1. 1 National Healthy Start Association, Inc. Prepared for Secretary Advisory Committee on Infant Mortality January 2008 Historical Overview of the Healthy Start Initiative and the NHSA Peggy Sanchez Mills, CEO National Healthy Start Association

2. 2 History of the Healthy Start Initiative  1991: The Time was Right for Healthy Start U.S. infant mortality rate was rising. Traditional strategies to combat infant mortality were not as successful as expected. Babies were being born to crack-addicted mothers. Black infants were dying higher rates than other populations. There was a new focus on racial and ethnic disparities in health and health care.

3. 3 History of Healthy Start  HRSA began H.S. in 1991 with funding to 15 urban and rural sites with IMR of 1.5 – 2.5 times the national average.  At inception, the nation ranked 22nd in developed countries’ infant mortality rate.

4. 4 1991 - Phase I: Demonstration Phase Hawaii Puerto Rico Virgin Islands

5. 1991 - Phase I: Demonstration Phase 5 States included in the demonstration phase: California, South Dakota, Louisiana, Illinois, Michigan, Indiana, Ohio, Alabama, Georgia, South Carolina, Maryland, Pennsylvania, New York, Masssachusetts

6. 6 1994 - Phase I: Special Projects Added Hawaii Puerto Rico Virgin Islands

7. 1994 - Phase I: Special Projects Added States with special projects added: Texas, Wisconsin, Mississippi, Florida, Georgia, Virginia, New Jersey 7

8. 8 1997 - Phase II: 55 Projects Added Hawaii Puerto Rico Virgin Islands

9. 1997 - Phase II: 55 Projects Added Phase II: 55 projects addedTexas, Wisconsin, Mississippi, Georgia, Florida, Virginia, New Jersey 9

10. 10 1999 - Phase II: Eliminating Disparities & Infrastructure/ Capacity Building Grants Added (19) Hawaii Puerto Rico Virgin Islands

11. 1999 - Phase II: Eliminating Disparities & Infrastructure/ Capacity Building Grants Added (19) Phase II: Eliminating health disparities Hawaii, New Mexico, Minnesota, Puerto Rico, Virgin Islands 11

12. 12 2000: Three New Racial Disparities Projects Added Hawaii Puerto Rico Virgin Islands

13. 2000: Three New Racial Disparities Projects Added Three new racial disparities projects added: Tennessee 13

14. 14 2001-2002 – Phase III: 96 Healthy Start Projects

15. Phase III: 96 Healthy Start Projects Oregon, California, Arizona, New Mexico, Colorado, Nebraska, Kansas, Oklahoma, Texas, South Dakota, Minnesota, Iowa, Missouri, Arkansas, Louisiana, Wisconsin, Michigan, Illinois, Indiana, Ohio, Kentucky, Tennessee, Mississippi, Alabama, Georgia, Florida, South Carolina, North Carolina, Virginia, West Virginia, Maryland, Pennsylvania, New Jersey, New York, Massachusetts, Puerto Rico, Virgin Islands, Hawaii 15

16. 16 2005 – Eliminating Disparities in Perinatal Health Hawaii Puerto Rico Virgin Islands

17. 2005 – Eliminating Disparities in Perinatal Health Eliminating Disparities in Perinatal Health Oregon, California, Arizona, New Mexico, Colorado, Nebraska, Kansas, Oklahoma, Texas, South Dakota, Minnesota, Iowa, Missouri, Arkansas, Louisiana, Wisconsin, Michigan, Illinois, Indiana, Ohio, Kentucky, Tennessee, Mississippi, Alabama, Georgia, Florida, South Carolina, North Carolina, Virginia, West Virginia, Maryland, Pennsylvania, New Jersey, New York, Connecticut, Massachusetts, Puerto Rico, Virgin Islands, Hawaii, District of Columbia 17

18. 18

19. States with Health Start Communities: Alabama, Arizona, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, South Carolina, South Dakota, Tennessee, Texas, Virginia, West Virginia, Wisconsin 19

20. 20 Healthy Start Program  Core Services: Outreach Case Management Health Education Consortium Interconceptional Care Perinatal Depression Screening

21. 21 NHSA Historical Overview  Mission of the National Healthy Start Association (NHSA) is to promote the development of community-based maternal and child health programs, particularly those addressing the issues of infant mortality, low birthweight and racial disparities in perinatal outcomes. As part of its mission, the NHSA supports the expansion of wide range of activities and efforts that are rooted in the community and actively involve community residents in their design and implementation.

22. 22 NHSA’s Historical Highlights 1997 Informally organized 1998 Incorporated in the State of Maryland 2000 First Annual Spring Conference 2000 Achieved Authorization of the H.S. Program 2001 First Annie E. Casey Grant 2003 First Special Congressional Funding Initiative 2004 Six Regional Conferences 2005 Second AECF and Congressional Funding Awards; Partnership Grant 2005 Awarded 5 year Partnership Grant by HRSA 2006 Held Six Regional Conferences attended by 660; Awarded 4 year HSLTI Grant 2007 Eighth Annual Spring Conference 2007 Hired first CEO & will begin occupying office in DC

23. NHSA’s Historical Highlight’s 2007 Launched Infant Mortality Awareness Month Campaign 2007 Report on Male Initiative Involvement 2007 Launched Peer Learning Network 2007 First Capitol Hill Briefing 2007 Held first session of HSLTI 2008 10 th Anniversary of NHSA 23

24. 24 NHSA  H.S. projects comprise the voting membership.  Consistently at 96-100% since inception.  Benefits include allotments of quarterly newsletters (Getting off to a Healthy Start), access to the Members Only section on the web site, voting for board of directors, notification of the monthly online Update and much more.  Web site: http://www.healthystartassoc.org. http://www.healthystartassoc.org

25. 25 The NHSA’s Toolkits  The Healthy Start Guide to Financial Sustainability (2005)  The Healthy Start Guide to Risk Factor Assessment & How to Communicate about Perinatal Risk to Local Communities (2005)  The Healthy Start Guide to Evaluating Success and Measuring Program Impact (2005)  The Healthy Start Guide to Strategies for Success (2006)  The Healthy Start Guide to Effective Community Involvement (2006)  Infant Mortality Awareness Month Campaign Kit

26. 26 National Healthy Start Association, Inc. 1220 19 th Street, NW Suite 801 Washington, DC 20036 202.296.2195 phone 202.296.2197 fax psanchezmills@nationalhealthystart.org http://www.healthystartassoc.org