This article is republished from The Conversation, an independent and nonprofit source of news, analysis and commentary from academic experts. is a Ph.D. Candidate at and is a Professor of Health Services Criminology, Schar School of Policy and Government,
One in 10 babies in the U.S. 鈥� nearly 374,000 infants 鈥� , meaning . More than 15% were very preterm, . A full-term pregnancy lasts 40 weeks.
Florida鈥檚 rate is slightly higher, at about . In an average week, 456 of the 4,257 babies born in the state will be preterm, and 75 of those will be very preterm.
According to the March of Dimes, preterm birth and low birthweight-related health complications nationwide. This makes preterm birth the second-leading cause of infant deaths, after birth defects. Preterm babies who survive infancy are susceptible to , including cerebral palsy and learning disabilities.
Preterm and 鈥� those weighing less than 5.5 pounds (2,500 grams) 鈥� are far more likely to , or NICU. Very preterm infants tend to have the longest NICU stays, .
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Beyond the emotional toll this takes on a family, preterm births and their resulting health complications carry substantial financial costs. The average NICU admission in 2021 . And economists estimated the lifetime societal cost of all preterm babies born in 2016, from birth to subsequent disability care, at .
We are a and focusing on health policy and population health outcomes.
Recently, we were sifting through the data on preterm and low birthweight rates in the U.S., in search of places that are doing better than average at preventing preterm births. And that is what we found in the program, which serves a cluster of .
In 2008, this program published records showing among families at highest risk. Peer-reviewed evaluations link participation in the program to substantial reductions in preterm and low-birthweight outcomes.
These remarkable improvements .
When we looked at what this program is doing, we found a set of practices that can serve as a model for other counties in Florida and around the U.S. to lower preterm birth rates, saving money and, more importantly, lives.
Screening for risk factors
The program does early screening for risk factors of preterm birth using at the pregnant person鈥檚 first prenatal visit. This screening has been proven to , while avoiding many false alarms, helping scarce services reach families who need them most.
This is key, because the risk of preterm birth isn鈥檛 spread out evenly across all pregnancies. The include many young, , unmarried, families that are eligible for Medicaid. All of these factors place them at .
Early screening allows the Healthy Start program to identify mothers at highest risk and tailor its resources to assist them.
Measuring against the rest of the state
The Florida Healthy Start prenatal risk screen is available throughout the state. Florida precisely to reduce infant deaths and low birthweight through universal prenatal and infant risk screening, community coalitions and coordinated services.
While , the most recent year for which there is data, was 10.7%, Hillsborough County tracked at about 10.2% of .
That difference may seem small, but it represents 85 fewer preterm babies in Hillsborough County, and at the average rate of $71,000 per NICU admission, that鈥檚 about $6 million in hospital spending avoided in a single year.
Infants born preterm must remain in the NICU until their organs develop enough to keep them alive without medical support. In addition, statewide, in 2023, slightly higher than the 14.65% average across the U.S. In Hillsborough County in the same year, it was .
Among pregnant women without a partner, participation and halved the rate of very low-birthweight babies 鈥� .
Obese mothers in the program had , which means , than comparable women elsewhere in Florida. Even exposure to air pollution, a known risk factor for preterm birth, was .
So what has Central Hillsborough Healthy Start been doing differently?
The Central Hillsborough Healthy Start model
The model used by Central Hillsborough Healthy Start is practical and straightforward.
After early screening, and help coordinate patient care for mothers in the program.
Central Hillsborough Healthy Start also provides prenatal education, depression screening and programs to help pregnant mothers improve their health and such as smoking or substance abuse. These programs are critical, because are significant risk factors for preterm births.
The program also helps to connect patients to resources they may need during and after pregnancy by making personal introductions to such as in women, infants and children, or WIC, clinics.
Healthy Start workers also connect patients to for healthy birth spacing between pregnancies, which can help prevent future preterm births. Studies show that more than 30% of U.S. mothers who give birth preterm conceived their baby .
The Healthy Start staff use to track referrals and follow up across partners. This is vital to helping the program鈥檚 staff see who has been contacted, which services were delivered and whether referrals took place. They can then follow up if necessary.
Stability and sustainability
Central Hillsborough Healthy Start operates through a local nonprofit, , in partnership with the and the .
Its funding comes primarily from the federal government through the . The program鈥檚 extends into 2029. But threaten to eliminate this funding altogether.
The program鈥檚 budget is supplemented by , including Hillsborough County, which helps sustain operations despite federal uncertainty.
Locally, the includes programs that work together like one team, sharing information so families keep getting help even when one grant ends. These partnerships with local community organizations allow the program to remain stable.
A model for others
Looking at the data, we believe Central Hillsborough Healthy Start has succeeded by using the same basic approach for everyone, then customizing. Everyone gets screened early and set up with nurse visits. Then, its adds what each family needs so that support fits real life.
The Central Hillsborough story shows that health disparities are not inevitable. And this model can serve as a feasible blueprint for other communities. With early identification, consistent support and sustained investment, the outcomes for mothers and babies can improve dramatically.
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