Maternal and child health: use of health status indicators in coordinating and targeting federal programs

The United States has achieved dramatic improvements in overall maternal and child health status, yet faces disturbingly wide variations in the health status of many population subgroups. The Surgeon General in 1980 published specific quantitative objectives to stimulate further improvements in the health of the American people by 1990. A critical step in meeting relevant objectives is the more effective use at national, state, and local levels of available data, particularly infant, perinatal, neonatal, and maternal mortality rates and the incidence of low weight births. This paper reviews variations in infant mortality rates and five current federal "categorical" programs that aim to improve maternal and child health: Supplemental Feeding Program for Women, Infants and Children; Head Start; Maternal and Child Health; Family Planning; and Community Health Centers. Several examples are cited of effective use of data in the coordination and targeting of resources from these large public programs. Recommendations are made for enhancement of federal maternal and child health programs within current funding levels. These recommendations will be all the more relevant if the Congress enacts block grants to the states with lower total funding.