In 2023, nearly 374,000 infants in the United States were born preterm, arriving before the 37-week mark of pregnancy. This alarming statistic includes more than 15% who were very preterm, born before 32 weeks. In Florida, the situation is slightly more acute, with approximately 1 in 9 babies born preterm. This translates to about 456 of the 4,257 babies born weekly in the state arriving early, with 75 of these being very preterm.
Preterm births are a significant contributor to infant mortality, accounting for 37.5% of infant deaths nationwide, according to the March of Dimes. These early births are the second-leading cause of infant deaths after birth defects. Survivors often face long-term health challenges, including cerebral palsy and learning disabilities. The financial burden is equally staggering, with the average NICU admission costing around $71,000 in 2021, and the lifetime societal cost of preterm births estimated at $25.2 billion for babies born in 2016.
Central Hillsborough Healthy Start: A Success Story
Amid these daunting statistics, the Central Hillsborough Healthy Start program in Tampa, Florida, stands out as a beacon of hope. Serving a cluster of ZIP codes with around 177,000 residents, this program has achieved a 30% reduction in preterm and low-birthweight rates among high-risk families since 2008. These improvements have been consistently maintained through 2020, demonstrating the program’s effectiveness and potential as a model for other communities.
Screening and Early Intervention
A cornerstone of the Central Hillsborough Healthy Start program is its early screening for risk factors of preterm birth. Utilizing Florida’s Healthy Start prenatal risk screen at the first prenatal visit, the program effectively identifies higher-risk pregnancies, ensuring that resources are directed to those who need them most. This is particularly crucial in the neighborhoods served by the program, which include many young, Black, unmarried, and low-income families eligible for Medicaid.
By identifying mothers at highest risk early on, the program can tailor its resources to provide the necessary support, significantly reducing the likelihood of preterm births.
Comparative Success
While Florida’s preterm birth rate was 10.7% in 2023, Hillsborough County tracked slightly below the national average at 10.2%, representing 85 fewer preterm babies. This reduction translates to approximately $6 million in avoided hospital spending annually, given the average NICU costs.
Statewide, 14.8% of Black infants were born preterm in 2023, compared to 13.9% in Hillsborough County.
For pregnant women without a partner, the program reduced very preterm births by 52% and halved the rate of very low-birthweight babies. Obese mothers in the program had a 61% lower chance of extremely preterm birth compared to their counterparts elsewhere in Florida.
The Central Hillsborough Model
The model employed by Central Hillsborough Healthy Start is both practical and straightforward. Following early screening, nurses conduct home visits and coordinate patient care, providing prenatal education, depression screening, and programs aimed at improving maternal health and reducing harmful practices such as smoking.
Additionally, the program connects patients with essential resources during and after pregnancy, including community partners like WIC clinics. This holistic approach ensures comprehensive care and support for mothers and their babies.
Studies show that over 30% of U.S. mothers who give birth preterm conceived their baby less than 18 months after their previous child.
Central Hillsborough Healthy Start also emphasizes interconception care to promote healthy birth spacing, further reducing the risk of future preterm births.
Stability and Sustainability
The program operates through REACHUP Inc., in partnership with the University of South Florida and the Hillsborough Healthy Start Coalition. Funded primarily by the federal government through the Health Resources and Services Administration’s national Healthy Start program, its current funding is secure until 2029. However, proposed federal budget changes threaten to eliminate this funding, prompting reliance on local partners like Hillsborough County to sustain operations.
These local partnerships are crucial, allowing the program to remain stable and continue providing services even when federal funding is uncertain.
A Model for Other Communities
The success of Central Hillsborough Healthy Start demonstrates that health disparities are not insurmountable. By employing a basic approach of early screening and nurse visits, then customizing support to meet individual family needs, the program offers a feasible blueprint for other communities aiming to reduce preterm birth rates.
With early identification, consistent support, and sustained investment, the outcomes for mothers and babies can improve dramatically. As the program continues to thrive, it stands as a testament to the power of targeted, community-based interventions in addressing public health challenges.
