Background:

Originally established in 1991, 15 locations around the country were funded as HS Demonstration Projects. Since then, the program has been authorized and has grown to include 104 communities in 38 States, the District of Columbia, and Puerto Rico.  Communities that are served by HS have large minority populations with high rates of unemployment, poverty and major crime.  Parents at highest risk for adverse perinatal health outcomes typically have less than a high school education, low income and limited access to safe housing.  Within their community, the number of perinatal providers is limited; regular access to these providers is challenged by long commutes accomplished only with help from friends for those living in rural areas or on crowded public transportation in urban areas.  While each project is unique, using local input to shape strategies, all projects share the same “core” program goals:  to reduce racial and ethnic disparities in access to and use of health services; to improve local health care systems; and, to increase consumer or community voice in health care decisions.