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Maternal, Infant, and Child Health Data Details

MICH-1 Reduce the rate of fetal and infant deaths

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Fetal Death (NVSS-FD); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
National Vital Statistics System-Natality (NVSS-N)
Changed Since the Healthy People 2020 Launch
No
Measure
per 1,000 live births plus fetal deaths 
Baseline (Year)
6.2 (2005)
Target
5.6
Target-Setting Method
10 percent improvement
Numerator
Number of fetal deaths (20 or more weeks of gestation)
Denominator
Number of live births plus fetal deaths (20 or more weeks gestation)
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

A description of the primary measurement used to determine the infant’s gestational age—the interval between the first day of the last normal menstrual period (LMP) and the birth—has been published by NCHS.1

This objective uses the same measurement protocol as the comparable Healthy People 2000 objective 14.2 and Healthy People 2010 objective 16.1a, A description of the fetal death measurement has been published by NCHS.2

States are required to report fetal deaths if they occur in the 20th week of pregnancy or later, or if they weigh at least 350 grams.3 The number of fetal deaths may be underreported in part because of variations in reporting requirements by States.

1. Martin, J.A.; Hamilton, B.E.; Sutton, P.D.; et al. Births: Final data for 2003. National Vital Statistics Reports Vol. 54, No. 2. Hyattsville, MD: National Center for Health Statistics, 2005.

2. Heck, K.E., and Klein, R.J. Operational definitions for year 2000 objectives: Priority area 14, Maternal and Infant Health. Healthy People 2000 Statistical Note. No. 14. Hyattsville, MD: NCHS, 1998.

3. National Center for Health Statistics. Technical Appendix. Vital Statistics of the United States, 1999. Vol. II, Mortality, Part A. Available from: www.cdc.gov/nchs/data/statab/techap99.pdf

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Linked Birth/Infant Death Data Set; Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
National Vital Statistics System-Fetal Death (NVSS-FD)
Changed Since the Healthy People 2020 Launch
No
Measure
per 1,000 live births plus fetal deaths 
Baseline (Year)
6.6 (2005)
Target
5.9
Target-Setting Method
10 percent improvement
Numerator
Number of fetal and infant deaths during the perinatal period (28 weeks of gestation to 7 days after birth)
Denominator
Number of live births plus fetal deaths of at least 28 weeks of gestation
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

To create linked data files, death certificates are linked with corresponding birth certificates for infants who die in the U.S. before their first birthday. The linked file is used for calculating infant mortality rates by race and ethnicity because these variables are more accurately collected on the birth certificate than the death certificate.

MICH-1.3 Reduce the rate of all infant deaths (within 1 year) Leading Health Indicators

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Linked Birth/Infant Death Data Set; Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
per 1,000 live births 
Baseline (Year)
6.7 (2006)
Target
6.0
Target-Setting Method
10 percent improvement
Numerator
Number of deaths of infants under 1 year of age
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Leading Health Indicator
Maternal, Infant, and Child Health
Methodology Notes

To create linked data files, death certificates are linked with corresponding birth certificates for infants who die in the U.S. before their first birthday. The linked file is used for calculating infant mortality rates by race and ethnicity because these variables are more accurately collected on the birth certificate than the death certificate.

Depending upon county population size, the period county percent for the most recent 3, 5, or 10 years is reported.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Linked Birth/Infant Death Data Set; Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
per 1,000 live births 
Baseline (Year)
4.5 (2006)
Target
4.1
Target-Setting Method
10 percent improvement
Numerator
Number of deaths of infants aged 27 days and under
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

To create linked data files, death certificates are linked with corresponding birth certificates for infants who die in the U.S. before their first birthday. The linked file is used for calculating infant mortality rates by race and ethnicity because these variables are more accurately collected on the birth certificate than the death certificate.

Depending upon county population size, the period county percent for the most recent 3, 5, or 10 years is reported.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Linked Birth/Infant Death Data Set; Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
per 1,000 live births 
Baseline (Year)
2.2 (2006)
Target
2.0
Target-Setting Method
10 percent improvement
Numerator
Number of deaths of infants aged 28 days to less than 1 year
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

To create linked data files, death certificates are linked with corresponding birth certificates for infants who die in the U.S. before their first birthday. The linked file is used for calculating infant mortality rates by race and ethnicity because these variables are more accurately collected on the birth certificate than the death certificate.

Depending upon county population size, the period county percent for the most recent 3, 5, or 10 years is reported.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Linked Birth/Infant Death Data Set; Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
per 1,000 live births 
Baseline (Year)
1.4 (2006)
Target
1.3
Target-Setting Method
10 percent improvement
Numerator
Number of infant (under age 1 year) deaths due to birth defects (ICD-10 codes Q00-Q99)
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

To create linked data files, death certificates are linked with corresponding birth certificates for infants who die in the U.S. before their first birthday. The linked file is used for calculating infant mortality rates by race and ethnicity because these variables are more accurately collected on the birth certificate than the death certificate.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Linked Birth/Infant Death Data Set; Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
per 1,000 live births 
Baseline (Year)
0.38 (2006)
Target
0.34
Target-Setting Method
10 percent improvement
Numerator
Number of infant (under age 1 year) deaths due to congenital heart (ICD-10 codes Q20-24) and vascular defects (ICD-10 codes Q25-Q28)
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

To create linked data files, death certificates are linked with corresponding birth certificates for infants who die in the U.S. before their first birthday. The linked file is used for calculating infant mortality rates by race and ethnicity because these variables are more accurately collected on the birth certificate than the death certificate.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Linked Birth/Infant Death Data Set; Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
per 1,000 live births 
Baseline (Year)
0.55 (2006)
Target
0.50
Target-Setting Method
10 percent improvement
Numerator
Number of infant (under age 1 year) deaths due to SIDS (ICD-10 code R95)
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

To create linked data files, death certificates are linked with corresponding birth certificates for infants who die in the U.S. before their first birthday. The linked file is used for calculating infant mortality rates by race and ethnicity because these variables are more accurately collected on the birth certificate than the death certificate.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Linked Birth/Infant Death Data Set; Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
per 1,000 live births 
Baseline (Year)
0.93 (2006)
Target
0.84
Target-Setting Method
10 percent improvement
Numerator
Number of infant (under age 1 year) deaths due to sudden unexpected infant death (SUID) [ICD-10 codes: R95 (SIDS), R99 (Unknown Cause) and W75 (Accidental Suffocation and Strangulation in Bed)]
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

To create linked data files, death certificates are linked with corresponding birth certificates for infants who die in the U.S. before their first birthday. The linked file is used for calculating infant mortality rates by race and ethnicity because these variables are more accurately collected on the birth certificate than the death certificate.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Birth Defects Prevention Network (NBDPN); Centers for Disease Control and Prevention, National Center for Birth Defects and Developmental Disabilities (CDC/NCBDDD)
Changed Since the Healthy People 2020 Launch
No
Measure
per 1,000 infants with Down syndrome 
Baseline (Year)
48.6 (2005-2006)
Target
43.7
Target-Setting Method
10 percent improvement
Numerator
Number of live born infants with a confirmed Down syndrome diagnosis who died in the first year of life
Denominator
Number of live born infants with a confirmed Down syndrome diagnosis
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Down syndrome includes cytogenetically confirmed full trisomy and translocation but excludes mosaic Down syndrome. Down syndrome diagnosis is obtained using either ICD-9 (confirmed 758.0, EXCLUDE mosaic Down syndrome) or CDC/BPA (758.000, 758.010, 758.020, 758.030, EXCLUDE 758.040 (mosaic Down syndrome), 758.090 (Down syndrome, NOS) codes. Fourteen state birth defects surveillance programs contributed data.

MICH-3 Reduce the rate of child deaths

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 100,000 
Baseline (Year)
29.4 (2007)
Target
26.5
Target-Setting Method
10 percent improvement
Numerator
Number of deaths among children aged 1 to 4 years
Denominator
Number of children aged 1to 4 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

FOR SINGLE DATA YEARS: Death rates are calculated based on the resident population of the United States for the data year involved. For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, rates for 2007–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses instead of the postcensal estimates for the denominator. Thus, the original baseline was revised from 28.6 to 29.4 deaths per 100,000 children aged 1-4 years. The target was adjusted from 25.7 to 26.5 deaths per 100,000 to reflect the revised baseline using the original target-setting method.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 100,000 
Baseline (Year)
13.8 (2007)
Target
12.4
Target-Setting Method
10 percent improvement
Numerator
Number of deaths among children aged 5 to 9 years
Denominator
Number of children aged 5 to 9 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

FOR SINGLE DATA YEARS: Death rates are calculated based on the resident population of the United States for the data year involved. For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, rates for 2007–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses instead of the postcensal estimates for the denominator. Thus, the original baseline was revised from 13.7 to 13.8 deaths per 100,000 children aged 5-9 years. The target was adjusted from 12.3 to 12.4 deaths per 100,000 to reflect the revised baseline using the original target-setting method.

MICH-4 Reduce the rate of adolescent and young adult deaths

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 100,000 
Baseline (Year)
16.5 (2007)
Target
14.8
Target-Setting Method
10 percent improvement
Numerator
Number of deaths among persons aged 10 to 14 years
Denominator
Number of persons aged 10 to 14 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

FOR SINGLE DATA YEARS: Death rates are calculated based on the resident population of the United States for the data year involved. For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, rates for 2007–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses instead of the postcensal estimates for the denominator. Thus, the original baseline was revised from 16.9 to 16.5 deaths per 100,000 adolescents aged 10-14 years. The target was adjusted from 15.2 to 14.8 per 100,000 to reflect the revised baseline using the original target-setting method.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 100,000 
Baseline (Year)
60.3 (2007)
Target
54.3
Target-Setting Method
10 percent improvement
Numerator
Number of deaths among persons aged 15 to 19 years
Denominator
Number of persons aged 15 to 19 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

FOR SINGLE DATA YEARS: Death rates are calculated based on the resident population of the United States for the data year involved. For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, rates for 2007–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses instead of the postcensal estimates for the denominator. Thus, the original baseline was revised from 61.9 to 60.3 deaths per 100,000 persons aged 15-19 years. The target was adjusted from 55.7 to 54.3 deaths per 100,000 to reflect the revised baseline using the original target-setting method.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Population Estimates; U.S. Census Bureau (Census)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 100,000 
Baseline (Year)
98.1 (2007)
Target
88.3
Target-Setting Method
10 percent improvement
Numerator
Number of deaths among persons aged 20 to 24 years
Denominator
Number of persons aged 20 to 24 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

FOR SINGLE DATA YEARS: Death rates are calculated based on the resident population of the United States for the data year involved. For census years (e.g. 2010), population counts enumerated as of April 1 are used. For all other years, populations estimates as of July 1 are used. Postcensal population estimates are used in rate calculations for years after a census year and match the data year vintage (e.g. July 1, 2011 resident population estimates from Vintage 2011 are used as the denominator for 2011 rates). Intercensal population estimates are used in rate calculations for the years between censuses (e.g. 1991-1999, 2001-2009). Race-specific population estimates for 1991 and later use bridged-race categories.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, rates for 2007–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses instead of the postcensal estimates for the denominator. Thus, the original baseline was revised from 98.3 to 98.1 deaths per 100,000 persons aged 20-24 years. The target was adjusted from 88.5 to 88.3 deaths per 100,000 to reflect the revised baseline using the original target-setting method.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Mortality (NVSS-M); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
National Vital Statistics System-Natality (NVSS-N)
Changed Since the Healthy People 2020 Launch
No
Measure
per 100,000 live births 
Baseline (Year)
12.7 (2007)
Target
11.4
Target-Setting Method
10 percent improvement
Numerator
Number of female deaths due to obstetric causes (ICD-10 codes A34, O00-O95, O98-O99) within 42 days of a pregnancy
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Maternal mortality rates are computed on the basis of the number of live births. The maternal mortality rate indicates the likelihood of a pregnant woman dying of maternal causes. They are calculated by dividing the number of maternal deaths in a calendar year by the number of live births registered for the same period and are presented as rates per 100,000 live births. The number of live births used in the denominator is an approximation of the population of pregnant women who are at risk of a maternal death. “Maternal deaths” are defined by the World Health Organization as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes." Included in these deaths are ICD–10 codes A34, O00-O95, and O98-O99. A description of the maternal mortality measurement has been published by NCHS.

