State of South Dakota's Child: 2023.

In 2022, there was a decrease in births in the state with 111 fewer resident newborns than in the previous year. This represented a decrease of 1% of its white and 3.5% of its AIBO (American Indian, Black and Other) births. The 2022 birth rate per 1,000 population for the state (12.3) is higher than observed nationally (10.9) but matches its 2020 rate that was an historic low. Approximately 22% of all births in 2022 were AIBO and this percent of the state's entire birth cohort has decreased in the past several years. The American Indian contribution to the AIBO cohort has also decreased as its racial diversity has increased. The percent of births that are low birth weight has consistently been lower in South Dakota than nationally. An increase of 16 infant deaths in 2022 from 2021 and the decreased number of births led to an increase in the infant mortality rate (IMR = deaths in first year of life per 1,000 live births) from 6.3 to 7.8, but this 2022 IMR is not statistically significantly higher than its previous five-year mean. Further, the 2022 increase in the IMR was almost entirely among white infants with the post neonatal mortality rate (PNMR = deaths between 28 and 365 days of life) decreasing between these two years for AIBO infants. Nonetheless, the state's five year mean rates of death (2018-2022) are significantly higher for the AIBO than white infants for the neonatal (0-27 days) and post neonatal periods of the first year of life. Recently, however, the ratio of AIBO to white post neonatal mortality rate (PNMR) has decreased, but increased for the neonatal mortality rate (NMR). Infants in South Dakota are significantly more likely between 2018 and 2022 to die of congenital anomalies, sudden unexpected infant death (SUID), and accidents/homicides than in the United States in 2021. SUID remains the leading cause of post neonatal death and its risk may be decreased when babies are placed to sleep supine and alone in environments that are devoid of soft hazards.

State of South Dakota's Child: 2022.

In 2021, South Dakota observed an increase in the number of births from 2020 when the state experienced its lowest historic birth rate. Nonetheless, this increase represented a 3.7 percent decrease from the state's previous five year (2016-2020) mean of live births. This growth in the 2021 cohort of newborns was seen almost entirely among its white population. Further, South Dakota's current rate of birth remains slightly higher than that observed nationally. Over recent years, the racial diversity of South Dakota's newborns became similar to that observed nation-wide with nearly one quarter being American Indian, Black or Other races (AIBO). This trended down in 2021 with 22 percent of the state's newborns AIBO. Further, in South Dakota, the percent of all AIBO newborns who are American Indian is decreasing. Currently, 60 percent of the AIBO population is American Indian compared to more than 90 percent in 1980. During the pandemic years of 2020 and 2021, racial disparities in perinatal outcome occurring during previous years continued to be observed but the onset of prenatal care in the first trimester for both white or AIBO pregnant women did not change. There were 71 infant deaths in 2021 yielding a decrease in South Dakota's infant mortality rate (IMR) from 7.4 to 6.3 (higher than the 5.4 IMR for 2020 for the U.S.). Though there was a decrease in the state's 2021 IMR to 6.3, the reduced rate from its previous five year mean of 6.5 is not statistically significant. The state's 2021 neonatal mortality rate (NMR = 0 to 27 days per 1,000 live births) and post neonatal mortality rate (PNMR=28 to 364 days per 1,000 live births) dropped for the white population and increased for the AIBO population, though the actual number of AIBO deaths associated with these rate increases were low. Between 2017- 2021, the South Dakota rates of death for AIBO compared to white newborns was significantly higher for perinatal causes, sudden unexpected death (SUID), and other causes. Compared to the U.S.' 2020 rates of infant mortality, South Dakota's comparable 2017-21 rates were significantly higher for congenital anomalies. In 2021 there were 15 deaths in the state due to SUID; a decrease from the previous year, yet little overall improvement in decreasing the rate of this cause of death has not been achieved. Between 2017 and 2021, SUIDs comprised 22 percent of infant deaths for both white and AIBO infants. A discussion of strategies to prevent these persisting tragedies is presented.

State of South Dakota's Child: 2021.

