Reaching equitable birth outcomes through healthy start

Over twenty years ago, the Congress authorized Healthy Start as a program designed to reduce the rate of infant mortality and to improve perinatal health in locations with the highest rates of infant mortality. The program has grown from the original 15 grantees to 104 sites nationally that currently serve 36,000 women, babies, and their fathers operating in urban, rural, and border communities. The overwhelming majority enrolled in Healthy Start is African American, Hispanic, or Native American. The core services include outreach and recruitment, case management, depression screening and referral, and interconceptual care. Additionally, Healthy Start sites engage in building consortium for developing local action plans, sustainability measures and collaboration, and coordination with Title V. The USDHHS Secretary's Advisory Committee on Infant Mortality (SACIM) recommends that HHS supports and transforms the federal Healthy Start program as a priority initiative to maximize its potential to reduce infant mortality, eliminate disparities, and increase health equity. Additional recommendations are; 1) to implement new performance standards, evidence-based, (practice-based) interventions, and systems-based strategies, 2) to use HS grantees as a hub for new place-based initiatives, and 3) to use an interagency collaborative model to address the social determinants by investing in multiple programs including Healthy Start.