NEEDS ASSESSMENT

Virginia ranks 18th for the overall health of women and children (2019)

Women’s/Maternal Health

Title V’s strategies align with the 2021 Maternal Health Strategic Plan, focusing on improving birth outcomes and reducing the Black/White maternal and infant mortality disparity.  Virginia’s Maternal Mortality Review Team findings influence Title V’s priorities. Access to oral health services for pregnant people is also a priority. 

• 7th overall for the health of women (2020) 

• Percentage of women reporting that they wanted to become pregnant later or never was 25.1% (2020)

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• 45.4% of pregnancies were described by women as unintended (2020)

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• Maternal morbidity rate was 66.9 per 10,000 delivery hospitalizations (NOM 2)

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• non-Hispanic White – 55.1; 

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• non-Hispanic Black – 95.1;

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• ≥35 years – 102 

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• Maternal mortality rate was 21.6 per 100,000 live births (NOM 3)

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• non-Hispanic White – 23.7; 

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• non-Hispanic Black – 49.1

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• Leading causes of pregnancy-associated deaths were accidental overdoses, cancer, cardiac conditions, homicide, and infections

• Percentage of women who experienced postpartum depressive symptoms following a recent live birth was 11.8% (2020)

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• 46.7% of moms had a preventive dental visit during pregnancy (NPM 13.1)

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• Percentage of women who did not attend postpartum care due to COVID-19 pandemic was 7.4% (2020)

Perinatal/Infant Health

Title V’s statewide partnerships and fourth-trimester initiatives focus on sustaining breastfeeding and addressing social determinants of health and systemic structures affecting the infant mortality disparity between white and black infants. 

• 25th overall for the health of infants (2020) 

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• 86.5% of moms ever breastfed and 22.4% breastfed for 1-10 weeks; 53.3% were still breastfeeding at the time of the VA PRAMS survey 

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• non-Hispanic White – 56.6%; 

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• non-Hispanic Black – 33.6%; 

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• Hispanic – 55.8%

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• Infant mortality rate was 5.3 per 1,000 live births (2020) 

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• White – 3.8; 

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• Black – 10.2; 

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• Other – 4.3

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• Leading causes of infant mortality were birth defects, disorders related to short gestation and low birth weight, and sudden infant death syndrome

Child Health

Title V promotes the value and availability of developmental screening, with early follow-up and referral for intervention services when needed. We work to reduce barriers to well-child health visits, increase and track rates of developmental screening, increase connection to services.  Child safety, reduction of non-fatal hospitalizations, and access to oral health are additional priorities in this domain.  

• 15th overall for the health of children (2020)

• Percent of children, ages 9-35 months, who received a developmental screening using a parent-completed screening tool in the past year is 31.3% (NPM 6)

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• Rate of hospitalization for non-fatal injury among children was 95.1 per 100,000 (NPM 7.1) 

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• <1 year – 225.8; 

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• 1-4 years – 102.7; 

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• 5-9 years – 64.3 

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• 57.5% of children ages 1-5 years and 87.7% of children ages 6-11 years had a preventive dental visit (NPM 13.2)

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Adolescent Health

Virginia’s Title V strategies to help address adolescent suicide include: Strategic partnering with VDH’s Injury Prevention Team and School Health Programs to leverage and synthesize existing relationships to meaningfully engage in creating solutions to increase protection from suicide risk.

• Rate of hospitalization for non-fatal injury among adolescents was 173.7 per 100,000 (NPM 7.2)

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• 10-14 years – 93.9; 

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• 15-19 years – 251.2 

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• 46.7% of middle school students experienced at least one form of bullying, bullying on school property or cyberbullying (2019)
  • Those who experienced cyberbullying, were more likely to report suicidality (47.9%), not feeling good about themselves (46.8%), ever drank alcohol (31.0%) and ever used electronic vapor products (24.3%).

• 22.6% of high school students were victims of any form of bullying (2019) 
  • Those who experienced cyberbullying, were more likely to report feeling sad for 2 weeks or more (59.6%), current alcohol use (42.5%), suicidality (41.0%), purposely hurting themselves without wanting to die (36.4%), electronic vapor products use (35.5%) and current marijuana use (29.0%).

• 17.4% of adolescents received services necessary to make transitions to adult health care (NPM 12)

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• 83.4% of adolescents (ages 12-17) had a preventive dental visit (NPM 13.2)

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• Teen pregnancy rate is 17.3 per 1,000 females ages 15 to 19 years

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Children with Special Health Care Needs

Virginia’s statewide network of programs for children and youth with special healthcare needs are cornerstones of excellence for children who have or are at risk for chronic physical, developmental, behavioral, or emotional conditions.  Legislatively mandated, Virginia’s CYSHCN exceeds national benchmarks in its efforts to ensure the highest level of diagnostic services, care coordination, supportive services, and family engagement for all programs serving this population. 

• Percent of children with special health care needs (CSHCN) is 18.0% (NOM 17.1)

• 46.4% of CSHCN had a medical home (NPM 11)

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• 17.4% of CSHCN age 12-17 years were engaged in transition services to adult health care (NPM 12)

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• 67.7% of CSHCN continuously and adequately insured (NPM 15)

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Cross-Cutting / Systems Building

An important area of Title V’s work is promoting the value and availability of a seamless comprehensive system of care from newborn screening to early follow-up and referral for intervention services when needed.  Family engagement is essential to all Title V programs, and Virginia’s Youth Advisors provide essential guidance across all programs regarding effective methods to shape programs that empower youth and young adults. Virginia’s Title V program values a workforce that is equity focused.  Prioritizing the identification and elimination of structural and systemic racism, focused efforts center around professional development and strategic community-led partnerships. 

• Expand capacity to document and track referrals of infants from the Newborn Screening Program to CSHCN programs.

• Develop and sustain the VDH Youth Advisor Program.

• Develop and strengthen MCH workforce that advances racial equity.

• Maintain and expand family engagement.