Secretary of Health and Human Services Louis W. Sullivan launched a national campaign against infant mortality yesterday and strongly defended President Bush's proposed "Healthy Start" project against charges it is being funded largely by shifts from similar programs.
Florida Gov. Lawton Chiles (D), chairman of the National Commission to Prevent Infant Mortality, said last week that the new pilot program is simply "robbing Peter to pay Paul." And Sarah Rosenbaum, health policy director of the Children's Defense Fund, contends a large portion of the money to fund pilot programs in 10 cities will come at the expense of existing programs that serve all communities.
Sullivan and aides yesterday disputed that, saying that $105 million for the $171 million program is new money. They said it would be spent in addition to existing programs that combat infant mortality.
"It is unthinkable that the United States of America, a nation of enormous resources and wealth, should continue 24th among nations in the rate of survival of our infants," Sullivan said in a speech to the March of Dimes national leadership conference in Dallas last night.
In 1989, the infant mortality rate was 9.7, referring to the number of children out of 1,000 born alive who died before reaching their first birthday. That is about half the rate of 1970, but twice that of Japan.
"It is unconscionable that currently 40,000 American babies die before their first birthday and that fully a quarter of a million will be born with low birth weight, susceptible to early death, disability and lifelong chronic illness," Sullivan said.
Better prenatal health care, including anti-drug and smoking treatment and better nutrition for low-income pregnant women could cut the number of deaths substantially, he said.
The Healthy Start project would authorize $171 million in fiscal 1992 for projects in 10 communities where the infant mortality rate was 15 per 1,000 live births or higher. It is designed to find poor pregnant women who do not now get early pregnancy care, sign them up for Medicaid, special food programs and community health services and make sure they get prenatal care.
Radio and TV ads, door to door campaigns in public housing projects, outreach projects by community organizations and churches and health recruiters at welfare and other program offices are among the potential methods to be used in the project.
At least 4,000 women a year in each community who would not otherwise receive early prenatal services will get them under the pilot project, officals said, and thousands of others will get more extensive care than they now receive.
The aim is to cut the existing rates of infant mortality in half within five years, Sullivan said.
Aides said once the best methods of getting the women to the early health services are found, the object would be to replicate the most successful campaigns in a wide range of communities.
They said that use of some existing money for the pilot projects would be worthwile because it will produce better understanding of how to get high risk women to the needed services.
Rosenbaum said yesterday that a large share of the $171 million will be available because the administration is not proposing to provide for increased costs caused by inflation in several programs that already are providing care for low-income people.
Those programs are for Community Health Centers and migrant health, she said, as well as Maternal and Child Health grant programs.
Funding for these programs has been frozen at the 1991 level, she said, and part of the money for these programs that goes to all states has been redirected into the Healthy Start initiative.
However, budget officials said the decision to freeze the MCS and CHS programs was made before the decision on the Healthy Start program, based on generally very tight budget constraints that now exist. The $105 million was then added later for the new pilot program.