000324048 000__ 04184cam\a2200373\a\4500 000324048 001__ 324048 000324048 005__ 20210513120432.0 000324048 008__ 080626s2008\\\\mduad\\\\bs\\f000\0\eng\c 000324048 035__ $$a(OCoLC)ocn232637295 000324048 035__ $$a324048 000324048 040__ $$aHNC$$cHNC$$dCZL$$dGPO$$dISE 000324048 042__ $$apcc 000324048 043__ $$an-us--- 000324048 049__ $$aISEA 000324048 074__ $$a0486-A-06 000324048 074__ $$a0486-A-06 (online) 000324048 0860_ $$aHE 20.9202:T 72 000324048 090__ $$aRJ59$$b.E95 2008 000324048 096__ $$aWA 900 AA1 000324048 24500 $$aEvidence of trends, risk factors, and intervention strategies :$$ba report from the Healthy Start national evaluation 2006 : racial and ethnic disparities in infant mortality. 000324048 24630 $$aReport from the Healthy Start national evaluation 2006 000324048 24630 $$aRacial and ethnic disparities in infant mortality 000324048 260__ $$a[Rockville, MD] :$$bU.S. Dept. of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau,$$c[2008?] 000324048 300__ $$a40 p. :$$bill., charts ;$$c28 cm. 000324048 500__ $$aCover title. 000324048 500__ $$aShipping list no.: 2008-0345-P. 000324048 504__ $$aIncludes bibliographical references (p. 33-40). 000324048 5050_ $$aI. Introduction -- II. Racial/ethnic disparities in birth outcomes -- III. Risk factors for poor birth outcomes -- IV. Discussion -- Appendix A: Detailed tables -- Appendix B: Glossary 000324048 520__ $$a"The rate of infant mortality in the United States declined by 74 percent between 1960 and 2000, but the degree of decline has slowed in the past decade. Experts believe that eliminating racial/ethnic disparities in birth outcomes is key to the continued reduction in the overall rate of infant mortality in the United States. Blacks, American Indian/ Alaska Natives, and Puerto Ricans, in descending order, have notably higher rates of infant mortality than other races/ethnicities. Several programs have been implemented to address racial/ethnic disparities in birth outcomes. Healthy Start, a national initiative begun in 1991 by the Health Resources and Services Administration, Maternal and Child Health Bureau, is the largest of these programs. Healthy Start is a community-based program targeted to eliminating or reducing racial/ ethnic disparities in birth outcomes in high-risk communities. The goals of Healthy Start are to improve the quality of the local perinatal system of care, to enhance the cultural competence of providers who work within the system, and to improve women's access to the system of care. These objectives are accomplished through outreach, health education, case management, and enhanced community collaboration within the local perinatal health system. The activities of the Healthy Start program are designed to encourage pregnant and interconceptional women, providers, and other community stakeholders to address the risk factors associated with poor perinatal health outcomes. In this paper, an evidence base is provided to support the targeted interventions implemented by the national Healthy Start program and other perinatal health initiatives to reduce racial/ethnic disparities in birth outcomes. In light of this objective, the racial/ethnic disparities in birth outcomes are described and the evidence on behavioral, biological, and social risk factors for poor perinatal outcomes in the context of such racial/ethnic disparities is reviewed. The risk factors reviewed are prenatal care, folic acid use, periodontal care, infant sleep position, breastfeeding, well-child care, interconceptional care, maternal smoking, alcohol and other drug use, adolescent pregnancy, perinatal depression, stress, bacterial vaginosis, domestic violence, and maternal birthweight"--p. 3 000324048 530__ $$aAlso available via the World Wide Web from HRSA web site as an Acrobat .pdf file (1.72 MB, 60). Address as of 6/26/08: http://mchb.hrsa.gov/healthystart/evaluation/benchmarkreport/; current access available via PURL. 000324048 650_0 $$aInfants$$xMortality$$zUnited States. 000324048 7101_ $$aUnited States.$$bMaternal and Child Health Bureau. 000324048 85200 $$bgen$$hRJ59$$i.E95$$i2008 000324048 8564_ $$zOnline access$$uhttp://mchb.hrsa.gov/healthystart/evaluation/benchmarkreport/ 000324048 85641 $$zOnline access via PURL$$uhttp://purl.access.gpo.gov/GPO/LPS99065 000324048 909CO $$ooai:library.usi.edu:324048$$pGLOBAL_SET 000324048 980__ $$aBIB 000324048 980__ $$aBOOK