * *

50.5 *
50.5 50.0
* * *

75.2 17.0 68.0 45.2
6.4 75.0
*

31.1

*

*

*

*

11.1

*

*

*

*

*

6.9

*

*

*

*

*

*

*

*

*

*

*

13.8

*

*

*

*

*

*

*

*

*

*

*

*

6.8

6.4

12.3

4.2

4.1

6.7

*

*

*

*

*

1.2

*

*

*

*

*

*

8.8

7.2

10.3

7.9

6.2

8.0

*

*

*

*

*

1.3

*

*

7.0

*

*

2.9

25.9 11.9 29.1
* 23.6
* *

41.7 10.1 30.4
* 28.2
* *

27.8 11.1 29.0
* 28.6
* *

36.5 8.6
27.9 *
24.8 *
11.3

26.6 5.5 20.6
* 20.8
* 6.3

31.2 9.4
27.4 0.7
25.0 1.1 6.1

.

*

*

*

*

0.7

.

*

*

3.5

*

1.2

.

*

8.2

10.1

8.5

6.9

82.8 15.1
* 51.9 41.9 32.5
.

74.1 18.5
* 56.1 42.4 37.4
*

77.7 13.2
* 61.1 57.9 49.2 22.2

73.0 19.5
* 62.1 55.7 48.6 18.6

85.0 11.2
* 55.5 49.3 43.2 30.1

78.7 15.5 10.8 57.1 49.1 41.8 17.8

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

419

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Randolph County - 120

1990
8023 1736
180
20.0 17.7 22.0
28 9
140 20 67
7 3 20 8
1 1 0 4 0 0
19 3 1
19 2 2
43 42 43
1 20
0 13
. . .
109 22
2 109 81 71
. 0

1991
8023 1747 181
20.9 19.8 20.5
24 7
131 19 77 5 2 26 4
1 1 0 3 1 3
11 1 0 7 4 2
43 43 49
0 16
1 6
3 0 11
98 15
0 111 100
95 0 0

Total
1992 1993

8000 1753
182

8003 1766 183

19.0 20.4 24.0

18.8 18.0 23.5

23

23

4

5

132

113

21

21

71

64

11

9

4

5

22

12

3

2

1

5

1

5

0

0

7

9

0

0

1

2

14

13

3

3

0

3

14

13

2

2

2

2

55

39

39

38

34

39

1

1

14

17

1

0

8

4

6

5

3

5

36

30

101

80

27

17

0

1

104

93

94

90

79

83

0

5

0

0

1994 5-year

7986 1773
183

40035 8775 908

18.5 16.6 23.5

19.3 18.5 22.0

23

121

2

27

106

622

14

95

64

343

8

40

0

14

20

100

6

23

1

9

1

9

0

0

1

24

0

1

0

6

10

67

2

12

0

4

6

59

1

11

2

10

42

222

42

204

36

201

0

3

9

76

0

2

6

37

10

24

3

11

24

101

85

473

16

97

2

5

79

496

80

445

64

392

21

26

0

0

1990
3310 654 54

1991
3283 646
54

White
1992 1993

3245 637 53

3218 630
53

1994 5-year

3183 621 52

16239 3188 266

20.8 18.8 20.5

23.1 21.3 19.5

21.9 18.5 22.0

23.3 16.8 21.0

20.4 17.4 20.0

21.2 19.0 20.0

5

2

4

3

7

21

2

0

0

0

0

2

42

35

39

32

34

182

3

2

3

1

4

13

7

5

4

9

7

32

3

2

5

6

2

18

0

0

0

2

0

2

3

10

7

6

7

33

2

0

1

2

2

7

0

0

0

0

1

1

0

0

0

0

1

1

0

0

0

0

0

0

0

0

1

2

1

4

0

0

0

0

0

0

0

1

0

1

0

2

2

2

3

4

1

12

0

0

1

0

0

1

0

0

0

0

0

0

6

2

4

4

1

17

0

1

0

1

0

2

0

0

0

0

2

2

12

6

10

9

10

47

1

3

2

6

4

16

11

8

9

9

12

49

0

0

1

0

0

1

12

7

6

11

7

43

0

0

0

0

0

0

1

0

1

3

0

5

.

2

0

2

3

7

.

0

2

0

3

5

.

1

1

10

4

16

41

30

35

26

31

163

5

7

10

4

5

31

2

0

0

1

1

4

28

26

28

22

26

130

13

18

16

18

16

81

10

17

13

16

14

70

.

0

0

0

3

3

0

0

0

0

0

0

1990
4645 1053
126

1991
4645 1059 127

Black
1992 1993

4632 1061
127

4633 1068 128

1994 5-year

4624 1071
128

23179 5311 636

18.9 17.6 25.0

19.9 18.0 21.5

18.3 21.5 24.5

18.8 22.8 25.0

18.4 15.7 29.0

18.5 17.9 25.0

23

22

19

20

16

100

7

7

4

5

2

25

98

95

92

81

72

438

17

17

18

20

10

82

60

72

67

55

57

311

4

3

6

3

6

22

3

2

4

3

0

12

17

16

14

5

13

65

6

4

2

0

4

16

1

1

1

5

0

8

1

1

1

5

0

8

0

0

0

0

0

0

4

3

6

7

0

20

0

1

0

0

0

1

0

2

1

1

0

4

17

9

11

9

9

55

3

1

2

3

2

11

1

0

0

3

0

4

13

5

10

9

5

42

2

3

2

1

1

9

2

2

2

2

0

8

31

37

45

30

32

175

41

40

37

32

38

188

32

40

25

30

24

151

1

0

0

1

0

2

8

9

8

6

2

33

0

1

1

0

0

2

12

6

7

1

6

32

.

1

6

1

4

12

.

0

1

5

0

6

.

10

35

14

13

72

68

67

66

54

54

309

17

7

17

13

11

65

0

0

0

0

1

1

81

84

76

71

53

365

68

81

78

72

64

363

61

77

66

67

50

321

.

0

0

5

18

23

0

0

0

0

0

0

420

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Randolph County - 120

17.4 80.6
2.3 49.3
2.5 11.5
0.3 116.3
6.9
155.6 32.1 111.1 90.0 44.4 100.0
*
* * * * * *
13.6 * *
14.0 * *
37.7 30.9 31.6
* 14.8
* 14.8
. . .
77.9 18.6
* 80.1 59.6 52.2
.

16.3 75.0
2.1 60.6
3.2 14.9
0.4 156.6
5.2
132.6 29.2
105.0 89.5 * * *
* * * * * *
8.4 * *
5.5 * *
38.1 33.9 38.6
* 13.0
* 7.3
* * 4.7
75.4 12.7
* 87.4 78.7 74.8
*

16.5 75.3 2.1 55.0 2.8 12.5 0.3 129.4 9.1
126.7 *
115.7 84.2 * * *
* * * 51.5 * *
10.7 * *
10.9 * *
45.8 30.0 26.4
* 10.9
* 9.3
2.5 *
15.3
77.1 22.5
* 80.0 72.3 60.8
*

14.1 64.0
1.8 57.7
1.5 6.8 0.2 84.5 9.6
126.0 21.7
115.1 95.0 * * 27.4
44.2 44.2
* 76.3
* *
11.5 * *
11.7 * *
39.0 34.2 35.1
* 15.3
* *
2.1 2.1 12.7
71.4 16.8
* 83.8 81.1 74.8
4.5

13.3 59.8 1.7 61.0 2.5 11.3 0.3 148.1 5.1
125.4 *
76.3 85.7 32.7 100.0
*
* * * * * *
9.4 * *
5.7 * *
42.9 40.0 34.3
* 8.6
* 9.4
4.3 *
10.2
81.0 16.3
* 75.2 76.2 61.0 20.0

15.5 70.9
2.0 56.4
2.5 11.4
0.3 127.4
7.2
133.2 22.3 104.6 89.1 25.3 95.7 15.4
14.5 14.5
* 37.7
* 0.7
10.8 1.9 * 9.7 1.8 1.6
40.7 33.5 33.1
* 12.6
* 9.7
2.5 1.2 10.7
76.5 17.5
9.3 81.4 73.1 64.4
5.5

12.7 64.2
2.0 16.7
* * * * 7.6

10.7 54.2
1.7 14.7
3.0 15.5
0.4 212.8
*

12.0 61.2 1.9
* 2.2 11.0 0.3 134.6 9.4

9.9 50.8
1.6 29.0
1.9 9.5 0.3 122.4 17.5

10.7 54.8 1.7 20.6 2.2 11.3 0.3 162.8
*

11.2 57.1
1.8 17.8
2.0 10.4
0.3 136.9
8.2

92.6

*

*

* 133.8

79.0

*

*

*

*

*

*

*

*

*

*

*

48.9

*

*

*

*

*

*

*

*

*

*

*

26.3

*

*

*

*

*

85.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

6.6

*

*

*

*

*

*

*

*

*

*

*

*

14.3

*

*

*

*

9.4

*

*

*

*

*

*

*

*

*

*

*

*

30.8 *
26.2 *
28.6 * *

19.4 *
23.5 *
21.2 * *

26.3 *
23.1 *
15.4 * *

33.3 19.4 29.0
* 35.5
* *

32.3 *
35.3 *
20.6 * *

28.3 8.9
27.2 *
24.0 *
4.4

.

*

*

*

*

2.7

.

*

*

*

*

1.9

.

*

*

15.4

*

6.1

97.6 14.7
* 66.7 31.0 23.8
.

85.7 24.1
* 76.5 52.9 50.0
*

89.7 27.8
* 71.8 41.0 33.3
*

83.9 * *
71.0 58.1 51.6
*

91.2 15.6
* 76.5 47.1 41.2
*

90.1 19.6
* 72.2 45.0 38.9
*

21.1 93.1
2.6 63.8
3.7 16.1
0.4 139.3
6.6

20.5 89.7
2.5 78.3
3.4 15.1
0.4 135.6
6.6

19.9 86.7 2.4 74.4 3.0 13.2 0.4 120.7 9.4

17.5 75.9
2.0 68.8
1.1 4.7 0.1 54.3 5.6

15.6 67.2 1.8 80.3 2.8 12.1 0.3 141.3 6.5

18.9 82.5
2.3 72.8
2.8 12.2
0.3 120.4
7.0

182.5 30.4 134.9 100.0 47.6 100.0
*

173.6 31.8
134.2 100.0
* * *

149.6 *
141.7 100.0
* * *

156.6 25.0
156.6 94.7 * * 39.2

124.6 *
77.9 100.0
* * *

157.3 25.0 129.0 98.7 25.2 100.0 18.9

*

*

*

61.7

*

18.3

*

*

*

61.7

*

18.3

*

*

*

*

*

*

*

*

62.5

83.3

*

44.4

*

*

*

*

*

*

*

*

*

*

*

*

17.3 * *
13.8 * *

9.5

12.0

11.1

12.5

12.6

*

*

*

*

2.5

*

*

*

*

*

5.4

11.1

11.3

7.0

9.8

*

*

*

*

2.1

*

*

*

*

1.8

41.3 43.6 34.0
* 8.6
* 19.7

45.7 43.5 43.5
* 10.1
* 9.8

54.9 41.1 27.8
* 8.9
* 11.1

41.1 40.0 37.5
* 7.5
* *

47.8 53.5 33.8
* * * 13.3

46.3 44.0 35.4
* 7.8
* 11.9

.

*

3.6

*

*

1.8

.

*

*

3.0

*

0.9

.

5.9

20.8

8.3

7.7

10.7

69.4 20.2
* 86.2 72.3 64.9
.

71.3 8.0 *
91.3 88.0 83.7
*

71.7 20.5
* 84.4 86.7 73.3
*

66.7 17.6
* 88.8 90.0 83.8
6.3

76.1

70.9

16.7

16.5

*

*

74.6

85.5

90.1

85.0

70.4

75.2

25.4

6.9

421

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Richmond County - 121

1990
189719 47163
3897
21.2 19.8 23.0
540 137 3697 388 1546 321 49 1354 132
57 38 19 86
7 20
375 81
3 435 47 62
1414 910 941 82 657 93 194
. . .
2624 503 52
1669 1327 1026
. 13

1991
191917 47687 3933
21.0 19.8 23.0
528 140 3708 396 1648 296
49 1274 116
52 34 18 83 10 15
390 80 13
395 49 53
1431 940 1025
90 619
96 195
0 0 0
2683 471
66 2020 1674 1438
36 7

Total
1992 1993

194114 48211 3969

196314 48738 4006

21.0 19.8 23.0

21.2 20.0 23.0

529 158 3536 384 1661 336
47 1191
120

497 136 3462 396 1645 310
36 1106
85

49

31

34

20

15

11

79

57

5

8

17

8

347

351

65

66

6

11

357

376

40

35

68

58

1203 995 943 69 555 81 233

1148 944 858
49 485
60 186

20

106

12

41

134

414

2535 454 67
1853 1755 1385
97 0

2598 512
55 1949 1930 1525 352
4

1994 5-year

198509 49261 4041

970573 241060
19846

20.8 19.3 24.0

21.0 19.8 23.0

490 107 3243 364 1542 305
31 1061
109

2584 678
17646 1928 8042 1568 212 5986 562

41

230

26

152

15

78

56

361

6

36

17

77

352

1815

82

374

7

40

338

1901

53

224

40

281

1045 882 805 49 373 64 138

6241 4671 4572
339 2689
394 946

137

263

39

92

493

1041

2496 479 66
1772 1782 1362
254 0

12936 2419 306 9263 8468 6736 739 24

White
1990 1991 1992 1993 1994 5-year

104612 24229 1707

104605 24155 1693

104596 24080 1678

104590 24007 1664

104582 23932 1649

522985 120403
8390

22.2 20.0 23.0

22.2 20.8 23.0

22.4 19.9 23.0

22.4 20.8 23.0

22.1 19.8 23.0

22.2 20.3 23.0

188 43 1754 131 354 163
9 567 49

148 35
1677 108 389 136 18 495 32

167 40
1618 118 393 147 16 455 44

153 29
1582 121 385 142 11 442 27

155 31
1455 120 356 136 10 392 31

811 178 8086 598 1877 724
64 2351
183

15

19

13

13

13

73

11

10

7

9

8

45

4

9

6

4

5

28

20

27

23

17

18

105

4

3

4

1

1

13

13

7

10

4

10

44

108

119

96

112

119

554

21

15

17

16

26

95

0

1

1

2

2

6

139

135

122

128

113

637

17

25

16

17

26

101

27

17

24

27

19

114

574

534

459

432

414

2413

173

190

192

212

192

959

388

381

371

331

303

1774

10

17

8

10

10

55

409

389

362

322

240

1722

36

38

36

24

31

165

56

55

78

55

46

290

.

0

4

47

45

96

.

0

4

21

16

41

.

0

26

95

98

219

1417 241 21 545 390 283 . 8

1369 217 24 624 482 394 11 4

1290 227 28 649 555 430 27 0

1292 250 25 650 606 443 90 0

1202 197 33 608 569 424 86 0

6570 1132
131 3076 2602 1974
214 12

1990
79639 21222
2066

1991
80562 21457
2085

Black
1992 1993

81484 21691
2104

82407 21927
2124

1994 5-year

83329 22161
2143

407421 108457
10522

20.0 19.0 24.0

19.7 18.8 24.0

19.8 19.3 25.0

19.9 19.0 24.0

19.8 18.7 25.0

19.8 18.9 24.0

350 94
1885 257
1183 153 40 730 81

378 105 1965 287 1257 155
31 725
83

360 117 1848 266 1263 185
30 684
75

336 103 1816 270 1247 165
25 623
55

331 75
1725 241
1173 161 21 637 78

1755 494
9239 1321 6123
819 147 3399 372

41

33

36

18

26

154

26

24

27

11

17

105

15

9

9

7

9

49

65

56

55

39

38

253

3

7

1

7

5

23

7

8

7

4

7

33

263

265

248

233

230

1239

58

65

47

49

56

275

3

12

5

8

5

33

289

254

230

240

223

1236

29

23

23

18

26

119

34

36

43

30

21

164

824

873

729

701

614

3741

732

747

801

725

682

3687

547

635

560

520

493

2755

72

73

59

39

39

282

243

227

184

153

129

936

57

57

45

34

31

224

134

138

151

126

90

639

.

0

14

56

78

148

.

0

7

18

19

44

.

0

101

306

367

774

1162 256 29
1112 928 737 . 4

1258 242
42 1377 1178 1036
23 3

1189 222 38
1192 1191
950 70 0

1257 255
29 1275 1306 1070 260
4

1242 271 32
1140 1191
922 165
0

6108 1246
170 6096 5794 4715
518 11
422

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Richmond County - 121

19.5 78.4
2.3 42.4
7.1 28.7
0.7 248.9
8.2
138.6 25.4 99.6 81.0 33.9 97.0
6.2
15.4 10.3
5.2 23.0
0.6 0.6
10.1 2.2 *
11.9 1.3 1.7
39.8 24.9 25.9
2.3 18.1
2.6 9.3
. . .
71.3 15.1 16.4 45.7 36.4 28.1
.

19.3 77.8
2.3 45.1
6.6 26.7
0.7 238.1
7.7
134.2 26.5
100.7 90.5 29.5 95.6 5.8
14.0 9.2 4.9
22.1 0.8 0.4
10.5 2.2 0.4
10.8 1.3 1.4
40.1 25.7 28.1
2.5 17.2
2.7 9.3
* * *
72.6 14.3 18.5 55.2 45.8 39.3
1.0

18.2 73.3 2.2 47.6 6.1 24.7 0.6 232.4 8.2
133.3 29.9 96.7 87.4 30.2 97.5 8.1
13.9 9.6 4.3 22.0 0.4 0.5
9.8 1.8 0.2 10.2 1.1 1.9
34.9 28.5 27.1 2.0 16.0 2.3 11.1
0.4 0.2 2.5
71.9 14.4 19.9 53.0 50.2 39.6
2.8

17.6 71.0
2.1 48.0
5.6 22.7
0.6 224.3
7.4
124.1 27.4 98.9 89.8 21.2
100.0 4.7
9.0 5.8 3.2 16.3 0.6 0.2
10.1 1.9 0.3
11.0 1.0 1.7
33.7 27.6 25.1
1.4 14.2
1.8 9.5
2.0 0.8 7.7
75.1 16.6 15.9 56.9 56.3 44.5 10.3

16.3 65.8 2.0 48.3 5.3 21.5 0.6 228.2 7.0
121.2 21.8 90.1 87.3 27.0 98.1 4.9
12.6 8.0 4.7
17.1 0.5 0.4
10.9 2.5 0.2
10.6 1.7 1.2
33.1 27.6 25.4 1.5 11.7 2.0
7.6
2.5 0.7 9.0
77.2 16.9 18.2 55.5 55.9 42.7 8.0

18.2 73.2
2.2 46.2
6.2 24.8
0.6 234.8
7.7
130.2 26.2 97.1 87.2 28.3 97.5
5.9
13.0 8.6 4.5
20.2 0.6 0.4
10.3 2.1 0.2
10.9 1.3 1.6
36.4 26.8 26.4
1.9 15.5
2.3 9.4
1.2 0.4 4.9
73.5 15.4 17.8 53.2 48.6 38.7
5.4

16.8 72.4
2.1 20.4
5.4 23.4
0.6 226.8
7.4

16.0 69.4
2.0 23.5
4.7 20.5
0.5 211.9
6.8

15.5 67.2 2.0 24.6 4.4 18.9 0.5 202.9 7.0

15.1 65.9
2.0 24.6
4.2 18.4
0.5 202.6
6.6

13.9 60.8 1.8 24.9 3.7 16.4 0.4 196.3 6.3

15.5 67.2
2.0 23.5
4.5 19.5
0.5 208.8
6.8

110.1 22.9 76.7 46.2 28.7 91.8
5.3

87.4 23.6 63.8 70.1 18.9 90.6
5.9

99.5 24.0 70.3 61.5 26.2 95.3 4.2

92.0 19.0 72.7 71.7 16.2 100.0
3.6

94.0 20.0 72.8 66.4 18.8 100.0 4.2

96.7 21.9 71.3 62.7 21.8 95.0
4.6

8.6 6.3
* 11.3
* 0.8

11.3 6.0 5.4
15.9 *
0.4

8.0 4.3 3.7 14.1
* 0.6

8.2 5.7
* 10.7
* *

8.9 5.5 3.5 12.3
* 0.6

9.0 5.6 3.5 12.9 0.5 0.5

6.2

7.1

5.9

7.1

8.2

6.9

1.2

0.9

1.1

1.0

1.8

1.2

*

*

*

*

*

0.1

8.0

8.2

7.6

8.2

7.9

8.0

1.0

1.5

1.0

1.1

1.8

1.3

1.5

1.0

1.5

1.7

1.3

1.4

33.8 10.0 22.4
0.6 23.7
2.1 6.3

33.0 11.5 23.1
1.0 23.9
2.3 6.3

29.1 12.0 23.2 0.5 22.7 2.3
8.9

27.8 13.5 21.2
0.6 20.7
1.5 6.7

29.3 13.4 21.3 0.7 16.9 2.2
5.8

30.7 12.0 22.3
0.7 21.7
2.1 6.8

.

*

*

2.0

2.0

1.0

.

*

*

0.9

0.7

0.4

.

*

1.1

4.1

4.3

2.4

81.0 15.2 13.6 31.4 22.5 16.3
.

82.0 14.7 13.4 37.8 29.2 23.8
0.7

79.8 15.7 17.5 40.5 34.6 26.8 1.7

81.7 17.6 17.1 41.5 38.7 28.3
5.8

82.9 15.5 21.0 42.5 39.8 29.7 6.0

81.4 15.7 16.5 38.5 32.6 24.7
3.4

23.7 88.8
2.6 63.8
9.2 34.4
0.9 259.0
9.6

24.4 91.6
2.7 64.9
9.0 33.8
0.8 251.0
9.3

22.7 85.2 2.5 69.3 8.4 31.5 0.8 248.3 10.3

22.0 82.8
2.5 69.4
7.6 28.4
0.7 236.0
9.2

20.7 77.8 2.4 69.0 7.6 28.7 0.7 249.9 8.4

22.7 85.2
2.5 67.2
8.3 31.3
0.8 249.0
9.3

169.4 26.9 124.4 98.8 39.2 100.0
7.3

181.3 27.8
137.6 98.6 39.8 97.5 6.2

171.1 32.5
126.4 98.9 35.6 98.7 11.4

158.2 30.7
127.1 98.1 25.9
100.0 6.1

154.5 22.7
112.5 97.9 36.4 97.4 5.6

166.8 28.1
125.6 98.5 35.4 98.6 7.3

21.8 13.8
8.1 33.8
* 0.4

16.8 12.2
4.6 28.1
1.1 0.4

19.5 14.6 4.9 29.3
* 0.4

9.9 6.1 3.9 21.2 1.0
*

15.1 9.9 5.3
21.8 0.7 0.3

16.7 11.4
5.4 27.0
0.7 0.3

14.0 3.1 *
15.6 1.6 1.8

13.5 3.3 0.6
13.1 1.2 1.8

13.4 2.5 0.3 12.6 1.3 2.3

12.8 2.7 0.4
13.4 1.0 1.7

13.3 3.2 0.3 13.1 1.5 1.2

13.4 3.0 0.4
13.6 1.3 1.8

45.7 39.5 29.6
3.9 13.1
3.1 11.5

46.0 38.5 32.9
3.8 11.8
3.0 11.4

40.5 43.9 30.9 3.2 10.2 2.5 13.0

39.2 40.3 29.0
2.2 8.5 1.9 11.5

36.5 40.1 29.2 2.3
7.6 1.8 9.1

41.7 40.5 30.3
3.1 10.3
2.5 11.4

.

*

0.5

2.0

2.7

1.3

.

*

0.3

0.6

0.7

0.4

.

*

3.6

10.9

12.8

6.9

62.0 15.1 18.4 59.9 50.0 39.7
.

64.2 13.7 23.7 71.0 60.7 53.4
1.2

64.5 13.5 21.8 65.4 65.3 52.1
3.8

69.3 15.9 14.7 71.0 72.7 59.5 14.5

72.0

66.3

18.1

15.2

15.9

18.7

67.1

66.9

70.1

63.6

54.3

51.7

9.7

7.1

423

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Rockdale County - 122

1990
54091 13387
1296
23.4 19.6 21.0
83 15 817 48 165 55 11 288 31
9 6 3 17 1 3
53 11
0 63 12 16
193 85 166 11 153 12 28
. . .
630 124 20 246 189 152
. 0

1991
56128 13733
1330
24.0 18.6 22.0
89 18 823 50 177 75
8 259
36
6 5 1 13 2 5
78 17
1 76 11 12
193 75
175 9
159 19 23
12 5
33
647 139
23 292 253 222
27 0

Total
1992 1993

58158 14078
1363

60198 14426
1397

22.4 19.3 22.0

22.6 19.5 22.0

97

90

22

15

856

815

62

59

198

196

67

57

8

6

251

266

32

30

6

10

3

5

3

5

11

9

2

1

3

2

62

60

12

9

1

1

75

61

15

11

12

7

182

211

89

78

178

175

10

10

172

146

10

6

28

29

41

27

23

14

99

168

672

676

119

113

24

26

294

336

288

306

225

256

22

16

0

4

1994 5-year

62225 14770
1431

290800 70394
6818

22.5 18.9 22.0

23.0 19.3 22.0

107

466

20

90

819

4130

73

292

202

938

53

307

14

47

226

1290

31

160

9

40

6

25

3

15

20

70

3

9

3

16

66

319

10

59

2

5

72

347

12

61

1

48

189

968

78

405

186

880

11

51

140

770

17

64

18

126

31

111

13

55

152

452

702

3327

100

595

25

118

350

1518

311

1347

272

1127

14

79

2

6

1990
48915 12023
1171

1991
50733 12315
1196

White
1992 1993

52543 12606
1221

54364 12899
1246

1994 5-year

56174 13190
1271

262729 63033
6105

23.6 19.5 21.0

24.1 18.5 22.0

22.5 19.3 22.0

22.9 19.5 22.0

22.9 19.2 22.0

23.2 19.3 22.0

73

73

79

73

82

380

11

14

15

12

13

65

717

681

733

702

699

3532

41

43

52

46

52

234

113

102

129

134

140

618

47

65

57

46

45

260

8

6

6

4

12

36

238

208

189

213

186

1034

29

28

24

26

28

135

6

3

3

6

6

24

5

2

2

3

3

15

1

1

1

3

3

9

14

8

8

5

15

50

1

2

1

1

3

8

3

5

3

2

3

16

44

53

41

46

49

233

8

12

5

3

5

33

0

1

1

0

0

2

52

58

56

47

56

269

12

9

13

11

12

57

14

9

11

7

1

42

158

148

142

176

148

772

64

43

56

50

55

268

146

143

152

147

154

742

10

6

8

8

7

39

144

148

161

131

132

716

10

17

9

4

14

54

21

13

19

23

11

87

.

11

35

20

20

86

.

5

23

9

9

46

.

22

67

110

94

293

570

561

590

591

606

2918

110

116

105

99

88

518

20

19

21

22

22

104

189

203

225

258

277

1152

150

179

216

239

245

1029

123

154

169

195

215

856

.

19

18

13

13

63

0

0

0

3

2

5

1990
4355 1142
106

1991
4519 1170
109

Black
1992 1993

4682 1198
112

4847 1226
114

1994 5-year

5010 1254
117

23413 5990 558

22.6 22.1 26.0

23.4 19.5 24.0

21.6 18.7 25.5

20.0 19.0 25.5

18.9 18.3 27.0

20.9 19.0 25.0

10

15

16

17

24

82

4

4

7

3

7

25

94

124

108

103

107

536

7

7

9

13

20

56

52

74

68

61

59

314

8

10

10

11

8

47

3

2

2

2

2

11

41

41

46

43

35

206

2

7

7

4

3

23

3

3

3

4

3

16

1

3

1

2

3

10

2

0

2

2

0

6

3

5

3

4

5

20

0

0

1

0

0

1

0

0

0

0

0

0

8

23

18

14

15

78

3

5

5

6

5

24

0

0

0

1

2

3

11

18

16

14

16

75

0

2

2

0

0

4

2

2

1

0

0

5

34

39

35

33

36

177

21

31

32

27

23

134

18

29

25

26

30

128

1

3

2

2

4

12

9

10

9

15

7

50

2

2

1

2

3

10

7

9

8

6

5

35

.

1

4

4

8

17

.

0

0

4

4

8

.

1

27

52

49

129

57

72

70

76

86

361

14

21

11

12

10

68

0

1

3

3

3

10

55

85

66

75

68

349

37

70

68

64

61

300

28

64

53

58

52

255

.

7

4

3

1

15

0

0

0

1

0

1

424

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Rockdale County - 122

15.1 61.0
1.9 20.5
5.3 21.5
0.7 244.9
5.3
64.0 18.1 37.0 66.7 23.9 100.0
4.6
11.0 7.3 *
20.5 * *
6.5 1.3
* 7.8 1.5 2.0
26.4 10.6 20.8
1.4 19.1
1.5 6.1
. . .
77.5 17.6 20.0 30.6 23.5 18.9
.

14.7 59.9
1.9 21.8
4.6 18.9
0.6 221.0
6.6
66.9 20.2 37.6 57.1 27.1 100.0
3.8
7.3 6.1
* 15.6
* 0.4
9.5 2.1
* 9.4 1.4 1.5
27.0 9.2
21.7 1.1
19.7 2.4 5.5
0.8 0.3 2.1
78.9 19.3 25.0 36.0 31.2 27.3
3.3

14.7 60.8 1.9 23.6 4.3 17.8 0.6 212.0
5.5
71.1 22.7 45.5 72.6 23.5 93.8
*
7.0 * *
12.7 * *
7.2 1.4
* 8.9 1.8 1.4
23.5 10.6 21.2 1.2 20.6 1.2
5.8
2.5 1.4 6.0
78.5 16.0 24.5 35.0 34.3 26.8 2.6

13.5 56.5
1.8 24.4
4.4 18.4
0.6 232.5
4.4
64.4 16.7 42.2 66.1 21.5 100.0
*
12.3 6.1 6.2
11.0 * *
7.4 1.1
* 7.6 1.4 0.9
27.8 9.7
21.8 1.2
18.3 0.8 6.5
1.6 0.8 9.9
83.0 15.9 28.0 41.8 38.1 31.9
2.0

13.2 55.5 1.8 25.1 3.6 15.3 0.5 202.1
4.9
74.8 18.7 51.0 67.1 21.7 93.5
*
11.0 7.3 *
24.0 * *
8.1 1.2
* 8.9 1.5
*
26.6 9.7 23.3 1.4 17.7 2.1 4.2
1.8 0.7 8.7
85.8 13.9 29.4 43.4 38.6 33.7 1.7

14.2 58.7
1.9 23.1
4.4 18.3
0.6 222.6
5.3
68.4 19.3 42.8 66.3 23.5 97.5
3.1
9.7 6.1 3.7 16.8 0.5 0.3
7.7 1.4 0.1 8.5 1.5 1.2
26.3 10.0 21.8
1.3 19.1
1.6 5.6
1.7 0.8 6.8
80.7 16.5 25.2 37.3 33.1 27.7
2.4

14.7 59.6
1.9 16.1
4.9 19.8
0.7 234.9
4.8

13.4 55.3
1.8 15.2
4.1 16.9
0.5 215.8
6.1

14.0 58.1 1.9 17.9 3.6 15.0 0.5 191.5
5.2

12.9 54.4
1.7 19.4
3.9 16.5
0.5 220.7
3.9

12.4 53.0 1.7 20.4 3.3 14.1 0.5 196.6
4.6

13.4 56.0
1.8 17.8
3.9 16.4
0.5 212.1
4.9

62.3 15.1 35.0 61.0 24.8 100.0
*

61.0 19.2 35.9 52.4 23.4 100.0
*

64.7 19.0 42.6 67.3 19.7 95.8
*

58.6 16.4 36.9 56.5 20.9 100.0
*

64.5 15.9 40.9 55.8 22.0 96.4
*

62.2 17.1 38.3 58.8 22.1 98.5
2.6

8.4 7.0
* 19.3
* *

* * * 11.6 * 0.5

* * * 10.8 * *

8.5

8.6

6.8

*

*

4.2

*

*

2.6

7.1

21.1

14.0

*

*

0.5

*

*

0.3

6.1

7.8

5.6

6.6

7.0

6.6

1.1

1.8

0.7

*

0.7

0.9

*

*

*

*

*

*

7.4

8.6

7.8

6.8

8.2

7.7

1.7

1.3

1.8

1.6

1.7

1.6

2.0

1.3

1.5

1.0

*

1.2

24.6 9.1
20.9 1.4
20.5 1.4 5.3

24.8 6.4
21.4 0.9
22.1 2.5 3.8

21.3 7.8
21.2 1.1 22.5 1.3 4.7

26.7 7.2
21.3 1.2
19.1 *
6.0

24.4 8.0
22.7 1.0 19.6 2.1 3.0

24.4 7.7
21.5 1.1
20.8 1.6 4.6

.

0.8

2.4

1.3

1.3

1.5

.

0.4

1.6

0.6

0.6

0.8

.

1.6

4.7

7.4

6.2

5.0

79.9 17.9 22.5 26.8 21.3 17.4
.

82.7 19.4 25.3 30.2 26.6 22.9
2.8

80.5 16.5 25.3 31.3 30.0 23.5 2.5

84.2 16.1 28.9 37.4 34.6 28.3
1.9

86.8 14.3 30.6 40.4 35.7 31.3 1.9

82.8 16.8 26.3 33.2 29.6 24.6
2.3

21.6 82.3
2.4 55.3
9.4 35.9
1.0 277.0
11.4

27.4 106.0
3.1 60.7
9.1 35.0
1.0 227.8
12.8

23.1 90.2 2.7 64.8 9.8 38.4 1.1 277.1 10.0

21.3 84.0
2.4 59.2
8.9 35.1
1.0 270.4
10.6

21.4 85.3 2.5 55.1 7.0 27.9 0.8 228.8
8.8

22.9 89.5
2.6 59.1
8.8 34.4
1.0 255.6 10.7

94.3 *
66.0 100.0
* * *

137.9 *
64.3 85.7 64.3 100.0
*

143.5 43.8 80.7
100.0 62.8 85.7 *

148.7 *
113.7 100.0
* * *

205.1 29.2
170.9 95.0 * * *

147.1 30.5
100.4 96.4 41.2 91.3 9.0

*

*

*

*

*

29.9

*

*

*

*

*

18.7

*

*

*

*

*

11.4

*

39.7

*

*

45.9

36.6

*

*

*

*

*

*

*

*

*

*

*

*

8.5 * *
11.7 * *

18.5 4.0 *
14.8 * *

16.7 4.6
* 15.2
* *

13.6 5.8 *
13.6 * *

14.0 4.7
* 15.0
* *

14.6 4.5 *
14.1 *
0.9

41.0 22.3 19.1
* 9.6
* 11.7

37.5 25.4 24.0
* 8.3
* 13.2

37.6 30.5 23.8
* 8.6
* 11.4

36.3 26.2 25.2
* 14.7
* 10.5

38.7 21.5 28.6
* 6.6
* 8.9

38.1 25.2 24.2
2.3 9.5 1.9 11.3

.

*

*

*

4.7

2.6

.

*

*

*

*

1.2

.

*

16.9

31.5

28.8

19.8

60.6 16.5
* 58.5 39.4 29.8
.

58.1 19.1
* 69.7 57.4 52.5
5.7

64.8 12.2
* 62.9 64.8 50.5
*

74.5 13.6
* 72.8 62.1 56.3
*

80.4

67.5

10.6

14.6

*

15.6

63.6

65.7

57.0

56.5

48.6

48.0

*

3.4

425

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Schley County - 123

1990
3588 784 89
19.1 16.9 19.5
9 2 45 6 17 5 1 8 2
1 1 0 2 0 2
8 1 1 8 1 0
19 10 14
1 5 0 2
. . .
30 4 0
25 21 16
. 0

1991
3624 783
89
21.0 .
20.0
3 0 49 3 19 8 0 3 0
1 1 0 1 0 0
7 1 0 7 0 0
16 10 17
0 10
4 7
0 0 12
36 5 0
30 27 23
1 0

Total
1992 1993

3655 779 88

3700 780
88

20.3 .
19.5

20.9 .
21.0

14

4

6

2

53

45

14

4

23

17

2

6

0

0

8

4

0

0

0

0

0

0

0

0

0

0

0

0

0

1

3

4

1

0

0

0

4

5

0

1

0

1

15

21

13

7

23

15

1

0

11

6

1

2

1

0

1

10

1

0

21

20

37

30

12

6

3

0

37

29

29

27

25

24

4

12

0

0

1994 5-year

3737 777 87

18304 3903 440

19.4 17.7 23.0

20.2 16.9 20.0

9

39

0

10

49

241

6

33

21

97

6

27

0

1

8

31

3

5

0

2

0

2

0

0

0

3

0

0

0

3

2

24

0

3

0

1

7

31

0

2

1

2

15

86

12

52

11

80

0

2

3

35

0

7

3

13

3

14

4

5

16

69

40

173

6

33

0

3

28

149

28

132

23

111

11

28

0

0

1990
2317 514 54

1991
2345 512
53

White
1992 1993

2374 508 52

2410 508
52

1994 5-year

2442 505 51

11888 2547 262

20.1 17.6 19.0

21.0 .
20.0

21.2 .
19.0

24.6 .
21.0

19.7 19.8 20.0

20.7 18.8 20.0

4

1

6

0

4

15

1

0

1

0

0

2

19

30

33

24

30

136

2

1

6

0

3

12

3

5

7

2

3

20

4

4

2

6

4

20

1

0

0

0

0

1

4

2

5

3

6

20

1

0

0

0

1

2

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

0

1

0

0

0

0

0

0

1

0

0

0

0

1

1

0

2

1

1

5

0

0

0

0

0

0

0

0

0

0

0

0

3

0

1

2

3

9

0

0

0

0

0

0

0

0

0

0

0

0

9

6

8

8

8

39

0

2

3

0

2

7

6

8

12

3

5

34

0

0

0

0

0

0

2

7

9

3

3

24

0

0

1

0

0

1

0

3

0

0

0

3

.

0

1

7

0

8

.

0

0

0

3

3

.

3

3

5

11

22

17

24

26

20

26

113

1

4

10

3

1

19

0

0

3

0

0

3

8

17

20

13

14

72

6

12

11

11

13

53

4

10

9

9

10

42

.

1

1

4

7

13

0

0

0

0

0

0

1990
1222 257 32

1991
1234 257
32

Black
1992 1993

1245 256 32

1260 256
32

1994 5-year

1273 255 31

6234 1280
158

18.7 14.9 24.0

19.2 .
23.0

18.7 .
24.0

18.3 . .

18.7 16.0 40.0

18.7 15.9 24.0

5

2

8

4

5

24

1

0

5

2

0

8

25

19

20

21

19

104

4

2

8

4

3

21

14

14

16

15

18

77

1

4

0

0

2

7

0

0

0

0

0

0

4

1

3

1

2

11

1

0

0

0

2

3

1

1

0

0

0

2

1

1

0

0

0

2

0

0

0

0

0

0

1

1

0

0

0

2

0

0

0

0

0

0

1

0

0

1

0

2

7

7

1

3

1

19

1

1

1

0

0

3

1

0

0

0

0

1

5

7

3

3

4

22

1

0

0

1

0

2

0

0

0

1

1

2

10

10

7

13

7

47

10

8

10

7

10

45

8

9

11

12

6

46

1

0

1

0

0

2

3

3

2

3

0

11

0

4

0

2

0

6

2

4

1

0

3

10

.

0

0

3

1

4

.

0

0

0

1

1

.

1

11

15

5

32

13

12

11

10

14

60

2

1

2

3

5

13

0

0

0

0

0

0

17

13

17

16

14

77

15

15

18

16

15

79

12

13

16

15

13

69

.

0

3

8

4

15

0

0

0

0

0

0

426

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

12.5

General fertility rate

57.4

Total fertility rate

1.7

% Livebirths to unmarried women

38.6

Crude abortion rate

2.2

General abortion rate

10.2

Total abortion rate

0.3

Abortion ratio

135.6

Fetal Death rate

7.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

101.1

% Repeat conceptions to women under 18

*

Livebirths to women under 18

67.4

% Livebirths to unmarried women under 18

*

Induced abortions to women under 18

*

% Abortions to unmarried women under 18

*

Fetal deaths to women under 18

*

Infant and child survival rates

Infant mortality

*

Neonatal mortality

*

Postneonatal mortality

*

Perinatal mortality ratio

*

Deaths of children 1-4 yrs

*

Deaths of children 5-17 yrs

*

Infant health rates

% Low birthweight

17.8

% Very low birthweight

*

% Under 500 grams

*

% Preterm gestation

18.2

% Multiple gestation

*

% Birth defect

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

46.3

% with father not named on birth certificate

22.7

% with maternal education less than high school

31.8

% No prenatal care

*

% Maternal smoking during pregnancy

11.4

% Maternal alcohol use during pregnancy

*

% Interpregnancy interval less than 6 months

*

Child abuse and neglect rates

Physical

.

Sexual

.

Neglect

.

Interventions to improve infant & child survival

% Prenatal care first trimester

66.7

% Primary C-section delivery

*

% Vaginal birth after previous C-section

*

% WIC during pregnancy

56.8

% Medicaid during pregnancy

47.7

% Medicaid and WIC during pregnancy

36.4

% Perinatal case management

.

Schley County - 123

13.5 62.6
1.9 38.8
* * * * 11.5

14.5 68.0 2.0 43.4 2.2 10.3 0.3 125.0
*

* 159.5

*

42.9

* 159.5

*

78.6

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

14.3

*

*

*

*

*

14.3

*

*

*

*

*

34.0 20.4 34.7
* 20.4
* 21.9

30.0 24.5 43.4
* 20.8
* *

*

*

*

*

11.8

20.7

73.5 11.1
* 61.2 55.1 46.9
*

69.8 25.0
* 69.8 54.7 47.2
*

12.2 57.7
1.7 38.6
* * * * 9.0

13.1 63.1 1.9 42.9 2.1 10.3 0.3 127.0 7.7

13.2 61.7
1.8 40.6
1.7 7.9 0.2 102.3 7.9

* 103.9

88.6

*

*

25.6

*

69.3

75.0

*

*

78.8

*

*

11.4

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

* * * 11.4 * *

* * * 14.3 * *

10.0 * *
13.0 * *

48.8 15.9 34.1
* 13.6
* *

32.6 24.5 22.4
* * * *

37.9 21.8 33.5
* 14.7
3.0 9.5

9.8 *
19.7

* * 15.7

3.4 1.2 17.0

66.7 15.0
* 65.9 61.4 54.5 27.3

81.6 13.3
* 57.1 57.1 46.9 22.4

71.8 15.1
* 62.3 55.2 46.4 14.4

8.2 37.0
1.2 * * * * *
9.7
* * * * * * *
* * * * * *
* * * * * *
47.4 *
31.6 * * * *
. . .
89.5 * *
42.1 31.6
* .

12.8 58.6
1.9 16.7
* * * * 9.8

13.9 65.0 2.0 21.2 2.1 9.8 0.3 125.0
*

* 114.7

*

*

* 114.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

20.0 *
26.7 *
23.3 * *

25.8 *
36.4 *
27.3 * *

*

*

*

*

*

*

80.0 * *
56.7 40.0 33.3
*

78.8 35.7
* 60.6 33.3 27.3
*

10.0 47.2
1.5 * * * * *
13.8

12.3 59.4 1.9
* 2.5 11.9 0.4 150.0
*

11.4 53.4
1.7 14.7
1.7 7.9 0.3 111.7 9.0

*

*

57.2

*

*

*

*

*

45.8

*

*

41.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

3.7

*

*

*

*

*

*

*

*

6.6

*

*

*

*

*

*

33.3 * * * * * *

28.6 *
16.7 * * * *

29.5 5.1
25.0 *
17.8 * *

12.2

*

3.5

*

*

*

8.7

19.3

9.6

83.3 * *
54.2 45.8 37.5
*

86.7 * *
46.7 43.3 33.3 23.3

83.1 15.8
* 52.9 39.0 30.9 11.1

20.5 97.3
2.6 58.3
* * * * *
156.3 * * * * * *
* * * * * *
28.0 * *
20.8 * *
47.6 41.7 33.3
* * * *
. . .
52.0 * *
70.8 62.5 50.0
.

15.4 74.0
2.1 73.7
* * * * *

16.1 78.3 2.1 80.0
* * * * *

* 253.2

*

62.5

* 253.2

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

36.8

*

*

*

*

*

36.8

*

*

*

*

*

58.8 42.1 47.4
* * * *

36.8 50.0 55.0
* * * *

*

*

*

*

*

26.8

63.2 * *
68.4 78.9 68.4
*

55.0 * *
85.0 90.0 80.0
*

16.7 82.1
2.3 75.0
* * * * *

14.9 74.5 2.1 94.7
* * * * *

16.7 81.3
2.3 75.5
1.8 8.6 0.2 89.4 6.3

* 160.8 151.6

*

*

33.3

*

* 132.7

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

18.3

*

*

*

*

*

*

*

*

21.6

*

*

*

*

*

*

68.4 35.0 60.0
* * * *

38.9 52.6 31.6
* * * *

50.0 44.1 45.1
* 10.8
5.9 15.4

* * 36.5

* * 12.2

* * 19.5

47.6

73.7

57.7

*

.

13.4

*

*

*

80.0

73.7

75.5

80.0

78.9

77.5

75.0

68.4

67.6

40.0

*

19.2

427

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Screven County - 124

1990
13842 3019 310
19.3 19.3 22.0
42 13 246 36 109 23
4 31
4
4 0 4 5 1 1
26 5 1
29 2 5
113 66 85
7 44
8 17
. . .
147 29
2 123 103 81
. 0

1991
13818 2986 305
20.0 18.9 22.0
29 5
242 23
111 25 6 38 4
2 2 0 9 0 1
22 8 1
21 1 4
125 58 59 7 37 10 22
0 0 4
176 25 2
150 120 104
6 0

Total
1992 1993

13784 2950 299

13756 2916 293

20.2 17.4 23.0

19.7 16.3 22.5

27

45

6

7

232

231

20

37

105

98

18

15

3

0

28

31

5

8

3

3

1

2

2

1

4

2

0

1

0

2

14

27

2

8

0

0

11

29

0

5

0

3

85

80

53

59

70

71

1

2

34

32

7

8

11

12

2

11

2

7

48

54

155

151

35

42

6

3

132

131

130

140

103

113

28

70

0

0

1994 5-year

13718 2879 287

68918 14750
1494

19.8 16.5 23.0

19.8 17.5 23.0

39

182

9

40

183

1134

27

143

86

509

14

95

5

18

37

165

9

30

1

13

1

6

0

7

6

26

0

2

1

5

16

105

4

27

1

3

16

106

3

11

0

12

63

466

38

274

62

347

5

22

25

172

5

38

10

72

6

19

5

14

106

212

112

741

39

170

1

14

107

643

115

608

91

492

69

173

0

0

1990
7598 1528
137

1991
7583 1508
135

White
1992 1993

7562 1488
132

7545 1468
130

1994 5-year

7521 1447
127

37809 7439 660

21.2 22.4 21.0

21.5 19.8 22.0

23.2 18.2 23.0

22.9 20.3 20.0

21.1 16.2 21.0

22.0 18.9 21.0

14

11

6

14

11

56

6

1

1

3

1

12

117

103

93

99

86

498

13

6

4

12

6

41

18

15

10

12

10

65

12

13

7

6

7

45

0

1

1

0

2

4

10

21

9

11

13

64

1

3

2

1

5

12

0

0

1

0

0

1

0

0

1

0

0

1

0

0

0

0

0

0

0

1

2

0

2

5

1

0

0

0

0

1

0

1

0

1

0

2

6

6

4

9

8

33

1

3

0

2

0

6

0

0

0

0

0

0

7

7

3

10

10

37

1

0

0

1

1

3

0

2

0

1

0

3

42

38

26

36

25

167

11

9

5

7

3

35

36

22

17

26

25

126

1

0

0

0

0

1

29

22

20

21

19

111

3

7

2

3

2

17

4

3

2

3

1

13

.

0

0

1

3

4

.

0

0

4

4

8

.

0

17

21

30

68

82

85

74

83

69

393

21

12

19

19

16

87

0

1

2

0

0

3

44

47

36

38

42

207

24

34

28

38

40

164

22

33

25

29

34

143

.

1

1

15

25

42

0

0

0

0

0

0

1990
6209 1480
172

1991
6198 1463 169

Black
1992 1993

6183 1444
166

6170 1427 163

1994 5-year

6153 1407
159

30914 7221 829

18.1 18.4 23.0

19.3 18.2 29.0

19.0 16.7 23.0

18.5 15.9 28.0

18.6 16.7 30.5

18.8 17.0 25.0

28

18

21

30

7

4

5

3

129

139

139

131

23

17

16

24

91

96

95

85

11

12

11

9

4

5

2

0

21

17

19

19

3

1

3

7

28

125

8

27

97

635

21

101

76

443

7

50

3

14

24

100

4

18

4

2

2

3

1

12

0

2

0

2

1

5

4

0

2

1

0

7

5

8

2

2

4

21

0

0

0

1

0

1

1

0

0

1

1

3

20

16

10

18

4

5

2

6

1

1

0

0

22

14

8

19

1

1

0

4

5

2

0

2

8

72

4

21

1

3

6

69

2

8

0

9

71

87

59

43

38

298

55

49

48

52

35

239

49

37

53

44

37

220

6

7

1

2

5

21

15

15

14

11

6

61

5

3

5

5

3

21

13

19

9

9

9

59

.

0

1

10

2

13

.

0

2

3

1

6

.

4

22

33

74

133

65

91

81

68

8

13

16

23

2

1

4

3

79

103

96

93

79

86

102

101

59

71

78

84

.

5

27

55

0

0

0

0

43

348

23

83

1

11

65

436

75

443

57

349

44

131

0

0

428

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Screven County - 124

17.8 81.5
2.5 44.7
2.2 10.3
0.3 101.0
9.9
135.5 31.0 116.1 75.0
* * *
* * * 20.0 * *
10.6 2.0 *
11.9 *
2.0
48.7 27.0 35.0
2.9 18.1
3.3 11.3
. . .
61.0 12.7
* 50.4 42.2 33.2
.

17.5 81.0
2.5 46.1
2.8 12.7
0.4 121.8
10.7
95.2 17.2 75.5 87.0
* * *
* * * 36.3 * *
9.1 3.3
* 8.7
* *
52.7 24.1 24.7
2.9 15.4
4.2 15.0
* * *
73.3 11.5
* 62.2 49.8 43.2
2.5

16.8 78.6 2.4 45.3 2.0 9.5 0.3 98.9 7.8
90.4 22.2 67.0 80.0 16.7 100.0
*
* * * * * *
6.0 * *
4.7 * *
38.1 22.8 30.2
* 14.7
3.0 8.0
* * 11.9
67.1 16.8 25.0 56.9 56.0 44.4 12.1

16.8 79.2
2.4 43.4
2.3 10.6
0.3 111.9
5.1
153.5 15.6
126.2 80.6 27.3
100.0 *
* * * * * *
11.7 3.5 *
12.8 2.2 *
38.6 26.1 31.4
* 14.2
3.6 9.4
2.7 1.7 13.3
67.7 20.5
* 58.0 61.9 50.0 31.0

13.3 63.6 2.0 47.5 2.7 12.9 0.4 153.5 7.3
135.8 23.1 94.0 88.9 31.3
100.0 *
* * * 31.9 * *
8.7 * *
8.8 * *
39.1 21.0 34.6
2.8 13.9
2.8 11.0
1.5 1.2 26.2
64.0 24.1
* 59.1 63.5 50.3 38.1

16.5 76.9
2.3 45.3
2.4 11.2
0.3 116.2
8.2
121.9 22.0 95.7 81.7 20.1 100.0
6.7
11.5 5.3 6.2
22.6 *
0.3
9.3 2.4
* 9.4 1.0 1.1
44.0 24.4 31.0
2.0 15.4
3.4 11.0
1.2 0.9 13.1
66.8 16.7 13.6 57.2 54.1 43.8 19.7

15.4 76.6
2.3 15.5
1.3 6.5 0.2 71.4 8.5

13.6 68.3
2.1 14.6
2.8 13.9
0.4 151.1
9.9

102.2 42.9 94.9 38.5
* * *

81.8 *
44.6 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

5.1

5.8

*

*

*

*

6.0

6.8

*

*

*

*

38.2 9.5
31.0 *
25.2 * *

36.9 8.7
21.4 *
21.4 6.9 *

.

*

.

*

.

*

70.1 19.3
* 37.9 20.7 19.0
.

