Fulton County exceeded the state average in the number of babies per capita born with low birth weight, a condition closely linked with poverty, smoking and other lack of access to proper medical care, according to a report card released today by an independent health care advocacy group.
Fulton County’s low-birth-weight rate was nine babies per 100. The Bronx was the only other county in the state that exceeded the state average. Its rate was 7.8. The state average is 6.8 per 100 live births.
Low birth weight means birth weight less than 5.5 pounds, whereas the average birth weight after a normal pregnancy is 7.5 pounds. Birth weight is the single most important factor causing death in newborns and a significant determining factor in infant deaths between 1 and 12 months of age, according the coalition.
Dr. David Pratt, commissioner of health for Schenectady County, said low birth weight is “an interesting indicator of community health. Its causes have to do with nutrition, prematurity, misuse of tobacco or drugs. It has to do with the maternal-fetal environment.”
Other factors influencing low birth weight are teenage pregnancy, poverty and lack of access to prenatal medical care, Pratt said. “We know that low-birth-weight babies have significant problems,” he said. “Low birth weights represent a cascade of events in the mom’s life: school; maternal stress; is she worried about her own safety? Is she worried about paying the rent?”
Sue Cridland, director of community education for Nathan Littauer Hospital in Fulton County, said many factors contribute to low-birth-weight babies, “but the one that stands out in my mind is the disproportionately high percentage of mothers who smoke while pregnant. We know that we have more than the state average of moms who smoke, and we try working to get them to quit.”
Smoking tobacco reduces the amount of oxygen reaching the baby through the placenta and also introduces a variety of toxins into the baby’s bloodstream, Cridland said.
The Niagara Health Quality Coalition released the data as part of its annual report card on hospitals in New York and on prevention quality indicators in the state’s counties. Coalition President and CEO Bruce Boissonnault said the report card seeks to improve both transparency and community health care. The 2010 report card is based on data from 2008.
Fulton County also exceeded state averages for uncontrolled diabetes, long-term complications of diabetes and chronic obstructive pulmonary disease — other prevention quality indicators. A prevention quality indicator measures hospital admissions for illnesses and chronic conditions that could have been prevented had the patient received timely and adequate outpatient care.
Boissonnault said, “The indicators show how well physicians are doing to keep people out of the hospital with these preventable conditions. We only report on conditions where the literature clearly indicates that people with proper care can be controlled.”
Montgomery County exceeded the state average for angina, for short-term complications of diabetes and for congestive heart failure. Schenectady County exceeded state averages for short-term complications of diabetes and congestive heart failure, according to the coalition’s report card.
Ellis Medicine officials said they are aware of Schenectady County’s rates and are working to reduce them to below the state average. “We have addressed this by creating our medical home at the former St. Clare’s Hospital on McClellan Avenue,” said Dr. David Liebers, chief medical officer for Ellis.
The medical home brings together the Ellis Family Health Center, its Pediatric Health Center and its Dental Health Center as well as outpatient services, such as child and adolescent mental health, diabetes education and imaging, laboratory and emergency services.
The medical home employs specially trained nurses, called health services navigators, who connect patients to medical care and social services. The navigators will help patients enroll in health insurance programs.
Maryellen Crittenden, vice president of quality at Ellis Medicine, said Ellis has hired an endocrinologist to work with physician practices and nurses to tackle the high incidence of people with short-term complications of diabetes.
Ellis is also employing “heart patient coaches” who visit outpatients with heart disease in their homes to ensure they are compliant with their hospital discharge plans.