Estimates were calculated with data supplied by the states that had adopted the 2003 version of the U.S. State Certificate of Live Birth. Trends over time cannot be evaluated until such time as all states provide data in the same format.

Twenty-two states had implemented the 2003 birth certificate as of January 1, 2007. The 22 revised states represent 53% of all U.S. births.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Hospital Discharge Survey (NHDS); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
31.1 (2007)
Target
28.0
Target-Setting Method
10 percent improvement
Numerator
Number of hospital discharges for females with any listed diagnosis of maternal complications (ICD-9-CM codes 641, 642 0-642 7, 642 9, 643 2, 646 2, 646 6, 646 7, 648 0, 648 5, 648 6, 648 8, 658 4, 659 2, 659 3, 664 2, 664 3, 664 5, 665 0-665 9, 666, 668, 669 0-669 4, 670, 671 3-671 5, 672, 673, 674 0-674 3, 674 50-674 54, 674 8, 674 9)
Denominator
Number of hospital discharges for females who delivered one or more infants (principal diagnosis of ICD-9-CM code V27)
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Principal diagnosis is the diagnosis chiefly responsible for admission of the person to the hospital.

Data by race and ethnicity may be underreported in the National Hospital Discharge Survey (NHDS).

MICH-7 Reduce cesarean births among low-risk (full-term, singleton, and vertex presentation) women

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
26.5 (2007)
Target
23.9
Target-Setting Method
10 percent improvement
Numerator
Number of births delivered by cesarean section to low-risk females (full-term, singleton, vertex presentation)
Denominator
Number of live births to low-risk females (full-term, singleton, vertex presentation)
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

A low-risk female is defined as one with a full-term (at least 37 weeks since LMP) singleton (not a multiple pregnancy), with a vertex fetus (head facing in a downward position in the birth canal). A description of the primary measurement used to determine the fetus’s gestational age, the interval between the first day of LMP and the birth has been published by NCHS.

Estimates were calculated with data supplied by the states that had adopted the 2003 version of the U.S. State Certificate of Live Birth. Trends over time cannot be evaluated until such time as all states provide data in the same format.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
90.8 (2007)
Target
81.7
Target-Setting Method
10 percent improvement
Numerator
Number of births delivered by cesarean section to low-risk females with a prior cesarean birth
Denominator
Number of live births to low-risk females with a prior cesarean birth
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

A low-risk female is defined as one with a full-term (at least 37 weeks since LMP) singleton (not a multiple pregnancy), with a vertex fetus (head facing in a downward position in the birth canal). A description of the primary measurement used to determine the fetus’s gestational age, the interval between the first day of LMP and the birth has been published by NCHS.

Estimates were calculated with data supplied by the states that had adopted the 2003 version of the U.S. State Certificate of Live Birth. Trends over time cannot be evaluated until such time as all states provide data in the same format.

MICH-8 Reduce low birth weight (LBW) and very low birth weight (VLBW)

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
8.2 (2007)
Target
7.8
Target-Setting Method
Projection/trend analysis
Numerator
Number of live births with birth weight of less than 2,500 grams (5 lbs, 8oz)
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

This objective is identical to Healthy People 2000 objective 14.5 and Healthy People 2010 objective 16-10a.

Information on birthweight is available for the entire United States. Birthweight is reported in some areas in pounds and ounces and in other areas as grams. However, the metric system is used to tabulate and present the statistics to facilitate comparison with data published by other groups. The categories for birthweight are consistent with the recommendations in the International Statistical Classification of Diseases, Ninth Revision (ICD–9) and the International Statistical Classification of Diseases, Tenth Revision (ICD–10). ICD–9 and ICD–10 define low birthweight as less than 2,500 grams. Very low birthweight is defined as less than 1,500 grams.

To establish the continuity of class intervals needed to convert pounds and ounces to grams, the end points of these intervals are assumed to be half an ounce less at the lower end and half an ounce more at the upper end. For example, 2 lb 4 oz–3 lb 4 oz is interpreted as 2 lb 3 ½ oz–3 lb 4 ½ oz.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
1.5 (2007)
Target
1.4
Target-Setting Method
Projection/trend analysis
Numerator
Number of live births with birth weight of less than 1,500 grams (3 lbs, 4oz)
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

This objective is identical to Healthy People 2000 objective 14.5 and Healthy People 2010 objective 16-10b.

Information on birthweight is available for the entire United States. Birthweight is reported in some areas in pounds and ounces and in other areas as grams. However, the metric system is used to tabulate and present the statistics to facilitate comparison with data published by other groups. The categories for birthweight are consistent with the recommendations in the International Statistical Classification of Diseases, Ninth Revision (ICD–9) and the International Statistical Classification of Diseases, Tenth Revision (ICD–10). ICD–9 and ICD–10 define low birthweight as less than 2,500 grams. Very low birthweight is defined as less than 1,500 grams.

To establish the continuity of class intervals needed to convert pounds and ounces to grams, the end points of these intervals are assumed to be half an ounce less at the lower end and half an ounce more at the upper end. For example, 2 lb 4 oz–3 lb 4 oz is interpreted as 2 lb 3 ½ oz–3 lb 4 ½ oz.

A description of the very low birth weight measurement has been published by NCHS.

References

Additional resources about the objective.

  1. Heck, K.E., and Klein, R.J. Operational definitions for year 2000 objectives: Priority area 14, Maternal and Infant Health. Healthy People 2000 Statistical Note. No. 14. Hyattsville, MD: NCHS, 1998.
MICH-9 Reduce preterm births
MICH-9.1 Reduce total preterm births Leading Health Indicators

Leading Health Indicators are a subset of Healthy People 2020 objectives selected to communicate high-priority health issues.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
12.7 (2007)
Target
11.4
Target-Setting Method
10 percent improvement
Numerator
Number of infants born before 37 completed weeks of gestation
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Leading Health Indicator
Maternal, Infant, and Child Health
Methodology Notes

Estimates of preterm birth are calculated based on gestational age information reported on the birth certificate. The primary measure used to determine the gestational age of the newborn is the interval between the first day of the mother’s last normal menstrual period (LMP) and the date of birth, and presented as number of weeks. It is subject to error for several reasons, including imperfect maternal recall or misidentification of the LMP because of postconception bleeding, delayed ovulation, or intervening early miscarriage. These data are edited for LMP-based gestational ages that are clearly inconsistent with the infant’s plurality and birthweight, but reporting problems for this item persist and may occur more frequently among some subpopulations and among births with shorter gestations.

The 1989 revision of the U.S. Standard Certificate of Live Birth includes an item, “clinical estimate of gestation” and the 2003 revision of the birth certificate includes a comparable item “Obstetric estimate of gestation”. The clinical or obstetric estimate was compared with length of gestation computed using the LMP when the latter appears to be inconsistent with birth weight. This was done for normal weight births of apparently short gestations and very low birth weight births reported to be full term. For those births, the clinical or obstetric estimate was used if it was compatible with the reported birth weight. The clinical or gestation estimate was also used if the LMP date was not reported.

A description of the primary measurement used to determine the infant’s gestational age, the interval between the first day of LMP and the birth has been published by NCHS.

References

Additional resources about the objective.

  1. CDC-Preterm Birth
    http://www.cdc.gov/reproductivehealth/MaternalInfantHealth/PretermBirth.htm
  2. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. The Lancet, Volume 371, Issue 9606, 5 January 2008-11 January 2008, Pages 75-84.
  3. National Center for Health Statistics. User guide to the 2010 natality public use file. Hyattsville, MD.
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/DVS/natality/UserGuide2010.pdf

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
9.0 (2007)
Target
8.1
Target-Setting Method
10 percent improvement
Numerator
Number of infants born between 34 and 36 completed weeks of gestation
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Estimates of preterm birth are calculated based on gestational age information reported on the birth certificate. The primary measure used to determine the gestational age of the newborn is the interval between the first day of the mother’s last normal menstrual period (LMP) and the date of birth, and presented as number of weeks. It is subject to error for several reasons, including imperfect maternal recall or misidentification of the LMP because of postconception bleeding, delayed ovulation, or intervening early miscarriage. These data are edited for LMP-based gestational ages that are clearly inconsistent with the infant’s plurality and birthweight, but reporting problems for this item persist and may occur more frequently among some subpopulations and among births with shorter gestations.

The 1989 revision of the U.S. Standard Certificate of Live Birth includes an item, “clinical estimate of gestation” and the 2003 revision of the birth certificate includes a comparable item “Obstetric estimate of gestation”. The clinical or obstetric estimate was compared with length of gestation computed using the LMP when the latter appears to be inconsistent with birth weight. This was done for normal weight births of apparently short gestations and very low birth weight births reported to be full term. For those births, the clinical or obstetric estimate was used if it was compatible with the reported birth weight. The clinical or gestation estimate was also used if the LMP date was not reported.

A description of the primary measurement used to determine the infant’s gestational age, the interval between the first day of LMP and the birth has been published by NCHS.

References

Additional resources about the objective.

  1. CDC-Preterm Birth
    http://www.cdc.gov/reproductivehealth/MaternalInfantHealth/PretermBirth.htm
  2. National Center for Health Statistics. User guide to the 2010 natality public use file. Hyattsville, MD.
    tp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/DVS/natality/UserGuide2010.pdf

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
1.6 (2007)
Target
1.4
Target-Setting Method
10 percent improvement
Numerator
Number of infants born between 32 and 33 completed weeks of gestation
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Estimates of preterm birth are calculated based on gestational age information reported on the birth certificate. The primary measure used to determine the gestational age of the newborn is the interval between the first day of the mother’s last normal menstrual period (LMP) and the date of birth, and presented as number of weeks. It is subject to error for several reasons, including imperfect maternal recall or misidentification of the LMP because of postconception bleeding, delayed ovulation, or intervening early miscarriage. These data are edited for LMP-based gestational ages that are clearly inconsistent with the infant’s plurality and birthweight, but reporting problems for this item persist and may occur more frequently among some subpopulations and among births with shorter gestations.

The 1989 revision of the U.S. Standard Certificate of Live Birth includes an item, “clinical estimate of gestation” and the 2003 revision of the birth certificate includes a comparable item “Obstetric estimate of gestation”. The clinical or obstetric estimate was compared with length of gestation computed using the LMP when the latter appears to be inconsistent with birth weight. This was done for normal weight births of apparently short gestations and very low birth weight births reported to be full term. For those births, the clinical or obstetric estimate was used if it was compatible with the reported birth weight. The clinical or gestation estimate was also used if the LMP date was not reported.

