Finally got hold of someone in the state office to explain the rationale
behind the High Birth Score program.  The program was developed by a
physician in England in the early '70's.  He looked at almost 200 factors
pulled from a complex statistical analysis of infant deaths in Sheffield,
cross-referenced and weighted them, and eventually arrived at the 8 factors
mentioned in the earlier post as being significantly related statistically to
infant deaths between the age of one month and one year (it's called
postneonatal mortality)  His goal was to identify a  group who appear healthy
at birth but are at risk of death in the postneonatal period.  There is no
explanation for why these factors are significant--maybe some of them are
only markers for something unknown but related.  Whatever the reason, the
program has been quite successful in WV, which went from having one of the
ten worst postneonatal mortality rates in the US to one of the ten best
between 1985, when the program was instituted, and 1991.  In 1985 the rate
was 4.26/1000.  In 1992 it had dropped to 3.5/1000. That's an overall rate.
 The stat that really impressed me was that, in a comparison of two groups of
high birth score babies, the rate was 5.5 among the babies who got plugged
into the extra pediatric care versus 11.4 among those who did not get close
follow-up after they were identified.  That's a BIG difference.  Some other
figures:  Over 150,000 kids have been scored in the past 10 years.  About 17%
of  babies born in WV are labeled as HBS, and of those, 83% are low-income.
 Lois Morgan, who gave me this information, was quick to point out that the
HBS program does NOT finger babies who are at risk of developmental delays,
only physiologic problems which can cause death.  Because of that, they've
recently added five other questions which do focus on developmental problems.
 At this point, WV is the only state in the country which is using the
Sheffield system.  A few other states are tyring various other programs--for
instance, Florida looked at the WV stats, wanted something less complicated,
and is trying to pull relevant info from birth certificate information.  It's
too early to tell how successful that will be.  So, there, Judy K and anyone
else who has made it through this post--more than you really wanted to know
about the High
Birth Score program.  If this isn't enough, in the May issue of the American
Journal of Public Health is an article by Dr. Meyerburg (? spelling)
discussing use of the HBS program in WV.

Judy D