83.3 13.5
* 45.6 33.0 32.0
*

12.3 62.5 1.9 10.8 1.2 6.0 0.2 81.8 5.4

13.1 67.4
2.1 12.2
1.5 7.5 0.2 94.8 4.1

11.4 59.4 1.8 11.8 1.7
9.0 0.3 120.4 6.2

13.2 66.9
2.1 13.1
1.7 8.6 0.2 104.4 6.9

45.5 * * * * * *

108.1 *
92.7 50.0
* * *

86.7 *
47.3 *
39.4 100.0
*

84.9 21.4 62.1 43.9 18.2 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

10.0

*

*

*

*

*

*

*

*

*

9.1

9.3

6.6

*

*

*

1.2

*

*

*

*

*

10.2

11.8

7.5

*

*

*

*

*

*

*

*

28.6 5.4 18.3
* 21.5
* *

37.9 7.1
26.5 *
21.4 * *

33.3 *
29.4 *
22.6 * *

35.2 7.1
25.5 *
22.5 3.5 4.9

*

*

*

*

*

*

*

1.1

9.5

11.7

16.7

9.5

79.6 22.1
* 38.7 30.1 26.9
*

85.6 21.6
* 38.8 38.8 29.6 15.3

82.1 22.2
* 49.4 47.1 40.0 29.4

79.7 19.6
* 41.8 33.1 28.9 11.1

20.8 87.2
2.6 71.1
3.4 14.2
0.4 125.7
11.5

22.4 95.0
2.9 69.6
2.7 11.6
0.3 98.3 11.6

22.5 96.2 2.9 68.3 3.1 13.2 0.4 109.8 10.4

21.2 91.8
2.8 66.9
3.1 13.3
0.4 119.5
6.3

15.8 68.9 2.1 79.2 3.9 17.1 0.5 180.5 8.5

20.5 87.9
2.7 70.5
3.2 13.8
0.4 124.2
9.7

162.8 25.0 133.7 95.7
* * *

106.5 *
100.6 94.1 * * *

126.7 23.8 96.6
100.0 * * *

184.4 *
147.5 95.7 43.0
100.0 *

175.8 28.6
131.8 100.0
* * *

150.8 21.6
121.9 97.0 21.7 100.0
8.4

*

*

*

*

*

18.9

*

*

*

*

*

7.9

*

*

*

*

*

11.1

37.6

55.6

*

*

*

32.4

*

*

*

*

*

*

*

*

*

*

*

*

15.5

11.5

*

3.6

*

*

17.2

10.1

*

*

3.9

*

7.2

13.7

*

4.6

*

*

5.8

15.0

*

*

*

*

8.2

11.3

*

3.3

*

*

6.3

11.0

*

1.3

*

1.4

58.2 43.0 38.6
4.7 11.7
3.9 15.5

64.9 35.5 27.2
5.1 10.9
* 21.1

44.7 34.5 38.1
* 10.1
3.6 9.7

38.7 40.9 34.6
* 8.7 4.0 12.5

44.2 36.5 39.4 5.4 6.3
* 19.6

50.9 38.1 35.3
3.4 9.7 3.4 15.3

.

*

*

4.4

*

1.4

.

*

*

*

*

0.7

.

*

9.7

14.6

32.8

14.7

52.4 6.7 *
61.7 61.7 46.1
.

65.9 10.1
* 74.6 62.3 51.4
3.6

58.7 13.1
* 69.1 73.4 56.1 19.4

54.4 19.8
* 73.2 79.5 66.1 43.3

47.3

56.5

25.6

14.4

*

21.2

67.7

69.4

78.1

70.5

59.4

55.6

45.8

26.2

429

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Seminole County - 125

1990
9010 1826
201
20.1 .
22.0
22 8
140 22 69
4 2 4 0
4 4 0 6 1 0
9 2 0 7 1 6
51 37 42
0 17
2 9
. . .
95 21
1 83 75 60
. 0

1991
9025 1820 199
19.9 16.1 22.0
15 4
140 14 72 13 0 6 1
1 0 1 0 1 0
10 1 0 8 0 4
41 39 48
1 21
3 9
3 0 4
89 20
0 77 75 54
0 0

Total
1992 1993

9037 1809
197

9054 1802 195

18.4 .
21.0

19.1 .
21.0

17

24

1

9

136

125

17

23

73

63

9

7

0

0

5

3

0

0

1

0

1

0

0

0

1

0

0

0

0

1

13

14

3

2

1

0

10

8

0

1

0

3

34

41

43

29

50

53

4

2

26

23

3

6

11

11

1

7

1

6

17

9

90

82

16

15

1

1

96

88

98

91

82

75

12

14

0

0

1994 5-year

9061 1792
193

45187 9049 986

19.9 21.8 21.5

19.3 19.0 21.0

18

96

4

26

120

661

18

94

60

337

9

42

0

2

6

24

0

1

2

8

2

7

0

1

2

9

0

2

0

1

14

60

1

9

0

1

12

45

2

4

3

16

32

199

33

181

39

232

2

9

20

107

0

14

12

52

3

14

5

12

7

37

82

438

17

89

0

3

78

422

77

416

65

336

45

71

0

0

1990
6031 1129
108

1991
6011 1119 107

White
1992 1993

5995 1109
106

5975 1097 105

1994 5-year

5955 1088
104

29967 5542 529

22.7 .
21.0

20.3 16.1 21.0

19.1 .
21.0

20.1 .
20.5

21.4 .
20.0

20.2 16.1 21.0

4

5

9

12

8

38

0

0

1

4

1

6

58

55

63

63

48

287

4

4

9

11

8

36

11

8

16

13

9

57

4

4

2

2

6

18

0

0

0

0

0

0

2

4

3

0

2

11

0

1

0

0

0

1

0

0

0

0

1

1

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

1

1

0

1

0

0

0

1

0

0

0

1

0

1

3

4

6

6

4

23

0

1

1

1

1

4

0

0

1

0

0

1

2

3

5

3

4

17

0

0

0

1

0

1

2

0

0

1

1

4

15

8

8

16

7

54

6

2

10

5

5

28

14

19

23

23

14

93

0

1

2

0

0

3

11

13

21

17

12

74

2

0

0

1

0

3

2

2

5

3

2

14

.

3

0

2

1

6

.

0

0

4

3

7

.

3

2

0

0

5

47

47

46

48

42

230

6

6

8

9

7

36

1

0

0

1

0

2

20

19

36

41

21

137

17

16

36

35

19

123

13

13

27

31

15

99

.

0

3

4

6

13

0

0

0

0

0

0

1990
2943 693 92

1991
2948 690
91

Black
1992 1993

2952 686 90

2957 683
89

1994 5-year

2960 678 88

14760 3430 451

18.6 .
22.5

19.6 .
23.5

18.0 .
23.0

18.0 .
24.0

18.5 21.8 23.0

18.4 21.8 23.0

18

10

8

12

10

58

8

4

0

5

3

20

82

85

73

62

72

374

18

10

8

12

10

58

58

64

57

50

51

280

0

9

7

5

3

24

2

0

0

0

0

2

2

1

2

3

4

12

0

0

0

0

0

0

4

1

1

0

1

7

4

0

1

0

1

6

0

1

0

0

0

1

6

0

1

0

1

8

1

0

0

0

0

1

0

0

0

0

0

0

6

6

7

8

10

37

2

0

2

1

0

5

0

0

0

0

0

0

5

5

5

5

8

28

1

0

0

0

2

3

4

4

0

2

2

12

36

33

26

25

25

145

31

37

33

24

28

153

28

29

27

30

25

139

0

0

2

2

2

6

6

8

5

6

8

33

0

3

3

5

0

11

7

7

6

8

10

38

.

0

1

5

2

8

.

0

0

1

2

3

.

0

8

3

5

16

48

42

44

34

40

208

15

14

8

6

10

53

0

0

1

0

0

1

63

58

60

47

57

285

58

59

62

56

58

293

47

41

55

44

50

237

.

0

9

10

39

58

0

0

0

0

0

0

430

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

15.5

15.5

15.0

13.8

13.2

14.6

General fertility rate

76.7

76.9

75.2

69.4

67.0

73.0

Total fertility rate

2.2

2.3

2.2

2.0

2.0

2.1

% Livebirths to unmarried women

49.6

51.4

53.7

51.2

50.8

51.4

Crude abortion rate

*

0.7

0.6

*

0.7

0.5

General abortion rate

*

3.3

2.8

*

3.3

2.7

Total abortion rate

*

*

*

*

*

0.0

Abortion ratio

*

37.7

33.3

*

43.8

32.7

Fetal Death rate

4.4

7.1

5.0

4.4

6.1

5.4

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

109.5

75.3

86.3 122.9

93.2

97.4

% Repeat conceptions to women under 18

36.4

*

*

37.5

*

27.1

Livebirths to women under 18

109.5

70.2

86.3 117.8

93.2

95.4

% Livebirths to unmarried women under 18

90.5

78.6

58.8

78.3

77.8

77.4

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

12.1

Neonatal mortality

*

*

*

*

*

10.6

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

42.3

*

*

*

*

13.6

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

6.4

7.1

9.6

11.2

11.7

9.1

% Very low birthweight

*

*

*

*

*

1.4

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

5.0

5.7

7.4

6.5

10.2

6.8

% Multiple gestation

*

*

*

*

*

*

% Birth defect

4.5

*

*

*

*

2.7

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

41.1

38.0

28.8

37.3

32.3

35.6

% with father not named on birth certificate

26.6

27.9

31.6

23.4

28.0

27.5

% with maternal education less than high school

30.4

34.3

36.8

42.7

33.1

35.4

% No prenatal care

*

*

*

*

*

1.4

% Maternal smoking during pregnancy

13.0

18.4

21.8

20.2

20.0

18.5

% Maternal alcohol use during pregnancy

*

*

*

5.3

*

2.4

% Interpregnancy interval less than 6 months

11.1

9.2

12.9

13.3

17.4

12.5

Child abuse and neglect rates

Physical

.

*

*

2.9

*

1.5

Sexual

.

*

*

2.5

2.1

1.3

Neglect

.

*

7.2

3.8

2.9

3.9

Interventions to improve infant & child survival

% Prenatal care first trimester

68.3

64.0

66.7

65.6

68.9

66.7

% Primary C-section delivery

16.3

15.9

12.4

13.5

15.6

14.7

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

59.7

55.0

70.6

71.0

66.1

64.2

% Medicaid during pregnancy

54.0

53.6

72.1

73.4

65.3

63.3

% Medicaid and WIC during pregnancy

43.2

38.6

60.3

60.5

55.1

51.1

% Perinatal case management

.

*

8.8

11.3

38.1

13.7

Seminole County - 125

9.6 51.4
1.6 19.0
* * * * 4.4
* * * * * * *
* * * * * *
* * * * * *
31.9 10.3 24.6
* 22.0
* *
. . .
82.5 11.3
* 34.5 29.3 22.4
.

9.1 49.2
1.5 14.5
* * * * *
46.8 * * * * * *
* * * * * *
* * * * * *
24.2 *
34.5 *
38.2 * *
* * *
85.5 11.3
* 34.5 29.1 23.6
*

10.5 56.8 1.7 25.4
* * * * *

10.5 57.4
1.8 21.3
* * * * *

85.1 *
85.1 * * * *

114.6 *
105.1 63.6 * * *

*

*

*

*

*

*

*

*

*

*

*

*

9.5

9.5

*

*

*

*

7.9

*

*

*

*

*

16.7 15.9 36.5
* 42.9
* 15.2

31.4 8.1
37.1 *
32.7 * *

*

*

*

*

*

*

73.0 13.3
* 57.1 57.1 42.9
*

76.2 16.7
* 66.1 56.5 50.0
*

8.1 44.1 1.4 18.8
* * * * 7.4
77.3 *
77.3 * * * *
* * * * * *
* * * * * *
21.9 10.4 29.2
* 37.5
* *
* * *
87.5 15.2
* 43.8 39.6 31.3 12.5

9.6 51.8
1.6 20.0
0.4 2.0 0.0 34.5 3.8
71.8 15.8 68.1 47.2
* * *
* * * * * *
8.0 * *
5.9 * *
25.6 9.8
32.6 *
34.1 *
9.2
1.3 1.5 1.0
80.4 13.5
* 47.9 43.0 34.6
5.7

27.9 118.3
3.1 71.6
* * * * *

28.8 123.1
3.4 75.3
* * * * 13.0

24.7 106.5
2.9 78.1
* * * * 10.2

21.0 90.8
2.4 80.6
* * * * 8.8

24.3 106.1
3.0 72.9
* * * * *

25.3 109.0
3.0 75.5
0.8 3.5 0.1 29.0 8.2

195.7 44.4 195.7 100.0
* * *

109.6 *
109.6 90.0 * * *

88.7 *
88.7 100.0
* * *

134.2 41.7
134.2 91.7 * * *

113.1 *
113.1 100.0
* * *

128.5 34.5
128.5 96.5
* * *

*

*

*

*

*

18.7

*

*

*

*

*

16.0

*

*

*

*

*

*

71.4

*

*

*

*

21.3

*

*

*

*

*

*

*

*

*

*

*

*

7.3

7.1

9.6

12.9

13.9

9.9

*

*

*

*

*

1.3

*

*

*

*

*

*

6.2

5.9

6.8

8.1

11.4

7.5

*

*

*

*

*

*

*

*

*

*

*

3.3

46.8 38.3 34.6
* 7.4
* 13.5

44.0 43.5 34.1
* 10.0
* 10.9

37.1 45.2 37.0
* 7.1
* 11.5

42.4 38.7 48.4
* 9.7 8.1 17.0

37.3 40.0 35.7
* 11.8
* 20.8

41.7 41.2 37.5
1.6 9.1 3.0 14.4

.

*

*

4.5

*

1.8

.

*

*

*

*

*

.

*

7.2

*

4.5

3.6

58.5 19.7
* 77.8 71.6 58.0
.

50.0 19.2
* 68.2 69.4 48.2
*

61.1 11.6
* 82.2 84.9 75.3 12.3

54.8 10.5
* 75.8 90.3 71.0 16.1

56.3

56.1

15.9

15.7

*

*

81.4

76.8

82.9

79.0

71.4

63.9

55.7

20.0

431

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Spalding County - 126

1990
54457 12833
1297
20.5 19.0 21.0
149 35 993 118 383 54
8 207 26
8 8 0 15 3 2
101 11
0 79
8 10
279 166 382 12 185 18 47
. . .
742 153 11 501 381 327
. 0

1991
54961 12841
1293
20.5 19.6 21.0
154 52
965 113 402
66 11 212 30
12 6 6
17 1 1
91 15
3 94 14
7
279 175 351
17 163
12 50
39 35 195
773 162
15 572 447 408
24 5

Total
1992 1993

55452 12847
1289

55954 12856
1285

19.7 19.5 21.0

19.9 19.5 22.0

176

171

50

34

969

925

150

141

427

427

91

98

13

9

196

194

24

18

10

6

5

3

5

3

18

12

3

1

5

1

96

99

13

24

1

0

95

110

9

13

4

1

272

254

175

176

387

338

8

4

155

146

14

5

42

56

42

47

86

78

300

361

794

758

174

160

8

12

557

547

511

565

424

471

101

149

9

4

1994 5-year

56446 12863
1281

277270 64240
6446

19.9 19.4 21.5

20.1 19.4 21.0

148

798

25

196

795

4647

104

626

373

2012

91

400

14

55

204

1013

25

123

13

49

5

27

8

22

19

81

1

9

3

12

73

460

13

76

3

7

87

465

8

52

1

23

215

1299

151

843

293

1751

4

45

113

762

6

55

41

236

66

194

45

244

309

1165

647

3714

122

771

22

68

470

2647

466

2370

390

2020

195

469

11

29

1990
38281 8598 829

1991
38490 8553 822

White
1992 1993

38688 8506 814

38899 8462 806

1994 5-year

39099 8415
799

193457 42534
4069

22.0 18.9 20.0

21.9 19.5 20.0

21.1 19.8 20.0

21.1 19.3 21.0

20.8 19.5 21.0

21.4 19.5 20.0

66

61

65

73

61

326

11

17

11

10

8

57

587

566

545

539

488

2725

48

43

49

57

44

241

101

110

104

130

138

583

30

35

60

59

53

237

2

6

8

5

3

24

121

124

119

123

116

603

16

16

14

13

13

72

4

2

1

4

6

17

4

2

0

2

1

9

0

0

1

2

5

8

5

8

8

7

4

32

1

1

2

0

1

5

1

1

1

1

3

7

40

37

31

46

35

189

3

7

2

12

6

30

0

1

0

0

1

2

38

38

41

59

50

226

4

8

4

8

6

30

7

4

3

0

1

15

127

120

130

121

108

606

52

49

37

55

55

248

203

173

186

176

156

894

2

3

2

0

2

9

145

136

125

126

103

635

8

8

9

1

4

30

16

15

15

20

25

91

.

25

26

26

33

110

.

27

50

60

38

175

.

98

132

164

137

531

471

478

476

463

422

2310

89

98

118

103

70

478

5

8

6

10

12

41

207

249

243

253

238

1190

148

188

207

260

234

1037

117

168

174

211

193

863

.

4

27

53

78

162

0

0

4

3

8

15

1990
15785 4128 456

1991
15931 4127 455

Black
1992 1993

16073 4126 453

16219 4126 452

1994 5-year

16362 4125 450

80370 20632
2266

18.9 18.8 25.0

18.6 20.0 26.0

17.9 17.3 28.0

18.0 20.0 25.0

18.1 18.2 23.0

18.4 19.0 25.0

83

92

111

98

87

471

24

35

39

24

17

139

399

389

414

374

301

1877

70

70

101

84

60

385

281

292

322

296

235

1426

23

30

29

37

37

156

6

5

5

4

10

30

81

83

70

68

86

388

10

13

10

5

12

50

4

10

9

4

4

5

0

6

4

10

9

10

2

0

1

1

0

4

2

7

32

1

4

18

1

3

14

5

14

48

1

0

4

0

0

5

61

52

65

51

37

266

8

8

11

12

7

46

0

2

1

0

2

5

41

55

54

51

36

237

4

6

5

4

2

21

3

3

1

1

0

8

151

155

139

130

106

681

114

126

137

121

96

594

178

178

200

160

137

853

10

14

6

4

2

36

40

27

30

20

10

127

10

4

5

4

2

25

31

35

27

36

16

145

.

13

16

15

32

76

.

7

30

18

7

62

.

91

150

182

161

584

269

286

309

285

219

1368

62

63

56

56

51

288

6

7

2

2

10

27

292

320

310

291

231

1444

231

258

300

303

232

1324

208

239

247

258

197

1149

.

20

73

96

117

306

0

5

5

1

3

14

432

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Spalding County - 126

18.2 77.4
2.3 38.9
3.8 16.1
0.5 163.6
5.1
114.9 23.5 91.0 81.2 20.0 96.2
6.2
8.1 8.1
* 15.0
* *
10.2 1.1 * 8.0 0.8 1.0
31.8 16.9 39.1
1.2 18.9
1.8 8.7
. . .
75.6 17.1 12.4 50.9 38.7 33.2
.

17.6 75.1
2.3 42.3
3.9 16.5
0.5 167.3
7.0
119.1 33.8 87.4 83.2 23.2 93.3 8.5
12.4 6.2 6.3
17.4 * *
9.4 1.6
* 9.9 1.5 0.7
33.6 18.4 37.2
1.8 17.3
1.3 9.5
2.5 2.3 12.6
80.5 19.2 13.9 60.1 47.0 42.9
2.5

17.5 75.4 2.3 44.5 3.5 15.3 0.5 153.0
9.0
136.5 28.4
116.4 87.2 18.6 91.7 *
10.3 5.2 5.2 18.3
* 0.4
9.9 1.3
* 9.9 0.9
*
32.9 18.2 40.5
0.8 16.2
1.5 7.8
2.7 5.5 19.2
82.5 20.4 7.5 58.1 53.3 44.2 10.5

16.5 72.0
2.2 46.8
3.5 15.1
0.5 157.7
8.6
133.0 19.9
109.7 80.9 14.0
100.0 9.3
6.5 * *
12.8 * *
10.7 2.6 *
12.1 1.4 *
29.7 19.3 37.2
* 16.0
0.5 11.0
3.0 4.9 22.8
82.1 19.4 13.8 60.0 62.0 51.6 16.3

14.1 61.8 1.9 47.4 3.6 15.9 0.5 184.8
8.2
115.5 16.9 81.2 79.8 19.5
100.0 14.8
16.4 6.3 10.1 23.5
* *
9.2 1.6
* 11.1 1.0
*
28.4 19.2 37.4
* 14.4
0.8 9.3
4.1 2.8 19.3
81.4 17.8 21.6 59.7 59.2 49.6 24.8

16.8 72.3
2.2 43.8
3.7 15.8
0.5 164.8
7.6
123.8 24.6 97.1 82.7 19.1 95.9
8.4
10.5 5.8 4.8
17.2 0.5 0.2
9.9 1.6 0.2 10.1 1.1 0.5
31.3 18.4 38.3
1.0 16.7
1.2 9.2
3.1 3.9 18.5
80.4 18.8 13.8 57.6 51.6 44.0 13.0

15.3 68.3
2.1 17.3
3.2 14.1
0.4 163.1
4.0

14.7 66.2
2.0 19.8
3.2 14.5
0.4 167.3
6.0

14.1 64.1 2.0 19.3 3.1 14.0 0.4 160.6
9.1

13.9 63.7
2.0 24.5
3.2 14.5
0.4 168.7
7.9

12.5 58.0 1.8 28.6 3.0 13.8 0.4 175.8
6.7

14.1 64.1
2.0 21.7
3.1 14.2
0.4 166.9
6.7

79.6 16.7 57.9 56.3 19.3 93.8
*

74.2 27.9 52.3 60.5 19.5 87.5
*

79.9 16.9 60.2 67.3 17.2 85.7
*

90.5 13.7 70.7 57.9 16.1 100.0
*

76.4 13.1 55.1 54.5 16.3 100.0
*

80.1 17.5 59.2 59.3 17.7 93.1
3.2

*

*

*

*

12.3

6.2

*

*

*

*

*

3.3

*

*

*

*

10.3

2.9

8.5

14.0

14.5

12.9

*

11.6

*

*

*

*

*

0.5

*

*

*

*

*

0.2

6.8

6.5

5.7

8.5

7.2

6.9

*

1.2

*

2.2

1.2

1.1

*

*

*

*

*

*

6.5

6.8

7.6

11.1

10.4

8.4

*

1.4

*

1.5

1.2

1.1

1.2

*

*

*

*

0.6

24.7 8.9
35.1 *
25.1 1.4 5.1

24.8 8.8
31.5 *
24.7 1.5 5.3

27.4 6.9 34.5
* 23.2
1.7 5.4

24.5 10.4 33.3
* 23.7
* 7.0

23.6 11.4 32.5
* 21.5
* 9.5

25.0 9.2
33.4 0.3
23.7 1.1 6.4

.

2.6

2.7

2.7

3.4

2.8

.

2.8

5.2

6.2

3.9

4.5

.

10.2

13.7

16.9

14.1

13.8

81.3 16.8
9.3 35.5 25.4 20.1
.

84.9 19.5 14.5 44.7 33.8 30.2
*

87.8 24.6 9.8 45.0 38.3 32.2 5.0

85.9 21.9 16.4 47.6 49.0 39.7 10.0

86.5 16.5 20.7 49.4 48.5 40.0 16.2

85.2 19.9 14.2 44.2 38.5 32.0
7.7

25.3 96.7
2.8 71.3
5.1 19.6
0.6 158.8
7.3

24.4 94.2
2.7 76.0
5.2 20.1
0.6 162.7
9.2

25.8 100.3
2.9 78.7 4.4 17.0 0.5 134.4
9.0

23.1 90.6
2.6 80.0
4.2 16.5
0.5 140.5
10.2

18.4 73.0 2.1 78.6 5.3 20.8 0.6 198.2 11.4

23.4 91.0
2.6 76.8
4.8 18.8
0.5 157.8
9.4

182.0 28.9 153.5 98.6 21.9 100.0 13.2

202.3 38.0
153.9 97.1 28.6
100.0 19.8

244.9 35.1
222.9 97.0 22.1
100.0 *

216.9 24.5
185.9 96.4 11.1
100.0 19.9

193.2 19.5
133.2 98.3 26.6
100.0 33.3

207.8 29.5
169.9 97.4 22.1
100.0 18.1

* * * 24.7 * *

25.7 *
15.6 22.8
* *

21.7 12.1
* 23.9
* *

* * * 13.2 * *

23.3 * *
45.0 * *

17.0 9.6 7.5
25.2 *
0.2

15.3 2.0 *
10.4 * *

13.4 2.1 *
14.3 1.6 *

15.7 2.7
* 13.2 1.2
*

13.6 3.2 *
13.8 * *

12.3 2.3
* 12.0
* *

14.2 2.5 0.3
12.8 1.1 0.4

42.2 28.9 45.5
2.5 10.2
2.6 13.8

45.9 32.8 46.4
3.6 7.1
* 14.9

40.4 33.5 49.3 1.5 7.4 1.2 10.6

37.2 32.7 43.2
* 5.4
* 16.4

36.2 32.1 46.0
* 3.3
* 9.0

40.5 32.0 46.1
1.9 6.9 1.4 13.1

.

2.3

2.8

2.6

5.4

3.3

.

1.2

5.2

3.1

1.2

2.7

.

15.9

25.9

31.1

27.2

25.1

68.1 17.2 17.6 73.9 58.5 52.7
.

73.9 18.9 13.7 83.3 67.2 62.2
5.2

75.2 15.3
* 75.8 73.3 60.4 17.8

76.6 16.3
* 78.6 81.9 69.7 25.9

72.8

73.3

19.9

17.4

23.3

13.6

77.3

77.8

77.6

71.3

65.9

61.9

39.1

20.9

433

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Stephens County - 127

1990
23257 5198 483
20.6 19.9 20.0
40 8
356 36 89 30
1 57
2
4 3 1 3 0 0
26 2 0
17 4
19
89 44 93 13 52 10 17
. . .
217 60
3 174 130 108
. 0

1991
23459 5187 479
21.2 17.4 21.0
44 13 365 35 94 22
4 57
8
6 5 1 9 0 3
33 6 1
26 4
21
88 43 94
4 66
5 14
4 4 33
243 54 9
189 137 120
3 0

Total
1992 1993

23648 5173 474

23853 5162 470

20.8 20.3 21.0

21.5 19.3 22.0

41

30

10

8

356

323

37

24

94

81

35

22

4

4

38

59

2

6

4

7

4

5

0

2

8

9

0

2

3

3

30

26

9

5

1

1

25

29

3

1

17

16

132

80

53

40

104

79

5

4

62

51

8

5

22

19

6

14

15

13

27

55

228

229

50

47

9

7

193

170

172

155

141

132

23

6

0

0

1994 5-year

24043 5148 466

118260 25868 2372

21.9 15.6 22.0

21.2 18.7 21.0

19

174

4

43

315

1715

15

147

80

438

11

120

2

15

43

254

4

22

3

24

2

19

1

5

4

33

1

3

1

10

19

134

3

25

1

4

18

115

4

16

22

95

84

473

35

215

58

428

2

28

42

273

1

29

15

87

18

42

16

48

78

193

251

1168

56

267

6

34

154

880

147

741

119

620

4

36

2

2

1990
20300 4479 395

1991
20463 4467 391

White
1992 1993

20619 4454 387

20787 4443 383

1994 5-year

20941 4429 379

103110 22272 1934

21.2 19.9 20.5

21.4 17.4 21.0

21.4 19.6 21.0

21.9 20.3 21.0

21.9 16.8 21.0

21.5 18.8 21.0

27

32

28

21

16

124

5

9

6

5

3

28

287

307

296

280

259

1429

24

25

25

17

14

105

41

49

47

54

41

232

24

20

29

18

10

101

0

3

3

1

2

9

43

45

30

41

31

190

1

7

2

3

2

15

3

3

4

4

2

16

2

3

4

2

1

12

1

0

0

2

1

4

2

6

7

3

3

21

0

0

0

2

0

2

0

2

3

3

0

8

20

18

21

19

14

92

1

3

8

2

2

16

0

1

1

1

0

3

14

16

19

26

14

89

4

3

3

0

4

14

16

14

11

16

14

71

67

68

103

61

60

359

15

23

29

23

15

105

69

78

82

65

48

342

6

1

2

3

0

12

42

60

57

46

35

240

6

1

5

4

0

16

10

8

15

14

10

57

.

3

6

11

18

38

.

4

11

10

14

39

.

14

19

30

36

99

198

212

200

210

212

1032

46

41

40

40

43

210

3

9

6

5

4

27

125

144

150

136

119

674

87

100

125

124

108

544

72

86

103

104

90

455

.

2

13

3

3

21

0

0

0

0

1

1

1990
2787 672 84

1991
2811 671
83

Black
1992 1993

2834 669 83

2858 667
82

1994 5-year

2881 665 81

14172 3343 412

18.5 18.8 19.0

18.6 16.7 22.0

18.2 20.3 20.5

20.0 17.6 25.5

20.0 15.0 24.0

18.8 18.4 22.5

13

12

13

9

3

50

3

4

4

3

1

15

67

56

56

42

51

272

12

10

12

7

1

42

48

45

46

27

38

204

5

2

6

4

1

18

1

1

1

3

0

6

11

11

7

17

12

58

1

1

0

3

2

7

1

3

0

3

1

8

1

2

0

3

1

7

0

1

0

0

0

1

1

3

1

6

1

12

0

0

0

0

1

1

0

1

0

0

1

2

6

14

8

7

5

40

1

3

1

3

1

9

0

0

0

0

1

1

3

10

5

3

4

25

0

1

0

1

0

2

3

6

4

0

7

20

22

20

27

19

22

110

29

20

24

17

19

109

24

16

20

14

9

83

7

3

3

1

2

16

10

6

5

5

6

32

4

4

3

1

1

13

7

6

7

5

5

30

.

1

.

0

.

15

0

2

0

3

3

1

1

5

7

17

37

76

18

30

25

19

36

128

14

13

9

7

11

54

0

0

2

2

2

6

48

44

41

34

31

198

42

37

45

31

35

190

35

34

36

28

25

158

.

1

9

3

1

14

0

0

0

0

1

1

434

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

15.3

15.6

General fertility rate

68.5

70.4

Total fertility rate

2.0

2.1

% Livebirths to unmarried women

25.3

26.0

Crude abortion rate

2.5

2.4

General abortion rate

11.0

11.0

Total abortion rate

0.2

0.2

Abortion ratio

127.5 127.2

Fetal Death rate

6.5

5.0

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

82.8

91.9

% Repeat conceptions to women under 18

20.0

29.5

Livebirths to women under 18

74.5

73.1

% Livebirths to unmarried women under 18

66.7

54.3

Induced abortions to women under 18

*

16.7

% Abortions to unmarried women under 18

* 100.0

Fetal deaths to women under 18

*

*

Infant and child survival rates

Infant mortality

*

16.4

Neonatal mortality

*

13.7

Postneonatal mortality

*

*

Perinatal mortality ratio

*

24.4

Deaths of children 1-4 yrs

*

*

Deaths of children 5-17 yrs

*

*

Infant health rates

% Low birthweight

7.3

9.0

% Very low birthweight

*

1.6

% Under 500 grams

*

*

% Preterm gestation

4.8

7.2

% Multiple gestation

*

*

% Birth defect

5.8

6.3

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

31.8

29.9

% with father not named on birth certificate

12.5

11.9

% with maternal education less than high school

26.5

26.3

% No prenatal care

3.7

*

% Maternal smoking during pregnancy

16.2

20.2

% Maternal alcohol use during pregnancy

3.1

1.5

% Interpregnancy interval less than 6 months

8.9

7.4

Child abuse and neglect rates

Physical

.

*

Sexual

.

*

Neglect

.

5.9

Interventions to improve infant & child survival

% Prenatal care first trimester

61.3

67.1

% Primary C-section delivery

18.7

16.9

% Vaginal birth after previous C-section

*

21.4

% WIC during pregnancy

49.4

52.4

% Medicaid during pregnancy

36.9

38.0

% Medicaid and WIC during pregnancy

30.7

33.2

% Perinatal case management

.

*

Stephens County - 127

15.1 68.8 2.0 26.6 1.6 7.3 0.2 87.6
7.7

13.5 62.6
1.9 25.2
2.5 11.4
0.2 144.6
5.0

13.1 61.2 1.9 25.7 1.8 8.4 0.2 115.6
2.7

14.5 66.3
2.0 25.8
2.1 9.8 0.2 120.4 5.4

86.4 24.4 78.0 64.9
* * *

63.8 26.7 51.1 78.3 12.8 100.0
*

40.8 *
32.2 66.7
* * *

73.4 24.7 62.0 65.1
9.3 100.0
3.0

* * * 22.2 * *

21.7 15.5
* 27.5
* *

*

14.0

*

11.1

*

2.9

*

19.1

*

*

*

0.5

8.4

8.0

6.0

7.8

2.5

1.5

*

1.5

*

*

*

*

7.1

9.0

5.8

6.8

*

*

*

0.9

5.1

5.6

7.6

6.0

44.9 15.0 29.5
1.4 18.9 2.5 11.5

33.1 12.4 24.7
* 18.1
1.8 10.3

30.9 11.3 19.3
* 14.8
* 9.7

34.2 12.7 25.4
1.7 17.7
1.9 9.5

1.1

2.5

3.2

1.9

2.7

2.3

2.8

2.1

4.8

9.7

13.7

8.5

64.4 16.1 21.4 54.7 48.7 39.9
6.5

72.0 16.2 21.9 52.8 48.1 41.0
1.9

80.2 20.2 17.6 49.5 47.3 38.3
*

68.7 17.6 18.8 51.8 43.6 36.5
2.7

14.1 64.1
1.9 14.5
2.1 9.6 0.2 120.4 6.0

15.0 68.7
2.0 16.1
2.2 10.1
0.2 120.0
5.1

68.4 18.5 60.8 50.0
* * *

81.9 28.1 64.0 36.0 17.9 100.0
*

*

*

*

*

*

*

*

19.4

*

*

*

*

7.0

5.9

*

*

*

*

4.9

5.3

*

*

6.1

5.1

30.0 5.3
24.5 2.1
16.5 2.4 6.5

27.6 7.6
25.7 *
22.2 *
5.2

.

*

.

*

.

3.0

69.2 17.8
* 44.2 30.7 25.4
.

69.5 15.2 26.5 47.4 32.9 28.3
*

14.4 66.5 2.0 16.0 1.5 6.7 0.1 83.6
7.4

13.5 63.0
1.9 19.3
2.0 9.2 0.1 120.6 4.3

12.4 58.5 1.8 16.1 1.5
7.0 0.1 102.6 2.7

13.9 64.2
1.9 16.4
1.8 8.5 0.2 109.6 5.1

72.4 21.4 64.7 48.0
* * *

54.8 23.8 44.4 70.6
* * *

42.2 *
37.0 64.3
* * *

64.1 22.6 54.3 51.4
7.8 100.0
2.6

*

*

*

11.2

*

*

*

8.4

*

*

*

*

23.4

*

*

14.6

*

*

*

*

*

*

*

0.5

7.1

6.8

5.4

6.4

2.7

*

*

1.1

*

*

*

*

6.5

9.3

5.5

6.3

*

*

*

1.0

4.0

6.5

5.9

5.5

42.7 9.9 28.1
* 21.2 1.9
9.3

29.8 8.2
23.4 *
18.9 *
8.8

26.7 5.9
19.6 *
15.0 *
8.1

31.5 7.4
24.4 0.9
18.9 1.3 7.6

1.3

2.3

3.8

2.0

2.3

2.1

3.0

2.1

4.0

6.4

7.6

5.3

68.0 15.4 18.2 51.2 42.7 35.2
4.4

75.5 15.8 18.5 48.6 44.3 37.1
*

82.2 18.9
* 46.7 42.4 35.3
*

72.6 16.5 18.5 47.6 38.4 32.2
1.9

24.0 99.7
2.9 71.6
3.9 16.4
0.4 131.0
8.9

19.9 83.5
2.4 81.8
3.9 16.4
0.4 157.1
*

19.8 83.8 2.4 82.1 2.5 10.5 0.2 100.0 10.5

14.7 63.0
1.9 65.9
5.9 25.5
0.5 257.6
10.5

17.7 76.7 2.3 74.5 4.2 18.0 0.4 184.6
*

19.2 81.4
2.4 75.6
4.1 17.3
0.4 163.4
7.5

154.8 *
142.9 100.0
* * *

144.2 *
120.2 100.0
* * *

157.6 *
145.5 100.0
* * *

110.2 *
85.7 100.0
* * *

* 121.2

*

30.0

* 101.8

* 100.0

*

17.0

* 100.0

*

*

*

*

*

*

*

29.4

*

*

*

*

*

25.7

*

*

*

*

*

*

*

*

* 133.3

*

43.2

*

*

*

*

*

*

*

*

*

*

*

*

9.0

25.0

14.3

16.7

9.8

14.7

*

*

*

*

*

3.3

*

*

*

*

*

*

*

18.2

8.9

*

*

9.3

*

*

*

*

*

*

*

10.9

*

*

15.2

7.6

39.3 43.3 35.8 10.4 15.4
* 18.9

43.5 36.4 30.2
* 11.1
* 18.2

55.1 42.9 35.7
* 9.1
* 23.3

51.4 41.5 34.1
* 13.2
* 20.8

52.4 37.3 17.6
* 13.0
* 16.7

47.8 40.4 31.0
6.0 12.4
5.0 19.5

.

*

.

*

.

17.3

*

*

*

*

*

*

*

1.4

8.0

19.4

42.1

21.7

27.3 23.0
* 71.6 62.7 52.2
.

54.5 27.7
* 80.0 67.3 61.8
*

44.6 18.8
* 73.2 80.4 64.3 16.1

47.5 19.4
* 82.9 75.6 68.3
*

72.0

47.9

25.0

22.9

*

17.6

60.8

73.3

68.6

70.4

49.0

58.5

*

6.9

435

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Stewart County - 128

1990
5654 1182
146
18.3 19.5 23.0
18 3
80 15 45
1 2 12 3
2 2 0 4 0 0
10 3 0
10 0 0
35 35 27
0 20
2 5
. . .
47 16
1 56 52 44
. 0

1991
5658 1178 145
18.4 17.5 23.0
17 4
81 14 49
1 2 9 3
5 3 2 5 0 0
15 3 2
11 2 4
30 40 23
6 15
2 5
1 2 4
36 11
3 62 54 46
0 0

Total
1992 1993

5649 1168
144

5657 1165 143

19.1 16.0 23.0

20.0 18.4 22.0

15

11

2

1

73

73

13

11

42

44

2

4

0

0

11

5

2

0

0

1

0

0

0

1

0

0

0

0

0

0

11

7

1

2

0

0

5

5

1

3

0

1

32

34

31

34

17

17

3

1

7

11

2

2

3

2

1

0

2

0

11

1

47

41

10

11

0

2

46

57

51

61

38

54

0

2

0

0

1994 5-year

5651 1158
143

28269 5851 721

22.6 16.3 23.0

19.3 17.5 23.0

13

74

3

13

84

391

8

61

54

234

3

11

2

6

14

51

4

12

2

10

1

6

1

4

3

12

0

0

0

0

9

52

3

12

0

2

7

38

2

8

0

5

37

168

36

176

23

107

3

13

12

65

1

9

6

21

5

7

6

10

45

61

48

219

10

58

1

7

57

278

67

285

50

232

3

5

1

1

1990
2041 353 42

1991
2040 349
42

White
1992 1993

2036 344 42

2036 341
42

1994 5-year

2031 336 42

10184 1723 210

20.2 19.8 22.0

19.7 .
23.0

25.0 .
21.0

22.4 .
19.0

22.9 17.9 22.0

23.0 19.5 22.0

5

2

0

1

2

10

1

0

0

0

0

1

19

17

19

13

19

87

4

2

0

1

1

8

2

3

1

0

3

9

1

0

0

1

2

4

0

1

0

0

0

1

8

1

1

3

4

17

1

0

0

0

1

2

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

2

1

0

1

4

0

0

0

0

0

0

0

0

0

0

0

0

1

1

1

0

1

4

0

0

0

0

0

0

0

0

0

0

0

0

7

5

7

6

5

30

0

3

1

0

0

4

5

5

1

3

3

17

0

1

0

0

0

1

7

6

1

3

3

20

0

0

0

1

0

1

2

1

0

0

0

3

.

1

0

0

1

2

.

1

2

0

5

8

.

0

0

0

12

12

12

11

19

11

16

69

4

3

4

3

3

17

0

1

0

0

0

1

7

8

8

7

13

43

6

5

5

5

8

29

4

4

3

5

8

24

.

0

0

0

2

2

0

0

0

0

0

0

1990
3578 819 103

1991
3581 816 103

Black
1992 1993

3575 809 102

3580 806 101

1994 5-year

3576 801 101

17889 4050 509

18.3 15.3 25.0

18.4 17.5 24.0

17.5 16.0 24.5

19.6 18.4 25.0

19.8 15.8 28.0

18.4 15.8 25.0

13

15

15

10

11

64

2

4

2

1

3

12

61

64

54

60

65

304

11

12

13

10

7

53

43

46

41

44

51

225

0

1

2

3

0

6

2

1

0

0

1

4

4

8

10

2

9

33

2

3

2

0

3

10

2

5

0

1

2

10

2

3

0

0

1

6

0

2

0

1

1

4

4

4

0

0

2

10

0

0

0

0

0

0

0

0

0

0

0

0

10

13

10

7

8

48

3

3

1

2

3

12

0

2

0

0

0

2

9

10

4

5

6

34

0

2

1

3

2

8

0

4

0

1

0

5

28

25

25

28

32

138

35

37

30

34

36

172

22

18

16

14

20

90

0

5

3

1

3

12

13

9

6

8

9

45

2

2

2

1

1

8

3

4

3

2

6

18

.

0

0

0

4

4

.

1

0

0

1

2

.

0

11

0

32

43

35

25

28

30

32

150

12

8

6

8

7

41

1

2

0

2

1

6

49

54

38

50

44

235

46

49

46

56

59

256

40

42

35

49

42

208

.

0

0

2

1

3

0

0

0

0

1

1

436

Maternal and Child Health Rates
Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Stewart County - 128

1990
14.1 67.7
2.0 56.3
2.1 10.2
0.3 126.3
*
123.3 *
102.7 66.7
* * *
* * * * * *
12.5 * *
12.5 * *
43.8 43.8 33.8
* 25.0
* 10.9
. . .
58.8 21.6
* 70.0 65.0 55.0
.

1991
14.3 68.8
2.0 62.0
1.6 7.6 0.2 96.8
*
117.0 *
96.4 100.0
* * *
61.7 * *
60.2 * *
18.5 * *
13.9 * *
40.5 50.6 29.1
7.6 19.2
* 10.9
* * *
44.4 15.5
* 78.5 68.4 58.2
*

Total
1992 1993

12.9 62.5 1.8 58.3 1.9 9.4 0.3 127.9
*
104.2 *
90.3 100.0
* * *
* * * * * *
15.1 * *
6.9 * *
46.4 43.1 23.6
* 9.7
* *
* * 7.2
64.4 15.6
* 63.9 70.8 52.8
*

12.9 62.7
1.9 62.9
0.9 4.3 0.1 60.2 4.3
76.8 *
76.8 90.9
* * *
* * * * * *
9.6 * *
7.1 * *
50.7 48.6 24.3
* 15.7
* *
* * *
56.2 16.9
* 81.4 87.1 77.1
*

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

14.9 72.5 2.2 66.7 2.5 12.1 0.4 134.6 5.2

13.8 66.8
2.0 61.3
1.8 8.7 0.3 110.6 3.2

91.2 *
56.1 100.0
* * *

102.6 17.6 84.6 90.2 16.6 100.0
*

*

25.6

*

15.3

*

*

*

30.2

*

*

*

*

10.7 * *
8.6 * *

13.3 3.1 * 9.9 2.1 1.3

48.1 44.4 28.4
* 14.8
* 12.5

45.8 46.1 28.0
3.4 17.1
2.4 9.6

3.3 4.0 30.0

1.2 1.6 10.0

57.1 13.7
* 70.4 82.7 61.7
*

56.0 16.7 20.0 72.8 74.6 60.7
1.7

9.3 53.8
1.9 *
3.9 22.7
0.7 285.7
*
119.0 * * * * * *
* * * * * *
* * * * * *
36.8 *
26.3 *
36.8 * *
. . .
63.2 * *
36.8 31.6
* .

8.3 48.7
1.6 * * * * * *

9.3 55.2 1.9
* * * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

33.3 *
29.4 *
37.5 * *

38.9 * * * * * *

*

*

*

*

*

*

64.7 * *
47.1 29.4
* *

100.0 * *
42.1 26.3
* *

6.4 38.1
1.3 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
46.2 * * * * * *
* * *
84.6 * *
53.8 38.5 38.5
*

9.4 56.5 1.9
* * * * * *

8.5 50.5
1.7 10.5
1.7 9.9 0.3 156.0 2.9

*

47.6

*

*

*

38.1

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

27.8 * * * * * *

36.1 *
19.8 *
23.5 * *

*

*

12.1

4.8

29.1

7.1

84.2 * *
72.2 44.4 44.4
*

79.3 22.1
* 50.0 33.7 27.9
*

17.0 74.5
2.1 70.5
* * * * *

17.9 78.5
2.2 74.2
2.2 9.8 0.3 108.1
*

15.1 66.8 1.9 77.4 2.8 12.4 0.4 151.5
*

16.8 74.4
2.1 77.2
* * * * *

18.2 81.2 2.3 81.0 2.5 11.2 0.3 118.4
*

17.0 75.1
2.1 76.0
1.8 8.1 0.2 94.6 3.0

126.2 *
106.8 90.9 * * *

146.3 *
117.1 100.0
* * *

147.8 *
128.1 100.0
* * *

98.9 *
98.9 100.0
* * *

109.3 *
69.6 100.0
* * *

125.8 18.8 104.2 98.1 19.7 100.0
*

*

78.1

*

*

*

32.9

*

*

*

*

*

19.7

*

*

*

*

*

*

*

*

*

*

*

32.5

*

*

*

*

*

*

*

*

*

*

*

*

16.4 * *
14.8 * *

20.3 * *
16.1 * *

18.5 * * * * *

11.7 * *
8.8 * *

12.3 * *
9.5 * *

15.8 3.9 *
11.5 2.7 1.6

45.9 57.4 36.1
* 21.3
* *

42.4 59.7 29.0
8.1 14.5
* *

49.0 56.6 30.2
* 11.3
* *

51.9 59.6 24.6
* 14.0
* *

54.2 57.1 31.7
* 14.3
* 14.3

48.6 58.1 30.4
4.1 15.2
2.7 10.2

.

*

*

*

*

*

.

*

*

*

*

*

.

*

10.2

*

30.1

10.0

57.4 21.1
* 80.3 75.4 65.6
.

39.1 14.0
* 87.1 79.0 67.7
*

51.9 13.0
* 71.7 86.8 66.0
*

50.0 15.1
* 87.7 98.2 86.0
*

49.2

49.3

12.3

15.2

*

23.1

69.8

79.4

93.7

86.5

66.7

70.3

*

*

437

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Sumter County - 129

1990
30228 7301 760
19.4 19.0 22.0
101 24 611 80 279 51
6 121 18
11 10
1 15
2 5
46 9 1
57 5
14
252 137 211
7 90 17 35
. . .
432 60 12 358 298 239
. 0

1991
30436 7310 756
19.6 18.3 22.0
109 30
567 71
284 62 6
144 29
9 7 2 14 1 4
59 16
0 58 11
9
212 142 199
11 82
8 30
7 9 61
383 59 17
371 297 264
65 0

Total
1992 1993

30633 7316 752

30838 7323 747

20.0 19.1 23.0

20.3 19.5 23.0

95

97

23

30

521

548

73

73

247

287

42

42

4

9

137

121

18

17

3

7

3

4

0

3

6

13

0

0

3

1

42

46

5

8

0

0

49

54

7

9

7

8

195

243

121

129

191

178

9

7

67

59

10

6

36

31

16

13

24

17

97

74

366

389

70

73

11

21

327

395

311

379

252

346

75

166

0

1

1994 5-year

31035 7329 743

153170 36579 3759

20.6 19.4 23.0

20.0 19.2 23.0

84

486

17

124

497

2744

63

360

262

1359

61

258

8

33

124

647

18

100

8

38

5

29

3

9

13

61

1

4

9

22

56

249

12

50

2

3

66

284

9

41

5

43

206

1108

125

654

157

936

10

44

59

357

10

51

23

155

19

55

10

60

77

309

363

1933

87

349

7

68

323

1774

308

1593

262

1363

158

464

0

1

1990
15910 3566 325

1991
15904 3528 319

White
1992 1993

15890 3489 313

15881 3450 306

1994 5-year

15868 3411 300

79453 17444
1562

21.2 19.7 21.0

21.1 19.7 22.0

22.3 19.0 22.0

23.8 19.6 22.0

24.5 20.1 22.0

22.7 19.6 22.0

24

25

18

23

15

105

6

1

3

8

2

20

245

222

206

217

189

1079

15

14

12

17

10

68

36

37

25

40

28

166

29

22

17

16

18

102

0

0

1

0

3

4

55

66

53

49

54

277

8

8

5

6

5

32

3

1

1

4

0

9

2

1

1

1

0

5

1

0

0

3

0

4

2

1

1

1

3

8

1

0

0

0

0

1

3

2

0

0

3

8

5

15

11

14

16

61

1

4

0

1

3

9

0

0

0

0

0

0

12

13

13

15

18

71

1

1

3

3

2

10

5

2

3

1

1

12

80

55

46

58

51

290

14

19

10

17

11

71

64

58

47

51

43

263

1

2

3

1

1

8

58

50

37

44

36

225

4

2

1

3

0

10

8

2

5

5

2

22

.

1

8

4

4

17

.

2

11

7

4

24

.

29

44

20

18

111

214

187

173

180

160

914

25

18

29

30

34

136

6

5

2

4

2

19

92

103

91

108

84

478

67

69

75

99

70

380

54

61

63

86

59

323

.

24

24

48

33

129

0

0

0

0

0

0

1990
14045 3648 432

1991
14142 3651 430

Black
1992 1993

14233 3653 427

14328 3656 425

1994 5-year

14420 3658 423

71168 18266
2137

18.1 18.0 24.5

18.6 17.3 23.0

18.2 19.0 25.0

18.9 18.6 25.0

18.9 18.6 24.0

18.5 18.1 24.0

77

84

77

74

69

381

18

29

20

22

15

104

363

344

311

328

306

1652

65

57

61

56

53

292

243

247

221

247

234

1192

22

39

25

26

42

154

6

6

3

9

5

29

64

78

82

71

68

363

10

21

13

11

13

68

8

8

8

6

0

2

13

13

1

1

2

2

2

3

8

29

2

3

5

24

0

0

3

5

5

12

10

53

0

0

1

3

3

1

6

14

40

44

31

32

40

187

8

12

5

7

9

41

1

0

0

0

2

3

45

45

35

38

48

211

4

10

4

6

7

31

9

7

4

7

4

31

171

156

146

184

153

810

123

123

111

112

114

583

147

141

141

127

113

669

6

9

6

6

9

36

32

32

30

15

23

132

13

6

9

3

10

41

27

28

30

26

21

132

.

1

7

9

15

32

.

7

12

10

6

35

.

30

50

54

54

188

216

195

190

207

202

1010

35

41

41

43

53

213

6

12

9

17

5

49

265

268

235

286

239

1293

230

228

235

279

238

1210

184

203

188

259

203

1037

.

41

51

117

125

334

0

0

0

1

0

1

438

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Sumter County - 129

20.2 83.7
2.4 46.0
4.0 16.6
0.5 152.2
8.6
132.9 23.8 105.3 88.8 23.7 100.0
*
18.0 16.4
* 24.3
* 0.8
7.5 1.5
* 9.4 0.8 2.3
42.9 22.6 35.0
1.2 14.9
2.8 9.2
. . .
70.8 10.9 21.4 59.1 49.2 39.4
.

18.6 77.6
2.2 51.1
4.7 19.7
0.5 184.4
9.6
144.2 27.5 93.9 91.4 38.4
100.0 14.6
15.9 12.3
* 24.4
* *
10.4 2.8 *
10.4 2.0 1.6
39.7 25.5 35.8
2.0 14.7
1.4 8.5
0.8 1.0 6.8
67.5 12.0 27.0 66.7 53.4 47.5 11.7

17.0 71.2 2.0 48.1 4.5 18.7 0.5 192.4
7.4
126.3 24.2 97.1 88.9 23.9
100.0 6.6
* * * 11.4 * *
8.1 1.0
* 9.5 1.4 1.3
39.2 23.5 37.2
1.8 13.1
1.9 11.6
1.8 2.7 10.8
70.7 14.9 25.6 63.6 60.5 49.0 14.6

17.8 74.8
2.1 53.3
3.9 16.5
0.5 167.4
7.4
129.8 30.9 97.7 87.5 22.7
100.0 12.0
12.8 * *
23.3 * *
8.4 1.5
* 10.0
1.7 1.5
46.9 24.0 33.1
1.3 11.0
1.1 9.4
1.4 1.9 8.2
71.2 15.0 41.2 73.4 70.4 64.3 30.9

16.0 67.8 1.9 53.8 4.0 16.9 0.5 178.4 10.1
113.0 20.2 84.7 91.8 24.2
100.0 6.7
16.1 10.1
* 25.7
* 1.4
11.3 2.4
* 13.6 1.8 1.0
44.6 25.7 32.2
2.1 12.1
2.1 8.4
2.1 1.1 8.4
73.0 19.9 14.3 66.3 63.2 53.8 32.4

17.9 75.0
2.1 50.3
4.2 17.7
0.5 174.6
8.6
129.3 25.5 95.8 89.6 26.6 100.0
9.0
13.8 10.6
3.3 22.0
* 0.7
9.1 1.8
* 10.5
1.5 1.6
42.6 24.2 34.7
1.6 13.2
1.9 9.4
1.5 1.7 8.5
70.6 14.3 26.0 65.7 59.0 50.5 22.1

15.4 68.7
2.0 14.8
3.5 15.4
0.4 167.2
8.1

14.0 62.9
1.8 16.7
4.1 18.7
0.5 211.5
6.8

13.0 59.0 1.7 12.3 3.3 15.2 0.4 190.0 5.7

13.7 62.9
1.8 18.8
3.1 14.2
0.4 172.5
5.2

11.9 55.4 1.6 15.1 3.4 15.8 0.5 203.8
6.4

13.6 61.9
1.8 15.6
3.5 15.9
0.5 188.6
6.5

73.8 25.0 46.2 60.0 24.6 100.0
*

78.4 *
43.9 64.3 25.1 100.0
*

57.6 *
38.4 58.3 16.0 100.0
*

75.2 34.8 55.6 58.8 19.6 100.0
*

50.1 *
33.4 50.0 16.7 100.0
*

67.2 19.0 43.5 58.8 20.5 100.0
3.2

*

*

*

*

*

8.3

*

*

*

*

*

4.6

*

*

*

*

*

*

*

*

*

*

*

7.4

*

*

*

*

*

*

*

*

*

*

*

0.6

2.0

6.8

5.3

6.5

8.5

5.7

*

*

*

*

*

0.8

*

*

*

*

*

*

4.9

5.9

6.4

7.0

9.7

6.7

*

*

*

*

*

0.9

2.0

*

*

*

*

1.1

33.5 5.7
26.3 *
23.8 *
5.5

25.6 8.6
26.2 *
22.6 * *

23.2 4.9 23.2
* 18.3
* 4.3

27.9 8.0
23.9 *
20.8 *
4.2

28.3 5.9
23.1 *
19.4 * *

27.9 6.7
24.7 0.7
21.1 0.9 3.6

.