A description of the primary measurement used to determine the infant’s gestational age, the interval between the first day of LMP and the birth has been published by NCHS.

References

Additional resources about the objective.

  1. National Center for Health Statistics. User guide to the 2010 natality public use file. Hyattsville, MD.
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/DVS/natality/UserGuide2010.pdf

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
2.0 (2007)
Target
1.8
Target-Setting Method
10 percent improvement
Numerator
Number of infants born at less than 32 completed weeks of gestation
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Estimates of preterm birth are calculated based on gestational age information reported on the birth certificate. The primary measure used to determine the gestational age of the newborn is the interval between the first day of the mother’s last normal menstrual period (LMP) and the date of birth, and presented as number of weeks. It is subject to error for several reasons, including imperfect maternal recall or misidentification of the LMP because of postconception bleeding, delayed ovulation, or intervening early miscarriage. These data are edited for LMP-based gestational ages that are clearly inconsistent with the infant’s plurality and birthweight, but reporting problems for this item persist and may occur more frequently among some subpopulations and among births with shorter gestations.

The 1989 revision of the U.S. Standard Certificate of Live Birth includes an item, “clinical estimate of gestation” and the 2003 revision of the birth certificate includes a comparable item “Obstetric estimate of gestation”. The clinical or obstetric estimate was compared with length of gestation computed using the LMP when the latter appears to be inconsistent with birth weight. This was done for normal weight births of apparently short gestations and very low birth weight births reported to be full term. For those births, the clinical or obstetric estimate was used if it was compatible with the reported birth weight. The clinical or gestation estimate was also used if the LMP date was not reported.

A description of the primary measurement used to determine the infant’s gestational age, the interval between the first day of LMP and the birth has been published by NCHS.

References

Additional resources about the objective.

  1. National Center for Health Statistics. User guide to the 2010 natality public use file. Hyattsville, MD.
    ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/DVS/natality/UserGuide2010.pdf
MICH-10 Increase the proportion of pregnant women who receive early and adequate prenatal care

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
70.8 (2007)
Target
77.9
Target-Setting Method
10 percent improvement
Numerator
Number of births to females receiving prenatal care in the first trimester (three months) of pregnancy in states that use the 2003 standard certificate of birth
Denominator
Number of live births in states that use the 2003 standard certificate of birth
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Estimates were calculated with data supplied by the states that had adopted the 2003 version of the U.S. State Certificate of Live Birth. Trends over time cannot be evaluated until such time as all states provide data in the same format.

Caveats and Limitations
Twenty-two states had implemented the 2003 birth certificate as of January 1, 2007. The 22 revised states represent 53% of all U.S. births.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
70.5 (2007)
Target
77.6
Target-Setting Method
10 percent improvement
Numerator
Number of births to females receiving adequate prenatal care by the Adequacy of Prenatal Care Utilization Index (APNCU) in states that use the 2003 standard certificate of birth
Denominator
Number of live births in states that use the 2003 standard certificate of birth
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

The Adequacy of Prenatal Care Utilization Index (APNCU) is a measure of prenatal care utilization that combines the month of pregnancy prenatal care begun with the number of prenatal visits. Rates can be classified as “intensive use,” “adequate,” “intermediate,” or “less than adequate.” For this measure, adequate prenatal care is defined as a score of either “adequate” or “intensive use.” A discussion of the APNCU has been published.

Estimates were calculated with data supplied by the states that had adopted the 2003 version of the U.S. State Certificate of Live Birth. Trends over time cannot be evaluated until such time as all states provide data in the same format.

Caveats and Limitations
Twenty-two states had implemented the 2003 birth certificate as of January 1, 2007. The 22 revised states represent 53% of all U.S. births.
MICH-11 Increase abstinence from alcohol, cigarettes, and illicit drugs among pregnant women

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey on Drug Use and Health (NSDUH); Substance Abuse and Mental Health Services Administration (SAMHSA)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
89.4 (2007-2008)
Target
98.3
Target-Setting Method
10 percent improvement
Numerator
Number of pregnant females aged 15 to 44 years reporting no alcohol use in past 30 days
Denominator
Number of pregnant females aged 15 to 44 years
Questions Used to Obtain the National Baseline Data

From the 2007-08 National Survey on Drug Use and Health:

[NUMERATOR:]

How long has it been since you last drank an alcoholic beverage?

  1. Within the past 30 days - that is, since [DATE]
  2. More than 30 days ago but within the past 12 months
  3. More than 12 months ago

Are you currently pregnant?

  1. Yes
  2. No

[If yes:]

How many months pregnant are you?

  • Number of months pregnant _____
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

To ensure adequate precision of estimates for pregnant women, estimates are based on combined data from two years.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

During regular data collection and processing checks, errors were identified in the NSDUH data. These errors affected the data for Pennsylvania (2006-2010) and Maryland (2008-2009). These errors had minimal impact on the national estimates and no effect on direct estimates for the other 48 states and the District of Columbia. Comparing estimates for Pennsylvania, Maryland, the mid-Atlantic division, and the Northeast region were of most concern. However, the baseline and target values did not change as a result.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey on Drug Use and Health (NSDUH); Substance Abuse and Mental Health Services Administration (SAMHSA)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
95.0 (2007-2008)
Target
100
Target-Setting Method
Total coverage
Numerator
Number of pregnant females aged 15 to 44 years reporting no past month binge drinking (4 or more drinks per occasion on at least 1 day within the past 30 days)
Denominator
Number of pregnant females aged 15 to 44 years
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Binge drinking for women is defined as drinking 4 or more alcoholic beverages at the same time or within a couple of hours of each other during the past 30 days. To ensure adequate precision of estimates for pregnant women, estimates are based on combined data 2 years.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

During regular data collection and processing checks, errors were identified in the NSDUH data. These errors affected the data for Pennsylvania (2006-2010) and Maryland (2008-2009). These errors had minimal impact on the national estimates and no effect on direct estimates for the other 48 states and the District of Columbia. Comparing estimates for Pennsylvania, Maryland, the mid-Atlantic division, and the Northeast region were of most concern. However, the baseline and target values did not change as a result.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
89.6 (2007)
Target
98.6
Target-Setting Method
10 percent improvement
Numerator
The number of women with a recent live birth who report not smoking during pregnancy in states that use the 2003 standard certificate of birth
Denominator
Number of women with a recent live birth in states that use the 2003 standard certificate of birth
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Estimates were calculated with data supplied by the states that had adopted the 2003 version of the U.S. State Certificate of Live Birth. Trends over time cannot be evaluated until such time as all states provide data in the same format.

Caveats and Limitations
Twenty-two states had implemented the 2003 birth certificate as of January 1, 2007. The 22 revised states represent 53% of all U.S. births.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey on Drug Use and Health (NSDUH); Substance Abuse and Mental Health Services Administration (SAMHSA)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
94.8 (2007-2008)
Target
100
Target-Setting Method
Total coverage
Numerator
Number of pregnant females aged 15 to 44 years reporting not using any illicit drugs in the past month (30 days)
Denominator
Number of pregnant females aged 15 to 44 years
Questions Used to Obtain the National Baseline Data

From the 2007-08 National Survey on Drug Use and Health:

[NUMERATOR:]

[The following question is asked separately for each illicit drug: marijuana or hashish, cocaine, "crack," heroin, hallucinogens, and inhalants:]

How long has it been since you last used [marijuana or hashish, cocaine, "crack," heroin, hallucinogens, inhalants]?

  • Marijuana or Hashish______
  • Cocaine______
  • Heroin______
  • Hallucinogens______
  • Inhalants______

[The following questions are asked separately for nonmedical use of analgesics (prescription pain killers), tranquilizers, stimulants, and sedatives:]

How long has it been since you last used (a pain killer, tranquilizers, stimulants, sedatives) that was not prescribed for you, or that you took only for the experience or feeling it caused?

  • Pain killer______
  • Tranquilizers______
  • Stimulants______
  • Sedatives ______

Are you currently pregnant?

  1. Yes
  2. No

[If yes:]

How many months pregnant are you?

  • Number of months pregnant _____
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Illicit drugs are defined as marijuana or hashish, cocaine (including crack), inhalants, hallucinogens (including PCP and LSD), heroin, and nonmedical use of psychotherapeutics. To ensure adequate precision of estimates for pregnant women, estimates are based on combined data from two years.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

During regular data collection and processing checks, errors were identified in the NSDUH data. These errors affected the data for Pennsylvania (2006-2010) and Maryland (2008-2009). These errors had minimal impact on the national estimates and no effect on direct estimates for the other 48 states and the District of Columbia. Comparing estimates for Pennsylvania, Maryland, the mid-Atlantic division, and the Northeast region were of most concern. As a result in 2013, the original baseline was revised from 94.9 to 94.8 percent. However, the 100 percent target was retained.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
California's Maternal and Infant Health Assessment (MIHA); California Department of Public Health (CDPH)
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
Number of women with a live birth who ever attended a childbirth class
Denominator
Number of women with a live birth
Questions Used to Obtain the National Baseline Data

From 2012 Pregnancy Risk Assessment Monitoring System:

[NUMERATOR:]

During your most recent pregnancy, did you get any of these services?

For each one, circle Y (Yes) if you got the service or circle N (No) if you did not get it.

Classes to prepare you for childbirth and what to expect during labor and delivery

  • Yes
  • No
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
*** Missing ***
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
23.8 (2003-2006)
Target
26.2
Target-Setting Method
10 percent improvement
Numerator
Number of non-pregnant women aged 15 to 44 years with usual daily total intake of folic acid of  greater than or equal to 400 micrograms
Denominator
Number of non-pregnant women aged 15 to 44 years
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

The proportion of non-pregnant women aged 15 to 44 years with usual daily folic acid intake of 400 mg or more is estimated from questionnaire and dietary recall data as part of the standard NHANES protocol. The method of calculation of dietary folic acid for this objective involves estimating the daily usual intake of synthetic folic acid from foods reported in two 24-hour dietary recalls using a specialized statistical program, PC-SIDE (Nusser et al., 1996). The U.S. Public Health Service published a recommendation in 1992 that all women capable of becoming pregnant consume 400 mg of folic acid daily through supplements and/or fortified foods to prevent the occurrence of neural tube defects (NTDs) (Centers for Disease Control and Prevention, 1992). The folic acid fortification of enriched cereal grain products became mandatory in 1998 (Food and Drug Administration, 1996). Prior to fortification, folic acid intake was monitored only through intake of dietary supplements containing folic acid (U.S. Department of Health and Human Services, 2000). After fortification, monitoring folic acid intake from foods became an important aspect of monitoring total folic acid intake; however it was not possible to distinguish between naturally occurring food folate and synthetic folic acid using data from NHANES until 2001. Further, it was not until the 2003-2004 NHANES that a second day of dietary recall was added, which allowed for the proper estimation of usual intake of folic acid in the population, accounting for both intra- and inter-individual variation in intake (Nusser et al., 1996; Tinker et al., 2010).

References

Additional resources about the objective.

