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February 21, 2001

Hawaii gets "A" grade on birth defects prevention
But the program is in jeopardy without a funding source

The Department of Health’s Hawaii Birth Defects Program is one of the best in the nation, according to a new "report card" from the Trust for America’s Health (RFAH), a Washington, DC-based advocacy group.

Hawaii, along with only seven other states received an "A", the highest grade possible in the report – Birth Defects Tracking and Prevention: Too Many States Are Not Making the Grade -- released this month. Hawaii was also one of only four states that met all the criteria used for the report. The report gives each of the states, a letter grade based on their efforts to monitor, research and uncover possible causes of birth defects.

Health Director Bruce Anderson said, "Although Hawaii has one of the best birth defects programs in the nation, our efforts to secure a permanent funding source for the program have been unsuccessful. Resources for the program are a very serious concern."

Program Administrator Ruth D. Merz said, "Proper recording and tracking of birth defects is a critical first step toward understanding their causes and in the development of prevention measures down the road."

The Hawaii Birth Defects Program (HBDP) was established in 1988 and monitors birth defects and other adverse pregnancy outcomes for trends and changes over time, this includes the investigation of geographic and other clusters. The program conducts extensive data analysis and reporting and offers prevention-oriented initiatives, conducts needs assessments on babies diagnosed with birth defects, and evaluates community and public health concerns.

Since 1990 the HBDP has conducted three studies of potential birth defects clusters and environmental factors (e.g., hazardous waste sites) in Hawaii communities linked with birth defects.

The HBDP is a contracted program of the Department of Health’s Children With Special Needs Branch, and has been funded by a patchwork of state, federal and private funding since 1996. A federal CDC grant will end this year and a permanent funding source is required to continue the program beyond February 2002. Legislation to establish a stable funding source is being considered this year.

HBDP collects and analyzes data on about 1,000 birth defects cases in Hawaii per year. It also provides valuable information to the community and researchers, gives presentations locally and nationally, and publishes articles to increase the public’s awareness about birth defects and their possible causes. The program is a valuable state resource for planning and development of appropriate statewide and community level services and preventive strategies.

According to the March of Dimes, in the United States, approximately 150,000 babies are born each year with birth defects – one out of every 28 infants. Many factors, including genetic and environmental factors, can cause birth defects. However, the causes of as many as 80 percent of birth defects are currently unknown.

Birth defects also remain the number one cause of infant mortality in the nation, accounting for about 20% of all infant deaths each year.

Beyond the often serious problems experienced by the child, birth defects also place tremendous emotional and social burdens on parents, and financial costs that can range from $140,000 to $700,000 per child per lifetime. It is estimated that for children born in 1988, the lifetime expenses associated with just 12 birth defects are estimated at more than $8 billion in today’s dollars.

More information and the full text of the report are available on the TFAH Web site at www.healthyamericans.org.

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