Although New Haven Healthy Start has been successful in reducing the city’s infant mortality rate from more than 150 percent of the national average 20 years ago, its staunchest advocates say there is yet more work to do.

“The disparity remains,” said Kenn Harris, director of New Haven Healthy Start and president of the National Healthy Start Association, referring to persistent disparities in infant mortality along lines of race, educational attainment and income, among others.

Harris said advocates in the arena of public health know more about best practices since New Haven Healthy Start launched 20 years ago, and much of it is informed by the effects of inequality.

“The work is continuing to evolve,” he said. “There’s hope. We have a message of hope, and hope comes because we see things are possible when we work together.”

In the last 30 years, the Community Foundation for Greater New Haven, which runs the Healthy Start program locally, reports the number of infants dying in their first year of birth has fallen from one in 50 to one in 150.

“It’s been a remarkable progression,” said Jean Adnopoz, the former chair of the Commission on Infant and Child Health, which predates NHHS. “What Healthy Start demonstrates is the importance of the community coming together.”

Nurse midwife Heather Reynolds, chairwoman of the NHHS Perinatal Partnership, said the effectiveness of NHHS is rooted in community partnerships and the dissemination of information.

“We brought in data to help us try and grapple with the highest incidents of infant mortality and mapped out where in the city morbidity and mortality was occurring,” she said.

Two groups who community advocates desired to reach were pregnant teenagers and drug users, Reynolds said, as both generally displayed an element of stigma or fear around pregnancy; teenagers, because they often hide their pregnancies until their second trimester and drug users because they fear that coming forward for an ultrasound might mean losing their babies to the government.

“We did outreach to get pregnant women into care sooner,” she said. “It was done with love, care, compassion and not berating or judgment.”