  1. Centers for Disease Control and Prevention. Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR Recomm Rep 1992 41(RR-14):1-7.
  2. Food and Drug Administration. Food Standards: Amendment of Standards of Identity For Enriched Grain Products to Require Addition of Folic Acid. Federal Register 1996;61:8781-8797.
  3. Nusser SM, Carriquiry AL, Dodd KW, Fuller WA. A semiparametric transformation approach to estimating usual nutrient intake distributions. J Am Stat Assoc 1996;91:1440-9.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
24.9 (2007-2010)
Target
22.4
Target-Setting Method
10 percent improvement
Numerator
Number of non-pregnant women aged 15 to 44 years with red-blood-cell (RBC) folate concentration <337 ng/mL, below the 25th percentile of RBC concentrations among this group in 2007-2010
Denominator
Number of non-pregnant women aged 15 to 44 years with RBC concentrations
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Lower RBC folate concentration is a population weighted estimate from the blood specimens collected from women aged 15 to 44 years as part of the standard NHANES protocol. According to data from the National Health and Nutrition Examination Survey (NHANES), median RBC folate concentrations increased substantially between 1988-94 and 1999-2000, pre- and post-fortification with folic acid, and then declined slightly in the post-fortification period (Pfeiffer et al., 2007, CDC, 2007). In 1999-2000, HP2010 objective 16-16b was met for all nonpregnant US women aged 15-44 y, and for non-Hispanic white and Mexican-American, but not non-Hispanic black women (CDC, 2007). The decreases from 1999-2000 to 2003-2004 were not in the low end of the distribution and thus did not raise concerns about inadequate status. However, continued monitoring remains important. The concentration of RBC folate associated with the lowest neural tube defect risk is unknown (Daly et al., 1995; Wald et al., 1998). In 2007-2010, the 25th percentile of RBC folate among US women aged 15-44 years was 337 ng/ml. Given that folic acid has been shown to reduce NTDs, reductions in the proportion of women with lower RBC folate concentrations should move us towards this goal.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the baseline was revised from 24.5% (2003-06) to 24.9% (2007-10) because the assay that was used to measure RBC folate concentrations changed after the 2005-2006 NHANES cycle. Through survey year 2006 the Bio-Rad Quantaphase II radioassay (BR) was used, and from 2007 forward the microbiological assay (MA) was used. Although regression equations are provided in the NHANES documentation for converting BR values to MA values, they are dependent on methylenetetrahydrofolate reductase(MTHFR) genotype information, which is not available in the continuous NHANES data. MTHFR genotypes have been found to vary by race/ethnicity and without taking these differences into account the converted BR data do not reflect the true differences between race/ethnicity sub-groups. However, the MA does not have this issue and will be used in future NHANES. The target was adjusted from 22.1% to 22.4% to reflect the revised baseline using the original target-setting method. Also, the objective text was changed from ‘Reduce the proportion of women of childbearing potential who have low RBC folate concentrations’ to ‘Reduce the proportion of women of childbearing potential who have lower RBC folate concentrations.’ Finally the numerator was changed from ‘Number of non-pregnant women aged 15-44 years with red-blood-cell (RBC) foliate concentration <195 ng/ml, the 25th percentile of RBC concentrations among this group in 2003-2006’ to ‘Number of non-pregnant women aged 15-44 years with red-blood-cell (RBC) folate concentration <337 ng/mL, below the 25th percentile of RBC concentrations among this group in 2007-2010.’

References

Additional resources about the objective.

  1. Blood Folate Levels: The Latest NHANES Results
    http://www.cdc.gov/nchs/data/databriefs/db06.pdf
  2. CDC. Folate status in women of childbearing age, by race/ethnicity---United States, 1999---2000, 2001-2002, and 2003-2004. MMWR 2007;55:1377-1380.
  3. Daly LE, Krik PN, Molloy A et al. Folate levels and neural tube defects. JAMA 1995;274:1698-1702.
  4. Pfeiffer CM, Johnson CL, Jain RB, et al. Trends in blood folate and vitamin B-12 concentrations in the United States, 1988-2004. Am J Clin Nutr; 86:718-27
MICH-16 Increase the proportion of women delivering a live birth who received preconception care services and practiced key recommended preconception health behaviors

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
California's Maternal and Infant Health Assessment (MIHA); California Department of Public Health (CDPH)
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
Women with a recent live birth who reported discussing preconception health with a health care worker prior to pregnancy
Denominator
Number of women with a recent live birth
Questions Used to Obtain the National Baseline Data

From the Pregnancy Risk Assessment Monitoring System and California Maternal and Infant Health Assessment:

[NUMERATOR:]

Have you discussed preconception health prior to pregnancy?

Comparable Healthy People 2010 Objective
Not applicable

References

Additional resources about the objective.

  1. Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care – United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR 2006; 55 (No. RR-6).
  2. Institute of Medicine. Preventing low birth weight. Washington, DC: National Academy Press; 1985.
  3. Korenbrot C, Steinberg A, Bender C, Newberry S (2002). Preconception care: A systematic Review. MCH Journal, Vol. 7, No 2, pp.75-88.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
California's Maternal and Infant Health Assessment (MIHA); California Department of Public Health (CDPH)
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
30.1 (2007)
Target
33.1
Target-Setting Method
10 percent improvement
Numerator
Women with a recent live birth who reported taking multivitamin/folic acid every day in the month prior to pregnancy
Denominator
Number of women with a recent live birth
Questions Used to Obtain the National Baseline Data

From the 2007 Pregnancy Risk Assessment Monitoring System and California Maternal and Infant Health Assessment:

[NUMERATOR:]

Took multivitamins/folic acid

During the month before you got pregnant with your new baby, how many times a week did you take a multivitamin, a prenatal vitamin, or a folic acid vitamin?

  1. I didn't take a multivitamin, prenatal vitamin, or folic acid vitamin at all
  2. 1 to 3 times a week
  3. 4 to 6 times a week
  4. Every day of the week
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

A woman was considered to have taken multivitamins/folic acid if she reported taking it every day of the week during the month before she got pregnant. The following PRAMS states were included in preparing the estimate: AK, AR, CO, DE, GA, HI, IL, ME, MD, MA, MI, MN, MO, NJ, NC, NY, NYC, OH, OK, OR, PA, RI, SC, UT, VT, WA, WV, WI, and WY. These data were combined with data from the California's Maternal and Infant Health Assessment to produce the displayed estimate. The PRAMS response category was “every day” while the MIHA response category was “every day or almost every day.”

Health Insurance status data reflect prepregnancy insurance coverage of mother.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
77.6 (2007)
Target
85.4
Target-Setting Method
10 percent improvement
Numerator
Women with a recent live birth who reported not smoking in the three months prior to pregnancy
Denominator
Number of women with a recent live birth
Questions Used to Obtain the National Baseline Data

From the 2007 Pregnancy Risk Assessment Monitoring System:

[NUMERATOR:]

In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day? (A pack has 20 cigarettes.)

  1. 41 cigarettes or more
  2. 21 to 40 cigarettes
  3. 11 to 20 cigarettes
  4. 6 to 10 cigarettes
  5. 1 to 5 cigarettes
  6. Less than 1 cigarette
  7. I didn't smoke then

From the 2007 California Maternal and Infant Health Assessment:

[NUMERATOR:]

During the 3 months before you got pregnant, how many cigarettes or packs of cigarettes did you smoke on an average day? (A pack has 20 cigarettes.)

  1. ___ cigarettes OR ___ packs
  2. Less than one cigarette a day
  3. I didn't smoke at all during the 3 months before I got pregnant
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The following PRAMS states were included in preparing the estimate: AK, AR, CO, DE, GA, HI, IL, ME, MD, MA, MI, MN, MO, NJ, NC, NY, NYC, OH, OK, OR, PA, RI, SC, UT, VT, WA, WV, WI, and WY. Data from California’s MIHA has not yet been included.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
California's Maternal and Infant Health Assessment (MIHA); California Department of Public Health (CDPH)
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
51.3 (2007)
Target
56.4
Target-Setting Method
10 percent improvement
Numerator
Women with a recent live birth who reported not drinking alcohol at all in the 3 months prior to pregnancy
Denominator
Number of women with a recent live birth
Questions Used to Obtain the National Baseline Data

From the 2007 Pregnancy Risk Assessment Monitoring System:

[NUMERATOR:]

During the 3 months before you got pregnant, how many alcoholic drinks did you have in an average week?

  1. 14 drinks or more a week
  2. 7 to 13 drinks a week
  3. 4 to 6 drinks a week
  4. 1 to 3 drinks a week
  5. Less than 1 drink a week
  6. I didn't drink then

From the 2007 California Maternal and Infant Health Assessment:

[NUMERATOR:]

During the 3 months before you got pregnant, about how many drinks with alcohol did you have in an average week?

  1. I didn't drink at all during the 3 months before I got pregnant
  2. Less than one drink per week
  3. 1 to 3 per week
  4. 4 to 6 per week
  5. 7 -13 per week
  6. 14 or more drinks per week
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The following PRAMS states were included in preparing the estimate: AK, AR, CO, DE, GA, HI, IL, ME, MD, MA, MI, MN, MO, NJ, NC, NY, NYC, OH, OK, OR, PA, RI, SC, UT, VT, WA, WV, WI, and WY. These data were combined with data from the California's Maternal and Infant Health Assessment to produce the displayed estimate.

Health Insurance status data reflect prepregnancy insurance coverage of mother.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
California's Maternal and Infant Health Assessment (MIHA); California Department of Public Health (CDPH)
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
48.5 (2007)
Target
53.4
Target-Setting Method
10 percent improvement
Numerator
Women with a recent live birth who reported having a healthy weight (BMI: 18.5 - 24.9) prior to pregnancy
Denominator
Number of women with a recent live birth
Questions Used to Obtain the National Baseline Data

From the 2007 Pregnancy Risk Assessment Monitoring System:

[NUMERATOR:]

Just before you got pregnant with your new baby, how much did you weigh?
_____ Pounds  OR  _____ Kilos

How tall are you without shoes?
_____ Feet _____ Inches  OR  _____ Meters

From the 2007 California Maternal and Infant Health Assessment:

[NUMERATOR:]

Just before you got pregnant, how much did you weigh?
_____ Pounds  OR  _____ Kilos

How much weight did you gain during your most recent pregnancy?
_____ Pounds  OR  _____ Kilos
_____ I LOST weight during my pregnancy
_____ I stayed the same
_____ I don't know

How tall are you without shoes?
       _____ Feet  and  _____ Inches
OR _____ Meters  and  _____ cms

Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The most current IOM recommendations were used to determine BMI categories: BMI+ (kg/m2) Underweight 18.5-24.9 Overweight Obese The following PRAMS states were included in preparing the estimate: AK, AR, CO, DE, GA, HI, IL, ME, MD, MA, MI, MN, MO, NJ, NC, NY, NYC, OH, OK, OR, PA, RI, SC, UT, VT, WA, WV, WI, and WY. These data were combined with data from the California's Maternal and Infant Health Assessment to produce the displayed estimate.

Health Insurance status data reflect prepregnancy insurance coverage.

References

Additional resources about the objective.

  1. Institute of Medicine (2009). Weight Gain During Pregnancy: Reexamining the Guidelines, National Academies Press, Washington DC. Available online at: www.iom.edu/Reports/2009/Weight-Gain-During-Pregnancy-Reexamining-the-Guidelines.aspx.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
California's Maternal and Infant Health Assessment (MIHA); California Department of Public Health (CDPH)
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
Women with a recent live birth who reported using contraception to plan pregnancy
Denominator
Number of women with a recent live birth
Questions Used to Obtain the National Baseline Data

From the Pregnancy Risk Assessment Monitoring System and California Maternal and Infant Health Assessment:

[NUMERATOR:]

Did you use contraception to plan your most recent pregnancy?

Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable

References

Additional resources about the objective.

