The City of Hartford, Connecticut, is the relatively small (pop. 136,000) center of an area called Greater Hartford (pop. 700,000). The socioeconomic characteristics of Hartford stand in sharp contrast to the state as a whole. Like many central cities, its resident population includes a concentration of low-income families and a growing number of ethnic minorities, including African-Americans and a quickly growing subgroup of Puerto Rican descent. In recent years, concern has mounted over revelations that rates of infant mortality in Hartford were among the highest in the nation. Corporate sponsored studies confirmed these findings and provided corporate leaders with sobering information about the future implications of such conditions.
The Hartford Action Plan on Infant Health (HAPIH) represents an innovative way to structure and combine existing community elements to support a comprehensive approach to pre- and post-natal care and the prevention of unwanted pregnancy. Elements include a sophisticated and enlightened corporate approach to philanthropy as well as a new local public health administration pursuing a revised community leadership strategy. The effort has also allowed an ethnically and economically diverse political community to unite in support of a fundamental cause, and has encouraged a number of community-based organizations who see the program as an opportunity to better serve the interests of their particular constituencies.
The overarching strategy of HAPIH is to mobilize a wide array of relevant community resources to attack the dual challenges plaguing the Hartford community: birth outcomes and undesired pregnancy. HAPIH seeks to improve the utilization of existing services by pregnant females by employing an outreach and case manager technique. It also seeks to reduce the incidence of unwanted teen pregnancy through a long range, comprehensive process of education for children, youth, and parents.
The goals of HAPIH are three-fold: 1) to decrease rates of low birth weights in seven target neighborhoods, 2) to decrease infant mortality, and 3) to increase first trimester prenatal care. At the time of application, merely three years into program operation, evaluation of the extent to which long-range goals were met was unavailable. However, strides were taken to ensure eventual data collection: In 1983, a report showing the status of efforts to address teen pregnancy, low birth weight, and infant mortality was commissioned and, in 1984, a task force put together to evaluate the five year plan of action.