*

2.2

*

*

1.2

.

*

3.1

2.0

*

1.7

.

8.1

12.3

5.6

5.1

7.8

87.3 11.1 31.6 37.7 27.5 22.1
.

84.2 9.2
19.2 46.6 31.2 27.6 10.9

85.2 15.5
* 44.8 36.9 31.0 11.8

83.3 15.2
* 50.7 46.5 40.4 22.5

84.7 19.2
* 45.2 37.6 31.7 17.7

85.0 13.9 22.1 44.8 35.6 30.3 15.7

25.8 99.5
2.7 67.7
4.6 17.5
0.5 138.8
9.3

24.3 94.2
2.6 74.0
5.5 21.4
0.6 167.0
12.3

21.9 85.1 2.3 72.0 5.8 22.4 0.6 192.0 9.3

22.9 89.7
2.5 76.7
5.0 19.4
0.5 163.2
9.8

21.2 83.7 2.3 78.3 4.7 18.6 0.5 160.0 13.9

23.2 90.4
2.5 73.5
5.1 19.9
0.5 163.9 10.9

178.2 23.4 150.5 95.4 23.1 100.0
*

195.5 34.5
132.7 98.2 48.9
100.0 18.6

180.2 26.0
142.7 95.0 30.4
100.0 *

174.2 29.7
131.8 96.4 25.9
100.0 21.2

163.3 21.7
125.4 100.0
30.8 100.0
11.8

178.3 27.3
136.7 96.9 31.8 100.0 13.6

22.0 22.0
* 35.2
* *

23.3 17.4
* 37.1
* *

* * * 15.9 * *

* * * 35.6 * *

26.1 16.3
* 32.2
* 1.6

17.6 14.5
3.1 31.5
* 0.7

11.0 2.2 *
12.5 *
2.5

12.8 3.5 *
13.5 3.0 2.0

10.0 1.6
* 11.4
* *

9.8 2.1
* 11.8
1.9 2.1

13.1 2.9 * 16.1 2.3 *

11.3 2.5 *
13.0 1.9 1.9

49.6 34.3 41.2
1.7 8.9 3.6 11.5

49.1 36.8 42.2
2.7 9.6 1.8 12.5

49.5 36.2 45.9 2.0 9.8 2.9 15.5

59.9 34.8 39.4
1.9 4.7
* 12.4

54.6 38.1 37.8 3.0 7.7 3.3 11.9

52.4 36.0 41.3
2.2 8.1 2.5 12.7

.

*

1.3

1.7

2.8

1.5

.

1.3

2.3

1.9

1.1

1.7

.

5.8

9.5

10.2

10.1

8.9

59.7 10.9 16.2 73.8 64.1 51.3
.

56.7 13.8 32.4 80.2 68.3 60.8 12.3

61.1 14.6 33.3 76.5 76.5 61.2 16.6

63.3 15.0 48.6 88.8 86.6 80.4 36.3

66.0

61.2

20.5

14.7

12.5

27.8

79.9

79.8

79.6

74.6

67.9

64.0

41.8

26.5

439

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Talbot County - 130

1990
6524 1506
141
22.5 16.4 20.0
11 4
100 7
54 3 1
16 4
2 2 0 3 0 0
11 2 0
10 1 1
38 31 21
3 19
4 4
. . .
65 20
1 63 47 38
. 0

1991
6533 1490 139
21.5 20.7 23.5
15 4
111 12 58 2 1 16 3
0 0 0 1 0 0
14 1 0
13 0 2
45 39 26
8 22
3 4
2 6 7
66 17
0 79 65 58
2 0

Total
1992 1993

6531 1472
138

6540 1456 136

21.5 25.3 23.0

21.0 17.2 24.5

13

23

4

6

129

122

10

19

66

72

8

8

0

2

16

13

2

3

1

2

1

2

0

0

1

4

1

0

0

0

22

17

5

3

0

1

22

21

4

4

2

3

45

43

38

45

28

35

9

5

16

13

4

3

4

8

4

3

2

2

10

28

68

62

16

11

3

3

81

92

73

87

55

76

6

6

0

0

1994 5-year

6542 1437
134

32670 7361 688

19.5 17.8 25.0

21.5 17.8 23.0

9

71

3

21

63

525

4

52

35

285

4

25

0

4

22

83

5

17

0

5

0

5

0

0

0

9

0

1

0

0

9

73

1

12

0

1

4

70

2

11

0

8

20

191

24

177

10

120

3

28

4

74

1

15

4

24

5

14

3

13

32

77

33

294

4

68

0

7

46

361

45

317

38

265

0

14

0

0

1990
2436 468 39

1991
2453 464
38

White
1992 1993

2463 459 38

2478 455
37

1994 5-year

2492 450 37

12322 2296 189

23.1 17.3 19.5

22.7 19.5 21.5

20.7 .
21.5

23.0 16.6 22.0

27.1 18.3 21.0

22.9 17.8 21.0

3

3

1

5

0

12

1

1

0

0

0

2

29

37

34

33

16

149

2

3

1

4

0

10

3

6

4

9

2

24

0

0

2

1

2

5

0

0

0

1

0

1

5

3

1

2

4

15

1

0

0

1

0

2

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

1

0

0

0

0

0

0

0

0

0

0

0

0

2

5

8

3

3

21

0

0

1

0

1

2

0

0

0

0

0

0

4

4

7

4

2

21

1

0

2

1

1

5

0

1

0

1

0

2

9

14

1

3

6

8

1

0

9

10

0

0

0

0

5

13

2

6

6

10

1

1

4

7

1

1

2

1

3

44

2

14

2

32

0

3

2

32

1

3

0

3

.

1

1

0

3

5

.

1

1

0

3

5

.

0

2

1

17

20

24

29

21

18

13

105

7

6

7

5

2

27

0

0

0

1

0

1

9

15

8

16

10

58

8

14

11

15

7

55

6

10

4

12

5

37

.

1

2

1

0

4

0

0

0

0

0

0

1990
4067 1036
102

1991
4073 1024 101

Black
1992 1993

4071 1011
100

4077 1000
98

1994 5-year

4078 986 97

20366 5058 497

22.0 15.4 20.5

21.4 22.0 27.5

21.8 25.3 26.0

20.4 20.0 27.0

19.2 17.3 29.5

20.8 18.0 26.5

8

12

12

18

9

59

3

3

4

6

3

19

71

74

95

89

47

376

5

9

9

15

4

42

51

52

62

63

33

261

3

2

6

7

2

20

1

1

0

1

0

3

11

13

14

11

18

67

3

3

2

2

5

15

2

0

1

2

0

5

2

0

1

2

0

5

0

0

0

0

0

0

3

1

1

3

0

8

0

0

1

0

0

1

0

0

0

0

0

0

9

9

14

14

6

52

2

1

4

3

0

10

0

0

0

1

0

1

6

9

15

17

2

49

0

0

2

3

1

6

1

1

2

2

0

6

29

31

40

30

17

147

30

36

36

39

22

163

15

18

22

25

8

88

2

8

8

4

3

25

10

12

12

6

2

42

4

3

3

2

0

12

4

4

2

7

4

21

.

0

3

3

2

8

.

5

1

2

0

8

.

7

7

22

11

47

41

37

47

44

20

189

13

11

9

6

2

41

1

0

3

2

0

6

54

64

73

76

36

303

39

51

62

72

38

262

32

48

51

64

33

228

.

1

4

5

0

10

0

0

0

0

0

0

440

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Talbot County - 130

15.3 66.4
2.0 55.1
2.5 10.6
0.3 133.3
*
78.0 *
49.6 85.7
* * *
* * * * * *
11.0 * *
10.2 * *
41.3 31.6 21.6
* 19.4
* *
. . .
65.0 21.7
* 64.3 48.0 38.8
.

17.0 74.5
2.3 52.3
2.4 10.7
0.3 122.1
*
107.7 *
86.1 83.3
* * *
* * * * * *
12.6 * *
11.7 * *
41.3 35.1 23.4
7.3 20.0
* *
* 3.4 4.0
60.6 17.2
* 71.2 58.6 52.3
*

19.8 87.6 2.7 52.8 2.4 10.9 0.3 104.6
5.4
94.5 *
72.7 100.0
* * *
* * * * * *
17.1 3.9
* 17.7
* *
37.8 30.4 22.4
7.2 12.9
* *
* * 5.7
52.7 14.4
* 64.8 58.4 44.0
4.8

18.7 83.8
2.7 61.0
2.0 8.9 0.3 88.4 8.2
169.4 26.1
139.9 89.5 * * *
* * * * * *
13.9 * *
17.8 * *
37.4 38.1 29.7
4.2 11.1
* 11.3
* * 15.9
50.8 10.5
* 78.0 73.7 64.4
5.1

9.6 43.8 1.4 57.4 3.4 15.3 0.5 247.2
*
67.1 * * *
37.3 * *
* * * * * *
14.3 * * * * *
34.5 39.3 16.4
* * * *
2.8 *
18.2
53.2 * *
75.4 73.8 62.3
*

16.1 71.3
2.2 55.6
2.5 11.3
0.3 129.7
4.3
103.2 29.6 75.6 90.4 24.7 94.1
*
9.5 9.5
* 17.0
* *
13.9 2.3 *
13.7 2.1 1.5
38.7 34.5 23.4
5.5 14.5
2.9 8.2
2.0 1.8 10.9
56.3 14.7 14.0 70.4 61.8 51.7
3.4

11.9 62.0
2.0 *
2.1 10.7
* . *
* * * * * * *
* * * * * *
* * * * * *
32.1 *
21.4 *
32.1 * *
. . .
82.8 28.0
* 32.1 28.6 21.4
.

15.1 79.7
2.7 16.2
* * * * *
* * * * * * *
* * * * * *
13.5 * * * * *
38.9 *
21.6 *
27.0 * *
* * *
82.9 18.2
* 40.5 37.8 27.0
*

13.8 74.1 2.4
* * * * * *

13.3 72.5
2.5 28.1
* * * * *

* 134.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

23.5

*

*

*

*

*

21.9

*

*

*

*

*

15.6 *
18.8 * * * *

40.6 18.8 31.3
* 21.9
* *

*

*

*

*

*

*

61.8 26.9
* 25.0 34.4
* *

54.5 19.2
* 50.0 46.9 37.5
*

6.4 35.6 1.2
* * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* * 32.9
81.3 * *
66.7 46.7 33.3
*

12.1 64.9
2.2 16.7
1.2 6.5 0.2 87.7 3.0
63.4 *
52.8 50.0
* * *
* * * * * *
14.1 * *
14.6 3.5 *
30.8 9.7
22.2 *
22.2 * *
2.4 2.4 9.7
71.4 22.1
* 40.3 38.2 25.7
*

17.5 68.5
2.0 72.9
2.7 10.6
0.3 127.9
*

18.2 72.2
2.2 70.3
3.2 12.7
0.4 142.9
*

23.3 93.9 2.9 66.7 3.4 13.8 0.4 121.7 5.9

21.8 89.0
2.8 73.3
2.7 11.0
0.3 100.9
9.0

11.5 47.7 1.5 71.7 4.4 18.3 0.6 268.7
*

18.5 74.3
2.3 70.7
3.3 13.2
0.4 143.2
4.9

78.4 *
49.0 100.0
* * *

119.2 *
89.4 100.0
* * *

120.6 *
90.5 100.0
* * *

183.3 33.3
152.7 100.0
* * *

92.8 * * *
51.5 * *

118.6 32.2 84.4 100.0 30.2 93.3
*

*

*

*

*

*

13.3

*

*

*

*

*

13.3

*

*

*

*

*

*

*

*

*

*

*

21.1

*

*

*

*

*

*

*

*

*

*

*

*

12.7 * *
8.6 * *

12.2 * *
12.2 * *

14.7 * *
16.3 * *

15.7 * *
19.8 * *

12.8 * * * * *

13.8 2.7 *
13.3 1.6 1.6

45.3 42.9 21.7
* 14.3
* *

42.5 48.6 24.3 10.8 16.4
* *

46.0 38.7 23.7 8.6 13.0
* *

36.1 45.3 29.1
* 7.1
* 13.5

39.5 47.8 17.4
* * * *

42.0 44.2 23.9
6.8 11.5
3.3 10.1

.

*

*

*

*

1.6

.

4.0

*

*

*

1.6

.

5.6

5.6

17.5

8.8

9.4

57.7 19.4
* 77.1 55.7 45.7
.

50.0 16.7
* 86.5 68.9 64.9
*

49.5 10.6
* 78.5 66.7 54.8
*

49.4 7.6 *
88.4 83.7 74.4
5.8

43.5

50.4

*

12.0

*

21.4

78.3

82.1

82.6

71.0

71.7

61.8

*

3.3

441

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Taliaferro County - 131

1990
1915 368 53
19.2 .
22.0
2 1 16 2 7 0 1 2 0
0 0 0 1 1 1
3 0 0 3 0 0
8 2 8 1 3 0 0
. . .
9 3 1 10 10 8 . 0

1991
1915 368
52
19.2 30.6 20.5
2 0 23 2 10 1 2 2 0
0 0 0 2 0 0
3 0 0 0 0 0
15 7
12 0 3 0 2
2 0 3
18 1 0
15 14 13
1 0

Total
1992 1993

1914 371 53

1925 373
52

22.3 .
22.0

19.3 .
28.0

1

5

1

1

22

24

1

5

11

15

0

0

0

0

3

2

0

0

0

0

0

0

0

0

0

0

0

0

0

1

5

2

2

0

0

0

4

1

1

0

0

1

10

5

5

10

9

11

0

0

3

4

0

0

3

1

1

1

0

2

5

4

12

14

4

2

0

0

13

19

14

21

11

18

5

10

0

0

1994 5-year

1921 373 52

9590 1853
262

17.1 18.1 24.0

19.3 18.1 23.0

3

13

0

3

14

99

2

12

10

53

0

1

1

4

6

15

1

1

2

2

1

1

1

1

2

5

0

1

0

2

2

15

1

3

1

1

3

11

0

1

1

2

9

47

5

29

6

46

0

1

6

19

1

1

2

8

3

7

0

2

6

18

9

62

2

12

0

1

13

70

12

71

12

62

7

23

2

2

1990
736 119
17

1991
747 121
16

White
1992 1993

758

771

126

129

16

16

1994 5-year

778

3790

131

626

15

81

. . 22.0

18.9 .
18.0

24.1 .
21.0

19.3 .
16.0

17.1 18.1 20.0

18.9 18.1 20.0

0

0

0

0

1

1

0

0

0

0

0

0

4

12

8

8

5

37

0

0

0

0

1

1

0

0

1

1

2

4

0

1

0

0

0

1

1

1

0

0

0

2

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

1

1

0

0

0

0

0

0

1

1

0

0

1

3

0

0

0

0

0

0

0

0

0

0

0

0

0

1

2

1

2

6

0

0

2

0

1

3

0

0

0

0

1

1

1

0

1

1

2

5

0

0

1

0

0

1

0

0

0

1

0

1

1

5

3

0

3

12

0

0

1

1

1

3

3

5

4

3

3

18

0

0

0

0

0

0

2

2

1

2

3

10

0

0

0

0

0

0

0

1

2

0

0

3

.

0

0

0

1

1

.

0

0

0

0

0

.

3

1

0

0

4

3

10

3

4

4

24

1

0

3

0

1

5

1

0

0

0

0

1

1

6

5

4

4

20

1

4

5

7

3

20

0

4

5

4

3

16

.

0

3

2

3

8

0

0

0

0

1

1

1990
1167 245 35

1991
1167 245
35

Black
1992 1993

1166 247 35

1173 249
35

1994 5-year

1171 249 34

5844 1234
173

19.2 .
22.5

19.7 30.6 25.5

20.4 .
27.0

19.5 .
28.0

17.1 17.9 29.0

20.0 18.2 25.0

2

2

1

5

1

0

1

1

12

11

14

16

2

2

1

5

7

10

10

14

0

0

0

0

0

1

0

0

2

2

3

2

0

0

0

0

2

12

0

3

9

62

1

11

8

49

0

0

1

2

5

14

1

1

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

1

1

0

1

0

0

1

2

1

0

0

0

0

1

1

0

0

1

0

2

3

2

3

1

0

9

0

0

0

0

0

0

0

0

0

0

0

0

2

0

3

0

1

6

0

0

0

0

0

0

0

0

0

0

1

1

7

10

7

5

6

35

2

7

4

9

4

26

5

7

5

8

3

28

1

0

0

0

0

1

1

1

2

2

3

9

0

0

0

0

1

1

0

1

1

1

2

5

.

2

1

1

2

6

.

0

0

2

0

2

.

0

4

2

5

11

6

8

2

1

0

0

9

9

9

10

8

9

.

1

0

0

9

10

1

2

0

0

8

15

9

14

6

14

2

8

0

0

5

38

1

7

0

0

9

50

9

51

9

46

4

15

1

1

442

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

8.4

12.0

11.5

12.5

7.3

10.3

General fertility rate

43.5

62.5

59.3

64.3

37.5

53.4

Total fertility rate

1.3

1.9

1.6

1.9

1.2

1.6

% Livebirths to unmarried women

43.8

43.5

52.4

62.5

71.4

54.1

Crude abortion rate

*

*

*

*

3.1

1.6

General abortion rate

*

*

*

*

16.1

8.1

Total abortion rate

*

*

*

*

0.5

0.2

Abortion ratio

*

*

*

* 285.7 126.1

Fetal Death rate

*

*

*

*

*

2.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

*

*

*

95.6

*

49.6

% Repeat conceptions to women under 18

*

*

*

*

*

*

Livebirths to women under 18

*

*

*

95.6

*

45.7

% Livebirths to unmarried women under 18

*

*

* 100.0

*

91.7

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

*

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

48.5

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

*

*

22.7

*

*

15.2

% Very low birthweight

*

*

*

*

*

*

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

*

*

*

*

*

11.2

% Multiple gestation

*

*

*

*

*

*

% Birth defect

*

*

*

*

*

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

53.3

68.2

55.6

21.7

64.3

51.1

% with father not named on birth certificate

*

30.4

23.8

41.7

35.7

29.6

% with maternal education less than high school

50.0

54.5

42.9

45.8

42.9

47.4

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

*

*

*

*

42.9

20.2

% Maternal alcohol use during pregnancy

*

*

*

*

*

*

% Interpregnancy interval less than 6 months

*

*

*

*

*

13.1

Child abuse and neglect rates

Physical

.

*

*

*

*

3.4

Sexual

.

*

*

*

*

*

Neglect

.

*

9.7

*

11.8

8.7

Interventions to improve infant & child survival

% Prenatal care first trimester

56.3

81.8

60.0

63.6

64.3

66.0

% Primary C-section delivery

*

*

*

*

*

13.8

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

62.5

65.2

61.9

79.2

92.9

71.4

% Medicaid during pregnancy

62.5

60.9

66.7

87.5

85.7

72.4

% Medicaid and WIC during pregnancy

50.0

56.5

52.4

75.0

85.7

63.3

% Perinatal case management

.

*

23.8

41.7

50.0

28.0

Taliaferro County - 131

*

16.1

10.6

10.4

6.4

9.8

*

99.2

63.5

62.0

38.2

59.1

*

3.0

1.9

2.0

1.3

1.8

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

16.2

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

13.9

*

*

*

*

*

*

*

*

*

*

*

*

*

45.5

*

*

*

35.3

*

*

*

*

*

*

*

41.7

*

*

*

50.0

*

*

*

*

*

*

*

*

*

*

*

28.6

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

*

90.9

*

*

*

*

*

*

*

*

*

*

*

50.0

71.4

*

*

*

71.4

87.5

*

*

71.4

*

.

*

*

*

*

68.6

*

16.1

*

*

*

55.6

*

55.6

*

44.4

*

25.0

10.3 49.0
1.4 58.3
* * * * *
* * * * * * *
* * * * * *
* * * * * *
63.6 *
41.7 * * * *
. . .
50.0 * *
75.0 75.0 66.7
.

9.4 44.9
1.3 90.9
* * * * *
* * * * * * *
* * * * * *
* * * * * *
90.9 63.6 70.0
* * * *
* * *
72.7 * *
81.8 90.9 81.8
*

12.0 56.7 1.5 71.4
* * * * *

13.6 64.4
1.9 87.5
* * * * *

7.7 36.2 1.2 88.9 4.3 20.1 0.7 333.3
*

10.6 50.2
1.5 79.0
2.4 11.3
0.3 179.5
*

* 144.5

*

*

* 144.5

* 100.0

*

*

*

*

*

*

*

69.2

*

*

*

63.5

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

14.5

*

*

*

*

*

*

*

*

*

*

*

9.7

*

*

*

*

*

*

*

*

63.6 *
35.7 * * * *

31.3 56.3 50.0
* * * *

66.7 * * * * * *

60.3 41.9 45.9
* 15.3
* 14.3

*

*

*

4.2

*

*

*

*

*

*

14.2

7.7

69.2

71.4

55.6

64.4

*

*

*

12.5

*

*

*

*

57.1

93.8 100.0

80.6

64.3

87.5 100.0

82.3

42.9

87.5 100.0

74.2

*

50.0

*

30.0

443

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Tattnall County - 132

1990
17722 3334 357
19.7 16.9 21.0
55 12 272 41 112 16
2 47 13
1 1 0 3 1 0
16 2 0
25 0 5
91 67 114
4 52
7 18
. . .
189 37
1 168 125 107
. 0

1991
17847 3344 358
19.3 19.9 21.0
39 11 254 36 102 32
2 33
3
7 4 3 6 2 0
26 6 2
26 2 5
118 62
103 6
27 6
14
5 11 34
160 29 3
186 145 134
34 2

Total
1992 1993

17965 3354 359

18092 3366 359

20.4 18.3 20.0

20.3 19.4 21.0

25

41

4

10

304

278

21

34

93

103

23

30

4

4

39

37

3

5

2

3

0

1

2

2

4

5

1

0

4

1

24

24

3

3

0

0

13

27

5

1

3

2

122

98

64

65

108

109

4

2

35

41

5

2

13

7

11

10

26

23

78

122

196

173

30

45

2

1

191

197

161

188

143

164

116

132

0

1

1994 5-year

18214 3378 360

89840 16776
1792

19.6 19.4 21.0

19.9 18.3 21.0

45

205

5

42

245

1353

39

171

103

513

22

123

5

17

27

183

5

29

3

16

2

8

1

8

7

25

1

5

2

7

21

111

5

19

0

2

17

108

2

10

3

18

104

533

54

312

93

527

1

17

38

193

3

23

13

65

17

43

21

81

85

319

160

878

39

180

3

10

174

916

153

772

137

685

125

407

3

6

1990
12087 2347 242

1991
12132 2351 243

White
1992 1993

12172 2356 244

12220 2361 245

1994 5-year

12266 2367 246

60877 11782
1219

20.5 16.9 20.0

19.8 19.9 21.0

20.7 18.3 20.0

21.6 19.4 21.0

20.4 19.2 21.0

20.6 18.3 20.0

32

23

16

22

22

115

3

5

4

7

4

23

172

163

206

181

176

898

20

21

13

16

19

89

47

37

37

34

51

206

12

22

14

23

17

88

1

0

3

1

3

8

35

24

23

30

14

126

12

2

2

5

3

24

0

6

2

3

2

13

0

4

0

1

2

7

0

2

2

2

0

6

1

4

3

2

4

14

0

0

1

0

0

1

0

0

3

0

2

5

14

13

13

11

11

62

2

5

3

1

3

14

0

2

0

0

0

2

19

13

8

16

9

65

0

1

5

0

2

8

4

4

2

1

1

12

54

65

67

61

66

313

25

18

20

18

28

109

73

59

66

64

58

320

1

4

0

2

1

8

48

26

33

35

32

174

5

5

2

1

2

15

7

7

7

3

7

31

.

3

8

8

10

29

.

10

14

15

15

54

.

17

40

41

29

127

124

109

144

121

122

620

22

22

23

26

29

122

0

1

2

1

1

5

87

110

110

109

122

538

63

77

86

105

97

428

52

71

76

85

90

374

.

16

59

67

79

221

0

1

0

0

1

2

1990
5177 895 99

1991
5214 897 99

Black
1992 1993

5248 899 100

5285 902 100

1994 5-year

5321 905 100

26244 4498 497

17.9 17.9 28.0

18.7 .
23.0

19.6 16.6 24.0

18.5 .
23.0

17.3 19.5 23.0

18.4 18.9 24.0

23

16

9

19

23

90

9

6

0

3

1

19

100

90

96

96

69

451

21

15

8

18

20

82

65

65

56

69

52

307

4

10

9

7

5

35

1

2

1

3

2

9

11

9

16

7

13

56

1

1

1

0

2

5

1

1

0

0

1

3

1

0

0

0

0

1

0

1

0

0

1

2

2

2

1

3

3

11

1

2

0

0

1

4

0

0

1

1

0

2

2

12

11

13

10

48

0

1

0

2

2

5

0

0

0

0

0

0

6

12

5

11

8

42

0

1

0

1

0

2

1

1

1

1

2

6

37

53

53

36

38

217

42

44

44

47

26

203

41

44

42

45

35

207

3

2

4

0

0

9

4

1

1

5

6

17

2

1

3

1

1

8

11

7

6

3

6

33

.

2

3

2

4

11

.

1

10

7

4

22

.

15

32

65

29

141

65

51

52

52

38

258

15

6

7

19

10

57

1

2

0

0

2

5

81

75

79

87

52

374

62

67

74

83

56

342

55

62

66

79

47

309

.

18

56

65

46

185

0

1

0

0

2

3

444

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Tattnall County - 132

15.3 81.6
2.4 41.2
2.7 14.1
0.4 139.1
5.7
154.1 21.8 114.8 78.0 36.4 100.0
*
* * * * * *
5.9 * *
9.2 *
1.8
39.4 24.6 42.4
* 19.5
2.6 10.9
. . .
70.5 14.9
* 61.8 46.0 39.3
.

14.2 76.0
2.2 40.5
1.8 9.9 0.3 102.2 10.8
109.1 28.2
100.7 69.4 * * *
27.6 * *
23.4 * *
10.2 2.4 *
10.3 *
2.0
49.6 24.6 41.4
2.4 10.8
2.4 10.1
1.2 2.6 7.9
65.3 13.2
* 73.8 57.5 53.2 13.5

16.9 90.6 2.7 31.2 2.2 11.6 0.3 105.4 8.1
69.7 *
58.5 71.4
* * *
* * * * * *
7.9 * *
4.4 1.7
*
44.2 21.5 36.9
* 11.9
1.7 6.7
2.5 6.0 18.1
67.4 11.5
* 64.1 54.0 48.0 38.9

15.4 82.6
2.4 37.2
2.0 11.0
0.3 106.0
10.1
114.3 24.4 94.8 70.6 13.9
100.0 *
* * * 17.7 * *
8.6 * *
9.7 * *
41.5 23.5 39.6
* 14.9
* 4.5
2.3 5.3 28.1
64.8 18.3
* 71.1 67.9 59.2 47.7

13.5 72.5 2.1 42.4 1.5 8.0 0.2 90.3 8.0
125.0 11.1
108.3 74.4 13.9
100.0 *
* * * 28.0 * *
8.6 2.0
* 7.0
* *
45.6 22.2 39.1
* 15.7
* 11.0
3.9 4.8 19.5
68.1 17.6
* 71.6 63.0 56.4 51.4

15.1 80.7
2.4 38.2
2.0 10.9
0.3 109.0
8.5
114.4 20.5 95.4 73.1 16.2 100.0
4.5
11.8 5.9 5.9
18.2 1.0 *
8.2 1.4
* 8.1 0.7 1.3
44.1 23.2 39.8
1.3 14.5
1.7 8.4
2.5 4.7 18.4
67.2 15.0
6.9 68.3 57.5 51.0 38.0

14.2 73.3
2.2 27.3
2.9 14.9
0.5 158.4
6.0

13.4 69.3
2.1 22.8
2.0 10.2
0.3 113.7
10.2

132.2 *
82.6 65.0 49.6 100.0
*

94.8 21.7 86.6 47.6
* * *

*

36.8

*

*

*

*

*

*

*

*

*

*

8.1

8.0

*

3.1

*

*

11.0

8.0

*

*

*

*

35.8 14.5 43.2
* 28.7
3.0 7.4

42.2 11.1 37.1
* 16.0
3.1 8.2

.

*

.

3.6

.

6.1

73.4 13.8
* 50.6 36.6 30.2
.

69.0 15.4
* 67.9 47.5 43.8
9.9

16.9 87.4 2.6 18.5 1.9 9.8 0.3 93.5 7.2

14.8 76.7
2.3 18.8
2.5 12.7
0.4 127.7
10.2

65.6 *
53.3 53.8
* * *

90.0 31.8 65.4 37.5 20.4 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

6.3

6.1

*

*

*

*

4.0

8.8

2.5

*

*

*

35.6 10.0 33.8
* 16.7
* 5.7

38.9 9.9
35.6 *
19.4 * *

2.9 5.0 14.3

2.8 5.3 14.5

71.6 13.5
* 55.0 43.0 38.0 29.5

69.5 16.4
* 60.2 58.0 47.0 37.0

14.3 74.4 2.2 29.3 1.1
5.9 0.2 66.7 8.4

14.8 76.2
2.3 23.2
2.1 10.7
0.3 112.2
8.4

89.5 *
77.3 57.9
* * *

94.4 20.0 73.0 52.8 19.7 100.0
4.1

*

14.5

*

7.8

*

6.7

*

15.5

*

*

*

*

6.3

6.9

*

1.6

*

*

5.2

7.3

*

0.9

*

1.3

40.5 16.1 33.9
* 18.5
* 8.4

38.5 12.3 36.6
0.9 19.8
1.7 6.3

3.5 5.3 10.2

2.6 4.8 11.3

73.1 18.4
* 70.1 55.7 51.7 45.4

71.3 15.4
5.1 60.5 48.1 42.1 30.8

19.3 111.7
3.1 65.0
2.1 12.3
0.4 94.8
5.6

17.3 100.3
2.8 73.0
1.7 10.0
0.3 81.1 13.4

18.3 106.7
3.0 58.3 3.0 17.8 0.5 131.1 11.1

18.2 106.4
3.0 72.6
1.3 7.8 0.2 61.9 11.1

13.0 76.3 2.1 75.4 2.4 14.4 0.4 146.1 7.7

17.2 100.3
2.8 68.4
2.1 12.4
0.4 101.6
9.8

232.3 39.1 212.1 90.5
* * *

161.3 37.5
151.2 100.0
* * *

90.5 *
80.4 100.0
* * *

191.0 *
180.9 100.0
* * *

230.5 *
200.4 90.0 * * *

181.1 21.1 165.0 95.1 10.1 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

23.9

*

*

*

*

*

*

*

*

*

*

*

*

*

13.3

11.5

13.5

14.5

10.6

*

*

*

*

*

1.1

*

*

*

*

*

*

6.0

13.5

5.2

11.6

11.6

9.4

*

*

*

*

*

*

*

*

*

*

*

1.3

46.3 42.0 41.0
* * * 15.7

63.9 49.4 49.4
* * * 13.0

61.6 45.8 43.8
* * * 8.5

46.2 49.5 47.9
* 5.3
* *

58.5 37.7 52.2
* 8.7
* 17.1

55.4 45.2 46.4
2.0 3.8 1.8 11.7

.

*

*

*

*

2.0

.

*

7.1

5.0

*

3.9

.

10.7

22.8

46.1

20.5

25.1

65.7 16.9
* 81.0 62.0 55.0
.

59.3 7.9 *
84.3 75.3 69.7 20.2

59.1 7.9 *
82.3 77.1 68.8 58.3

56.5 22.1
* 91.6 87.4 83.2 68.4

55.9

59.6

15.6

14.1

*

11.1

75.4

83.3

81.2

76.2

68.1

68.8

66.7

53.0

445

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Taylor County - 133

1990
7642 1718
192
20.5 18.1 22.0
24 6
129 17 63
5 2 26 5
3 2 1 4 0 2
15 2 0
14 3 2
34 39 53
6 18
4 9
. . .
64 17
0 75 74 57
. 0

1991
7634 1706 189
19.2 19.6 20.0
24 5
156 20 81 10 1 14 2
2 2 0 3 0 0
22 5 0
21 1 4
51 44 65
3 42
8 9
2 2 23
84 23
2 118
93 89
8 0

Total
1992 1993

7623 1696
186

7616 1685 183

21.2 18.6 20.0

19.6 18.0 22.0

16

26

3

8

136

130

14

20

64

66

10

13

0

1

15

20

2

5

2

0

2

0

0

0

2

1

0

0

0

1

22

9

4

1

2

0

25

15

1

0

2

1

52

45

45

33

46

37

2

3

34

13

3

3

15

6

6

6

2

3

43

22

82

83

23

28

0

1

86

106

80

97

69

88

56

59

0

0

1994 5-year

7600 1673
180

38115 8478 930

20.6 15.4 22.0

20.3 18.0 21.0

27

117

5

27

134

685

20

91

67

341

9

47

1

5

19

94

5

19

0

7

0

6

0

1

1

11

0

0

0

3

14

82

2

14

0

2

14

89

2

7

0

9

45

227

33

194

46

247

2

16

18

125

5

23

5

44

4

18

5

12

66

154

87

400

14

105

1

4

98

483

94

438

81

384

73

196

0

0

1990
4292 871 85

1991
4260 858
83

White
1992 1993

4229 847 82

4196 834
80

1994 5-year

4161 821 78

21138 4231 408

23.9 18.1 21.0

22.7 22.0 20.0

20.9 19.0 19.0

20.6 19.9 21.0

22.8 16.1 20.5

22.5 18.4 20.0

4

6

6

4

7

27

1

1

0

1

1

4

51

63

62

55

57

288

2

5

6

3

3

19

6

10

8

7

6

37

2

5

6

3

3

19

0

0

0

0

0

0

13

7

4

7

10

41

2

1

0

1

3

7

2

1

0

0

0

3

1

1

0

0

0

2

1

0

0

0

0

1

1

1

0

0

0

2

0

0

0

0

0

0

2

0

0

1

0

3

1

7

6

3

4

21

1

1

1

1

2

6

0

0

0

0

0

0

2

8

9

10

3

32

1

0

1

0

1

3

1

1

2

1

0

5

13

19

19

15

10

76

3

5

7

4

4

23

12

16

18

12

11

69

1

0

1

0

0

2

9

22

18

8

17

74

2

2

0

0

0

4

4

0

4

0

1

9

.

0

4

1

1

6

.

0

1

2

2

5

.

6

14

4

20

44

36

48

48

45

45

222

9

11

12

9

4

45

0

0

0

0

1

1

24

39

31

37

35

166

17

25

27

32

29

130

13

23

23

26

25

110

.

4

18

14

24

60

0

0

0

0

0

0

1990
3300 841 106

1991
3297 834 105

Black
1992 1993

3292 828 103

3289 822 101

1994 5-year

3282 815 99

16459 4140 513

17.8 18.9 23.0

19.0 18.9 22.0

22.1 15.4 26.5

19.2 18.0 24.0

18.1 14.2 26.0

19.0 17.8 24.0

20

18

10

22

20

90

5

4

3

7

4

23

78

93

74

75

76

396

15

15

8

17

17

72

57

71

56

59

61

304

3

5

4

10

6

28

2

1

0

1

1

5

13

7

11

13

9

53

3

1

2

4

2

12

1

1

2

0

0

4

1

1

2

0

0

4

0

0

0

0

0

0

3

2

2

1

1

9

0

0

0

0

0

0

0

0

0

0

0

0

14

15

16

1

4

3

0

0

2

12

13

16

2

1

0

1

3

0

6

10

61

0

0

8

0

0

2

5

11

57

0

1

4

0

0

4

21

32

33

30

35

151

36

39

38

29

29

171

41

49

28

25

34

177

5

3

1

3

2

14

9

20

16

5

1

51

2

6

3

3

5

19

5

9

11

6

4

35

.

1

2

3

0

6

.

2

0

1

1

4

.

12

19

12

28

71

28

36

34

38

41

177

8

12

11

19

10

60

0

2

0

1

0

3

51

79

55

69

62

316

57

68

53

65

64

307

44

66

46

62

55

273

.

4

38

45

48

135

0

0

0

0

0

0

446

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

16.9

20.4

General fertility rate

75.1

91.4

Total fertility rate

2.1

2.6

% Livebirths to unmarried women

50.0

52.3

Crude abortion rate

3.4

1.8

General abortion rate

15.1

8.2

Total abortion rate

0.4

0.2

Abortion ratio

160.5

76.9

Fetal Death rate

4.1

7.0

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

125.0 126.8

% Repeat conceptions to women under 18

25.0

20.8

Livebirths to women under 18

88.5 105.7

% Livebirths to unmarried women under 18

100.0

85.0

Induced abortions to women under 18

26.0

*

% Abortions to unmarried women under 18

100.0

*

Fetal deaths to women under 18

*

*

Infant and child survival rates

Infant mortality

*

*

Neonatal mortality

*

*

Postneonatal mortality

*

*

Perinatal mortality ratio

*

*

Deaths of children 1-4 yrs

*

*

Deaths of children 5-17 yrs

*

*

Infant health rates

% Low birthweight

11.6

14.1

% Very low birthweight

*

3.2

% Under 500 grams

*

*

% Preterm gestation

11.1

13.5

% Multiple gestation

*

*

% Birth defect

*

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

36.2

33.3

% with father not named on birth certificate

31.0

28.4

% with maternal education less than high school

42.1

41.9

% No prenatal care

4.8

*

% Maternal smoking during pregnancy

14.3

27.1

% Maternal alcohol use during pregnancy

*

5.2

% Interpregnancy interval less than 6 months

11.1

11.1

Child abuse and neglect rates

Physical

.

*

Sexual

.

*

Neglect

.

10.8

Interventions to improve infant & child survival

% Prenatal care first trimester

49.6

55.3

% Primary C-section delivery

14.9

16.9

% Vaginal birth after previous C-section

*

*

% WIC during pregnancy

59.5

76.1

% Medicaid during pregnancy

58.7

60.0

% Medicaid and WIC during pregnancy

45.2

57.4

% Perinatal case management

.

5.2

Taylor County - 133

17.8 80.2 2.4 47.4 2.0
8.8 0.3 93.2 5.9

17.1 77.2
2.3 50.8
2.6 11.9
0.3 121.2
8.9

17.6 80.1 2.4 50.8 2.5 11.4 0.3 115.9 6.6

18.0 80.8
2.4 50.3
2.5 11.1
0.3 112.7
6.5

86.1 *
75.3 85.7
* * *

142.1 30.8
109.3 95.0 27.3
100.0 *

150.3 18.5
111.3 85.0 27.8 * *

125.8 23.1 97.9 90.1 20.4 100.0
7.5

*

*

*

10.2

*

*

*

8.8

*

*

*

*

*

*

*

15.9

*

*

*

*

*

*

*

*

16.2 * *
18.5 * *

6.9 * *
11.5 * *

10.4 * *
10.6 * *

12.0 2.0 *
13.1 1.0 1.3

40.0 33.3 34.1
* 25.2
* 18.1

36.6 25.4 28.7
* 10.1
* 9.4

34.4 25.0 34.8
* 13.6 3.8 7.0

36.0 28.6 36.5
2.4 18.5
3.4 11.6

2.8 *
20.1

2.8 *
10.3

* 2.3 30.7

2.1 1.4 18.0

61.7 18.1
* 63.7 59.3 51.1 41.5

64.8 22.0
* 81.5 74.6 67.7 45.4

64.9 11.5
* 74.2 71.2 61.4 55.3

59.2 16.8
* 71.2 64.6 56.6 35.5

11.9 58.6
1.8 12.0
3.0 14.9
0.4 197.0
*
* * * * * * *
* * * * * *
* * * * * *
31.7 *
24.0 *
18.0 * *
. . .
70.6 20.5
* 48.0 34.0 26.0
.

14.8 73.4
2.2 15.9
1.6 8.2 0.2 92.1 7.0
72.0 *
60.0 * * * *
* * * * * *
11.1 * *
12.7 * *
30.6 7.9
25.4 *
34.9 * *
* * 6.1
78.7 20.0
* 61.9 39.7 36.5
*

14.7 73.2 2.2 13.1
* * * * 7.1

13.1 65.9
2.0 12.7
1.7 8.4 0.3 106.1
*

13.7 69.4 2.1 10.7 2.4 12.2 0.3 142.9
*

13.6 68.1
2.1 13.0
1.9 9.7 0.3 117.1 5.0

73.5 *
73.5 * * * *

*

89.5

66.2

*

*

*

*

*

46.6

*

*

52.6

*

*

17.2

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

9.7 * *
14.8 * *

* * * 18.2 * *

*

7.3

*

2.1

*

*

*

11.2

*

*

*

1.7

32.2 11.5 29.5
* 29.5
* *

28.3 *
21.8 *
14.8 * *

18.2 *
19.6 *
30.4 * *

28.1 8.1
24.2 *
26.1 *
6.1

* * 14.2

*

*

1.5

*

*

1.3

*

20.6

11.2

77.4 21.8
* 50.8 44.3 37.7 29.5

83.3 16.7
* 67.3 58.2 47.3 25.5

78.9 * *
62.5 51.8 44.6 42.9

77.9 17.4
* 58.2 45.6 38.6 25.5

23.6 92.7
2.5 75.0
3.9 15.5
0.4 135.4
5.9

28.2 111.5
3.0 77.2
2.1 8.4 0.2 66.0 7.2

22.5 89.4 2.6 75.7 3.3 13.3 0.4 123.6
*

22.8 91.3
2.5 78.7
4.0 15.8
0.4 131.3
13.4

23.2 93.3 2.7 81.3 2.7 11.0 0.3 96.8 9.8

24.1 95.6
2.7 77.6
3.2 12.8
0.3 109.7
8.2

188.7 25.0 141.5 100.0
* * *

172.2 *
143.5 100.0
* * *

97.5 *
78.0 100.0
* * *

217.6 31.8
168.2 100.0
* * *

201.6 *
171.4 100.0
* * *

175.3 25.6 140.2 100.0 23.4 100.0 11.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

22.4

*

*

*

*

*

*

*

*

*

*

*

*

17.9 * *
15.8 * *

16.1 * *
14.1 * *

21.6 * *
21.6 * *

8.0

13.2

15.4

*

*

2.0

*

*

*

6.7

14.7

14.5

*

*

*

*

*

*

39.6 47.4 53.9
6.6 11.8
* 9.3

35.2 42.4 53.3
* 21.7
6.5 17.0

46.5 51.4 37.8
* 21.6
* 23.9

42.9 38.7 33.8
* 6.7
* 16.7

46.7 38.7 45.3
* * 6.7 *

41.9 43.6 45.3
3.6 13.0
4.8 15.1

.

*

*

*

*

1.3

.

*

*

*

*

*

.

10.6

16.8

10.6

24.7

15.7

35.9 11.4
* 67.1 75.0 57.9
.

39.6 14.8
* 85.9 73.9 71.7
*

47.9 15.3
* 74.3 71.6 62.2 51.4

51.4 26.0
* 92.0 86.7 82.7 60.0

53.9

45.4

14.1

16.3

*

*

82.7

80.6

85.3

78.3

73.3

69.6

64.0

42.7

447

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Telfair County - 134

1990
11000 2359 223
20.1 19.7 21.0
23 2
179 21 67
9 4 25 2
4 3 1 7 0 0
19 4 1
24 1 2
61 44 63
0 38
7 7
. . .
122 27
1 95 78 62
. 0

1991
11070 2382 228
20.0 18.2 21.0
38 10 179 35 76 10
3 20
3
3 1 2 4 0 2
17 3 0
15 2 0
50 48 66
0 43
4 8
1 3 14
113 16 1
124 99 91 47 0

Total
1992 1993

11137 2404 232

11206 2428 238

21.6 19.0 22.0

19.9 17.0 20.0

21

23

7

2

174

160

17

20

83

64

11

6

2

2

23

11

4

3

4

1

3

1

1

0

5

3

1

0

2

1

18

6

5

0

2

0

20

15

3

1

4

0

60

48

54

41

61

52

3

4

35

23

6

4

15

6

6

8

12

9

20

19

109

103

22

23

4

0

123

113

108

113

98

95

86

77

1

0

1994 5-year

11271 2449 242

55684 12022
1163

20.8 15.3 22.0

20.5 18.5 21.0

20

125

3

24

177

869

17

110

74

364

17

53

1

12

12

91

2

14

1

13

0

8

1

5

1

20

2

3

1

6

18

78

2

14

0

3

16

90

5

12

3

9

63

282

38

225

55

297

1

8

22

161

1

22

9

45

15

30

5

29

81

134

120

567

23

111

1

7

117

572

106

504

90

436

79

289

4

5

1990
7202 1460
123

1991
7215 1465
125

White
1992 1993

7220 1470
127

7233 1478
130

1994 5-year

7242 1483
132

36112 7356 638

22.0 19.8 20.0

20.6 18.2 20.0

22.5 25.2 21.0

21.1 18.0 20.0

22.1 20.1 21.0

21.6 19.4 20.0

9

18

6

0

6

2

105

103

100

8

16

6

10

20

25

4

6

5

1

1

0

18

9

8

1

1

0

9

5

47

0

0

8

86

105

499

8

3

41

17

23

95

2

8

25

1

1

4

5

6

46

1

1

4

1

2

1

0

0

4

1

0

1

0

0

2

0

2

0

0

0

2

2

1

1

1

1

6

0

0

0

0

1

1

0

1

2

0

1

4

6

3

5

0

3

17

1

0

1

0

1

3

1

0

0

0

0

1

10

5

9

6

5

35

1

1

1

0

2

5

2

0

3

0

2

7

28

22

32

24

31

137

5

11

14

6

7

43

30

40

36

25

23

154

0

0

0

1

0

1

27

31

26

18

20

122

1

1

3

1

0

6

3

3

9

2

6

23

.

0

1

4

7

12

.

1

7

7

2

17

.

8

13

12

40

73

84

77

73

66

82

382

14

9

14

14

16

67

1

0

3

0

1

5

43

59

61

51

64

278

30

46

51

54

46

227

22

42

45

42

43

194

.

21

41

34

35

131

0

0

0

0

1

1

1990
3773 893 98

1991
3797 902 100

Black
1992 1993

3820 910 102

3844 919 104

1994 5-year

3866 927 106

19100 4552 511

17.7 19.3 23.0

17.5 19.3 25.5

20.0 18.3 23.5

18.6 15.8 24.0

18.3 14.8 24.0

18.6 17.9 24.0

14

20

15

14

15

78

2

4

5

2

3

16

74

76

73

73

72

368

13

19

11

12

14

69

57

56

58

47

51

269

5

4

6

4

9

28

3

2

2

1

0

8

7

10

15

6

6

44

1

2

4

2

1

10

3

1

3

1

1

9

2

1

2

1

0

6

1

0

1

0

1

3

5

3

4

2

0

14

0

0

1

0

1

2

0

1

0

1

0

2

13

14

13

3

3

4

0

0

2

14

10

11

0

1

2

0

0

1

6

15

61

0

1

11

0

0

2

9

11

55

1

3

7

0

1

2

33

28

28

24

32

145

39

37

40

35

31

182

33

26

24

26

32

141

0

0

3

3

1

7

11

12

9

5

2

39

6

3

3

3

1

16

4

5

6

4

3

22

.

1

5

4

7

17

.

2

5

2

3

12

.

6

7

7

38

58

38

36

35

37

38

184

13

7

8

9

7

44

0

1

1

0

0

2

52

65

62

61

53

293

48

53

57

58

60

276

40

49

53

52

47

241

.

26

45

42

44

157

0

0

1

0

3

4

448

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

16.3

16.2

15.6

14.3

15.7

15.6

General fertility rate

75.9

75.1

72.4

65.9

72.3

72.3

Total fertility rate

2.3

2.3

2.2

2.0

2.1

2.2

% Livebirths to unmarried women

37.6

42.9

48.5

40.3

43.0

42.5

Crude abortion rate

2.3

1.8

2.1

1.0

1.1

1.6

General abortion rate

10.6

8.4

9.6

4.5

4.9

7.6

Total abortion rate

0.3

0.3

0.3

0.1

0.1

0.2

Abortion ratio

114.2

93.9 109.0

61.5

58.0

88.4

Fetal Death rate

6.4

5.9

5.8

3.3

7.3

5.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

103.1 166.9

90.4

96.8

82.6 107.5

% Repeat conceptions to women under 18

*

26.3

33.3

*

*

19.2

Livebirths to women under 18

94.2 153.7

73.2

84.2

70.2

94.6

% Livebirths to unmarried women under 18

76.2

76.5

82.4

78.9

93.8

80.4

Induced abortions to women under 18

*

*

*

*

*

12.0

% Abortions to unmarried women under 18

*

*

*

*

* 100.0

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

15.0

Neonatal mortality

*

*

*

*

*

9.2

Postneonatal mortality

*

*

*

*

*

5.8

Perinatal mortality ratio

38.3

*

28.4

*

*

22.7

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

0.5

Infant health rates

% Low birthweight

10.6

9.5

10.3

3.8

10.2

9.0

% Very low birthweight

*

*

2.9

*

*

1.6

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

13.5

8.5

11.7

9.4

9.3

10.5

% Multiple gestation

*

*

*

*

2.9

1.4

% Birth defect

*

*

*

*

*

1.0

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

41.2

34.2

42.9

36.4

44.7

39.9

% with father not named on birth certificate

24.7

27.1

31.6

25.8

22.1

26.3

% with maternal education less than high school

35.6

37.7

36.1

32.9

32.0

34.9

% No prenatal care

*

*

*

*

*

0.9

% Maternal smoking during pregnancy

21.3

24.3

20.5

14.5

12.8

18.8

% Maternal alcohol use during pregnancy

3.9

*

3.5

*

*

2.6

% Interpregnancy interval less than 6 months

6.3

7.6

12.9

6.5

8.7

8.5

Child abuse and neglect rates

Physical

.

*

2.0

2.6

4.9

2.4

Sexual

.

*

3.9

2.9

1.6

2.4

Neglect

.

4.6

6.5

6.2

26.3

10.9

Interventions to improve infant & child survival

% Prenatal care first trimester

68.9

64.9

64.1

65.6

68.6

66.5

% Primary C-section delivery

16.6

10.3

14.8

15.5

15.9

14.6

% Vaginal birth after previous C-section

*

*

*

*

*

7.3

% WIC during pregnancy

53.4

70.1

71.9

71.1

68.0

66.7

% Medicaid during pregnancy

43.8

55.9

63.2

71.1

61.6

58.8

% Medicaid and WIC during pregnancy

34.8

51.4

57.3

59.7

52.3

50.9

% Perinatal case management

.

26.6

50.3

48.4

45.9

42.6

Telfair County - 134

14.6 71.9
2.3 9.6 2.5 12.3 0.4 139.5 4.1

14.3 70.3
2.2 19.6
1.2 6.1 0.2 75.0 5.5

73.2 *
65.0 * * * *

143.8 33.3
127.8 50.0 * * *

*

*

*

*

*

*

*

*

*

*

*

*

5.7

*

*

*

*

*

9.6

4.9

*

*

*

*

34.1 4.8
28.8 *
26.0 * *

26.5 10.8 40.0
* 30.4
* *

.

*

.

*

.

4.6

81.6 15.2
* 41.3 28.8 21.2
.