  1. Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care – United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR 2006; 55 (No. RR-6).
  2. Institute of Medicine. Preventing low birth weight. Washington, DC: National Academy Press; 1985.
  3. Korenbrot C, Steinberg A, Bender C, Newberry S (2002). Preconception care: A systematic Review. MCH Journal, Vol. 7, No 2, pp.75-88.
MICH-17 Reduce the proportion of persons aged 18 to 44 years who have impaired fecundity (i.e., a physical barrier preventing pregnancy or carrying a pregnancy to term)

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Family Growth (NSFG); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
12.7 (2002)
Target
11.4
Target-Setting Method
10 percent improvement
Numerator
Females aged 18 to 44 years with impaired fecundity
Denominator
Females aged 18 to 44 years
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Impaired fecundity is a common measure of fertility impairment and most commonly described as a physical inability to have a child.  This measure encompasses both infertility (i.e. difficulty with conceiving a pregnancy) and difficulty with carrying a pregnancy to term, as with recurrent pregnancy loss. Impaired fecundity as defined in the National Survey of Family Growth (NSFG) has 3 components: nonsurgical sterility (i.e,. physically impossible to have a child), subfecundity (i.e. physically difficult but not impossible), and "long interval without conception" (i.e. 36-months infertility).

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the original baseline was revised from 11.8 to 12.7 (2002) percent due to a change in the methodology. The target was adjusted from 10.8 to 11.4 percent to reflect the revised baseline using the original target-setting method.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Family Growth (NSFG); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
Males aged 18 to 44 years with impaired fecundity
Denominator
All U.S. males aged 18 to 44 years
Comparable Healthy People 2010 Objective
Not applicable

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
California's Maternal and Infant Health Assessment (MIHA); California Department of Public Health (CDPH)
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
Number of women who are smoking after delivery
Denominator
Number of women who quit smoking during the last 3 months of pregnancy and who reported smoking during the 3 months of pregnancy
Questions Used to Obtain the National Baseline Data

From the Pregnancy Risk Assessment Monitoring System and California Maternal and Infant Health Assessment:

[NUMERATOR:]

In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day? (A pack has 20 cigarettes.)

  1. 41 cigarettes or more
  2. 21 to 40 cigarettes
  3. 11 to 20 cigarettes
  4. 6 to 10 cigarettes
  5. 1 to 5 cigarettes
  6. Less than 1 cigarette
  7. I didn't smoke then

In the last 3 months of your pregnancy, how many cigarettes did you smoke on an average day? (A pack has 20 cigarettes.)

  1. 41 cigarettes or more
  2. 21 to 40 cigarettes
  3. 11 to 20 cigarettes
  4. 6 to 10 cigarettes
  5. 1 to 5 cigarettes
  6. Less than 1 cigarette
  7. I didn't smoke then

How many cigarettes do you smoke on an average day now? (A pack has 20 cigarettes.)

  1. 41 cigarettes or more
  2. 21 to 40 cigarettes
  3. 11 to 20 cigarettes
  4. 6 to 10 cigarettes
  5. 1 to 5 cigarettes
  6. Less than 1 cigarette
  7. I don't smoke now
Comparable Healthy People 2010 Objective
Not applicable

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
California's Maternal and Infant Health Assessment (MIHA); California Department of Public Health (CDPH)
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
Women with a recent live birth who received a postpartum care visit 4-6 weeks after the birth
Denominator
Number of women with a recent live birth
Questions Used to Obtain the National Baseline Data

From the Pregnancy Risk Assessment Monitoring System and California Maternal and Infant Health Assessment:

[NUMERATOR:]

Since your new baby was born, have you had a postpartum checkup for yourself? (A postpartum checkup is the regular checkup a woman has about 4-6 weeks after she gives birth.)

  1. Yes
  2. No
Comparable Healthy People 2010 Objective
Not applicable

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
California's Maternal and Infant Health Assessment (MIHA); California Department of Public Health (CDPH)
Pregnancy Risk Assessment Monitoring System (PRAMS); Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
69.0 (2007)
Target
75.9
Target-Setting Method
10 percent improvement
Numerator
The number of infants who are put down to sleep on their backs
Denominator
Number of women with a recent live birth
Questions Used to Obtain the National Baseline Data

From the 2007 Pregnancy Risk Assessment Monitoring System:

[NUMERATOR:]

How do you most often lay your baby down to sleep now? [Check one answer.]

  • (__) On his/her side
  • (__) On his/her back
  • (__) On his/her stomach

From the 2007 Maternal and Infant Health Assessment:

[NUMERATOR:]

How do you put your new baby down to sleep most of the time? [Check only one answer].

  • (__) On his/her side
  • (__) On his/her back
  • (__) On his/her stomach
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

The following PRAMS states were included in preparing the estimate: AK, AR, CO, DE, GA, HI, IL, ME, MD, MA, MI, MN, MO, NJ, NC, NY, NYC, OH, OK, OR, PA, RI, SC, UT, VT, WA, WV, WI, and WY. These data were combined with data from the California's Maternal and Infant Health Assessment to produce the displayed estimate.

Health Insurance status data reflect prepregnancy insurance coverage of mother.

MICH-21 Increase the proportion of infants who are breastfed

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Immunization Survey (NIS); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
74.0 (2006)
Target
81.9
Target-Setting Method
Projection/trend analysis
Numerator
Number of caregivers of children born in a cohort year who indicate their child was ever breastfed or fed breast milk
Denominator
Number of children aged 19 to 35 months born in the same cohort year
Questions Used to Obtain the National Baseline Data

From the 2006 National Immunization Survey:

[NUMERATOR:]

Was [child] ever breastfed or fed breast milk?

  1. Yes
  2. No
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Using a computer-generated list, the National Immunization Survey (NIS) identifies households across the United States with children aged 19–35 months and interviews the person who is most knowledgeable about the child’s immunization status (“caregiver”). Survey years are combined to calculate breastfeeding statistics by year of child’s birth (cohort) instead of the year in which the participant was surveyed. To calculate breastfeeding indicators by year of child birth, data are combined across all relevant survey years. Because children are 19—35 months of age at the time of the parent interview, each survey year represents children born over three years. For example, breastfeeding data for children in the 2006 birth cohort are obtained from NIS 2007, 2008, and 2009.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2012, the word 'breastfeed' was changed to 'breastfed' to reflect the data collected in the survey. Specifically, the NIS data relate to infants who are breastfed, not mothers who breastfeed.

References

Additional resources about the objective.

  1. CDC. NIS survey methods. Available at: http://www.cdc.gov/breastfeeding/data/NIS_data/survey_methods.htm (Accessed March 21, 2010.)
  2. Smith PJ, Zhao Z, Wolter KM, Singleton JA, Nuorti JP. Age-period-cohort analyses of public health data collected from independent serial cross-sectional complex probability sample surveys. Seattle, WA: Joint Statistical Meeting; 2006. Available at http://www.amstat.org/Sections/Srms/Proceedings/y2006/Files/JSM2006-000537.pdf

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Immunization Survey (NIS); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
43.5 (2006)
Target
60.6
Target-Setting Method
Projection/trend analysis
Numerator
Number of caregivers of children born in a cohort year who indicate their child was breastfed any amount at 6 months of age
Denominator
Number of children aged 19 to 35 months born in the same cohort year
Questions Used to Obtain the National Baseline Data

From the 2006 National Immunization Survey:

[NUMERATOR:]

Was [child] ever breastfed or fed breast milk?

  1. Yes
  2. No

How old was [child's name] when (he/she) completely stopped breastfeeding or being fed breast milk?

  1. ≥6 months
  2. Still breastfeeding
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Using a computer-generated list, the National Immunization Survey (NIS) identifies households across the United States with children aged 19-35 months and interviews the person who is most knowledgeable about the child’s immunization status (“caregiver”). Survey years are combined to calculate breastfeeding statistics by year of child’s birth (cohort) instead of the year in which the participant was surveyed. To calculate breastfeeding indicators by year of child birth, data are combined across all relevant survey years. Because children are 19-35 months of age at the time of the parent interview, each survey year represents children born over three years. For example, breastfeeding data for children in the 2006 birth cohort are obtained from NIS 2007, 2008, and 2009.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2012, the word 'breastfeed' was changed to 'breastfed' to reflect the data collected in the survey. Specifically, the NIS data relate to infants who are breastfed, not mothers who breastfeed.

References

Additional resources about the objective.

  1. CDC. NIS survey methods. Available at: http://www.cdc.gov/breastfeeding/data/NIS_data/survey_methods.htm (Accessed March 21, 2010.)
  2. Smith PJ, Zhao Z, Wolter KM, Singleton JA, Nuorti JP. Age-period-cohort analyses of public health data collected from independent serial cross-sectional complex probability sample surveys. Seattle, WA: Joint Statistical Meeting; 2006. Available at http://www.amstat.org/Sections/Srms/Proceedings/y2006/Files/JSM2006-000537.pdf

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Immunization Survey (NIS); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
22.7 (2006)
Target
34.1
Target-Setting Method
Projection/trend analysis
Numerator
Number of caregivers of children born in a cohort year who indicate their child was breastfed any amount at 1 year of age
Denominator
Number of children aged 19-35 months born in the same cohort year
Questions Used to Obtain the National Baseline Data

From the 2006 National Immunization Survey:

[NUMERATOR:]

Was [child] ever breastfed or fed breast milk?

  1. Yes
  2. No

How old was [child's name] when (he/she) completely stopped breastfeeding or being fed breast milk?

  1. ≥1 year
  2. Still breastfeeding
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Using a computer-generated list, the National Immunization Survey (NIS) identifies households across the United States with children aged 19–35 months and interviews the person who is most knowledgeable about the child’s immunization status (“caregiver”). Survey years are combined to calculate breastfeeding statistics by year of child’s birth (cohort) instead of the year in which the participant was surveyed. To calculate breastfeeding indicators by year of child birth, data are combined across all relevant survey years. Because children are 19—35 months of age at the time of the parent interview, each survey year represents children born over three years. For example, breastfeeding data for children in the 2006 birth cohort are obtained from NIS 2007, 2008, and 2009.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2012, the word 'breastfeed' was changed to 'breastfed' to reflect the data collected in the survey. Specifically, the NIS data relate to infants who are breastfed, not mothers who breastfeed.

References

Additional resources about the objective.

  1. CDC. NIS survey methods. Available at: http://www.cdc.gov/breastfeeding/data/NIS_data/survey_methods.htm (Accessed March 21, 2010.)
  2. Smith PJ, Zhao Z, Wolter KM, Singleton JA, Nuorti JP. Age-period-cohort analyses of public health data collected from independent serial cross-sectional complex probability sample surveys. Seattle, WA: Joint Statistical Meeting; 2006. Available at http://www.amstat.org/Sections/Srms/Proceedings/y2006/Files/JSM2006-000537.pdf

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Immunization Survey (NIS); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
33.6 (2006)
Target
46.2
Target-Setting Method
Projection/trend analysis
Numerator
Number of caregivers of children born in a cohort year who indicate their child was exclusively breastfed (given nothing but breast milk) through 3 months of age
Denominator
Number of children aged 19 to 35 months born in the same cohort year
Questions Used to Obtain the National Baseline Data

From the 2006 National Immunization Survey:

[NUMERATOR:]

Exclusively through 3 months

Was the child ever breastfed or fed breast milk?

  1. Yes
  2. No

How old was [child's name] when [child's name] completely stopped breastfeeding or being fed breast milk?

