Remarks to the Secretary’s Advisory Committee
on Infant Mortality

Prepared Remarks of Elizabeth M. Duke, Ph.D.
Administrator, Health Resources and Services Administration

Arlington, Virginia
November 20, 2002

It’s a pleasure to welcome you all to this meeting of the Secretary’s Advisory Committee Meeting on Infant Mortality. I especially want to thank Peter, whose leadership has helped make sure that this committee’s recommendations receive the focus and visibility they deserve. And I thank all of you for your sustained commitment to us at HRSA. Your work supports our fundamental mission of ensuring greater access to quality health care for our country’s most vulnerable individuals and families.

I can tell you that Secretary Thompson sees your work as critically important. Your recommendations inform his decision-making in the area of maternal and child health. At your last meeting, we discussed Secretary Thompson’s desire to put together an Interagency Coordinating Council and a Department-wide research agenda on the impact of low birthweight.

As a follow-up, HRSA Deputy Administrator Dennis Williams, Senior Advisor Steve Smith, and Peter met recently with senior staff at the National Institute of Child Health and Human Development to develop plans to make the Secretary’s wish a reality. It was decided that HRSA, working closely with NICHD, would take the lead on getting this initiative moving and that we would try to have our first meeting by the end of January. I am so pleased that we are working to improve coordination and collaboration on the problem of low birth weight and preterm birth. This effort is the culmination of years of effort and enduring professional dedication by this advisory committee. You are to be congratulated for your fine work in this area.

As I told you when we met last July, President Bush has put HRSA at the core of an unprecedented push to increase direct health care to uninsured and underinsured Americans. The President’s five-year health centers initiative calls for creating new or expanded health center sites in 1,200 communities and increasing the number of patients served annually to more than 16 million. And we have already made great progress.

In our first year we have funded 171 new health center sites and awarded 131 grants to existing centers to help them expand services. These grants will save lives and improve the lives of hundreds of thousands of Americans, including women and children. And our work in 2002 puts us ahead of schedule to meet President Bush’s five-year goal.

As we grow this initiative, we’re also building on the successes of the Health Disparities Collaboratives, sponsored by the Bureau of Primary Health Care. They bring together staff from dozens of health centers to target improvements in the management of common chronic diseases. So far, the collaboratives have shown impressive results in treating diabetes, cardiovascular disease, asthma and depression. And as I promised you, our next collaborative - a partnership between BPHC and our Maternal and Child Health Bureau -- will focus on pregnancy, delivery and the first six months of life. We’ll be moving on it quickly because we all want our children to have a good start in life.

We want our health centers to focus attention on children and their moms and to reach out to the rapidly growing number of people over age 85. These two ends of the age spectrum are very vulnerable and need recognition that they are not just “little adults” or “older adults.”

In addition to the health centers initiative, we are also working to expand and reform the National Health Service Corps, and the President’s third initiative -- the Healthy Communities Innovation Initiative - is modeled on the Healthy Start demonstration projects of which we’re so proud. /p>

If Congress appropriates requested funds for Fiscal Year 2003 - HRSA will set up demonstration programs to combat asthma, diabetes and obesity and improve health outcomes in five communities where illness and death rates due to these diseases are high.

I emphasize these three presidential initiatives because they represent the foundation of HRSA’s current and future efforts to expand access to health care and close the health disparities gap. As an advisory committee, I ask that you consider how your recommendations can both enhance and support this important work we are doing at HRSA.

And, as you know, for fiscal year 2003, the President has maintained funding for the Healthy Start program at the FY 2002 level of $99 million. This is a tribute to your dedicated efforts on behalf of healthy mothers and babies across the nation.

You also should be aware that HRSA is committed to bringing high quality research to bear on our policies and practice with regard to the health and well-being of pregnant women and their children. For example, we are looking at how welfare reform impacts the health of immigrant mothers and their infants in New York and California.

We are in the midst of a three year case study to determine whether enhanced perinatal services that include nutrition, psychosocial, and health education services are associated with measurable benefits for women enrolled in Medicaid Managed Care plans. We’ll look to see whether those benefits differ across ethnic groups.

You can be sure that our findings from these and other research projects will be shared with all of you as you continue your work to improve health care for moms and babies nationwide.

In closing, I commend you all for your willingness to devote your time and effort to this most worthwhile endeavor. After all, as health professionals, what could be more important than making sure our youngest get a good start in life. At HRSA, we value your expert advice and counsel on how to provide quality prenatal care. And, as always, we look forward to your continuing recommendations.

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