75.5 9.8 *
57.8 45.1 41.2 20.6

13.9 68.0 2.1 25.3 1.1 5.4 0.2 70.2 4.1
47.1 *
47.1 * * * *
* * * * * *
5.0 * *
9.1 * *
41.0 14.1 36.7
* 26.3
* 12.7
* 4.0 7.5
74.5 16.9
* 61.6 51.5 45.5 41.4

11.9 58.2
1.8 19.8
0.7 3.4 0.1 53.2
*
69.2 *
61.5 * * * *
* * * * * *
* * * 7.0 * *
34.8 7.0
29.4 *
20.9 * *
* 4.0 6.9
78.6 17.1
* 59.3 62.8 48.8 39.5

14.5 70.8 2.1 22.3 0.8 4.0 0.1 50.0 6.1
37.8 * * * * * *
* * * * * *
* * * 4.9 * *
38.3 6.8 22.3
* 19.4
* 9.2
4.0 *
23.1
78.8 18.8
* 62.1 44.7 41.7 34.0

13.8 67.8
2.1 19.2
1.3 6.3 0.2 79.7 4.4
73.7 17.0 64.3 51.2
* * *
* * * 11.9 * *
3.4 * *
7.1 1.0 1.4
34.9 8.7
31.4 *
24.7 1.2 7.6
1.7 2.5 10.5
77.8 15.4
8.3 56.3 46.0 39.3 33.6

19.6 82.9
2.3 77.0
1.9 7.8 0.2 77.8 10.1

20.0 84.3
2.4 74.7
2.6 11.1
0.3 108.7
6.7

19.1 80.2 2.2 81.7 3.9 16.5 0.5 156.3 8.8

19.0 79.4
2.3 65.3
1.6 6.5 0.2 71.4 5.4

18.6 77.6 2.2 73.9 1.6 6.5 0.2 69.0 9.7

19.3 80.9
2.3 74.5
2.3 9.7 0.3 98.0 8.1

142.9 *
132.7 92.3
* * *

200.0 *
190.0 100.0
* * *

146.9 33.3
107.7 100.0
* * *

134.1 *
114.9 100.0
* * *

141.0 *
131.6 100.0
* * *

152.7 20.5
135.1 98.5 19.6 100.0 *

*

*

*

*

*

24.5

*

*

*

*

*

16.3

*

*

*

*

*

*

64.9

*

*

*

*

37.2

*

*

*

*

*

*

*

*

*

*

*

*

17.6 * *
18.9 * *

18.4 * *
13.3 * *

17.8 * *
15.5 * *

8.2 * *
12.5 * *

20.8 * *
15.9 * *

16.6 3.0 *
15.2 1.9 *

50.0 52.7 45.2
* 14.9
8.1 *

44.4 49.3 34.7
* 16.0
* 11.4

45.9 56.3 34.3
* 12.7
* 13.6

38.7 48.6 36.1
* 6.9
* *

53.3 44.9 46.4
* * * *

46.5 50.4 39.3
2.0 10.8
4.4 9.8

.

*

3.8

*

5.3

3.2

.

*

3.8

*

*

2.3

.

4.6

5.4

5.3

28.9

11.1

51.4 18.3
* 70.3 64.9 54.1
.

50.0 10.9
* 86.7 70.7 65.3 34.7

49.3 12.3
* 87.3 80.3 74.6 63.4

51.4 13.8
* 84.7 80.6 72.2 58.3

53.5

51.1

11.7

13.5

*

*

76.8

81.2

87.0

76.5

68.1

66.8

63.8

54.7

449

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Terrell County - 135

1990
10653 2282 260
19.7 21.2 22.0
32 5
185 29 91 13
4 24
1
2 1 1 5 0 0
22 5 1
26 4 5
64 52 72
2 18
4 11
. . .
116 27
1 101 110 77
. 0

1991
10636 2270 260
21.2 17.5 22.0
32 10 183 26 96 14
2 24
5
2 2 0 4 0 0
16 3 2
18 1 1
69 51 69
2 8 2 13
2 2 5
145 25 2
111 117
88 1 0

Total
1992 1993

10618 2256 260

10600 2241 260

19.5 17.2 22.0

19.1 19.7 25.0

35

29

5

10

195

161

30

24

116

92

9

15

2

1

34

37

5

4

3

1

3

1

0

0

5

2

2

0

6

1

25

18

7

6

2

1

25

18

3

0

0

2

81

66

65

49

81

56

3

2

13

23

4

7

10

11

5

6

2

3

53

61

156

114

30

17

0

3

122

110

140

120

108

99

4

79

1

1

1994 5-year

10584 2230 260

53091 11279
1300

18.5 21.5 22.0

19.3 18.8 22.0

36

164

7

37

193

917

33

142

128

523

12

63

0

9

26

145

2

17

2

10

2

9

0

1

3

19

0

2

0

7

26

107

8

29

0

6

27

114

1

9

0

8

69

349

50

267

74

352

5

14

12

74

4

21

11

56

2

15

6

13

82

201

139

670

22

121

2

8

140

584

138

625

119

491

104

188

0

2

1990
4251 771 69

1991
4238 758 68

White
1992 1993

4227 746 67

4212 732 66

1994 5-year

4201 720 65

21129 3727 334

22.0 22.7 20.0

22.5 20.5 21.0

23.6 17.2 20.0

22.5 18.9 21.0

26.4 21.6 22.0

23.0 19.9 21.0

4

6

7

5

3

25

1

1

1

2

1

6

49

52

44

45

35

225

4

5

5

3

2

19

5

3

5

11

5

29

3

3

4

5

6

21

0

0

0

1

0

1

6

5

7

6

8

32

0

1

2

1

1

5

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

1

0

0

1

0

0

1

0

0

2

0

0

2

2

2

3

4

5

16

0

0

0

0

0

0

0

0

0

0

0

0

3

2

3

1

5

14

0

0

0

0

1

1

3

0

0

0

0

3

11

14

13

20

11

69

1

1

4

6

0

12

14

14

10

9

9

56

0

0

0

0

0

0

5

4

6

8

5

28

0

1

1

0

1

3

0

1

0

2

1

4

.

0

0

1

0

1

.

0

1

0

0

1

.

0

7

8

14

29

43

52

38

42

33

208

9

12

5

6

6

38

0

1

0

1

2

4

15

22

17

16

12

82

15

19

19

18

15

86

10

18

14

14

12

68

.

0

1

9

8

18

0

0

1

0

0

1

1990
6377 1504
191

1991
6367 1496
191

Black
1992 1993

6356 1486
191

6345 1475
191

1994 5-year

6336 1468
191

31781 7428 955

18.5 21.2 22.0

20.5 17.5 23.5

18.4 18.0 26.0

18.8 20.5 27.0

18.2 21.0 23.0

18.6 18.7 25.0

28

26

28

24

33

139

4

9

4

8

6

31

136

131

151

116

158

692

25

21

25

21

31

123

86

93

111

81

123

494

9

10

5

10

6

40

4

2

2

0

0

8

18

19

27

31

18

113

1

4

3

3

1

12

2

2

3

1

2

10

1

2

3

1

2

9

1

0

0

0

0

1

5

4

5

1

3

18

0

0

1

0

0

1

0

0

4

1

0

5

20

14

22

14

21

91

5

3

7

6

8

29

1

2

2

1

0

6

23

16

22

17

22

100

4

1

3

0

0

8

2

1

0

2

0

5

53

55

68

46

58

280

51

50

61

43

50

255

58

55

71

47

65

296

2

2

3

2

5

14

13

4

7

15

7

46

4

1

3

7

3

18

11

12

10

9

10

52

.

2

5

5

2

14

.

2

1

2

6

11

.

5

43

50

62

160

73

93

118

72

106

462

18

13

25

11

16

83

1

1

0

2

0

4

86

89

105

94

128

502

95

98

121

102

123

539

67

70

94

85

107

423

.

1

3

70

96

170

0

0

0

1

0

1

450

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Terrell County - 135

17.4 81.1
2.4 50.6
2.3 10.5
0.3 105.7
7.9
123.1 15.6 111.5 86.2
* * *
* * * 26.5 * *
11.9 2.7 *
14.4 *
2.7
43.2 28.9 40.2
* 10.1
* 11.1
. . .
67.4 15.8
* 56.1 61.1 42.8
.

17.2 80.6
2.4 52.7
2.3 10.6
0.3 105.7
8.8
123.1 31.3
100.0 80.8 19.2 * *
* * * * * *
8.7 * *
9.9 * *
43.4 28.0 37.9
* 4.4
* 11.6
* * 1.6
80.6 14.7
* 61.0 64.3 48.4
*

18.4 86.4 2.5 60.4 3.2 15.1 0.4 138.2 7.5
134.6 14.3
115.4 86.7 19.2
100.0 *
* * * 25.4 * 2.6
12.8 3.6
* 13.0
* *
50.6 33.9 42.4
* 6.8
* 8.6
1.6 *
16.9
82.1 17.8
* 63.5 72.9 56.3
*

15.2 71.8
2.1 57.1
3.5 16.5
0.5 172.9
7.1
111.5 34.5 92.3 91.7 * * *
* * * * * *
11.2 3.7 *
11.2 * *
52.0 30.4 34.8
* 14.3
4.3 10.9
1.9 *
19.6
73.1 11.9
* 68.3 74.5 61.5 49.1

18.2 86.5 2.5 66.7 2.5 11.7 0.4 112.1 5.8
138.5 19.4
126.9 100.0
* * *
* * * * * *
13.5 4.1
* 14.1
* *
42.6 26.0 38.5 2.6 6.3
* 9.6
* 1.9 26.5
72.0 12.3
* 72.9 71.9 62.0 54.2

17.3 81.3
2.4 57.7
2.7 12.9
0.4 126.5
7.4
126.2 22.6 109.2 89.4 13.1 94.1
5.4
10.9 9.8 *
20.5 *
0.6
11.7 3.2 0.7
12.6 1.0 0.9
46.2 29.4 38.9
1.6 8.2 2.3 10.3
1.2 1.0 16.1
75.2 14.5 10.7 64.4 68.9 54.1 25.9

11.5 63.6
2.1 10.2
1.4 7.8 0.2 101.7
*

12.3 68.6
2.2 *
1.2 6.6 0.2 83.3
*

10.4 59.0 1.9 11.4 1.7 9.4 0.3 125.0 6.7

10.7 61.5
2.0 24.4
1.4 8.2 0.3 105.3 8.2

8.3 48.6 1.6 14.7 1.9 11.1 0.4 163.3 8.3

10.6 60.4
2.0 12.9
1.5 8.6 0.3 113.9 6.4

*

88.5 105.1

75.8

*

*

*

*

*

73.7

75.1

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

74.8

*

24.0

*

56.9

*

26.3

*

15.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

14.3

7.1

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

14.7

6.3

*

*

*

*

*

*

*

*

*

*

*

*

24.4 *
28.6 *
10.2 * *

28.0 *
26.9 * * * *

30.2 *
23.3 *
14.0 * *

46.5 13.3 20.0
* 17.8
* *

33.3 *
26.5 *
14.7 * *

32.2 5.4
25.1 *
12.6 * *

.

*

*

*

*

*

.

*

*

*

*

*

.

*

8.8

10.2

18.0

9.2

91.5 19.1
* 30.6 30.6 20.4
.

100.0 25.0 * 42.3 36.5 34.6 *

86.4 13.5
* 38.6 43.2 31.8
*

93.3 15.0
* 35.6 40.0 31.1 20.0

94.3 20.7
* 35.3 44.1 35.3 23.5

93.3 18.9
* 36.6 38.4 30.4 10.3

21.3 90.4
2.5 65.6
2.8 12.0
0.3 107.8
8.6

20.6 87.6
2.4 71.5
3.0 12.7
0.3 114.5
10.7

23.8 101.6
2.8 75.0 4.2 18.2 0.5 142.1 8.1

18.3 78.6
2.2 69.8
4.9 21.0
0.6 197.5
6.8

24.9 107.7
3.0 77.8 2.8 12.3 0.4 98.4 4.8

21.8 93.2
2.6 72.3
3.6 15.2
0.4 130.9
7.8

146.6 *
130.9 100.0
* * *

136.1 34.6
109.9 95.2 * * *

146.6 *
130.9 100.0
* * *

125.7 33.3
109.9 100.0
* * *

172.8 18.2
162.3 100.0
* * *

145.5 22.3
128.8 99.2 12.6 100.0 5.2

*

*

*

*

*

14.5

*

*

*

*

*

13.0

*

*

*

*

*

*

35.7

*

32.7

*

*

25.7

*

*

*

*

*

*

*

*

*

*

*

0.6

14.7 3.7 *
17.6 * *

10.7 * *
12.4 * *

14.6 4.6 *
14.9 * *

12.1 5.2 *
14.7 * *

13.3 5.1 *
14.0 * *

13.2 4.2 0.9
14.7 1.2 0.7

51.5 38.9 44.6
* 10.0
* 14.7

50.5 38.5 42.3
* * * 13.8

58.1 41.2 48.0
* 4.7
* 10.5

54.8 37.1 40.5
* 12.9
6.0 12.3

45.0 31.6 41.1 3.2 4.4
* 10.6

51.7 37.3 43.4
2.1 6.7 2.6 12.3

.

*

2.2

2.2

*

1.5

.

*

*

*

2.6

1.2

.

2.1

18.6

21.7

27.0

17.3

58.4 14.5
* 65.6 72.5 51.1
.

72.7 10.7
* 68.5 75.4 53.8
*

80.8 18.9
* 70.9 81.8 63.5
*

64.9 10.7
* 81.0 87.9 73.3 60.3

67.1

69.2

10.7

13.2

*

*

81.0

73.5

77.8

78.9

67.7

61.9

60.8

30.8

451

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Thomas County - 136

1990
38986 8810 933
19.6 17.3 21.0
103 26 713 94 307 39
9 5 1
10 6 4
16 1 7
57 15
1 52
4 3
261 153 192
5 37
4 35
. . .
479 73 18 389 349 280
. 0

1991
39318 8846 933
19.3 20.9 22.0
99 30 684 91 324 68 12
7 1
6 2 4 14 3 3
52 7 0
43 9 5
232 152 223
9 35
9 49
5 7 22
433 82 18
392 368 311
81 3

Total
1992 1993

39650 8881 934

39982 8917 934

19.3 16.9 21.0

19.2 15.9 22.0

111

95

31

19

679

580

107

90

302

272

67

60

11

9

7

8

2

3

8

7

4

4

4

3

15

13

0

1

2

8

60

59

11

11

1

0

82

69

7

9

5

4

179

195

128

124

214

156

4

12

37

44

2

3

52

29

20

8

18

1

131

52

471

434

76

66

8

8

393

376

400

383

327

336

244

266

2

7

1994 5-year

40311 8951 934

198247 44405 4667

20.5 15.9 22.0

19.6 16.6 22.0

91

499

16

122

657

3313

84

466

298

1503

77

311

4

45

10

37

3

10

3

34

2

18

1

16

6

64

1

6

5

25

52

280

13

57

2

4

66

312

5

34

3

20

245

1112

144

701

184

969

6

36

43

196

7

25

25

190

9

42

23

49

43

248

538

2355

82

379

10

62

440

1990

427

1927

381

1635

326

917

4

16

1990
23971 5122 475

1991
24156 5133 477

White
1992 1993

24345 5143 479

24533 5155 481

1994 5-year

24721 5165 483

121726 25718 2395

20.8 .
20.5

21.7 20.9 21.0

21.4 .
20.0

21.4 23.1 21.0

22.0 15.9 21.0

21.4 19.1 21.0

28

23

39

27

31

148

5

5

7

5

4

26

366

327

343

278

340

1654

27

21

37

27

26

138

56

52

67

57

55

287

14

32

39

34

33

152

1

5

3

1

1

11

0

3

1

3

5

12

0

0

0

0

2

2

4

3

3

1

1

12

1

1

2

1

0

5

3

2

1

0

1

7

2

6

5

2

1

16

1

0

0

1

1

3

2

2

2

1

2

9

19

18

24

20

16

97

3

1

4

1

4

13

0

0

0

0

1

1

20

16

40

32

28

136

4

7

3

3

3

20

1

3

1

2

0

7

108

92

77

82

103

462

31

29

33

26

33

152

96

88

106

63

80

433

1

0

1

3

3

8

28

31

29

33

39

160

3

5

2

2

2

14

10

12

17

11

6

56

.

1

12

5

5

23

.

4

10

1

9

24

.

5

54

18

20

97

285

250

278

225

306

1344

45

47

40

25

47

204

11

9

5

5

5

35

119

119

146

128

168

680

113

103

135

132

165

648

78

83

107

109

143

520

.

22

70

92

129

313

0

2

1

2

1

6

1990
14759 3618 451

1991
14885 3630 451

Black
1992 1993

15010 3642 451

15136 3654 451

1994 5-year

15261 3666 451

75051 18210
2256

19.1 17.3 23.0

18.6 19.3 24.0

18.3 16.9 24.0

18.1 15.3 25.0

18.4 18.3 24.0

18.4 15.7 24.0

75

76

71

68

60

350

21

25

23

14

12

95

345

355

332

300

316

1648

67

70

69

63

58

327

251

272

233

215

242

1213

25

36

28

26

44

159

8

7

8

8

3

34

5

4

6

5

5

25

1

1

2

3

1

8

6

3

5

6

2

22

5

1

2

3

2

13

1

2

3

3

0

9

14

8

10

11

5

48

0

3

0

0

0

3

5

1

0

7

3

16

37

34

36

37

36

180

12

6

7

10

9

44

1

0

1

0

1

3

31

27

42

37

38

175

0

2

4

5

2

13

2

2

4

2

3

13

153

139

101

112

141

646

122

123

95

98

111

549

95

135

106

93

104

533

4

9

3

9

3

28

9

3

8

11

4

35

1

4

0

1

5

11

25

37

34

18

19

133

.

2

8

3

4

17

.

1

8

0

13

22

.

14

71

34

20

139

192

181

193

208

232

1006

28

35

36

41

35

175

7

9

3

3

5

27

269

272

246

248

271

1306

235

265

265

251

262

1278

201

228

220

227

238

1114

.

59

174

174

197

604

0

1

1

5

3

10

452

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Thomas County - 136

18.3 80.9
2.5 43.4
0.1 0.6 0.0 6.5 6.0
110.4 25.2 100.8 83.9
* * 9.6
14.0 8.4 *
22.2 *
0.9
8.0 2.1
* 7.3
* *
38.6 21.6 27.2
0.7 5.4
* 8.5
. . .
67.8 11.0 40.9 54.9 49.3 39.5
.

17.4 77.3
2.3 48.1
0.2 0.8 0.0 9.0 9.8
106.1 30.3 97.5 85.7 * * 11.8
8.8 * *
20.1 * *
7.6 1.0
* 6.4 1.3 0.8
35.7 22.6 33.1
1.3 5.3 1.4 11.9
0.4 0.6 2.0
63.5 13.3 31.0 58.2 54.6 46.1 12.0

17.1 76.5 2.3 45.1 0.2 0.8 0.0
9.1 9.7
118.9 27.9
114.6 78.5 * * 6.4
11.8 * *
21.7 * *
8.8 1.6
* 12.3 1.0 0.8
27.7 19.1 31.9
* 5.7
* 13.2
1.8 1.6 11.6
69.6 12.1 19.0 58.6 59.6 48.7 36.4

14.5 65.0
2.0 47.7
0.2 0.9 0.0 12.1 8.3
101.8 20.0 96.4 82.0 * * *
12.1 * *
22.1 *
1.0
10.2 1.9 *
12.1 1.6 *
36.0 21.7 27.3
2.1 8.0
* 8.4
0.7 *
4.6
76.3 12.7 15.1 65.8 67.1 58.8 46.6

16.3 73.4 2.3 45.8 0.2 1.1 0.0 13.2
9.8

16.7 74.6
2.3 45.9
0.2 0.8 0.0 9.9 8.7

97.5 17.6 90.0 85.7
* * 7.5

106.9 24.4 99.9 83.0
2.1 100.0
7.9

*

10.3

*

5.4

*

4.9

9.1

19.1

*

0.5

0.6

0.6

7.9

8.5

2.0

1.7

*

*

10.1

9.5

0.8

1.0

*

0.6

39.3 22.1 28.4
0.9 6.8 1.1 6.6

35.4 21.4 29.6
1.1 6.2 0.8 9.8

0.8

0.9

2.0

1.1

3.7

5.5

82.4 13.9 16.1 67.6 65.6 58.5 50.1

71.6 12.6 23.9 60.8 58.8 49.9 35.7

15.3 71.5
2.3 15.5
* * * * 3.3
58.9 17.9 56.8 57.7
* * *
* * * * * *
5.2 * *
5.5 * *
31.1 8.6
26.5 *
7.9 *
5.0
. . .
78.3 13.5 39.3 32.9 31.2 21.5
.

13.5 63.7
2.0 16.3
* * * * 7.4
48.2 21.7 44.0 38.1
* * *
* * * 18.1 * *
5.5 * *
5.0 2.2
*
30.2 9.1
27.6 *
10.1 1.6 6.2
* * 0.8
76.7 16.5 25.7 37.3 32.3 26.0
6.9

14.1 66.7 2.1 19.8
* * * * 8.7
81.4 17.9 77.2 43.2
* * *
* * * 14.5 * *
7.0 * *
11.8 * *
23.7 9.7 31.3
* 8.9
* 9.4
2.0 1.7 9.1
81.0 12.8 19.2 43.1 39.8 31.6 20.6

11.3 53.9
1.7 20.7
* * * * 7.4
56.1 18.5 56.1 48.1
* * *
* * * * * *
7.2 * *
11.6 * *
30.9 9.5
22.9 *
12.4 *
6.8
0.8 *
3.0
81.8 10.2 16.1 46.5 48.0 39.6 33.5

13.8 65.8 2.1 16.4 0.2 1.0 0.0 13.2
6.8
64.2 *
53.8 57.7
* * *
* * * * * *
4.7 * *
8.3 * *
32.1 9.8
23.9 *
12.1 *
3.3
0.8 1.5 3.3
90.8 15.2 19.2 50.0 49.1 42.6 38.4

13.6 64.3
2.0 17.6
0.1 0.5 0.0 6.5 6.7
61.8 17.6 57.6 48.9
* * 5.4
7.3 3.0 4.2 9.6
* 0.4
5.9 0.8
* 8.3 1.2 0.4
29.6 9.3
26.6 0.5
10.1 0.9 6.1
1.0 1.0 4.1
81.7 13.7 24.0 41.7 39.7 31.9 24.7

23.4 95.4
2.7 73.0
0.3 1.4 0.0 13.0 10.0

23.8 97.8
2.7 77.1
* * * * 13.5

22.1 91.2 2.6 71.0 0.4 1.6 0.0 15.8 11.3

19.8 82.1
2.3 73.1
0.3 1.4 0.0 14.7 9.9

20.7 86.2 2.5 77.3 0.3 1.4 0.0 13.4 14.5

22.0 90.5
2.6 74.3
0.3 1.4 0.0 13.2 11.8

166.3 28.0 148.6 94.0
* * 15.5

168.5 32.9
155.2 100.0
* * 17.7

157.3 32.4
152.9 98.6 * * *

150.7 20.6
139.6 96.8 * * *

132.9 20.0
128.5 98.3 * * *

155.1 27.1
145.0 97.5 3.5 100.0 10.6

17.4 14.5
* 39.7
* 1.3

* * * 22.1 * *

15.1 * *
29.4 * *

20.0 * *
35.7 *
1.8

* * * 15.7 * *

13.3 7.9 5.5
28.5 *
0.8

10.7 3.5 * 9.0 * *

9.6

10.8

12.3

11.4

10.9

1.7

2.1

3.3

2.8

2.7

*

*

*

*

*

7.6

12.8

12.5

12.1

10.7

*

*

1.7

*

0.8

*

*

*

*

0.8

46.6 35.5 27.8
* 2.7
* 11.9

40.4 34.8 38.2
2.6 * *
17.0

31.7 29.0 32.3
* 2.5
* 16.1

40.6 33.2 31.5
3.1 3.9
* 9.9

46.8 35.4 33.2
* * 1.6 9.8

41.2 33.6 32.7
1.7 2.2 0.7 13.1

.

*

1.5

*

*

0.8

.

*

1.5

*

2.4

1.0

.

2.7

13.4

6.4

3.7

6.6

56.3 8.5
43.8 78.2 68.3 58.4
.

51.1 10.6 39.1 77.1 75.1 64.6 16.7

58.3 11.5
* 75.0 80.8 67.1 53.0

71.2 15.0
* 84.1 85.1 76.9 59.0

73.7

61.6

12.6

11.5

13.9

24.1

86.3

79.9

83.4

78.2

75.8

68.2

62.7

46.8

453

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Tift County - 137

1990
34998 8175 857
20.3 19.1 21.0
90 28 603 80 237 21
7 56
7
7 5 2 13 2 3
51 7 1
68 2 5
224 144 233
7 118 13 40
. . .
449 87
9 321 270 214
. 1

1991
35373 8221 853
20.8 18.3 21.0
83 26 628 73 250 14
9 49
8
9 4 5 12 3 3
68 12
0 78
6 1
226 125 235
7 119
9 34
10 4
80
435 72 4
341 301 240
68 5

Total
1992 1993

35748 8267 849

36126 8314 846

19.8 19.4 22.0

19.6 20.5 22.0

97

99

25

22

591

601

89

97

244

280

7

0

1

0

51

37

7

3

10

8

7

7

3

1

8

7

2

4

5

4

56

67

6

8

0

1

77

78

11

8

16

14

224

245

115

140

221

232

4

8

110

84

9

1

43

38

26

22

20

24

85

111

393

393

61

64

13

12

313

334

330

392

254

289

95

141

0

7

1994 5-year

36499 8362 842

178744 41339 4247

19.9 19.9 22.0

20.2 19.0 22.0

98

467

22

123

634

3057

91

430

270

1281

9

51

4

21

38

231

7

32

4

38

3

26

1

12

9

49

1

12

3

18

59

301

7

40

1

3

66

367

6

33

11

47

229

1148

116

640

249

1170

10

36

93

524

5

37

37

192

34

92

28

76

147

423

442

2112

72

356

12

50

328

1637

381

1674

271

1268

184

488

0

13

1990
24941 5636 549

1991
25095 5631 544

White
1992 1993

25253 5628 538

25409 5624 533

1994 5-year

25564 5622 528

126262 28141 2691

21.2 19.1 21.0

21.8 18.5 20.0

20.6 19.2 20.5

20.6 18.9 21.0

22.8 20.2 21.0

21.4 18.9 21.0

45

45

50

42

35

217

12

11

11

9

8

51

376

398

369

358

384

1885

38

40

44

41

30

193

77

83

79

91

89

419

7

6

3

0

5

21

6

2

0

0

3

11

42

34

35

28

25

164

6

5

6

2

4

23

1

3

7

3

2

16

1

2

4

3

1

11

0

1

3

0

1

5

8

3

3

3

5

22

1

1

0

3

0

5

1

0

2

2

1

6

20

24

29

29

28

130

1

1

1

3

3

9

1

0

0

0

0

1

27

33

41

34

33

168

2

3

7

3

3

18

2

0

8

6

7

23

119

135

130

137

130

651

44

50

34

43

33

204

134

136

131

132

124

657

1

2

0

3

4

10

91

97

87

68

77

420

3

1

3

0

0

7

19

12

17

20

20

88

.

3

7

14

19

43

.

3

17

18

15

53

.

23

44

49

54

170

294

301

263

259

284

1401

62

44

41

39

52

238

8

2

6

9

6

31

158

179

159

156

160

812

131

146

160

185

181

803

102

118

122

129

128

599

.

33

52

73

110

268

1

2

0

3

0

6

1990
9371 2393
291

1991
9471 2405 290

Black
1992 1993

9572 2417
288

9673 2429 287

1994 5-year

9773 2441
286

47860 12084
1442

18.9 20.4 25.0

19.3 18.2 25.0

18.2 24.7 25.0

18.6 17.8 23.5

17.7 17.4 25.0

18.3 19.0 25.0

45

36

47

57

63

248

16

15

14

13

14

72

222

227

218

238

241

1146

42

33

45

56

61

237

160

167

163

187

179

856

14

8

4

0

4

30

1

7

1

0

1

10

14

11

16

6

11

58

1

1

1

1

3

7

6

6

3

5

2

22

4

2

3

4

2

15

2

4

0

1

0

7

5

9

5

4

4

27

1

2

2

1

1

7

2

3

3

2

2

12

31

44

27

37

31

170

6

11

5

5

4

31

0

0

0

1

1

2

40

45

36

44

33

198

0

3

4

4

3

14

2

1

8

8

4

23

103

90

92

107

97

489

100

75

80

95

83

433

97

99

89

99

123

507

6

5

4

5

6

26

27

22

22

16

16

103

10

8

6

1

5

30

21

22

26

18

17

104

.

7

18

7

14

46

.

1

3

5

13

22

.

53

30

55

80

218

152

132

127

132

152

695

23

28

19

24

20

114

1

2

7

2

6

18

161

161

154

176

162

814

136

154

168

203

194

855

110

122

132

158

138

660

.

35

43

66

70

214

0

3

0

3

0

6

454

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Tift County - 137

17.2 73.8
2.2 39.4
1.6 6.9 0.2 81.3 3.7
105.0 31.1 93.3 75.0
8.2 85.7
*
11.6 8.3 *
21.3 * *
8.5 1.2
* 11.3
* 0.8
38.0 24.0 38.8
1.2 19.7
2.2 11.0
. . .
74.5 16.7 11.1 53.4 44.9 35.6
.

17.8 76.4
2.2 40.3
1.4 6.0 0.2 69.9 2.9
97.3 31.3 85.6 61.6
9.4 100.0
*
14.3 *
8.0 18.8
* *
10.8 1.9 *
12.6 1.0 *
37.0 20.1 38.0
1.1 19.2
1.5 8.9
1.0 *
7.9
69.5 13.2
* 54.9 48.5 38.6 11.0

16.5 71.5 2.1 42.1 1.4 6.2 0.2 78.1 1.3
114.2 25.8
104.8 66.3 8.2 85.7 *
16.9 11.8
* 13.5
* *
9.5 1.0
* 13.3
1.9 2.7
39.3 19.8 38.3
* 19.1
1.6 12.9
2.5 2.0 8.3
66.7 12.3 15.3 54.0 56.9 43.8 16.4

16.6 72.3
2.1 47.2
1.0 4.5 0.1
. *
117.1 22.2
114.7 74.0 * * *
13.3 11.6
* . * *
11.1 1.3 *
13.2 1.3 2.3
41.7 23.6 39.1
1.3 14.2
* 11.4
2.1 2.3 10.7
65.5 12.3 16.7 56.3 66.1 48.7 23.8

17.4 75.8 2.2 43.0 1.0 4.5 0.1 55.4 1.7
116.4 22.4
108.1 87.8 8.3 85.7 *
* * * 14.1 * *
9.3 1.1
* 10.5
1.0 1.7
36.8 18.5 39.7 1.6 14.8 0.8 9.7
3.3 2.7 14.1
70.2 12.7 19.7 52.2 60.7 43.2 29.3

17.1 73.9
2.2 42.4
1.3 5.6 0.2 68.6 1.9
110.0 26.3 101.3 73.4
7.5 90.6
2.1
12.4 8.5 4.0
15.9 1.0 0.5
9.8 1.3
* 12.1
1.1 1.5
38.5 21.2 38.8
1.2 17.4
1.2 10.7
2.2 1.8 10.3
69.3 13.4 13.3 54.2 55.4 41.9 20.1

15.1 66.7
2.0 20.6
1.7 7.5 0.2 97.2 2.5

15.9 70.7
2.1 21.0
1.4 6.0 0.2 77.1 1.6

82.0 26.7 69.2 50.0 10.9 83.3
*

82.8 24.4 73.6 35.0
9.2 100.0
*

*

*

*

*

*

*

20.9

*

*

*

*

*

5.3

6.0

*

*

*

*

7.2

8.4

*

*

*

*

32.4 11.8 35.8
* 24.5
* 8.6

34.6 12.7 34.4
* 24.6
* 5.2

.

*

.

*

.

3.7

78.2 19.4 14.8 42.2 35.0 27.3
.

75.6 12.8
* 45.3 37.0 29.9
8.4

14.6 65.6 2.0 21.8 1.4 6.2 0.2 86.0
*
92.9 22.0 81.8 38.6 11.2 83.3
*
19.0 * * * * *
7.9 * *
11.3 1.9 2.2
36.7 9.4 36.4
* 24.2
* 8.7
1.1 2.7 7.0
71.5 13.1 12.2 43.9 44.2 33.7 14.4

14.1 63.7
1.9 25.6
1.1 5.0 0.1
. *
78.8 21.4 76.9 45.0
* * *
* * * * * *
8.1 * *
9.6 *
1.7
38.8 12.1 37.2
* 19.3
* 9.9
2.2 2.9 7.8
72.5 12.7 18.8 43.9 52.1 36.3 20.6

15.0 68.3 2.1 23.4 1.0 4.4 0.1 60.0 1.4
66.4 22.9 56.9 76.7
* * *
* * * 12.9 * *
7.3 * *
8.7 *
1.8
34.5 8.7
32.6 *
20.2 *
8.5
3.0 2.4 8.6
74.3 15.3 14.6 42.0 47.5 33.6 28.9

14.9 67.0
2.0 22.4
1.3 5.8 0.2 78.7 1.2
80.6 23.5 71.7 47.4
8.5 87.0
*
8.5 5.8 2.7 11.6 0.7 0.3
6.9 0.5
* 9.0 1.0 1.2
35.4 10.9 35.2
0.5 22.6
0.4 8.1
1.7 2.1 6.8
74.5 14.7 12.8 43.5 43.0 32.1 18.0

23.7 92.8
2.5 72.1
1.5 5.9 0.2 55.6 6.7

24.0 94.4
2.6 74.9
1.2 4.6 0.1 43.5 6.2

22.8 90.2 2.4 76.2 1.7 6.6 0.2 66.1 3.3

24.6 98.0
2.7 79.9
0.6 2.5 0.1
. *

24.7 98.7 2.7 75.2 1.1 4.5 0.1 42.6 2.5

23.9 94.8
2.6 75.7
1.2 4.8 0.1 46.4 3.7

154.6 35.6 144.3 97.6
* * *

124.3 41.7
113.9 93.9 * * *

163.0 29.8
156.1 93.3 * * *

198.5 22.8
195.0 94.6 * * *

220.4 22.2
213.4 93.3 * * *

172.0 29.0
164.4 94.5 4.9 100.0 4.9

27.0 * *
22.4 * *

26.4 * *
38.5 * *

* * * 22.8 * *

21.0 * * * * *

*

19.2

*

13.1

*

6.2

*

23.4

*

1.6

*

0.9

14.0 2.7 *
18.0 * *

19.4 4.8 *
20.2 * *

12.4 2.3
* 16.8
* 3.7

15.5 2.1 *
18.8 *
3.4

12.9 * *
13.9 * *

14.8 2.7 *
17.5 1.2 2.0

47.2 45.0 43.9
2.7 12.2
4.5 14.8

41.5 33.6 44.8
2.3 9.9 3.6 14.6

43.2 37.4 41.6
* 10.3
2.8 19.1

46.5 40.6 42.3
2.1 6.8
* 14.0

41.1 34.9 51.7 2.5 6.7 2.1 12.0

43.9 38.3 44.9
2.3 9.1 2.7 14.9

.

1.9

.

*

.

14.6

4.9

1.9

3.7

3.1

*

1.4

3.5

1.5

8.2

14.9

21.4

14.8

68.5 11.7
* 72.5 61.3 49.5
.

58.7 14.1
* 72.2 69.1 54.7 15.7

58.5 10.7 19.4 72.0 78.5 61.7 20.1

55.5 11.4
* 75.2 86.8 67.5 28.2

63.6

60.9

9.2

11.4

30.0

13.8

68.1

72.0

81.5

75.6

58.0

58.4

29.4

23.5

455

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Toombs County - 138

1990
24072 5457 569
20.1 17.8 21.0
71 14 441 54 141 22
6 76 15
4 2 2 9 1 2
39 8 0
58 6 2
147 77 149
5 67 13 25
. . .
314 56
3 222 191 156
. 0

1991
24315 5473 570
20.3 21.9 21.5
71 17 436 61 173 29
7 54
6
9 6 3 12 0 3
32 5 1
43 6 6
139 94
153 0
46 7
20
7 13 96
294 65 9
269 239 208
94 0

Total
1992 1993

24560 5485 570

24808 5501 571

19.9 18.0 20.0

19.7 19.1 22.0

65

79

19

19

452

439

53

66

193

199

27

42

3

4

55

57

11

9

1

5

1

3

0

2

4

7

0

0

3

2

39

41

6

6

0

2

43

39

8

1

5

5

126

115

105

96

149

142

5

6

46

39

2

2

27

23

22

7

26

20

239

149

239

250

75

73

3

1

279

277

273

287

225

237

201

194

0

0

1994 5-year

25055 5514 571

122810 27430 2851

19.8 18.2 21.0

19.9 18.7 21.0

57

343

9

78

364

2132

50

284

158

864

28

148

1

21

43

285

7

48

6

25

4

16

2

9

5

37

1

2

2

12

34

185

7

32

0

3

45

228

3

24

4

22

116

643

81

453

143

736

4

20

31

229

1

25

24

119

20

56

28

87

196

680

236

1333

66

335

1

17

231

1278

237

1227

201

1027

186

675

4

4

1990
17596 3912 362

1991
17728 3909 364

White
1992 1993

17860 3904 366

17995 3901 367

1994 5-year

18129 3896 369

89308 19522
1828

21.5 18.4 20.0

21.4 23.9 21.0

20.2 17.3 20.0

20.3 19.1 22.0

20.7 18.0 21.0

20.7 18.9 21.0

30

30

31

42

26

159

3

5

7

5

4

24

295

284

294

289

236

1398

21

25

24

34

21

125

45

61

79

78

61

324

13

19

19

24

16

91

1

2

2

1

0

6

49

41

37

39

24

190

9

4

7

6

5

31

4

2

1

3

5

15

2

2

1

1

4

10

2

0

0

2

1

5

4

4

3

2

4

17

1

0

0

0

1

2

2

2

2

2

1

9

26

15

17

17

17

92

2

0

2

2

3

9

0

0

0

0

0

0

38

26

23

19

26

132

5

5

5

1

1

17

1

3

1

2

2

9

94

86

73

61

71

385

22

36

37

34

23

152

92

91

94

91

79

447

2

0

3

3

4

12

49

37

41

31

22

180

5

4

0

2

1

12

9

8

13

10

13

53

.

3

13

2

11

29

.

5

13

17

20

55

.

28

108

71

90

297

222

209

175

187

168

961

37

44

54

58

44

237

2

5

2

1

1

11

123

143

164

158

124

712

92

121

146

159

132

650

79

106

125

131

107

548

.

46

107

108

101

362

0

0

0

0

3

3

1990
5637 1360
184

1991
5694 1363 184

Black
1992 1993

5751 1365
184

5809 1368 185

1994 5-year

5867 1370
185

28759 6826 922

17.8 16.3 25.0

18.1 19.7 24.0

18.6 18.0 22.0

18.5 17.8 24.0

17.9 19.6 23.0

18.3 17.8 24.0

41

41

34

37

31

184

11

12

12

14

5

54

142

150

156

147

126

721

33

36

29

32

29

159

96

111

114

121

97

539

9

10

8

17

12

56

5

5

1

3

1

15

27

12

17

18

19

93

6

2

4

3

2

17

0

7

0

2

1

10

0

4

0

2

0

6

0

3

0

0

1

4

5

8

1

5

1

20

0

0

0

0

0

0

0

1

1

0

1

3

12

16

22

24

17

91

6

5

4

4

4

23

0

1

0

2

0

3

20

17

20

19

19

95

1

1

3

0

2

7

1

3

4

2

2

12

52

52

53

54

45

256

55

58

68

61

58

300

57

62

55

50

63

287

3

0

2

2

0

7

18

8

5

8

9

48

8

3

2

0

0

13

16

12

14

13

11

66

.

4

8

4

8

24

.

8

10

1

7

26

.

56

104

69

95

324

88

84

62

62

67

363

18

19

21

14

22

94

1

4

1

0

0

6

99

124

114

117

107

561

98

116

126

126

104

570

77

100

99

104

94

474

.

48

93

85

85

311

0

0

0

0

1

1

456

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Toombs County - 138

18.3 80.8
2.5 32.4
3.2 13.9
0.4 139.4
5.1
124.8 19.7 94.9 75.5 26.4 100.0
8.8
* * * 20.1 * *
8.8 1.8
* 13.3
1.4 *
36.9 17.7 34.6
1.2 15.5
3.0 9.9
. . .
71.7 13.8
* 51.0 43.9 35.9
.

17.9 79.7
2.4 40.2
2.2 9.9 0.3 101.7 7.5
124.6 23.9
107.1 77.0 10.5
100.0 8.8
20.6 13.8
* 27.1
* *
7.4 1.1
* 10.0
1.4 1.4
37.7 21.9 35.8
* 10.7
1.6 8.8
1.0 1.8 13.4
73.0 16.8 20.9 62.6 55.6 48.4 21.9

18.4 82.4 2.5 43.5 2.2 10.0 0.3 102.0
5.8
114.0 29.2 92.9 75.0 19.3
100.0 *
* * * * * *
8.6 1.3
* 9.7 1.8 1.1
37.0 23.6 33.7 1.3 10.4
* 10.6
3.0 3.6 33.1
63.2 19.0
* 62.8 61.5 50.7 45.3

17.7 79.8
2.4 45.5
2.3 10.4
0.3 105.0
8.5
138.4 24.1
115.6 77.3 15.8
100.0 8.8
11.4 * *
15.8 * *
9.3 1.4
* 8.9
* 1.1
36.5 21.9 32.6
1.5 9.0
* 9.3
1.0 2.7 20.5
61.3 18.2
* 63.2 65.5 54.1 44.3

14.5 66.0 2.0 43.8 1.7 7.8 0.2 98.2
5.6
99.8 15.8 87.5 82.0 12.3 100.0
*
16.5 * *
13.7 * *
9.3 1.9
* 12.5
* *
33.8 22.4 39.7
* 8.6
* 12.3
2.7 3.8 26.7
65.2 20.4
* 64.0 65.7 55.7 51.5

17.4 77.7
2.4 41.0
2.3 10.4
0.3 109.8
6.5
120.3 22.7 99.6 77.3 16.8 100.0
6.7
11.7 7.5 4.3
17.2 *
0.5
8.7 1.5
* 10.8
1.1 1.0
36.4 21.5 35.1
1.0 10.9
1.2 10.1
1.9 3.0 23.5
67.0 17.5
8.6 60.6 58.2 48.7 40.3

16.8 75.4
2.4 15.5
2.8 12.5
0.4 136.9
3.6

16.0 72.7
2.3 21.9
2.3 10.5
0.3 117.5
6.1

16.5 75.3 2.4 27.3 2.1 9.5 0.3 104.8
5.6

16.1 74.1
2.4 27.1
2.2 10.0
0.3 110.2
6.7

13.0 60.6 2.0 26.0 1.3
6.2 0.2 86.3 4.6

15.7 71.6
2.3 23.5
2.1 9.7 0.3 112.3 5.3

82.9 *
58.0 40.0 24.9 100.0
*

82.5 16.7 68.7 48.0
* * *

84.8 22.6 65.6 50.0 19.1 100.0
*

114.3 11.9 92.6 61.8 16.3
100.0 *

70.4 *
56.9 57.1 13.5 100.0
*

87.0 15.1 68.4 52.4 17.0 100.0
3.8

*

*

*

*

21.2

10.7

*

*

*

*

*

7.2

*

*

*

*

*

3.6

*

*

*

*

*

12.1

*

*

*

*

*

*

*

*

*

*

*

0.5

8.8

5.3

5.8

5.9

7.2

6.6

*

*

*

*

*

0.6

*

*

*

*

*

*

13.1

9.3

8.0

6.6

11.1

9.6

1.7

1.8

1.7

*

*

1.2

*

*

*

*

*

0.6

34.7 7.6
32.2 *
16.9 1.7 5.6

35.0 12.9 32.9
* 13.4
* 5.2

31.5 12.8 32.6
* 14.3
* 8.1

29.6 11.8 31.6
* 10.8
* 6.6

32.3 9.8
33.8 *
9.4 *
10.7

32.8 11.0 32.6
0.9 13.1
0.9 7.1

.

*

2.8

*

2.3

1.6

.

1.1

2.8

3.6

4.2

2.9

.

6.1

23.2

15.2

19.1

15.9

75.8 13.9
* 42.4 31.7 27.2
.

78.6 17.5 18.5 51.3 43.4 38.0 16.5

67.8 21.0
* 56.7 50.5 43.3 37.0

68.8 21.6
* 54.9 55.2 45.5 37.5

71.5 20.7
* 52.8 56.2 45.5 43.0

72.6 18.9
8.9 51.6 47.1 39.7 33.2

25.2 104.4
2.9 68.1
4.8 19.9
0.5 147.5
10.3

26.3 110.1
3.0 74.5
2.1 8.8 0.2 67.0 12.5

27.1 114.3
3.1 74.5 3.0 12.5 0.3 92.9 7.3

25.3 107.5
3.0 82.3
3.1 13.2
0.3 97.3 14.6

21.5 92.0 2.5 78.2 3.2 13.9 0.4 120.3 9.5

25.1 105.6
2.9 75.5
3.2 13.6
0.4 104.7 10.8

222.8 26.8 179.3 97.0 32.6 100.0
*

222.6 29.3
195.4 97.2 * * *

184.4 35.3
157.3 96.4 * * *

200.4 37.8
173.3 93.8 * * *

167.7 16.1
156.9 100.0
* * *

199.6 29.3
172.5 96.8 18.4 100.0 13.0

* * * 34.0 * *

46.7 * *
51.6 * *

*

*

*

*

*

*

*

33.3

*

*

*

*

*

13.9

*

8.3

*

*

*

27.2

*

*

*

*

8.5 4.2
* 14.2
* *

10.7 3.4 *
11.4 * *

14.1 * *
13.1 * *

16.3 * *
12.9 * *

13.5 * *
15.3 * *

12.6 3.2 *
13.3 1.0 1.7

41.9 39.0 40.4
* 13.0
5.8 17.8

43.0 38.9 41.9
* 5.4
* 16.4

49.1 44.4 36.2
* 3.3
* 15.1

50.0 41.5 34.2
* 5.4
* 14.0

37.2 46.8 50.8
* 7.3
* 15.1

44.0 42.0 40.4
1.1 6.8 1.8 15.6

.

*

3.7

*

3.6

2.7

.

3.7

4.6

*

3.2

3.0

.

25.9

47.6

31.3

42.8

36.9

62.4 13.4
* 70.2 69.5 54.6
.

61.8 14.3
* 83.2 77.9 67.1 32.2

52.5 15.4
* 74.5 82.4 64.7 60.8

46.3 10.9
* 79.6 85.7 70.7 57.8

53.2

55.4

20.2

14.7

*

8.2

86.3

78.6

83.9

79.8

75.8

66.4

68.5

54.3

457

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Towns County - 139

1990
6754 1297
114
19.5 19.7 19.0
7 0 53 7 8 11 2 12 0
1 1 0 2 0 1
3 0 0 4 0 0
7 3 17 0 8 0 0
. . .
45 7 0
35 19 16
. 0

1991
6952 1311 114
19.1 19.1 20.0
12 2
60 11
9 5 0 10 1
0 0 0 0 0 0
5 0 0 2 1 0
11 5
22 0 5 0 1
3 2 9
51 11
1 48 28 26 12
0

Total
1992 1993

7154 1326
114

7348 1340 113

22.0 25.5 22.0

21.2 18.8 20.0

4

6

0

0

58

67

3

5

7

9

3

7

0

2

17

19

1

1

1

1

1

1

0

0

1

3

0

0

1

1

5

7

1

1

0

0

4

3

0

1

2

1

14

15

5

4

12

16

0

0

9

10

1

0

1

1

3

7

3

0

15

18

52

60

4

4

1

3

39

46

29

41

27

39

8

2

0

0

1994 5-year

7545 1354
113

35753 6628 567

24.0 19.9 18.5

21.2 19.6 20.0

4

33

1

3

56

294

3

29

10

43

3

29

0

4

10

68

1

4

0

3

0

3

0

0

0

6

0

0

0

3

1

21

0

2

0

0

1

14

0

2

1

4

16

63

6

23

10

77

0

0

3

35

0

1

1

4

5

18

9

14

4

46

49

257

6

32

0

5

33

201

28

145

25

133

1

23

0

0

1990
6734 1291
114

1991
6932 1305 114

White
1992 1993

7134 1320
114

7330 1334 113

1994 5-year

7527 1348
113

35657 6598 567

19.5 19.6 18.0

19.1 19.1 20.0

22.0 25.5 22.0

21.2 18.8 20.0

24.1 19.9 18.0

21.2 19.4 20.0

7

12

4

6

4

33

0

2

0

0

1

3

53

60

58

65

54

290

7

11

3

5

3

29

8

9

7

9

9

42

11

5

3

7

3

29

2

0

0

2

0

4

10

10

17

19

10

66

0

1

1

1

1

4

1

0

1

1

0

3

1

0

1

1

0

3

0

0

0

0

0

0

2

0

1

3

0

6

0

0

0

0

0

0

1

0

1

1

0

3

3

5

5

7

1

21

0

0

1

1

0

2

0

0

0

0

0

0

4

2

4

3

1

14

0

1

0

1

0

2

0

0

2

1

1

4

7

11

14

14

16

62

3

5

5

4

5

22

17

22

12

15

9

75

0

0

0

0

0

0

8

5

9

10

3

35

0

0

1

0

0

1

0

1

1

1

1

4

.

3

2

7

5

17

.

2

1

0

9

12

.

9

13

16

4

42

45

51

52

59

48

255

7

11

4

4

6

32

0

1

1

2

0

4

35

48

39

45

32

199

19

28

29

40

27

143

16

26

27

38

24

131

.

12

8

2

1

23

0

0

0

0

0

0

1990
0 0 0

1991
0 0 0

Black
1992 1993

0

0

0

0

0

0

1994 5-year

0

0

0

0

0

0

.

.

.

.

.

.

.

.

.

.

.

.

28.0

.

.

.

19.0

23.5

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

0

0

0

0

0

0

458

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Towns County - 139

7.8 40.9
1.2 15.1
1.8 9.3 0.2 153.8 10.0
61.4 *
61.4 * * * *
* * * * * *
* * * * * *
21.2 *
32.1 *
18.6 * *
. . .
84.9 14.6
* 66.0 35.8 30.2
.

8.6 45.8
1.3 15.3
1.4 7.6 0.2 133.3 3.8
105.6 *
96.8 * * * *
* * * * * *
8.3 * * * * *
31.4 8.5
37.3 *
9.8 * *
* * 7.6
86.4 19.6
* 81.4 47.5 44.1 20.3

8.1 43.7 1.4 12.1 2.4 12.8 0.4 215.2
*
* * * * * * *
* * * * * *
8.6 * * * * *
35.9 8.6
20.7 *
18.0 * *
* * 12.4
89.7 * *
67.2 50.0 46.6 13.8

9.1 50.0
1.6 13.8
2.6 14.2
0.3 200.0
6.7
53.0 *
44.1 * * * *
* * * * * *
10.6 * * * * *
34.9 *
24.6 *
15.9 * *
5.7 *
14.7
90.9 * *
70.8 63.1 60.0
*

7.4 41.4 1.3 17.9 1.3 7.4 0.2 144.9
*
* * * * * * *
* * * * * *
* * * * * *
34.0 10.7 17.9
* * * *
4.0 7.3
*
87.5 11.1
* 58.9 50.0 44.6
*

8.2 44.4
1.4 14.8
1.9 10.3
0.3 171.7
5.1
58.2 *
51.1 20.7
* * *
* * * 20.1 * *
7.2 * *
4.8 * *
32.0 7.9
26.5 *
13.6 * *
3.7 2.9 9.5
88.0 11.8 25.0 69.1 49.8 45.7
9.7

7.9 41.1
1.2 15.1
1.5 7.7 0.2 131.6 10.1

8.7 46.0
1.4 15.3
1.4 7.7 0.2 133.3 3.8

8.1 43.9 1.4 12.1 2.4 12.9 0.4 215.2
*

8.9 48.7
1.6 14.1
2.6 14.2
0.3 204.3
6.7

7.2 40.1 1.3 16.7 1.3 7.4 0.2 149.3
*

8.1 44.0
1.4 14.6
1.9 10.0
0.3 169.2
5.2

61.4 *
61.4 * * * *

105.6 *
96.8 * * * *

*

53.0

*

*

*

44.1

*

*

*

*

*

*

*

*

*

58.2

*

*

*

51.1

*

20.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

20.4

*

*

*

*

*

*

*

*

*

*

*

*

*

8.3

8.6

10.8

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

7.2

*

*

*

*

*

4.9

*

*

*

*

21.2 *
32.1 *
18.6 * *

31.4 8.5
37.3 *
9.8 * *

35.9 8.6 20.7
* 18.0
* *

33.3 *
23.4 *
16.1 * *

34.8 9.3 16.7
* * * *

31.8 7.6
26.0 *
13.7 * *

.

*

*

5.7

4.0

3.5

.

*

*

*

7.3

2.5

.

7.6

10.8

13.1

*

8.6

84.9 14.6
* 66.0 35.8 30.2
.