  1. ≥3 months
  2. Still breastfeeding

How old was [child's name] when (he/she) was first fed formula?

  1. ≥3 months
  2. Never fed formula

This next question is about the first thing that [child] was given other than breast milk or formula. Please include juice, cow's milk, sugar water, baby food, or anything else that [child] may have been given, even water.

How old was [child's name] when (he/she) was first fed anything other than breast milk or formula?

  1. ≥3 months
  2. Never given anything but breast milk
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Infants are considered to have been breastfed exclusively through 3 months if the responses to questions about age when first fed formula AND age when first fed something other than breast milk or formula both indicate that the child was ≥3 months when either occurred OR that the child has never had formula nor anything but breast milk.

Using a computer-generated list, the National Immunization Survey (NIS) identifies households across the United States with children aged 19–35 months and interviews the person who is most knowledgeable about the child’s immunization status (“caregiver”). Survey years are combined to calculate breastfeeding statistics by year of child’s birth (cohort) instead of the year in which the participant was surveyed. To calculate breastfeeding indicators by year of child birth, data are combined across all relevant survey years. Because children are 19—35 months of age at the time of the parent interview, each survey year represents children born over three years. For example, breastfeeding data for children in the 2006 birth cohort are obtained from NIS 2007, 2008, and 2009.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2012, the word 'breastfeed' was changed to 'breastfed' to reflect the data collected in the survey. Specifically, the NIS data relate to infants who are breastfed, not mothers who breastfeed.

References

Additional resources about the objective.

  1. CDC. NIS survey methods. Available at: http://www.cdc.gov/breastfeeding/data/NIS_data/survey_methods.htm (Accessed March 21, 2010.)
  2. CDC. Provisional exclusive breastfeeding rates by socio-demographic factors, among children born in 2006. Available at: http://www.cdc.gov/breastfeeding/data/NIS_data/2006/socio-demographic.htm (Accessed March 20, 2010.)
  3. Smith PJ, Zhao Z, Wolter KM, Singleton JA, Nuorti JP. Age-period-cohort analyses of public health data collected from independent serial cross-sectional complex probability sample surveys. Seattle, WA: Joint Statistical Meeting; 2006. Available at http://www.amstat.org/Sections/Srms/Proceedings/y2006/Files/JSM2006-000537.pdf

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Immunization Survey (NIS); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
14.1 (2006)
Target
25.5
Target-Setting Method
Projection/trend analysis
Numerator
Number of caregivers of children born in a cohort year who indicate their child was exclusively breastfed (given nothing but breast milk) through 6 months of age
Denominator
Number of children aged 19-35 months born in the same cohort year
Questions Used to Obtain the National Baseline Data

From the 2006 National Immunization Survey:

[NUMERATOR:]

Was the child ever breastfed or fed breast milk?

  1. Yes
  2. No

How old was [child's name] when [child's name] completely stopped breastfeeding or being fed breast milk?

  1. ≥6 months
  2. Still breastfeeding

How old was [child's name] when (he/she) was first fed formula?

  1. ≥6 months
  2. Never fed formula

This next question is about the first thing that [child] was given other than breast milk or formula. Please include juice, cow's milk, sugar water, baby food, or anything else that [child] may have been given, even water.

How old was [child's name] when (he/she) was first fed anything other than breast milk or formula?

  1. ≥6 months
  2. Never given anything but breast milk
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Infants are considered to have been breastfed exclusively through 6 months if the responses to questions about age when first fed formula AND age when first fed something other than breast milk or formula both indicate that the child was ≥6 months when either occurred OR that the child has never had formula nor anything but breast milk.

Using a computer-generated list, the National Immunization Survey (NIS) identifies households across the United States with children aged 19–35 months and interviews the person who is most knowledgeable about the child’s immunization status (“caregiver”). Survey years are combined to calculate breastfeeding statistics by year of child’s birth (cohort) instead of the year in which the participant was surveyed. To calculate breastfeeding indicators by year of child birth, data are combined across all relevant survey years. Because children are 19—35 months of age at the time of the parent interview, each survey year represents children born over three years. For example, breastfeeding data for children in the 2006 birth cohort are obtained from NIS 2007, 2008, and 2009.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2012, the word 'breastfeed' was changed to 'breastfed' to reflect the data collected in the survey. Specifically, the NIS data relate to infants who are breastfed, not mothers who breastfeed.

References

Additional resources about the objective.

  1. CDC. NIS survey methods. Available at: http://www.cdc.gov/breastfeeding/data/NIS_data/survey_methods.htm (Accessed March 21, 2010.)
  2. CDC. Provisional exclusive breastfeeding rates by socio-demographic factors, among children born in 2006. Available at: http://www.cdc.gov/breastfeeding/data/NIS_data/2006/socio-demographic.htm (Accessed March 20, 2010.)
  3. Smith PJ, Zhao Z, Wolter KM, Singleton JA, Nuorti JP. Age-period-cohort analyses of public health data collected from independent serial cross-sectional complex probability sample surveys. Seattle, WA: Joint Statistical Meeting; 2006. Available at http://www.amstat.org/Sections/Srms/Proceedings/y2006/Files/JSM2006-000537.pdf

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Employee Benefits Survey; Society for Human Resource Management (SHRM)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
25 (2009)
Target
38
Target-Setting Method
Projection/trend analysis
Numerator
Number of employers indicating they provide an on-site lactation/mother's room
Denominator
Number of employers responding to the relevant question(s) in the Society for Human Resource Management Benefits Survey
Questions Used to Obtain the National Baseline Data

From the 2009 Employee Benefits Survey:

[NUMERATOR:]

Do you provide employees an on-site lactation/mother's room?

  1. Yes
  2. No
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Employers who answer "yes" are included as providing worksite lactation support.

In February 2009, the Society for Human Resource Management (SHRM) conducted its annual survey to gather information on the types of benefits employers offer to their employees. The report provides an analysis of the 2009 SHRM Employee Benefits Survey results. The survey instrument listed 274 benefits and asked human resource (HR) professionals to indicate whether they offered these benefits to their employees.

References

Additional resources about the objective.

  1. Society for Human Resource Management. 2009 Employee Benefits: A Survey Report by SHRM. June 2009. Available at: http://www.shrm.org/Research/SurveyFindings/Articles/Documents/09-0295_Employee_Benefits_Survey_Report_spread_FNL.pdf (Accessed March 10, 2010.)
  2. Society for Human Resource Management. Information available at: http://www.shrm.org/about/pages/default.aspx Accessed March 10, 2010.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Immunization Survey (NIS); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
24.2 (2006)
Target
14.2
Target-Setting Method
Projection/trend analysis
Numerator
Number of caregivers of breastfed infants born in cohort year (for current baseline, year 2006) who indicate their infant received formula supplementation within the first 2 days of life
Denominator
Number of children aged 19-35 months born in one calendar year (e g , baseline refers to the 2006 birth cohort) who were breastfeeding at 2 days of life
Questions Used to Obtain the National Baseline Data

From the 2006 National Immunization Survey

[NUMERATOR:]

Was [child] ever breastfed or fed breast milk?

  1. Yes
  2. No
<

How old was [child's name] when (he/she) was first fed formula?

  1. ≤ 2 days of age
  2. Other
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

If the response to the first question (Was child ever breastfed or fed breast milk?) is No, the child is not considered a breastfed newborn and is not included in the denominator.

The National Immunization Survey (NIS) is conducted annually and collects data on children through age 35 months, and enables CDC to calculate breastfeeding rates each year. Because children are 19-35 months of age at the time of the NIS interview, each cross-sectional survey includes children born in three different calendar years. Using a computer-generated list, the NIS identifies households across the United States with children aged 19–35 months and interviews the person who is most knowledgeable about the child’s immunization status (“caregiver”). Starting January 2003, all respondents to the household telephone survey were asked questions related to breastfeeding, with modification of breastfeeding questions in 2004 and 2006. Survey years are combined to calculate breastfeeding by year of child’s birth (cohort) instead of year in which the participant was surveyed. To calculate breastfeeding indicators by year of child birth, data are combined across all available survey years.

References

Additional resources about the objective.

  1. Smith PJ, Zhao Z, Wolter KM, Singleton JA, Nuorti JP. Age-period-cohort analyses of public health data collected from independent serial cross-sectional complex probability sample surveys. Seattle, WA: Joint Statistical Meeting; 2006. Available at http://www.amstat.org/Sections/Srms/Proceedings/y2006/Files/JSM2006-000537.pdf

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Breastfeeding Report Card; Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (CDC/NCCDPHP)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
2.9 (2009)
Target
8.1
Target-Setting Method
Projection/trend analysis
Numerator
Number of live births that occur in hospitals and birth centers designated as providing all the recommended elements of care for lactating mothers and their babies
Denominator
Number of live births
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Hospital and birth center practices significantly affect whether a woman chooses to start breastfeeding and how long she continues to breastfeed. Several specific policies and practices, in combination, determine how much overall support for breastfeeding a mother giving birth in a particular hospital or birth center is likely to receive. The recommended elements of care for lactating mothers and their babies are those that are required for a hospital or birth center to be designated as “Baby-Friendly.” These elements are: (1) Have a written breastfeeding policy that is routinely communicated to all health care staff; (2) Train all health care staff in skills necessary to implement the policy; (3) Inform all pregnant women about the benefits and management of breastfeeding; (4) Help mothers initiate breastfeeding within one hour of birth; (5) Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants; (6) Give newborn infants no food or drink other than breast milk, unless medically indicated; (7) Practice “rooming in” – allow mothers and infants to remain together 24 hours a day; (8) Encourage breastfeeding on cue; (9) Give no pacifiers or artificial nipples to breastfeeding infants; (10) Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for lactation based on the WHO/UNICEF Ten Steps to Successful Breastfeeding for Hospitals. In the United States, the nonprofit organization Baby-Friendly USA oversees this program. To be designated as “Baby-Friendly,” facilities undergo external evaluation to demonstrate that the facility meets all ten of the recommended elements of care. All types and sizes of birth facilities can seek the Baby-Friendly designation. Some states have several small Baby-Friendly facilities, others have only one or two large Baby-Friendly facilities, and still others have none at all. Because birth facilities vary in size and the number of annual births, measuring the effect of their maternity care and practices on public health requires more than just counting the number of Baby-Friendly facilities per state. Thus, the public health impact is assessed by using the proportion of annual live births in the U.S. that occurred at facilities that have earned the Baby-Friendly designation.

References

Additional resources about the objective.

