Funding for the program could be discontinued as early as next spring, said Five Rivers Health Centers CEO Gina McFarlane-El.
“We have received funding through November, and we’re waiting to get our last portion of funding from December until March,” she said. “And we’re not sure if we’re going to be funded, any of the other programs are going to be funded, so we’ve been working with our federal legislators.”
Healthy Start is a federal program that first launched in 1991 to fund projects that specifically target communities with high rates of infant mortality and poor maternal health outcomes.
These communities are experiencing the highest rates of infant mortality—more than 1.5 times the national average, according to the National Healthy Start Association.
Although the program was reauthorized in 2020, Congress has not authorized funding for next year and onward. Five Rivers signed onto a letter that national advocacy groups sent to federal lawmakers in July, calling for at least $145 million to power the national program.
“For more than three decades, Healthy Start has served as a lifeline for thousands of families, particularly in maternity care deserts, where access to prenatal and maternal care is severely limited or nonexistent,” the letter said. “Established in 1991 with strong bipartisan support, Healthy Start remains a critical tool in our nation’s fight against infant mortality and in improving maternal health.”
Ohio is among the top states for infant deaths, with a rate of 7.11 deaths per 1,000 live births, according to 2022 data from the U.S. Centers for Disease Control.
Last year, Montgomery County had an infant mortality rate of 7.4 infant deaths per 1,000 live births, according to the Ohio Department of Health’s infant mortality scorecard, which tracks trends for all 88 counties.
A study released by Groundwork Ohio and Caresource this year also highlighted Montgomery County as having among the highest ratios of pregnancy-related deaths in the state and found disparities statewide in health outcomes between Black and white babies.
There are 115 Healthy Start projects administered throughout the nation — five of those are in Ohio, with Dayton’s Head Start program running through Five Rivers Health Centers.
For Five Rivers Health Centers, the Healthy Start program assists families by helping them apply for insurance, educating them about pregnancy, labor, parenting and infant care, and connecting them to other resources that can keep their children healthy.
“We help navigate all of those social determinants of health for our patients and our outcomes have been fabulous,” McFarlane-El said.
McFarlane-El said the local program has been running for a dozen years and has served roughly 13,000 people. A major success of the program has been the work to reduce low birth weight.
Low birth weight has been identified by federal health officials as a top contributor to the death of infants before their first birthday. Babies born with a low birth weight (less than 5.5 pounds) have a much higher risk of death compared to other infants.
Locally, the Healthy Start program has contributed to reducing the Five Rivers patient population’s low birth weight rate from 12% to 5% in recent years, McFarlane-El said.
The issue of maternal and infant mortality persists locally. Montgomery County officials, in partnership with the Greater Dayton Area Hospital Association, last year relaunched the Maternal and Infant Health Task Force.
“We understand the federal government needs to make certain adjustments, but this is one that’s definitely going to impact the patients that we serve here in Montgomery County,” McFarlane-El said.
By the numbers
7.4: The rate of infant deaths, per 1,000 live births, in Montgomery County in 2024
115: The number of Healthy Start projects throughout the U.S.
2020: The last year funding was authorized for the federal program
13,000: The number of local residents served by Healthy Start
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