In 1989, the California Department of Public Health launched BIH to address the alarming two-to-one disparity in infant mortality rates between African Americans and their white counterparts. BIH has developed in parallel with Healthy Start, the widely adopted federal program begun in 1991 to address infant mortality and related problems, including low birthweight and preterm births. Today, BIH spans 15 local health jurisdictions across California where more than 75 percent of African American births in the state occur.

BIH began with a focus on prenatal care. Yet an assessment of the program conducted in 2006 by the Center on Social Disparities in Health (CSDH) at the University of California, San Francisco found that although great work was happening across the state, the program’s one-on-one case-management model and its emphasis on prenatal care did not go far enough.

BIH leadership retained CSDH to work with them to develop a new model that supports prenatal care while more fully addressing the social factors impacting African American mothers, especially chronic stress due to economic hardship; isolation and lack of social support; and the need for self-actualization and empowerment.