The Right Start for America's Newborns: A Decade of City and State Trends (1990-1999). Child Trends/KIDS COUNT Working Paper.

This paper traces the history of "The Right Start," discussing differences between the 50 largest cities and the nation overall and differences among states. It highlights eight measures reflecting a healthy start: teen births, repeat teen births, births to unmarried women, births to mothers with low educational attainment, late or no pregnancy care, smoking during pregnancy, low-birthweight births, and preterm births. Mother's age, educational attainment, and marital status are often related to the newborn's socioeconomic and social status. Poverty rates for children born to unmarried, teenage high school dropouts are 10 times those of children born to unmarried high school graduates over age 20 years. Low birthweight and short gestation are closely linked to newborn health. Mortality rates for low-birthweight babies are 20 times those of normal-birthweight babies. Conditions such as inadequate prenatal care and/or smoking during pregnancy affect birth outcomes. Between 1990-99, five of the eight measures improved nationally, though births to unmarried women increased substantially. The largest cities lagged behind the nation on everything but smoking during pregnancy. The 50 cities made important progress during the 1990s on the same five measures that improved nationally. (SM)