Healthy Start – Eliminating Disparities in Perinatal Health

The health of a mother and her newborn should not be determined by their zip code. Yet clearly this is the case in Delaware County communities where the poverty level is high.

Between 2007 and 2009, the rate of infant mortality among African American women in southeast Delaware County was more than two-and-a-half times greater than infant mortality in the United States and higher than the rate in 56 other countries.

Further, the 15.7 deaths per 1,000 live births for African American women in these communities was more than six times higher than the rate for white non-Hispanic women and three times the rate for Hispanic women in the communities.

For the past 20 years, Healthy Start, a federally funded program, has been successfully reducing the infant mortality rate and improving birth outcomes in the target area — Chester, Upland, Eddystone, Woodlyn, Parkside, Chester Township, Marcus Hook, Trainer and Linwood. The program serves pregnant women, expectant fathers, the family and children up to age two. Services include the following:

  • Intensive outreach, engagement and recruitment of pregnant women
  • Tiered case management based on assessed need and home visiting
  • Education that focuses on health, pregnancy, parenting, early childhood development, life skills, financial literacy and management
  • Civil legal information and leadership development

Healthy Start serves a minimum of 800 participants annually, using quality improvement, performance monitoring and program evaluation to track and improve results. Women can enroll during their pregnancy and after delivery, and can continue in the program until the child is two years old. For information about how to apply, download the Healthy Start brochure.

What the Research Says

Recent research suggests that where a mother lives, adverse childhood experiences and trauma, and an understanding of the importance of preconception care all contribute to poor birth outcomes. African American women with less than a high school diploma are particularly at risk.

Several unique components of the program are leading to improved outcomes.

  • Delaware Law School’s Medical Legal Partnership: This unique partnership between Healthy Start and Widener University School of Law provides direct legal representation, systemic advocacy and training to support program participants, staff and the community.
  • El Centro Hispanic Resource Center: The center is a “one-stop-shop” that connects program participants and other individuals with services including case management, translation, appointment scheduling, health education, assistance with applications and agency referrals.
  • Perinatal Periods of Risk: The PPOR project, in collaboration with the Delaware County Child Death Review Team, is collecting data and reviewing fetal and infant deaths to better understand why infants are dying during certain periods of risk.

Program participants say Healthy Start has had a significant positive impact on their lives. “I almost dropped out of school when I became pregnant, but my Healthy Start case manager helped me sign up for home school,” one participant said. “I now have my high school diploma.”

Another participant said having access to a lawyer ensured better access to services. “Before, agencies were giving me a run around, but having a lawyer there gets things done. Her help is very effective and has had a huge impact on my family.”

Find us on Facebook at Crozer-Keystone Healthy Start.

And learn more about: