Setting a goal to reduce teen births in Milwaukee by 2015.

INTRODUCTION: Although teen birth rates have declined significantly since 1991, teen pregnancy remains a significant public health problem in Milwaukee, Wis. Using historical teen birth data trends, this study sets a birth rate reduction goal by the year 2015 for Milwaukee teenagers between the ages of 15 and 17. METHODS: Birth counts and birth rates for teenagers between the ages of 15 and 17 were obtained from the Wisconsin Interactive Statistics on Health (WISH). Trend analyses were performed on teen birth rate data gathered between 1991 and 2006 in an effort to forecast and set a birth rate goal for the year 2015. RESULTS/DISCUSSION: Trend analyses yielded a predicted birth rate projection of 35.9 (Adjusted R2 = .95, P < .001) births per 1000 females. Using the exponential function estimate as well as national and state goals, Milwaukee community leaders set a feasible goal of 30 births per 1000 teens aged 15-17 years for the year 2015, which represents a 46% reduction of the 2006 rate of 55/1000.

Prevalence of children with special health care needs in Milwaukee, Wisconsin: data from the Milwaukee metropolitan statistical area.

BACKGROUND: The Milwaukee Health Department and the Wisconsin Southeast Regional Center for Children with Special Health Care Needs (CSHCN) were interested in understanding the level of need and prevalence of CSHCN in the city of Milwaukee. It was determined that a survey of the Milwaukee area was needed to obtain a prevalence estimate. METHODS: A survey to identify children with special health care needs in the Milwaukee metropolitan statistical area (MSA) was conducted using the CSHCN Screener. The survey was administered as part of the Greater Milwaukee Survey in October and November of 2004. Results from this survey were compared to state and national data from the National Survey of Children with Special Health Care Needs, 2001. RESULTS: The prevalence of CSHCN in Milwaukee (23.5%) was found to be almost double that of the surrounding Milwaukee MSA counties (12.1%), the state (13.4%), and the nation (12.8%). The number and type of positive screener questions were not significantly different among the geographic areas. CONCLUSIONS: The prevalence of CSHCN has been consistently associated with poverty in numerous other studies. The survey conducted in Milwaukee MSA indicated increased prevalence in Milwaukee among poor and African American children. Improvement and augmentation of services available to urban poor is necessary to alleviate this excessive burden.

Second births to teenage mothers: risk factors for low birth weight and preterm birth.

CONTEXT: Teenagers are more likely than older women to have a low-birth-weight infant or a preterm birth, and the risks may be particularly high when they have a second birth. Identifying predictors of these outcomes in second teenage births is essential for developing preventive strategies. METHODS: Birth certificate data for 1993-2002 were linked to identify second births to Milwaukee teenagers. Predictors of having a low-birth-weight second infant or a preterm second birth were identified using logistic regression. RESULTS: The same proportion of first and second infants were low-birth-weight (12%), but second births were more likely than first births to be preterm (15% vs. 12%). In analyses that adjusted for demographic, pregnancy and behavioral characteristics, the odds that a second infant was low-birth-weight or preterm were elevated if the mother smoked during pregnancy (odds ratios, 2.2 and 1.9, respectively), had inadequate prenatal weight gain (1.8 and 1.4), had an interpregnancy interval of less than 18 months (1.6-2.9 and 1.4-2.3) or was black (2.7 and 1.7). Women who had received an adequate level of prenatal care had reduced odds of both outcomes (0.6 and 0.4). Women younger than 16 also had increased odds of having a low-birth-weight second infant. Further adjustment for socioeconomic characteristics yielded largely the same results. In addition, women who were unmarried or did not identify a father were at increased risk of both outcomes (1.5 for each), and poor women were at risk of having a low-birth-weight infant (1.3). CONCLUSIONS: Predictors of poor birth outcomes include modifiable behaviors. Prenatal interventions addressing these behaviors could help improve outcomes.

Cost of illness in the 1993 waterborne Cryptosporidium outbreak, Milwaukee, Wisconsin.

To assess the total medical costs and productivity losses associated with the 1993 waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, including the average cost per person with mild, moderate, and severe illness, we conducted a retrospective cost-of-illness analysis using data from 11 hospitals in the greater Milwaukee area and epidemiologic data collected during the outbreak. The total cost of outbreak-associated illness was 96.2 million US dollars: 31.7 million US dollars in medical costs and 64.6 million US dollars in productivity losses. The average total costs for persons with mild, moderate, and severe illness were 116 US dollars, 47 US dollars, and 7,808 US dollars, respectively. The potentially high cost of waterborne disease outbreaks should be considered in economic decisions regarding the safety of public drinking water supplies.