Among all 50 states and the District of Columbia, Missouri’s rank advanced to 37th overall in America’s Health Rankings - Health of Women and Children Report 2019, up from 41st in 2018.
Within women’s health specifically, Missouri jumped eight spots on the ranking list. The report uses over 60 metrics to compare and rank the health of women of reproductive age, infants, and children among the 50 states. While Missouri officials appreciate some of the successes seen among public health care of women, infants and children, they also acknowledge areas more progress is needed.
“We greatly appreciate the collaborative efforts of so many partners in the state that have resulted in our state’s health rankings advancing from 46th to 38th for women’s health and from 36th to 32nd for children’s health,” said Dr. Randall Williams, Department of Health and Senior Services Director and board-certified OB-GYN. “And yet, the report clearly identifies areas in which we are determined to improve the state’s infrastructure and workforce to meet our fundamental mission of prevention as it relates to maternal mortality, vaccination of preventable diseases and other clinical outcomes.”
One of the challenges noted in the report is the high rate of maternal mortality in Missouri. Several collaborations are in place that all share the same goal: to eliminate preventable maternal mortality and severe morbidity nationwide.
Missouri legislators passed Senate Bill 514 this year which established a Pregnancy-Associated Mortality Review (PAMR) in order to improve data collection and reporting of maternal deaths in Missouri, and the newly formed PAMR Board is responsible for analyzing all maternal deaths and making recommendations for preventative measures. DHSS was recently accepted into Alliance for Innovation on Maternal Health collaborative, and the department is also coordinating with the CDC to identify, review and characterize maternal deaths and identify prevention opportunities.
Nationally, tobacco use during pregnancy decreased to 6.9 percent of live births compared to 14.5 percent of Missouri’s live births over the last year. Pregnant women who use tobacco, or even breathe in secondhand smoke, become more at risk for having a miscarriage, a stillbirth or a low birthweight infant.
One of the strengths for Missouri includes a high flu vaccination coverage among women which is in line with the national trend showing a 5 percent increase in flu vaccination among women ages 18-44 (in the past three years).
During the 2018-2019 flu season, Missouri Governor Mike Parson and First Lady Teresa Parson participated in a public awareness campaign asking Missouri employers to encourage their workforce to get their flu shot. Their messaging with the assistance of media partners helped increase Missouri’s flu vaccination count by 14 percent, or more than 147,000 doses.
Through a variety of initiatives, DHSS is working to increase accessibility to immunizations to decrease preventable disease for all Missourians.
DHSS has entered a contract with the Missouri Primary Care Association to implement quality improvement standards in order to increase immunization rates among adolescents at 13 Missouri clinics. Part of this project promotes the adoption of certain proven standards to minimize missed opportunities for keeping patients up-to-date on immunizations, which includes making sure the follow-up appointment is scheduled the same day.
Through the passing of Senate Bill 826, Missouri pharmacists gained the ability in August 2018 to administer vaccines by protocol to individuals as young as seven years old, or the age recommended by the CDC, whichever is higher.
ShowMeVax, Missouri’s immunization registry, is also being upgraded to become more user-friendly for health care providers, schools and child care facilities. This tool allows these organizations a one-stop shop to order vaccines, look-up immunization records and determine vaccination recommendations, and the upgrade will also allow providers to calculate immunization rates for their clinic’s patients.