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1991.04.17 :  Grants -- Healthy Start

Contact: Bill Grigg (202) 245-6867 
Lynn Trible (301) 443-3377, HRSA
April 17, 1991

       The Department of Health and Human Services today
published criteria for communities which wish to participate in
the new "Healthy Start" initiative, intended to dramatically
improve infant and maternal health in areas with high infant
mortality rates.
       Funding of $25 million will be available this year under
the new initiative, which is to be carried out in 10 high infant
death areas.  Proposed funding for next year is $171 million. 
The initiative, which will continue over five years, aims at
reducing infant mortality by 50 percent in the 10 areas, and
techniques proven through the initiative will be applied in other
communities throughout the nation.
       According to the announcement in today's Federal Register,
the Healthy Start project areas must have at least 50 infant
deaths per year "to assure selection of communities with a
sufficient magnitude of the problem to justify concentrating
resources" but no more than 200 infant deaths per year "to assure
projects of manageable size."
       Project areas must also have an infant mortality rate of
at least 15.7 per 1,000 live births, which is 150 percent of the
national rate, using five-year averages of official vital
statistics data.
       The limits mean that large cities generally would not
qualify as a whole -- but neighborhoods within them could.  So
might several rural counties, or parts of them, that might apply
together.
       According to today's notice, selection of the
approximately 10 areas will be based in part on their "commitment
and involvement," and the integration and increased accessibility
of proposed services.  In particular, communities will be asked
to identify ways to encourage eligible women and children to
utilize Medicaid benefits and to maximize other programs such as
JOBS and WIC to address a wide array of health and social
problems.                       
     Consideration will also be given for innovative education
programs designed to increase pregnant women's (and, where
possible, future fathers') sense of personal responsibility and
encourage them to become involved in comprehensive maternity and
infant care as well as in an array of social and educational
services.  In addition, the areas must show strength in
administration, financial management and program evaluation.  

       The Health Resources and Services Administration also
announced in a separate Federal Register notice that public
meetings will be held for pre-application technical assistance to
all interested applicants.  These will be held April 30 in Los
Angeles, May 9 in Philadelphia, May 10 in Atlanta and May 13 in
Chicago.

       Applications must be received by July 15 for
consideration.

       The selected areas would be announced in the fall and
could begin organizing their programs with their share of $25
million provided by Congress for the current year.  For fiscal
1992, the first full year of the program's operation, President
Bush, in his Feb. 4 budget message to Congress, asked for $171
million.  

       Areas meeting the criteria probably will have significant
populations of minorities with high infant mortality.  While
Mexican-Americans and Asians have lower-than-average infant
mortality, the rate for Puerto Rican infants is 40 percent higher
than for whites, and the rate for blacks is twice that of whites.

       HHS Secretary Louis W. Sullivan, M.D., said today, "There
is no statistic more important to this nation or to me as
secretary of this department -- and a father -- than infant
mortality, the risk of an infant dying before reaching a first
birthday.

       "Each year," he said, "the national rate goes down a bit. 
I'm pleased it dropped to 9.1 per thousand in the provisional
data for 1990, as we reported April 8.  But all groups have not
participated equally in the decline and these pockets of high
infant mortality have held the United States to 24th among the
nations.  This new program concentrates resources on these
pockets, and produces new, innovative approaches as models to
help reduce the toll nationally.

       "Many approaches will be necessary, addressing specific
community needs, and requiring improved coordination of all
available resources, both public and private.  Each of us has a
vested interest in creating a climate of personal, family and
community responsibility.  Encouraging our nation's young mothers
and fathers to choose healthy behaviors is key to reducing many
of society's ills for both this generation and the next."

       A goal of Healthy People 2000, a Public Health Service-led
program to meet national health objectives, is to bring the
national infant mortality rate down to seven deaths per 1,000 by
the year 2000.

       HHS Assistant Secretary for Health James O. Mason, M.D.,
who heads the Public Health Service, said, "Today, in communities
with high infant deaths, the problems are basic -- the community
can't hire the doctors and nurses needed for prenatal or infant
care, or they won't serve without malpractice insurance, or
without an escort in a high crime area.  The grants can be used
to solve those problems.

       "If the problem is teens getting pregnant too soon, with
no family or spouse for responsible support and encouragement,
programs should be aimed at that.  If mothers are having low-
weight babies because of cigarette smoking, or babies damaged by
crack use, drug intervention programs can be aimed at helping
them get off these habits.

       "I'm very excited about what the impact of this program
can be.  When we find what works in a particular environment,
there'll be a 'spill-over' effect into other communities with
similar problems.  All will benefit."

       Robert G. Harmon, M.D., M.P.H., administrator of HRSA, the
PHS agency that will administer Healthy Start, said, "We look
forward to working with community leaders, state and local
agencies, professional organizations, charitable and religious
organizations, advocacy groups and especially families in
implementing this new program.  Healthy Start is the banner that
will bring us all together."

       Grant applications may be obtained from the Office of
Grants Management, Maternal and Child Health Bureau, 12300
Twinbrook Parkway, Suite 100-A, Rockville, Md.  20852.


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