June 16, 2008
The Health Collaborative Seeks Participants for Project Measure Up Volunteer Corps
May 3, 2008
Celebrate Mother's Day with Gifts that Encourage a Healthy Lifestyle
April 10, 2008
Enjoy a Fun, Fit Fiesta!
March 3, 2008
Make Family Fitness Activities Part of Your Spring Break
Infant and Child Health
Infant Mortality
Infant mortality has been used as a broad measure of community health because of the sensitivity of infant to social conditions. For the past several decades the infant mortality rate in the United States and Texas has been declining. In 2000 the infant mortality rate was 5.7 deaths per 1,000 live births. In Bexar and Harris County the rate was even lower at 4.9 deaths per 1,000 live births. In the past four years there has been a reversal of the trend. The infant mortality rate has risen to above 6 deaths per 1,000 live births. The reason for this increase is not yet clear. It is likely a product of random variation in rates involving, in this case, a small number of deaths. Public Health officials speculate that the increase may be the result of increased use of fertility drugs to help families conceive who otherwise would not be able to have a child. If this is the case the utility of infant mortality as a measure of community health may be reduced.
In 2004 the infant mortality rate in Bexar County was 6.2 deaths per 1,000 live births. This is slightly higher than the Texas rate. The infant mortality rate has increased across the county in all sectors except the Southeast. It is surprising that the Southeast rate (6.7) is only a little higher than the County rate this rate is down fro 7.7 in 2000. Typically the African American population have infant mortality rates 1.7 to 2.0 times higher than the general population. The fact that the West has the highest rate in the County at 7.7 is also an area of concern. This rate has increased from 4.8 in 2000. It is less likely that in the Westside and West areas that the increase in infant mortality is the result of the use of fertility drugs. Low incomes and other social factors may be contributing to the increase in infant mortality. In the Northwest the infant mortality rate has also increased since 2000. More information is needed to help understand the changes in infant mortality in Bexar County.
Fertility in women ages 15 to 44
The fertility rate establishes the size of the future population. There were 25,020 births in Bexar County in 2004. This results in a fertility rate of 72 births born per 1,000 females age 15-44. The fertility rate in Bexar County has remained fairly constant since 1992 when the fertility rate was 74. The Bexar rate is consistent with the Texas rate and slightly lower than the Harris County rate (79 per 1,000).
The fertility rate throughout the northern sectors in Bexar County varies from 62 to 67 births per 1,000 females. This rate is similar to the non-Hispanic fertility rate which is 61 per 1,000 females in Bexar County. In the southern sectors, fertility rates are much higher than the county average. In the West sector, the rate is 89 and the Southeast and South have rates of 85 and 84 respectively. These rates are similar to the Hispanic fertility rate of 84 for Bexar County but are noticeably lower that the Texas Hispanic fertility rate of 100/1000. The fertility rates in the northern sectors are approximately 20 births per 1,000 fewer than in the south.
Prenatal care in the first trimester of pregnancy
Early prenatal care helps ensure a healthy pregnancy and can identify risks to the health of the fetus or mother. Eighty-six percent of mothers in Bexar County received early prenatal care in 2004. Across Texas the percentage of mothers receiving prenatal care beginning in the first trimester of pregnancy has slowly but steadily increased since 1992. The percentage of Bexar County mothers receiving prenatal care is consistently slightly higher than Harris County and the state average. The 2004 state average for mothers receiving prenatal care in the first trimester is 82 percent.
In 2004, 86 percent of Bexar County mothers began prenatal care in the first trimester. Slightly more mothers in the north appear to start prenatal care early. The North Central sector has the highest percentage of mothers seeking early prenatal care with 89 percent. The East sector has the lowest early prenatal care rate with 83 percent of mothers received early prenatal care, this is only one point higher than the state average of 82 percent.
Recent reports suggest that there was a dramatic drop in the number of mothers seeking prenatal care in 2005. A new birth certificate introduced across the United States in 2005 changed the way information was obtained about when prenatal care began. It is likely that the change in the way the information is obtained is responsible for the change in prenatal care rates, not mothers’ prenatal care seeking behavior. See appendix A for more information on this issue.
Late or no prenatal care
In 2004, of the 25,020 births to residents of Bexar County, only 2.8 percent of Bexar County mothers received no prenatal care or waited to start care in the third trimester. This number is slightly lower but consistent with the rates for the state and Harris County. After a noticeable drop in the percentage of mothers receiving late or no prenatal care between 1992 and 1996 rates for the state, Bexar and Harris County have remained at stable rates since 1996.
Within Bexar County, the percent of mothers who receive late or no prenatal care varies little. Rates of mothers receiving late or no prenatal care in each of the sectors is lower than the state average of 4.5 percent. Slightly more mothers in the south sectors receive late or no prenatal care. The sector with the highest rate of mothers receiving late or no prenatal care is the East sector, with a rate of 3.6 percent, followed closely by the South (3.4 percent) and the West (3.3 percent). The rate in the northern sectors ranges from 1.9 percent in the North Central to 2.3 in the Northwest and 2.5 percent in the Northeast.