Fathers Join Fight on Infant Mortality : Pediatrics: Healthy Start draws praise as it reaches into depressed neighborhoods, teaching men and pregnant women.

BALTIMORE —  Willie Ricks was a creature of Baltimore’s rundown Harlem Park and Sandtown-Winchester neighborhoods. He did drugs among the boarded-up row houses and, as a teen-ager, fathered a little girl.

But a federal program--and two more babies--taught Ricks the meaning of fatherhood and its connection to manhood, something the streets never did.

Construction-worker tough with dark, piercing eyes, Ricks is now a part of the lives of his baby girls, 1-year-old Dorlene and 2-year-old Renee. He reads to them and works in their nursery.

“Before, I was doing construction. I was a man. I was always a man. When I became involved in this program, I became a father,” said Ricks, 30. “I came from the streets, from hard times. I didn’t care about nothing. It was just me out there.”

Ricks’ life changed when the mother of his youngest children enrolled in Healthy Start, a federally funded program to reduce infant deaths in Baltimore and 14 other communities with very high rates of infant mortality.

The U.S. Department of Health and Human Services will spend $89 million on Healthy Start this year. HHS announced recently that it is expanding the program for the first time since 1991 to seven additional communities, including the Mississippi Delta.

On Baltimore’s west side, Healthy Start is reaching 900 low-income families with 100 employees, many of them current and former welfare recipients.

Every six to eight weeks, these neighborhood health advocates canvass the trash-strewn streets of Sandtown-Winchester and Harlem Park.

They knock on every door in search of pregnant women who may need prenatal care, nutrition counseling, parenting advice, treatment for substance abuse, transportation to the doctor, a hot lunch or just someone to talk to, services provided by Healthy Start at a former high school.

“We don’t take no for an answer,” said Judy Washington, a recruitment supervisor.

The strategy is to find the women when they are pregnant, and then use the opportunity to encourage healthier behaviors and family relationships. There is a strong emphasis on breast-feeding and preventing unplanned pregnancies. The women stay in the program for the first three years after the birth of their babies.

“From a long-term infant-mortality strategy, the time after the pregnancy is just as critical as during pregnancy,” said Tom Coyle, assistant commissioner for the city’s Health Department, which runs Healthy Start. “You have much more time to work with the woman around her life goals, her health issues, and particularly family planning.”

Timeka Harrison, whose baby is due in mid-November, says she was four months pregnant when she saw the recruiters on her street.

Harrison, whose smile reveals a gold tooth stamped with a dollar sign, could not bring herself to approach them. She stood on her porch and hoped they would notice her swelling belly and not mistake her condition as “just fat.”

“I was rubbing my stomach and finally they came over,” said Harrison. She says Healthy Start has been helpful, especially the support group for mothers. “It’s like a big old family, like a bunch of sisters.”

“I’ve never seen so many people in one room that could get along,” added Tina Dixon, who lost her job and her car when she got pregnant with her second child and then tried to starve herself because she was so depressed.

Healthy Start found her in time.

“They help you, talk you through your problems,” said Dixon as she held a healthy 5-month-old boy in her lap.

Coyle says the program’s heavy reliance on hiring welfare recipients is unique. Recruiting in the neighborhood puts money back into the community and results in Healthy Start employees who can relate to the problems of young women struggling to survive amid violence, few opportunities and little hope.

The program also reaches out to the fathers because it has found a very strong male influence on the women while they are pregnant and after they give birth. This influence, the program says, is reflected in the decisions the women make about breast-feeding and family planning.