Guests listen intently about an announcement of a $9.5-million grant to the San Antonio Metro Health District. Photo by Katherine Nickas.
Guests listen intently about an announcement of a $9.5-million grant to the San Antonio Metro Health District. Photo by Katherine Nickas.

San Antonio’s Metropolitan Health District received a $9.7-million grant from the U.S. Department of Health and Human Services on Thursday that will go toward reducing high infant mortality rates and other problems related to pregnancy and mothers’ health in Bexar County.

The grant will provide about $2 million per year over the next five years to expand Metro Health’s Healthy Start services. Three new Healthy Start offices in three areas of need – the near West, the Northeast, and the Southsides – will open by the end of the year. The grant will also fund research into mental and behavioral stress during pregnancy and promote father involvement.

Representatives from Healthy Start and the March of Dimes, who are partnering in the effort to improve the health of babies, gathered at the Urban Ecology Center at Phil Hardberger Park for a joint press conference announcing the grant and its contribution to Healthy Start, which aims to prevent infant mortality in 87 communities with infant mortality rates that are at least 1.5 times the national average, which is about six deaths per 1,000 live births a year.

Certain areas of Bexar County, including the near West, Northeast, and Southsides, have consistently experienced higher infant mortality rates according to Christus Santa Rosa Health. Some have reported almost twice the national average, said Michael Lu, associate administrator of maternal and child health in the U.S. Health Resources and Service Administration.

The leading causes of death for infants and children are conditions originating in the perinatal period, which starts when a woman is 22 weeks pregnant and ends when a child is seven days old, including birth trauma and infections.

Prematurity is the leading cause of death before age one, and 1,037 babies are born prematurely in Bexar County each year, with 658 born weighing less than five pounds, said Alice Gong, a neonatologist with the University Health System.

According to Bexar County and Metropolitan Health District data, the infant mortality rate was 6.5 infants per 1,000 live births in 2012, with 8 infant deaths per 1,000 among African-Americans, 6 infant deaths per 1,000 among Hispanics, and 5 infant deaths per 1,000 among whites – the highest reported rate since 2008.

“We want to give every child and family a fair shot of reaching their full potential,” Lu said.

The Healthy Start program also addresses high rates of low birthweight, preterm birth, maternal mortality and maternal morbidity, which are serious conditions resulting from or aggravated by pregnancy and delivery.

Dr. Thomas Schlenker, public health director at SAMHD, said the San Antonio’s Healthy Start program is now a regional leader of the movement to improve infant mortality.

Public Health Director Thomas Schlenker speaks about Healthy Start's regional leadership in reducing infant mortality. Photo by Katherine Nickas.
San Antonio Metropolitan Health District Public Health Director Thomas Schlenker speaks about Healthy Start’s regional leadership in reducing infant mortality. Photo by Katherine Nickas.

“We also are implementing new and innovative strategies in this area that coincide with a neighborhood approach, concentrating on neighborhoods that struggle,” Schlenker said. “The entire neighborhood and community plays a big role in birthing healthy babies. We are thankful to the March of Dimes, which nationally has been focusing on this for years and is part of the entire effort.”

Kelly Bellinger, health program manager with San Antonio Healthy Start, emphasized the neighborhood approach of the program. Photo by Katherine Nickas.
Kelly Bellinger, health program manager with San Antonio Healthy Start, emphasized the neighborhood approach of the program. Photo by Katherine Nickas.

Kelly Bellinger, health program manager with San Antonio Healthy Start, said the neighborhood approach would involve activities created through neighborhood conversations.

“Any neighborhood group, whether it’s a community garden or a small business co-op to spur economic development, comes from the passions and interests of the families involved,” she said. “Our own Healthy Start families have told us they love the information they get, so we will be training them, as well.”

Martha Martinez, the program services committee chair with the March of Dimes, said $400,000 has been invested at the University of Texas at San Antonio Health Science Center for a cure for pre-term labor and reducing pre-term babies born and also to provide services to high-risk women.

Applicants for the Healthy Start program, which began in 1991, are required to undertake specific activities under each strategy:

  • Improve women’s health, with a focus on access to care
  • Promote quality services
  • Strengthen family resilience
  • Achieve collective community impact
  • Increase program accountability

The Healthy Start grants awarded to San Antonio are at levels 2 and 3, meaning it will provide the Enhanced Services Healthy Start Program to improve programs at the community level and the Leadership and Mentoring Healthy Start Program to improve outcomes at the regional level.

San Antonio will join 14 other grantees to form a Collaborative and Innovation Network (CoIIN) to develop national strategies to reduce infant mortality.

Healthy Start also leads the Healthy Families Network (HFN), a consortium to strengthen community partnerships and linkages to reduce infant mortality and support successful birth outcomes in Bexar County.

Martha Martinez, program services committee chair of March of Dimes, talks about the partnership with Healthy Start. Photo by Katherine Nickas.
Martha Martinez, program services committee chair of March of Dimes, talks about the partnership with Healthy Start. Photo by Katherine Nickas.

In the HFN, three work groups focus on specific areas including epidemiology, reproductive life planning initiatives, and healthy outcomes through perinatal education and support.

The last work group serves as an advisory board for several parents as teachers through home visiting programs, in which members of the Healthy Start program visit women in at-risk areas to provide support and education.

One of the women involved in the program is Chelsea Rodriguez, mother of 9-month-old Amber, now works for Healthy Start after participating in the initiative for about a year.

“They can really help you out with everything – I am so proud to be a part of it,” she said. “I am now visiting homes and helping women who don’t know how to get the resources, teaching them to better themselves and providing them with general information from month-to-month visits, providing needed supplies, and more.”

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Katherine Nickas was born in San Antonio near Fort Sam Houston but grew up in southern Indiana. In 2007, she began working for Indiana AgriNews where she covered topics ranging from corn and soybean production...