Highlight on South Dakota: Information announced by Department of Health

New information regarding South Dakota’s tuberculosis control program, oral health progress among grade school children, the reduction of early elective deliveries, and the availability of a web-based health data query system has been announced by the South Dakota Department of Health (SDDH).

TB Control Program

According to the 2014 South Dakota Tuberculosis Control Program Annual Report, during the last 10 years, the state has averaged 14 cases of tuberculosis (TB) per year. During 2014, there were only eight cases reported to the SDDH, which is the second straight year that the lowest number of cases was reported in the state. While the development of anti-TB medications has lead to a decrease in TB cases since the 1950’s, the report concludes that reductions also have been the result of mandatory reporting of suspected cases to the SDDH, case management, new treatment regimens and comprehensive contact investigations to to ensure prompt intervention.

Historically, American Indian TB rates have dropped in South Dakota while white cases have been consistently low. TB cases among black, Asian, and other races in South Dakota mainly represent cases contracted outside the United States that were diagnosed within the state. The majority of TB cases in South Dakota are of African descent, with diagnosed individuals from countries of birth including Afghanistan, China, El Salvador, Indonesia, Romania, Russia, Nepal, Mauritania, Vietnam, South Korea, Bhutan, Kenya, and Palau. South Dakota’s goal was to reduce TB cases to no more than 3.5 cases per 100,000 of population by 2015, and to no more than 15 cases per 100,000 for American Indians by 2015, with both of these objectives having been met.

Nationally, 85 percent of TB cases are reported as pulmonary disease (carried by the lungs) and 15 percent as non-pulmonary.  In 2014, South Dakota reported 2 cases (24 percent) as non-pulmonary sites of disease, i.e., bone, liver, peritoneal, pleural, renal, and lymphatic TB. Because co-infection with HIV is an important risk factor, in South Dakota, all TB cases are offered HIV testing.

Oral Health

According to a 2014 oral health survey of South Dakota children, 56 percent of third graders had experienced dental decay; however, this was a 11 percent decrease from a baseline survey in 2003. The 2014 survey also indicated a decrease in untreated decay (22 percent in 2014), down from 29 percent in 2010. According to the survey, this means that in the 2013-2014 school year, an estimated 2,645 third grade children had untreated tooth decay in South Dakota. One way to prevent tooth decay among children is with evidence-based dental sealants. The survey showed that only 56 percent of third grade children has benefited from dental sealants. American Indian children and children enrolled in the National School Lunch Program had significantly higher prevalence of decay and untreated decay.

Early Elective Deliveries

South Dakota’s First Lady Linda Daugaard announced on March 4, 2015, that 16 of the 24 South Dakota hospitals that perform deliveries have signed pledges to reduce the number of early deliveries done for non-medical reasons. First Lady Daugaard and North Dakota First Lady Betsy Dalrymple had previously challenged birthing hospitals in the two states to reduce early elective deliveries (EEDs).

EEDs are non-medically indicated deliveries performed before 39 weeks of pregnancy for no specific medical reason. According to CMS, EEDs may occur either by induction or cesarean section (C-section), and result in an increased risk of maternal and neonatal death and longer hospital stays for both mothers and newborns, as compared to deliveries occurring between 39 and 40 completed weeks gestation. Due to the health risks to both mother and baby, the American College of Obstetricians and Gynecologists (ACOG) recommends against induced labor or C-sections before 39 weeks of pregnancy unless there is a medical necessity.

A June 2014 data brief from the National Center for Health Statistics (NCHS) reported that the North and South Dakota were among only five states to reduce induction rates at 38 weeks of pregnancy by 30 percent or more, which lead the nation. Improving birth outcomes and the health of infants is one goal of SDDH’s Health 2020 initiative.

Web-Based Data Query System

The SDDH also announced that its Office of Health Statistics has created a new web-based data query system. The system includes statewide and county level health related data. The system provides death and birth statistics from 2000-2012 and cancer incidence and mortality rates from 2001-2011. The Office of Health Statistics plans to update the  site annually. The system includes data based on various demographics such as age, race, ethnicity, and gender.