Healthy Start faces uphill battle

A recent uptick in infant mortality rates in the United States — after years of steady decline — has renewed experts’ concerns for the Elm City, which has traditionally lagged behind other Connecticut cities in dealing with the issue.

The New Haven Healthy Start Program, which works with pregnant women to reduce infant mortality and improve birth outcomes, may need to refocus its efforts heading into its 11th year, according Dr. Brian Forsyth, the medical director of pediatric primary care at Yale-New Haven Hospital The program’s 10th anniversary celebration, which took place last week, comes at a time when infant mortality rates are rising city-wide.

“New Haven hasn’t caught up,” said Richa Sharma EPH ’09, who published a study on Connecticut’s infant mortality rates last month. “New Haven is not on par with Bridgeport and Hartford, which have been steadily doing better.”

Still, she said, the city has gotten better. Several years ago, New Haven had the highest infant mortality rate in the state, Sharma said. At Healthy Start’s inception, the rate was around 20 deaths per 1000 births, Healthy Start Director Delores Greenlee said.

“The community came together and said we want to do something about it,” she said.

Their efforts yielded tangible results. In 2004, according to the national health charity March of Dimes, the infant mortality rate dropped to 7 deaths per 1000 births.

But while the program saw a decrease in infant mortality during its early years, Forsyth said this rate has shown a slight rise over the last two years. He warned, however, that it is difficult to draw conclusions from infant mortality data because the sample sizes on which the metric is based are typically low.

To deal with rising rates, Forsyth said he believes the program should narrow its focus, paying greater attention to women who will repeatedly have poor birth outcomes.

“Women who have had a poor outcome are at higher risk to have another poor outcome,” he said. “We need to go a little bit further to ensure that we’re doing the best we can.”

Healthy Start has already changed its core services to keep up with changing conditions, such as the economic decline, Greenlee said. For example, for the past few years, Healthy Start has begun to offer screening for depression and health education, case management and care coordination services.

“We are trying to change with the times,” she said. “Different issues affect women differently during different periods.”

Healthy Start also works closely with the community. The organization partners with New Haven health care centers, such as Yale-New Haven Hospital, Greenlee said. Additionally, three Healthy Start members work in the city health department, linking pregnant women to support services and medical care, New Haven Director of Women’s Health Maria Damiani said.

“We really are adding value to what they’re doing,” Damiani said of the Health Department.

Future goals, Greenlee said, include addressing the specific needs of undocumented and black women and optimizing healthy decisions at all stages of pregnancy.

“We will really be looking at the health of the baby prior to conception, during and after,” she said.

At its anniversary celebration, Healthy Start paid tribute to the founders of the Commission on Infant Health and Christian Community Action, Greenlee said. Amos Smith was also given an award for being the program’s first principal investigator.

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