86.4 19.6
* 81.4 47.5 44.1 20.3

89.7 * *
67.2 50.0 46.6 13.8

90.8 * *
70.3 62.5 59.4
*

88.9 11.5
* 59.3 50.0 44.4
*

88.2 11.9
* 69.1 49.7 45.5
9.8

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

459

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Treutlen County - 140

1990
5994 1296
155
19.3 17.9 20.5
19 3
95 16 35
6 1 6 2
2 0 2 1 0 1
4 1 0 5 0 3
24 24 34
2 17
3 11
. . .
71 14
1 68 59 54
. 0

1991
6040 1301 154
20.5 17.5 19.0
23 6
95 13 35
5 3 10 6
1 0 1 3 0 0
3 1 0 6 0 1
15 22 39
1 11
0 6
0 0 11
69 14
0 83 63 61 37
1

Total
1992 1993

6076 1307
153

6115 1311 151

19.2 19.7 20.0

18.7 17.0 20.0

15

16

3

2

90

85

13

13

36

30

11

5

0

0

9

12

1

3

0

3

0

3

0

0

0

3

0

0

0

0

6

8

0

2

0

0

4

6

1

1

3

4

17

11

22

16

34

30

0

2

12

6

1

0

6

5

6

2

3

8

19

20

76

64

14

11

0

0

68

63

67

61

61

55

59

40

0

0

1994 5-year

6154 1317
150

30379 6532 763

21.2 18.7 21.0

19.9 17.9 20.0

13

86

3

17

83

448

10

65

27

163

1

28

1

5

13

50

3

15

2

8

0

3

2

5

1

8

0

0

3

4

6

27

2

6

0

0

6

27

1

3

0

11

18

85

14

98

32

169

0

5

14

60

0

4

5

33

2

10

0

11

23

73

78

358

21

74

1

2

66

348

61

311

56

287

48

184

0

1

1990
4001 776 74

1991
4027 778
75

White
1992 1993

4043 779 75

4066 781
76

1994 5-year

4087 783 76

20224 3897 376

20.1 17.9 19.0

20.8 17.6 18.0

19.5 19.9 20.0

19.3 16.8 19.0

20.1 21.3 20.0

20.0 17.9 19.0

8

16

7

8

9

48

1

3

1

2

2

9

47

52

50

49

57

255

7

9

6

6

9

37

5

5

8

7

11

36

4

3

4

2

1

14

0

1

0

0

1

2

2

7

6

5

5

25

1

4

1

2

0

8

0

1

0

2

2

5

0

0

0

2

0

2

0

1

0

0

2

3

0

1

0

2

1

4

0

0

0

0

0

0

0

0

0

0

1

1

1

1

3

4

4

13

0

0

0

0

2

2

0

0

0

0

0

0

2

1

2

3

5

13

0

0

1

0

1

2

0

0

3

2

0

5

7

8

7

6

13

41

2

2

6

1

4

15

17

21

19

18

25

100

0

0

0

1

0

1

7

9

10

6

11

43

0

0

1

0

0

1

4

1

5

3

3

16

.

0

4

2

1

7

.

0

2

7

0

9

.

1

8

4

3

16

35

43

45

45

52

220

10

9

10

4

13

46

1

0

0

0

1

2

26

43

34

30

43

176

26

30

33

27

39

155

21

30

30

23

35

139

.

16

31

19

27

93

0

1

0

0

0

1

1990
1984 518 81

1991
1999 520
80

Black
1992 1993

2011 523 80

2024 524
79

1994 5-year

2037 527 78

10055 2612 398

19.2 19.7 26.0

20.5 15.7 26.0

19.2 19.4 21.0

18.4 17.7 23.0

24.1 17.8 23.0

19.4 17.8 24.0

11

7

8

8

4

38

2

3

2

0

1

8

48

43

40

36

26

193

9

4

7

7

1

28

30

30

28

23

16

127

2

2

7

3

0

14

1

2

0

0

0

3

4

3

3

7

8

25

1

2

0

1

3

7

2

0

0

1

0

3

0

0

0

1

0

1

2

0

0

0

0

2

1

2

0

1

0

4

0

0

0

0

0

0

1

0

0

0

2

3

3

2

3

4

2

14

1

1

0

2

0

4

0

0

0

0

0

0

3

5

2

3

1

14

0

0

0

1

0

1

3

1

0

2

0

6

17

7

10

5

5

44

22

20

16

15

10

83

17

18

15

12

7

69

2

1

0

1

0

4

10

2

2

0

3

17

3

0

0

0

0

3

7

5

1

2

2

17

.

0

2

0

1

3

.

0

1

1

0

2

.

10

10

14

18

52

36

26

31

19

26

138

4

5

4

7

8

28

0

0

0

0

0

0

42

40

34

33

23

172

33

33

34

34

22

156

33

31

31

32

21

148

.

21

28

21

21

91

0

0

0

0

0

0

460

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

15.8

15.7

General fertility rate

73.3

73.0

Total fertility rate

2.2

2.2

% Livebirths to unmarried women

36.8

36.8

Crude abortion rate

1.0

1.7

General abortion rate

4.6

7.7

Total abortion rate

0.1

0.2

Abortion ratio

55.0

87.0

Fetal Death rate

6.2

7.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

122.6 149.4

% Repeat conceptions to women under 18

*

26.1

Livebirths to women under 18

103.2

84.5

% Livebirths to unmarried women under 18

68.8

46.2

Induced abortions to women under 18

*

39.0

% Abortions to unmarried women under 18

* 100.0

Fetal deaths to women under 18

*

*

Infant and child survival rates

Infant mortality

*

*

Neonatal mortality

*

*

Postneonatal mortality

*

*

Perinatal mortality ratio

*

*

Deaths of children 1-4 yrs

*

*

Deaths of children 5-17 yrs

*

*

Infant health rates

% Low birthweight

*

*

% Very low birthweight

*

*

% Under 500 grams

*

*

% Preterm gestation

5.3

6.3

% Multiple gestation

*

*

% Birth defect

*

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

42.1

26.3

% with father not named on birth certificate

25.3

23.2

% with maternal education less than high school

36.2

41.1

% No prenatal care

*

*

% Maternal smoking during pregnancy

17.9

11.6

% Maternal alcohol use during pregnancy

*

*

% Interpregnancy interval less than 6 months

20.8

12.2

Child abuse and neglect rates

Physical

.

*

Sexual

.

*

Neglect

.

6.4

Interventions to improve infant & child survival

% Prenatal care first trimester

75.5

74.2

% Primary C-section delivery

16.1

16.3

% Vaginal birth after previous C-section

*

*

% WIC during pregnancy

71.6

87.4

% Medicaid during pregnancy

62.1

66.3

% Medicaid and WIC during pregnancy

56.8

64.2

% Perinatal case management

.

38.9

Treutlen County - 140

14.8 68.9 2.0 40.4 1.5
6.9 0.2 81.8 8.4

13.9 64.8
1.9 35.7
2.0 9.2 0.2 116.5 4.6

13.5 63.0 1.8 32.5 2.1
9.9 0.3 132.7
*

14.7 68.6
2.0 36.5
1.6 7.7 0.2 93.5 5.7

98.2 *
85.1 69.2
* * *

106.0 *
86.1 84.6
* * *

86.7 *
66.7 * * * *

112.8 19.8 85.2 63.1 19.7 100.0 10.5

*

*

*

17.9

*

*

*

*

*

*

*

11.2

*

*

*

17.7

*

*

*

*

*

*

*

*

6.7

9.4

7.2

6.0

*

*

*

1.3

*

*

*

*

*

7.1

7.2

6.1

*

*

*

*

*

*

*

2.5

30.9 24.7 38.2
* 13.5
* 10.3

22.9 19.0 35.7
* 7.1
* 10.4

32.7 16.9 38.6
* 16.9
* 10.9

31.3 22.0 38.0
1.1 13.5
* 13.0

3.5 *
11.1

* 4.7 11.7

* * 13.4

1.5 1.6 10.6

84.4 17.3
* 76.4 75.3 68.5 66.3

76.2 15.1
* 75.0 72.6 65.5 47.6

95.1 28.8
* 79.5 73.5 67.5 57.8

80.8 18.5
* 78.0 69.7 64.3 52.4

11.7 60.6
1.9 10.6
* * * * 6.4

12.9 66.8
2.1 9.6 1.7 9.0 0.3 109.4 6.4

12.4 64.2 2.0 16.3 1.5
7.7 0.2 100.0
*

12.1 62.7
1.9 14.3
1.2 6.4 0.2 87.7
*

13.9 72.8 2.2 19.3 1.2
6.4 0.2 78.1
*

12.6 65.4
2.0 14.2
1.2 6.4 0.2 83.6 4.9

108.1 *
94.6 * * * *

214.5 *
120.6 * * * *

93.2 *
79.9 * * * *

105.7 *
79.3 * * * *

118.1 *
118.1 * * * *

127.8 18.8 98.5 37.8 21.3 100.0 13.3

*

*

*

*

*

19.6

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

5.1

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

8.8

5.1

*

*

*

*

*

*

*

*

*

*

*

2.0

25.0 *
36.2 *
14.9 * *

26.7 *
40.4 *
17.3 * *

21.9 12.2 38.8
* 20.4
* 16.1

21.4 *
36.7 *
12.2 * *

33.3 *
43.9 *
19.3 * *

26.1 5.9
39.4 *
16.9 *
11.4

.

*

*

*

*

1.8

.

*

*

7.0

*

2.3

.

*

8.1

*

*

4.0

76.1 23.3
* 55.3 55.3 44.7
.

84.3 18.8
* 82.7 57.7 57.7 30.8

90.0 22.7
* 69.4 67.3 61.2 63.3

91.8 * *
61.2 55.1 46.9 38.8

92.9 26.5
* 75.4 68.4 61.4 47.4

87.3 20.4
* 69.3 61.0 54.7 44.9

24.2 92.7
2.6 62.5
* * * * *
135.8 *
111.1 100.0
* * *
* * * * * *
* * * * * *
58.6 45.8 36.2
* 20.8
* 24.1
. . .
75.0 * *
87.5 68.8 68.8
.

21.5 82.7
2.2 69.8
* * * * 9.6

19.9 76.5 2.0 70.0
* * * * 13.4

17.8 68.7
1.9 65.7
3.5 13.4
0.3 152.2
*

12.8 49.4 1.5 61.5 3.9 15.2 0.4
. *

19.2 73.9
2.0 66.1
2.5 9.6 0.2 105.9 6.9

87.1 * * * * * *

100.3 *
87.7 100.0
* * *

101.4 *
88.7 100.0
* * *

*

95.4

*

21.1

*

70.3

*

96.4

*

17.6

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

7.3

*

*

*

*

*

*

*

*

*

*

11.6

*

*

*

7.3

*

*

*

*

*

*

*

*

*

3.1

25.9 46.5 41.9
* * * 19.2

43.5 40.0 37.5
* * * *

25.0 42.9 34.3
* * * *

31.3 38.5 26.9
* * * *

38.3 43.2 36.1
* 8.9
* 14.9

* * 14.1

* * 14.1

* * 19.7

* * 25.2

* * 18.3

61.9 13.2
* 93.0 76.7 72.1 48.8

77.5 * *
85.0 85.0 77.5 70.0

54.3 100.0

72.3

21.9

33.3

16.0

*

*

*

94.3

88.5

89.6

97.1

84.6

81.3

91.4

80.8

77.1

60.0

80.8

63.2

461

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Troup County - 141

1990
55536 12914
1274
20.6 19.4 21.0
149 38 1010 111 421 67 19 278 34
14 10
4 29
3 7
98 18
1 109 15 11
135 267 325 16 102 14 53
. . .
760 86
6 386 350 239
. 0

1991
56420 13064
1282
21.0 18.7 21.0
165 39
945 114 367
35 8
272 49
12 8 4
16 4 4
89 19
2 105
11 5
181 217 272
19 100
17 47
15 17 118
701 128
13 499 402 349
29 4

Total
1992 1993

57299 13212
1290

58187 13363
1299

20.7 18.9 22.0

20.5 18.6 22.0

173

159

45

38

997

954

131

127

390

422

52

40

6

4

245

225

35

32

12

20

11

10

1

10

16

14

3

1

5

5

90

101

21

33

4

3

97

108

12

8

3

12

260

246

225

267

286

277

19

15

85

127

10

13

50

45

26

27

21

19

212

159

671

667

161

146

8

10

511

527

488

528

412

439

228

201

2

6

1994 5-year

59064 13513
1307

286506 66066
6452

20.6 19.6 22.0

20.7 19.0 22.0

162

808

43

203

914

4820

122

605

399

1999

35

229

8

45

237

1257

37

187

13

71

8

47

5

24

16

91

0

11

1

22

92

470

25

116

4

14

103

522

11

57

4

35

315

1137

236

1212

246

1406

4

73

93

507

6

60

48

243

20

88

23

80

165

654

716

3515

110

631

21

58

483

2406

488

2256

406

1845

262

720

4

16

1990
38458 8693 814

1991
39098 8797 817

White
1992 1993

39736 8900 821

40379 9006 825

1994 5-year

41015 9110
828

198686 44506
4106

22.1 20.2 21.0

22.6 19.1 20.0

21.4 19.3 21.0

22.0 18.5 21.0

23.2 20.1 21.0

22.1 19.5 21.0

66

60

82

69

63

340

13

10

16

9

16

64

589

562

609

594

555

2909

50

41

62

54

44

251

110

82

108

135

114

549

42

21

27

25

22

137

9

2

3

2

5

21

159

145

122

111

132

669

14

19

18

15

16

82

10

3

4

8

4

29

8

1

3

3

2

17

2

2

1

5

2

12

17

3

6

5

7

38

2

3

2

1

0

8

5

1

3

5

0

14

39

32

42

40

48

201

8

3

9

11

11

42

1

0

1

1

0

3

45

46

45

47

50

233

9

4

7

5

5

30

5

2

3

9

3

22

66

83

141

134

161

585

62

48

62

75

56

303

174

139

148

135

121

717

4

4

10

7

1

26

79

76

69

107

78

409

3

7

6

5

2

23

16

12

16

20

21

85

.

7

18

14

11

50

.

11

16

11

13

51

.

52

83

72

95

302

488

469

459

469

459

2344

60

87

99

92

69

407

4

9

6

4

10

33

151

205

220

242

209

1027

141

160

208

237

223

969

94

138

165

183

172

752

.

10

79

91

119

299

0

2

0

5

1

8

1990
16694 4108 452

1991
16960 4153 455

Black
1992 1993

17224 4198 458

17491 4243 461

1994 5-year

17755 4288 464

86123 20989
2289

19.0 17.0 23.0

18.8 17.7 24.0

19.5 17.7 26.0

18.7 18.6 24.0

19.1 17.6 26.0

19.0 17.7 25.0

83

105

91

90

98

467

25

29

29

29

27

139

420

383

384

357

354

1898

61

73

69

73

77

353

311

285

282

287

282

1447

25

11

25

15

13

89

10

6

3

2

3

24

114

124

112

109

104

563

20

30

17

17

21

105

4

9

8

12

2

7

8

7

2

2

0

5

12

13

10

9

1

1

1

0

2

3

2

0

9

42

6

30

3

12

9

53

0

3

1

8

58

57

48

61

44

268

10

16

12

22

14

74

0

2

3

2

4

11

64

59

52

61

53

289

6

7

5

3

6

27

6

3

0

3

1

13

68

98

118

112

153

549

205

169

163

192

177

906

151

133

138

142

123

687

12

15

9

8

3

47

23

24

16

19

15

97

11

10

4

8

4

37

37

35

34

25

27

158

.

7

6

11

9

33

.

6

3

6

7

22

.

62

124

73

64

323

271

232

210

195

253

1161

26

41

61

54

39

221

2

4

2

6

11

25

235

294

289

284

273

1375

209

242

278

290

264

1283

145

211

245

255

233

1089

.

19

148

109

142

418

0

1

2

1

3

7

462

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Troup County - 141

18.2 78.2
2.3 42.4
5.0 21.5
0.6 201.3
7.2
117.0 25.5 87.1 76.6 26.7 100.0
*
13.9 9.9 *
28.2 *
0.6
9.7 1.8
* 11.0
1.5 1.2
35.7 26.9 33.0
1.6 11.2
1.5 8.8
. . .
75.7 9.3 8.8
38.9 35.2 24.1
.

16.7 72.3
2.2 39.3
4.8 20.8
0.6 215.5
3.4
128.7 23.6 88.9 81.6 38.2 97.8 *
12.7 8.5 *
16.8 * *
9.4 2.0
* 11.3
1.2 0.5
35.3 23.2 29.4
2.1 10.8
1.8 9.5
1.0 1.1 7.5
75.1 15.5 12.3 53.4 43.0 37.4
3.1

17.4 75.5 2.3 39.6 4.3 18.5 0.5 188.3 4.5
134.1 26.0
101.6 73.3 27.1 97.1 5.4
12.0 11.0
* 16.0
* 0.4
9.0 2.1
* 9.8 1.2
*
35.1 22.8 29.1 1.9 8.8 1.0
9.0
1.6 1.3 13.2
67.5 18.0 8.6 51.8 49.5 41.8 23.1

16.4 71.4
2.2 44.7
3.9 16.8
0.5 183.5
3.5
122.4 23.9 97.8 84.3 24.6
100.0 *
21.0 10.5 10.6 14.6
* 0.4
10.6 3.5 *
11.4 0.8 1.3
33.5 28.3 29.4
1.6 14.0
1.4 8.9
1.7 1.2 9.8
70.1 17.2 10.4 55.8 55.9 46.5 21.3

15.5 67.6 2.0 44.2 4.0 17.5 0.5 198.2 3.3
123.9 26.5 93.3 85.1 28.3 97.1 3.8
14.2 8.8 5.5 17.4
* *
10.1 2.7
* 11.4
1.2 *
36.2 26.1 27.3
* 10.6
0.7 9.5
1.2 1.4 10.0
78.6 13.8 20.4 53.5 54.0 45.0 29.0

16.8 73.0
2.2 42.0
4.4 19.0
0.6 197.5
4.4
125.2 25.1 93.8 80.1 29.0 98.3
3.1
14.7 9.8 5.0
18.7 0.6 0.4
9.8 2.4 0.3 11.0 1.2 0.8
35.1 25.5 29.7
1.5 11.0
1.3 9.1
1.4 1.2 10.1
73.3 14.7 12.4 50.5 47.4 38.8 19.1

15.3 67.8
2.1 19.0
4.1 18.3
0.5 198.5
6.1

14.4 63.9
1.9 14.7
3.7 16.5
0.5 198.6
2.6

15.3 68.4 2.1 17.9 3.1 13.7 0.4 160.3 3.4

14.7 66.0
2.0 22.9
2.7 12.3
0.4 151.0
3.3

13.5 60.9 1.9 20.7 3.2 14.5 0.4 184.4 3.2

14.6 65.4
2.0 19.1
3.4 15.0
0.5 178.7
3.7

81.1 19.7 61.4 50.0 17.2 100.0
*

73.4 16.7 50.2 51.2 23.2 94.4
*

99.9 19.5 75.5 48.4 21.9 94.4
*

83.6 13.0 65.5 64.8 18.2 100.0
*

76.1 25.4 53.1 59.1 19.3 93.3
*

82.8 18.8 61.1 54.6 20.0 96.3
2.4

17.0 13.6
* 28.4
* 0.7

*

*

13.5

*

10.0

*

*

*

*

5.8

*

*

8.5

*

4.1

*

9.8

8.4

12.5

13.0

*

*

*

*

0.7

*

*

0.7

*

0.4

6.6

5.7

6.9

6.7

8.6

6.9

1.4

*

1.5

1.9

2.0

1.4

*

*

*

*

*

*

7.8

8.3

7.5

8.0

9.1

8.1

1.6

*

1.2

0.8

0.9

1.0

0.9

*

*

1.6

*

0.8

30.0 10.7 30.3
* 15.1
* 4.8

26.1 8.6
25.1 *
13.7 1.3 4.3

29.8 10.3 24.6 1.7 11.6 1.0
4.9

29.0 12.7 23.0
1.2 18.9
0.9 6.5

30.3 10.2 22.0
* 14.6
* 6.7

29.2 10.5 25.0
0.9 14.8
0.8 5.5

.

0.7

1.8

1.4

1.1

1.2

.

1.1

1.6

1.1

1.3

1.3

.

5.3

8.4

7.1

9.3

7.5

83.4 11.3
* 26.1 24.4 16.2
.

84.4 17.7 13.6 36.7 28.7 24.7
1.8

75.4 18.3 9.7 36.5 34.5 27.4 13.1

79.0 17.5
* 41.1 40.2 31.1 15.4

83.0 14.3 14.5 38.0 40.5 31.3 21.6

80.9 15.8 10.7 35.7 33.7 26.1 13.0

25.2 102.2
2.9 75.5
6.8 27.8
0.8 199.0
9.5

22.6 92.2
2.6 75.8
7.3 29.9
0.8 236.2
4.3

22.3 91.5 2.7 74.4 6.5 26.7 0.7 213.3 6.9

20.4 84.1
2.5 81.5
6.2 25.7
0.7 225.7
4.0

19.9 82.6 2.4 81.0 5.9 24.3 0.7 219.4 3.7

22.0 90.4
2.6 77.5
6.5 26.8
0.8 218.2
5.7

183.6 30.1 135.0 98.4 44.2 100.0
*

230.8 27.6
160.5 98.6 65.9
100.0 *

198.9 31.9
150.8 95.7 37.2
100.0 10.9

195.3 32.2
158.4 98.6 36.9
100.0 *

211.3 27.6
166.1 100.0
45.3 100.0
*

204.0 29.8
154.2 98.3 45.9
100.0 4.4

* * * 27.9 * *

23.5 18.3
* 33.4
* *

20.8 20.8
* 25.8
* *

33.6 19.6 14.3 25.1
* *

25.4 16.9
* 25.2
* *

22.1 15.8
6.4 27.6
* 0.4

13.8 2.4 *
15.5 1.5 1.5

14.9 4.2 *
15.8 1.9 *

12.5 3.1
* 13.7 1.3
*

17.1 6.2 *
17.3 * *

12.4 4.0
* 15.2
1.7 *

14.1 3.9 0.6
15.5 1.4 0.7

43.3 49.6 36.9
2.9 5.9 2.8 13.8

50.3 44.9 35.8
4.0 6.5 2.7 16.2

44.5 43.0 36.5 2.4 4.3
* 15.1

41.3 54.5 40.5
2.3 5.6 2.3 12.6

45.7 50.9 35.5
* 4.4
* 14.3

44.9 48.5 37.0
2.5 5.4 2.0 14.4

.

1.2

1.0

1.8

1.5

1.4

.

1.0

*

1.0

1.1

0.9

.

10.6

20.8

12.0

10.4

13.4

64.8 6.6 *
56.9 50.6 35.1
.

61.5 12.2
* 78.2 64.4 56.1
5.1

55.1 17.5
* 76.3 73.4 64.6 39.1

55.1 17.0 17.6 80.7 82.4 72.4 31.0

71.7

61.7

12.4

12.9

32.4

15.7

78.4

73.6

75.9

68.7

67.0

58.3

40.8

28.7

463

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Turner County - 142

1990
8703 1878
206
18.7 18.7 20.5
29 5
157 28 75
8 2 14 1
2 1 1 3 0 1
25 3 0
23 1 1
63 38 67
2 24
2 12
. . .
116 17
1 98 97 74
. 0

1991
8643 1854 204
19.9 15.8 20.5
25 11 139 21 69
3 3 15 2
1 1 0 4 0 0
19 2 1
21 1 0
62 31 56
1 20
3 11
3 4 13
95 20
2 81 84 60
4 0

Total
1992 1993

8583 1832
201

8519 1805 198

18.6 14.7 20.0

18.7 26.9 21.0

36

35

8

11

154

170

34

35

77

96

5

2

0

0

10

8

2

0

4

4

2

3

2

1

2

3

1

0

2

0

15

12

4

5

1

0

24

23

3

2

2

6

57

52

48

38

66

65

1

1

23

27

4

1

7

12

1

6

25

23

32

29

106

112

17

14

3

1

106

115

104

126

88

101

37

43

2

0

1994 5-year

8456 1781
195

42904 9150 1004

19.4 21.9 22.0

19.0 18.7 21.0

34

159

12

47

161

781

32

150

77

394

5

23

1

6

9

56

1

6

0

11

0

7

0

4

1

13

2

3

2

5

14

85

3

17

0

2

19

110

0

7

6

15

53

287

43

198

74

328

1

6

19

113

1

11

10

52

7

17

7

59

31

105

125

554

14

82

2

9

115

515

113

524

98

421

58

142

4

6

1990
5129 1016
102

1991
5059 991
99

White
1992 1993

4987 966 97

4915 938
93

1994 5-year

4845 913 91

24935 4824 482

21.7 18.9 19.0

21.0 .
20.0

20.2 15.5 20.0

20.6 26.9 20.0

22.3 23.3 21.0

20.8 19.2 20.0

6

4

8

9

7

34

1

1

1

3

2

8

68

62

77

73

73

353

6

4

7

9

7

33

3

12

12

14

11

52

3

1

2

2

2

10

1

1

0

0

1

3

7

6

3

3

4

23

0

0

1

0

0

1

0

0

0

1

0

1

0

0

0

1

0

1

0

0

0

0

0

0

1

1

0

1

1

4

0

0

0

0

0

0

0

0

0

0

0

0

7

3

4

3

6

23

0

0

1

2

2

5

0

0

0

0

0

0

6

5

7

8

8

34

0

0

1

0

0

1

1

0

1

2

3

7

20

23

26

20

15

104

1

3

9

5

6

24

18

17

26

23

26

110

1

0

0

0

1

2

14

14

15

20

15

78

0

0

0

0

0

0

5

6

3

4

0

18

.

0

0

1

2

3

.

2

7

15

4

28

.

0

8

9

14

31

57

53

66

52

60

288

9

10

11

9

9

48

0

0

0

1

2

3

30

28

49

41

41

189

24

25

38

40

39

166

14

18

38

32

33

135

.

1

16

17

24

58

0

0

0

0

0

0

1990
3534 850 104

1991
3510 839 103

Black
1992 1993

3485 829 101

3459 816 100

1994 5-year

3434 805 99

17422 4139 507

17.4 17.2 24.0

18.5 15.8 27.0

17.0 13.9 22.0

17.5 .
23.0

16.8 20.1 22.5

17.3 17.1 24.0

23

21

28

26

27

125

4

10

7

8

10

39

89

77

76

97

87

426

22

17

27

26

25

117

72

57

65

82

66

342

5

2

3

0

3

13

1

2

0

0

0

3

7

9

7

3

5

31

1

2

1

0

1

5

2

1

4

3

0

10

1

1

2

2

0

6

1

0

2

1

0

4

2

3

2

2

0

9

0

0

1

0

2

3

1

0

2

0

2

5

18

16

11

9

8

62

3

2

3

3

1

12

0

1

1

0

0

2

17

16

17

15

11

76

1

1

2

2

0

6

0

0

1

4

3

8

43

39

31

32

37

182

37

28

39

33

37

174

49

39

40

42

48

218

1

1

1

1

0

4

10

6

8

7

4

35

2

3

4

1

1

11

7

5

4

8

10

34

.

3

1

5

5

14

.

2

17

8

3

30

.

13

23

14

17

67

59

42

39

60

65

265

8

10

6

5

5

34

1

2

3

0

0

6

68

53

57

74

74

326

73

59

66

86

74

358

60

42

50

69

65

286

.

3

21

26

34

84

0

0

2

0

4

6

464

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Turner County - 142

18.0 83.6
2.4 48.1
1.6 7.5 0.2 77.3 5.3
140.8 17.2 135.9 77.8
* * *
* * * * * *
15.9 * *
14.7 * *
41.2 24.4 42.9
* 15.4
* 12.6
. . .
73.9 11.9
* 62.8 62.2 47.4
.

16.1 75.0
2.2 50.0
1.7 8.1 0.2 93.8 3.2
122.7 44.0
103.1 95.2 * * *
* * * * * *
13.7 * *
15.2 * *
45.6 22.5 40.6
* 14.5
* 13.3
* * 4.8
68.3 16.0
* 58.7 60.9 43.5
*

17.9 84.1 2.4 51.0 1.2 5.5 0.2 58.8 3.3
179.2 22.2
169.2 81.8 * * *
* * * * * *
9.7 * *
15.9 * *
38.3 31.8 44.0
* 15.2
* 9.2
* 9.4 12.0
68.8 12.5
* 70.2 68.9 58.3 24.5

20.0 94.2
2.7 57.1
0.9 4.4 0.1 44.4
*
176.7 31.4
176.7 85.7 * * *
* * * * * *
7.1 2.9
* 13.7
* 3.5
31.0 22.6 38.7
* 16.1
* 12.5
2.3 8.7 11.0
65.9 8.9 *
68.5 75.0 60.1 25.6

19.0 90.4 2.6 47.8 1.1 5.1 0.2 51.1 3.4
174.2 35.3
163.9 78.1 * * *
* * * * * *
8.7 * *
11.8 *
3.7
33.1 26.7 46.0
* 11.8
* 10.2
2.7 2.7 11.8
77.6 9.6
* 71.4 70.2 60.9 36.0

18.2 85.4
2.5 50.9
1.3 6.1 0.2 64.6 3.3
158.4 29.6 149.4 83.1
6.0 100.0
7.0
14.1 9.0 *
16.5 *
0.5
10.9 2.2 *
14.2 0.9 1.9
37.5 25.6 42.4
0.8 14.6
1.4 11.6
1.6 5.6 9.9
70.9 11.6 13.6 66.5 67.7 54.4 23.0

13.3 66.9
2.1 *
1.4 6.9 0.2 88.6
*
58.8 *
58.8 * * * *
* * * * * *
10.3 * *
8.8 * *
29.9 *
26.5 *
20.6 *
12.2
. . .
83.8 14.8
* 44.1 35.3 20.6
.

12.3 62.6
2.0 19.4
1.2 6.1 0.2 85.7
*
* * * * * * *
* * * * * *
* * * 8.1 * *
37.1 *
27.4 *
22.6 *
18.2
* * *
85.5 18.5
* 45.2 40.3 29.0
*

15.4 79.7 2.6 15.8
* * * * *
82.9 *
72.5 * * * *
* * * * * *
* * * 9.2 * *
34.7 11.8 34.2
* 19.7
* *
* 6.1 7.0
85.7 16.7
* 64.5 50.0 50.0 21.1

14.9 77.8
2.5 19.2
* * * * *
96.6 *
96.6 55.6
* * *
* * * * * *
* * * 11.0 * *
27.4 6.8
31.5 *
27.4 * *
* 13.4
8.0
71.2 13.2
* 56.2 54.8 43.8 23.3

15.1 80.0 2.6 15.1
* * * * *
77.3 *
77.3 * * * *
* * * * * *
8.2 * *
11.0 * *
20.5 8.2 35.6
* 20.5
* *
* * 12.8
82.2 13.8
* 56.2 53.4 45.2 32.9

14.2 73.2
2.4 14.8
0.9 4.8 0.2 59.1 2.7
70.6 23.5 68.5 30.3
* * *
* * * * * *
6.5 1.4
* 9.7
* 2.0
29.7 6.8
31.3 *
22.2 *
9.4
* 6.2 6.9
81.6 15.3
* 53.7 47.2 38.4 20.4

25.2 104.7
2.8 81.8
2.0 8.2 0.2 68.6 7.1

21.9 91.8
2.4 75.0
2.6 10.7
0.3 100.0
*

21.8 91.7 2.4 87.8 2.0 8.4 0.2 80.5
*

28.0 118.8
3.2 86.3
* * * * *

25.3 108.1
2.9 75.9 1.5 6.2 0.2 52.6
*

24.5 102.9
2.7 81.4
1.8 7.5 0.2 65.4 4.1

221.2 *
211.5 100.0
* * *

204.1 47.6
165.2 100.0
* * *

276.1 25.0
266.3 100.0
* * *

260.0 30.8
260.0 96.2 * * *

273.8 37.0
253.5 96.0 * * *

246.6 31.2
230.8 98.3 9.9
100.0 9.9

*

*

*

*

*

23.5

*

*

*

*

*

14.1

*

*

*

*

*

*

*

*

*

*

*

21.0

*

*

*

*

*

*

*

*

*

*

*

0.9

20.2 * *
19.3 * *

20.8 * *
21.1 * *

14.5 * *
23.0 * *

9.3 * *
15.8 * *

9.2 * *
12.6 * *

14.6 2.8 *
18.1 1.4 1.9

50.0 42.0 55.7
* 11.4
* 13.0

52.7 36.8 51.3
* 7.9
* 10.0

42.5 52.7 54.8
* 10.8
* *

33.7 34.7 44.2
* 7.4
* 14.3

43.0 42.5 55.2
* * * 17.2

44.0 41.4 52.0
* 8.3 2.6 13.3

.

*

*

3.4

3.4

2.4

.

*

11.4

5.4

*

5.0

.

8.6

15.4

9.5

11.6

11.3

66.3 9.8 *
77.3 83.0 68.2
.

54.5 14.1
* 69.7 77.6 55.3
*

51.3 8.7
* 77.0 89.2 67.6 28.4

61.9 5.6 *
77.9 90.5 72.6 27.4

74.7

62.2

6.3

8.7

*

21.4

85.1

77.6

85.1

85.2

74.7

68.1

39.1

25.3

465

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Twiggs County - 143

1990
9806 2223
224
20.8 18.8 21.0
21 5
154 14 67
9 4 30 7
1 1 0 5 0 0
18 2 1
21 0 1
51 45 61
3 24
0 10
. . .
121 17
2 106 71 63
. 0

1991
9851 2232 229
21.4 18.9 21.5
18 3
155 14 62 4 0 32 4
1 1 0 1 0 2
17 2 1
17 1 0
51 36 47
4 9 2 8
5 1 21
123 23 3
116 77 73 0 0

Total
1992 1993

9889 2233
233

9929 2242 237

20.3 19.9 22.0

20.0 18.4 21.0

22

18

4

2

142

138

19

15

69

54

1

3

1

1

25

16

3

2

1

2

0

2

1

0

1

3

0

1

0

1

10

15

2

6

0

2

10

17

1

1

2

1

46

41

39

36

58

50

6

2

14

15

2

0

7

4

9

10

11

4

39

24

102

104

22

14

3

4

101

106

76

87

70

80

30

51

2

1

1994 5-year

9964 2247
242

49439 11177
1165

21.2 19.8 21.0

20.6 19.0 21.0

13

92

2

16

134

723

11

73

58

310

4

21

2

8

25

128

2

18

1

6

0

4

1

2

2

12

0

1

0

3

10

70

3

15

0

4

16

81

1

4

0

4

34

223

27

183

35

251

4

19

16

78

0

4

2

31

12

36

8

24

36

120

104

554

23

99

1

13

102

531

82

393

75

361

58

139

0

3

1990
5290 1183
86

1991
5359 1195
89

White
1992 1993

5421 1204
92

5485 1216
95

1994 5-year

5547 1226
98

27102 6024 460

21.0 19.7 20.0

22.0 19.5 21.0

21.5 18.0 21.0

20.3 17.7 20.5

21.4 28.9 19.0

21.2 18.8 20.0

7

7

5

11

5

35

2

2

1

1

0

6

72

72

65

69

72

350

5

5

4

8

4

26

16

11

19

15

12

73

6

3

1

2

1

13

0

0

0

1

0

1

13

12

11

8

7

51

2

2

1

2

1

8

0

0

1

0

0

1

0

0

0

0

0

0

0

0

1

0

0

1

0

0

0

1

0

1

0

0

0

0

0

0

0

2

0

1

0

3

3

4

3

5

5

20

0

0

0

2

1

3

0

0

0

0

0

0

6

8

3

3

7

27

0

0

0

1

0

1

0

0

0

1

0

1

22

17

20

14

16

89

8

4

12

9

5

38

24

21

24

28

19

116

0

0

1

1

1

3

19

7

10

12

15

63

0

1

0

0

0

1

5

3

1

1

0

10

.

0

5

8

6

19

.

0

7

4

6

17

.

9

23

15

18

65

63

67

50

59

67

306

10

14

12

6

15

57

1

1

2

4

0

8

39

45

40

46

48

218

21

24

30

37

36

148

20

23

28

34

33

138

.

0

10

24

25

59

0

0

2

1

0

3

1990
4501 1033
137

1991
4522 1037
140

Black
1992 1993

4539 1038
142

4558 1042 145

1994 5-year

4574 1045
148

22693 5196 713

20.1 16.4 22.0

19.4 18.9 22.0

19.3 20.2 23.0

19.7 19.6 24.0

20.5 19.8 28.0

20.0 19.6 24.0

14

11

17

7

8

57

3

1

3

1

2

10

82

82

77

69

62

372

9

9

15

7

7

47

51

50

50

39

46

236

3

1

0

1

3

8

4

0

1

0

2

7

15

20

14

8

18

75

5

2

2

0

1

10

1

1

0

2

1

5

1

1

0

2

0

4

0

0

0

0

1

1

5

1

1

2

2

11

0

0

0

1

0

1

0

0

0

0

0

0

15

13

2

2

1

1

15

9

0

1

1

0

7

10

2

4

0

2

7

14

1

0

2

0

5

50

2

12

0

4

9

54

1

3

0

3

29

34

26

27

18

134

37

32

27

27

22

145

37

26

34

22

16

135

3

4

5

1

3

16

5

2

4

3

1

15

0

1

2

0

0

3

5

5

6

3

2

21

.

2

3

2

5

12

.

0

0

0

2

2

.

7

14

7

13

41

58

55

52

45

37

247

7

9

10

8

8

42

1

2

1

0

1

5

67

71

61

60

54

313

50

53

46

50

46

245

43

50

42

46

42

223

.

0

20

27

33

80

0

0

0

0

0

0

466

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Twiggs County - 143

15.7 69.3
2.0 43.8
3.1 13.5
0.4 152.3
5.8
93.8 23.8 62.5 78.6 31.3 100.0
*
* * * 31.6 * *
11.7 * *
13.7 * *
35.9 29.4 39.9
* 15.7
* 11.2
. . .
79.6 13.1
* 69.3 46.4 41.2
.

15.7 69.4
2.1 40.3
3.2 14.3
0.4 167.5
*
78.6 *
61.2 78.6
* * *
* * * * * *
11.0 * *
11.0 * *
37.8 23.4 30.5
* 5.8
* 8.8
1.7 *
7.0
81.5 16.7
* 75.3 50.0 47.4
*

14.4 63.6 1.9 48.9 2.5 11.2 0.3 147.9
*
94.6 *
81.7 89.5
* * *
* * * * * *
7.0 * *
7.1 * *
36.8 27.7 41.1 4.3
9.9 *
7.9
3.0 3.7 13.0
72.9 17.2
* 71.6 53.9 49.6 21.3

13.9 61.6
1.9 39.4
1.6 7.1 0.2 101.3
*
75.8 *
63.2 66.7
* * *
* * * * * *
10.9 4.3 *
12.4 * *
35.3 26.3 36.5
* 10.9
* *
3.3 *
8.0
75.4 11.6
* 77.4 63.5 58.4 37.2

13.4 59.6 1.8 43.6 2.5 11.1 0.3 151.5 2.7
53.7 *
45.4 72.7
* * *
* * * * * *
7.5 * *
12.1 * *
27.9 20.3 26.3
* 12.0
* *
4.0 2.7 12.0
77.6 19.3
* 76.7 61.7 56.4 43.6

14.6 64.7
1.9 43.2
2.6 11.5
0.3 145.5
2.6
79.0 17.4 62.7 78.1 15.4 100.0
*
8.3 * *
16.4 * *
9.7 2.1
* 11.3
* *
34.8 25.5 35.0
2.7 10.9
* 7.2
3.0 2.0 10.0
77.5 15.6 15.9 74.0 54.7 50.3 24.6

13.6 60.9
1.9 22.2
2.5 11.0
0.4 142.9
5.1

13.4 60.3
1.9 15.3
2.2 10.0
0.3 137.9
*

12.0 54.0 1.7 29.2 2.0 9.1 0.3 142.9
*

12.6 56.7
1.8 22.1
1.5 6.6 0.2 100.0
*

81.4 *
58.1 * * * *

78.6 *
56.1 * * * *

54.5 * * * * * *

115.9 *
84.3 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

8.3

11.1

*

*

*

*

*

7.2

*

*

*

*

*

*

*

*

*

*

31.0 11.1 33.3
* 26.4
* 13.9

25.8 *
29.2 *
9.7 * *

33.3 18.5 36.9
* 15.4
* *

22.2 13.2 41.2
* 17.6
* *

.

*

3.5

5.5

.

*

4.9

*

.

6.3

16.0

10.3

87.5 17.2
* 54.2 29.2 27.8
.

94.4 22.6
* 62.5 33.3 31.9
*

78.1 21.8
* 61.5 46.2 43.1 15.4

85.5 10.0
* 67.6 54.4 50.0 35.3

13.0 58.7 1.9 16.7 1.3
5.7 0.2 87.5
*

12.9 58.1
1.8 20.9
1.9 8.5 0.3 122.9 2.3

51.0 * * * * * *

76.1 17.1 56.6 38.5 17.4 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

6.9

5.7

*

*

*

*

9.7

7.7

*

*

*

*

23.5 6.9
26.4 *
20.8 * *

27.1 10.9 33.2
* 18.1
* 5.1

4.1

3.3

4.1

2.9

12.3

11.2

93.1 23.8
* 66.7 50.0 45.8 34.7

87.9 19.1 15.7 62.5 42.4 39.5 21.3

18.2 79.4
2.2 63.0
3.3 14.5
0.4 144.2
6.8

18.1 79.0
2.2 61.7
4.4 19.3
0.5 194.2
*

17.0 74.2 2.1 65.8 3.1 13.5 0.4 152.2
*

15.1 66.2
1.9 56.5
1.8 7.7 0.2 102.6
*

13.6 59.3 1.7 75.4 3.9 17.2 0.5 211.8 4.8

16.4 71.6
2.1 64.1
3.3 14.4
0.4 162.3
2.9

102.2 *
65.7 100.0
36.5 100.0
*

78.6 *
64.3 100.0
* * *

119.5 *
105.5 100.0
* * *

48.2 *
48.2 100.0
* * *

54.0 *
47.2 100.0
* * *

80.0 17.5 66.0 100.0 14.0 100.0
*

*

*

*

*

*

13.4

*

*

*

*

*

*

*

*

*

*

*

*

58.1

*

*

*

*

29.0

*

*

*

*

*

*

*

*

*

*

*

*

18.3 * *
18.5 * *

15.9 * *
11.1 * *

9.1

14.5

8.1

13.4

*

*

*

3.2

*

*

*

*

9.2

20.3

15.0

14.7

*

*

*

*

*

*

*

*

40.8 45.7 45.7
* 6.2
* 9.4

50.0 39.5 32.1
* * * 10.2

40.0 35.5 44.7 6.7
* * 14.3

50.9 39.1 31.9
* * * *

33.3 36.1 26.2
* * * *

43.1 39.4 36.7
4.4 4.1
* 9.1

.

*

*

*

3.2

1.9

.

*

*

*

*

*

.

4.4

8.9

4.4

8.2

6.5

72.5 9.7 *
82.7 61.7 53.1
.

69.6 12.0
* 87.7 65.4 61.7
*

68.4 13.7
* 80.3 60.5 55.3 26.3

65.2 13.1
* 87.0 72.5 66.7 39.1

59.7

67.5

14.3

12.5

*

16.1

88.5

85.1

75.4

66.6

68.9

60.6

54.1

27.9

467

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Union County - 144

1990
11993 2285 221
20.0 19.7 19.0
16 1
140 16 19
7 1 18 1
0 0 0 1 0 2
12 3 0
12 1 2
38 10 44
0 16
0 5
. . .
122 26
2 77 49 43
. 0

1991
12233 2285 222
21.0 20.9 20.0
16 3
136 13 28 9 0 16 2
0 0 0 0 1 2
8 1 0 8 0 1
32 7
48 0
28 1 7
2 15 13
121 22 2 88 68 61 23 1

Total
1992 1993

12473 2284 223

12716 2285 225

20.7 22.4 19.0

21.6 22.2 20.5

19

18

3

5

146

126

17

14

23

24

14

16

0

2

17

15

1

1

0

1

0

0

0

1

0

2

1

0

2

0

9

6

1

2

0

0

6

3

3

1

2

0

30

25

12

6

39

41

0

0

15

10

0

0

2

3

9

8

8

4

21

32

131

120

18

22

6

2

91

76

72

67

67

61

26

0

1

1

1994 5-year

12954 2283 226

62369 11422
1118

22.0 19.3 20.0

20.9 21.4 20.0

20

89

3

15

130

678

16

76

24

118

14

60

1

4

14

80

2

7

1

2

1

1

0

1

2

5

0

2

1

7

7

42

2

9

1

1

7

36

1

6

2

7

41

166

13

48

40

212

1

1

16

85

0

1

2

19

8

27

8

35

12

78

119

613

16

104

7

19

81

413

75

331

66

298

2

51

0

3

1990
11925 2270 221

1991
12165 2270 222

White
1992 1993

12403 2269 223

12642 2270 225

1994 5-year

12879 2268 226

62014 11347
1118

20.0 19.7 19.0

21.0 20.9 20.0

20.7 22.4 19.0

21.6 22.2 20.5

22.0 19.3 20.0

20.9 21.4 20.0

16

16

19

18

19

88

1

3

3

5

2

14

139

136

145

126

129

675

16

13

17

14

15

75

18

28

23

24

23

116

7

9

13

16

14

59

1

0

0

2

1

4

17

15

16

15

14

77

1

2

1

1

2

7

0

0

0

1

1

2

0

0

0

0

1

1

0

0

0

1

0

1

1

0

0

2

2

5

0

1

1

0

0

2

2

2

2

0

1

7

12

8

9

6

7

42

3

1

1

2

2

9

0

0

0

0

1

1

12

8

6

3

7

36

1

0

3

1

1

6

2

1

2

0

2

7

38

32

30

25

40

165

9

7

12

6

13

47

44

48

39

41

39

211

0

0

0

0

1

1

16

28

15

10

16

85

0

1

0

0

0

1

5

7

2

3

2

19

.

2

9

8

8

27

.

12

8

4

7

31

.

13

21

32

12

78

121

121

130

120

119

611

26

22

18

22

16

104

2

2

6

2

7

19

77

88

91

76

80

412

49

68

72

67

74

330

43

61

67

61

65

297

.

23

26

0

2

51

0

1

1

1

0

3

1990
19 1 0

1991
19 1 0

Black
1992 1993

20

20

1

1

0

0

1994 5-year

21

99

1

5

0

0

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

30.0

30.0

0

0

0

0

1

1

0

0

0

0

1

1

0

0

0

0

1

1

0

0

0

0

1

1

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

0

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

.

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

0

0

0

0

1

1

0

0

0

0

1

1

.

0

0

0

0

0

0

0

0

0

0

0

468

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

11.7

11.1

11.7

9.9

10.0

10.9

General fertility rate

61.3

59.5

63.9

55.1

56.9

59.4

Total fertility rate

2.0

1.9

2.1

1.8

1.9

1.9

% Livebirths to unmarried women

13.9

20.6

16.1

19.2

18.6

17.6

Crude abortion rate

1.5

1.3

1.4

1.2

1.1

1.3

General abortion rate

7.9

7.0

7.4

6.6

6.1

7.0

Total abortion rate

0.2

0.2

0.2

0.2

0.2

0.2

Abortion ratio

107.8

99.4

95.5

93.8

87.5

96.9

Fetal Death rate

3.9

3.9

6.6

8.3

7.0

6.0

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

72.4

72.0

85.0

79.9

88.3

79.6

% Repeat conceptions to women under 18

*

*

*

27.8

*

16.9

Livebirths to women under 18

72.4

58.5

76.1

62.2

70.7

68.0

% Livebirths to unmarried women under 18

33.3

38.5

52.9

50.0

50.0

45.3

Induced abortions to women under 18

*

*

*

*

*

6.3

% Abortions to unmarried women under 18

*

*

*

*

* 100.0

Fetal deaths to women under 18

*

*

*

*

*

7.2

Infant and child survival rates

Infant mortality

*

*

*

*

*

*

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

7.3

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

0.7

Infant health rates

% Low birthweight

8.6

5.9

6.2

4.8

5.4

6.2

% Very low birthweight

*

*

*

*

*

1.3

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

8.8

5.9

4.2

*

5.4

5.4

% Multiple gestation

*

*

*

*

*

0.9

% Birth defect

*

*

*

*

*

1.1

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

34.2

32.0

27.3

24.8

34.2

30.6

% with father not named on birth certificate

7.3

5.1

8.4

4.8

10.1

7.2

% with maternal education less than high school

32.1

35.3

27.3

32.8

31.3

31.7

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

11.9

21.9

11.1

8.1

13.0

13.2

% Maternal alcohol use during pregnancy

*

*

*

*

*

*

% Interpregnancy interval less than 6 months

6.3

8.3

*

*

*

4.9

Child abuse and neglect rates

Physical

.

*

3.3

2.9

2.9

2.5

Sexual

.

5.6

2.9

*

2.9

3.2

Neglect

.

4.8

7.7

11.6

4.3

7.1

Interventions to improve infant & child survival

% Prenatal care first trimester

87.1

89.0

90.3

95.2

91.5

90.5

% Primary C-section delivery

20.2

17.9

15.0

19.5

13.7

17.3

% Vaginal birth after previous C-section

*

*

26.1

*

58.3

27.9

% WIC during pregnancy

56.2

64.7

63.6

60.8

62.8

61.6

% Medicaid during pregnancy

35.8

50.0

50.3

53.6

58.1

49.4

% Medicaid and WIC during pregnancy

31.4

44.9

46.9

48.8

51.2

44.5

% Perinatal case management

.

16.9

18.2

*

*

9.6

Union County - 144

11.7 61.2
2.0 13.2
1.4 7.5 0.2 103.0 4.0
72.4 *
72.4 33.3
* * *
* * * * * *
8.6 * *
8.8 * *
34.5 6.6
32.4 *
12.0 *
6.3
. . .
87.1 20.3
* 56.6 36.0 31.6
.

11.2 59.9
1.9 20.6
1.2 6.6 0.2 93.8 4.0
72.0 *
58.5 38.5
* * *
* * * * * *
5.9 * *
5.9 * *
32.0 5.1
35.3 *
21.9 *
8.3
* 4.5 4.8
89.0 17.9
* 64.7 50.0 44.9 16.9

11.7 63.9 2.1 16.2 1.3 7.1 0.2 91.4 6.2
85.0 *
76.1 52.9
* * *
* * * * * *
6.2 * *
4.2 * *
27.5 8.5 27.5
* 11.2
* *
3.3 3.0 7.7
90.3 15.1 26.1 64.1 50.7 47.2 18.3

10.0 55.5
1.8 19.2
1.2 6.6 0.2 93.8 8.4
79.9 27.8 62.2 50.0
* * *
* * * * * *
4.8 * * * * *
24.8 4.8
32.8 *
8.1 * *
2.9 *
11.7
95.2 19.5
* 60.8 53.6 48.8
*

10.0 56.9 1.9 18.0 1.1 6.2 0.2 88.1 7.1

10.9 59.5
1.9 17.4
1.2 6.8 0.2 94.0 5.9

83.9 *
66.3 46.7
* * *

78.7 15.9 67.1 44.6
6.3 100.0
7.2

*

*

*

*

*

*

*

7.4

*

*

*

0.7

5.4

6.2

*

1.3

*

*

5.5

5.4

*

0.9

*

1.1

33.6 10.2 30.7
* 13.1
* *

30.6 7.0
31.7 *
13.3 *
4.9

2.9

2.5

2.5

2.8

4.3

7.2

92.2 13.8 58.3 62.5 57.8 50.8
*

90.7 17.4 27.9 61.8 49.5 44.5
9.6

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

469

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Upson County - 145

1990
26300 5722 551
19.8 19.1 20.0
61 14 377 46 141 34
7 83 10
2 1 1 9 2 3
35 8 1
34 5 3
105 72 146
8 82
7 15
. . .
209 35
4 216 156 122
. 0

1991
26310 5690 547
20.2 19.0 21.0
52 7
370 38
139 41 4 67 10
3 2 1 6 1 0
39 9 0
34 4 8
100 63
113 12 79 17 21
0 0 0
213 38 1
225 166 137
0 0

Total
1992 1993

26306 5653 543

26317 5622 539

20.0 19.4 21.0

21.1 18.8 22.0

66

54

15

12

416

381

56

39

157

139

38

29

5

9

79

99

8

15

5

4

5

2

0

2

10

11

1

2

1

3

40

38

7

5

0

0

36

30

5

5

6

9

123

98

77

74

145

111

7

6

90

76

15

6

15

18

8

23

3

19

12

41

258

262

57

56

0

0

241

224

233

218

184

177

3

8

0

0

1994 5-year

26317 5586 534

131550 28273 2714

20.3 18.5 21.0

20.4 19.0 21.0

73

306

12

60

357

1901

52

231

153

729

39

181

8

33

91

419

18

61

2

16

1

11

1

5

9

45

0

6

0

7

37

189

8

37

0

1

37

171

7

26

7

33

120

546

75

361

121

636

3

36

57

384

5

50

12

81

28

59

25

47

52

105

260

1202

44

230

3

8

226

1132

222

995

184

804

6

17

0

0

1990
18897 3837 346

1991
18887 3812 345

White
1992 1993

18863 3782 344

18854 3757 344

1994 5-year

18836 3729 343

94337 18917
1722

21.3 19.6 19.0

20.9 19.5 20.0

20.5 21.0 20.0

21.1 18.0 21.0

20.7 18.5 20.0

21.0 19.3 20.0

26

25

35

28

35

149

5

3

7

3

3

21

225

228

278

248

224

1203

20

16

34

19

23

112

28

37

54

43

52

214

18

30

31

21

24

124

3

0

1

4

3

11

47

36

38

43

48

212

4

5

1

9

10

29

2

1

3

1

1

8

1

1

3

0

0

5

1

0

0

1

1

3

5

1

4

4

3

17

2

1

1

1

0

5

2

0

0

2

0

4

17

20

17

19

20

93

4

5

2

1

6

18

1

0

0

0

0

1

17

16

18

14

23

88

2

1

3

3

3

12

0

5

6

4

5

20

53

47

77

62

69

308

10

20

25

21

29

105

76

59

87

63

62

347

4

4

1

2

1

12

70

66

76

70

50

332

3

11

8

2

4

28

5

10

9

10

5

39

.