  1. Baby-Friendly USA. The Ten Steps to Successful Breastfeeding. Information available at http://www.babyfriendlyusa.org/eng/10steps.html (Accessed June 19, 2009.)
  2. CDC. Breastfeeding Report Card – United States, 2009. Available at http://www.cdc.gov/breastfeeding/data/report_card.htm#Data%20Sources (Accessed March 25, 2010.)
  3. Protecting, promoting and supporting breast-feeding: The special role of maternity services. A Joint WHO/UNICEF Statement. Geneva, World Health Organization, 1989.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Fetal Alcohol Surveillance System Network (FASSNet); Centers for Disease Control and Prevention, National Center for Birth Defects and Developmental Disabilities (CDC/NCBDDD)
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
per 10,000 live births 
Baseline (Year)
3.6 (2001-2004)
Target
Not applicable
Target-Setting Method
This measure is being tracked for informational purposes. If warranted, a target will be set during the decade.
Numerator
Number of children born in 2001-04 with suspected or confirmed Fetal Alcohol Syndrome
Denominator
Number of live births in 2006 to women residing in the selected surveillance area as determined by birth certificate data
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Fetal alcohol syndrome (FAS) is caused by maternal alcohol used during pregnancy and is one of the leading causes of preventable birth defects and developmental disabilities. The 2001-2004 estimate for FAS was determined using data from seven state-based FAS surveillance programs. The analyses included children who were born during 2001-2004 to a mother residing in a surveillance area at the time of the birth of the child, and who met the surveillance case definition for confirmed or probable FAS. The denominator consisted of live births to women residing in the selected surveillance area as determined by birth certificate data. Race/ethnic specific prevalence were calculated using mother’s race/ethnicity from birth certificates. Child’s race/ethnicity was used if mother’s race/ethnicity was not available. Prevalence calculations were standardized to the race/ethnic distribution of the 2006 US live births according to NCHS.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP); Centers for Disease Control and Prevention, National Center for Birth Defects and Developmental Disabilities (CDC/NCBDDD)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
15.1 (1991-2004)
Target
13.6
Target-Setting Method
10 percent improvement
Numerator
Number of 3-10 year-old children diagnosed with a disorder through newborn bloodspot screening who experience developmental delay requiring special education services
Denominator
Number of 3-10 year-old children diagnosed with a disorder through newborn bloodspot screening
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The Autism and Developmental Disabilities Monitoring Network (ADDM) provides reliable, population-based prevalence estimates of the number of school-aged children with developmental disabilities over time and is the only program in the US conducting active surveillance for serious developmental disabilities using data on individual children. ADDM sites with access to both education records and newborn blood-spot screening data will contribute to these data points. Data from newborn bloodspot screening will be used to establish the denominator and these data will be linked to special education data obtained annually by each ADDM site with access to education records.

References

Additional resources about the objective.

  1. Powell KK, Van Naarden Braun K, Singh RH, Shapira SK, Olney RS, Yeargin-Allsopp M. Long-term speech and language developmental issues among children with Duarte galactosemia. Genetics Med. 2009; (12):874-9.
  2. Powell, K. K., Van Naarden Braun, K., Singh, R. H., Shapira, S. K., Olney, R. S., Yeargin-Allsopp, M. Prevalence of developmental disabilities and receipt of special education services among children with an inborn error of metabolism. J of Pediatrics 2010 156:420-426.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Autism and Developmental Disabilities Monitoring Network (ADDM); Centers for Disease Control and Prevention, National Center for Birth Defects and Developmental Disabilities (CDC/NCBDDD)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
50.0 (2006)
Target
45.0
Target-Setting Method
10 percent improvement
Numerator
Number of 8-year-old children with cerebral palsy born as low birth weight infants (<2500 grams)
Denominator
Number of 8-year-old children with cerebral palsy
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

The Autism and Developmental Disabilities Monitoring (ADDM) Network provides reliable, population-based prevalence estimates of the number of school-aged children with cerebral palsy and other developmental disabilities over time and is the only program in the US conducting active surveillance for serious developmental disabilities using data on individual children. For the majority of children with cerebral palsy (CP) the cause of their cerebral palsy is unknown. The effects of improved neonatal care overtime which differ dramatically by birth weight have had particular implications for CP. This indicator focuses on one of the leading risk factors for cerebral palsy. Monitoring potentially modifiable, major risk factors is an area ripe for introducing interventions and improving outcomes.

The denominator for this objective reflects the number of 8-year-old children with CP who were born in the participating ADDM states and resided in the respective surveillance areas at 8 years of age.

References

Additional resources about the objective.

  1. Christensen D, Van Naarden Braun K, Doernberg NS, Maenner MJ, Arneson CL, Durkin MS, Benedict RE, Kirby RS, Wingate MS, Fitzgerald R, Yeargin-Allsopp M. Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning - Autism and Developmental Disabilities Monitoring Network, USA, 2008. Dev Med Child Neurol. 2013 Oct 1.
    http://www.ncbi.nlm.nih.gov/pubmed/24117446
  2. Pakula A, Van Naarden Braun K, Yeargin-Allsopp M. Epidemiology and Classification of Cerebral Palsy. Phys Med Rehabil Clin N Am 20 (2009) 425–452.
MICH-28 Reduce occurrence of neural tube defects

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Birth Defects Prevention Network (NBDPN); Centers for Disease Control and Prevention, National Center for Birth Defects and Developmental Disabilities (CDC/NCBDDD)
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 100,000 live births 
Baseline (Year)
34.2 (2005-2006)
Target
30.8
Target-Setting Method
10 percent improvement
Numerator
Cases of spina bifida
Denominator
Number of live births
Data Collection Frequency
Biennial
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

CDC's National Center for Birth Defects and Developmental Disabilities (NCBDDD) is collaborating with states in the National Birth Defects Prevention Network (NBDPN) to systematically collect population-based birth defects data on neural tube defects in a timely manner. Twenty-four state birth defects surveillance programs that collect spina bifida cases for any pregnancy outcome were included in the dataset. Spina bifida cases are identified using either ICD-9 (740.0 – 740.1) or CDC/BPA (740.00 – 740.10) codes.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the words “live births and/or fetal deaths” were replaced with “cases” and the phrase “were diagnosed”' was removed from the data label to reflect the data collected in the surveillance instrument. Data for spina bifida from any pregnancy outcome were aggregated from multiple population-based surveillance systems across the U.S. Some of these cases might have resulted in a termination. Additionally, the cases were occurrences and may not have necessarily been diagnosed in the base line or target year.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Birth Defects Prevention Network (NBDPN); Centers for Disease Control and Prevention, National Center for Birth Defects and Developmental Disabilities (CDC/NCBDDD)
National Vital Statistics System-Natality (NVSS-N); Centers for Disease Control and Prevention, National Center for Health Statistics (CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
per 100,000 live births 
Baseline (Year)
24.6 (2005-2006)
Target
22.1
Target-Setting Method
10 percent improvement
Numerator
Cases of anencephaly
Denominator
Number of live births
Data Collection Frequency
Biennial
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

CDC's National Center for Birth Defects and Developmental Disabilities (NCBDDD) is collaborating with states in the National Birth Defects Prevention Network (NBDPN) to systematically collect population-based birth defects data on neural tube defects in a timely manner. Nine state birth defects surveillance programs that can collect anencephaly cases for all pregnancy outcomes were included in the dataset. Anencephaly cases are identified using either ICD-9 (741.0, 741.9) or CDC/BPA (741.00 – 741.99) codes.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2013, the words “live births and/or fetal deaths” were replaced with “cases” and the phrase “were diagnosed”' was removed from the data label to reflect the data collected in the surveillance instrument. Data for anencephaly from any pregnancy outcome were aggregated from multiple population-based surveillance systems across the U.S. Some of these cases might have resulted in a termination. Additionally, the cases were occurrences and may not have necessarily been diagnosed in the base line or target year.

MICH-29 Increase the proportion of young children with an autism spectrum disorder (ASD) and other developmental delays who are screened, evaluated, and enrolled in early intervention services in a timely manner

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Children's Health (NSCH); Health Resources and Services Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics (HRSA/MCHB and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
Yes
Measure
percent 
Baseline (Year)
22.6 (2007)
Target
24.9
Target-Setting Method
10 percent improvement
Numerator
Number of children (10-35 months of age) who are screened for autism and other developmental delays in the past year
Denominator
Number of children (10-35 months of age)
Questions Used to Obtain the National Baseline Data

From the 2007 National Survey of Children's Health:

[NUMERATOR:]

Sometimes a child's doctor or other health care provider will ask a parent to fill out a questionnaire at home or during their child's visit. During the past 12 months, did a doctor or other health care provider have you fill out a questionnaire about specific concerns or observations you may have about (Specific Child)'s developmental, communication or social behaviors?

  1. Yes
  2. No

Did this questionnaire ask about your concerns or observations about how (Specific Child) talks or makes speech sounds?

  1. Yes
  2. No

Did this questionnaire ask about your concerns or observations about how (Specific Child) interacts with you and others?

  1. Yes
  2. No

Did this questionnaire ask about your concerns or observations about words and phrases (Specific Child) uses and understands?

  1. Yes
  2. No

Did this questionnaire ask about your concerns or observations about how (Specific Child) behaves and gets along with you and others?

  1. Yes
  2. No
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Autism Spectrum Disorders (ASD) are defined as a constellation of behaviors indicating social, communicative, and behavioral impairment or abnormalities. The essential features of ASD are (a) impaired reciprocal social interactions, (b) delayed or unusual communication styles, and (c) restricted or repetitive behavior patterns. A child is included as a confirmed case of ASD if he or she displays behaviors (as described by a doctor or other health care provider) consistent with the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) diagnostic criteria for Autistic Disorder, Pervasive Developmental Disorder-Not Otherwise Specified (including Atypical Autism), or Asperger's Disorder. Behavioral descriptions are reviewed by autism experts using a coding scheme based on DSM-IV criteria to determine autism case status.

Changes Between HP2010 and HP2020
This objective differs from Healthy People 2010 objective 16-14c, which tracked the median age, in months, at first identification of an autism spectrum disorder using data from the Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP). This objective tracks screening for autism and other developmental delays in children aged 10-35 months using data from the National Survey of Children's Health (NSCH).

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch

In 2012, the original baseline was revised from 19.5% (2007) to 22.6% (2007) because the objective text did not accurately reflect what is measured by the data source. The objective text was revised from screening of “young children” by age 24 months to screening within the past year of children aged 10 to 35 months. The target was adjusted from 21.5% to 24.9% to reflect the revised baseline using the original target-setting method.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Autism and Developmental Disabilities Monitoring Network (ADDM); Centers for Disease Control and Prevention, National Center for Birth Defects and Developmental Disabilities (CDC/NCBDDD)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
39.0 (2006)
Target
42.9
Target-Setting Method
10 percent improvement
Numerator
Number of 8-year-old children with an Autism Spectrum Disorder (ASD) with a first evaluation by 36 months of age
Denominator
Number of 8-year-old children with an Autism Spectrum Disorder (ASD)
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Data will be used from the National Survey of Child’s Health (NSCH), HRSA, when available.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP); Centers for Disease Control and Prevention, National Center for Birth Defects and Developmental Disabilities (CDC/NCBDDD)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
52.4 (2006)
Target
57.6
Target-Setting Method
10 percent improvement
Numerator
Number of 8-year-old children with an Autism Spectrum Disorder (ASD) enrolled in special education services by 48 months of age
Denominator
Number of 8-year-old children with an Autism Spectrum Disorder
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Autism Spectrum Disorders (ASD) are defined as a group of behaviors indicating social, communicative, and behavioral impairment or abnormalities. The essential features of ASD are (a) impaired reciprocal social interactions, (b) delayed or unusual communication styles, and (c) restricted or repetitive behavior patterns.

A child is included in the Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) as a confirmed case of ASD if he or she displays behaviors (as described on a comprehensive evaluation by a qualified professional) that are consistent with the diagnostic criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) for any of the following conditions: Autistic Disorder, Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS, including Atypical Autism), or Asperger's Disorder.

To determine MADDSP case status, information is abstracted from health and education records and then reviewed by an ASD clinician reviewer using a coding scheme based on DSM-IV-TR criteria for Autistic Disorder, PDD-NOS, and Asperger’s Disorder.

A qualified professional is defined as a medical, clinical, or educational professional in a position to observe children with developmental disabilities (including, but not limited to, psychologist, physician, teacher, learning specialist, speech/language pathologist, occupational therapist, physical therapist, nurse, social worker).

An ASD clinician reviewer is defined as a qualified diagnostician with specialized training and experience in autism assessment and diagnosis.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Children's Health (NSCH); Health Resources and Services Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics (HRSA/MCHB and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
Number of children (10-48 months of age) with a developmental delay with a first evaluation by 36 months of age
Denominator
Number of children (10-48 months of age) with a developmental delay
Comparable Healthy People 2010 Objective
Not applicable

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Children's Health (NSCH); Health Resources and Services Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics (HRSA/MCHB and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
Number of children (10-60 months of age) with a developmental delay with a first IEP/IFSP by 48 months of age
Denominator
Number of children (10-60 months of age) with a developmental delay
Comparable Healthy People 2010 Objective
Not applicable
MICH-30 Increase the proportion of children, including those with special health care needs, who have access to a medical home

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Children's Health (NSCH); Health Resources and Services Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics (HRSA/MCHB and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
57.5 (2007)
Target
63.3
Target-Setting Method
10 percent improvement
Numerator
Number of children under 18 years of age receiving care in medical homes
Denominator
Number of children under 18 years of age
Questions Used to Obtain the National Baseline Data

From the 2007 National Survey of Children's Health:

[NUMERATOR:]

Child has one or more health care providers considered to be personal doctor or nurse (PDN)

During past 12 months, how often did all child's doctors and other health providers:

Spend enough time with child?

Listen carefully to parent?

Provide needed information?

Help parents feel like partner in child's care?

Referrals for specialist care

During past 12 months:

Needed a referral to see any doctors or receive any services?

  1. Yes
  2. No

[IF yes:] any problems getting the referral that was needed?

  1. Yes
  2. No

Usual sources for care

Is there a place child usually goes when he/she is sick?

  1. Yes
  2. No

[IF yes:] What kind of place is it?

  1. Doctor's office
  2. Emergency room
  3. Hospital outpatient department
  4. Clinic
  5. Some other place

Help with care coordination

Does anyone help family to arrange or coordinate child's care?

  1. Yes
  2. No

Did family need extra help arranging or coordinating child's health care?

  1. Yes
  2. No

[IF yes:] How often got as much help as needed arranging or coordinating child's health care?

Provider communication

How satisfied with communication between child's doctors and other providers?

Needed doctors or other providers to communicate with child's school or other programs?

  1. Yes
  2. No

[IF yes;:] How satisfied with that communication?

Respect for diversity

During past 12 months, how often were child's doctors and other health providers:

Sensitive to family's values and customs?

Language services

During past 12 months:

Needed an interpreter to help speak with child's doctors or nurses?

  1. Yes
  2. No

[IF yes:] How often able to get someone other than a family member to help speak with child's doctors or nurses?

Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

The measurement of medical home access in the 2007 National Survey of Children’s Health has been described in detail elsewhere. In brief, the overall medical home measure from the 2007 NSCH is a composite of five different sub-component topics assessing the following: Child has at least one personal doctor or nurse; Family-centered care; Getting needed referral; Usual source(s) for care; Effective care coordination.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Children with Special Health Care Needs (NS-CSHCN); Health Resources and Services Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics (HRSA/MCHB and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
47.1 (2005-2006)
Target
51.8
Target-Setting Method
10 percent improvement
Numerator
Number of children under 18 years of age with special health care needs receiving care in medical homes
Denominator
Number of children under 18 years of age with special health care needs
Questions Used to Obtain the National Baseline Data

From the 2007 National Survey of Children's Health:

[NUMERATOR:]

Child has one or more health care providers considered to be personal doctor or nurse (PDN)

During past 12 months, how often did all child's doctors and other health providers:

Spend enough time with child?

Listen carefully to parent?

Provide needed information?

Help parents feel like partner in child's care?

Referrals for specialist care

During past 12 months:

Needed a referral to see any doctors or receive any services?

  1. Yes
  2. No

[IF yes:] any problems getting the referral that was needed?

Usual sources for care

Is there a place child usually goes when he/she is sick?

  1. Yes
  2. No

[IF yes:] What kind of place is it? Is it a Doctor's office, emergency room, hospital outpatient department, clinic, or some other place?

Help with care coordination

Does anyone help family to arrange or coordinate child's care?

  1. Yes
  2. No

Did family need extra help arranging or coordinating child's health care?

  1. Yes
  2. No

[IF yes:] How often got as much help as needed arranging or coordinating child's health care?

Provider communication

How satisfied with communication between child's doctors and other providers?

Needed doctors or other providers to communicate with child's school or other programs?

  1. Yes
  2. No

[IF yes:] How satisfied with that communication?

Respect for diversity

During past 12 months, how often were child's doctors and other health providers:

Sensitive to family's values and customs?

Language services

During past 12 months:

Needed an interpreter to help speak with child's doctors or nurses?

  1. Yes
  2. No

[IF yes:] How often able to get someone other than a family member to help speak with child's doctors or nurses?

Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

The measurement of medical home access in the 2007 National Survey of Children’s Health has been described in detail elsewhere. In brief, the overall medical home measure from the 2007 NSCH is a composite of five different sub-component topics assessing the following: Child has at least one personal doctor or nurse, Family-centered care;, Getting needed referral;, Usual source(s) for care; Effective care coordination.

Children with Special Health Care Needs are defined using questions k2q10-k2q23 of the children with special health care needs screener.

MICH-31 Increase the proportion of children with special health care needs who receive their care in family-centered, comprehensive, and coordinated systems

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Children with Special Health Care Needs (NS-CSHCN); Health Resources and Services Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics (HRSA/MCHB and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
20.4 (2005-2006)
Target
22.4
Target-Setting Method
10 percent improvement
Numerator
Number of children aged 0 to 11 years with special health care needs who receive their care in family-centered, comprehensive, and coordinated systems
Denominator
Number of children aged 0 to 11 years with special health care needs
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Five indicators are used to measure the quality of a system of care for CSHCN aged 0-11: Families of children and youth with special health care needs partner in decision making at all levels and are satisfied with the services they receive; Children and youth with special health care needs receive coordinated Updated: Ongoing comprehensive care within a medical home; Families of CSHCN have adequate private and/or public insurance to pay for the services they need; Children are screened early and continuously for special health care needs; Community-based services for children and youth with special health care needs are organized so families can use them easily; A child is considered to be served by a “service system,” as described in the Healthy People objective, if his or her care met all relevant criteria for his or her age. For children from birth through age 11 years, the first five outcomes were included; and additional outcome related to transition planning is included for children from age 12 through 17 years. Children with Special Health Care Needs CSHCN were identified using the CSHCN Screener, which consists of five questions concerning common health care consequences experienced by CSHCN.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Survey of Children with Special Health Care Needs (NS-CSHCN); Health Resources and Services Administration, Maternal and Child Health Bureau, and Centers for Disease Control and Prevention, National Center for Health Statistics (HRSA/MCHB and CDC/NCHS)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
13.8 (2005-2006)
Target
15.1
Target-Setting Method
10 percent improvement
Numerator
Number of children aged 12 to 17 years with special health care needs who receive their care in family-centered, comprehensive, and coordinated systems
Denominator
Number of children aged 12 to 17 years with special health care needs
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Not applicable
Methodology Notes

Six indicators are used to measure the quality of a system of care for CSHCN aged 12-17 years: Families of children and youth with special health care needs partner in decision making at all levels and are satisfied with the services they receive; Children and youth with special health care needs receive coordinated Updated: Ongoing comprehensive care within a medical home; Families of CSHCN have adequate private and/or public insurance to pay for the services they need; Children are screened early and continuously for special health care needs; Community-based services for children and youth with special health care needs are organized so families can use them easily; Youth with special health care needs receive the services necessary to make transitions to all aspects of adult life, including adult health care, work, and independence. A child is considered to be served by a “service system,” as described in the Healthy People objective, if his or her care met all relevant criteria for his or her age. For children from birth through age 11 years, the first five outcomes were included, and all six outcomes were counted for children from age 12 through 17 years. Children with Special Health Care Needs CSHCN were identified using the CSHCN Screener, which consists of five questions concerning common health care consequences experienced by CSHCN.

MICH-32 Increase appropriate newborn blood-spot screening and follow-up testing

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Newborn Screen and Genetic Resource Center (NNSGRC); University of Texas Health Science Center at San Antonio, Department of Pediatrics (UTHSCSA)
Changed Since the Healthy People 2020 Launch
No
Measure
number 
Baseline (Year)
21 (2010)
Target
45
Target-Setting Method
Projection/trend analysis
Numerator
Number of states and DC that verify through linkage with vital records that all newborns are screened shortly after birth for conditions mandated by their State-sponsored screening program
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Title V Information System (TVIS); Health Resources and Services Administration, Maternal and Child Health Bureau (HRSA/MCHB)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
98.3 (2003-2006)
Target
100
Target-Setting Method
Total coverage
Numerator
Number of screen-positive children identified through newborn blood spot screening who receive follow-up testing within the recommended time period
Denominator
Number of screen-positive children identified through newborn blood spot screening
Data Collection Frequency
Annual
Comparable Healthy People 2010 Objective
Adapted from HP2010 objective
Methodology Notes

Data are submitted using Form 6 of the Title V Block Grant application submitted annually by all states and the District of Columbia well as Territories.

As such, estimates reflect data from 59 states and jurisdictions. While the National Center for Health Statistics (NCHS) traditionally presents data for 50 States and DC, an exception was made to remain consistent with published reports of these data.

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
National Newborn Screen and Genetic Resource Center (NNSGRC); University of Texas Health Science Center at San Antonio, Department of Pediatrics (UTHSCSA)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Numerator
Number of children with a diagnosed condition identified through newborn screening that have an annual assessment of services needed and received
Denominator
Number of children with a diagnosed condition identified through newborn screening
Comparable Healthy People 2010 Objective
Not applicable

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

National Data Source
Title V Information System (TVIS); Health Resources and Services Administration, Maternal and Child Health Bureau (HRSA/MCHB)
Changed Since the Healthy People 2020 Launch
No
Measure
percent 
Baseline (Year)
75.0 (2003-2006)
Target
83.7
Target-Setting Method
10 percent improvement
Numerator
Number of infants born very low birth weight (VLBW) at a subspecialty perinatal facilities (Level III facilities)
Denominator
Number of infants born VLBW
Data Collection Frequency
Periodic
Comparable Healthy People 2010 Objective
Retained from HP2010 objective
Methodology Notes

Very low birth weight (VLBW) is defined as a birth weight of less than 1,500 grams (3 lbs 4 ounces). Data are reported by states each year as part of the Maternal and Child Health Block Grant application. A national weighted average is calculated by summing the numerator and denominator information reported by each jurisdiction.

Estimates reflect data from 59 states and jurisdictions. While the National Center for Health Statistics (NCHS) traditionally presents data for 50 States and DC, an exception was made to remain consistent with published reports of these data.

Before 2006, states reported on the following: The percent of newborns who are screened and confirmed with condition(s) mandated by their state-sponsored newborn screening programs (e.g., phenylketonuria and hemoglobinopathies) who receive appropriate follow-up as defined by their state. After 2006, states reported on the following: The percent of screen positive newborns who received timely follow up to definitive diagnosis and clinical management for condition(s) mandated by their State-sponsored newborn screening programs.