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1991.04.17 :  Competition for Grants -- Healthy Start
Contact: Bill Grigg (202) 245-6867
Sylvia Shaffer (301)443-3371, HRSA 

     The federal government today invited communities or
neighborhoods with high infant deaths to compete for millions of
dollars to be made available in ten locations under the five-year
Healthy Start program announced by President Bush Feb. 4.
     The grants would be aimed at helping the ten locations cut
their high infant death rates in half.  
     Many urban neighborhoods and rural areas have the high
infant death rate necessary to apply -- 15.7 or more infants who
die before they are a year old per 1,000 live births, or half
again the national average for five recent years, 1984-88.)  
     According to the announcement in today's Federal Register,
neighborhoods or contiguous rural counties must also have had 50
infant deaths per year "to assure selection of communities with a
sufficient magnitude of problem to justify concentrating
resources" but no more than 200 infant deaths per year "to assure
projects of manageable size."
     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 ten areas will
be based in part on their "commitment and involvement," their
proposed services and their plans for educational programs aimed
at getting pregnant women into programs of early prenatal care
through their child's infancy.  The areas must also show strong
financial management and administration. 
     In a separate announcement in the Federal Register, help in
applying was offered by the Health Resources and Services
Administration, part of the PHS family of health agencies within
HHS, at public meetings April   in Philadelphia, April    in
Chicago and April   in Los Angeles.
     Applications must be received by July 1 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 $171 million, about
$100 million "new" money and the rest reprogramed from previously
planned increases for less focussed health programs.  Over the
five years, a selected area might get $40-$50 million or more for
increases in infant mortality programs. 
     Areas meeting the criteria probably will have significant
populations of blacks or other 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 black rate 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 continued, "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 Monday.  But all groups
have not shared equally in the decline and these pockets of high
infant mortality have held the United States to 24th among the
nations.  This new program is an attempt to concentrate resources
on these pockets -- and thus reduce the toll nationally."
     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 l,000 by
the year 2,000.  
     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.  Many solutions will be necessary. 
But I'm very excited about what the impact can be.  Anb, when we
show it works, there'll be a 'spill-over' effect into other
communities.  All will benefit."
     Grant applications may be obtained from the Office of Grants
Management, Maternal and Child Health Bureau, 13200 Twinbrooke
Parkway, suite 100-A, Rockville, Md. 20852.