0

3

16

13

32

.

0

3

18

18

39

.

0

9

18

30

57

148

163

194

193

191

889

21

29

40

42

30

162

2

0

0

0

1

3

111

120

147

123

125

626

62

75

136

108

114

495

49

63

107

84

94

397

.

0

2

5

4

11

0

0

0

0

0

0

1990
7272 1845
201

1991
7275 1833 200

Black
1992 1993

7274 1819
198

7277 1808 197

1994 5-year

7277 1794
195

36374 9100 990

18.4 18.4 24.0

18.8 18.5 22.0

18.8 18.0 25.0

19.3 19.9 27.0

19.8 17.6 25.5

19.1 18.4 25.0

35

27

31

26

38

157

9

4

8

9

9

39

151

142

136

133

130

692

26

22

22

20

29

119

113

102

103

96

101

515

15

9

7

8

15

54

4

4

4

5

5

22

34

31

39

52

42

198

6

5

7

6

8

32

0

2

2

3

1

8

0

1

2

2

1

6

0

1

0

1

0

2

4

5

6

7

6

28

0

0

0

1

0

1

1

0

1

1

0

3

18

19

23

19

17

96

4

4

5

4

2

19

0

0

0

0

0

0

17

18

18

16

14

83

3

3

2

2

4

14

3

3

0

5

2

13

51

53

46

36

51

237

62

43

52

53

46

256

70

54

58

48

58

288

4

8

6

4

2

24

12

13

14

6

7

52

4

6

7

4

1

22

10

11

6

8

7

42

.

0

4

7

13

24

.

0

0

0

6

6

.

0

2

23

19

44

60

50

14

9

2

1

105

105

94

91

73

74

.

0

0

0

62

69

67

308

17

14

14

68

0

0

2

5

94

101

100

505

97

110

106

498

77

93

89

406

1

3

2

6

0

0

0

0

470

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Upson County - 145

14.3 65.9
2.0 37.9
3.2 14.5
0.4 165.0
7.5
110.7 23.0 83.5 69.6 18.1 100.0
9.1
* * * 23.4 * *
9.3 2.1
* 9.1 1.3
*
31.4 19.4 39.5
2.2 22.0
1.9 6.9
. . .
56.0 10.1
* 58.1 41.9 32.8
.

14.1 65.0
2.0 38.0
2.5 11.8
0.4 136.7
9.3
95.0 13.5 69.4 71.1 18.3 100.0
*
* * * 16.0 * *
10.5 2.4 * 9.3 * 2.2
28.1 17.2 30.9
3.3 21.6
4.6 10.1
* * *
58.7 11.3
* 61.5 45.4 37.4
*

15.8 73.6 2.2 38.3 3.0 14.0 0.4 146.8
7.6
121.6 22.7
103.2 66.1 14.7
100.0 *
12.0 12.0
* 23.8
* *
9.6 1.7
* 8.8 1.2 1.4
30.8 18.7 35.3
1.7 22.0
3.7 6.8
1.2 *
1.8
62.8 14.6
* 58.6 56.7 44.8
*

14.5 67.8
2.1 37.1
3.8 17.6
0.5 189.7
7.5
100.2 22.2 72.4 79.5 27.8
100.0 *
* * * 28.2 * *
10.0 1.3 * 8.0 1.3 2.4
26.6 19.7 29.6
1.6 20.3
1.6 8.5
3.4 2.8 6.1
68.8 15.8
* 59.7 58.1 47.2
2.1

13.6 63.9 2.0 43.7 3.5 16.3 0.5 183.5
8.6
136.7 16.4 97.4 86.3 33.7
100.0 *
* * * 24.7 * *
10.4 2.2
* 10.6 2.0 2.0
34.7 21.4 34.8
* 16.4
1.4 6.3
4.2 3.7 7.8
73.0 13.8
* 64.6 63.4 52.6 1.7

14.5 67.2
2.1 38.9
3.2 14.8
0.5 164.4
8.1
112.7 19.6 85.1 74.3 22.5 100.0
5.5
8.4 5.8 2.6 23.3 0.8 0.3
9.9 1.9
* 9.1 1.4 1.7
30.3 19.3 34.0
1.9 20.5
2.7 7.7
2.2 1.8 3.9
63.8 13.2
6.4 60.4 53.1 42.9
1.1

11.9 58.6
1.8 12.6
2.5 12.2
0.4 159.9
5.7

12.1 59.8
1.8 16.3
1.9 9.4 0.3 120.8 8.9

14.7 73.5 2.3 19.7 2.0 10.0 0.3 109.2
8.5

13.2 66.0
2.1 17.6
2.3 11.4
0.4 135.2
7.2

11.9 60.1 1.9 23.5 2.5 12.9 0.4 160.5
7.2

12.8 63.6
2.0 18.0
2.2 11.2
0.3 136.2
7.5

75.1 19.2 57.8 30.0
* * *

72.4 *
46.3 31.3 14.5 100.0
*

101.7 20.0 98.8 44.1 * * *

81.5 *
55.3 57.9 26.2 100.0
*

102.2 *
67.2 69.6 29.2 100.0
*

86.5 14.1 65.1 47.3 16.8 100.0
4.6

*

*

*

*

*

6.7

*

*

*

*

*

4.2

*

*

*

*

*

*

21.9

*

*

*

*

14.0

*

*

*

*

*

1.0

*

*

*

*

*

*

7.6

8.8

6.1

7.7

8.9

7.7

*

2.2

*

*

2.7

1.5

*

*

*

*

*

*

7.6

7.1

6.5

5.7

10.4

7.4

*

*

*

*

*

1.0

*

2.2

2.2

*

2.2

1.7

24.8 4.5
34.2 *
31.4 *
4.0

21.3 8.8
26.0 *
29.1 4.8 7.9

28.4 9.1 31.6
* 27.7
2.9 6.4

25.9 8.6
25.8 *
28.8 *
7.1

31.5 13.1 28.2
* 22.7
* 4.3

26.5 8.8
29.2 1.0
28.0 2.4 6.0

.

*

*

3.6

3.0

1.8

.

*

*

4.1

4.1

2.2

.

*

2.0

4.1

6.8

3.2

66.4 10.0
* 49.8 27.8 22.0
.

72.8 14.0
* 52.9 33.0 27.8
*

69.8 15.2
* 53.5 49.5 38.9
*

77.8 18.4
* 50.4 44.3 34.4
2.0

85.7 14.8
* 56.6 51.6 42.5
*

74.3 14.6
* 52.6 41.6 33.4
1.1

20.8 81.8
2.3 76.4
4.7 18.4
0.5 165.9 10.8

19.5 77.5
2.2 73.4
4.3 16.9
0.5 163.2
9.3

18.7 74.7 2.2 76.9 5.4 21.4 0.6 209.7
6.0

18.3 73.6
2.1 73.3
7.1 28.8
0.8 260.0
8.3

17.9 72.4 2.1 80.2 5.8 23.4 0.7 217.6 11.7

19.0 76.0
2.2 76.0
5.4 21.8
0.6 203.3
9.2

174.1 25.7 129.4 100.0 29.9 100.0
*

135.2 *
110.2 100.0
25.0 100.0
*

156.6 25.8
111.2 100.0
35.4 100.0
*

132.2 34.6
101.7 100.0
30.5 100.0
*

195.1 23.7
148.9 100.0
41.1 100.0
*

158.6 24.8
120.2 100.0
32.3 100.0
7.1

*

*

*

*

*

11.6

*

*

*

*

*

8.7

*

*

*

*

*

*

*

34.2

42.9

50.7

44.4

39.2

*

*

*

*

*

*

*

*

*

*

*

*

11.9 * *
11.5 * *

13.4 * *
12.9 * *

16.9 3.7
* 13.4
* *

14.3 * *
12.2 *
3.8

13.1 * *
11.1 * *

13.9 2.7 *
12.2 2.1 1.9

42.9 41.9 47.6
* 8.1
* 10.9

39.3 30.9 38.8
5.9 9.4 4.3 13.4

36.5 38.8 43.3 4.7 10.5 5.3
7.7

27.7 40.5 36.6
* 4.6
* 11.1

41.1 36.5 46.4
* 5.6
* 9.6

37.4 37.8 42.6
3.6 7.7 3.3 10.6

.

*

*

3.1

5.8

2.7

.

*

*

*

2.7

0.7

.

*

*

10.2

8.4

4.9

40.3 10.1
* 70.9 63.5 49.3
.

36.0 6.9 *
75.5 65.5 53.2
*

47.3 13.7
* 70.1 72.4 57.5
*

51.9 11.1
* 77.1 84.0 71.0
*

51.5

45.2

12.3

10.8

*

10.9

79.4

74.5

84.1

73.5

70.6

59.9

*

1.1

471

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Walker County - 146

1990
58340 12932
1289
20.3 18.7 20.0
105 25 841 101 188
6 6 143 4
16 11
5 17
1 5
72 14
3 78
9 7
285 88 307
4 120
5 27
. . .
670 72 10 360 232 191
. 0

1991
58770 12949
1283
20.0 19.3 20.0
121 16
851 112 237
49 7
139 4
13 8 5
14 1 4
69 19
2 73 13
1
159 107 316
8 126
3 34
11 6
20
667 52 5
465 318 284
30 2

Total
1992 1993

59185 12959
1277

59620 12977
1272

20.2 20.4 20.0

20.3 18.5 20.0

100

123

17

30

757

772

93

103

185

230

45

61

13

10

122

101

5

11

5

9

1

2

4

7

14

12

3

0

6

6

63

59

6

12

0

1

55

63

8

5

1

4

44

140

92

105

274

301

3

4

75

111

0

3

35

30

32

31

13

10

54

59

622

630

46

39

2

8

358

413

278

347

232

305

125

114

0

0

1994 5-year

60035 12988
1266

295950 64805
6388

19.8 18.1 20.0

20.1 19.0 20.0

133

582

21

109

832

4053

109

518

259

1099

42

203

7

43

93

598

20

44

11

54

7

29

4

25

12

69

3

8

6

27

80

343

7

58

0

6

80

349

12

47

3

16

180

808

108

500

317

1515

8

27

203

635

5

16

39

165

17

91

12

41

66

199

644

3233

68

277

17

42

449

2045

368

1543

316

1328

175

444

0

2

1990
55779 12379
1223

1991
56204 12397
1219

White
1992 1993

56621 12410
1215

57048 12428
1211

1994 5-year

57463 12442
1207

283115 62056
6075

20.4 18.6 19.0

20.0 19.1 20.0

20.3 20.4 20.0

20.3 18.5 20.0

19.8 18.1 20.0

20.2 19.0 20.0

101

114

94

119

124

552

24

16

15

29

20

104

801

806

720

745

789

3861

97

105

89

100

100

491

162

212

161

210

231

976

6

47

43

59

39

194

4

7

13

10

6

40

132

132

112

97

86

559

4

4

3

11

20

42

16

13

4

9

11

53

11

8

1

2

7

29

5

5

3

7

4

24

15

14

14

12

11

66

1

1

3

0

3

8

5

4

6

6

6

27

68

66

58

56

73

321

12

19

6

12

6

55

3

2

0

1

0

6

74

70

48

62

71

325

9

13

7

4

12

45

7

1

1

3

3

15

268

149

41

133

170

761

73

93

80

96

89

431

297

304

267

294

300

1462

3

8

3

2

7

23

114

123

73

109

201

620

3

3

0

2

4

12

24

33

33

29

37

156

.

7

28

26

17

78

.

6

12

10

12

40

.

19

49

51

40

159

649

644

599

613

621

3126

67

50

44

35

66

262

9

5

2

8

16

40

339

434

337

399

429

1938

217

299

260

333

347

1456

178

267

217

294

303

1259

.

24

115

111

164

414

0

2

0

0

0

2

1990
2246 478 58

1991
2263 478
58

Black
1992 1993

2279 479 58

2295 479
57

1994 5-year

2311 479 57

11394 2393 287

19.3 18.7 30.0

18.5 21.7 21.0

18.8 19.0 23.0

22.2 20.4 30.0

18.9 .
22.0

18.9 20.4 23.5

4

7

6

3

8

28

1

0

2

1

1

5

38

39

32

25

39

173

4

7

4

2

8

25

25

24

24

19

27

119

0

2

2

2

2

8

2

0

0

0

1

3

7

5

7

2

4

25

0

0

2

0

0

2

0

0

1

0

0

1

0

0

0

0

0

0

0

0

1

0

0

1

2

0

0

0

1

3

0

0

0

0

0

0

0

0

0

0

0

0

4

3

5

3

7

22

2

0

0

0

1

3

0

0

0

0

0

0

4

3

6

1

8

22

0

0

1

1

0

2

0

0

0

1

0

1

17

9

3

15

13

12

9

11

7

1

0

0

6

3

2

2

0

0

3

1

2

7

9

45

8

19

67

5

15

47

2

1

4

2

2

15

1

1

4

1

2

9

.

0

2

2

0

4

.

0

1

0

0

1

.

0

3

6

1

10

20

19

20

16

22

97

5

1

2

3

1

12

0

0

0

0

1

1

21

29

20

14

20

104

14

18

18

14

19

83

13

16

15

11

13

68

.

5

10

3

10

28

0

0

0

0

0

0

472

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Walker County - 146

14.4 65.0
2.0 22.6
2.5 11.1
0.1 143.3
1.1
81.5 23.8 78.4 58.0
* * *
19.0 13.1
6.0 20.1
* 0.4
8.6 1.7
* 9.4 1.1 0.9
44.3 10.6 37.2
* 16.4
0.7 6.0
. . .
81.6 9.3
16.7 43.3 27.9 23.0
.

14.5 65.7
2.1 28.3
2.4 10.7
0.1 131.9
4.9
94.3 13.2 87.3 58.6
* * 4.7
15.3 9.4 5.9
16.3 * *
8.1 2.2
* 8.7 1.6
*
28.2 12.8 37.8
1.0 21.8
* 7.9
0.7 0.4 1.3
80.8 6.5
14.7 55.5 37.9 33.9
3.6

12.8 58.4 1.8 24.7 2.1 9.4 0.1 129.0 5.2
78.3 17.0 72.8 61.5 3.9 100.0
*
6.6 * *
18.2 *
0.5
8.3 0.8
* 7.4 1.1
*
9.1 12.3 36.6
* 15.4
* 8.2
2.1 0.9 3.6
86.1 6.4
* 47.8 37.1 31.0 16.7

12.9 59.5
1.9 30.0
1.7 7.8 0.1 106.7 5.7
96.7 24.4 81.0 62.1
8.6 100.0
7.9
11.7 *
9.1 15.3
* 0.5
7.7 1.6
* 8.2 0.7
*
27.2 13.7 39.4
* 21.3
* 7.4
2.0 0.7 3.9
85.3 5.4
20.0 53.9 45.3 39.8 14.9

13.9 64.1 2.0 31.7 1.5 7.2 0.2 95.2 4.0
105.1 15.8 86.1 67.9 15.8
100.0 *
13.2 8.4
* 14.3
* *
9.6 0.8
* 9.7 1.5
*
30.8 13.2 38.7 1.0 34.2 0.8 9.0
1.1 0.8 4.3
80.9 8.9 28.3 54.7 44.8 38.5 21.3

13.7 62.5
1.9 27.5
2.0 9.2 0.1 121.5 4.2
91.1 18.7 81.1 61.7
6.9 100.0
3.9
13.3 7.2 6.2
16.8 0.5 0.5
8.5 1.4 0.1 8.7 1.2 0.5
29.0 12.5 38.0
0.7 21.8
0.6 7.7
1.5 0.7 3.3
82.8 7.3
19.1 51.0 38.5 33.2 14.0

14.4 64.7
2.0 20.5
2.4 10.7
0.1 139.7
1.0

14.3 65.0
2.0 26.8
2.3 10.6
0.1 132.1
4.9

12.7 58.0 1.8 22.6 2.0 9.0 0.1 124.9 5.2

13.1 59.9
1.9 28.4
1.7 7.8 0.1 106.1 5.8

13.7 63.4 2.0 29.8 1.5
6.9 0.2 93.2 3.9

13.6 62.2
1.9 25.6
2.0 9.0 0.1 119.5 4.2

82.6 23.8 79.3 56.3
* * *

93.5 14.0 86.1 55.8
* * 4.9

77.4 16.0 73.3 59.8
* * *

98.2 24.4 82.6 62.0
9.1 100.0
7.4

102.8 16.1 82.9 66.0 16.6
100.0 *

90.9 18.8 80.8 60.0
6.9 100.0
4.0

20.0 13.7
6.3 18.6
* 0.5

16.1 9.9 6.3
17.2 * *

* * * 19.1 * 0.6

12.1 *
9.4 15.9
* 0.6

13.9 8.9
* 13.8
* *

13.7 7.5 6.3
16.9 0.5 0.5

8.5

8.2

8.1

7.5

9.3

8.3

1.5

2.4

0.8

1.6

0.8

1.4

*

*

*

*

*

0.2

9.3

8.8

6.7

8.4

9.1

8.5

1.1

1.6

1.0

*

1.5

1.2

1.0

*

*

*

*

0.5

44.0 9.2
37.7 *
16.3 *
5.6

28.1 11.7 38.5
1.0 22.6
* 8.0

9.0 11.2 37.4
* 15.9
* 8.2

26.7 13.0 39.9
* 21.7
* 7.4

30.5 11.4 38.7 0.9 35.6
* 9.0

28.7 11.3 38.4
0.6 22.4
0.4 7.6

.

0.5

1.9

1.8

1.2

1.3

.

0.4

0.8

0.7

0.8

0.7

.

1.3

3.4

3.5

2.7

2.7

82.7 9.1
15.8 42.8 27.4 22.5
.

82.0 6.5
17.2 54.7 37.7 33.7
3.0

87.1 6.4
* 47.3 36.5 30.4 16.1

85.7 5.0
22.2 53.9 45.0 39.7 15.0

82.4 9.1 28.6 55.1 44.6 38.9 21.1

83.9 7.2
19.9 50.8 38.2 33.0 13.7

16.9 79.5
2.4 65.8
3.1 14.6
* 148.9
*

17.2 81.5
2.4 61.5
2.2 10.5
* 108.7
*

14.0 66.9 2.0 77.4 3.1 14.6 0.3 170.7
*

* 121.3 104.3

*

*

*

* 121.3

*

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

15.6

*

*

*

*

*

*

*

*

19.4

*

*

*

*

*

*

51.5 39.5 25.0
* 17.6
* *

31.0 33.3 28.2
* * * *

* 38.7 22.6
* * * *

.

*

*

.

*

*

.

*

*

58.8 13.9
* 55.3 36.8 34.2
.

55.9 * *
74.4 46.2 41.0 12.8

66.7 * *
64.5 58.1 48.4 32.3

10.9 52.2
1.6 79.2
* * * * *

16.9 81.4 2.3 71.1
* * * * *

15.2 72.3
2.1 70.0
2.2 10.4
0.2 119.6
4.6

* 140.4

*

*

* 140.4

*

87.5

*

*

*

*

*

*

97.4 17.9 87.0 96.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

17.9

12.7

*

*

*

*

*

*

*

20.5

12.9

*

*

*

*

*

*

43.8 33.3 20.8
* * * *

39.1 48.7 38.5
* * * *

36.0 39.2 27.8
* 11.6
* 9.2

* * 10.2

*

*

*

*

*

4.2

69.6

57.9

61.0

*

*

7.8

*

*

*

58.3

51.3

60.8

58.3

48.7

48.5

45.8

33.3

39.8

*

25.6

21.1

473

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Walton County - 147

1990
38586 9043 868
21.2 18.2 20.0
95 24 710 69 202 48
8 137 24
10 7 3
15 1 2
68 12
2 77
7 11
195 105 225 10 133 17 34
. . .
520 102 12 221 236 154
. 0

1991
39515 9185 877
20.8 21.2 21.0
84 18 694 64 205 51 11 157 16
7 6 1 16 2 3
56 6 3
68 8
13
187 97
209 11
124 11 32
18 10 42
521 104
15 309 292 226
44 0

Total
1992 1993

40450 9329 886

41381 9471 895

22.5 19.6 21.0

21.5 18.0 22.0

81

101

13

19

693

734

65

73

203

224

48

56

5

8

145

151

15

27

8

9

3

4

5

5

8

12

0

1

2

1

61

52

13

8

0

0

57

58

12

8

23

26

160

183

96

96

210

194

8

6

98

102

9

8

31

33

43

45

30

21

120

71

530

579

100

84

17

21

298

314

303

361

240

265

162

199

0

5

1994 5-year

42308 9616 904

202240 46644 4430

22.2 19.6 22.0

21.6 19.5 21.0

102

463

17

91

732

3563

75

346

217

1051

64

267

8

40

136

726

20

102

1

35

0

20

1

15

8

59

0

4

3

11

64

301

10

49

0

5

68

328

13

48

11

84

182

907

101

495

192

1030

5

40

118

575

15

60

21

151

26

132

32

93

129

362

605

2755

99

489

14

79

310

1452

329

1521

260

1145

238

643

1

6

1990
31177 7110 663

1991
32028 7247 671

White
1992 1993

32881 7387 679

33735 7524 687

1994 5-year

34586 7664 695

164407 36932 3395

21.9 18.0 19.0

21.9 20.3 20.0

23.3 18.2 21.0

22.2 18.4 21.0

23.7 19.0 21.0

22.5 18.8 21.0

61

53

53

63

65

295

15

9

6

14

8

52

514

533

525

554

567

2693

43

39

37

44

44

207

64

79

80

92

89

404

32

37

36

44

45

194

5

8

4

4

4

25

93

118

104

114

92

521

18

13

15

19

16

81

3

6

7

4

1

21

2

5

2

2

0

11

1

1

5

2

1

10

7

12

6

6

4

35

1

1

0

1

0

3

2

3

2

1

2

10

36

31

39

34

45

185

4

3

7

5

7

26

0

1

0

0

0

1

47

40

33

40

49

209

3

4

7

5

9

28

8

11

15

19

5

58

119

128

126

125

121

619

35

32

31

32

37

167

129

147

138

126

121

661

5

5

5

5

3

23

114

114

90

91

96

505

10

9

7

4

5

35

19

22

16

17

11

85

.

12

27

33

19

91

.

3

22

16

24

65

.

19

63

49

88

219

403

428

421

473

493

2218

73

85

78

56

78

370

8

12

15

15

10

60

115

193

178

187

184

857

115

175

182

216

207

895

72

133

143

150

153

651

.

26

97

106

137

366

0

0

0

3

1

4

1990
7105 1856
201

1991
7276 1880 203

Black
1992 1993

7448 1905
205

7620 1930 207

1994 5-year

7790 1955
209

37239 9526 1026

19.0 19.4 23.0

18.1 24.0 24.0

19.2 20.8 24.0

19.1 16.0 27.5

18.6 19.9 25.5

18.7 20.3 25.0

34

31

28

38

37

168

9

9

7

5

9

39

193

161

164

179

160

857

26

25

28

29

31

139

138

126

123

132

126

645

16

13

11

12

19

71

3

3

1

4

4

15

41

38

38

35

44

196

6

3

0

8

4

21

7

1

1

5

0

14

5

1

1

2

0

9

2

0

0

3

0

5

8

4

2

6

4

24

0

1

0

0

0

1

0

0

0

0

1

1

31

25

21

18

18

113

8

3

6

3

3

23

2

2

0

0

0

4

30

28

24

18

18

118

4

4

5

3

4

20

3

2

7

7

6

25

76

59

33

58

59

285

70

65

64

63

63

325

94

62

71

68

70

365

5

6

3

1

2

17

19

10

8

11

22

70

7

2

2

4

10

25

15

10

15

16

10

66

.

6

14

9

6

35

.

7

8

4

8

27

.

21

55

21

40

137

114

93

107

105

107

526

29

19

20

28

21

117

4

3

2

6

4

19

104

116

119

127

125

591

120

117

120

145

120

622

81

93

96

115

106

491

.

18

65

93

99

275

0

0

0

2

0

2

474

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Walton County - 147

18.4 78.5
2.3 28.8
3.6 15.1
0.4 151.0
6.6
109.4 25.3 79.5 60.3 27.6 95.8
6.9
14.1 9.9 *
20.9 * *
9.6 1.7
* 11.0
1.0 1.6
32.9 14.9 32.6
1.4 19.2
2.5 8.8
. . .
74.5 16.0 17.9 31.4 33.6 21.9
.

17.6 75.6
2.3 29.9
4.0 17.1
0.5 171.2
7.2
95.8 21.4 73.0 56.3 18.2 100.0
*
10.1 8.6 *
22.7 * *
8.1 0.9
* 9.9 1.2 1.9
34.7 14.1 31.0
1.6 19.6
1.7 9.0
1.6 0.9 3.8
75.6 16.9 20.8 45.0 42.6 32.9
6.4

17.1 74.3 2.2 29.8 3.6 15.5 0.5 162.4
5.9
91.4 16.0 73.4 60.0 16.9 100.0
*
11.5 *
7.2 11.5
* *
8.8 1.9
* 8.4 1.8 3.3
29.3 14.1 31.3
1.2 16.6
1.5 9.1
3.8 2.7 10.7
77.4 16.1 27.9 43.7 44.4 35.2 23.8

17.7 77.5
2.4 30.9
3.6 15.9
0.5 158.8
7.0
112.9 18.8 81.6 67.1 30.2 96.3 *
12.3 *
6.8 16.2
* *
7.1 1.1
* 8.0 1.1 3.6
30.0 13.2 27.0
0.8 15.9
1.2 8.3
3.9 1.8 6.2
79.4 12.9 28.4 43.3 49.7 36.5 27.4

17.3 76.1 2.3 30.2 3.2 14.1 0.4 144.4
7.7
112.8 16.7 82.9 67.6 22.1 94.4 8.8
* * * 10.8 * *
8.7 1.4
* 9.5 1.8 1.5
29.9 14.0 26.9
0.7 17.5
2.2 5.6
2.2 2.7 11.0
82.8 14.9 25.0 43.1 45.8 36.2 33.1

17.6 76.4
2.3 29.9
3.6 15.6
0.5 157.5
6.9
104.5 19.7 78.1 62.5 23.0 97.0
4.5
9.8 5.6 4.2 16.4
* 0.3
8.5 1.4 0.1 9.3 1.4 2.4
31.3 14.1 29.7
1.1 17.8
1.9 8.1
2.9 2.0 8.0
78.0 15.3 23.9 41.3 43.3 32.6 22.9

16.5 72.3
2.2 12.5
3.0 13.1
0.4 143.7
5.6

16.6 73.5
2.2 14.9
3.7 16.3
0.5 168.8
6.6

16.0 71.1 2.2 15.4 3.2 14.1 0.4 155.5
5.4

16.4 73.6
2.3 16.8
3.4 15.2
0.5 159.0
6.5

16.4 74.0 2.3 15.9 2.7 12.0 0.4 129.9
6.4

16.4 72.9
2.2 15.2
3.2 14.1
0.4 151.5
6.1

92.0 24.6 64.9 41.9 27.1 94.4
*

79.0 17.0 58.1 28.2 19.4 100.0
*

78.0 11.3 54.5 29.7 22.1 100.0
*

91.7 22.2 64.1 47.7 27.7 94.7
*

93.5 12.3 63.3 45.5 23.0 93.8
7.2

86.9 17.6 61.0 39.1 23.9 96.3
2.7

* * * 13.5 * *

11.3 9.4 *
22.2 * *

13.3 *
9.6 11.3
* *

* * * 10.8 * *

*

7.8

*

4.1

*

3.7

*

12.9

*

*

*

0.3

7.0

5.8

7.4

6.1

7.9

6.9

*

*

1.3

0.9

1.2

1.0

*

*

*

*

*

*

9.2

7.6

6.4

7.3

8.8

7.8

*

*

1.3

0.9

1.6

1.1

1.6

2.1

2.9

3.4

0.9

2.2

28.0 6.8
25.9 1.0
22.6 2.0 7.2

30.1 6.0
28.2 1.0
22.7 1.8 8.4

29.4 6.0 27.1 1.0 19.4 1.5 6.4

26.5 5.8
23.2 0.9
18.3 *
5.7

26.1 6.6
21.8 *
18.6 1.0 3.8

28.0 6.3
25.2 0.9
20.3 1.4 6.3

.

1.4

3.1

3.7

2.1

2.6

.

*

2.5

1.8

2.6

1.8

.

2.2

7.2

5.5

9.6

6.2

79.5 15.8 16.7 22.5 22.5 14.1
.

80.9 17.9 21.8 36.5 33.1 25.1
4.9

80.7 16.7 29.4 34.3 35.1 27.6 18.7

86.0 11.3 27.8 34.1 39.3 27.3 19.3

87.1 15.2 22.7 33.0 37.1 27.4 24.6

82.9 15.3 23.8 32.1 33.6 24.4 17.0

27.2 104.0
2.7 73.0
5.8 22.1
0.6 161.4 10.8

22.1 85.6
2.3 80.3
5.2 20.2
0.5 175.9
9.0

22.0 86.1 2.3 77.4 5.1 19.9 0.5 175.9
7.3

23.5 92.8
2.6 75.0
4.6 18.1
0.5 151.5
8.8

20.5 81.8 2.3 80.8 5.6 22.5 0.6 192.1 12.8

23.0 90.0
2.4 77.1
5.3 20.6
0.6 171.0
9.8

169.2 26.5 129.4 92.0 29.9 100.0
*

152.6 29.0
123.1 100.0
* * *

136.5 25.0
136.5 100.0
* * *

183.4 13.2
140.0 96.6 38.6
100.0 *

176.7 24.3
148.0 100.0
* * *

163.8 23.2
135.5 97.8 20.5 100.0 10.7

36.3

*

*

27.9

*

16.3

25.9

*

*

*

*

10.5

*

*

*

*

*

5.9

40.8

*

*

32.8

*

27.5

*

*

*

*

*

*

*

*

*

*

*

*

16.1 4.1 *
15.9 * *

15.5 * *
17.8 * *

12.9 3.7
* 15.1 3.1 4.3

10.1 * *
10.2 *
3.9

11.3 * *
11.5 *
3.8

13.2 2.7 *
14.1 2.4 2.9

45.8 37.0 49.7
2.7 10.2
3.8 12.6

51.8 41.4 40.5
3.8 7.8
* 10.4

28.9 40.3 45.2
* 6.3
* 16.7

42.3 35.8 39.1
* 7.5
* 15.4

41.5 40.4 45.5
* 14.3
6.5 11.8

42.3 38.8 44.1
2.0 9.4 3.4 13.4

.

2.5

5.6

3.5

2.3

3.5

.

2.9

3.2

*

3.1

2.7

.

8.6

22.1

8.2

15.4

13.6

60.6 17.0
* 55.0 63.5 42.9
.

58.1 13.6
* 73.9 74.5 59.2 11.5

66.9 13.3
* 74.8 75.5 60.4 40.9

59.0 17.9 30.0 72.2 82.4 65.3 52.8

66.9

62.2

14.5

15.4

*

25.3

80.1

70.6

76.9

74.3

67.9

58.7

63.5

42.4

475

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Ware County - 148

1990
35471 7530 875
19.6 18.6 20.5
83 23 537 74 203 47 13 11
4
10 4 6
17 1 2
49 11
1 55
6 12
157 110 203 15 96 15 30
. . .
316 93
0 325 268 237
. 0

1991
35564 7520 866
19.6 19.7 20.0
88 21 525 84 199 45 12
9 2
5 3 2 15 1 1
34 3 1
33 5 1
178 103 197
4 91
6 26
14 29 153
327 73 8
375 290 275 144
0

Total
1992 1993

35653 7506 856

35750 7497 846

19.8 18.9 21.0

19.8 16.2 21.0

76

75

19

12

519

501

71

68

176

198

66

69

14

6

5

9

0

1

5

7

3

3

2

4

17

9

1

2

3

1

45

49

7

11

1

0

57

57

7

7

6

6

176

173

93

101

176

169

8

5

81

89

8

9

29

26

20

15

28

28

153

153

328

346

77

68

3

2

311

351

310

338

265

301

214

216

0

0

1994 5-year

35840 7486 837

178278 37539 4279

19.8 21.1 21.0

19.7 18.8 21.0

79

401

18

93

483

2565

79

376

206

982

49

276

7

52

18

52

1

8

2

29

0

13

2

16

7

65

3

8

3

10

46

223

8

40

0

3

45

247

7

32

6

31

149

833

109

516

160

905

2

34

87

444

4

42

26

137

34

83

17

102

151

610

357

1674

62

373

7

20

355

1717

335

1541

309

1387

253

827

0

0

1990
26007 5478 606

1991
25962 5434 596

White
1992 1993

25915 5388 586

25872 5344 576

1994 5-year

25823 5299 565

129579 26943 2928

20.1 20.0 20.0

19.8 19.7 20.0

20.6 18.9 20.0

21.2 16.2 20.0

20.6 23.1 20.0

20.5 18.8 20.0

44

48

35

41

37

205

10

8

8

6

6

38

327

352

341

326

302

1648

39

46

33

37

37

192

61

77

55

72

68

333

37

27

48

44

32

188

4

3

3

3

4

17

9

6

1

4

8

28

2

2

0

1

1

6

4

3

1

4

1

13

2

2

1

2

0

7

2

1

0

2

1

6

6

5

4

5

4

24

0

0

0

1

1

2

1

1

1

1

2

6

24

18

20

27

21

110

4

2

1

7

4

18

0

1

0

0

0

1

26

20

32

34

23

135

3

2

4

5

5

19

6

1

6

4

4

21

78

97

104

109

31

39

30

36

114

127

104

100

4

2

0

1

78

77

67

73

6

5

2

4

11

12

11

12

85

473

35

171

97

542

1

8

69

364

2

19

13

59

.

8

11

12

23

54

.

17

18

21

13

69

.

95

86

78

81

340

228

245

244

250

231

1198

71

50

52

48

42

263

0

2

1

1

6

10

160

223

176

197

193

949

119

165

171

192

182

829

105

154

147

163

161

730

.

70

117

111

127

425

0

0

0

0

0

0

1990
9238 1994
266

1991
9262 1991 263

Black
1992 1993

9285 1987
260

9311 1985 257

1994 5-year

9334 1982
254

46430 9939 1301

18.9 17.4 24.0

18.3 .
24.0

18.0 .
25.0

17.8 .
23.0

18.3 19.0 25.0

18.3 18.2 24.0

39

40

40

34

42

195

13

13

10

6

12

54

210

171

176

173

176

906

35

38

38

31

42

184

142

122

121

126

138

649

10

18

18

24

15

85

9

9

10

3

3

34

2

3

4

4

10

23

2

0

0

0

0

2

6

2

4

3

1

16

2

1

2

1

0

6

4

1

2

2

1

10

11

10

12

4

3

40

1

1

1

1

2

6

1

0

2

0

1

4

25

16

25

21

25

112

7

1

6

4

4

22

1

0

1

0

0

2

29

13

24

22

22

110

3

3

3

2

2

13

6

0

0

2

1

9

79

81

72

64

63

359

79

64

63

65

74

345

89

70

71

68

61

359

11

2

8

4

1

26

18

14

14

16

16

78

9

1

6

5

2

23

19

14

18

14

13

78

.

5

9

3

9

26

.

11

10

7

4

32

.

53

62

74

65

254

88

81

83

94

122

468

22

23

23

20

18

106

0

6

2

1

1

10

165

151

134

154

159

763

149

124

138

146

150

707

132

120

117

138

146

653

.

73

96

105

124

398

0

0

0

0

0

0

476

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

15.1

14.8

14.6

14.0

13.5

14.4

General fertility rate

71.3

69.8

69.1

66.8

64.5

68.3

Total fertility rate

2.2

2.1

2.1

2.0

2.0

2.1

% Livebirths to unmarried women

38.3

38.3

34.4

40.1

43.3

38.8

Crude abortion rate

0.3

0.3

0.1

0.3

0.5

0.3

General abortion rate

1.5

1.2

0.7

1.2

2.4

1.4

Total abortion rate

0.0

0.0

0.0

0.0

0.1

0.0

Abortion ratio

17.9

15.1

8.2

15.4

32.3

17.6

Fetal Death rate

8.6

8.1

11.1

10.0

7.6

9.1

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

94.9 101.7

88.8

88.6

94.4

93.7

% Repeat conceptions to women under 18

27.7

23.9

25.0

16.0

22.8

23.2

Livebirths to women under 18

84.6

97.0

83.0

80.4

94.4

87.9

% Livebirths to unmarried women under 18

65.8

68.7

78.9

72.1

74.4

71.8

Induced abortions to women under 18

*

*

*

*

*

1.9

% Abortions to unmarried women under 18

*

*

*

*

* 100.0

Fetal deaths to women under 18

12.6

8.1

17.5

13.0

*

10.7

Infant and child survival rates

Infant mortality

18.6

9.5

9.6

14.0

*

11.3

Neonatal mortality

*

*

*

*

*

5.1

Postneonatal mortality

11.3

*

*

*

*

6.3

Perinatal mortality ratio

30.9

27.9

31.9

17.8

14.3

24.8

Deaths of children 1-4 yrs

*

*

*

*

*

0.8

Deaths of children 5-17 yrs

*

*

*

*

*

0.3

Infant health rates

% Low birthweight

9.1

6.5

8.7

9.8

9.5

8.7

% Very low birthweight

2.0

*

1.3

2.2

1.7

1.6

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

10.4

6.3

11.1

11.5

9.5

9.8

% Multiple gestation

1.1

1.0

1.4

1.4

1.5

1.3

% Birth defect

2.2

*

1.2

1.2

1.3

1.2

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

31.3

36.1

36.0

37.3

32.8

34.7

% with father not named on birth certificate

20.8

19.8

18.2

20.4

22.9

20.4

% with maternal education less than high school

38.4

38.0

34.4

35.1

33.8

36.0

% No prenatal care

2.8

*

1.6

1.0

*

1.3

% Maternal smoking during pregnancy

18.1

17.6

15.9

18.4

18.6

17.7

% Maternal alcohol use during pregnancy

2.8

1.2

1.6

1.9

*

1.7

% Interpregnancy interval less than 6 months

10.0

9.0

9.3

9.0

9.8

9.4

Child abuse and neglect rates

Physical

.

1.5

2.1

1.6

3.6

2.2

Sexual

.

3.1

3.0

3.0

1.8

2.7

Neglect

.

16.1

16.1

16.2

16.0

16.1

Interventions to improve infant & child survival

% Prenatal care first trimester

61.4

63.4

63.9

70.8

75.3

66.8

% Primary C-section delivery

19.6

15.9

16.8

15.6

15.3

16.7

% Vaginal birth after previous C-section

*

13.1

*

*

9.9

6.7

% WIC during pregnancy

61.3

72.1

60.7

71.1

74.6

67.8

% Medicaid during pregnancy

50.6

55.8

60.5

68.4

70.4

60.9

% Medicaid and WIC during pregnancy

44.7

52.9

51.8

60.9

64.9

54.8

% Perinatal case management

.

27.7

41.8

43.7

53.2

41.3

Ware County - 148

12.6 59.7
1.9 18.8
0.3 1.6 0.1 23.8 7.7
72.6 22.7 64.4 35.9
* * 9.9
* * * 18.1 * *
7.3 * *
8.0 *
1.8
24.8 9.6
35.2 *
24.1 1.9 6.5
. . .
72.6 24.2
* 49.4 36.7 32.4
.

13.6 64.8
2.0 22.0
0.2 1.1 0.0 15.4 5.7
80.6 16.7 77.2 47.8
* * *
* * * 14.1 * *
5.1 * *
5.7 * *
28.9 11.1 36.3
* 22.2
1.4 6.5
1.3 2.7 15.2
71.0 15.8
* 63.7 47.1 44.0 20.0

13.2 63.3 2.0 16.3
* * * * 9.7
59.8 22.9 56.3 57.6
* * 13.7
* * * * * *
5.9 * *
9.5 *
1.8
31.7 8.9
31.0 *
20.0 *
5.7
1.8 2.9 13.9
72.6 17.2
* 52.2 50.7 43.6 34.7

12.6 61.0
1.9 22.4
* * * * 8.8
71.2 14.6 64.3 51.4
* * 8.7
* * * 15.2 * *
8.3 2.1
* 10.6
1.6 *
35.4 11.2 32.2
* 23.4
* 6.7
2.0 3.4 12.7
78.1 17.0
* 61.4 59.8 50.8 34.6

11.7 57.0 1.8 22.9 0.3 1.5 0.0 23.1
7.0

12.7 61.2
1.9 20.4
0.2 1.0 0.0 14.9 7.8

65.4 16.2 65.4 44.4
* * *

70.0 18.5 65.6 47.1
2.0 100.0
7.9

*

7.9

*

4.2

*

3.7

*

14.4

*

*

*

*

7.0

6.7

*

1.1

*

*

7.7

8.3

1.7

1.2

*

1.3

30.0 11.8 32.8
* 23.9
* 8.1

30.1 10.5 33.5
0.5 22.7
1.2 6.7

3.8 2.1 13.3

2.2 2.8 13.8

77.8 16.5 14.3 65.0 61.3 54.2 42.8

74.3 18.1
5.6 58.3 50.9 44.8 32.6

22.7 105.3
3.0 68.9
* * * * 11.5

18.5 85.9
2.5 72.6
* * * * 15.1

19.0 88.6 2.5 69.9
* * * * 15.1

18.6 87.2
2.4 73.7
* * * * 13.6

18.9 88.8 2.5 79.3 1.1 5.0 0.2 49.0 9.1

19.5 91.2
2.6 72.8
0.5 2.3 0.1 21.8 12.9

146.6 33.3 131.6 100.0
* * 18.8

152.0 32.5
144.4 94.6 * * *

153.8 25.0
146.1 97.4 * * 23.1

132.2 17.6
120.5 96.8 * * 23.3

165.1 28.6
165.1 100.0
* * *

149.9 27.7
141.5 97.8 * * 16.9

28.6

*

*

*

*

17.7

*

*

*

*

*

6.6

*

*

*

*

*

11.1

50.2

55.6

64.5

*

*

42.6

*

*

*

*

*

1.7

*

*

*

*

*

*

11.9 3.3 *
14.1 *
2.9

9.4

14.2

12.1

14.2

12.4

*

3.4

*

*

2.4

*

*

*

*

*

7.7

13.9

12.9

12.6

12.3

*

*

*

*

1.5

*

*

*

*

1.0

42.5 38.3 43.4
5.3 8.7 4.4 14.4

51.9 38.1 41.7
* 8.3
* 13.6

45.0 36.4 41.0 4.6 8.2 3.5 15.3

41.3 38.0 40.5
* 9.4 2.9 12.8

38.0 42.5 35.5
* 9.2
* 13.0

43.6 38.7 40.5
2.9 8.8 2.6 13.9

.

1.6

2.9

*

2.9

2.1

.

3.5

3.2

2.2

*

2.6

.

16.9

19.8

23.7

20.8

20.3

43.8 12.1
* 80.1 72.3 64.1
.

47.9 16.2 23.1 89.9 73.8 71.4 43.5

47.4 15.0
* 77.5 79.8 67.6 55.5

56.3 13.2
* 90.1 85.4 80.7 61.4

70.9

52.9

12.3

13.7

*

8.5

91.4

85.5

86.2

79.3

83.9

73.2

71.3

58.0

477

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Warren County - 149

1990
6078 1346
124
21.0 15.4 23.0
16 4
100 12 57
1 0 20 4
2 2 0 2 0 0
12 3 0
13 0 2
75 21 36
3 8 1 9
. . .
66 11
0 64 47 41
. 0

1991
6132 1356 127
21.2 17.3 21.5
22 7
102 13 56 2 0 29 9
1 1 0 1 0 0
16 2 1
13 0 1
75 32 36
3 11
1 8
1 0 4
78 8 1
73 57 54
3 0

Total
1992 1993

6179 1366
129

6234 1376 131

21.0 16.5 21.0

19.4 19.9 27.0

11

15

4

5

95

80

6

10

55

51

4

7

0

1

22

21

5

5

0

5

0

5

0

0

0

6

0

0

1

1

13

13

1

8

0

3

10

13

0

2

0

2

43

35

33

28

27

25

1

0

11

3

2

0

4

3

1

0

3

2

2

0

67

71

14

3

5

3

62

61

61

61

49

55

7

17

1

1

1994 5-year

6283 1386
134

30906 6830 645

20.2 18.1 22.0

20.9 17.5 22.0

15

79

3

23

82

459

13

54

54

273

5

19

0

1

16

108

2

25

4

12

4

12

0

0

4

13

1

1

0

2

14

68

6

20

2

6

9

58

2

4

2

7

27

255

28

142

26

150

0

7

9

42

1

5

3

27

0

2

1

6

11

17

71

353

9

45

1

10

55

315

49

275

41

240

20

47

1

3

1990
2413 447 37

1991
2427 451
38

White
1992 1993

2436 453 38

2449 457
38

1994 5-year

2462 461 39

12187 2269 189

23.0 .
22.0

24.5 20.8 22.0

22.2 18.2 21.0

19.5 21.0 21.0

21.9 18.5 22.0

22.3 20.3 22.0

0

1

0

2

3

6

0

0

0

1

0

1

21

23

27

15

20

106

0

1

0

2

3

6

3

0

3

2

5

13

1

1

2

4

0

8

0

0

0

1

0

1

3

3

2

5

3

16

0

0

0

0

0

0

0

0

0

1

0

1

0

0

0

1

0

1

0

0

0

0

0

0

0

0

0

2

0

2

0

0

0

0

0

0

0

0

0

1

0

1

1

4

1

1

0

7

0

0

0

1

0

1

0

0

0

1

0

1

3

3

2

1

0

9

0

0

0

0

0

0

0

0

0

0

0

0

11

9

9

5

7

41

1

0

3

0

3

7

3

3

4

2

5

17

1

0

0

0

0

1

5

5

6

1

5

22

1

1

1

0

0

3

1

0

0

0

0

1

.

0

0

0

0

0

.

0

0

0

1

1

.

4

0

0

0

4

17

21

18

14

17

87

6

5

5

1

5

22

0

0

1

0

0

1

7

5

8

7

5

32

5

6

7

7

3

28

4

4

5

6

3

22

.

0

0

1

1

2

0

0

0

1

0

1

1990
3656 895 87

1991
3689 901
89

Black
1992 1993

3717 907 90

3750 912
92

1994 5-year

3779 918 94

18590 4533 452

19.4 15.4 25.0

20.5 16.8 21.0

20.1 15.3 20.0

19.3 16.9 28.0

19.8 17.8 25.5

19.8 16.4 25.0

16

21

11

13

12

73

4

7

4

4

3

22

79

79

67

65

62

352

12

12

6

8

10

48

54

56

52

49

49

260

0

1

2

3

5

11

0

0

0

0

0

0

17

26

20

14

13

90

4

9

5

5

2

25

2

1

0

4

4

11

2

1

0

4

4

11

0

0

0

0

0

0

2

1

0

4

4

11

0

0

0

0

1

1

0

0

1

0

0

1

11

12

11

12

14

60

3

2

1

7

6

19

0

1

0

2

2

5

10

10

7

12

9

48

0

0

0

2

2

4

2

1

0

2

2

7

64

66

33

30

20

213

20

32

30

28

25

135

33

33

23

23

21

133

2

3

1

0

0

6

3

6

5

2

4

20

0

0

1

0

1

2

8

8

4

3

3

26

.

0

1

0

0

1

.

0

1

2

0

3

.

0

2

0

11

13

49

57

48

57

54

265

5

3

9

2

4

23

0

1

3

3

1

8

57

68

54

54

50

283

42

51

54

54

46

247

37

50

44

49

38

218

.

3

7

16

19

45

0

0

1

0

1

2

478

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Warren County - 149

16.5 74.3
2.2 57.0
3.3 14.9
0.4 165.3
*
129.0 *
96.8 100.0
* * *
* * * * * *
12.0 * *
13.0 * *
76.5 21.0 36.4
* 8.0
* 15.0
. . .
66.7 11.5
* 64.0 47.0 41.0
.

16.6 75.2
2.2 55.4
4.7 21.4
0.6 218.0
*
173.9 31.8
102.8 92.3 71.1
100.0 *
* * * * * *
15.7 * *
12.9 * *
78.1 31.4 35.3
* 11.1
* 13.8
* * *
76.5 8.3 *
71.6 55.9 52.9
*

15.4 69.5 2.1 57.9 3.6 16.1 0.5 181.8
*
85.3 *
46.5 100.0
38.8 100.0
*
* * * * * *
13.7 * *
10.5 * *
46.2 34.7 29.0
* 11.7
* *
* * *
70.5 16.3 55.6 65.3 64.2 51.6 7.4

12.8 58.1
1.7 65.4
3.4 15.3
0.4 190.9
6.5
114.2 33.3 76.1 90.0 38.1
100.0 *
62.5 62.5
* 74.1
* *
16.2 10.0
* 16.7
* *
44.9 35.9 32.1
* * * *
* * *
88.8 * *
78.2 78.2 70.5 21.8

13.1 59.2 1.8 67.5 2.5 11.5 0.3 155.3
3.6
112.1 *
97.2 100.0
* * *
* * * * * *
17.1 7.3
* 11.3
* *
34.6 35.0 32.9
* 11.4
* *
* * 6.2
86.6 12.0
* 68.8 61.3 51.3 25.0

14.9 67.2
2.0 60.1
3.5 15.8
0.4 183.7
3.1
122.6 29.1 83.8 96.3 38.8 100.0
*
26.1 26.1
* 28.3
* *
14.8 4.4 1.3
12.8 *
1.5
57.6 31.2 33.3
1.5 9.3 1.1 9.9
* 0.9 2.4
77.1 10.7 30.3 69.2 60.4 52.7 13.2

8.7 47.0
1.5 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
52.4 * * *
23.8 * *
. . .
81.0 31.6
* 33.3 23.8
* .

9.5 51.0
1.6 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
45.0 * * *
22.7 * *
* * *
91.3 22.7
* 21.7 26.1
* *

11.1 59.6 1.9
* * * * * *

6.1 32.8
1.0 *
2.0 10.9
* 200.0
10.9

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

36.0 * * *
23.1 * *

33.3 * * * * * *

*

*

*

*

*

*

66.7 20.8
* 29.6 25.9 18.5
*

93.3 * *
46.7 46.7 40.0
*

8.1 43.4 1.4 25.0
* * * * *

8.7 46.7
1.5 12.3
1.3 7.1 0.2 122.1 4.0

*

31.7

*

*

*

31.7

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

6.6

*

*

*

*

*

8.5

*

*

*

*

36.8 *
25.0 *
26.3 * *

41.0 6.6
16.2 *
21.4 * *

*

*

*

*

*

*

85.0 26.3
* 25.0
* * *

82.1 22.9
* 30.2 26.4 20.8
*

21.6 88.3
2.5 68.4
4.6 19.0
0.5 . *

21.4 87.7
2.5 71.8
7.0 28.9
0.8 245.3
*

18.0 73.9 2.1 77.6 5.4 22.1 0.6 224.7
*

17.3 71.2
2.1 77.8
3.7 15.3
0.4 168.7
*

16.4 67.5 1.9 81.7 3.4 14.2 0.4 162.5 5.4

18.9 77.7
2.2 74.9
4.8 19.9
0.5 198.2
2.6

183.9 *
137.9 100.0
* * *

236.8 33.3
135.3 100.0 101.5 100.0
*

121.7 *
66.4 100.0
55.3 100.0
*

141.0 *
86.8 100.0
54.2 100.0
*

127.8 *
106.5 100.0
* * *

161.4 30.1 106.1
100.0 55.3 100.0 *

*

*

*

*

*

31.3

*

*

*

*

*

31.3

*

*

*

*

*

*

*

*

*

*

*

.

*

*

*

*

*

*

*

*

*

*

*

*

13.9 * *
12.7 * *

15.2 * *
12.8 * *

16.4 * *
10.4 * *

18.5 10.8
* 19.0
* *

22.6 9.7
* 15.0
* *

17.0 5.4 1.4
13.8 *
2.0

83.1 25.3 42.3
* * * 15.1

86.8 40.5 41.8
* 7.8
* 16.3

49.3 44.8 34.8
* 7.5
* *

47.6 44.4 36.5
* * * *

33.9 41.7 35.6
* * * *

62.3 38.8 38.6
1.7 5.8
* 11.6

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

*

8.3

2.5

62.8 6.5 *
72.2 53.2 46.8
.