The total number of 2020 resident births in South Dakota continues to decline with a 4 percent decrease from the previous year yielding the state's lowest crude birth rate (12.3 per 1,000 population) since its first recording in 1910. Currently, similar to the U.S., approximately one-quarter of all births are minority. The percentage of American Indian births is decreasing in its contribution to this population of the state with a growing percent of African American and multi-race newborns comprising the minority population in the state. South Dakota had one more infant death in 2020 (n=81) compared to 2019. The decrease in births led to a non-significant increase in the state's infant mortality rate (IMR) from 7.0 to 7.4 that is significantly higher than the U.S. rate (5.6) in 2019. An increase in nine sudden unexpected infant deaths (SUID) from 2019 to 2020 contributed to the rising IMR. Compared to the U.S., South Dakota has a lower percent of its infant deaths among those who are low birth weight (55 vs. 66 percent). Approximately one-third of white infant deaths occurred after the first 27 days of life; this was true for approximately half of all minority infants. Overall, South Dakota's minority infants have significantly higher rates of neonatal and post neonatal death than its whites, specifically due to perinatal causes, SUID, and accidents/homicide. How SUID contributes to the state's IMR is an area for needed attention as these deaths are increasingly known to accompany risks that, if alleviated, could prevent loss of early life. An examination of data from the year 2020 is the first opportunity to see possible relationships between perinatal outcomes and the pandemic that spanned approximately three-quarters of this year. Drawing causal relationships is not possible, but several observations about the impact of the pandemic are made as natality and infant mortality data for this year are explored in this annual report.

State of South Dakota's Child: 2020.

Between 2015 and 2019, the total number of births in South Dakota declined by 7 percent. As infant mortality rates are calculated per 1,000 live births, slight increases or decreases in total deaths and deaths due to specific causes manifest in notable shifts in yearly infant mortality rates (IMR). In 2019, 10 more infants died than in 2018 (80 vs. 70). With the decline in the state's births, the IMR increased from 5.9 to 6.7, which is significantly higher than the U.S. rate of 5.7 for 2018. South Dakota's 2019 increase in births of very low birth weight infants and deaths due to congenital anomalies contributed to this increase in mortality. In South Dakota, between 2015-19, 62 percent of all infant deaths occurred during the first 27 days of life. Though the rate of death for the state's minority infants remains significantly higher than that of its white infants, a decline in the ratio of the minority to white IMR is noted. Further, the rate of death due to sudden unexpected infant death (SUID) remained stable between 2018-19 but there is evidence that increasingly these deaths are caused by accidental suffocation or strangulation in bed which is typically preventable with safe sleeping environments for infants. The interactions between birth weight, incidence, cause, and timing of death are explored in this annual review of infant mortality.

State of South Dakota's Child: 2019.

The year 2018 continued a three-year trend of decreasing live resident births in South Dakota with increased racial diversity among the minority cohort of newborns. In 2018 there was a decrease in very low birth weight newborns and this was reflected in a decline from the previous year's infant mortality rate (IMR) of 7.8 to 5.9 per 1,000 births. The state's 2018 IMR also is lower than its previous five year (2013-17) mean rate of 6.5 and is not significantly different than the most current 2017 rate (5.8) for the U.S. Decreases from 2017 were also seen in the state's neonatal mortality rate for its white and minority populations, although not for its post neonatal mortality rate. The distribution of causes of infant death in 2014-18 in South Dakota show that compared to the U.S. (2017), a lower percent of infant deaths were caused by perinatal causes and a higher percent were caused by sudden unexpected infant death (SUID). In South Dakota, there is a significantly higher rate of death due to SUID among its minority than white infants and the state's rate of death due to this cause is significanly higher than what is observed nationally in 2017. The complexity of addressing this cause of death in the state is discussed.

State of South Dakota's Child: 2015.

In 2014 there was an increase in the number of births in the state with 24 percent representing minority populations. This year also brought a decrease from 2013 in deaths for infants, yielding an infant mortality rate of deaths per 1,000 live births (5.9) slightly below that of the most current national rate of 6.0 in 2013. Consistent with previous years, disparities persist in rates of death for white and minority infants with 45 percent of 2014 infant deaths (versus 24 percent of the births) represented by minorities. Between 2010 and 2014, 57 percent of white and 60 percent of minority post neonatal deaths in South Dakota were attributable to sudden unexpected infant death, accidents and homicide for both whites and minorities. The rates of infant deaths due to these causes, however, were significantly higher (p < .01) for minorities than for whites.

