Prepared Remarks of Elizabeth M. Duke, Ph.D.
Administrator, Health Resources and Services Administration
Washington, D.C.
April 15, 2002
It’s
my great pleasure to welcome you all to this Secretary's Advisory
Committee Meeting on Infant Mortality.
Thank you, Peter and Kerry, for asking me to join you
today. You and your MCH team have shown such dedication
in dealing with the many challenges facing the Nation’s mothers
and children. In
so doing, you’ve kept MCH and the important work of this committee
going.
Your sustained commitment helps us at HRSA meet our
fundamental mission of ensuring greater access to quality health
care for some of the country’s most vulnerable families and
individuals.
As an Advisory Council, your work has
great importance to the Secretary
and to all of us who are committed to improve the health care
and status of women and infants in communities all across America.
We are working together to ensure the health and well-being
of our smallest citizens. As health care professionals, nothing
we do could be more important.
I
am honored that I speak to you today as HRSA Administrator.
As you know, I had been serving as Acting Administrator since
last March when Secretary Thompson asked me to come to HRSA.
When he appointed me Administrator last month, I was
delighted to become part of the HRSA family. We are fortunate
that we have such passionate support from Secretary Thompson
for the work we do at HRSA. I can assure you that he cares
deeply about our efforts to reduce the Nation’s infant mortality
rate.
I
want to congratulate all of you for the completion of your final
report to the Secretary and Congress titled: Promoting the
Health of Newborns and Mothers Through Postpartum Services.
Your work in this area
will help us do an even better job of improving care for mothers
after childbirth. With nearly 4 million women giving birth
each year, we must make the health care community aware of the
very best postpartum services that are available. We also
thank you for your Low Birth Weight Report and your recommendations
on the future of the Healthy Start Initiative. They will
be the subject of an upcoming meeting with the Secretary and
a delegation from this advisory committee.
As
you know, the President’s 2003 budget reflects some very tough
choices that had to be made as the Nation and the Department
focus on a series of new priorities.
We needed funds to strengthen the overall public health
system, and we needed to immediately address many preparedness
issues associated with the realities of the world after September
11. There are many aspects of the budget which I would
be glad to discuss, but let me address just a few now.
In spite of all the new demands, I am happy to report that for
fiscal year 2003, the President has maintained funding for the
Healthy Start program at the fiscal year 2002 level of
$99 million. This is a compliment to your dedicated
efforts on behalf of healthy moms and babies everywhere.
The President’s FY 2003 budget also includes a new
$20 million Healthy Communities Innovation Initiative, an effort
to bring together community-wide resources to help prevent diabetes,
asthma and obesity. And if imitation is truly the sincerest
form of flattery, the healthy start folks should be supremely
flattered. Why? Because this new initiative is modeled
on our Healthy Start demonstration program. Funds will
target creation of healthy environments to improve the health
outcomes in areas where death rates associated with asthma,
diabetes, and obesity are too high. HRSA has responsibility
for this new effort in collaboration with the Centers for Disease
Control and Prevention and the HHS Office of Disease Prevention
and Health Promotion.
Healthy
Start has had much success in getting rural, isolated, teenage
or urban women from many different backgrounds into prenatal
care. Currently 96 high-risk communities in 37 states, the District of
Columbia, Puerto Rico, and the Virgin Islands participate in
this initiative. Beginning
with prenatal care and continuing through the infant’s second
year of life, our Healthy Start communities are implementing
evidence-based practices to reduce disparities. For example,
projects focus on smoking cessation, screening and referral
for depression, case management, and outreach to reduce behavioral
and medical risk factors and to promote healthy outcomes for
young women and their families.
We are also working to increase prenatal provider screening
for alcohol, to develop systems of care for addressing domestic
violence, and establish state level infrastructure for women’s
health – all activities that compliment the work we’re doing
with pregnant mothers.
To date, Healthy Start projects have made great strides
in reducing infant mortality and helping mothers to have healthy
infants. The provisional infant mortality rate for the
year 2000 reached a historic low of 6.9 deaths per 1,000 live
births. This resulted predominately from a 4.1 percent decline in the
rate for black infants -- from 14.6 to 14.0.
However, the preliminary mortality rate for black infants
was 14.0 -- over twice the 5.7 rate for white infants – a rate
that is simply unacceptable in a Nation like ours.
Just last month, the Washington Post heralded
the unprecedented decline of the infant mortality rate in the
District of Columbia – the rate dropped by 20.7 percent from
1999 to 2000, reaching its lowest record level ever.
And the District’s Health Department Director reported
that the local Healthy Start program achieved a zero infant
mortality rate among its clients in 2000. We can all celebrate
this kind of progress.
From your own report, I know you well understand the
effects of low birthweight and preterm babies. I would
like to comment briefly on a new study published in the January
issue of Pediatric and Perinatal Epidemiology titled
“Birthweight and Gestational Age Effects on Motor and Social
Development.” The
research for this study was conducted by a team at the National
Institute of Child Health and Human Development and included
HRSA’s own Dr. Mary Overpeck.
This new research indicates that babies born less than
5 ½ pounds or before 37 weeks of pregnancy may experience delays
in motor and social development throughout early childhood,
up to age 4.
The
researchers urge health care providers to consider both low
birthweight and preterm delivery when evaluating development
in young children -- a message we must ensure gets back to providers
in local communities.
In closing, I share with you my belief that strengthening
partnerships is the best way to create healthy families and
communities. We must continue working together to reach
the goals we all share. We all want to see an America
where good healthcare is a steppingstone to childhood success
and a future of fulfilled ambitions. We all want an America
where children everywhere are able to enjoy active, productive
lives. Our children are the hope of tomorrow, and we must
do all we can to help them meet their full potential.
Again, I thank you for
your willingness to help in this critical endeavor. We value
your expert advice and counsel as we continue the fight to take
down the barriers to quality prenatal care. We look forward
to your continuing recommendations. |