72.2 * *
86.1 64.6 63.3
*

71.6 14.5
* 80.6 80.6 65.7 10.4

87.7 * *
85.7 85.7 77.8 25.4

87.1

75.5

*

7.1

*

36.4

83.3

81.3

76.7

71.0

63.3

62.6

31.7

16.7

479

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Washington County - 150

1990
19112 4388 462
19.9 17.1 24.0
57 9
324 38 163
9 5 62 18
3 2 1 7 1 2
31 9 0
31 8 3
177 95 96
9 45
7 13
. . .
236 40
0 169 157 122
. 0

1991
19277 4405 465
20.9 19.2 22.0
45 9
311 38
157 15 3 54 6
6 2 4 5 0 2
31 2 0
35 3 1
166 94 90 8 23 5 17
6 8 21
237 32 2
164 169 136
1 0

Total
1992 1993

19441 4424 468

19604 4442 472

20.9 19.5 22.0

20.8 16.6 23.0

42

43

7

10

330

294

35

31

176

162

10

14

5

6

53

59

7

12

3

3

2

2

1

1

7

8

0

1

5

2

33

29

2

2

0

0

35

36

5

6

4

7

124

138

91

99

98

77

6

5

26

15

4

3

22

11

13

25

16

16

26

46

262

225

32

26

6

4

175

165

193

191

151

156

28

100

0

3

1994 5-year

19762 4459 475

97196 22118
2342

21.0 20.6 23.0

20.8 18.4 23.0

46

233

10

45

276

1535

39

181

142

800

17

65

5

24

58

286

9

52

5

20

4

12

1

8

9

36

0

2

1

12

29

153

6

21

0

0

27

164

6

28

2

17

92

697

77

456

74

435

3

31

22

131

3

22

7

70

9

53

13

53

41

134

225

1185

41

171

2

14

150

823

158

868

125

690

82

211

0

3

1990
9198 1950
198

1991
9244 1952 199

White
1992 1993

9292 1954
200

9336 1957 201

1994 5-year

9381 1959
202

46451 9772 999

22.1 17.1 22.0

22.3 20.1 21.0

24.1 20.7 21.0

22.7 16.4 21.0

24.3 20.6 22.0

23.1 19.7 21.0

11

7

8

0

0

1

106

113

107

6

5

7

7

16

17

2

10

6

1

0

1

16

22

19

4

2

1

8

10

44

3

1

5

99

104

529

3

4

25

21

15

76

7

5

30

2

1

5

17

19

93

5

5

17

0

1

0

2

2

5

0

0

0

1

1

2

0

1

0

1

1

3

1

0

1

3

2

7

0

0

0

0

0

0

1

0

3

0

1

5

5

6

4

7

6

28

1

0

0

0

0

1

0

0

0

0

0

0

11

4

6

7

9

37

1

1

1

1

2

6

1

0

1

1

2

5

38

31

31

41

30

171

6

14

8

6

9

43

17

21

17

17

14

86

2

0

1

1

0

4

18

12

14

11

13

68

1

0

1

1

1

4

2

2

0

1

4

9

.

1

6

2

3

12

.

5

6

6

4

21

.

3

7

10

12

32

97

97

98

87

95

474

19

18

16

11

17

81

0

1

1

1

0

3

20

30

22

27

27

126

17

30

24

35

32

138

10

26

14

25

22

97

.

0

6

10

10

26

0

0

0

2

0

2

1990
9874 2426
263

1991
9959 2434 265

Black
1992 1993

10044 2444 267

10128 2453 268

1994 5-year

10210 2461 271

50215 12218
1333

19.0 17.2 26.0

19.3 18.2 28.5

19.8 18.7 25.0

19.4 16.8 26.0

18.8 20.8 26.0

19.3 17.8 26.0

46

38

34

35

36

189

9

9

6

7

9

40

217

197

222

194

170

1000

32

33

28

28

35

156

156

141

159

141

127

724

7

5

4

7

12

35

4

3

4

4

4

19

46

32

34

42

39

193

14

4

6

7

4

35

3

5

3

1

3

15

2

2

2

1

3

10

1

3

1

0

0

5

6

5

6

5

7

29

1

0

0

1

0

2

1

2

2

2

0

7

26

25

29

22

23

125

8

2

2

2

6

20

0

0

0

0

0

0

20

31

29

29

18

127

7

2

4

5

4

22

2

1

3

6

0

12

139

134

93

96

62

524

89

80

83

93

68

413

79

69

81

60

59

348

7

8

5

4

3

27

27

11

12

4

9

63

6

5

3

2

2

18

11

15

22

10

3

61

.

4

7

20

2

33

.

3

10

9

8

30

.

18

19

24

24

85

138

139

163

138

129

707

21

14

15

15

24

89

0

1

5

3

2

11

149

133

153

138

123

696

140

139

169

156

126

730

112

110

137

131

103

593

.

1

22

90

72

185

0

0

0

1

0

1

480

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Washington County - 150

17.0 73.8
2.2 51.4
3.2 14.1
0.4 154.6
3.4
123.4 15.8 82.3 81.6 39.0 100.0
*
* * * 21.3 * *
9.6 2.8
* 9.8 2.5
*
62.3 30.0 30.7
2.9 14.3
2.2 7.1
. . .
73.5 13.8
* 53.3 49.5 38.5
.

16.1 70.6
2.1 51.0
2.8 12.3
0.4 139.9
4.8
96.7 20.0 81.7 94.7 12.9 100.0
*
19.3 * *
15.9 * *
10.0 * *
11.4 * *
67.8 30.5 29.4
2.6 7.5 1.6 9.5
1.1 1.4 3.7
78.2 11.5
* 53.2 54.9 44.2
*

17.0 74.6 2.2 54.0 2.7 12.0 0.4 132.8 3.6
89.7 16.7 74.7 88.6 14.9 100.0
*
* * * 20.9 * 1.2
10.0 * *
10.7 1.5
*
44.8 27.9 30.2
1.8 8.1
* 11.6
2.3 2.8 4.6
79.6 10.6 24.0 53.7 59.2 46.3
8.6

15.0 66.2
2.0 56.4
3.0 13.3
0.4 158.2
4.5
91.2 23.3 65.7 100.0 25.5 100.0
*
* * * 26.7 * *
9.9 * *
12.5 2.1 2.4
54.1 34.5 27.0
1.8 5.2
* 6.4
4.4 2.8 8.0
77.6 10.3
* 57.5 66.6 54.4 34.8

14.0 61.9 1.9 52.4 2.9 13.0 0.4 162.9 4.9
96.8 21.7 82.1 91.7 18.9 100.0
*
18.1 * *
32.0 * *
10.5 2.2 *
10.0 2.2 *
39.5 28.4 27.3
* 8.2
* 4.6
1.6 2.3 7.1
82.1 17.0
* 55.4 58.3 46.1 30.3

15.8 69.4
2.1 53.0
2.9 12.9
0.4 149.3
4.2
99.5 19.3 77.3 91.0 22.2 100.0
*
13.0 7.8 5.3
23.1 *
0.6
10.0 1.4 *
10.9 1.9 1.1
53.9 30.2 29.0
2.1 8.7 1.5 8.0
2.3 2.3 5.9
78.1 12.5
9.6 54.5 57.5 45.7 17.7

11.5 54.4
1.7 6.7 1.7 8.2 0.3 128.0
*

12.2 57.9
1.8 14.3
2.4 11.3
0.4 149.7
6.1

11.5 54.8 1.7 15.9 2.0 9.7 0.3 142.9 3.6

10.6 50.6
1.6 21.4
1.8 8.7 0.3 136.0 4.6

11.1 53.1 1.7 14.6 2.0
9.7 0.3 147.3 3.1

11.4 54.1
1.7 14.5
2.0 9.5 0.3 141.1 3.8

55.6 *
30.3 * * * *

35.2 *
25.2 * * * *

40.0 *
35.0 * * * *

39.9 * * *
24.9 100.0
*

49.6 * * *
24.8 100.0
*

44.0 11.4 25.0 48.0 17.0 100.0
*

*

*

*

*

*

9.5

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

13.1

*

*

*

*

*

*

*

*

*

*

*

0.6

4.7

5.3

*

7.1

5.8

5.3

*

*

*

*

*

*

*

*

*

*

*

*

10.5

*

5.6

7.1

8.7

7.0

*

*

*

*

*

1.1

*

*

*

*

*

0.9

40.4 5.7
16.5 *
17.3 * *

34.8 12.5 18.8
* 10.8
* *

36.0 7.5 16.0
* 13.3
* *

48.2 6.1
17.3 *
11.2 * *

35.7 8.7
13.6 *
12.7 * *

39.0 8.2
16.5 *
13.1 *
3.2

.

*

2.7

*

*

1.3

.

2.2

2.7

2.7

*

2.4

.

*

3.1

4.5

5.4

3.6

91.5 20.2
* 19.0 16.2
9.5 .

85.8 18.8
* 26.8 26.8 23.2
*

92.5 16.7
* 20.6 22.4 13.1 5.6

88.8 12.9
* 27.6 35.7 25.5 10.2

92.2 20.0
* 26.2 31.1 21.4
9.7

90.1 17.8
* 24.0 26.3 18.5
6.2

22.0 89.4
2.5 73.9
4.7 19.0
0.5 167.9
4.5

19.8 80.9
2.3 72.3
3.2 13.1
0.4 134.5
3.7

22.1 90.8 2.6 72.9 3.4 13.9 0.4 128.3 3.7

19.2 79.1
2.3 75.0
4.1 17.1
0.5 170.0
4.5

16.7 69.1 2.0 76.5 3.8 15.8 0.4 173.3 6.5

19.9 81.8
2.4 74.0
3.8 15.8
0.4 154.5
4.6

174.9 19.6 121.7 93.8 53.2 100.0
*

143.5 23.7
124.6 97.0 * * *

127.5 17.6
105.0 100.0
22.5 100.0
*

130.4 20.0
104.3 100.0
26.1 100.0
*

133.0 25.0
129.3 100.0
* * *

141.7 21.2
117.0 98.0 26.2 100.0 *

* * * 27.1 * *

25.4 * *
25.0 * *

* * * 26.5 * *

* * * 25.3 * *

* * * 40.2 * *

15.0 10.0
5.1 28.5
* 0.6

12.0 3.7 * 9.6 3.3 *

12.7 * *
16.1 * *

13.1 * *
13.3 * *

11.3 * *
15.4 2.7 3.1

13.5 3.5 * 10.9 * *

12.5 2.0 *
13.1 2.2 1.2

73.5 42.2 37.8
3.4 12.9
2.9 8.7

86.5 41.0 35.8
4.2 5.6 2.6 12.5

48.7 38.1 37.3 2.3 5.6
* 16.9

56.8 49.5 32.3
* * * 8.3

42.2 41.0 35.5
* 5.5
* *

61.6 42.2 35.8
2.8 6.5 1.9 10.3

.

*

2.1

5.8

*

2.4

.

*

2.9

2.6

2.3

2.2

.

5.3

5.6

7.0

7.0

6.2

64.5 10.7
* 70.6 66.4 53.1
.

73.5 7.7 *
68.2 71.3 56.4
*

73.4 7.4 35.7 70.2 77.5 62.8 10.1

72.3 9.0 *
73.4 83.0 69.7 47.9

76.3

71.8

15.6

9.9

*

14.7

74.1

71.2

75.9

74.6

62.0

60.6

43.4

24.1

481

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Wayne County - 151

1990
22356 4959 536
20.4 19.4 20.0
55 18 361 51 117
6 1 33 4
0 0 0 1 0 2
24 4 0
38 2 4
120 55 119
4 69 13 17
. . .
243 67
9 188 152 119
. 0

1991
22556 4982 538
19.5 18.1 20.0
63 16 360 57 123 15
5 26
5
1 1 0 6 2 3
32 5 0
40 4 4
120 60
138 8
69 10 25
1 2 31
212 47 6
211 160 148
58 0

Total
1992 1993

22747 5004 540

22950 5029 542

19.5 17.8 21.0

19.7 17.8 21.0

60

58

17

13

404

344

55

52

137

120

19

5

5

1

23

24

6

6

5

5

3

1

2

4

8

2

0

0

3

2

39

22

8

6

1

0

43

34

6

3

4

3

142

107

74

48

149

116

5

4

90

71

7

5

22

12

7

15

14

28

49

35

275

250

63

61

6

6

232

217

215

222

183

191

156

136

0

0

1994 5-year

23146 5051 544

113755 25025 2700

19.6 17.3 21.0

19.7 18.0 20.0

58

294

13

77

307

1776

48

263

108

605

4

49

1

13

25

131

10

31

2

13

0

5

2

8

2

19

2

4

1

11

21

138

1

24

0

1

28

183

2

17

2

17

107

596

47

284

109

631

4

25

51

350

3

38

10

86

10

33

24

68

46

161

239

1219

49

287

8

35

185

1033

194

943

158

799

133

483

1

1

1990
17884 3916 398

1991
18046 3925 397

White
1992 1993

18205 3933 396

18367 3943 394

1994 5-year

18527 3951 393

91029 19668
1977

20.9 21.3 20.0

20.6 18.3 19.0

20.2 17.8 21.0

20.4 17.1 20.5

20.2 17.4 21.0

20.5 18.0 20.0

34

36

41

36

39

186

11

8

11

7

8

45

267

256

304

258

230

1315

33

32

37

31

31

164

50

51

66

60

54

281

4

14

18

5

3

44

1

3

2

1

1

8

19

18

15

15

18

85

1

3

5

5

8

22

0

0

3

4

2

9

0

0

2

1

0

3

0

0

1

3

2

6

1

3

4

2

2

12

0

2

0

0

1

3

2

3

1

2

1

9

16

15

23

12

13

79

3

1

8

2

1

15

0

0

1

0

0

1

27

25

25

23

20

120

2

3

4

2

1

12

4

2

3

2

2

13

79

75

100

71

78

403

25

18

38

21

26

128

80

85

107

81

77

430

2

5

4

2

3

16

57

61

80

66

45

309

8

7

4

3

2

24

8

12

13

10

5

48

.

0

6

9

8

23

.

2

12

22

20

56

.

10

34

18

27

89

199

165

226

202

183

975

50

35

51

46

40

222

6

3

3

4

6

22

129

124

160

153

129

695

94

88

142

150

131

605

76

80

120

132

107

515

.

25

102

89

90

306

0

0

0

0

1

1

1990
4358 1016
137

1991
4397 1020 138

Black
1992 1993

4434 1024
138

4474 1029 138

1994 5-year

4512 1033
139

22175 5122 690

18.8 18.4 24.0

18.0 17.1 25.5

18.0 17.3 22.0

18.8 28.1 24.5

18.1 15.8 23.0

18.3 18.1 24.0

21

27

19

22

19

108

7

8

6

6

5

32

93

102

99

83

77

454

18

25

18

21

17

99

67

71

71

60

54

323

2

0

1

0

0

3

0

2

3

0

0

5

13

8

8

9

7

45

3

2

1

1

2

9

0

1

2

1

0

4

0

1

1

0

0

2

0

0

1

1

0

2

0

3

4

0

0

7

0

0

0

0

1

1

0

0

2

0

0

2

8

17

16

8

1

4

0

2

0

0

0

0

11

15

18

10

0

1

2

0

0

2

1

1

8

57

0

7

0

0

8

62

1

4

0

4

41

44

41

36

29

191

30

42

36

27

21

156

39

52

42

34

32

199

2

3

1

2

1

9

12

8

10

5

6

41

5

3

3

2

1

14

9

13

9

2

5

38

.

1

0

6

2

9

.

0

1

5

1

7

.

19

12

16

15

62

43

46

49

46

56

240

17

12

12

15

9

65

3

3

3

1

2

12

59

86

72

62

56

335

58

71

73

70

63

335

43

67

63

57

51

281

.

33

54

46

43

176

0

0

0

0

0

0

482

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Wayne County - 151

16.1 72.8
2.3 32.7
1.5 6.7 0.2 82.3 1.4
102.6 32.7 95.1 64.7
* * *
* * * * * *
6.6 * *
10.6 * *
34.9 15.3 33.1
* 19.3
3.6 8.1
. . .
67.5 21.1 22.0 52.4 42.3 33.1
.

16.0 72.3
2.2 34.5
1.2 5.2 0.2 63.9 4.2
117.1 25.4
106.0 69.6 9.3
100.0 *
* * * 16.4 * *
8.9 1.4
* 11.2
* *
35.8 16.8 38.7
2.2 19.6
2.8 12.5
* * 4.7
59.1 14.4 20.0 59.1 44.8 41.5 16.2

17.8 80.7 2.5 34.4 1.0 4.6 0.1 51.0 4.8
111.0 28.3
101.8 68.5 11.1 83.3 *
12.4 * *
19.6 * *
9.7 2.0
* 10.8
1.5 *
37.7 18.6 37.6
1.3 23.0
1.8 9.0
1.1 2.1 7.5
68.6 17.9 13.0 58.3 54.0 46.0 39.2

15.0 68.4
2.1 35.2
1.0 4.8 0.1 64.2 1.2
107.1 22.4 96.0 58.8 11.1
100.0 *
14.5 * * * * *
6.4 1.7
* 10.0
* *
32.2 14.1 34.0
* 20.9
1.5 6.2
2.3 4.2 5.3
72.7 20.0 16.7 63.6 65.1 56.0 39.9

13.3 60.8 1.9 35.4 1.1 4.9 0.1 74.2 1.0
106.6 22.4 88.3 62.5 18.4
100.0 *
* * * * * *
6.8 * *
9.2 * *
36.1 15.4 35.7
* 16.8
* 6.1
1.5 3.6 6.9
78.4 18.1 23.5 60.7 63.6 51.8 43.6

15.6 71.0
2.2 34.4
1.2 5.2 0.2 66.5 2.5
108.9 26.2 97.4 65.0 11.5 96.8
*
7.3 2.8 4.5 10.6
* 0.5
7.8 1.4
* 10.4
1.0 1.0
35.4 16.1 35.9
1.4 20.1
2.2 8.5
1.3 2.6 6.1
68.9 18.2 18.7 58.7 53.6 45.4 34.5

14.9 68.2
2.2 18.9
1.1 4.9 0.2 65.3 1.3
85.4 32.4 82.9 45.5
* * *
* * * * * *
6.0 * *
10.2 * *
31.0 9.4
30.2 *
21.6 3.0 5.4
. . .
74.8 21.1 21.4 48.7 35.5 28.7
.

14.2 65.2
2.0 20.1
1.0 4.6 0.1 61.6 4.6

16.7 77.3 2.4 22.0 0.8 3.8 0.1 44.2 5.1

14.0 65.4
2.0 23.4
0.8 3.8 0.1 53.8 1.5

12.4 58.2 1.8 23.6 1.0 4.6 0.1 71.4
*

90.7 22.2 80.6 53.1
* * *

103.6 26.8 93.5 58.3 12.6 * *

91.4 19.4 78.7 30.0 12.7 100.0
*

99.3 20.5 78.9 45.2 20.4 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

5.9

7.6

4.7

5.7

*

2.6

*

*

*

*

*

*

9.8

8.3

9.0

8.7

*

*

*

*

*

*

*

*

31.6 7.1
33.5 2.0
24.4 2.8 8.5

34.7 12.7 35.8
* 27.1
* 7.2

28.4 8.2
31.6 *
26.0 *
6.6

35.3 11.4 33.6
* 19.7
* 4.2

*

1.2

1.8

1.6

*

2.5

4.5

4.1

2.1

7.0

3.7

5.5

64.7 15.2
* 48.8 34.6 31.5
9.8

74.8 19.2
* 53.3 47.3 40.0 34.0

78.3 20.4
* 59.8 58.6 51.6 34.8

79.9 19.5 25.0 56.3 57.2 46.7 39.3

14.4 66.9
2.1 21.6
0.9 4.3 0.1 58.5 2.7
94.1 24.2 83.0 46.9 11.1 95.5
*
6.8 *
4.6 9.1
* 0.5
6.0 1.1
* 9.2 0.9 1.0
32.2 9.8
33.0 1.2
23.9 1.9 6.5
1.2 2.9 4.6
74.4 19.1 15.7 53.3 46.4 39.5 29.5

21.3 91.5
2.6 72.0
3.0 12.8
0.3 120.4
*

23.2 100.0
2.8 70.3
1.8 7.8 0.2 71.4
*

22.3 96.7 2.7 73.2 1.8 7.8 0.2 72.1
*

18.6 80.7
2.3 72.3
2.0 8.7 0.2
. *

17.1 74.6 2.1 71.1 1.6 6.8 0.2
. *

20.5 88.6
2.5 71.8
2.0 8.8 0.2 88.8 1.6

153.3 33.3 131.4 100.0
* * *

196.4 29.6
181.8 91.7 * * *

137.6 31.6
130.3 88.9 * * *

159.0 27.3
151.7 100.0
* * *

136.7 26.3
122.3 94.1 * * *

156.5 29.6
143.5 94.9 13.0 100.0 *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

15.3

*

*

*

*

*

*

*

*

*

*

*

*

8.6 * *
11.8 * *

16.7 * *
14.9 * *

16.2 * *
18.6 * *

9.6 * *
12.0 * *

10.4 * *
10.5 * *

12.6 1.5 *
13.8 * *

46.6 32.3 41.9
* 12.9
5.4 15.0

45.8 41.6 51.5
* 8.0
* 22.4

46.6 37.1 43.8
* 10.4
* 13.8

45.0 32.5 41.0
* 6.0
* *

38.7 27.6 42.1
* 7.9
* 10.6

44.7 34.7 44.3
2.0 9.2 3.1 14.0

.

*

*

3.6

*

1.3

.

*

*

3.0

*

1.0

.

11.5

7.2

9.6

8.9

9.3

46.2 21.0
* 63.4 62.4 46.2
.

45.1 12.8
* 85.1 70.3 66.3 32.7

50.0 14.0
* 74.2 75.3 64.9 55.7

55.4 19.2
* 74.7 84.3 68.7 55.4

73.7

53.1

13.6

16.0

*

26.7

73.7

74.4

82.9

74.4

67.1

62.4

56.6

49.3

483

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Webster County - 152

1990
2263 520 46
22.5 19.9 19.5
3 1 24 3 8 2 2 6 0
0 0 0 2 0 1
0 0 0 1 0 2
7 5 7 1 3 0 0
. . .
15 1 0
20 16 14
. 0

1991
2262 519
46
21.3 .
21.0
4 1 22 4 8 4 1 7 0
2 2 0 3 0 1
3 2 0 4 0 1
6 3 6 0 2 0 1
0 0 1
17 5 0
17 7 7 0 0

Total
1992 1993

2250 513 46

2248 512
46

19.4 14.6 25.0

19.9 .
19.0

5

4

0

1

34

28

4

4

16

14

1

1

0

0

2

1

1

0

0

0

0

0

0

0

0

0

1

0

0

0

4

3

1

2

0

0

3

3

0

0

1

1

14

5

4

10

7

7

1

2

3

1

0

1

1

4

3

0

1

0

16

1

22

18

8

7

0

0

26

20

17

21

15

17

1

5

0

0

1994 5-year

2237 509 45

11260 2573 228

19.9 .
23.0

20.1 17.3 21.0

4

20

1

4

24

132

2

17

9

55

3

11

0

3

3

19

1

2

0

2

0

2

0

0

0

5

0

1

0

2

1

11

0

5

0

0

3

14

1

1

0

5

11

43

6

28

6

33

0

4

2

11

0

1

1

7

0

3

0

1

7

25

15

87

4

25

0

0

18

101

15

76

14

67

5

11

1

1

1990
1127 221 23

1991
1124 220 23

White
1992 1993

1120 215 23

1118 213 23

1994 5-year

1112 210 22

5601 1079
113

28.2 19.9 18.0

19.4 .
20.0

18.8 .
21.0

18.9 .
19.0

19.9 .
22.0

19.4 19.9 20.0

1

2

1

1

1

6

0

0

0

0

0

0

9

11

13

11

14

58

1

2

1

1

1

6

0

3

3

3

0

9

0

2

1

0

0

3

0

0

0

0

0

0

3

4

0

0

0

7

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

1

2

0

4

0

0

1

1

0

2

0

0

0

0

0

0

1

2

1

1

2

7

0

0

0

0

1

1

2

0

0

0

0

2

3

2

2

0

4

11

0

1

3

2

0

6

2

4

4

3

4

17

1

0

1

1

0

3

3

1

2

1

2

9

0

0

0

1

0

1

0

1

0

0

1

2

.

0

2

0

0

2

.

0

0

0

0

0

.

1

8

0

4

13

6

9

10

9

11

45

0

2

3

3

2

10

0

0

0

0

0

0

5

7

8

7

9

36

6

2

6

7

7

28

4

2

5

4

6

21

.

0

1

1

1

3

0

0

0

0

1

1

1990
1132 299 23

1991
1132 298 23

Black
1992 1993

1126 294 23

1125 293
23

1994 5-year

1119 291 23

5633 1476
114

21.5 .
20.0

23.7 .
24.5

20.0 14.6 35.0

21.2 .
23.0

20.3 .
27.0

21.3 14.6 25.0

2

2

4

3

3

14

1

1

0

1

1

4

15

11

21

17

10

74

2

2

3

3

1

11

8

5

13

11

9

46

2

2

0

1

3

8

2

1

0

0

0

3

3

3

2

1

3

12

0

0

1

0

1

2

0

2

0

0

0

2

0

2

0

0

0

2

0

0

0

0

0

0

2

3

0

0

0

5

0

0

1

0

0

1

1

1

0

0

0

2

0

2

3

1

1

7

0

2

0

1

0

3

0

0

0

0

0

0

0

2

2

2

1

7

0

0

0

0

0

0

0

1

1

1

0

3

4

4

12

5

7

32

5

2

1

8

6

22

5

2

3

4

2

16

0

0

0

1

0

1

0

1

1

0

0

2

0

0

0

0

0

0

0

0

1

4

0

5

.

0

1

0

0

1

.

0

1

0

0

1

.

0

8

1

3

12

9

8

12

9

1

3

5

4

0

0

0

0

15

10

18

13

10

5

11

14

10

5

10

13

.

0

0

4

0

0

0

0

4

42

2

15

0

0

9

65

8

48

8

46

4

8

0

0

484

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

10.6

9.7

15.1

12.5

10.7

11.7

General fertility rate

46.2

42.4

66.3

54.7

47.2

51.3

Total fertility rate

1.4

1.3

2.0

1.7

1.4

1.5

% Livebirths to unmarried women

33.3

36.4

47.1

50.0

39.1

42.0

Crude abortion rate

2.7

3.1

*

*

*

1.7

General abortion rate

11.5

13.5

*

*

*

7.4

Total abortion rate

0.4

0.4

*

*

*

0.2

Abortion ratio

176.5 205.9

*

*

* 114.5

Fetal Death rate

*

9.6

*

*

*

5.8

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

*

* 109.9

*

*

87.7

% Repeat conceptions to women under 18

*

*

*

*

*

*

Livebirths to women under 18

*

*

*

*

*

74.6

% Livebirths to unmarried women under 18

*

*

*

*

*

88.2

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

*

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

37.0

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

*

*

*

*

*

8.3

% Very low birthweight

*

*

*

*

*

3.8

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

*

*

*

*

*

10.7

% Multiple gestation

*

*

*

*

*

*

% Birth defect

*

*

*

*

*

3.8

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

30.4

27.3

42.4

21.7

50.0

35.0

% with father not named on birth certificate

20.8

*

*

35.7

26.1

21.4

% with maternal education less than high school

29.2

27.3

20.6

25.9

26.1

25.4

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

*

*

*

*

*

8.4

% Maternal alcohol use during pregnancy

*

*

*

*

*

*

% Interpregnancy interval less than 6 months

*

*

*

*

*

10.9

Child abuse and neglect rates

Physical

.

*

*

*

*

*

Sexual

.

*

*

*

*

*

Neglect

.

*

26.5

*

12.0

10.4

Interventions to improve infant & child survival

% Prenatal care first trimester

62.5

77.3

64.7

64.3

62.5

65.9

% Primary C-section delivery

*

.

24.2

26.9

*

20.0

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

83.3

77.3

76.5

71.4

78.3

77.1

% Medicaid during pregnancy

66.7

31.8

50.0

75.0

65.2

58.0

% Medicaid and WIC during pregnancy

58.3

31.8

44.1

60.7

60.9

51.1

% Perinatal case management

.

*

*

17.9

21.7

10.3

Webster County - 152

8.0 40.7
1.3 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
. . .
66.7 * *
55.6 66.7
* .

9.8 50.0
1.7 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* * *
81.8 * *
63.6 * * *

11.6 60.5 2.0
* * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* * 29.8
76.9 * *
61.5 46.2 38.5
*

9.8 51.6
1.7 * * * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* * *
81.8 * *
63.6 63.6
* *

12.6 66.7 2.3
* * * * * *

10.4 53.8
1.8 15.8
1.2 6.5 0.2 102.9
*

*

53.1

*

*

*

53.1

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

12.3

*

*

*

*

*

20.8

*

10.5

*

30.4

*

*

*

15.8

*

*

*

*

*

*

*

*

*

12.2

78.6 * *
69.2 53.8 46.2
*

77.6 18.9
* 63.2 49.1 36.8
*

13.3 50.2
1.4 53.3
* * * * *
* * * * * * *
* * * * * *
* * * * * *
* 33.3 33.3
* * * *
. . .
60.0 * *
100.0 66.7 66.7 .

9.7 36.9
1.0 45.5
* * * * *
* * * * * * *
* * * * * *
* * * * * *
* * * * * * *
* * *
72.7 * *
90.9 45.5 45.5
*

18.7 71.4 2.1 61.9
* * * * *
* * * * * * *
* * * * * *
* * * * * *
57.1 * * * * * *
* * 24.0
57.1 . *
85.7 52.4 47.6
*

15.1 58.0
1.7 64.7
* * * * *
* * * * * * *
* * * * * *
* * * * * *
35.7 47.1
* * * * *
* * *
52.9 * *
76.5 82.4 76.5
*

8.9 34.3 1.0 90.0
* * * * *

13.1 50.1
1.4 62.2
2.1 8.1 0.2 122.4 8.1

* 122.9

*

*

*

96.6

* 100.0

*

*

*

*

*

*

*

*

*

*

*

*

*

64.9

*

*

*

*

*

9.5

*

*

*

*

*

9.5

*

*

*

*

70.0 60.0
* * * * *

45.7 29.7 21.6
* * * 13.9

*

*

*

*

*

9.1

*

56.8

*

20.8

*

*

90.0

87.8

80.0

64.9

80.0

62.2

*

13.6

485

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Wheeler County - 153

1990
4903 1016
139
19.9 25.7 20.0
13 6
73 13 27
2 0 5 0
0 0 0 0 0 0
5 1 0 7 1 0
18 15 24
0 10
2 5
. . .
55 11
0 50 31 30
. 0

1991
4945 1020 135
20.2 27.8 21.0
7 1 81 7 26 3 1 4 0
2 1 1 2 0 1
6 3 0 6 1 1
21 14 29
0 10
0 7
0 0 4
59 13
0 62 46 43 20
0

Total
1992 1993

4982 1023
132

5023 1027 128

19.3 17.7 22.0

20.0 20.7 21.0

13

9

2

1

65

54

10

7

19

19

3

5

0

0

8

10

2

0

2

0

0

0

2

0

0

0

0

0

0

0

4

3

0

2

0

0

6

3

0

0

1

0

17

8

15

11

24

23

1

0

9

7

1

0

5

1

1

6

0

1

1

27

44

41

9

10

0

0

54

41

42

35

39

33

32

20

0

0

1994 5-year

5061 1029
124

24914 5115 657

20.9 20.6 21.0

20.3 19.7 21.0

9

51

2

12

64

337

8

45

23

114

6

19

1

2

5

32

1

3

1

5

0

1

1

4

2

4

0

0

1

2

9

27

3

9

0

0

7

29

0

2

1

3

21

85

14

69

20

120

0

1

10

46

0

3

3

21

1

8

6

7

57

89

47

246

18

61

0

0

52

259

48

202

46

191

47

119

1

1

1990
3352 677 91

1991
3371 676
88

White
1992 1993

3387 673 85

3403 671
83

1994 5-year

3420 669 80

16933 3366 427

22.1 .
20.0

19.0 .
20.0

20.9 16.6 22.0

21.0 .
19.0

21.6 19.3 20.0

20.9 17.9 20.0

8

5

6

5

4

28

5

1

1

0

1

8

48

46

44

38

40

216

8

5

4

5

3

25

12

9

6

6

5

38

2

1

2

1

4

10

0

1

0

0

0

1

0

2

6

5

3

16

0

0

2

0

1

3

0

0

0

0

1

1

0

0

0

0

0

0

0

0

0

0

1

1

0

1

0

0

0

1

0

0

0

0

0

0

0

1

0

0

1

2

2

0

1

1

1

5

0

0

0

0

0

0

0

0

0

0

0

0

4

0

2

1

1

8

0

0

0

0

0

0

0

0

0

0

0

0

13

10

10

6

12

51

7

5

4

3

5

24

18

22

16

17

11

84

0

0

1

0

0

1

6

8

9

6

7

36

1

0

1

0

0

2

4

4

3

0

2

13

.

0

1

3

1

5

.

0

0

0

5

5

.

0

1

21

31

53

41

36

33

33

31

174

8

7

5

9

10

39

0

0

0

0

0

0

29

32

36

25

30

152

19

26

26

22

26

119

18

24

24

20

25

111

.

10

20

9

26

65

0

0

0

0

1

1

1990
1474 329 48

1991
1487 331
47

Black
1992 1993

1498 332 45

1510 333
44

1994 5-year

1522 334 43

7490 1659
227

18.4 25.7 22.5

21.3 27.8 24.0

18.4 22.0 26.5

19.1 18.2 23.0

20.8 26.2 30.0

19.3 23.9 24.5

5

2

7

4

5

23

1

0

1

1

1

4

25

35

21

16

24

121

5

2

6

2

5

20

15

17

13

13

18

76

0

2

1

4

2

9

0

0

0

0

1

1

5

2

2

4

2

15

0

0

0

0

0

0

0

2

2

0

0

4

0

1

0

0

0

1

0

1

2

0

0

3

0

1

0

0

2

3

0

0

0

0

0

0

0

0

0

0

0

0

3

6

3

2

8

22

1

3

0

2

3

9

0

0

0

0

0

0

3

6

4

2

6

21

1

1

0

0

0

2

0

1

1

0

1

3

5

11

7

2

9

34

8

9

11

8

9

45

6

7

8

6

9

36

0

0

0

0

0

0

4

2

0

1

3

10

1

0

0

0

0

1

1

3

2

1

1

8

.

0

0

3

0

3

.

0

0

1

1

2

.

0

0

6

24

30

14

23

11

8

16

72

3

6

4

1

8

22

0

0

0

0

0

0

21

30

18

16

22

107

12

20

16

13

22

83

12

19

15

13

21

80

.

10

12

11

21

54

0

0

0

0

0

0

486

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

14.9

16.4

13.0

10.8

12.6

13.5

General fertility rate

71.9

79.4

63.5

52.6

62.2

65.9

Total fertility rate

2.2

2.4

1.8

1.5

1.8

1.9

% Livebirths to unmarried women

37.5

32.5

29.7

35.2

35.9

34.1

Crude abortion rate

1.0

*

1.6

2.0

1.0

1.3

General abortion rate

4.9

*

7.8

9.7

4.9

6.3

Total abortion rate

0.1

*

0.2

0.2

0.1

0.2

Abortion ratio

61.7

* 103.9 142.9

64.9

81.2

Fetal Death rate

*

*

*

5.8

7.8

4.9

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

93.5

51.8

98.9

70.5

72.6

77.6

% Repeat conceptions to women under 18

46.2

*

*

*

*

23.5

Livebirths to women under 18

93.5

51.8

76.0

54.8

64.5

68.5

% Livebirths to unmarried women under 18

53.8

*

70.0

71.4

62.5

62.2

Induced abortions to women under 18

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

7.6

Infant and child survival rates

Infant mortality

*

*

*

*

*

14.8

Neonatal mortality

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

*

Deaths of children 1-4 yrs

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

Infant health rates

% Low birthweight

6.8

7.4

*

*

14.1

8.0

% Very low birthweight

*

*

*

*

*

2.7

% Under 500 grams

*

*

*

*

*

*

% Preterm gestation

9.7

7.5

9.2

*

10.9

8.7

% Multiple gestation

*

*

*

*

*

*

% Birth defect

*

*

*

*

*

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

34.0

35.6

35.4

22.9

38.2

34.0

% with father not named on birth certificate

20.8

17.5

23.1

20.4

21.9

20.6

% with maternal education less than high school

33.3

36.3

36.9

42.6

31.7

35.9

% No prenatal care

*

*

*

*

*

*

% Maternal smoking during pregnancy

13.9

12.7

14.1

13.0

15.6

13.8

% Maternal alcohol use during pregnancy

*

*

*

*

*

*

% Interpregnancy interval less than 6 months

13.9

14.0

14.3

*

*

12.1

Child abuse and neglect rates

Physical

.

*

*

4.3

*

1.4

Sexual

.

*

*

*

4.3

1.2

Neglect

.

*

*

19.3

40.7

15.9

Interventions to improve infant & child survival

% Prenatal care first trimester

76.4

77.6

75.9

78.8

73.4

76.4

% Primary C-section delivery

17.7

17.6

17.0

22.2

29.0

20.6

% Vaginal birth after previous C-section

*

*

*

*

*

*

% WIC during pregnancy

69.4

77.5

83.1

75.9

81.3

77.3

% Medicaid during pregnancy

43.1

57.5

64.6

64.8

75.0

60.3

% Medicaid and WIC during pregnancy

41.7

53.8

60.0

61.1

71.9

57.0

% Perinatal case management

.

25.0

49.2

37.0

73.4

45.2

Wheeler County - 153

14.3 70.9
2.3 25.0
* * * * *
87.9 62.5 87.9
* * * *
* * * * * *
* * * * * *
39.4 14.6 37.5
* 12.5
* *
. . .
85.4 20.0
* 60.4 39.6 37.5
.

13.6 68.0
2.1 19.6
* * * * *

13.0 65.4 2.0 13.6 1.8
8.9 0.3 113.2
*

11.2 56.6
1.7 15.8
1.5 7.5
* 113.6
*

56.6 *
56.6 * * * *

70.4 * * * * * *

60.5 *
60.5 * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

30.3 10.9 47.8
* 17.8
* *

31.3 *
36.4 *
20.5 * *

23.1 *
44.7 *
15.8 * *

*

*

*

*

*

*

*

*

25.3

81.8 16.7
* 69.6 56.5 52.2 21.7

82.5 14.3
* 81.8 59.1 54.5 45.5

91.7 28.1
* 65.8 57.9 52.6 23.7

11.7 59.8 1.8 12.5
* * * * 7.5
* * * * * * *
* * * * * *
* * * * * *
36.4 12.5 27.5
* 17.5
* *
* 6.0 37.4
77.5 26.3
* 75.0 65.0 62.5 65.0

12.8 64.2
2.0 17.6
0.9 4.8 0.1 65.0 4.2
65.5 28.6 58.5 36.0
* * *
* * * * * *
2.3 * *
3.7 * *
32.5 11.1 38.9
* 16.7
* 11.7
1.5 1.5 15.9
83.7 20.9
* 70.4 55.1 51.4 38.7

17.0 76.0
2.1 62.5
3.4 15.2
0.4 . *

23.5 105.9
3.4 50.0
* * * * *

14.0 63.3 1.6 65.0
* * * * *

10.6 48.0
1.3 81.3
* * * * 15.0

15.8 71.8 2.1 75.0
* * * * *

16.2 72.9
2.1 64.4
2.0 9.0 0.2 102.0 6.6

104.2 *
104.2 * * * *

* 154.2

*

*

* 132.2

* 100.0

*

*

*

*

*

*

* 116.8 101.3

*

*

*

* 116.8

88.1

* 100.0

95.0

*

*

*

*

*

*

*

*

22.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

17.1

*

*

33.3

18.2

*

*

*

*

*

7.4

*

*

*

*

*

*

*

17.6

*

*

25.0

17.6

*

*

*

*

*

*

*

*

*

*

*

*

25.0 33.3 25.0
* * * *

42.3 26.5 20.6
* * * *

43.8 52.4 38.1
* * * *

* 50.0 37.5
* * * *

40.9 37.5 39.1
* * * *

36.6 37.8 30.5
* 8.5
* 12.9

.

*

*

*

*

*

.

*

*

*

*

*

.

*

*

11.0

44.0

13.7

58.3 * *
87.5 50.0 50.0
.

71.9 18.8
* 88.2 58.8 55.9 29.4

61.1 * *
85.7 76.2 71.4 57.1

50.0 * *
100.0 81.3 81.3 68.8

66.7

63.2

.

20.2

*

*

91.7

89.9

91.7

69.7

87.5

67.2

87.5

56.8

487

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
White County - 154

1990
13006 2778 271
22.1 19.6 20.0
19 5
182 14 32 14
0 40
4
1 1 0 1 0 1
8 0 0 16 1 5
32 17 37
0 24
2 4
. . .
140 28
3 95 47 41
. 0

1991
13309 2802 273
22.4 19.9 21.0
19 3
179 14 32 17 2 36 4
2 2 0 4 0 0
19 3 0
14 2 4
28 18 44
1 33
3 0
1 5 11
137 21 1
104 76 71 5 0

Total
1992 1993

13611 2824 274

13911 2847 276

22.2 18.7 20.0

21.9 20.3 21.0

21

19

4

0

188

174

19

14

35

27

17

20

0

0

31

32

3

3

3

2

1

2

2

0

1

2

0

2

0

2

11

10

2

3

0

0

12

15

4

0

1

2

28

18

17

20

55

39

1

1

32

21

3

1

6

5

8

6

12

8

25

19

137

150

24

19

3

5

91

98

71

88

61

76

16

3

0

2

1994 5-year

14211 2870 277

68048 14121
1370

21.1 22.0 21.0

21.8 20.0 20.0

17

95

2

14

162

885

17

78

25

151

11

79

0

2

31

170

0

14

2

10

1

7

1

3

1

9

1

3

0

3

11

59

1

9

0

0

5

62

1

8

5

17

22

128

13

85

40

215

1

4

20

130

1

10

3

18

13

28

12

37

37

92

146

710

27

119

1

13

89

477

80

362

66

315

3

27

3

5

1990
12522 2653 257

1991
12821 2679 259

White
1992 1993

13117 2702 261

13415 2727 263

1994 5-year

13710 2751 264

65585 13512
1304

22.8 20.7 20.0

22.4 19.9 21.0

22.1 18.7 20.0

21.7 20.3 21.0

21.3 22.0 21.0

21.9 20.2 20.0

15

18

20

19

15

87

5

3

3

0

2

13

169

173

178

169

159

848

10

14

18

14

15

71

22

29

27

26

23

127

13

17

15

20

10

75

0

1

0

0

0

1

36

34

29

31

30

160

4

4

3

3

0

14

1

2

3

2

2

10

1

2

1

2

1

7

0

0

2

0

1

3

1

3

1

2

1

8

0

0

0

1

1

2

1

0

0

2

0

3

7

19

10

9

11

56

0

3

2

3

1

9

0

0

0

0

0

0

15

14

12

14

5

60

1

2

4

0

1

8

4

4

1

2

5

16

27

26

23

18

21

115

12

16

12

19

12

71

32

43

52

38

39

204

0

1

1

0

1

3

23

31

29

21

20

124

2

2

3

1

1

9

3

0

6

5

3

17

.

0

0

4

12

16

.

0

2

6

11

19

.

0

4

19

34

57

135

133

132

146

144

690

26

20

23

18

26

113

3

1

3

5

1

13

86

98

84

96

86

450

39

71

63

87

78

338

35

66

54

75

64

294

.

5

14

3

3

25

0

0

0

2

3

5

1990
360 92 9

1991
368 93 9

Black
1992 1993

377

385

94

94

9

9

1994 5-year

393 1884

95

467

9

46

17.6 19.3 25.0

. . 23.0

38.3 . .

29.9 . .

15.8 .
29.5

17.8 19.3 24.0

4

1

1

0

2

8

0

0

1

0

0

1

11

5

9

3

3

31

4

0

1

0

2

7

9

3

7

1

2

22

1

0

2

0

1

4

0

1

0

0

0

1

3

1

2

0

1

7

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

0

1

0

0

0

1

0

1

0

0

0

0

0

0

1

0

1

1

0

3

0

0

0

0

0

0

0

0

0

0

0

0

1

0

0

1

0

2

0

0

0

0

0

0

0

0

0

0

0

0

5

2

4

0

1

12

5

2

4

1

1

13

3

1

2

0

1

7

0

0

0

1

0

1

0

2

3

0

0

5

0

1

0

0

0

1

0

0

0

0

0

0

.

0

0

1

0

1

.

0

0

0

0

0

.

0

0

0

1

1

5

4

5

2

2

18

2

1

1

1

1

6

0

0

0

0

0

0

8

5

7

2

3

25

8

4

7

1

2

22

6

4

7

1

2

20

.

0

2

0

0

2

0

0

0

0

0

0

488

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates

Crude birth rate

14.0

13.4

13.8

12.5

11.4

13.0

13.5

13.5

13.6

12.6

11.6

12.9

30.6

13.6

23.9

*

*

16.5

General fertility rate

65.5

63.9

66.6

61.1

56.4

62.7

63.7

64.6

65.9

62.0

57.8

62.8

119.6

53.9

96.3

*

*

66.3

Total fertility rate

2.1

2.0

2.1

2.0

1.8

2.0

2.0

2.0

2.1

2.0

1.8

2.0

4.0

2.2

3.4

*

*

2.3

% Livebirths to unmarried women

17.7

18.1

19.0

15.5

15.5

17.2

13.1

17.0

15.5

15.4

14.6

15.1

81.8

*

77.8

*

*

71.0

Crude abortion rate

3.1

2.7

2.3

2.3

2.2

2.5

2.9

2.7

2.2

2.3

2.2

2.4

*

*

*

*

*

3.7

General abortion rate

14.4

12.8

11.0

11.2

10.8

12.0

13.6

12.7

10.7

11.4

10.9

11.8

*

*

*

*

*

15.0

Total abortion rate

0.4

0.4

0.3

0.3

0.3

0.4

0.4

0.4

0.3

0.3

0.3

0.4

*

*

*

*

*

0.4

Abortion ratio

169.5 152.5 130.8 141.0 151.2 149.0

165.1 149.8 130.0 140.3 150.0 146.9

*

*

*

*

* 162.8

Fetal Death rate

5.0

7.5

6.4

7.4

4.2

6.1

4.9

7.5

5.9

7.7

4.0

6.0

*

*

*

*

*

10.7

Teen pregnancy & perinatal outcome rates

Conceptions to women under 18

70.1

69.7

76.6

68.9

61.3

69.3

58.4

69.5

76.7

72.3

56.8

66.7

*

*

*

*

* 175.4

% Repeat conceptions to women under 18

26.3

*

*

*

*

14.7

33.3

*

*

*

*

14.9

*

*

*

*

*

*

Livebirths to women under 18

51.7

51.4

69.3

50.8

61.3

56.9

38.9

54.0

69.1

53.3

56.8

54.5

*

*

*

*

* 153.5

% Livebirths to unmarried women under 18

71.4

*

*

50.0

58.8

44.2

60.0

*

*

50.0

53.3

38.6

*

*

*

*

* 100.0

Induced abortions to women under 18

*

*

*

*

*

10.2

*

*

*

*

*

10.7

*

*

*

*

*

*

% Abortions to unmarried women under 18

*

*

*

*

* 100.0

*

*

*

*

* 100.0

*

*

*

*

*

*

Fetal deaths to women under 18

*

*

*

*

*

4.4

*

*

*

*

*

3.8

*

*

*

*

*

*

Infant and child survival rates

Infant mortality

*

*

*

*

*

11.3

*

*

*

*

*

11.8

*

*

*

*

*

*

Neonatal mortality

*

*

*

*

*

7.9

*

*

*

*

*

8.3

*

*

*

*

*

*

Postneonatal mortality

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Perinatal mortality ratio

*

*

*

*

*

10.1

*

*

*

*

*

9.4

*

*

*

*

*

*

Deaths of children 1-4 yrs

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Deaths of children 5-17 yrs

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Infant health rates

% Low birthweight

4.4

10.6

5.9

5.7

6.8

6.7

4.1

11.0

5.6

5.3

6.9

6.6

*

*

*

*

*

*

% Very low birthweight

*

*

*

*

*

1.0

*

*

*

*

*

1.1

*

*

*

*

*

*

% Under 500 grams

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

% Preterm gestation

8.8

7.9

6.6

8.6

3.1

7.1

8.9

8.2

7.0

8.3

3.2

7.2

*

*

*

*

*

*

% Multiple gestation

*

*

*

*

*

0.9

*

*

*

*

*

1.0

*

*

*

*

*

*

% Birth defect

2.7

*

*

*

3.1

1.9

*

*

*

*

3.1

1.9

*

*

*

*

*

*

Maternal risk markers for lowered infant survival

% with weight gain < 25 lbs. during pregnancy

35.2

32.2

31.1

25.0

15.2

26.4

32.9

32.1

28.7

25.4

14.8

25.2

62.5

*

*

*

*

46.2

% with father not named on birth certificate

9.4

10.2

9.2

11.5

8.1

9.7

7.1

9.4

6.9

11.2

7.6

8.5

45.5

*

*

*

*

41.9

% with maternal education less than high school

20.6

25.3

30.7

23.2

26.7

25.3

19.2

25.6

30.8

23.0

26.4

25.0

*

*

*

*

*

24.1

% No prenatal care

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

% Maternal smoking during pregnancy

13.3

18.6

17.4

12.2

12.5

14.9

13.7

18.1

16.7

12.5

12.7

14.8

*

*

*

*

*

16.1

% Maternal alcohol use during pregnancy

*

*

*

*

*

1.1

*

*

*

*

*

1.1

*

*

*

*

*

*

% Interpregnancy interval less than 6 months

*

*

6.1

5.4

*

4.4

*

*

6.5

5.6

*

4.3

*

*

*

*

*

*

Child abuse and neglect rates

Physical

.

*

2.6

1.9

4.1

2.2

.

*

*

*

3.9

1.3

.

*

*

*

*

*

Sexual

.

1.6

3.9

2.5

3.8

3.0

.

*

*

2.0

3.6

1.6

.

*

*

*

*

*

Neglect

.

3.6

8.1

6.0

11.6

7.4

.

*

*

6.3

11.1

4.8

.

*

*

*

*

*

Interventions to improve infant & child survival

% Prenatal care first trimester

77.8

77.4

75.3

87.2

91.8

81.6

80.8

77.3

76.7

87.4

92.3

82.7

45.5

*

55.6

*

*

58.1

% Primary C-section delivery

17.0

12.5

14.4

12.3

18.6

14.9

17.1

12.3

14.6

12.0

18.2

14.8

*

*

*

*

*

20.7

% Vaginal birth after previous C-section

*

*

*

26.3

*

16.9

*

*

*

26.3

*

17.3

*

*

*

*

*

*

% WIC during pregnancy

52.5

58.8

49.5

56.3

55.3

54.4

51.2

57.3

48.3

56.8

54.4

53.6

72.7 100.0

77.8

*

*

80.6

% Medicaid during pregnancy

26.0

42.9

38.6

50.6

49.7

41.3

23.2

41.5

36.2

51.5

49.4

40.2

72.7

*

77.8

*

*

71.0

% Medicaid and WIC during pregnancy

22.7

40.1

33.2

43.7

41.0

35.9

20.8

38.6

31.0

44.4

40.5

35.0

54.5

*

77.8

*

*

64.5

% Perinatal case management

.

2.8

8.7

*

*

3.9

.

2.9

8.0

*

*

3.7

.

*

*

*

*

*

White County - 154

489

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Whitfield County - 155

1990
72462 17280
1627
20.6 20.5 20.0
179 43 1288 160 271 99 11 261 12
7 4 3 15 1 7
109 17
0 109
9 7
473 143 553 23 341 57 72
. . .
893 179 21 508 446 340
. 4

1991
73576 17314
1620
20.7 19.7 20.0
158 34
1244 141 249
95 8
261 14
12 8 4
15 1 5
86 11
2 108
22 8
371 154 514
15 313
47 65
32 26 120
867 163
22 598 487 419 186
5

Total
1992 1993

74688 17351
1614

75806 17386
1607

20.5 19.6 21.0

21.3 18.7 21.0

162 27
1282 136 322 97 8 242 19

158 25
1295 131 345
87 12 217 20

14

11

7

7

7

4

15

18

3

4

2

3

99

98

17

16

1

1

115

99

13

11

14

5

372

405

146

157

548

575

7

8

303

260

40

43

53

60

46

60

41

33

222

225

910

879

148

139

23

30

631

702

552

721

462

593

223

281

1

0

1994 5-year

76919 17424
1601

373451 86755
8069

20.3 19.5 21.0

20.6 19.5 21.0

193 37
1284 164 342 84 9 201 24

850 166 6393 732 1529 462
48 1182
89

15

59

11

37

4

22

18

81

4

13

5

22

89

481

19

80

3

7

105

536

14

69

4

38

417

2038

157

757

554

2744

15

68

233

1450

30

217

44

294

45

183

38

138

270

837

806

4355

142

771

29

125

652

3091

654

2860

534

2348

288

978

7

17

1990
67533 16157
1512

1991
68339 16135
1499

White
1992 1993

69147 16114
1486

69956 16093
1472

1994 5-year

70762 16072
1459

345737 80571
7428

20.5 20.5 20.0

20.7 19.7 20.0

20.6 20.1 21.0

21.3 18.8 21.0

20.2 19.9 21.0

20.6 19.8 20.0

168 40
1231 152 243 90 10 235 11

146 28
1195 130 218
91 8
239 13

150 26
1222 125 291 91 7 221 18

145 24
1231 121 307
78 10 188 17

181 36
1235 159 312 80 9 169 18

790 154 6114 687 1371 430
44 1052
77

7

10

13

11

15

56

4

7

6

7

11

35

3

3

7

4

4

21

14

14

13

16

18

75

1

1

3

4

4

13

7

4

2

3

5

21

100

83

94

83

82

442

15

10

14

14

17

70

0

1

1

1

3

6

99

103

106

88

98

494

9

22

12

9

14

66

7

8

14

5

4

38

448

363

354

381

393

1939

130

138

132

138

145

683

531

501

532

554

544

2662

22

13

6

8

13

62

335

307

299

252

226

1419

51

44

37

37

25

194

69

59

52

56

42

278

.

