A Strategic Framework for Infant Mortality Reduction: Implications for “Healthy Start”

The high infant mortality rate in the United States, especially in urban areas, remains a major federal concern. Four strategies for reducing infant mortality in cities participating in the federal “Healthy Start” are reducing high-risk pregnancies; reducing the incidence of low birthweight and preterm births; improving birthweight-specific survival; and reducing specific causes of postneonatal mortality. Estimates of the impact of known interventions indicate that the reduction in infant mortality would be large for only one strategy: improving birthweight-specific survival. Most interventions yield a 2 percent reduction, or less, in mortality and, when combined, would amount to about 30 percent. This strategic model provides a realistic framework to assess the impact of the Healthy Start demonstration and is useful in highlighting the interventions most likely to reduce infant mortality in a population.

Author(s): Donna Strobino; Patricia O’Campo; Kenneth C. Schoendorf; Jean M. Lawrence; Mary Ann Oberdorf; David M. Paige; Bernard Guyer

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Volume 73, Issue 4 (pages 507–533)
Published in 1995