CATE CAMPBELL, MPHWHITNEY MICHAEL, MPH

MATTHEW P. TURNER, PHD, MPH

Growing Pains: Delivering Women's Health

Services in Texas

Source: Texas Population Projections. Texas State Data Center, Austin, Texas. February 24, 2015.

2003

2005

2007

2009

2011

2013

2015

2017

2019

1

5,000,001

10,000,001

15,000,001

20,000,001

25,000,001

30,000,001

35,000,001

Projected Population Growth in Texas

Source: Texas Population Projections. Texas State Data Center, Austin, Texas. February 24, 2015.

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

0%

10%

20%

30%

40%

50%

60%

White Black Hispanic Other

Race/Ethnicity of Texas Population

Source: Texas Hospital Inpatient Discharge Public Use Data File, Q1-Q4, 2013. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015.

Admissionsper 100,000population8,203.9 - 19,998.02,244.0 - 8,203.81,013.2 - 2,243.98.4-1,013.1

Female Obstetric Unit Admissions per 100,000 Female Population, 2013

Source: 2012 Birth Certificate finalized data files. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015.

BirthRate19.2-21.517.5-19.110.5-17.45.6-10.4Less than20 births

Birth Rates per 1,000 Population, Texas Residents, 2012

Source: 2012 Birth Certificate finalized data files. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015.

FertilityRate86.6-108.170.1-86.563.1-70.042.4-63.0Less than20 births

Fertility Rates per 1,000 Female Population age 15-44, Texas Residents,

2012

Source: 2012 Birth Certificate finalized data files. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015.

Prenatal CareRate68.6-84.262.7-68.552.6-62.636.4-52.5Data suppressed

Percentage of Women Who Received Prenatal Care in the First Trimester of Pregnancy, Texas Residents, 2012

Source: 2014 Hospital survey file. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015.

Obstetrical Service Level321No obstetrical services

Highest Level Hospital Obstetrics Unit by County, 2014

Source: 2014 Physician licensure file. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015.

Population per provider4,539 - 10,800

10,801 - 27,31627,317 - 48,41648,417 - 84,511No providers

10,800StateRatio

Ratio of Population to Obstetrician/Gynecologist, 2014

Source: 2014 Nurse-midwife licensure file. Texas Department of State Health Services, Center for Health Statistics, Austin, Texas. February 24, 2015.

Population per provider204 - 4,521

4,522 - 16,90216,903 - 39,20439,205 - 81,491No providers

Population to CNMratio5739 - 8196481965 - 108107108108 - 202035202036 - 694429No CNMs

Ratio of Population to Certified Nurse-Midwives, 2014

Encouragement of earlier prenatal care for expectant mothers

Better access to higher level facilities at which to provide prenatal care, women’s health and labor and delivery services

More providers across state Programs to attract doctors to HPSAs Increased presence of medical/nursing schools

in areas with high birth and fertility rates

Conclusions

Questions?