29

39

55

35

158

.

25

39

31

33

128

.

96

187

184

218

685

859

843

878

844

775

4199

171

157

141

130

137

736

19

19

21

30

29

118

479

565

598

657

620

2919

416

463

525

681

626

2711

318

396

439

559

509

2221

.

175

209

262

277

923

4

3

1

0

6

14

1990
2901 731 81

1991
2946 733
81

Black
1992 1993

2990 734 80

3035 736
80

1994 5-year

3079 738 80

14951 3671 402

20.4 19.0 25.0

20.1 17.2 21.0

18.6 18.5 25.0

19.5 18.3 21.5

20.1 16.5 29.0

19.6 17.8 24.0

11

11

11

12

12

57

3

5

1

1

1

11

46

45

50

56

42

239

8

10

10

10

5

43

27

29

30

35

29

150

8

3

6

8

3

28

0

0

1

2

0

3

20

16

18

21

24

99

1

1

1

2

6

11

0

1

1

0

0

2

0

1

1

0

0

2

0

0

0

0

0

0

0

1

2

2

0

5

0

0

0

0

0

0

0

1

0

0

0

1

9

3

5

12

6

35

2

1

3

2

2

10

0

1

0

0

0

1

9

5

8

9

6

37

0

0

1

2

0

3

0

0

0

0

0

0

20

6

15

20

21

82

12

14

13

18

11

68

19

11

13

18

10

71

1

2

0

0

2

5

6

6

4

7

7

30

6

3

2

6

5

22

3

5

1

4

2

15

.

3

2

2

5

12

.

1

1

2

4

8

.

7

18

12

24

61

26

21

25

27

29

128

8

6

7

8

5

34

2

2

2

0

0

6

24

30

31

39

31

155

26

22

25

34

27

134

19

21

21

28

24

113

.

10

12

16

11

49

0

0

0

0

0

0

490

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Whitfield County - 155

17.8 74.5
2.2 21.2
3.6 15.1
0.2 156.7
6.8
110.0 24.0 98.3 44.0
7.4 91.7
4.9
5.4 * *
11.5 *
0.5
8.5 1.3
* 8.5 0.7 0.6
42.4 11.2 43.6
1.8 28.0
4.7 10.2
. . .
69.9 15.3 19.6 39.7 34.9 26.6
.

16.9 71.8
2.2 20.4
3.5 15.1
0.2 161.0
6.7
97.5 21.5 87.0 50.0
8.6 100.0
3.7
9.6 6.4
* 12.0
* 0.4
6.9 0.9
* 8.9 1.8 0.7
36.8 12.6 42.3
1.2 27.2
4.2 9.7
1.7 1.3 6.2
70.7 14.9 17.6 49.0 39.9 34.3 15.2

17.2 73.9 2.2 25.4 3.2 13.9 0.2 147.4
6.8
100.4 16.7 84.3 59.3 11.8 94.7 5.6
10.9 5.5 5.5 11.6
* *
7.7 1.3
* 9.1 1.0 1.1
35.3 11.5 43.7 0.6 25.1
3.5 7.1
2.3 2.1 11.3
72.6 13.0 18.1 49.7 43.5 36.4 17.6

17.1 74.5
2.3 26.9
2.9 12.5
0.3 134.1
6.1
98.3 15.8 81.5 64.6 12.4 100.0
5.0
8.5 5.4
* 13.8
* *
7.6 1.2
* 7.7 0.9 0.4
37.5 12.2 45.1
0.6 21.3
3.6 8.3
3.0 1.7 11.3
71.8 12.2 21.1 54.7 56.2 46.2 21.9

16.7 73.7 2.2 27.0 2.6 11.5 0.3 127.1
5.6
120.5 19.2
102.4 57.4 15.0 90.9 5.0
11.7 8.6
* 13.9
* 0.3
6.9 1.5
* 8.3 1.1
*
39.5 12.4 44.0 1.2 19.5
2.5 6.4
2.2 1.9 13.3
67.1 12.3 25.4 51.3 51.5 42.0 22.7

17.1 73.7
2.2 24.2
3.2 13.6
0.2 145.4
6.4
105.3 19.5 90.7 54.7 11.0 95.3
4.8
9.2 5.8 3.5 12.6 0.6 0.3
7.5 1.3 0.1 8.5 1.1 0.6
38.4 12.0 43.8
1.1 24.2
3.7 8.3
2.3 1.7 10.6
70.4 13.5 20.3 48.9 45.2 37.1 19.4

18.2 76.2
2.3 19.9
3.5 14.5
0.2 149.5
6.6

17.5 74.1
2.2 18.6
3.5 14.8
0.2 154.7
6.9

17.7 75.8 2.3 24.0 3.2 13.7 0.2 142.4
6.8

17.6 76.5
2.3 25.1
2.7 11.7
0.3 124.2
5.9

17.5 76.8 2.4 25.6 2.4 10.5 0.3 113.0
5.7

17.7 75.9
2.3 22.7
3.0 13.1
0.2 137.0
6.4

111.1 23.8 100.5 41.1
7.3 90.9
4.0

97.4 19.2 86.8 45.7
8.7 100.0
4.0

101.0 17.3 84.1 55.6 12.1 94.4 6.1

98.5 16.6 82.2 61.7 11.5 100.0
5.4

124.0 19.9
108.9 56.1 12.3 88.2 4.8

106.4 19.5 92.5 51.7 10.4 94.6
4.8

5.7 * *
11.3 *
0.6

8.4 5.9
* 11.6
* *

10.6 4.9 5.8 10.6
* *

8.9 5.7
* 12.9
* *

12.1 8.9
* 14.5
* 0.4

9.2 5.7 3.5 12.2 0.6 0.3

8.1

7.0

7.7

6.7

6.7

7.2

1.2

0.8

1.1

1.1

1.4

1.1

*

*

*

*

*

0.1

8.1

8.8

8.8

7.2

8.0

8.2

0.7

1.9

1.0

0.7

1.1

1.1

0.6

0.7

1.2

0.4

*

0.6

41.8 10.6 43.8
1.8 28.7
4.4 10.3

37.2 11.8 43.0
1.1 27.8
4.1 9.1

35.1 10.9 44.4 0.5 26.0
3.3 7.3

36.8 11.3 45.6
0.7 21.7
3.2 8.1

38.7 11.9 45.0 1.1 19.7
2.2 6.4

38.0 11.3 44.4
1.0 24.7
3.5 8.2

.

1.6

2.2

3.0

1.9

2.2

.

1.4

2.2

1.7

1.8

1.8

.

5.5

10.5

10.2

11.9

9.5

70.4 15.2 19.2 39.2 34.1 26.0
.

71.6 14.9 16.1 48.2 39.5 33.8 14.9

73.5 13.0 17.2 49.4 43.4 36.3 17.3

72.5 12.0 22.2 53.8 55.8 45.8 21.5

67.1 12.3 26.4 50.8 51.3 41.7 22.7

71.0 13.5 20.2 48.3 44.8 36.7 19.1

15.9 62.9
1.9 58.7
6.9 27.4
0.5 266.7 12.3

15.3 61.4
1.8 64.4
5.4 21.8
* 246.2
*

16.7 68.1 2.1 61.2 6.0 24.5 0.5 236.8 10.9

18.5 76.1
2.4 64.8
6.9 28.5
0.7 241.4
13.6

13.6 56.9 1.7 69.0 7.8 32.5 1.0 342.9
*

16.0 65.1
2.0 63.6
6.6 27.0
0.5 265.4
9.5

135.8 *
98.8 100.0
* * *

136.3 45.5
123.9 100.0
* * *

136.8 *
124.4 100.0
* * *

150.0 *
125.0 100.0
* * *

150.6 *
62.7 100.0
75.3 100.0
*

141.9 19.3 107.0 100.0 27.4 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

20.7

*

*

*

*

*

*

*

*

*

*

*

*

19.6

*

10.0

21.4

14.3

14.6

*

*

*

*

*

4.2

*

*

*

*

*

*

19.6

11.4

16.3

16.7

14.3

15.7

*

*

*

*

*

*

*

*

*

*

*

*

57.1 26.1 41.3
* 14.3 14.3
*

21.4 31.1 24.4
* 14.0
* 23.8

39.5 26.5 27.1
* * * *

52.6 33.3 33.3
* 13.7 12.0
*

61.8 26.2 23.8
* 17.5 12.5
*

47.4 28.8 30.2
2.1 13.5 10.2 12.3

.

*

*

*

5.3

3.2

.

*

*

*

*

2.2

.

7.8

19.6

12.8

25.2

16.4

56.5 20.5
* 52.2 56.5 41.3
.

46.7 15.4
* 66.7 48.9 46.7 22.2

52.1 15.9
* 63.3 51.0 42.9 24.5

50.9 16.7
* 72.2 63.0 51.9 29.6

70.7

54.9

13.2

16.3

*

21.4

73.8

65.7

64.3

56.8

57.1

47.9

26.2

25.8

491

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Wilcox County - 156

1990
7008 1461
151
20.0 17.1 20.0
10 0
85 7
31 3 1
12 3
1 0 1 1 0 0
15 0 0
12 5 2
31 16 27
0 21
2 6
. . .
49 24
0 58 43 38
. 0

1991
7053 1474 152
19.7 .
22.0
19 6
113 20 55 5 1 10 0
0 0 0 2 0 1
11 0 0
12 2 2
41 34 43
3 21
3 5
2 5 15
57 20
2 89 73 67 43
0

Total
1992 1993

7099 1489
153

7145 1503 153

21.6 15.7 21.0

19.8 20.6 21.0

13

15

3

2

104

101

8

14

42

49

3

4

2

1

13

12

4

1

1

2

1

2

0

0

3

3

0

0

0

0

5

7

2

2

0

0

7

10

1

2

0

2

30

32

24

23

31

27

2

1

17

12

3

1

11

2

4

6

5

0

81

88

62

63

13

11

1

2

75

78

70

69

66

68

57

54

0

0

1994 5-year

7188 1515
154

35493 7442 762

19.6 18.8 22.5

19.9 17.3 21.0

20

77

3

14

105

508

16

65

47

224

4

19

1

6

13

60

3

11

2

6

2

5

0

1

4

13

0

0

1

2

11

49

5

9

1

1

14

55

1

11

1

7

40

174

24

121

35

163

1

7

9

80

1

10

3

27

8

20

1

11

59

243

69

300

16

84

2

7

85

385

74

329

72

311

62

216

0

0

1990
4757 971 100

1991
4776 978
99

White
1992 1993

4796 984 98

4816 991
97

1994 5-year

4835 997 96

23980 4921 489

21.7 18.6 20.0

22.2 .
22.0

21.7 15.7 20.5

23.0 16.3 20.5

22.1 20.9 22.0

22.1 17.5 21.0

4

5

6

6

4

25

0

1

1

1

1

4

42

48

54

49

55

248

4

5

1

5

3

18

4

7

8

11

8

38

2

4

3

3

1

13

1

0

1

0

0

2

6

4

6

7

6

29

0

0

4

1

1

6

1

0

1

1

1

4

0

0

1

1

1

3

1

0

0

0

0

1

1

1

2

1

1

6

0

0

0

0

0

0

0

1

0

0

0

1

5

4

1

1

2

13

0

0

1

1

1

3

0

0

0

0

0

0

8

5

2

3

6

24

2

0

0

0

0

2

0

1

0

2

1

4

16

18

11

14

19

78

4

3

3

2

6

18

13

17

14

14

13

71

0

0

0

0

1

1

10

10

8

7

8

43

2

1

0

0

0

3

2

0

1

0

1

4

.

0

1

1

4

6

.

3

4

0

0

7

.

4

36

30

24

94

32

35

40

36

43

186

10

11

7

7

13

48

0

2

1

2

2

7

21

32

29

30

38

150

13

22

26

20

30

111

11

20

22

20

30

103

.

8

19

16

24

67

0

0

0

0

0

0

1990
2225 484 50

1991
2239 489
50

Black
1992 1993

2254 494 51

2269 499
51

1994 5-year

2282 503 51

11269 2468 253

19.0 17.1 21.0

18.8 .
26.0

18.8 .
22.5

19.0 25.0 21.0

17.6 16.8 27.0

18.7 17.6 23.5

5

14

7

9

15

50

0

5

2

1

2

10

43

65

50

52

47

257

3

15

7

9

12

46

27

48

34

38

38

185

1

1

0

1

3

6

0

1

1

1

1

4

5

6

7

5

7

30

2

0

0

0

2

4

0

0

0

1

1

2

0

0

0

1

1

2

0

0

0

0

0

0

0

1

1

2

3

7

0

0

0

0

0

0

0

0

0

0

1

1

10

7

4

6

9

36

0

0

1

1

4

6

0

0

0

0

1

1

4

7

5

7

8

31

3

2

1

2

1

9

2

1

0

0

0

3

15

23

19

18

21

96

12

31

21

21

17

102

14

26

17

13

20

90

0

3

2

1

0

6

11

11

9

5

1

37

0

2

3

1

1

7

4

5

10

2

2

23

.

1

3

4

4

12

.

1

1

0

1

3

.

7

41

40

35

123

17

22

22

27

24

112

14

9

6

4

3

36

0

0

0

0

0

0

37

57

46

48

44

232

30

51

44

49

42

216

27

47

44

48

40

206

.

35

38

38

36

147

0

0

0

0

0

0

492

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Wilcox County - 156

12.1 58.2
1.8 38.8
1.7 8.2 0.2 118.8
*
66.2 *
46.4 71.4
* * *
* * * * * *
17.6 * *
15.0 6.3 *
42.5 20.0 33.8
* 26.2
* 12.0
. . .
62.8 33.3
* 72.5 53.8 47.5
.

16.0 76.7
2.3 49.5
1.4 6.8 0.2 76.9 4.7
125.3 31.6
131.9 73.7 * * *
* * * * * *
9.7 * *
10.8 * *
43.2 30.6 39.1
* 18.9
* 7.9
* 2.5 7.6
51.8 19.8
* 80.2 65.8 60.4 38.7

14.6 69.8 2.1 41.6 1.8
8.7 0.2 106.6 3.4
85.1 *
52.4 100.0
* * *
* * * * * *
4.9 * *
6.9 * *
33.3 23.8 31.3
* 17.0
* 17.2
* 2.5 40.9
62.0 14.3
* 74.3 69.3 65.3 56.4

14.1 67.2
2.0 49.5
1.7 8.0 0.2 101.7 3.3
97.8 *
91.3 100.0
* * *
* * * * * *
7.0 * *
10.1 * *
36.0 23.2 27.3
* 12.1
* *
3.0 *
44.5
65.6 12.5
* 78.8 69.7 68.7 54.5

14.6 69.3 2.0 45.2 1.8
8.6 0.3 105.7 3.3
130.0 *
104.0 87.5 * * *
* * * * * *
10.5 4.8
* 13.5
* *
41.2 23.1 33.7
* 8.7
* *
4.1 *
29.9
70.4 16.8
* 81.7 71.2 69.2 59.6

14.3 68.3
2.0 45.3
1.7 8.1 0.2 101.0 3.5
101.0 18.2 85.3 85.9 14.4 100.0
*
11.8 9.8 *
25.3 * *
9.7 1.8
* 11.1
2.2 1.4
39.2 24.4 33.1
1.5 16.2
2.0 9.2
2.5 1.4 30.7
62.2 18.8 14.6 77.8 66.5 62.8 52.0

8.8 43.3
1.3 *
1.3 6.2 0.2 117.6
*
* * * * * * *
* * * * * *
11.9 * *
20.0 * *
41.0 *
32.5 *
25.0 * *
. . .
78.0 27.0
* 52.5 32.5 27.5
.

10.1 49.1
1.5 14.6
* * * * 5.1
50.6 *
50.6 * * * *
* * * * * *
* * * 10.4 * *
40.9 *
36.2 *
20.8 * *
* * *
72.9 25.0
* 66.7 45.8 41.7 16.7

11.3 54.9 1.7 15.4 1.3
6.1 0.2 93.8
*

10.2 49.4
1.5 22.4
1.5 7.1 0.2 118.6
*

61.4 * * * * * *

62.1 *
51.8 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

23.4 *
26.9 *
15.7 * *

29.8 *
28.6 *
14.3 * *

* * 32.0

* * 27.0

75.5 15.6
* 55.8 50.0 42.3 36.5

76.6 15.6
* 61.2 40.8 40.8 32.7

11.4 55.2 1.6 14.5 1.2
6.0 0.2 96.8
*

10.3 50.4
1.5 15.6
1.2 5.9 0.2 99.0 3.3

*

51.2

*

*

*

36.8

*

50.0

*

12.3

* 100.0

*

*

*

*

*

*

*

*

*

24.0

*

*

*

*

*

5.3

*

*

*

*

10.9

9.8

*

*

*

*

35.8 10.9 23.6
* 14.5
* *

33.9 7.4
29.2 *
17.7 * *

* * 21.9

1.3 1.6 21.0

82.7 27.1
* 69.1 54.5 54.5 43.6

77.2 21.9 28.0 61.5 45.5 42.2 32.8

19.3 88.8
2.6 67.5
2.2 10.3
0.3 102.0
*

29.0 133.1
3.8 76.2
2.7 12.3
0.4 82.2
*

22.2 101.3
2.9 69.4 3.1 14.2 0.4 120.7
*

22.9 104.3
2.9 76.0
2.2 10.0
0.3 84.7
*

20.6 93.5 2.6 82.6 3.1 13.9 0.4 120.7
*

22.8 104.1
3.0 74.6
2.7 12.2
0.4 101.0
4.1

100.0 * * * * * *

278.9 35.7
298.8 100.0
* * *

138.3 *
138.3 100.0
* * *

177.2 *
177.2 100.0
* * *

294.7 *
235.8 100.0
* * *

198.0 20.0
182.2 100.0
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

26.8

*

*

*

*

*

*

*

*

*

*

*

*

23.3 * * * * *

10.8 * *
11.1 * *

* * * 10.2 * *

11.8 * *
14.0 * *

19.1 * *
17.4 * *

14.1 2.3 *
12.5 3.6 *

44.1 30.0 35.0
* 27.5
* *

45.1 49.2 41.3
* 17.5
* 12.5

44.2 42.9 36.2
* 18.4
* 27.0

42.9 42.0 26.0
* 10.0
* *

50.0 37.0 43.5
* * * *

45.3 41.1 36.6
2.6 14.9
2.8 14.2

.

*

*

*

*

3.6

.

*

*

*

*

*

.

8.4

49.4

48.4

42.4

37.1

45.9 40.0
* 92.5 75.0 67.5
.

35.5 15.8
* 90.5 81.0 74.6 55.6

46.8 13.0
* 93.9 89.8 89.8 77.6

55.1 * *
96.0 98.0 96.0 76.0

54.5

46.9

*

16.0

*

*

95.7

93.5

91.3

87.1

87.0

83.1

78.3

70.7

493

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Wilkes County - 157

1990
10597 2208 226
20.2 17.2 22.0
23 5
129 15 59
6 0 37 8
2 0 2 0 0 2
12 3 0
10 1 3
68 36 31
1 21
4 3
. . .
89 19
0 72 51 43
. 0

1991
10622 2214 231
20.1 18.3 23.0
28 5
134 22 67 6 2 30 6
2 1 1 3 0 1
19 1 0
17 1 1
66 30 37
2 12
1 5
0 0 0
93 22
1 71 57 43
1 2

Total
1992 1993

10644 2221 236

10666 2228 241

20.0 19.8 22.0

20.7 15.2 24.0

18

17

3

3

146

149

14

15

57

58

8

1

0

2

32

15

4

2

0

1

0

1

0

0

0

3

1

0

2

4

11

18

0

2

0

1

10

12

1

3

2

0

50

57

34

36

33

47

3

2

19

19

1

4

6

2

4

6

1

2

2

14

106

109

20

22

2

3

80

71

80

85

62

64

4

5

1

1

1994 5-year

10686 2233 246

53215 11104
1180

20.6 16.6 22.0

20.2 17.9 22.0

25

111

4

20

131

689

20

86

61

302

4

25

0

4

13

127

5

25

1

6

0

2

1

4

0

6

0

1

0

9

13

73

0

6

0

1

15

64

0

6

4

10

47

288

31

167

34

182

1

9

19

90

3

13

7

23

8

18

1

4

26

42

102

499

21

104

2

8

72

366

78

351

58

270

1

11

1

5

1990
5650 1087
92

1991
5658 1086
94

White
1992 1993

5664 1084
97

5672 1084
99

1994 5-year

5676 1081
102

28320 5422 484

21.4 17.5 21.0

20.4 19.6 22.0

22.3 19.8 21.0

22.0 18.5 20.0

22.1 .
22.0

21.8 19.1 21.0

5

6

5

4

5

25

0

1

1

0

0

2

55

50

70

74

67

316

2

6

4

4

5

21

5

5

5

11

15

41

3

2

2

1

1

9

0

0

0

1

0

1

16

12

13

6

1

48

3

0

1

0

0

4

0

2

0

0

0

2

0

1

0

0

0

1

0

1

0

0

0

1

0

1

0

1

0

2

0

0

1

0

0

1

0

0

1

2

0

3

2

4

2

2

4

14

0

0

0

0

0

0

0

0

0

0

0

0

3

5

4

4

6

22

0

0

1

1

0

2

1

0

2

0

2

5

18

20

15

22

20

95

2

4

1

7

7

21

12

7

12

20

11

62

1

0

0

0

0

1

8

7

14

15

14

58

0

0

0

2

2

4

0

1

4

0

1

6

.

0

0

1

3

4

.

0

0

0

0

0

.

0

2

2

8

12

43

40

58

61

56

258

11

15

13

12

11

62

0

1

1

2

1

5

20

15

26

21

26

108

10

10

23

30

31

104

8

6

18

20

21

73

.

0

1

1

1

3

0

0

0

1

0

1

1990
4909 1113
134

1991
4921 1116
137

Black
1992 1993

4931 1120
140

4941 1123 143

1994 5-year

4950 1126
146

24652 5598 699

19.8 17.0 23.0

19.7 17.0 26.0

19.0 20.3 26.0

19.6 15.0 27.5

18.9 16.6 23.0

19.2 17.2 25.0

18

22

11

13

20

84

5

4

2

3

4

18

74

83

75

75

64

371

13

16

9

11

15

64

54

62

51

47

46

260

3

4

6

0

3

16

0

2

0

1

0

3

21

17

18

9

12

77

5

6

2

2

5

20

2

0

0

1

1

4

0

0

0

1

0

1

2

0

0

0

1

3

0

2

0

2

0

4

0

0

0

0

0

0

2

1

1

2

0

6

10

15

3

1

0

0

7

12

1

1

2

1

9

16

0

2

0

1

6

8

0

2

0

0

9

59

0

6

0

1

9

42

0

4

2

5

50

46

35

35

27

193

34

26

32

29

24

145

19

30

20

27

23

119

0

2

3

2

1

8

13

5

5

4

5

32

4

1

1

2

1

9

3

4

2

2

6

17

.

0

4

5

5

14

.

0

1

2

1

4

.

0

0

11

18

29

46

52

47

48

46

239

8

7

6

10

10

41

0

0

1

1

1

3

52

56

53

50

46

257

41

47

56

55

47

246

35

37

43

44

37

196

.

1

3

4

0

8

0

1

1

0

0

2

494

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Wilkes County - 157

12.2 58.4
1.8 46.1
3.5 16.8
0.5 215.1
2.7
101.8 21.7 66.4 93.3 35.4 100.0
*
* * * * * *
9.3 * *
7.9 * *
57.1 28.1 24.8
* 16.9
* * . . .
70.6 16.4
* 56.3 39.8 33.6
.

12.6 60.5
1.9 50.4
2.8 13.6
0.4 174.4
3.6
121.4 17.9 95.4 81.0 26.0
100.0 *
* * * * * *
14.2 * *
12.8 * *
56.4 22.6 28.5
* 9.4
* 7.5
* * *
71.5 18.5
* 53.4 42.9 32.3
*

13.7 65.7 2.0 39.3 3.0 14.4 0.5 171.1 4.1
76.2 *
59.3 78.6
* * *
* * * * * *
7.5 * *
6.9 * *
37.0 23.4 23.1
* 13.6
* 7.6
* * *
73.6 15.6
* 55.2 55.2 42.8
*

14.0 66.9
2.0 39.7
1.4 6.7 0.2 89.8
*

12.3 58.7 1.8 46.6 1.2 5.8 0.2 87.8
*

12.9 62.0
1.9 44.2
2.4 11.4
0.3 150.1
2.7

70.6 *
62.3 80.0
* * *

101.6 *
81.3 95.0 20.3 100.0
*

94.1 18.0 72.9 85.9 21.2 100.0
*

*

*

8.7

*

*

*

*

*

*

*

*

8.7

*

*

*

*

*

0.9

12.1 * *
8.2 * *

9.9 * *
11.5 * *

10.6 0.9 * 9.4 0.9 1.5

40.1 24.7 32.4
* 13.1

35.9 23.7 26.0
* 14.5

44.7 24.5 27.0
1.3 13.5

*

*

1.9

*

10.8

6.4

2.2

2.9

1.6

*

*

*

5.1

9.5

3.8

73.2 16.9
* 48.6 58.2 43.8
3.4

77.9 17.9
* 55.0 59.5 44.3
*

73.4 17.0 11.0 53.6 51.4 39.5
2.0

9.7 50.6
1.6 9.1 2.8 14.7 0.4 216.2
*

8.8 46.0
1.5 10.0
2.1 11.0
0.4 187.5
*

12.4 64.6 2.1
7.2 2.3 12.0 0.4 152.9
*

54.3 * * * * * *

63.6 *
63.6 * * * *

51.7 * * * * * *

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

10.0

*

*

*

*

*

*

*

34.6 *
22.6 *
15.1

44.4 *
14.3 *
14.9

23.8 *
17.4 *
20.9

*

*

*

*

*

*

.

*

*

.

*

*

.

*

*

81.1 22.9
* 36.4 18.2 14.5
.

80.0 34.1
* 30.0 20.0 12.0
*

84.1 21.3
* 37.7 33.3 26.1
*

13.0 68.3
2.2 15.1
1.1 5.5 0.2 73.2
*
* * * * * * *
* * * * * *
* * * * * *
31.0 9.6
27.4 *
20.8
* * * * *
82.4 19.4
* 28.8 41.1 27.4
*

11.8 62.0 2.0 22.4
* * * * *

11.2 58.3
1.9 13.1
1.7 8.9 0.3 128.3 1.8

49.2 *
49.2 * * * *

51.6 *
43.4 52.4
* * *

*

*

*

*

*

*

*

*

*

*

*

*

*

4.4

*

*

*

*

9.0

7.0

*

*

*

1.6

29.9 10.4 16.4
* 20.9

31.9 6.7
19.9 *
19.0

*

*

*

3.7

*

*

*

*

6.4

2.4

83.6 18.0
* 38.8 46.3 31.3
*

82.4 22.5 13.2 34.4 33.1 23.2
*

15.1 66.5
2.0 74.0
4.3 18.9
0.6 214.3
*

16.9 74.4
2.2 75.6
3.5 15.2
0.4 160.4
5.4

15.2 67.0 2.0 68.0 3.7 16.1 0.5 180.0 6.3

15.2 66.8
2.0 64.4
1.8 8.0 0.2 105.9
*

12.9 56.8 1.7 71.9 2.4 10.7 0.3 151.9
*

15.0 66.3
2.0 70.8
3.1 13.8
0.4 164.5
3.6

134.3 27.8 97.0 100.0 37.3 100.0
*

160.8 *
117.0 93.3 43.9
100.0 *

78.6 *
64.3 100.0
* * *

91.1 *
77.1 90.9
* * *

137.1 *
102.8 100.0
34.3 100.0
*

120.1 21.4 91.5 96.8 28.6 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

1.0

13.5 * *
9.7 * *

18.1 * *
14.6 * *

12.0 * *
8.0 * *

21.3 * *
11.0 * *

14.1 * *
14.1 * *

15.9 1.6 *
11.5 *
1.4

74.6 46.6 26.4
* 18.3

63.9 31.7 37.5
* 6.3

49.3 42.7 27.4
* 6.9

49.3 39.7 37.5
* *

42.2 37.5 35.9
* 7.8

55.9 39.5 33.0
2.2 8.9

*

*

*

*

*

2.5

*

*

*

*

17.6

8.5

.

*

*

3.3

3.4

2.3

.

*

*

*

*

*

.

*

*

7.3

12.1

4.8

63.0 11.8
* 71.2 56.2 47.9
.

65.8 9.5 *
68.3 57.3 45.1
*

63.5 9.1 *
70.7 74.7 57.3
*

64.0 14.7
* 68.5 75.3 60.3
*

71.9

65.5

17.9

12.3

*

*

71.9

70.0

73.4

67.0

57.8

53.4

*

2.7

495

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Wilkinson County - 158

1990
10228 2361 245
22.2 18.6 23.0
21 3
166 14 64 10
4 43
7
0 0 0 4 2 4
16 4 0
20 4 1
60 38 27
1 16
1 5
. . .
126 25
4 73 55 42
. 0

1991
10287 2370 247
20.4 21.0 23.0
22 2
152 15 73 6 3 36 5
2 2 0 5 0 2
9 1 0 17 0 2
45 36 39
4 17
0 11
2 1 14
103 20 4
108 78 72 2 0

Total
1992 1993

10343 2376 249

10396 2385 252

22.1 22.7 21.5

21.1 16.6 23.0

18

17

3

2

168

150

15

7

51

71

4

5

2

1

43

50

3

10

0

1

0

0

0

1

2

1

0

0

1

1

8

12

1

1

0

0

13

19

2

1

1

3

53

58

25

30

31

34

1

4

13

16

0

0

7

5

3

12

1

10

13

20

142

123

13

19

4

4

81

93

67

88

56

74

3

24

0

0

1994 5-year

10455 2392 254

51709 11884
1247

20.6 19.3 23.0

21.1 19.6 22.0

17

95

2

12

168

804

14

65

70

329

11

36

1

11

27

199

4

29

1

4

0

2

1

2

2

14

1

3

1

9

22

67

5

12

0

0

16

85

5

12

2

9

56

272

39

168

34

165

5

15

19

81

3

4

6

34

7

24

4

16

41

88

130

624

19

96

4

20

93

448

90

378

71

315

38

67

0

0

1990
5910 1261
112

1991
5968 1269
114

White
1992 1993

6025 1274
117

6083 1283
119

1994 5-year

6139 1289
121

30125 6376 583

22.8 18.4 20.0

21.7 19.6 22.0

24.1 20.2 21.0

21.3 18.6 21.0

21.7 17.8 20.0

22.2 18.6 21.0

11

6

7

4

7

35

2

1

1

0

0

4

83

64

95

68

86

396

8

1

5

2

6

22

10

11

8

14

14

57

5

2

1

2

7

17

3

0

2

1

0

6

22

16

15

17

8

78

3

4

2

2

1

12

0

0

0

1

0

1

0

0

0

0

0

0

0

0

0

1

0

1

3

0

2

1

1

7

0

0

0

0

0

0

0

1

1

0

0

2

9

4

3

2

9

27

3

0

1

0

2

6

0

0

0

0

0

0

10

8

4

5

8

35

2

0

0

0

2

4

1

1

0

1

1

4

26

19

25

25

23

118

7

4

2

6

6

25

13

9

13

16

15

66

0

0

1

0

3

4

13

15

10

14

13

65

1

0

0

0

3

4

2

2

3

1

2

10

.

2

1

3

3

9

.

0

1

7

1

9

.

4

4

4

10

22

76

52

91

60

76

355

13

11

7

6

7

44

2

0

2

2

1

7

26

36

32

35

35

164

14

18

23

30

30

115

13

16

20

25

24

98

.

1

1

4

11

17

0

0

0

0

0

0

1990
4302 1096
133

1991
4327 1100 134

Black
1992 1993

4350 1102
135

4373 1105 137

1994 5-year

4398 1108
138

21749 5511 677

20.9 18.8 26.0

18.7 21.2 27.0

19.0 23.4 23.0

20.5 16.2 28.0

20.2 19.9 24.0

20.1 20.6 27.0

10

16

11

13

10

60

1

1

2

2

2

8

82

88

72

82

81

405

6

14

10

5

8

43

54

62

42

57

55

270

5

4

3

3

4

19

1

3

0

0

1

5

21

20

27

33

18

119

4

1

1

8

3

17

0

2

0

0

1

3

0

2

0

0

0

2

0

0

0

0

1

1

1

5

0

0

1

7

2

0

0

0

1

3

4

1

0

1

1

7

7

5

5

10

12

39

1

1

0

1

3

6

0

0

0

0

0

0

10

9

9

14

7

49

2

0

2

1

3

8

0

1

1

2

1

5

33

26

28

33

33

153

31

32

23

24

33

143

14

30

18

18

19

99

1

4

0

4

2

11

3

2

3

2

6

16

0

0

0

0

0

0

3

9

4

4

4

24

.

0

2

9

2

13

.

1

0

3

0

4

.

7

9

16

24

56

50

51

51

63

53

268

12

9

6

13

12

52

2

4

2

2

3

13

47

72

48

58

58

283

41

60

43

58

59

261

29

56

35

49

47

216

.

1

2

20

27

50

0

0

0

0

0

0

496

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Wilkinson County - 158

16.2 70.3
2.0 39.5
4.2 18.2
0.5 192.8
5.9
85.7 *
57.1 71.4 28.6 100.0
*
* * * * * *
9.6 * *
12.4 * *
40.5 23.5 16.7
* 9.9
* 6.1
. . .
76.8 17.4
* 45.1 34.0 25.9
.

14.8 64.1
1.8 48.0
3.5 15.2
0.4 181.8
4.2
88.9 *
60.6 93.3 20.2 100.0
*
* * * 32.3 * *
6.0 * *
11.4 * *
38.5 23.7 26.0
* 11.2
* 12.2
* * 4.6
70.5 14.8
* 71.1 51.3 47.4
*

16.2 70.7 2.0 30.9 4.2 18.1 0.5 197.2 2.9
72.2 *
60.2 80.0
* * *
* * * * * *
4.8 * *
7.8 * *
34.9 15.1 18.7
* 7.9
* 7.0
* * 4.3
85.0 9.1
* 48.8 40.4 33.7
*

14.4 62.9
1.8 47.7
4.8 21.0
0.6 242.7
2.5
67.5 *
27.8 100.0
39.7 100.0
*
* * * * * *
8.0 * *
12.7 * *
44.3 20.0 22.7
* 10.7
* 5.3
3.9 3.3 6.6
82.0 14.2
* 62.0 58.7 49.3 16.0

16.1 70.2 2.1 42.7 2.6 11.3 0.3 129.8 5.4
67.1 *
55.2 92.3
* * *
* * * * * *
13.1 3.0
* 9.8 3.0
*
36.8 23.8 20.7
3.0 11.6
* 5.6
2.3 *
13.4
77.4 12.9
* 56.7 54.9 43.3 23.2

15.5 67.7
1.9 41.5
3.8 16.7
0.5 189.0
4.2
76.2 12.6 52.1 85.9 23.3 100.0
*
* * * 17.2 * 0.8
8.3 1.5
* 10.8
1.5 1.1
38.9 21.2 20.8
1.9 10.2
* 7.2
2.0 1.3 7.2
78.5 13.7 22.0 56.4 47.6 39.7 10.6

14.0 65.8
1.9 12.3
3.7 17.4
0.5 194.7
6.3

10.7 50.4
1.5 17.2
2.7 12.6
0.4 195.1
*

15.8 74.6 2.2 8.5 2.5 11.8 0.4 131.6
*

11.2 53.0
1.6 20.9
2.8 13.3
0.4 193.2
*

98.2

52.5

60.0

*

*

*

*

*

71.4

*

42.9

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

10.8 * *
12.5 * *

* * * 12.5 * *

*

*

*

*

*

*

*

7.4

*

*

*

*

34.2 8.6
16.0 *
16.0 * *

34.5 *
14.1 *
23.4 * *

28.1 *
13.7 *
10.6 * *

41.0 8.8
23.5 *
20.9 * *

.

*

*

*

.

*

*

4.6

.

*

*

*

91.6 20.0
* 32.1 17.3 16.0
.

82.5 19.3
* 56.3 28.1 25.0
*

96.8 8.8
* 33.7 24.2 21.1
*

88.2 10.0
* 51.5 44.1 36.8
*

14.0 66.7 2.0 16.5 1.3 6.2 0.2 79.2 5.4

13.1 62.1
1.8 14.6
2.6 12.2
0.4 156.6
3.8

57.7 *
49.5 83.3
* * *

60.0 *
37.7 63.6 20.6 100.0
*

*

*

*

*

*

*

*

17.4

*

*

*

*

10.5

6.8

*

1.5

*

*

9.4

8.9

*

*

*

*

29.9 7.1 17.6
* 15.3
* *

33.0 6.4
16.8 *
16.6 *
4.3

*

1.5

*

1.5

6.5

3.6

88.4 9.3
* 41.2 35.3 28.2 12.9

90.1 13.1 12.5 41.7 29.3 24.9
5.4

19.1 74.8
2.1 67.5
4.9 19.2
0.5 192.7
5.5

20.3 80.0
2.1 70.5
4.6 18.2
0.5 172.4
7.3

16.6 65.4 1.8 60.0 6.2 24.5 0.7 264.7
*

18.8 74.2
2.0 69.5
7.5 29.9
0.9 279.7
*

18.4 73.1 2.1 70.5 4.1 16.2 0.5 171.4 5.4

18.6 73.5
2.0 67.8
5.5 21.6
0.6 216.4
4.7

75.2 *
45.1 100.0
* * *

119.1 *
104.2 100.0
* * *

81.3 *
73.9 90.0
* * *

95.2 *
36.6 100.0
58.6 100.0
*

72.7 *
58.1 100.0
* * *

88.7 13.3 63.5 97.6 25.1 100.0
*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

54.9

*

*

*

17.1

*

*

*

*

*

*

*

*

*

*

*

1.2

8.5

5.7

6.9

12.2

14.8

9.7

*

*

*

*

*

1.5

*

*

*

*

*

*

12.5

10.6

12.9

17.1

9.0

12.4

*

*

*

*

*

2.0

*

*

*

*

*

1.2

46.5 38.8 17.5
* * * *

41.9 36.4 34.9
* * * 17.3

45.2 32.9 25.7
* * * *

47.1 29.3 22.0
* * * *

44.6 42.3 24.4
* 7.7
* *

45.1 35.9 25.0
2.8 4.0
* 10.1

.

*

*

5.7

*

2.1

.

*

*

*

*

*

.

4.5

5.8

10.2

15.3

9.0

62.5 15.4
* 58.8 51.3 36.3
.

61.4 11.5
* 81.8 68.2 63.6
*

70.8 9.7
* 68.6 61.4 50.0
*

76.8 17.6
* 70.7 70.7 59.8 24.4

65.4

67.3

16.9

14.3

*

37.1

74.4

71.1

75.6

65.6

60.3

54.3

34.6

15.7

497

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Events
Population Women age 15-44 Women age 15-17
Woman's median age at: Conception of first birth Conception of first abortion First marriage
Pregnancy and perinatal outcomes Conceptions to women under 18 Repeat conceptions to women under 18 Total Livebirths Livebirths to women under 18 Livebirths to unmarried women Early fetal deaths Fetal deaths 20 weeks or more gestation Total induced abortions Induced abortions to women under 18
Infant and child survival Infant deaths Neonatal deaths Postneonatal deaths Perinatal deaths Deaths of children 1-4 years Deaths of children 5-17 years
Infant health Low birthweight Very low birthweight Under 500 grams Preterm gestation Multiple gestation Born with birth defect
Maternal risk markers for lowered infant survival Weight gain less than 25 lbs. during pregnancy Father not named on birth certificate Maternal education less than high school No prenatal care Maternal smoking during pregnancy Maternal alcohol use during pregnancy Interpregnancy interval less than 6 months
Abuse & neglect to persons under age 18 years Physical Sexual Neglect
Interventions to improve infant & child survival Prenatal care first trimester Primary C-section delivery Vaginal birth after previous C-section WIC during pregnancy Medicaid during pregnancy WIC and Medicaid during pregnancy Perinatal case management Child fatality investigations
Worth County - 159

1990
19745 4589 537
19.7 18.9 21.0
53 10 359 48 153 36
2 30
4
7 5 2 6 2 0
53 10
0 39
3 7
129 80 141
1 49
8 20
. . .
279 59
2 196 197 149
. 2

1991
19932 4598 541
19.7 18.7 20.0
55 13 320 47 145 29 10 26
4
3 0 3 10 1 1
33 1 0
41 4 2
115 64
113 0
38 5
15
11 8
40
257 54 0
201 184 158
2 3

Total
1992 1993

20106 4606 545

20300 4615 548

19.6 19.9 21.0

20.1 18.3 22.0

49

58

11

19

293

319

41

49

139

134

24

30

3

6

28

29

6

3

1

4

0

2

1

2

3

8

1

3

1

0

21

34

4

5

0

0

27

34

2

4

2

5

104

103

61

52

124

116

2

2

40

43

2

5

24

18

19

21

21

24

36

50

245

255

44

47

1

2

175

190

182

203

150

160

7

88

2

0

1994 5-year

20476 4622 552

100559 23030 2722

20.1 19.7 22.0

19.9 18.8 21.0

43

258

13

66

283

1574

39

224

140

711

25

144

4

25

18

131

1

18

5

20

3

10

2

10

7

34

1

8

1

3

30

171

6

26

0

0

27

168

4

17

3

19

97

548

55

312

106

600

0

5

51

221

5

25

20

97

15

66

11

64

68

194

224

1260

42

246

1

6

167

929

180

946

139

756

133

230

3

10

1990
13540 3031 324

1991
13713 3049 326

White
1992 1993

13877 3067 329

14049 3085 331

1994 5-year

14216 3102 334

69395 15334
1644

22.7 18.5 20.0

20.2 18.8 20.0

21.0 20.0 21.0

22.1 16.8 21.0

21.3 22.8 20.0

21.3 18.8 20.0

21

24

17

24

17

103

4

3

4

7

6

24

192

174

150

188

168

872

16

20

14

19

17

86

33

35

21

33

42

164

23

16

13

13

13

78

2

2

0

3

0

7

19

14

18

14

9

74

4

3

2

3

0

12

2

0

1

1

4

8

2

0

0

1

3

6

0

0

1

0

1

2

3

2

0

4

3

12

1

0

0

2

1

4

0

1

1

0

0

2

17

14

7

14

18

70

2

0

1

2

3

8

0

0

0

0

0

0

12

25

10

21

17

85

1

2

0

3

3

9

2

1

0

0

2

5

64

62

52

58

59

295

16

17

9

13

15

70

61

52

52

63

53

281

1

0

0

0

0

1

31

26

25

34

40

156

2

1

1

3

1

8

9

5

8

7

6

35

.

7

12

15

6

40

.

7

14

15

6

42

.

19

14

30

14

77

163

150

131

160

142

746

31

29

25

32

30

147

1

0

0

1

0

2

75

87

62

89

86

399

61

71

67

93

82

374

48

64

51

72

66

301

.

2

5

42

58

107

1

0

1

0

3

5

1990
6051 1528
210

1991
6108 1530 212

Black
1992 1993

6162 1532
213

6221 1534 214

1994 5-year

6275 1536
216

30817 7661 1065

18.4 19.6 23.0

19.1 14.5 24.0

18.7 16.7 25.0

18.2 19.5 23.0

18.1 16.6 25.0

18.5 18.8 24.0

32

31

31

34

26

154

6

10

7

12

7

42

164

145

141

131

115

696

32

27

26

30

22

137

120

110

116

101

98

545

13

13

11

17

12

66

0

8

3

3

4

18

11

11

10

14

9

55

0

1

4

0

1

6

5

3

0

3

1

12

3

0

0

1

0

4

2

3

0

2

1

8

3

8

3

4

4

22

1

1

1

1

0

4

0

0

0

0

1

1

36

19

14

20

12

101

8

1

3

3

3

18

0

0

0

0

0

0

27

16

17

13

10

83

2

2

2

1

1

8

5

1

2

5

1

14

65

53

51

45

38

252

64

47

51

39

40

241

79

61

70

53

53

316

0

0

2

2

0

4

18

12

14

9

11

64

6

4

1

2

4

17

11

10

15

11

14

61

.

3

6

6

9

24

.

0

5

9

4

18

.

21

19

20

50

110

113

106

112

95

28

24

19

15

1

0

1

1

120

114

111

101

135

113

113

110

100

94

97

88

.

0

2

46

1

3

1

0

82

508

12

98

1

4

81

527

98

569

73

452

75

123

0

5

498

The Challenge of Change: A Mid-Decade Look at Maternal and Child Health in Georgia

Maternal and Child Health Rates

Total
1990 1991 1992 1993 1994 5-year

White
1990 1991 1992 1993 1994 5-year

Black
1990 1991 1992 1993 1994 5-year

Perinatal outcome rates Crude birth rate General fertility rate Total fertility rate % Livebirths to unmarried women Crude abortion rate General abortion rate Total abortion rate Abortion ratio Fetal Death rate
Teen pregnancy & perinatal outcome rates Conceptions to women under 18 % Repeat conceptions to women under 18 Livebirths to women under 18 % Livebirths to unmarried women under 18 Induced abortions to women under 18 % Abortions to unmarried women under 18 Fetal deaths to women under 18
Infant and child survival rates Infant mortality Neonatal mortality Postneonatal mortality Perinatal mortality ratio Deaths of children 1-4 yrs Deaths of children 5-17 yrs
Infant health rates % Low birthweight % Very low birthweight % Under 500 grams % Preterm gestation % Multiple gestation % Birth defect
Maternal risk markers for lowered infant survival % with weight gain < 25 lbs. during pregnancy % with father not named on birth certificate % with maternal education less than high school % No prenatal care % Maternal smoking during pregnancy % Maternal alcohol use during pregnancy % Interpregnancy interval less than 6 months
Child abuse and neglect rates Physical Sexual Neglect
Interventions to improve infant & child survival % Prenatal care first trimester % Primary C-section delivery % Vaginal birth after previous C-section % WIC during pregnancy % Medicaid during pregnancy % Medicaid and WIC during pregnancy % Perinatal case management
Worth County - 159

18.2 78.2
2.4 43.0
1.5 6.5 0.2 69.1 9.8

16.1 69.6
2.1 45.9
1.3 5.7 0.2 67.4 8.7

14.6 63.6 1.9 47.8 1.4 6.1 0.2 80.0
6.3

15.7 69.1
2.1 42.5
1.4 6.3 0.2 74.9 8.5

98.7 18.9 89.4 79.2
* * *

101.7 23.6 86.9 83.0 * * *

90.0 22.4 75.3 75.6 11.0 100.0
*

105.8 32.8 89.4 87.8 * * 10.9

19.5 13.9
* 16.6
* *

* * * 30.3 * *

*

*

*

*

*

*

*

24.6

*

*

*

*

14.8 2.8 *
11.0 *
1.9

10.3 * *
13.0 * *

7.2

10.7

*

1.6

*

*

9.3

10.8

*

*

*

1.6

37.9 22.5 39.7
* 13.8
2.2 9.5

38.7 20.3 35.8
* 12.1
1.6 8.2

39.2 21.0 42.6
* 13.8
* 13.8

37.3 16.5 36.8
* 13.8
1.6 9.6

.

1.8

3.1

3.4

.

1.3

3.4

3.9

.

6.6

5.9

8.1

79.0 18.4
* 55.1 55.3 41.9
.

81.1 19.3
* 63.6 58.2 50.0
*

84.2 17.7
* 60.1 62.5 51.5
2.4

81.2 17.6
* 60.3 64.4 50.8 27.9

13.8 61.2 1.9 50.2 0.9 3.9 0.1 53.9
7.1

15.7 68.3
2.1 45.7
1.3 5.7 0.2 69.3 8.1

77.9 30.2 70.7 87.2
* * *

94.8 25.6 82.3 82.6
6.6 100.0
7.0

17.7 * *
24.4 * *

12.7 6.4 6.4
21.3 1.2 *

10.6

10.9

2.1

1.7

*

*

9.7

10.8

*

1.1

*

1.2

36.9 19.7 38.0
* 18.3
1.8 12.1

38.0 20.0 38.6
0.3 14.2
1.6 10.5

2.4

2.7

1.8

2.6

10.9

7.9

79.4 17.4
* 59.9 64.5 49.8 47.7

80.9 18.1
3.0 59.7 60.8 48.6 19.2

14.2 63.3
2.0 17.3
1.4 6.3 0.2 80.2 8.6
64.8 *
49.4 43.8
* * *
* * * * * *
8.9 * *
6.3 * *
34.2 8.4
31.9 *
16.2 *
8.0
. . .
85.8 17.7
* 39.3 31.9 25.1
.

12.7 57.1
1.8 20.3
1.0 4.6 0.1 67.6 6.2
73.5 *
61.3 60.0
* * *
* * * * * *
8.0 * *
14.5 * *
37.6 9.9
30.2 *
15.1 *
5.3
1.9 1.9 5.2
87.2 19.0
* 50.6 41.3 37.2
*

10.8 48.9 1.5 14.0 1.3 5.9 0.2 99.4
4.2
51.7 *
42.6 * * * *
* * * * * *
4.7 * *
6.7 * *
36.6 6.0 34.7
* 16.8
* 9.1
3.3 3.8 3.8
87.9 19.7
* 41.3 44.7 34.0 3.3

13.4 60.9
1.9 17.8
1.0 4.5 0.1 64.2 5.2
72.4 29.2 57.3 68.4
* * *
* * * * * *
7.4 * *
11.4 * *
35.4 7.0
34.1 *
18.5 *
6.5
4.0 4.0 8.0
85.6 20.5
* 48.1 50.3 38.9 22.7

11.8 54.2 1.7 25.5 0.6 2.9 0.1 46.9
4.8

12.6 56.9
1.8 19.0
1.1 4.8 0.1 71.5 5.8

50.9 35.3 50.9 70.6
* * *

62.6 23.3 52.3 55.8
7.3 100.0
3.6

*

9.2

*

6.9

*

*

*

13.7

*

*

*

*

10.7

8.0

*

0.9

*

*

10.3

9.8

*

1.0

*

0.6

37.1 9.1
32.1 *
24.2 *
6.6

36.1 8.1
32.6 *
18.1 0.9 7.1

1.6

2.7

1.6

2.8

3.7

5.2

84.5 20.4
* 52.1 49.7 40.0 35.2

86.1 19.4
* 46.2 43.3 34.9 15.9

27.1 107.3
2.9 74.1
1.8 7.2 0.2 56.7 12.4

23.7 94.8
2.6 76.9
1.8 7.2 0.2 62.1 13.7

22.9 92.0 2.5 83.5 1.6 6.5 0.2 59.9 10.4

21.1 85.4
2.4 77.7
2.3 9.1 0.3 83.3 15.0

18.3 74.9 2.1 86.0 1.4 5.9 0.2 63.4 11.7

22.6 90.9
2.5 79.2
1.8 7.2 0.2 64.9 12.7

152.4 18.8 152.4 96.9
* * *

146.6 32.3
127.7 100.0
* * *

145.6 22.6
122.1 100.0
* * *

158.6 35.3
139.9 100.0
* * *

120.5 26.9
101.9 100.0
* * *

144.7 27.3
128.7 99.3 5.6 100.0 12.2

30.5

*

*

*

*

17.2

*

*

*

*

*

*

*

*

*

*

*

11.6

*

52.3

*

*

*

30.8

*

*

*

*

*

*

*

*

*

*

*

*

22.0 4.9 *
16.7 *
3.0

13.1 * *
11.2 * *

9.9 * *
12.2 * *

15.3 * *
10.0 *
3.8

10.4 * *
8.8 * *

14.5 2.6 *
12.1 1.2 2.0

43.3 39.5 49.1
* 11.1
3.7 11.6

40.5 32.9 42.7
* 8.5
* 11.4

42.1 36.7 50.4
* 10.1
* 17.6

40.2 30.0 40.8
* 7.0
* 13.8

36.5 35.1 46.5
* 9.6
* 18.9

40.8 35.0 46.0
* 9.4 2.5 14.5

.

*

2.5

2.5

3.7

2.5

.

*

2.1

3.7

*

1.9

.

8.9

8.0

8.3

20.5

11.5

70.6 19.6
* 74.1 83.3 61.7
.

73.6 19.0
* 79.7 79.0 65.7
*

80.0 16.0
* 79.9 81.3 69.8
*

74.8 13.5
* 77.7 84.6 67.7 35.4

71.9

74.2

12.6

16.5

*

*

71.1

76.6

86.0

82.7

64.0

65.7

65.8

23.4

499