1. Healthy Women, Healthy Babies Jeffrey Levi, PhD Executive Director Trust for America’s Health

2. General Overview  After 40 years of improvements, infant mortality rates in the U.S. have stalled since 2000.  Approximately 30 percent of women who give birth have some form of pregnancy complication.  In 2005, the annual costs (medical, educational and lost productivity) of preterm birth in the U.S. were at least $26.2 billion.

3. Health Disparities  Significant disparities exist among ethnic and racial groups in the U.S.  In 2005, black babies were dying at twice the rate of white infants in their first year of life AND  African American women had 13.6 low- birthweight babies per 1,000 births, compared to 7.3 low-birthweight babies per 1,000 births for white women.

4. What’s the reason for these poor birth outcomes?  The health of childbearing aged women is starting to get worse, especially among low-income women.  Increasing evidence is showing that how healthy a woman is before she becomes pregnant has a great impact on the health of the baby and whether there is an increased risk for infant death or birth defects.  Prematurity and low-birthweight rates are associated with health issues in the mother, such as diabetes, high blood pressure or obesity.

5. What can be done to address this problem?  We must improve preconception health and health care for all women of childbearing age, as nearly half of all pregnancies in the U.S. are unintended.  Specifically, we can: Fully implement and enhance Medicaid policies and give states the option to cover low-income adult women without needing a waiver. Fully fund other programs that provide primary care and other services to women of childbearing, such as the Healthy Start Program, community health centers, Title X family planning and HRSA’s Maternal and Child Health Block grant. Make research on preconception health & health care a priority.

6. What can be done to address this problem?  We must also improve the environment in which we all live to ensure better access to venues for physical activity and nutritious foods.  As a nation, we tend to over-medicalize health problems. Given the state of today ’ s science, medicine can only address the consequences of poor health, not prevent it.  Real prevention requires changing the communities in we live and approaching this as a community- wide, not just an individual challenge.

7. What can be done to address this problem?  TFAH just released a new report, Prevention for a Healthier America, which examines how much the country could save by strategically investing in community disease prevention programs.  It concludes that an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the country more than $16 billion annually within five years. This is a return of $5.60 for every $1.

8. Conclusion  To improve the health of women, babies and all Americans, we need a cultural shift, one in which healthy environments, physical activity and healthy eating become the norm. We know that even small changes can make a big difference in people ’ s health.  We need to build strong communities that provide all Americans with access to physical activity and nutritious options so that we can all make healthy choices.