HRSA News Room - Secretary's Advisory Committee on Infant Mortality

	U.S. Department of Health & Human Services Health Resources and Services Administration HRSA Press Office: (301) 443-3376 http://newsroom.hrsa.gov

Remarks to the Secretary's Advisory Committee on Infant Mortality

Prepared Remarks of Claude Earl Fox, M.D., M.P.H.
Administrator, Health Resources and Services Administration

Meeting of the Secretary's Advisory Committee on Infant Mortality
Washington, D.C.

February 26, 2001

Introduction

On behalf of the Health Resources and Services Administration, it is a pleasure to welcome each of you to this very important meeting of the Secretary’s Advisory Committee on Infant Mortality.

As many of you know, HRSA is all about access to health care to improve lives. Finding out how we can open access to care that prevents the tragedy of infant death is one of our most urgent, compelling tasks.

The good news is that many trends in infant mortality and maternal health are headed in the right direction. The U.S. infant mortality rate, which is the rate at which babies die before their first birthday, remained at an historic low of 7.2 deaths per 1,000 live births in 1998, the latest year for which statistics are available. The proportion of mothers getting early prenatal care is at a record high. The rate of cigarette smoking by pregnant women continues to plummet. And the birth rates among teenagers in all ethnic groups declined throughout the 1990s.

Yet, despite these many successes, the system is still far from perfect.

The United States continues to have sizable disparities among racial and ethnic groups in many maternal and child health categories. The infant mortality rate among black children is more than double that for white children. Access to first trimester prenatal care by black and Hispanic mothers continues to trail access rates for white mothers.

Far too often, women with late or no prenatal care fall through the cracks of our health care system. At HRSA, our job is to address the inadequacy of community services and other barriers preventing women, infants, and their families from accessing appropriate care.

What HRSA Is Doing

Our Healthy Start Initiative helps communities identify, plan, and implement a diverse range of strategies to significantly and successfully reduce disparities in perinatal health. These projects are designed to fully address the medical, behavioral and psychosocial needs of women and infants. Recently we announced a new framework for Healthy Start, which now will require participating communities to build strong linkages with statewide maternal and child health programs and offer a core set of proven interventions. This fresh direction is based on a six-year evaluation of the first 15 Healthy Start projects and recommendations of this Advisory Committee.

These first Healthy Start communities have given us valuable insight into what works and what doesn’t. Armed with this knowledge, we can help Healthy Start communities build stronger and more stable programs with statewide linkages that can help determine needs, set realistic goals, measure outcomes and continuously refine strategies.

To extend the message of Healthy Start, we have partnered with Lifetime television and the Ad Council to produce an hour-long documentary stressing the importance of prenatal care. Called A Healthy Start: Begin Before Baby’s Born, the film follows the pregnancies of three women and shows viewers how prenatal care made a difference in their babies’ health. This documentary aired nationwide last Friday on Lifetime, a top-rated cable television network for women. Plans call for it to be aired again in the future and videotapes are available.

Another program is our Healthy Child Care America effort that works to strengthen partnerships between child care and health care systems to protect the health of infants and young children in child care settings. States use three-year grants worth $100,000 annually to improve the quality of child care, build statewide networks of child care health consultants, and use the child care setting to sign up eligible children for health insurance programs such as Medicaid and the State Children’s Health Insurance Program.

HRSA is proud to have been integrally involved with SCHIP from the very beginning. We’re thrilled to see the states being so creative with their outreach efforts and so committed to enrolling millions of eligible children in high quality systems of care.

Our work with SCHIP mirrors some overall trends within the Agency and Department. We’re seeing much more collaboration within and among organizations, more cooperative efforts with state and local governments, and more intensive information gathering/data collection.

The public-private "Back to Sleep" campaign is an excellent example of the benefits of collaboration. This campaign tells parents that babies should sleep on their backs to lower their risk of death from Sudden Infant Death Syndrome. Studies show that the incidence of U.S. infants sleeping on their stomach has decreased from 70 percent in 1994, when the campaign began, to 21 percent in 1997. During that same time, the death rate from SIDS dropped 43 percent. The Back to Sleep campaign is led by the National Institute of Child Health and Human Development at the National Institutes of Health, HRSA and other HHS agencies, and is co-sponsored by the American Academy of Pediatrics.

From these few examples, you can see the kind of work we’re doing at HRSA to advance the health of women and babies.

Closing

We greatly appreciate your willingness to work with us in this most important effort. Your counsel will greatly inform our planning... help us advance the fight against infant mortality...and greatly improve the health of women and children in general. We look forward to your recommendations.

Thank you.