Impact of Healthy Start Home Visiting Model on Reduction of Perinatal Health Disparities in Allegheny County, PA: Evaluation of Seven-Year Major Perinatal Outcomes

Objective: The objective of this analysis, as a part of ongoing evaluation activities, was to assess impact on major perinatal outcomes in Allegheny County over the last seven years (2003 – 2009), by comparing birth outcomes in Healthy Start participants to the general population. Methods: The primary outcome variables assessed were infant mortality, preterm birth, low birth weight, and first trimester entry into prenatal care. Given the racial demographics of Healthy Start participants (~88% African-American) and the persistent racial disparities in perinatal health, all races and African-Americans in Allegheny County and statewide were used as comparison groups. Results: The infant mortality rate in Healthy Start Participants was significantly lower throughout the six year period than African-Americans in Allegheny County and statewide. The percent of preterm births was lower for Healthy Start participants compared to the African-Americans in Allegheny County. The percent low birth weights declined significantly throughout the six year period in Healthy Start participants, reducing to be significantly different than the African-Americans in Allegheny County and statewide. The percent of women entering prenatal care was higher than the African-Americans statewide, but similar to the other comparison groups. There were no significant differences in the Healthy Start participants compared to all races in Allegheny County and statewide. Conclusions: The results of this analysis provide further evidence that the Healthy Start Home Visiting Model is an effective method of reducing infant mortality rates, increasing access to care for mothers and infants, and ultimately, decreasing the gap in perinatal health disparities.