Daily Briefing

'A solvable crisis': How Philadelphia plans to improve birth outcomes

In an effort to improve outcomes in areas with the highest rates of low birth weights, the Philadelphia Department of Public Health (PDPH) earlier this month announced a program that will provide 250 pregnant city residents with $1,000 per month.

Philadelphia will give 250 pregnant residents $1,000 a month 

Starting in 2024, the city of Philadelphia will provide 250 pregnant residents with $1,000 a month through a program called the Philly Joy Bank, which is a guaranteed income pilot of the Philadelphia Community Action Network — a group focused on reducing racial disparities in infant mortality. 

To be eligible for the program, residents must be pregnant, have a combined household income below $100,000 per year, and live in one of the three areas with the highest rates of very low birth weight — Cobbs Creek, Strawberry Mansion, and Nicetown-Tioga. 

According to Stacey Kallem, director of PDPH's Division of Maternal, Child, and Family Health, these payments will be guaranteed under the program during six months of pregnancy and 12 months postpartum. 

"You have to go to one place if you need food, you have to send out a different application for heat or utilities," Kallem said. "The beauty of guaranteed income is it gives residents the flexibility to address their problems as they need to in the moment without all of that red tape of having to navigate different systems."

In addition, voluntary resources, including benefits and financial counseling, home visiting, lactation support, and doulas, will be offered to program participants. 

"The no-strings-attached is key," Kallem said. "We are respecting the dignity and autonomy of program participants to use the funds as they see fit to improve their health and the health of their babies." 

The goal of the program is to help relieve financial stressors and better support the everyday needs of participants. Ultimately, program leaders hope the guaranteed monthly income will reduce health disparities in a city where the infant mortality rate is 1.5 times higher than the national average and Black infants are more likely than white infants to die during their first year of life. 

"Research has shown that supporting pregnant people with cash payments can improve birth outcomes that are associated with infant mortality, including low birth weight and prematurity," said PDPH Health Commissioner Cheryl Bettigole.

While the program has already received over $3 million in donations from the William Penn Foundation and Spring Point Partners, Philadelphia leaders and city health officials said they need to raise a total of $6 million to launch the program. 

"That is a problem that's going to take a combination of science and community investment to change," Bettigole said. 

"Infant mortality in Philadelphia is a solvable crisis," Bettigole added. "We know that being able to better support pregnant people and new parents helps keep babies alive. As the poorest big city in the country, this is not always easy, especially in areas of the city that are being crushed by generational poverty and systemic racism." (Clark, The Independent, 3/24; Musto, Fox News, 3/23; Tilley, Daily Mail, 3/22; Leonard, "WHYY," PBS/NPR, 3/21)


3 ways the Philly Joy Bank program can impact health disparities

By Gabriela Marmolejos

­In recent years, the United States has seen a "stunning" increase in maternal mortality rates amid a longstanding decline in birth rates. While this shift can be attributed to several factors, financial pressures have played a significant role.

According to a report by the First Five Year Fund, the cost of raising a child has increased by 220% over the last three decades, with the average annual cost of raising a child under the age of six rising to roughly $10,000. ­

Meanwhile, the United States is faring far worse than its peers regarding infant and maternal mortality, with 5.4 infant deaths per 1,000 births and 23.8 maternal deaths per 100,000 births every year.

Among the ten most populated U.S. cities, Philadelphia has the highest rate of infant mortality, with an overall average 1.5 times higher than the national average. According to PDPH, disparities in birth outcomes by race and ethnicity are "large and alarming."

For example, more than 15% of infants born to non-Hispanic Black mothers in Philadelphia had low birthweights — roughly 40% higher than the city's average — and nearly 15% of infants born to non-Hispanic Black women were premature — roughly 30% higher than the city's average. Black infants in the city are more than four times as likely to die before their first birthday than white infants, PDPH said.

The Philly Joy Bank program aims to address both health disparities and financial challenges associated with pregnancy and postpartum in the communities with the worst outcomes. Under the program, participants could see a big impact in three major ways.

1. This could help address economic inequalities among pregnant people of color

We have written about the root causes of maternal health disparities and the impact poverty has on pregnant people's ability to afford key social goods, including maternity care, transportation, safe housing, and healthy food.

While programs like WIC and SNAP are available to low-income families, there are several barriers to access, including work requirements, tedious application processes, and language barriers. It is also important to acknowledge that WIC and SNAP provide an average value of just $57 and $121 in food per month, respectively.

The Philly Joy Bank could greatly improve access to healthy foods and other needs beyond what is currently offered by other social assistance programs. 

2. This could improve maternal health and birth outcomes among participants

According to CDC, over half of pregnancy-related deaths in the United States occur postpartum. This program could significantly reduce the risk of maternal mortality among participants by alleviating financial stressors 12 months postpartum. 

Philadelphia is not the first city to launch this type of program. The Philly Joy Bank mirrors similar programs in other cities, which led to fewer reported low birth weights, fewer preterm births, and increased adherence to childhood immunizations. 

Philadelphia' program mirrors a pilot study, the Abundant Birth Project, in California that offers unconditional $1,000/month cash supplements to Black and Pacific Islander mothers with a household income of less than $100,000 per year. The evaluation of this pilot is underway, but we've seen results from Canada's Healthy Baby Prenatal Benefit program, which reported fewer low birth weight and preterm births as well as increased adherence to childhood immunizations. 

3. This could better participants lives beyond the pregnancy period

In recent months, several leaders of health plans and health systems shared with my team their strategies to improve maternal health outcomes in their communities. Many of these strategies occur pre- and post- partum. For example, some employers are adding family-building benefits and many health systems now offer postpartum home blood pressure monitoring services. 

The determinants of maternal health extend beyond the pregnancy period, with roots in intergenerational and systemic racism. To address this, I encourage all organizations to investigate the root causes of maternal mortality and morbidity in their communities and consider the opportunities to improve the health of women and other birthing people outside the pregnancy period. (Shaheen, Daily Mail, 1/16)






Don't miss out on the latest Advisory Board insights

Create your free account to access 1 resource, including the latest research and webinars.

Want access without creating an account?


You have 1 free members-only resource remaining this month.

1 free members-only resources remaining

1 free members-only resources remaining

You've reached your limit of free insights

Become a member to access all of Advisory Board's resources, events, and experts

Never miss out on the latest innovative health care content tailored to you.

Benefits include:

Unlimited access to research and resources
Member-only access to events and trainings
Expert-led consultation and facilitation
The latest content delivered to your inbox

You've reached your limit of free insights

Become a member to access all of Advisory Board's resources, events, and experts

Never miss out on the latest innovative health care content tailored to you.

Benefits include:

Unlimited access to research and resources
Member-only access to events and trainings
Expert-led consultation and facilitation
The latest content delivered to your inbox
Thank you! Your updates have been made successfully.
Oh no! There was a problem with your request.
Error in form submission. Please try again.