Evaluating Maternal and Child Health and Leadership Competencies of Emerging MCH Leaders: The MCHC/RISE-UP Experience.

PURPOSE: This study examines maternal and child health core competencies and leadership characteristics of undergraduate students following participation in the Maternal and Child Health Careers/Research Initiatives for Student Enhancement-Undergraduate Program (MCHC/RISE-UP). MCHC/RISE-UP is a 10-week public health leadership program designed to promote diversity in public health workforce through mentored research, community engagement and advocacy, and clinical experiences for undergraduate students. DESCRIPTION: The MCHC/RISE-UP is a national consortium of University Centers for Excellence in Developmental Disabilities including, (1) Kennedy Krieger Institute (Kennedy Krieger, lead institution) partnering with Morgan State University, a Historically Black University, (2) the University of South Dakota partnering with Tribal Serving Institutions; and (3) the University of Southern California Children's Hospital-Los Angeles and their partner institution, California State University Los Angeles, a Hispanic Serving Institution. ASSESSMENT: Eighty-four junior and senior undergraduates and recent baccalaureate degree students who participated in the MCHC/RISE-UP worked on 48 maternal and child health projects. Following the MCHC/RISE-UP, students demonstrated statistically significant improvements in all maternal and child health core competencies. Transformational leadership characteristics also increased (mean increase 9.4, 95% CI 7.2-11.8; p < 0.001). At closing interview, over twice as many students endorsed a public health career goal compared to program admission (17.9 vs. 57.7%; p = 0.022). CONCLUSION: Multi-institutional collaborative public health leadership programs may extend the reach and recruitment of diverse students into the maternal and child health field. Experiential, didactic, and mentored learning opportunities may enhance student integration of maternal and child health competencies and transformational leadership characteristics.

Lifestyle Medicine Implementation in 8 Health Systems: Protocol for a Multiple Case Study Investigation.

BACKGROUND: Lifestyle medicine (LM) is the use of therapeutic lifestyle changes (including a whole-food, plant-predominant eating pattern; regular physical activity; restorative sleep; stress management; avoidance of risky substances; and positive social connection) to prevent and treat chronic illness. Despite growing evidence, LM is still not widely implemented in health care settings. Potential challenges to LM implementation include lack of clinician training, staffing concerns, and misalignment of LM services with fee-for-service reimbursement, but the full range of factors facilitating or obstructing its implementation and long-term success are not yet understood. To learn important lessons for success and failure, it is crucial to understand the experiences of different LM programs. OBJECTIVE: This study aims to describe in depth the protocol used to identify barriers and facilitators impacting the implementation of LM in health systems. METHODS: The study team comprises team members at the American College of Lifestyle Medicine (ACLM), including staff and researchers with expertise in public health, LM, and qualitative research. We recruited health systems that were members of the ACLM Health Systems Council. From among 15 self-nominating health systems, we selected 7 to represent a diversity of geographic location, type, size, expertise, funding, patients, and LM services. Partway through the study, we recruited 1 additional contrasting health system to serve as a negative case. For each case, we conducted in-depth interviews, document reviews, site visits (limited due to the COVID-19 pandemic), and study team debriefs. Interviews lasted 45-90 minutes and followed a semistructured interview guide, loosely based on the Consolidated Framework for Implementation Research (CFIR) model. We are constructing detailed case narrative reports for each health system that are subsequently used in cross-case analyses to develop a contextually rich and detailed understanding of various predetermined and emergent topics. Cross-case analyses will draw on a variety of methodologies, including in-depth case familiarization, inductive or deductive coding, and thematic analysis, to identify cross-cutting themes. RESULTS: The study team has completed data collection for all 8 participating health systems, including 68 interviews and 1 site visit. We are currently drafting descriptive case narratives, which will be disseminated to participating health systems for member checking and shared broadly as applied vignettes. We are also conducting cross-case analyses to identify critical facilitators and barriers, explore clinician training strategies to facilitate LM implementation, and develop an explanatory model connecting practitioner adoption of LM and experiences of burnout. CONCLUSIONS: This protocol paper offers real-world insights into research methods and practices to identify barriers and facilitators to the implementation of LM in health systems. Findings can advise LM implementation across various health system contexts. Methodological limitations and lessons learned can guide the execution of other studies with similar methodologies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/51562.