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Policy Approaches to Health Equity: Fundamental Determinants and Increased Diversity
Kathryn Cardarelli, PhD, Kelly Ylitalo and Rachael Jackson


Health
Maintaining a Competitive Health Care System
Right Start rankings in child health outcomes
Right Start rankings in child health outcomes
What does this indicator measure?
This indicator reports the findings of The Right Start, a joint project of the Annie E. Casey Foundation and Child Trends, a research organization. Using data from the National Center for Health Statistics, the report ranks the 50 largest cities and all states based on best and worst performance on each of the following eight measures:
  • Births to teens
  • Births to teens who were already mothers
  • Births to unmarried women
  • Births to mothers with less than 12 years of education
  • Births to mothers receiving late or no prenatal care
  • Births to mothers who smoked during pregnancy
  • Low-birthweight births (less than 5.5 pounds)
  • Preterm births (less than 37 weeks of gestation)

In addition, this indicator also reports descriptive information about births in the counties that comprise the Dallas MSA. Specifically, the following statistics are reported:

  • Total births
  • Low-birthweight infants (less than 2,500 grams or 5 pounds, 9 ounces)
  • Births to mothers 17 years of age and younger
  • Onset of prenatal care within first trimester

Why is this indicator important?
Facts about the circumstances and conditions under which children are born have a significant lifelong implication for the health and lives of children. For example, there is empirical support for the notion that children of mothers who receive little or no prenatal care are significantly more likely to experience chronic health problems than children of mothers who received prenatal care. The Right Start rankings are an adequate indicator of how the city of Dallas ranks within the context of the largest 50 cities in the country. However, these rankings provide no information about the rest of the Dallas MSA. Annual reports (vital statistics) from the Texas Department of State Health Services (formerly the Texas Department of Health) are used to describe births in the Dallas MSA.
How are we doing?
According to the Texas Department of State Health Services:
  • In 2002, Kaufman County had the highest proportion (8.9%) of low weight births among the Dallas MSA counties. During the same year, Rockwall County had the lowest proportion (5.9%) of low weight births.
  • In 2002, Henderson County had the highest proportion (7.2%) of births to mothers less than 17 years of age among the Dallas MSA counties. During the same year, Collin County had the lowest proportion (1.5%) of births to mothers less than 17 years of age.
  • In 2002, Hunt County had the greatest proportion of expectant mothers without prenatal care (31%) before the end of the first trimester. During the same year, Rockwall County had the lowest proportion of expectant mothers without prenatal care (11.4%) before the end of the first trimester.

The rankings from The Right Start project indicate that:

  • Although the proportion of births to teenagers went down between 2000 and 2001, the city of Dallas is still among the 15 cities with the highest proportion of births to teens.
  • The city of Dallas ranks among the top five cities with the highest proportion of births to teen mothers who already have children.
  • Among the nations largest cities, in 2000 and 2001, the city of Dallas had the greatest proportion of births to mothers with less than 12 years of education.
  • The city of Dallas ranked 20th among the top 50 cities in the percentage of low-birthweight babies (8.%) born in 2001.
  • Although the proportion of babies born prematurely in Dallas has not changed significantly between 2000 and 2001, the city's rank dropped significantly from 31st to 26th place from 2000 to 2001.
  • Overall, the city of Dallas ranked in the bottom half among the top 50 cities in six of the eight key indicators examined by The Right Start report.


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