1. The Goal

2. Note: Age at death was not available for year s 1947-1948. Source: VDH, Division of Health Statistics, April, 2011

3. How do we get there?

4. An example- Heart Attacks

5. By The Numbers Virginia Heart Attacks ^ ^ Myocardial infarctions (MI) † Age-adjusted mortality rates / 100,000 population. Population data from U.S. Census Bureau ‡ Unadjusted hospitalization rates / 100,000 population. Population data from U.S. Census Bureau Data Source: Mortality rate data – VDH Division of Health Statistics. Hospitalization rate data - Virginia Health Information via the VDH Data Warehouse Prepared by: Health Informatics & Integrated Surveillance Systems – Division of Disease Prevention - Office of Epidemiology 22% 2000 1% 2009 % disparity between white and black female heart attack rates ‡ 45 % Drop in overall heart attack mortality rates † between 2000-2009 1,872 Fewer Virginians died from heart attacks in 2009 than 2000

6. Heart Attack ^ Rates † Among Virginia Residents by Race, 2000 - 2009 ^ Acute myocardial infarctions, based on ICD-9 code 410. † Unadjusted rates of reported Virginia hospitalization data / 100,000 population. Population data from U.S. Census Bureau Data Source: Hospital inpatient data provided to VDH Data Warehouse via Virginia Health Information. Prepared by: Health Informatics & Integrated Surveillance Systems staff – Division of Disease Prevention - Office of Epidemiology

7. Heart Attack ^ Rates † Among Virginia Females by Race, 2000 - 2009 ^ Acute myocardial infarctions, based on ICD-9 code 410. † Unadjusted rates of reported Virginia hospitalization data / 100,000 population. Population data from U.S. Census Bureau Data Source: Hospital inpatient data provided to VDH Data Warehouse via Virginia Health Information. Prepared by: Health Informatics & Integrated Surveillance Systems staff – Division of Disease Prevention - Office of Epidemiology

8. An example- Heart Attacks

9. The Goal

10. Infant Mortality – The last Sixty Years

11. Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 1999-2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

12. Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 1999-2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

13. Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 1999-2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

14. Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 1999-2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

15. Virginia’s Late Preterm Birth Rate is Declining The rate of late preterm births declined by 8% from 2005 to 2009. Source: Virginia Department of Health, Division of Health Statistics, compiled by the Office of Family Health Services, Division of Child and Family Health, 2005-2009

16. Virginia’s Teenage Pregnancy Rate is Declining Source: Virginia Department of Health, Division of Health Statistics, compiled by the Office of Family Health Services, Division of Child and Family Health, 2000-2009 The rate of pregnancies to teens ages 10-19 years declined by 22% from 2000 to 2009.

17. By the Numbers Source: Virginia Department of Health, Division of Health Statistics, compiled by the Office of Family Health Services, Division of Child and Family Health 580 Fewer late preterm births in Virginia from 2005 to 2009 1,085 More full-term births in Virginia from 2005 to 2009 22% Decline in Virginia’s teen pregnancy rates from 2000 to 2009

18. Induced Terminations: National Comparison National Data Sources: (1) Guttmacher Institute, Facts on Induced Abortions in the United States, January 2011; (2)Jones RK, Finer LB, and Singh S, Characteristics of US Abortion Patients, 2008, New York, Guttmacher Institute 2010. Virginia Data Sources: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 2009, compiled by the Policy & Assessment Unit, Office of Family Health Services United States Virginia Number of Induced Terminations, 2008 1.21 million 25,822 Induced Terminations Rate per 1,000 females ages 15-44, 2008 19.6 per 1,000 16.1 per 1,000 Largest proportion of Induced Terminations: Race/ethnicity, 2008 Non-Hispanic White (36%) Non-Hispanic White (42%) Age group, 2008 20-29 years (58%) 20-29 years (57%) Marital Status, 2008 Unmarried (85%) Unmarried (72%) Previous Induced Terminations, 2008 No previous induced terminations (50%) No previous induced terminations (45%) Previous Live Births, 2008 One or more previous live births (61%) One or more previous live births (60%)

19. Induced Terminations: Percent of Total Pregnancies, Virginia 1999-2009 Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, and Induced Terminations of Pregnancy Certificates 1999-2009, compiled by the Policy & Assessment Unit, Office of Family Health Services

20. Source: VDH Division of Health Statistics Resident Live Birth and Induced Terminations of Pregnancy Certificates compiled by the Policy & Assessment Unit, Office of Family Health Services, 2009.

21. Virginia State Profile 2009 Source: VDH Division of Health Statistics Resident Live Birth, Fetal Death, Induced Terminations of Pregnancy, and Infant Death Certificates, and NCHS population estimates 2009, compiled by the Policy & Assessment Unit, Office of Family Health Services. 1 VDH Division of Immunization. Virginia Birth Rate (per 1,000 total population) 13.3 per 1,000 Pregnancy Rate (per 1,000 females ages 15-44) 84.5 per 1,000 Infant Mortality Rate (per 1,000 live births) 7.0 per 1,000 Teen Pregnancy Rate (per 1,000 females ages 10-19) 24.3 per 1,000 Induced Terminations Rate (per 1,000 females ages 15-44) 16.1 per 1,000 Immunization Rate (Percent Up-to-Date 4:3:1:3:3:1 Immunizations per 100 24 month old health district clients) 1 56.1%

22. *DMAS estimated eligibles based on 2006 Guttmacher Institute WIN data and 2008 Census Bureau percentage of women under 200%FPL who are uninsured and living in Virginia (35.7%) . *Estimated eligibles: 92,247

23. The Seen Epidemic

24. Obesity Trends Among U.S. Adults BRFSS, 1985 No Data <10% 10%–14%

25. Obesity Trends Among U.S. Adults BRFSS, 1990 No Data <10% 10%–14%

26. Obesity Trends Among U.S. Adults BRFSS, 1995 No Data <10% 10%–14% 15%–19%

27. Obesity Trends Among U.S. Adults BRFSS, 2000 No Data <10% 10%–14% 15%–19% 20%–24%

28. Obesity Trends Among U.S. Adults BRFSS, 2002 Source: Behavioral Risk Factor Surveillance System, CDC No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

30. How do we get there?